WorldWideScience

Sample records for program include closure

  1. Nevada Test Site closure program

    Energy Technology Data Exchange (ETDEWEB)

    Shenk, D.P.

    1994-08-01

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

  2. Distributed Programming via Safe Closure Passing

    Directory of Open Access Journals (Sweden)

    Philipp Haller

    2016-02-01

    Full Text Available Programming systems incorporating aspects of functional programming, e.g., higher-order functions, are becoming increasingly popular for large-scale distributed programming. New frameworks such as Apache Spark leverage functional techniques to provide high-level, declarative APIs for in-memory data analytics, often outperforming traditional "big data" frameworks like Hadoop MapReduce. However, widely-used programming models remain rather ad-hoc; aspects such as implementation trade-offs, static typing, and semantics are not yet well-understood. We present a new asynchronous programming model that has at its core several principles facilitating functional processing of distributed data. The emphasis of our model is on simplicity, performance, and expressiveness. The primary means of communication is by passing functions (closures to distributed, immutable data. To ensure safe and efficient distribution of closures, our model leverages both syntactic and type-based restrictions. We report on a prototype implementation in Scala. Finally, we present preliminary experimental results evaluating the performance impact of a static, type-based optimization of serialization.

  3. 75 FR 28655 - Rexam Closure Systems, Inc. a Subsidiary of Rexam PLC Including On-Site Leased Workers From...

    Science.gov (United States)

    2010-05-21

    ... Employment and Training Administration Rexam Closure Systems, Inc. a Subsidiary of Rexam PLC Including On... Closure Systems, Inc., a subsidiary of Rexam PLC, Hamlet, North Carolina. The notice was published in the... subsidiary of Rexam PLC purchased Owens Illinois Manufacturing. Some workers separated from employment at the...

  4. 75 FR 34172 - Rexam Closure Systems, Inc., a Subsidiary of Rexam PLC, Including On-Site Leased Workers From...

    Science.gov (United States)

    2010-06-16

    ... Employment and Training Administration Rexam Closure Systems, Inc., a Subsidiary of Rexam PLC, Including On... workers of Rexam Closure Systems, Inc., a subsidiary of Rexam PLC, Hamlet, North Carolina. The notice was... Systems, Inc., a subsidiary of Rexam PLC. The Department has determined that these workers were...

  5. Education Program on Fossil Resources Including Coal

    Science.gov (United States)

    Usami, Masahiro

    Fossil fuels including coal play a key role as crucial energies in contributing to economic development in Asia. On the other hand, its limited quantity and the environmental problems causing from its usage have become a serious global issue and a countermeasure to solve such problems is very much demanded. Along with the pursuit of sustainable development, environmentally-friendly use of highly efficient fossil resources should be therefore, accompanied. Kyushu-university‧s sophisticated research through long years of accumulated experience on the fossil resources and environmental sectors together with the advanced large-scale commercial and empirical equipments will enable us to foster cooperative research and provide internship program for the future researchers. Then, this program is executed as a consignment business from the Ministry of Economy, Trade and Industry from 2007 fiscal year to 2009 fiscal year. The lecture that uses the textbooks developed by this program is scheduled to be started a course in fiscal year 2010.

  6. Life Support Goals Including High Closure and Low Mass Should Be Reconsidered Using Systems Analysis

    Science.gov (United States)

    Jones, Harry W.

    2017-01-01

    Recycling space life support systems have been built and tested since the 1960s and have operated on the International Space Station (ISS) since the mid 2000s. The development of space life support has been guided by a general consensus focused on two important related goals, increasing system closure and reducing launch mass. High closure is achieved by recycling crew waste products such as carbon dioxide and condensed humidity. Recycling directly reduces the mass of oxygen and water for the crew that must be launched from Earth. The launch mass of life support can be further reduced by developing recycling systems with lower hardware mass and reduced power. The life support consensus has also favored using biological systems. The goal of increasing closure using biological systems suggests that food should be grown in space and that biological processors be used for air, water, and waste recycling. The goal of reducing launch mass led to use of Equivalent System Mass (ESM) in life support advocacy and technology selection. The recent consensus assumes that the recycling systems architecture developed in the 1960s and implemented on ISS will be used on all future long missions. NASA and other project organizations use the standard systems engineering process to guide hardware development. The systems process was used to develop ISS life support, but it has been less emphasized in planning future systems for the moon and Mars. Since such missions are far in the future, there has been less immediate need for systems engineering analysis to consider trade-offs, reliability, and Life Cycle Cost (LCC). Preliminary systems analysis suggests that the life support consensus concepts should be revised to reflect systems engineering requirements.

  7. 76 FR 4720 - Renewal of Agency Information Collection for Homeliving Programs and School Closure and...

    Science.gov (United States)

    2011-01-26

    ... bodies, and school boards are the respondents, and submission is mandatory. Number of Respondents: There... Bureau of Indian Affairs Renewal of Agency Information Collection for Homeliving Programs and School... (OMB) approval for the collection of information for Homeliving Programs and School Closure and...

  8. Evaluation of an autotutorial-simulator program for instruction of hollow organ closure.

    Science.gov (United States)

    Smeak, D D; Hill, L N; Beck, M L; Shaffer, C A; Birchard, S J

    1994-01-01

    groups. Mean closure time was not significantly different between groups for session one (Group T, mean, 31.5 minutes, range, 18.4 to 53.4; Group S, mean, 28.2 minutes, range, 16.8 to 36), but was significantly reduced for session two (Group T, mean, 21.3 minutes, range, 13.9 to 31). This AT/simulator program does not significantly influence students' overall gastrotomy closure technique; gross and video evaluation scores were not significantly different between groups. Without instructor supervision, an additional gastrotomy experience did not improve surgical technique appreciably for Group T; however, these students performed the second procedure with more confidence and speed.(ABSTRACT TRUNCATED AT 400 WORDS)

  9. Diversity: Including People with Disabilities in Outdoor Adventure Programs.

    Science.gov (United States)

    Sugerman, Deb

    1996-01-01

    Organizations that offer outdoor adventure activities can integrate programs to include individuals with disabilities. The paper describes how one organization includes diverse groups of people with and without disabilities in its outdoor activities, focusing on each member's strengths and encouraging cooperation. (SM)

  10. Closure The Definitive Guide

    CERN Document Server

    Bolin, Michael

    2010-01-01

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

  11. Ocean Margins Program: Closure on the global carbon cycle. Program description

    Energy Technology Data Exchange (ETDEWEB)

    Riches, M.R.

    1994-08-01

    The Department of Energy`s Ocean Margins Program (OMP) is designed to quantitatively assess the importance of coastal ocean systems in the global carbon cycle. Since the beginning of the Industrial Revolution, human energy-related activities have dramatically altered the global carbon cycle, and consequently, this cycle is not presently in a steady-state. To reduce major uncertainties in predicting future global environmental quality, it is imperative to understand the sources and sinks of atmospheric CO{sub 2}, the role of anthropogenic activities in disrupting the natural carbon cycle, and the effects of, and feedbacks between, these activities and the natural carbon cycle. Due to continuously increased loading of nutrients to the margins, which, globally, is related to the rate of human population growth and high population densities in coastal states, biological carbon fixation has been stimulated. Depending on the fate of the fixed carbon, this stimulation has the potential to mitigate the anthropogenically derived Co{sub 2}. Determining the factors that control the magnitude of carbon exchanges between the ocean margins and the atmosphere, and the subsequent fate of this carbon, is crucial to predicting the strength and capacity of the oceans to absorb excess anthropogenic atmospheric CO{sub 2}. The goals of the OMP are to: quantify the ecological and biogeochemical processes and mechanisms that define the cycling, flux, and storage of carbon and other biogenic elements at the land/ocean interface; identify how ocean-margin sources and sinks of carbon change in response to human activities; and determine whether continental shelves are quantitatively significant in removing atmospheric carbon dioxide and isolating it via burial in sediments or export to the interior of the open ocean.

  12. The Cementitious Barriers Partnership Experimental Programs and Software Advancing DOE’s Waste Disposal/Tank Closure Efforts – 15436

    Energy Technology Data Exchange (ETDEWEB)

    Burns, Heather [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Flach, Greg [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Smith, Frank [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Langton, Christine [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Brown, Kevin [Vanderbilt Univ./CRESP, Nashville, TN (United States); Kosson, David [Vanderbilt Univ./CRESP, Nashville, TN (United States); Samson, Eric [SIMCO Technologies, Inc. (United States); Mallick, Pramod [US DOE, Washington, DC (United States)

    2015-01-27

    The U.S. Department of Energy Environmental Management (DOE-EM) Office of Tank Waste Management-sponsored Cementitious Barriers Partnership (CBP) is chartered with providing the technical basis for implementing cement-based waste forms and radioactive waste containment structures for long-term disposal. DOE needs in this area include the following to support progress in final treatment and disposal of legacy waste and closure of High-Level Waste (HLW) tanks in the DOE complex: long-term performance predictions, flow sheet development and flow sheet enhancements, and conceptual designs for new disposal facilities. The DOE-EM Cementitious Barriers Partnership is producing software and experimental programs resulting in new methods and data needed for end-users involved with environmental cleanup and waste disposal. Both the modeling tools and the experimental data have already benefited the DOE sites in the areas of performance assessments by increasing confidence backed up with modeling support, leaching methods, and transport properties developed for actual DOE materials. In 2014, the CBP Partnership released the CBP Software Toolbox –“Version 2.0” which provides concrete degradation models for 1) sulfate attack, 2) carbonation, and 3) chloride initiated rebar corrosion, and includes constituent leaching. These models are applicable and can be used by both DOE and the Nuclear Regulatory Commission (NRC) for service life and long-term performance evaluations and predictions of nuclear and radioactive waste containment structures across the DOE complex, including future SRS Saltstone and HLW tank performance assessments and special analyses, Hanford site HLW tank closure projects and other projects in which cementitious barriers are required, the Advanced Simulation Capability for Environmental Management (ASCEM) project which requires source terms from cementitious containment structures as input to their flow simulations, regulatory reviews of DOE performance

  13. Restaurant closures

    CERN Document Server

    Novae Restauration

    2012-01-01

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

  14. 78 FR 32663 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...

    Science.gov (United States)

    2013-05-31

    ... Process CMS has learned of the closure of two teaching hospitals; Infirmary West Hospital of Mobile, AL... 5'') of the application and selection process. The table below identifies the two closed teaching... Teaching Hospitals and Opportunity To Apply for Available Slots AGENCY: Centers for Medicare & Medicaid...

  15. 40 CFR 264.113 - Closure; time allowed for closure.

    Science.gov (United States)

    2010-07-01

    ... corrective action program, compile all ground-water monitoring data, and evaluate the effect of the continued... assurance for closure and post-closure care as necessary and appropriate, to reflect any changes due to the presence of hazardous constituents in the non-hazardous wastes, and changes in closure activities...

  16. Hearing of Personnel Included in the USAF Hearing Conservation Program

    Science.gov (United States)

    1976-02-01

    ORGNIZTIO NAE AN ADRES - 10. PROGRAM ELEMENT. PROJECT. TASK 9. PFORINGORGAIZAIONNAMEANDADDESSAREA ft WORK UNIT NUMBERS USAF School of Aerospace Medicine...0 0)~’ to (00w " 0 -q N~ m M VC0 CO~j 0 N 01) a)inUjU) tD -4 N o O 0 N 0 a) m m~0 di .. 0 alO1 O0- cn cO N - m -4N (0-00N (0 it) W N n N . o4Ca 0 0

  17. BSN Program Admittance Criteria: Should Emotional Intelligence Be Included?

    Science.gov (United States)

    Smith, Tanya

    2017-01-01

    Emotional intelligence refers to the ability to identify and monitor emotions and remain aware of how emotions affect thoughts and actions. Emotional intelligence has been discussed as a better predictor of personal and occupational success than performance on intellectual intelligence tests. Despite the importance of one's emotional intelligence, BSN (Bachelor of Science in Nursing) nursing schools routinely admit candidates based on the student's cumulative college course grade point average (GPA). Nursing is a profession that requires one's ability to empathize, care, and react in emotionally sound manners. Is the GPA enough to determine if a student will evolve into a professional nurse? This article will explore the routine admittance criteria for BSN nursing programs and propose the concept of using the emotional intelligence tool as an adjunct to the cumulative college course GPA. The emotional intelligence theory will be identified and applied to the nursing profession. © 2016 Wiley Periodicals, Inc.

  18. Information to Include in Curriculum Vitae | Cancer Prevention Fellowship Program

    Science.gov (United States)

    Applicants are encouraged to use their current curriculum vitae and to add any necessary information. Please include your name and a page number on each page of the curriculum vitae. Some of the information requested below will not be applicable to all individuals. Please do not print or type your information on this page. Personal Information Name (First middle last) Gender (optional) Race (optional) Date of birth Place of birth (city,

  19. 34 CFR 263.4 - What training costs may a Professional Development program include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What training costs may a Professional Development... GRANT PROGRAMS Professional Development Program § 263.4 What training costs may a Professional Development program include? (a) A Professional Development program may include, as training costs, assistance...

  20. Preliminary recommendations on the design of the characterization program for the Hanford Site single-shell tanks: A system analysis. Volume 2, Closure-related analyte priorities, concentration thresholds, and detection limit goals based on public health concerns

    Energy Technology Data Exchange (ETDEWEB)

    Buck, J.W.; Peffers, M.S.; Hwang, S.T.

    1991-11-01

    The work described in this volume was conducted by Pacific Northwest Laboratory to provide preliminary recommendations on data quality objectives (DQOs) to support the Waste Characterization Plan (WCP) and closure decisions for the Hanford Site single-shell tanks (SSTs). The WCP describes the first of a two-phase characterization program that will obtain information to assess and implement disposal options for SSTs. This work was performed for the Westinghouse Hanford Company (WHC), the current operating contractor on the Hanford Site. The preliminary DQOs contained in this volume deal with the analysis of SST wastes in support of the WCP and final closure decisions. These DQOs include information on significant contributors and detection limit goals (DLGs) for SST analytes based on public health risk.

  1. Designing monitoring programs for chemicals of emerging concern in potable reuse ⋯ What to include and what not to include?

    KAUST Repository

    Drewes, Jorg

    2012-11-01

    This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than \\'1\\' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound. © IWA Publishing 2013.

  2. 34 CFR 86.100 - What must the IHE's drug prevention program include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What must the IHE's drug prevention program include? 86.100 Section 86.100 Education Office of the Secretary, Department of Education DRUG AND ALCOHOL ABUSE PREVENTION Institutions of Higher Education § 86.100 What must the IHE's drug prevention program include? The...

  3. Stabilization of In-Tank Residual Wastes and External-Tank Soil Contamination for the Hanford Tank Closure Program: Applications to the AX Tank Farm

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, H.L.; Dwyer, B.P.; Ho, C.; Krumhansl, J.L.; McKeen, G.; Molecke, M.A.; Westrich, H.R.; Zhang, P.

    1998-11-01

    Technical support for the Hanford Tank Closure Program focused on evaluation of concepts for immobilization of residual contaminants in the Hanford AX tanks and underlying soils, and identification of cost-effective approaches to improve long-term performance of AX tank farm cIosure systems. Project objectives are to develop materials or engineered systems that would significantly reduce the radionuclide transport to the groundwater from AX tanks containing residual waste. We pursued several studies that, if implemented, would help achieve these goals. They include: (1) tank fill design to reduce water inilltration and potential interaction with residual waste; (2) development of in-tank getter materials that would specifically sorb or sequester radionuclides; (3) evaluation of grout emplacement under and around the tanks to prevent waste leakage during waste retrieval or to minimize water infiltration beneath the tanks; (4) development of getters that will chemically fix specific radionuclides in soils under tanks; and (5) geochemical and hydrologic modeling of waste-water-soil-grout interactions. These studies differ in scope from the reducing grout tank fill employed at the Savannah River Site in that our strategy improves upon tank fill design by providing redundancy in the barriers to radionuclide migration and by modification the hydrogeochemistry external to the tanks.

  4. Closure of hazardous and mixed radioactive waste management units at DOE facilities. [Contains glossary

    Energy Technology Data Exchange (ETDEWEB)

    1990-06-01

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

  5. 36 CFR 1223.14 - What elements must a vital records program include?

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What elements must a vital... RECORDS ADMINISTRATION RECORDS MANAGEMENT MANAGING VITAL RECORDS § 1223.14 What elements must a vital records program include? To achieve compliance with this section, an agency's vital records program must...

  6. Efficacy of an Individualized Prevention Program Including Social Media Support on University Students with Gingivitis

    National Research Council Canada - National Science Library

    Carlos Alberto Serrano Méndez; Karen Andrea Avendaño Calderón; Paula Andrea Moreno Caro

    2017-01-01

    ...: Thirty-eight students with gingivitis participated in a program that included: Individualized oral hygiene instruction, professional removal of plaque and calculus and, recall and support on oral hygiene through the use of social media...

  7. FINAL CLOSURE PLAN SURFACE IMPOUNDMENTS CLOSURE, SITE 300

    Energy Technology Data Exchange (ETDEWEB)

    Lane, J E; Scott, J E; Mathews, S E

    2004-09-29

    Lawrence Livermore National Laboratory of the University of California (LLNL) operates two Class II surface impoundments that store wastewater that is discharged from a number of buildings located on the Site 300 Facility (Site 300). The wastewater is the by-product of explosives processing. Reduction in the volume of water discharged from these buildings over the past several years has significantly reduced the wastewater storage needs. In addition, the impoundments were constructed in 1984, and the high-density polyethylene (HDPE) geomembrane liners are nearing the end of their service life. The purpose of this project is to clean close the surface impoundments and provide new wastewater storage using portable, above ground storage tanks at six locations. The tanks will be installed prior to closure of the impoundments and will include heaters for allowing evaporation during relatively cool weather. Golder Associates (Golder) has prepared this Final Closure Plan (Closure Plan) on behalf of LLNL to address construction associated with the clean closure of the impoundments. This Closure Plan complies with State Water Resources Control Board (SWRCB) Section 21400 of the California Code of Regulations Title 27 (27 CCR {section}21400). As required by these regulations and guidance, this Plan provides the following information: (1) A site characterization, including the site location, history, current operations, and geology and hydrogeology; (2) The regulatory requirements relevant to clean closure of the impoundments; (3) The closure procedures; and, (4) The procedures for validation and documentation of clean closure.

  8. Comprehensive Adolescent Health Programs That Include Sexual and Reproductive Health Services: A Systematic Review

    Science.gov (United States)

    Parekh, Jenita; Tunçalp, Özge; Turke, Shani; Blum, Robert William

    2014-01-01

    We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998–2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects. PMID:25320876

  9. RECENT PROGRESS IN DOE WASTE TANK CLOSURE

    Energy Technology Data Exchange (ETDEWEB)

    Langton, C

    2008-02-01

    The USDOE complex currently has over 330 underground storage tanks that have been used to process and store radioactive waste generated from the production of weapons materials. These tanks contain over 380 million liters of high-level and low-level radioactive waste. The waste consists of radioactively contaminated sludge, supernate, salt cake or calcine. Most of the waste exists at four USDOE locations, the Hanford Site, the Savannah River Site, the Idaho Nuclear Technology and Engineering Center and the West Valley Demonstration Project. A summary of the DOE tank closure activities was first issued in 2001. Since then, regulatory changes have taken place that affect some of the sites and considerable progress has been made in closing tanks. This paper presents an overview of the current regulatory changes and drivers and a summary of the progress in tank closures at the various sites over the intervening six years. A number of areas are addressed including closure strategies, characterization of bulk waste and residual heel material, waste removal technologies for bulk waste, heel residuals and annuli, tank fill materials, closure system modeling and performance assessment programs, lessons learned, and external reviews.

  10. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study.

    Science.gov (United States)

    Larsson, Madelene; Pettersson, Camilla; Skoog, Therése; Eriksson, Charli

    2016-02-24

    Mental health problems among young women aged 16-24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone. First, we examined the psychological and social characteristics of the young women who chose to take part in the program as protégés. Second, we investigated adolescent female protégés' own experiences of the relationship process based on a relational-cultural theory perspective. The mixed-method study included 52 questionnaires and five semi-structured interviews with young women aged 15-26 who had contacted The Girls Zone between 2010 and 2012 in order to find a mentor. Their experience of the mentoring relationships varied in duration. Data were analysed statistically and with inductive qualitative content analysis. The group of protégés was heterogeneous in that some had poor mental health and some had good mental health. On the other hand, the group was homogenous in that all its members had shown pro-active self-care by actively seeking out the program due to experiences of loneliness and a need to meet and talk with a person who could listen to them. The relationships were initially characterized by feelings of nervousness and ambivalence. However, after some time, these developed into authentic, undemanding, non-hierarchical relationships on the protégés' terms. The closure of relationships aroused feelings of both abandonment and developing strength. Mentorships that are in line with perspectives of the relational-cultural theory meet the relationship needs expressed by the female protégés. Mentor training should focus on promoting skills such as active listening and respect

  11. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study

    Directory of Open Access Journals (Sweden)

    Madelene Larsson

    2016-02-01

    Full Text Available Abstract Background Mental health problems among young women aged 16–24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone. First, we examined the psychological and social characteristics of the young women who chose to take part in the program as protégés. Second, we investigated adolescent female protégés’ own experiences of the relationship process based on a relational-cultural theory perspective. Methods The mixed-method study included 52 questionnaires and five semi-structured interviews with young women aged 15–26 who had contacted The Girls Zone between 2010 and 2012 in order to find a mentor. Their experience of the mentoring relationships varied in duration. Data were analysed statistically and with inductive qualitative content analysis. Results The group of protégés was heterogeneous in that some had poor mental health and some had good mental health. On the other hand, the group was homogenous in that all its members had shown pro-active self-care by actively seeking out the program due to experiences of loneliness and a need to meet and talk with a person who could listen to them. The relationships were initially characterized by feelings of nervousness and ambivalence. However, after some time, these developed into authentic, undemanding, non-hierarchical relationships on the protégés’ terms. The closure of relationships aroused feelings of both abandonment and developing strength. Conclusions Mentorships that are in line with perspectives of the relational-cultural theory meet the relationship needs expressed by the female protégés. Mentor

  12. Single-shell tank closure work plan. Revision A

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

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

  13. 29 CFR 1472.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false What must I include in my drug-free awareness program? 1472.215 Section 1472.215 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND... of drug abuse in the workplace; (b) Your policy of maintaining a drug-free workplace; (c) Any...

  14. 29 CFR 94.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true What must I include in my drug-free awareness program? 94.215 Section 94.215 Labor Office of the Secretary of Labor GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE... inform employees about— (a) The dangers of drug abuse in the workplace; (b) Your policy of maintaining a...

  15. 31 CFR 20.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false What must I include in my drug-free awareness program? 20.215 Section 20.215 Money and Finance: Treasury Office of the Secretary of the Treasury GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Requirements for Recipients Other Than...

  16. 38 CFR 17.255 - Applications for grants for programs which include construction projects.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Applications for grants... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.255 Applications for grants for programs which include construction projects. In addition to the documents and...

  17. Integrative Biological Chemistry Program Includes the Use of Informatics Tools, GIS and SAS Software Applications

    Science.gov (United States)

    D'Souza, Malcolm J.; Kashmar, Richard J.; Hurst, Kent; Fiedler, Frank; Gross, Catherine E.; Deol, Jasbir K.; Wilson, Alora

    2015-01-01

    Wesley College is a private, primarily undergraduate minority-serving institution located in the historic district of Dover, Delaware (DE). The College recently revised its baccalaureate biological chemistry program requirements to include a one-semester Physical Chemistry for the Life Sciences course and project-based experiential learning…

  18. CLOSURE DEVICE

    Science.gov (United States)

    Linzell, S.M.; Dorcy, D.J.

    1958-08-26

    A quick opening type of stuffing box employing two banks of rotatable shoes, each of which has a caraming action that forces a neoprene sealing surface against a pipe or rod where it passes through a wall is presented. A ring having a handle or wrench attached is placed eccentric to and between the two banks of shoes. Head bolts from the shoes fit into slots in this ring, which are so arranged that when the ring is rotated a quarter turn in one direction the shoes are thrust inwardly to cramp the neopnrene about the pipe, malting a tight seal. Moving the ring in the reverse direction moves the shoes outwardly and frees the pipe which then may be readily removed from the stuffing box. This device has particular application as a closure for the end of a coolant tube of a neutronic reactor.

  19. 20 CFR 627.220 - Coordination with programs under title IV of the Higher Education Act including the Pell grant...

    Science.gov (United States)

    2010-04-01

    ... the Higher Education Act including the Pell grant program. 627.220 Section 627.220 Employees' Benefits... of the Higher Education Act including the Pell grant program. (a) Coordination. Financial assistance programs under title IV of the Higher Education Act of 1965, as amended (HEA) (the Pell Grant program, the...

  20. Predictors of Premature Match Closure in Youth Mentoring Relationships.

    Science.gov (United States)

    Kupersmidt, Janis B; Stump, Kathryn N; Stelter, Rebecca L; Rhodes, Jean E

    2017-03-01

    Although mentoring is a popular and effective means of intervention with youth, the positive effects of mentoring can be diminished by premature match closure of relationships. Program, mentor, and mentee characteristics were examined as predictors of premature match closure. Secondary data analyses were conducted on a large national database of mentoring programs consisting of match and youth risk information from 170 mentoring programs and 6468 matches from across the U.S. Premature closure was associated with mentee age at match inception and 19 individual mentee characteristics. The set of mentee characteristics were examined as part of a cumulative risk index encompassing seven conceptually combined categories including family background characteristics, school functioning problems, engagement in risky health behaviors, self-regulation difficulties, engagement in illegal or criminal activities, and internalizing and externalizing behavior problems. Both the age of mentees when matched and the cumulative risk index score significantly predicted premature closure. Results are discussed in terms of directions for future research and suggestions for enhancing mentoring program practices. © Society for Community Research and Action 2017.

  1. RELAP-7 Closure Correlations

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-04-01

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

  2. Transportation R and D included in thermal and mechanical sciences program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    Argonne National Laboratory is a multiprogram research and development laboratory operated by The University of Chicago for the US Department of Energy. At Argonne, applied research in thermal and mechanical sciences is performed within the Thermal and Mechanical Sciences Section of the Energy Technology Division. Current program areas include compact evaporators and condensers for the process and transportation industries, ice slurries for district cooling, advanced fluids for improved heat transfer and reduced pressure drop, flow-induced vibration and flow distribution in shell-and-tube heat exchangers, and dynamics and control of maglev systems. In general, the objective of the research is to extend the technology base in each of these areas and to facilitate its application in solving problems of importance to US industries and utilities. This is accomplished by developing validated design correlations and predictive methods. The staff of the Thermal and Mechanical Sciences Section have extensive experimental and analytical experience in heat transfer, multiphase flow, structural dynamics and control, fluid-structure interaction, transient flow and mixing, thermally driven flows, and flow visualization using ultra-high-speed video. Large, general-purpose test facilities and smaller, single-purpose test apparatuses are available for experiments and component design evaluation. A world-class capability in the study of flow-induced vibrations exists within the Section. Individual fact sheets, describing currently active research program areas, related facilities, and listing, as a contact, the principal investigator, are included.

  3. Body Image and quality of life of senior citizens included in a cardiac rehabilitation program

    Directory of Open Access Journals (Sweden)

    Fernanda Vargas Amaral

    2013-12-01

    Full Text Available Most people who have to live with some kind of disease tend to adopt healthy habits and create new ways of seeing themselves. The aim of this study is to explore the relationship between the index of quality of life and self perception of patients included in a cardiovascular rehabilitation program in Florianopolis/Brazil. The sample consists of 24 subjects of 62 ± 1.3 years of age, who have coronary artery disease. The Minnesota Living With Heart Failure Questionnaire (MLHFQ was used to assess the quality of life, and to identify the degree of body image discontentment the Stunkard and Sorensen questionnaire (1993 was applied. Statistical analysis was made through statistics programs and the software SPSS 11.0. The degree of association between variables was studied with Kendall test. It was verified that the higher the BMI and the current body shape, the greatest the degree of body image dissatisfaction. The emotional symptoms also appear to be significantly correlated with a desire for a smaller body shape and with indicators of lower quality of life (r = 0474 = 0735, p major 0.05. The physical symptoms were also considerably associated with the emotional symptoms. These results suggest that the variables concerning the quality of life are meaningful to significant body image and satisfaction, which seems to correlate with fewer emotional problems and better facing of the disease. Cardiovascular Rehabilitation Programs that implement physical activity in daily habits proves to be a suitable tool for improving these ailments in this post-acute phase

  4. Reliability Analysis of Brittle Material Structures - Including MEMS(?) - With the CARES/Life Program

    Science.gov (United States)

    Nemeth, Noel N.

    2002-01-01

    Brittle materials are being used, or considered, for a wide variety of high tech applications that operate in harsh environments, including static and rotating turbine parts. thermal protection systems, dental prosthetics, fuel cells, oxygen transport membranes, radomes, and MEMS. Designing components to sustain repeated load without fracturing while using the minimum amount of material requires the use of a probabilistic design methodology. The CARES/Life code provides a general-purpose analysis tool that predicts the probability of failure of a ceramic component as a function of its time in service. For this presentation an interview of the CARES/Life program will be provided. Emphasis will be placed on describing the latest enhancements to the code for reliability analysis with time varying loads and temperatures (fully transient reliability analysis). Also, early efforts in investigating the validity of using Weibull statistics, the basis of the CARES/Life program, to characterize the strength of MEMS structures will be described as as well as the version of CARES/Life for MEMS (CARES/MEMS) being prepared which incorporates single crystal and edge flaw reliability analysis capability. It is hoped this talk will open a dialog for potential collaboration in the area of MEMS testing and life prediction.

  5. A tool to include gamma analysis software into a quality assurance program.

    Science.gov (United States)

    Agnew, Christina E; McGarry, Conor K

    2016-03-01

    To provide a tool to enable gamma analysis software algorithms to be included in a quality assurance (QA) program. Four image sets were created comprising two geometric images to independently test the distance to agreement (DTA) and dose difference (DD) elements of the gamma algorithm, a clinical step and shoot IMRT field and a clinical VMAT arc. The images were analysed using global and local gamma analysis with 2 in-house and 8 commercially available software encompassing 15 software versions. The effect of image resolution on gamma pass rates was also investigated. All but one software accurately calculated the gamma passing rate for the geometric images. Variation in global gamma passing rates of 1% at 3%/3mm and over 2% at 1%/1mm was measured between software and software versions with analysis of appropriately sampled images. This study provides a suite of test images and the gamma pass rates achieved for a selection of commercially available software. This image suite will enable validation of gamma analysis software within a QA program and provide a frame of reference by which to compare results reported in the literature from various manufacturers and software versions. Copyright © 2015. Published by Elsevier Ireland Ltd.

  6. 78 FR 67369 - National Vaccine Injury Compensation Program: Addition to the Vaccine Injury Table to Include All...

    Science.gov (United States)

    2013-11-12

    ... HUMAN SERVICES Health Resources and Services Administration National Vaccine Injury Compensation Program: Addition to the Vaccine Injury Table to Include All Vaccines Against Seasonal Influenza AGENCY: Health... vaccines against seasonal influenza are covered under the National Vaccine Injury Compensation Program...

  7. Including nonadditive genetic effects in mating programs to maximize dairy farm profitability.

    Science.gov (United States)

    Aliloo, H; Pryce, J E; González-Recio, O; Cocks, B G; Goddard, M E; Hayes, B J

    2017-02-01

    We compared the outcome of mating programs based on different evaluation models that included nonadditive genetic effects (dominance and heterozygosity) in addition to additive effects. The additive and dominance marker effects and the values of regression on average heterozygosity were estimated using 632,003 single nucleotide polymorphisms from 7,902 and 7,510 Holstein cows with calving interval and production (milk, fat, and protein yields) records, respectively. Expected progeny values were computed based on the estimated genetic effects and genotype probabilities of hypothetical progeny from matings between the available genotyped cows and the top 50 young genomic bulls. An index combining the traits based on their economic values was developed and used to evaluate the performance of different mating scenarios in terms of dollar profit. We observed that mating programs with nonadditive genetic effects performed better than a model with only additive effects. Mating programs with dominance and heterozygosity effects increased milk, fat, and protein yields by up to 38, 1.57, and 1.21 kg, respectively. The inclusion of dominance and heterozygosity effects decreased calving interval by up to 0.70 d compared with random mating. The average reduction in progeny inbreeding by the inclusion of nonadditive genetic effects in matings compared with random mating was between 0.25 to 1.57 and 0.64 to 1.57 percentage points for calving interval and production traits, respectively. The reduction in inbreeding was accompanied by an average of A$8.42 (Australian dollars) more profit per mating for a model with additive, dominance, and heterozygosity effects compared with random mating. Mate allocations that benefit from nonadditive genetic effects can improve progeny performance only in the generation where it is being implemented, and the gain from specific combining abilities cannot be accumulated over generations. Continuous updating of genomic predictions and mate

  8. Full closure strategic analysis.

    Science.gov (United States)

    2014-07-01

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

  9. Educational program in crisis management for cardiac surgery teams including high realism simulation.

    Science.gov (United States)

    Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K

    2012-07-01

    Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. Algorithms and Programs for Strong Gravitational Lensing In Kerr Space-time Including Polarization

    Science.gov (United States)

    Chen, Bin; Kantowski, Ronald; Dai, Xinyu; Baron, Eddie; Maddumage, Prasad

    2015-05-01

    Active galactic nuclei (AGNs) and quasars are important astrophysical objects to understand. Recently, microlensing observations have constrained the size of the quasar X-ray emission region to be of the order of 10 gravitational radii of the central supermassive black hole. For distances within a few gravitational radii, light paths are strongly bent by the strong gravity field of the central black hole. If the central black hole has nonzero angular momentum (spin), then a photon’s polarization plane will be rotated by the gravitational Faraday effect. The observed X-ray flux and polarization will then be influenced significantly by the strong gravity field near the source. Consequently, linear gravitational lensing theory is inadequate for such extreme circumstances. We present simple algorithms computing the strong lensing effects of Kerr black holes, including the effects on polarization. Our algorithms are realized in a program “KERTAP” in two versions: MATLAB and Python. The key ingredients of KERTAP are a graphic user interface, a backward ray-tracing algorithm, a polarization propagator dealing with gravitational Faraday rotation, and algorithms computing observables such as flux magnification and polarization angles. Our algorithms can be easily realized in other programming languages such as FORTRAN, C, and C++. The MATLAB version of KERTAP is parallelized using the MATLAB Parallel Computing Toolbox and the Distributed Computing Server. The Python code was sped up using Cython and supports full implementation of MPI using the “mpi4py” package. As an example, we investigate the inclination angle dependence of the observed polarization and the strong lensing magnification of AGN X-ray emission. We conclude that it is possible to perform complex numerical-relativity related computations using interpreted languages such as MATLAB and Python.

  11. ALGORITHMS AND PROGRAMS FOR STRONG GRAVITATIONAL LENSING IN KERR SPACE-TIME INCLUDING POLARIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Bin; Maddumage, Prasad [Research Computing Center, Department of Scientific Computing, Florida State University, Tallahassee, FL 32306 (United States); Kantowski, Ronald; Dai, Xinyu; Baron, Eddie, E-mail: bchen3@fsu.edu [Homer L. Dodge Department of Physics and Astronomy, University of Oklahoma, Norman, OK 73019 (United States)

    2015-05-15

    Active galactic nuclei (AGNs) and quasars are important astrophysical objects to understand. Recently, microlensing observations have constrained the size of the quasar X-ray emission region to be of the order of 10 gravitational radii of the central supermassive black hole. For distances within a few gravitational radii, light paths are strongly bent by the strong gravity field of the central black hole. If the central black hole has nonzero angular momentum (spin), then a photon’s polarization plane will be rotated by the gravitational Faraday effect. The observed X-ray flux and polarization will then be influenced significantly by the strong gravity field near the source. Consequently, linear gravitational lensing theory is inadequate for such extreme circumstances. We present simple algorithms computing the strong lensing effects of Kerr black holes, including the effects on polarization. Our algorithms are realized in a program “KERTAP” in two versions: MATLAB and Python. The key ingredients of KERTAP are a graphic user interface, a backward ray-tracing algorithm, a polarization propagator dealing with gravitational Faraday rotation, and algorithms computing observables such as flux magnification and polarization angles. Our algorithms can be easily realized in other programming languages such as FORTRAN, C, and C++. The MATLAB version of KERTAP is parallelized using the MATLAB Parallel Computing Toolbox and the Distributed Computing Server. The Python code was sped up using Cython and supports full implementation of MPI using the “mpi4py” package. As an example, we investigate the inclination angle dependence of the observed polarization and the strong lensing magnification of AGN X-ray emission. We conclude that it is possible to perform complex numerical-relativity related computations using interpreted languages such as MATLAB and Python.

  12. 34 CFR 84.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... awareness program to inform employees about— (a) The dangers of drug abuse in the workplace; (b) Your policy... assistance programs; and (d) The penalties that you may impose upon them for drug abuse violations occurring in the workplace. (Authority: E.O.s 12549 and 12689; 20 U.S.C. 1082, 1094, 1221e-3 and 3474; and Sec...

  13. 25 CFR 170.623 - How are IRR Program projects and activities included in a self-governance agreement?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How are IRR Program projects and activities included in a self-governance agreement? 170.623 Section 170.623 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... self-governance agreement? To include an IRR Program project or activity in a self-governance agreement...

  14. [Michigan Technological University Pre-Service Teacher Enhancement Program]. [Includes a copy of the Student Guide

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, C.S.; Yarroch, W.L.

    1993-04-27

    The Michigan Technological University Teacher Education Program received funding from the US Department of Energy for the purpose of providing capable and suitably inclined, MTU Engineering and Science students a chance to explore high school level science and mathematics teaching as a career option. Ten undergraduate students were selected from nominations and were paired with mentor teachers for the study. This report covers the experience of the first ten nominees and their participation in the program.

  15. Vacuum-assisted closure in the treatment of poststernotomy mediastinitis

    NARCIS (Netherlands)

    Obdeijn, MC; de Lange, M.Y.; Lichtendahl, DHE; de Boer, Willem

    1999-01-01

    A new technique using vacuum-assist-ed closure was successfully applied in 3 patients with poststernotomy mediastinitis. After surgical debridement, this vacuum-assisted closure technique has made it possible to avoid the need for secondary surgical closure (including direct secondary surgical

  16. Simulated selection responses for breeding programs including resistance and resilience to parasites in Creole goats

    NARCIS (Netherlands)

    Gunia, M.; Phocas, F.; Gourdine, J.L.; Bijma, P.; Mandonnet, N.

    2013-01-01

    The Creole goat is a local breed used for meat production in Guadeloupe (French West Indies). As in other tropical countries, improvement of parasite resistance is needed. In this study, we compared predicted selection responses for alternative breeding programs with or without parasites resistance

  17. 77 FR 61012 - Expansion of Importer Self-Assessment Program To Include Qualified Importers of Focused...

    Science.gov (United States)

    2012-10-05

    ..., and to discuss the scope and methodology of the self-testing plan developed by the company. Companies... assessment methodology used by the company; the testing methodology; the frequency of self-testing activities... conducted at least annually. ( www.cbp.gov/xp/cgov/trade/trade_programs/importer_self_assessment/ ). Once...

  18. Program Review - Geothermal Exploration and Assessment Technology Program; Including a Report of the Reservoir Engineering Technical Advisory Group

    Energy Technology Data Exchange (ETDEWEB)

    Nielson, Dennis L., ed.

    1979-12-01

    In 1978, The Division of Geothermal Energy of the Department of Energy established the Geothermal Exploration and Assessment Technology Program. The purpose of this program is to ''provide assistance to the Nation's industrial community by helping to remove technical and associated economic barriers which presently inhibit efforts to bring geothermal electric power production and direct heat application on line''. In the near term this involves the adaptation of exploration and assessment techniques from the mineral and petroleum industry to geothermal applications. In the near to far term it involves the development of new technology which will improve the cost effectiveness of geothermal exploration.

  19. The case for including reach as a key element of program theory.

    Science.gov (United States)

    Montague, Steve; Porteous, Nancy L

    2013-02-01

    This paper suggests that there is a need to build reach in the logic models and results frameworks of public health initiatives. A lack of explicit thinking about reach in logic models can lead to problems such as narrow/constricted understanding of impacts chain, favoring of 'narrow and efficient' initiatives over 'wide and engaging' initiatives and biased thinking against equity considerations. An alternative approach described in this paper that explicitly considers reach demonstrates that an explicit description of reach in program theory and results logic depictions can improve equity in health and social systems. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Including everyone: A peer learning program that works for under-represented minorities?

    Directory of Open Access Journals (Sweden)

    Jacques van der Meer

    2013-04-01

    Full Text Available Peer learning has long been recognised as an effective way to induct first-year students into the academic skills required to succeed at university. One recognised successful model that has been extensively researched is the Supplemental Instruction (SI model; it has operated in the US since the mid-1970s. This model is commonly known in Australasia as the Peer Assisted Study Sessions (PASS program. Although there is a considerable amount of research into SI and PASS, very little has been published about the impact of peer learning on different student groups, for example indigenous and other ethnic groups. This article reports on the results from one New Zealand university of the effectiveness of PASS for Māori and Pasifika students. The questions this article seeks to address are whether attendance of the PASS program results in better final marks for these two groups of students, and whether the number of sessions attended has an impact on the final marks.

  1. 42 CFR 137.275 - May Self-Governance Tribes include IHS construction programs in a construction project agreement...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May Self-Governance Tribes include IHS construction... OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Purpose and Scope § 137.275 May Self-Governance Tribes include IHS construction programs in a construction project agreement or in a funding...

  2. Advanced theoretical and experimental studies in automatic control and information systems. [including mathematical programming and game theory

    Science.gov (United States)

    Desoer, C. A.; Polak, E.; Zadeh, L. A.

    1974-01-01

    A series of research projects is briefly summarized which includes investigations in the following areas: (1) mathematical programming problems for large system and infinite-dimensional spaces, (2) bounded-input bounded-output stability, (3) non-parametric approximations, and (4) differential games. A list of reports and papers which were published over the ten year period of research is included.

  3. 76 FR 9283 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...

    Science.gov (United States)

    2011-02-17

    ... base of an OPPC, we propose to define OPPC to include, at a minimum, wrong surgical or other invasive... experience serious injury and/or death if they undergo erroneous surgical or other invasive procedures and.... Under these NCDs, Medicare does not cover a particular surgical or other invasive procedure to treat a...

  4. Yucca Mountain Waste Package Closure System

    Energy Technology Data Exchange (ETDEWEB)

    Herschel Smartt; Arthur Watkins; David Pace; Rodney Bitsoi; Eric Larsen; Timothy McJunkin; Charles Tolle

    2006-04-01

    The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

  5. Yucca Mountain Waste Package Closure System

    Energy Technology Data Exchange (ETDEWEB)

    shelton-davis; Colleen Shelton-Davis; Greg Housley

    2005-10-01

    The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

  6. Palliative sedation for cancer patients included in a home care program: a retrospective study.

    Science.gov (United States)

    Calvo-Espinos, Claudio; Ruiz de Gaona, Estefania; Gonzalez, Cristina; Ruiz de Galarreta, Lucia; Lopez, Cristina

    2015-06-01

    Palliative sedation is a common treatment in palliative care. The home is a difficult environment for research, and there are few studies about sedation at home. Our aim was to analyze this practice in a home setting. We conducted a retrospective cross-sectional descriptive study in a home cohort during 2011. The inclusion criteria were as follows: 18 years or older and enrolled in the Palliative Home Care Program (PHCP) with advanced cancer. The variables employed were: sex, age, primary tumor location, and place of death. We also registered indication, type, drug and dose, awareness of diagnosis and prognosis, consent, survival, presence or absence of rales, painful mouth, and ulcers in patients sedated at home. We also collected the opinions of family members and professionals about the suffering of sedated patients. A total of 446 patients (56% at home) of the 617 admitted to the PHCP between January and December of 2011 passed away. The typical patient in our population was a 70-year-old man with a lung tumor. Some 35 (14%) home patients required sedation, compared to 93 (49%) at the hospital. The most frequent indication was delirium (70%), with midazolam the most common drug (mean dose, 40 mg). Survival was around three days. Rales were frequent (57%) as well as awareness of diagnosis and prognosis (77 and 71%, respectively). Perception of suffering after sedation was rare among relatives (17%) and professionals (8%). In most cases, the decision was made jointly by professionals and family members. Our study confirmed the role of palliative sedation as an appropriate therapeutic tool in the home environment.

  7. A Call to Include Severe Combined Immunodeficiency in Newborn Screening Program

    Directory of Open Access Journals (Sweden)

    Raz Somech

    2014-01-01

    Full Text Available Quantification of the T cell receptor excision circles (TRECs has recently emerged as a useful non-invasive clinical and research tool to investigate thymic activity. It allows the identification of T cell production by the thymus. Quantification of TREC copies has recently been implemented as the preferred test to screen neonates with severe combined immunodeficiency (SCID or significant lymphopenia. Neonatal genetic screening for SCID is highly important in countries with high rates of consanguinous marriages, such as Israel, and can be used for early diagnosis, enabling prompt therapeutic intervention that will save lives and improve the outcome of these patients. TREC measurement is also applicable in clinical settings where T cell immunity is involved, including any T cell immunodeficiencies, HIV infection, the aging process, autoimmune diseases, and immune reconstitution after bone marrow transplantation.

  8. Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management. Part 2

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities. This Part 2 includes chapters on implementation guidance for operational configuration management, implementation guidance for design reconstitution, and implementation guidance for material condition and aging management. Appendices are included on design control, examples of design information, conduct of walkdowns, and content of design information summaries.

  9. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

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

  10. Sternal exploration or closure

    Science.gov (United States)

    You may have already been receiving wound care or treatment and antibiotics. There are two main reasons for doing exploration and closure procedures for the chest wound after heart surgery: Get rid ...

  11. 45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

    Science.gov (United States)

    2010-10-01

    ... assessments, job creation and economic development activities? 287.130 Section 287.130 Public Welfare... creation and economic development activities? (a) A Tribe may conduct job market assessments within its NEW Program. These might include the following: (1) Consultation with the Tribe's economic development staff...

  12. Experiences of Students with Specific Learning Disorder (Including ADHD) in Online College Degree Programs: A Phenomenological Study

    Science.gov (United States)

    Bunch, Seleta LeAnn

    2016-01-01

    Enrollment in online degree programs is rapidly expanding due to the convenience and affordability offered to students and improvements in technology. The purpose of this hermeneutical phenomenological study was to understand the shared experiences of students with documented specific learning disorders (including Attention-Deficit/Hyperactivity…

  13. 12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

    Science.gov (United States)

    2010-01-01

    ... principles of personal financial management, banking operations, or the benefits of saving for the future... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE...

  14. Options for Closure of the Infected Abdomen

    Science.gov (United States)

    Campbell, Chris A.; Rosenberger, Laura H.; Politano, Amani D.; Davies, Stephen W.; Riccio, Lin M.; Sawyer, Robert G.

    2012-01-01

    Abstract Background The infected abdomen poses substantial challenges to surgeons, and often, both temporary and definitive closure techniques are required. We reviewed the options available to close the abdominal wall defect encountered frequently during and after the management of complicated intra-abdominal infections. Methods A comprehensive review was performed of the techniques and literature on abdominal closure in the setting of intra-abdominal infection. Results Temporary abdominal closure options include the Wittmann Patch, Bogota bag, vacuum-assisted closure (VAC), the AbThera™ device, and synthetic or biologic mesh. Definitive reconstruction has been described with mesh, components separation, and autologous tissue transfer. Conclusion Reconstructing the infected abdomen, both temporarily and definitively, can be accomplished with various techniques, each of which is associated with unique advantages and disadvantages. Appropriate judgment is required to optimize surgical outcomes in these complex cases. PMID:23216525

  15. Geothermal Exploration and Assessment Technology Program (review), including a report of the Reservoir Engineering Technical Advisory Group

    Energy Technology Data Exchange (ETDEWEB)

    Nielson, D.L. (ed.)

    1979-12-01

    The FY 1979 Program, recommended seismic surveys in conjunction with DOE/DGE's industry coupled program in the Northern Basin and Range Province, and the objectives of the Marina del Rey conference are presented. Final reports of six committees which met to define the state-of-the-art in geothermal exploration and to recommend exploration technology development are included. These committees are: structure, stratigraphy, and igneous processes; exploration architecture; electrical methods; seismic methods; thermal methods; water/rock interaction; and reservoir engineering. (MHR)

  16. Spontaneous closure of muscular ventricular septal defects

    Directory of Open Access Journals (Sweden)

    Pejčić Ljiljana

    2017-01-01

    Full Text Available Introduction/Objective. Ventricular septal defect (VSD is the most frequently diagnosed congenital heart anomaly. The prognosis is usually good as it has spontaneous closure evolution, especially small muscular VSDs. The aim of this study was to determine the natural history of isolated muscular VSDs including the frequency of spontaneous closure in relation to location in the muscular septum and the age at the time of closure. Methods. The study included 96 children (52 girls and 44 boys with isolated muscular VSD diagnosed during the first month of life. We analyzed the tendency of spontaneous closure of these defects for the duration of childhood during a follow-up period of 16 years. Two-dimensional color Doppler echocardiography was performed to detect muscular VSD as a primary cardiac lesion. There was significant prevalence of small apical versus trabecular defects and their outcomes were evaluated. Results. Our study evaluated 91 children, 49 (53.8% girls and 42 (46.2% boys who did not undergo surgery. Apically located VSD was diagnosed in 68 (74.7%, while trabecular defects were found in 23 (25.3% children. Spontaneous closure occurred in 56 out of 91 cases (61.5%. The time of spontaneous closure was most commonly recorded during the first six months after birth (46.4%. The overall rate of spontaneous closure was 81.3% by the end of the first year. Apically located ventricular defects underwent spontaneous closure in the majority of patients, in comparison to trabecular ventricular defects (χ2 = 12.581; p < 0.001. Kaplan–Meier analysis demonstrated a significant difference in the average time required for spontaneous closure between the analyzed patient groups (log-rank = 9.64, p = 0.002. Conclusion. The frequency of spontaneous closure of muscular VSDs, especially apically located, is very high in the first six months, especially within the first year of life. It is advisable to detect them early on using color flow imaging and to

  17. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  18. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Chen, Yu; Ye, Jinning; Song, Wu; Chen, Jianhui; Yuan, Yujie; Ren, Jianan

    2014-01-01

    Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62%) patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen. PMID:24987411

  19. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  20. Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

    Science.gov (United States)

    Farrell, Elizabeth; Naber, Erin; Geigle, Paula

    2010-01-01

    This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

  1. MSTor: A program for calculating partition functions, free energies, enthalpies, entropies, and heat capacities of complex molecules including torsional anharmonicity

    Science.gov (United States)

    Zheng, Jingjing; Mielke, Steven L.; Clarkson, Kenneth L.; Truhlar, Donald G.

    2012-08-01

    We present a Fortran program package, MSTor, which calculates partition functions and thermodynamic functions of complex molecules involving multiple torsional motions by the recently proposed MS-T method. This method interpolates between the local harmonic approximation in the low-temperature limit, and the limit of free internal rotation of all torsions at high temperature. The program can also carry out calculations in the multiple-structure local harmonic approximation. The program package also includes six utility codes that can be used as stand-alone programs to calculate reduced moment of inertia matrices by the method of Kilpatrick and Pitzer, to generate conformational structures, to calculate, either analytically or by Monte Carlo sampling, volumes for torsional subdomains defined by Voronoi tessellation of the conformational subspace, to generate template input files, and to calculate one-dimensional torsional partition functions using the torsional eigenvalue summation method. Catalogue identifier: AEMF_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEMF_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 77 434 No. of bytes in distributed program, including test data, etc.: 3 264 737 Distribution format: tar.gz Programming language: Fortran 90, C, and Perl Computer: Itasca (HP Linux cluster, each node has two-socket, quad-core 2.8 GHz Intel Xeon X5560 “Nehalem EP” processors), Calhoun (SGI Altix XE 1300 cluster, each node containing two quad-core 2.66 GHz Intel Xeon “Clovertown”-class processors sharing 16 GB of main memory), Koronis (Altix UV 1000 server with 190 6-core Intel Xeon X7542 “Westmere” processors at 2.66 GHz), Elmo (Sun Fire X4600 Linux cluster with AMD Opteron cores), and Mac Pro (two 2.8 GHz Quad-core Intel Xeon

  2. Tank closure reducing grout

    Energy Technology Data Exchange (ETDEWEB)

    Caldwell, T.B.

    1997-04-18

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

  3. Military Base Realignments and Closures: DOD Has Improved Environmental Cleanup Reporting but Should Obtain and Share More Information

    Science.gov (United States)

    2017-01-01

    DOD contamination from hazardous substances , pollutants , or contaminants; unexploded ordnance, discarded military munitions, or munitions constituents...ordnance. The program includes the investigation, identification, and cleanup of contamination from hazardous substances , pollutants , and...as hazardous substances or unexploded ordnance,1 found on military installations closed under the Base Realignment and Closure (BRAC) process has

  4. The Role of Endothelial Dysfunction Markers in Pregnant Women with Chorion Detachment, Included in the Program of Auxiliary Reproductive Technologies

    Directory of Open Access Journals (Sweden)

    Natalya Lytvyn

    2017-10-01

    Full Text Available An urgent medical and social problem is the restoration of reproductive function of womenwho suffer from infertility, which became possible due to auxiliary reproductive technologies. Women with induced pregnancy make thegroup of a high-risk on miscarriage, due to interrelated processes –immunological disorders and endothelial dysfunction that occur in the body of pregnant women after the use of extracorporal fertilization programs, and can lead to the chorion detachment and the formation of subchorionic hematomas. The purpose of the study is to determine the role of endothelial dysfunction as one of the leading factors that determine the development of a local non-progressive chorion detachment in infertile patients included in the program of auxiliary reproductive technologies. Materials and methods. We have examined 130 pregnant women, who were divided into groups: the control group included 30 women, whose pregnancy occurred in the natural cycle and with uncomplicated gestational course; the main group – 50 patients with induced pregnancy and risk factors of the occurrence of chorion detachment, who wereperformed the proposed pre-gravidapreparation; the comparative group – 50 pregnant women who received a standard scheme of pregnancy management before and after in-vitro fertilization. A general clinical examination, ultrasound examination, homocysteine level determination, endothelin-1 and nitrogen oxide metabolites were performed. Results. In women included into the program of auxiliary reproductive technologies with local chorion detachment were recorded changes of vascular endothelial function with a possible increase in endothelin-1 production and a decrease of the nitric oxidesynthesis. During the induced pregnancy with the presence of subchorionic hematoma, an increase of the level of endothelium-damaging factor of homocysteine was noted. Conclusions.This study identifies the parameters that reflect the main links of endothelial

  5. ROCKET PORT CLOSURE

    Science.gov (United States)

    Mattingly, J.T.

    1963-02-12

    This invention provides a simple pressure-actuated closure whereby windowless observation ports are opened to the atmosphere at preselected altitudes. The closure comprises a disk which seals a windowless observation port in rocket hull. An evacuated instrument compartment is affixed to the rocket hull adjacent the inner surface of the disk, while the outer disk surface is exposed to the atmosphere through which the rocket is traveling. The pressure differential between the evacuated instrument compartment and the relatively high pressure external atmosphere forces the disk against the edge of the observation port, thereby effecting a tight seai. The instrument compartment is evacuated to a pressure equal to the atmospheric pressure existing at the altitude at which it is desiretl that the closure should open. When the rocket reaches this preselected altitude, the inwardly directed atmospheric force on the disk is just equaled by the residual air pressure force within the instrument compartment. Consequently, the closure disk falls away and uncovers the open observation port. The separation of the disk from the rocket hull actuates a switch which energizes the mechanism of a detecting instrument disposed within the instrument compartment. (AE C)

  6. Mail Office annual closure

    CERN Multimedia

    2013-01-01

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

  7. Ring closure in actin polymers

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-18

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

  8. Ring closure in actin polymers

    OpenAIRE

    Sinha, Supurna; Chattopadhyay, Sebanti

    2017-01-01

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

  9. Anterior Segment Imaging for Angle Closure.

    Science.gov (United States)

    Chansangpetch, Sunee; Rojanapongpun, Prin; Lin, Shan C

    2018-01-31

    To summarize the role of anterior segment imaging (AS-imaging) in angle closure diagnosis and management, and the possible advantages over the current standard of gonioscopy. Literature review and perspective. Review of the pertinent publications with interpretation and perspective in relation to the use of AS-imaging in angle closure assessment focusing on anterior segment optical coherence tomography and ultrasound biomicroscopy. Several limitations have been encountered with the reference standard of gonioscopy for angle assessment. AS-imaging has been shown to have performance in angle closure detection compared to gonioscopy. Also, imaging has greater reproducibility and serves as better documentation for long-term follow-up than conventional gonioscopy. The qualitative and quantitative information obtained from AS-imaging enables better understanding of the underlying mechanisms of angle closure and provides useful parameters for risk assessment and possible prediction of the response to laser and surgical intervention. The latest technologies-including 3-dimensional imaging-have allowed for the assessment of the angle that simulates the gonioscopic view. These advantages suggest that AS-imaging has a potential to be a reference standard for the diagnosis and monitoring of angle closure disease in the future. Although gonioscopy remains the primary method of angle assessment, AS-imaging has an increasing role in angle closure screening and management. The test should be integrated into clinical practice as an adjunctive tool for angle assessment. It is arguable that AS-imaging should be considered first-line screening for patients at risk for angle closure. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Ocular Biometry in Angle Closure

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Razeghinejad

    2013-01-01

    Full Text Available Purpose: To compare ocular biometric parameters in primary angle closure suspects (PACS, primary angle closure glaucoma (PACG and acute primary angle closure (APAC. Methods: This cross-sectional study was performed on 113 patients including 33 cases of PACS, 45 patients with PACG and 35 subjects with APAC. Central corneal thickness (CCT, axial length (AL, anterior chamber depth (ACD and lens thickness (LT were measured with an ultrasonic biometer. Lens-axial length factor (LAF, relative lens position, corrected ACD (CACD and corrected lens position were calculated. The parameters were measured bilaterally but only data from the right eyes were compared. In the APAC group, biometric parameters were also compared between affected and unaffected fellow eyes. Logistic regression analysis was performed to identify risk factors. Results: No statistically significant difference was observed in biometric parameters between PACS and PACG eyes, or between affected and fellow eyes in the APAC group (P>0.05 for all comparisons. However, eyes with APAC had thicker cornea (P=0.001, thicker lens (P<0.0001, shallower ACD (P=0.009, shallower CACD (P=0.003 and larger LAF (P<0.0001. Based on ROC curve analysis, lower ACD, and larger LT, LAF and CCT values were associated with APAC. In the APAC group, LAF (P<0.0001 and CCT (P=0.001 were significant risk factors. Conclusion: This study revealed no significant difference in biometric characteristics in eyes with PACS and PACG. However, larger LAF and CCT were predictive of APAC.

  11. 45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

    Science.gov (United States)

    2010-10-01

    ... program(s); (2) The total amount of State and Tribal spending on TANF cash assistance payments; (3) The... Food Stamp Program or other State supportive and assistance programs; (4) The proportion of students...

  12. Space Station evolution study oxygen loop closure

    Science.gov (United States)

    Wood, M. G.; Delong, D.

    1993-01-01

    In the current Space Station Freedom (SSF) Permanently Manned Configuration (PMC), physical scars for closing the oxygen loop by the addition of oxygen generation and carbon dioxide reduction hardware are not included. During station restructuring, the capability for oxygen loop closure was deferred to the B-modules. As such, the ability to close the oxygen loop in the U.S. Laboratory module (LAB A) and the Habitation A module (HAB A) is contingent on the presence of the B modules. To base oxygen loop closure of SSF on the funding of the B-modules may not be desirable. Therefore, this study was requested to evaluate the necessary hooks and scars in the A-modules to facilitate closure of the oxygen loop at or subsequent to PMC. The study defines the scars for oxygen loop closure with impacts to cost, weight and volume and assesses the effects of byproduct venting. In addition, the recommended scenarios for closure with regard to topology and packaging are presented.

  13. CD4+ T Cell Help Confers a Cytotoxic T Cell Effector Program Including Coinhibitory Receptor Downregulation and Increased Tissue Invasiveness.

    Science.gov (United States)

    Ahrends, Tomasz; Spanjaard, Aldo; Pilzecker, Bas; Bąbała, Nikolina; Bovens, Astrid; Xiao, Yanling; Jacobs, Heinz; Borst, Jannie

    2017-11-21

    CD4+ T cells optimize the cytotoxic T cell (CTL) response in magnitude and quality, by unknown molecular mechanisms. We here present the transcriptomic changes in CTLs resulting from CD4+ T cell help after anti-cancer vaccination or virus infection. The gene expression signatures revealed that CD4+ T cell help during priming optimized CTLs in expression of cytotoxic effector molecules and many other functions that ensured efficacy of CTLs throughout their life cycle. Key features included downregulation of PD-1 and other coinhibitory receptors that impede CTL activity, and increased motility and migration capacities. "Helped" CTLs acquired chemokine receptors that helped them reach their tumor target tissue and metalloprotease activity that enabled them to invade into tumor tissue. A very large part of the "help" program was instilled in CD8+ T cells via CD27 costimulation. The help program thus enhances specific CTL effector functions in response to vaccination or a virus infection. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Evaluation design of a reactivation care program to prevent functional loss in hospitalised elderly: A cohort study including a randomised controlled trial

    National Research Council Canada - National Science Library

    Asmus-Szepesi, Kirsten; Vreede, Paul; Nieboer, Anna; Wijngaarden, Jeroen; Bakker, Ton; Steyerberg, Ewout; Mackenbach, Johan

    2011-01-01

    ... patients by comparing a new intervention program to two usual care programs. Methods/Design. This study will include an effect, process and cost evaluation using a mixed methods design of quantitative and qualitative methods...

  15. Summer season | Cafeteria closures

    CERN Multimedia

    2013-01-01

    Please note the following cafeteria closures over the summer season: Bldg. 54 closed from 29/07/2013 to 06/09/2013. Bldg. 13: closed from 13/07/2013 to 06/09/2013. Restaurant No. 2, table service (brasserie and restaurant): closed from 01/08/2013 to 06/09/2013. Bldg. 864: closed from 29/07/2013 to 06/09/2013. Bldg. 865: closed from 29/07/2013 to 06/09/2013.

  16. Vacuum-assisted closure for defects of the abdominal wall.

    Science.gov (United States)

    DeFranzo, Anthony J; Pitzer, Keith; Molnar, Joseph A; Marks, Malcolm W; Chang, Michael C; Miller, Preston R; Letton, Robert W; Argenta, Louis C

    2008-03-01

    Reconstruction of the abdominal wall poses a problem common to many surgical specialties. Abdominal wall defects may be caused by trauma and/or prior surgery, with dehiscence or infection. Several options to repair the structural integrity of the abdominal wall exist, including primary closure, flaps, mesh, and skin grafts. Complications of these procedures include recurrent infection of the abdominal wall, infection of mesh, dehiscence, flap death, and poor skin graft take. Risk factors predisposing to these complications include tissue edema, preoperative tissue infection, and patient debilitation, with poor wound healing potential. Ideally, reconstruction should be performed on a nonedematous, clean tissue bed with bacterial levels less than 10 bacteria/cm in a well-nourished patient. Vacuum-assisted closure was used in a series of patients in an attempt to prepare the abdominal wall for reconstruction and reduce the risk of complications. Charts were reviewed for 100 patients who underwent abdominal wall reconstruction after vacuum-assisted closure therapy. Their wound cause, reconstruction technique, complications, and number of days on the vacuum-assisted closure device are reported. The ability of vacuum-assisted closure to reduce edema, increase blood flow, potentially decrease bacterial colonization, and reduce wound size greatly facilitated abdominal wall reconstruction. The vacuum-assisted closure device served as a temporary dressing with which to control dehiscence and to maintain abdominal wall integrity when bowel wall edema prevented abdominal closure. Vacuum-assisted closure therapy frequently shortened time to abdominal wall reconstruction and simplified the method of reconstruction.

  17. Site-Wide Integrated Water Monitoring -- Defining and Implementing Sampling Objectives to Support Site Closure

    Energy Technology Data Exchange (ETDEWEB)

    Wilborn, Bill [NNSA/NFO, Nevada Site Office (United States); Farnham, Irene [Navarro-Interra LLC, Las Vegas (United States); Marutzky, Sam [Navarro-Interra LLC, Las Vegas (United States); Knapp, Kathryn [NNSA/NFO, Nevada Site Office (United States)

    2013-02-24

    The Underground Test Area (UGTA) activity is responsible for assessing and evaluating the effects of the underground nuclear weapons tests on groundwater at the Nevada National Security Site (NNSS), formerly the Nevada Test Site (NTS), and implementing a corrective action closure strategy. The UGTA strategy is based on a combination of characterization, modeling studies, monitoring, and institutional controls (i.e., monitored natural attenuation). The closure strategy verifies through appropriate monitoring activities that contaminants of concern do not exceed the SDWA at the regulatory boundary and that adequate institutional controls are established and administered to ensure protection of the public. Other programs conducted at the NNSS supporting the environmental mission include the Routine Radiological Environmental Monitoring Program (RREMP), Waste Management, and the Infrastructure Program. Given the current programmatic and operational demands for various water-monitoring activities at the same locations, and the ever-increasing resource challenges, cooperative and collaborative approaches to conducting the work are necessary. For this reason, an integrated sampling plan is being developed by the UGTA activity to define sampling and analysis objectives, reduce duplication, eliminate unnecessary activities, and minimize costs. The sampling plan will ensure the right data sets are developed to support closure and efficient transition to long-term monitoring. The plan will include an integrated reporting mechanism for communicating results and integrating process improvements within the UGTA activity as well as between other U.S. Department of Energy (DOE) Programs.

  18. Hamiltonian closures in fluid models for plasmas

    Science.gov (United States)

    Tassi, Emanuele

    2017-11-01

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

  19. Quantitative analysis of iris changes following mydriasis in subjects with different mechanisms of angle closure.

    Science.gov (United States)

    Zhang, Ye; Li, Si Zhen; Li, Lei; He, Ming Guang; Thomas, Ravi; Wang, Ning Li

    2015-01-08

    We estimate and compare change in iris cross-sectional area (IA) after physiologic and pharmacologic mydriasis in subjects with different dominant mechanisms for primary angle closure. Anterior segment optical coherence tomography (AS-OCT) measurements in light, dark, and following pharmacologic dilation were obtained on primary angle closure suspects (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG) examined during the 5-year follow-up of the Handan Eye Study. Subjects were categorized into three subgroups according to their dominant angle closure (AC) mechanisms as determined by AS-OCT: pupillary block (PB), plateau iris configuration (PIC), and thick peripheral iris roll (TPIR). The IA and other biometric parameters measured using the Zhongshan Angle Assessment Program in the right eyes of all subjects were analyzed. A total of 364 right eyes of subjects with PACS (333), and PAC/PACG (31) was included in the analysis. Significant differences in the change of IAs (P = 0.030), IA loss per mm pupil diameter (PD) increase (P = 0.001) in light versus pharmacologic dilation, and IA loss per mm PD increase (P = 0.011) from dark versus pharmacologic dilation were observed among the three groups. The smallest decrease occurred in the PB group. There are significant differences in IA and IA loss per mm of pupil change following physiologic or pharmacologic mydriasis in Chinese subjects with dissimilar dominant mechanisms for AC. Dynamic iris change may have a more important role in angle closure where PB is the dominant mechanism. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  20. Closure Report for Corrective Action Unit 127: Areas 25 and 26 Storage Tanks, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2008-02-01

    CAU 127, Areas 25 and 26 Storage Tanks, consists of twelve CASs located in Areas 25 and 26 of the NTS. The closure alternatives included no further action, clean closure, and closure in place with administrative controls. The purpose of this Closure Report is to provide a summary of the completed closure activities, documentation of waste disposal, and analytical data to confirm that the remediation goals were met.

  1. Closure for milliliter scale bioreactor

    Science.gov (United States)

    Klein, David L.; Laidlaw, Robert D.; Andronaco, Gregory; Boyer, Stephen G.

    2010-12-14

    A closure for a microreactor includes a cap that is configured to be inserted into a well of the microreactor. The cap, or at least a portion of the cap, is compliant so as to form a seal with the well when the cap is inserted. The cap includes an aperture that provides an airway between the inside of the well to the external environment when the cap is inserted into the well. A porous plug is inserted in the aperture, e.g., either directly or in tube that extends through the aperture. The porous plug permits gas within the well to pass through the aperture while preventing liquids from passing through to reduce evaporation and preventing microbes from passing through to provide a sterile environment. A one-way valve may also be used to help control the environment in the well.

  2. Post-Closure Strategy for Use-Restricted Sites on the Nevada National Security Site, Nevada Test and Training Range, and Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, A. J. [National Security Technologies, LLC. (NSTec), Mercury, NV (United States)

    2014-03-26

    intended to be a permanent long-term stewardship plan. However, it is intended to clarify requirements and identify components to effectively manage the sites until regulatory requirements are met or management of the site changes. The Environmental Management Program is required to manage these sites until the NNSS Environmental Restoration program is completed, currently planned for 2030. Prior to completion of the Environmental Restoration program, additional planning will be conducted to ensure that long-term stewardship of the sites is maintained. A comprehensive post-closure plan can be transitioned effectively into any future site-wide long-term stewardship program that may be developed. Therefore, the post-closure plan will include current aspects of the post-closure program that are also important aspects of long-term stewardship, including the following: • Management of physical and engineering controls such as fences, signs, and soil covers • Management of institutional and administrative controls such as use restrictions and real estate systems • Management of monitoring and maintenance programs • Management of information related to the sites such as geographic information system data and related documentation The strategy will also allow for periodic review and modification of any aspect of the program to ensure continued effectiveness.

  3. PFO closuRE and CryptogenIc StrokE (PRECISE) registry

    DEFF Research Database (Denmark)

    Wöhrle, Jochen; Bertrand, Bernard; Søndergaard, Lars

    2012-01-01

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

  4. The Effects of a Family Support Program Including Respite Care on Parenting Stress and Family Quality of Life Perceived by Primary Caregivers of Children with Disabilities in Korea

    Science.gov (United States)

    Sung, Minjung; Park, Jiyeon

    2012-01-01

    In this study, a family support program was carried out for primary caregivers of children with disabilities. The program included respite care, recreation programs, counseling, and social support coordination based on individual needs of each family. In order to verify the intervention effects, parenting stress and family quality of life were…

  5. [Study of the nutritional status of patients over 65 years included in the home care program in an urban population].

    Science.gov (United States)

    Muñoz Díaz, Belén; Arenas de Larriva, Antonio P; Molina-Recio, Guillermo; Moreno-Rojas, Rafael; Martínez de la Iglesia, Jorge

    2018-02-01

    To analyse the nutritional status of patients older than 65 years included in the home care program (PAD). Croos-sectional study. 3 urban health centers. 218 patients in the PAD. Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be Pnutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition. More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  6. A comparison of a new skin closure device and intradermal sutures in the closure of full-thickness surgical incisions.

    Science.gov (United States)

    Richter, Dirk; Stoff, Alexander; Ramakrishnan, Venkat; Exner, Klaus; Jernbeck, Jan; Blondeel, Phillip N

    2012-10-01

    A novel topical skin adhesive system was developed to close the outermost layer of skin in an expeditious manner. To determine its clinical utility, a clinical investigation was undertaken to demonstrate equivalence of a new adhesive skin closure system (Prineo Skin Closure System) to intradermal sutures in wound closure. The investigation included 83 patients who underwent elective abdominoplasty, circumferential body lift procedures, and breast reconstruction with deep inferior epigastric perforator flaps. Incisions were divided in half, and each half was randomized to wound closure with the new skin closure system, including a pressure-sensitive adhesive mesh tape for wound edge approximation and next-generation cyanoacrylate or intradermal sutures. Postoperative evaluations took place at 24 hours, 7 days, 12 to 25 days, 90 days, 6 months, and 12 months. The new skin closure system was found to be equivalent to intradermal sutures for the continuous approximation of wounds. The upper limit of the two-sided 90 percent confidence interval for difference in proportions was 10.9 percent. The mean time to closure for the new skin closure system was 1.46 minutes, approximately 5 minutes faster than that for intradermal sutures (p sutures for full-thickness surgical incisions with regard to safety and effectiveness. The ease and speed of application contribute to shortened operative times (4.5 times faster than intradermal sutures).

  7. Evaluation of 8-week body weight control program including sea tangle (Laminaria japonica) supplementation in Korean female college students

    OpenAIRE

    You, Jeong Soon; Sung, Min Jung; Chang, Kyung Ja

    2009-01-01

    This study was conducted to evaluate the effects of a body weight control program with supplementation of sea tangle (20 g/day) on 22 female college students. The contents of the program for 8 weeks contained diet therapy, exercise and behavioral modification through nutrition education. Body composition, dietary habit scores, serum lipid profiles, daily nutrient intakes and the quality of life were assessed at the beginning and at the end of the program. Average age of subjects and height we...

  8. MNC Subsidiary Closure

    DEFF Research Database (Denmark)

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

    We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. We ask to what degree the foreign knowledge that they were exposed to is valued in their new job. We argue theoretically that this foreign knowledge is both valuable and not readily available in the host...... country but is also distant and therefore difficult to absorb. We predict an inverse u-shaped relationship between the exposure to foreign knowledge and the salary in the new job. We empirically support our predictions for a sample of almost 140,000 affected employees in Portugal from 2002 to 2009....

  9. MNC Subsidiary Closure

    DEFF Research Database (Denmark)

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

    2013-01-01

    We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. We ask to what degree the foreign knowledge that they were exposed to is valued in their new job. We argue theoretically that this foreign knowledge is both valuable and not readily available in the host...... country but is also distant and therefore difficult to absorb. We predict an inverse u-shaped relationship between the exposure to foreign knowledge and the salary in the new job. We empirically support our predictions for a sample of almost 140,000 affected employees in Portugal from 2002 to 2009....

  10. Empirical Correlates of Narrative Closure

    Directory of Open Access Journals (Sweden)

    Tobias Klauk

    2016-06-01

    Full Text Available This paper presents an experimental investigation of the narratological concept of narrative closure. While narrative closure is a well-studied phenomenon in contemporary narratology, it still lacks a serious empirical foundation. In order to fill that lacuna, we performed a controlled rating experiment aimed at validating some of the properties of narrative closure proposed in the narratological literature. Our results suggest that narrative closure is closely related to two connected properties: to the completeness of the text and to questions left open by the text.

  11. Brassinosteroids modulate ABA-induced stomatal closure in Arabidopsis.

    Science.gov (United States)

    Ha, Yunmi; Shang, Yun; Nam, Kyoung Hee

    2016-12-01

    Stomatal movement in response to water availability is an important physiological process in the survival of land plants. The plant hormone abscisic acid (ABA) and brassinosteroids (BRs) regulate stomatal closure. The physiological functions of ABA and BRs, including germination, cell elongation and stomatal movement, are generally known to be antagonistic. Here, we investigated how BRs affect stomatal movement alone and in combination with ABA. We demonstrate that brassinoslide (BL), the most active BR, promotes stomatal closure in an ABA-independent manner. Interestingly, BL also inhibited ABA-induced stomatal closure when a high concentration of BL was added to ABA. Furthermore, we found that the induction of some genes for reactive oxygen species (ROS) generation by ABA (AtrbohD, NIA1 and NIA2) and subsequent ROS production were repressed by BL treatment. The BR signaling mutant bri1-301 failed to inhibit ABA-induced stomatal closure upon BL treatment. However, BRI1-overexpressing transgenic plants were hypersensitive to ABA during stomatal closure, and BL reversed ABA-induced stomatal closure more completely than in wild type plants. Taken together, these results suggest that BRs can positively and negatively modulate ABA-induced stomatal closure. Therefore, interactions between ABA and BR signaling are important for the regulation of stomatal closure. © The Author 2016. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  12. 25 CFR 170.137 - What types of activities can a recreation, tourism, and trails program include?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What types of activities can a recreation, tourism, and... INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Recreation, Tourism and Trails § 170.137 What types of activities can a recreation, tourism, and...

  13. 324 Building REC and HLV Tank Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    Becker-Khaleel, B; Schlick, K. [Scienfific Ecology Group, Inc. Richland, WA (United States)

    1995-12-01

    This closure plan describes the activities necessary to close the 324 Radiochemical Engineering Cells (REC) and High-Level Vault (HLV) in accordance with the Washington State Dangerous Waste regulations. To provide a complete description of the activities required, the closure plan relies on information contained in the 324 Building B-Cell Safety Cleanout Project (BCCP) plans, the 324 Building REC HLV Interim Waste Management Plan (IWMP), the Project Management Plan for Nuclear Facilities Management 300 Area Compliance Program, and the 324 High Level Vault Interim Removal Action Project (project management plan [PMP]). The IWMP addresses the management of mixed waste in accordance with state and federal hazardous waste regulations. It provides a strategy for managing high-activity mixed waste in compliance with Resource Conservation and Recovery Act (RCRA) requirements or provides for an alternative management approach for the waste. The BCCP outlines the past, present, and future activities necessary for removing from B-Cell the solid waste, including mixed waste generated as a result of historical research and development (R&D) activities conducted in the cell. The BCCP also includes all records and project files associated with the B-Cell cleanout. This information is referenced throughout the closure plan. The PMP sets forth the plans, organization, and systems that Pacific Northwest National Laboratory (PNNL) will use to direct and control the 324 High-Level Vault Interim Removal Action Project. This project will develop and implement a treatment strategy that will remove and stabilize the inventory of liquid waste from the 324 HLV tanks. The PMP also provides for flushing and sampling the flush solution.

  14. Accelerating cleanup: Paths to closure

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-06-01

    This report describes the status of Environmental Management`s (EM`s) cleanup program and a direction forward to complete achievement of the 2006 vision. Achieving the 2006 vision results in significant benefits related to accomplishing EM program objectives. As DOE sites accelerate cleanup activities, risks to public health, the environment, and worker safety and health are all reduced. Finding more efficient ways to conduct work can result in making compliance with applicable environmental requirements easier to achieve. Finally, as cleanup activities at sites are completed, the EM program can focus attention and resources on the small number of sites with more complex cleanup challenges. Chapter 1 describes the process by which this report has been developed and what it hopes to accomplish, its relationship to the EM decision-making process, and a general background of the EM mission and program. Chapter 2 describes how the site-by-site projections were constructed, and summarizes, for each of DOE`s 11 Operations/Field Offices, the projected costs and schedules for completing the cleanup mission. Chapter 3 presents summaries of the detailed cleanup projections from three of the 11 Operations/Field Offices: Rocky Flats (Colorado), Richland (Washington), and Savannah River (South Carolina). The remaining eight Operations/Field Office summaries are in Appendix E. Chapter 4 reviews the cost drivers, budgetary constraints, and performance enhancements underlying the detailed analysis of the 353 projects that comprise EM`s accelerated cleanup and closure effort. Chapter 5 describes a management system to support the EM program. Chapter 6 provides responses to the general comments received on the February draft of this document.

  15. Perturbed airway closure

    Science.gov (United States)

    Grotberg, James B.; Halpern, David

    1998-11-01

    The small airways of the lungs are lined with a thin viscous film. A surface-tension driven instability at the air-liquid interface may induce the formation of a liquid bridge blocking airflow if there is sufficient fluid within the film. As a result of the pressures generated within the non-uniform film, the airway wall may also collapse. These instabilities often occur in premature neonates who do not produce sufficient quantities of surfactant. Often, they are placed in ventilators to diminish the risk of airway closure. Two fundamental parameters are the frequency of the ventilation and the tidal volume of the delivered gas. In the current study, we consider the effect of an oscillatory shear stress impinged by the air on a thin film coating a single compliant tube. Nonlinear evolution equations are derived for the film thickness and the wall position. Numerical solutions show that the oscillatory shear stress can saturate the growth of a disturbance at the air-liquid interface. For a given film thickness, there is a critical frequency, dependent on wall parameters, above which closure does not occur when forced by oscillatory shear but will close when unforced.

  16. Development of a score and probability estimate for detecting angle closure based on anterior segment optical coherence tomography.

    Science.gov (United States)

    Nongpiur, Monisha E; Haaland, Benjamin A; Perera, Shamira A; Friedman, David S; He, Mingguang; Sakata, Lisandro M; Baskaran, Mani; Aung, Tin

    2014-01-01

    To develop a score along with an estimated probability of disease for detecting angle closure based on anterior segment optical coherence tomography (AS OCT) imaging. Cross-sectional study. A total of 2047 subjects 50 years of age and older were recruited from a community polyclinic in Singapore. All subjects underwent standardized ocular examination including gonioscopy and imaging by AS OCT (Carl Zeiss Meditec). Customized software (Zhongshan Angle Assessment Program) was used to measure AS OCT parameters. Complete data were available for 1368 subjects. Data from the right eyes were used for analysis. A stepwise logistic regression model with Akaike information criterion was used to generate a score that then was converted to an estimated probability of the presence of gonioscopic angle closure, defined as the inability to visualize the posterior trabecular meshwork for at least 180 degrees on nonindentation gonioscopy. Of the 1368 subjects, 295 (21.6%) had gonioscopic angle closure. The angle closure score was calculated from the shifted linear combination of the AS OCT parameters. The score can be converted to an estimated probability of having angle closure using the relationship: estimated probability = e(score)/(1 + e(score)), where e is the natural exponential. The score performed well in a second independent sample of 178 angle-closure subjects and 301 normal controls, with an area under the receiver operating characteristic curve of 0.94. A score derived from a single AS OCT image, coupled with an estimated probability, provides an objective platform for detection of angle closure. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. 40 CFR 265.1102 - Closure and post-closure care.

    Science.gov (United States)

    2010-07-01

    ..., STORAGE, AND DISPOSAL FACILITIES Containment Buildings § 265.1102 Closure and post-closure care. (a) At closure of a containment building, the owner or operator must remove or decontaminate all waste residues... applies. The closure plan, closure activities, cost estimates for closure, and financial responsibility...

  18. Ca analysis: An Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis☆

    Science.gov (United States)

    Greensmith, David J.

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. PMID:24125908

  19. Ca analysis: an Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis.

    Science.gov (United States)

    Greensmith, David J

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. Copyright © 2013 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

  20. Expanding the Lessons Learned Program to Include Corps Support Command Commanders and Theater Army Area Command Commanders

    Science.gov (United States)

    1989-03-10

    INTRODUCTION The Oral History Program’s purpose is to supplement oFficial histories , to isolate successful command, leadership and managerial...of -the program is to capture the experience of senior leaders in the areas of command, leadership , and management . The individual is interviewed...used to gain insight into command and management techniques and to further research in military history . In June of 1984, the Chief of Staff, General

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-11

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

  2. Pursestring Closure versus Conventional Primary Closure Following Stoma Reversal to Reduce Surgical Site Infection Rate: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Hsieh, Meng-Chiao; Kuo, Liang-Tseng; Chi, Ching-Chi; Huang, Wen-Shih; Chin, Chih-Chien

    2015-08-01

    Stoma reversal is a surgical procedure commonly used following temporary defunctioning stoma surgery. Surgical site infection is one of the most common postoperative morbidities. A few skin closure methods have been developed to decrease surgical site infection. However, the optimal skin closure method is still in debate. The aim of this study was to compare the surgical site infection rate and other postoperative outcomes between the pursestring closure and conventional primary closure techniques. We searched the MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for relevant trials. We conducted a meta-analysis of randomized controlled trials that compared the surgical outcomes following pursestring closure and conventional primary closure techniques. We conducted the meta-analysis by using the random-effects model. The primary outcome of interest was surgical site infection following stoma reversal within 30 days after operation. This meta-analysis included 4 randomized controlled trials with a total of 319 participants (162 in the pursestring closure group and 157 in the conventional primary closure group). Compared with the conventional primary closure group, the pursestring closure group had a significant decrease in surgical site infection (risk difference, -0.25; 95% CI, -0.36 to -0.15; p stoma reversal than conventional primary closure.

  3. Underground storage tank 253-D1U1 Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    Mancieri, S.; Giuntoli, N.

    1993-09-01

    This report is a closure plan for a diesel fuel tank at the Lawrence Livermore National Laboratory. Included are maps of the site, work plans, and personnel information regarding training and qualification.

  4. Management of hidradenitis suppurativa wounds with an internal vacuum-assisted closure device.

    Science.gov (United States)

    Chen, Y Erin; Gerstle, Theodore; Verma, Kapil; Treiser, Matthew D; Kimball, Alexandra B; Orgill, Dennis P

    2014-03-01

    Hidradenitis suppurativa is a chronic, debilitating disease that is difficult to treat. Once medical management fails, wide local excision offers the best chance for cure. However, the resultant wound often proves too large or contaminated for immediate closure. The authors performed a retrospective chart review of hidradenitis cases managed surgically between 2005 and 2010. Data collected included patient characteristics, management method, and outcomes. Approximately half of the patients received internal vacuum-assisted closure therapy using the vacuum-assisted closure system and delayed closure and half of the patients received immediate primary closure at the time of their excision. Delayed closure consisted of closing the majority of the wound in a linear fashion following internal vacuum-assisted closure while accepting healing by means of secondary intention for small wound areas. Patients managed with internal vacuum-assisted closure had wounds on average four times larger in area than patients managed without internal vacuum-assisted closure. In both groups, all wounds were eventually closed primarily. Healing times averaged 2.2 months with internal vacuum-assisted closure and 2.7 months without. At an average follow-up time of 2.3 months, all patients with internal vacuum-assisted closure had no recurrence of their local disease. Severe hidradenitis presents a treatment challenge, as surgical excisions are often complicated by difficult closures and unsatisfactory recurrence rates. This study demonstrates that wide local excision with reasonable outcomes can be achieved using accelerated delayed primary closure. This method uses internal vacuum-assisted closure as a bridge between excision and delayed primary closure, facilitating closure without recurrence in large, heavily contaminated wounds. Therapeutic, III.

  5. Recommended management practices for operation and closure of shallow injection wells at DOE facilities

    Energy Technology Data Exchange (ETDEWEB)

    1993-07-01

    The Safe Drinking Water Act established the Underground Injection Control (UIC) program to ensure that underground injection of wastes does not endanger an underground source of drinking water. Under UIC regulations, an injection well is a hole in the ground, deeper than it is wide, that receives wastes or other fluid substances. Types of injection wells range from deep cased wells to shallow sumps, drywells, and drainfields. The report describes the five classes of UIC wells and summarizes relevant regulations for each class of wells and for the UIC program. The main focus of the report is Class IV and V shallow injection wells. Class IV wells are prohibited and should be closed when they are identified. Class V wells are generally authorized by rule, but EPA or a delegated state may require a permit for a Class V well. This report provides recommendations on sound operating and closure practices for shallow injection wells. In addition the report contains copies of several relevant EPA documents that provide additional information on well operation and closure. Another appendix contains information on the UIC programs in 21 states in which there are DOE facilities discharging to injection wells. The appendix includes the name of the responsible regulatory agency and contact person, a summary of differences between the state`s regulations and Federal regulations, and any closure guidelines for Class IV and V wells.

  6. Starting at the End When Planning for Base Closure

    Science.gov (United States)

    2016-05-17

    Transfer Property Early An equally critical aspect of base closure that included the direct in- volvement and support of numerous contractors and...operations shaped the tempo of the overall base transfer. By involving engineer assets early , the RSS successfully set the conditions for closure. A...order-style mes- sages with all personnel on the base, including contractors , to ensure that everyone was aware of drawdown requirements and could

  7. A closure relation to molecular theory of solvation for macromolecules

    Science.gov (United States)

    Kobryn, Alexander E.

    We propose a closure to the integral equations of molecular theory of solvation, particularly suitable for polar and charged macromolecules in electrolyte solution. This includes such systems as oligomeric polyelectrolytes at a finite concentration in aqueous and various non-aqueous solutions, as well as drug-like compounds in solution. The new closure (KGK closure) imposes the mean spherical approximation (MSA) almost everywhere in the solvation shell but levels out the density distribution function to zero inside the repulsive core and in the spatial regions of strong density depletion emerging due to molecular associative interactions. We test the performance of the KGK closure coupled to the reference interaction site model (RISM) on the examples of LJ liquids, polar and nonpolar molecular solvents, including water, and aqueous solutions of simple ions, and use the KGK closure to obtain the solvation structure and thermodynamics of oligomeric polyelectrolytes and drug-like compounds at a finite concentration in electrolyte solution, for which no convergence is obtained with other closures. We further test the 3D-version of the KGK closure with 3D-RISM for molecular mixtures as well as oligomeric polyelectrolytes and drug-like molecules in electrolyte solutions. 11421 Saskatchewan Drive, Edmonton, Alberta, T6G 2M9, Canada.

  8. Tissue adhesives for closure of surgical incisions.

    Science.gov (United States)

    Dumville, Jo C; Coulthard, Paul; Worthington, Helen V; Riley, Philip; Patel, Neil; Darcey, James; Esposito, Marco; van der Elst, Maarten; van Waes, Oscar J F

    2014-11-28

    Sutures (stitches), staples and adhesive tapes have been used for many years as methods of wound closure, but tissue adhesives have entered clinical practice more recently. Closure of wounds with sutures enables the closure to be meticulous, but the sutures may show tissue reactivity and can require removal. Tissue adhesives offer the advantages of an absence of risk of needlestick injury and no requirement to remove sutures later. Initially, tissue adhesives were used primarily in emergency room settings, but this review looks at the use of tissue adhesives in the operating room/theatre where surgeons are using them increasingly for the closure of surgical skin incisions. To determine the effects of various tissue adhesives compared with conventional skin closure techniques for the closure of surgical wounds. In March 2014 for this second update we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We did not restrict the search and study selection with respect to language, date of publication or study setting. Only randomised controlled trials were eligible for inclusion. We conducted screening of eligible studies, data extraction and risk of bias assessment independently and in duplicate. We expressed results as random-effects models using mean difference for continuous outcomes and risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes. We investigated heterogeneity, including both clinical and methodological factors. This second update of the review identified 19 additional eligible trials resulting in a total of 33 studies (2793 participants) that met the inclusion criteria. There was low quality evidence that sutures were significantly better than tissue adhesives for reducing the risk of wound breakdown (dehiscence; RR 3.35; 95% CI 1.53 to 7

  9. Pilot monitoring program: geologic input for the hillslope component (includes a discussion of Caspar Creek geology and geomorphology)

    Science.gov (United States)

    T. E. Spittler

    1995-01-01

    The California Department of Conservation, Division of Mines and Geology (DMG) is submitting this report and accompanying maps to the California Department of Forestry and Fire Protection (CDF) to fulfill Interagency Agreement number 8CA38400, Pilot Monitoring Program -- Geologic Input for the Hillslope Component. Under this agreement, DMG has assisted CDF in the...

  10. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2015-01-01

    Conclusion: Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

  11. Quick Reference Guide: Working with Stakeholders to Identify Potential Improvement Strategies for Program Improvement (Including the SSIP)

    Science.gov (United States)

    Center for IDEA Early Childhood Data Systems (DaSy), 2015

    2015-01-01

    This 2015 quick reference guide is designed to assist states in understanding what information needs to be available in order for stakeholders to assist in selecting potential improvement strategies that will increase capacity of Local Education Agencies (LEAs), Early Intervention Services (EIS) programs, and practitioners to improve results for…

  12. Building a Steganography Program Including How to Load, Process, and Save JPEG and PNG Files in Java

    Science.gov (United States)

    Courtney, Mary F.; Stix, Allen

    2006-01-01

    Instructors teaching beginning programming classes are often interested in exercises that involve processing photographs (i.e., files stored as .jpeg). They may wish to offer activities such as color inversion, the color manipulation effects archived with pixel thresholding, or steganography, all of which Stevenson et al. [4] assert are sought by…

  13. 77 FR 22790 - ``Low Income Levels'' Used for Various Health Professions and Nursing Programs Included in Titles...

    Science.gov (United States)

    2012-04-17

    ... HUMAN SERVICES Health Resources and Services Administration ``Low Income Levels'' Used for Various... backgrounds, or (3) individuals from ``low-income'' families. SUPPLEMENTARY INFORMATION: The various health..., public or private nonprofit schools which offer graduate programs in behavioral health and mental health...

  14. 76 FR 14417 - ``Low Income Levels'' Used for Various Health Professions and Nursing Programs Included in Titles...

    Science.gov (United States)

    2011-03-16

    ... HUMAN SERVICES Health Resources and Services Administration ``Low Income Levels'' Used for Various... backgrounds, or (3) individuals from ``low-income'' families. SUPPLEMENTARY INFORMATION: The various health..., public or private nonprofit schools which offer graduate programs in behavioral health and mental health...

  15. Evaluation of 8-week body weight control program including sea tangle (Laminaria japonica) supplementation in Korean female college students.

    Science.gov (United States)

    You, Jeong Soon; Sung, Min Jung; Chang, Kyung Ja

    2009-01-01

    This study was conducted to evaluate the effects of a body weight control program with supplementation of sea tangle (20 g/day) on 22 female college students. The contents of the program for 8 weeks contained diet therapy, exercise and behavioral modification through nutrition education. Body composition, dietary habit scores, serum lipid profiles, daily nutrient intakes and the quality of life were assessed at the beginning and at the end of the program. Average age of subjects and height were 20.8 years and 161.9 cm, respectively. After 8 weeks, there were significant reductions in body weight, body fat mass, percent body fat, waist-hip ratio and BMI. The dietary habit score such as a balanced diet, regularity of mealtime, overeating, eating while watching TV or using the computer and eating salty food were increased significantly. Serum lipid levels such as total cholesterol level, LDL-cholesterol level and triglyceride level were decreased but not significantly. There were decreases in intake of energy, protein and fat and increases in intakes of dietary fiber, folic acid, calcium and potassium from the beginning to the end of the program. There were significant improvements on subcomponents of quality of life; physical functioning, general-health and vitality. The limitation of this study was the fact that there was no control group, but an overall evaluation suggests the 8-week body weight control program consisting of diet therapy, exercise and behavioral modification with supplementation of sea tangle would be helpful to improve the body composition, dietary habits, daily nutrient intakes and quality of life in Korean female college students.

  16. Results of vacuum assisted wound closure application.

    Science.gov (United States)

    Atay, Tolga; Burc, Halil; Baykal, Yakup Barbaros; Kirdemir, Vecihi

    2013-08-01

    In recent past, various methods have been used for wound treatment purpose. In this study, we aimed to compare our results established from the vacuum-assisted wound closure method, which has gained popularity day by day, with the literature. A total of 48 patients, who received vacuum-assisted wound closure treatment in our clinic between 2007and 2010, were included in this study. Etiological distribution of the patients was as follows: 32 traumatic, 6 pressure sore, 9 diabetic, and 1 iliac disarticulation. All cases were evaluated in terms of age, gender, etiology, period of treatment, and size of the wound. In the patients studied, 42 were men (87.5 %) and 6 were women (12.5 %). Mean age of the patients was 39.6 years (11-61 years). All of our traumatic patients suffered from open fracture. After the vacuum-assisted wound closure application, wound size reduced by 28.8 %, while the mean area of the surface of the wound was 94.7 cm(2) (13.7-216.3 cm(2)) on average. After the wounds became ready for surgery, 15 of them were treated with split-thickness grafting, 9 of them were treated with secondary suture, 18 of them were treated with full-thickness grafting, and 6 of them were treated with flap. Average period of the application of vacuum-assisted wound closure was 11.6 days (7-15 days). Results of vacuum-assisted wound closure can be regarded as satisfactory when cases are selected properly. This system has three different effect mechanisms. Firstly, it increases local blood flow on the wound bed. Secondly, cell proliferation is triggered following the mechanic stress. Thirdly, vacuum removes the proteases from the environment which obstructs healing. Therefore, it is intended to prepare alive wound bed which is required for subsequent soft tissue reconstructions.

  17. DIADORIM: a Monte Carlo Program for liquid simulations including quantum mechanics and molecular mechanics (QM/MM) facilities: applications to liquid ethanol

    OpenAIRE

    Freitas,Luiz Carlos Gomide

    2009-01-01

    This paper presents a Metropolis Monte Carlo (MMC) computer program developed to simulate liquids and solutions including QM/MM facilities: the energy from intermolecular interactions is calculated with classical force field functions and the internal molecular energies are calculated using Quantum Chemistry methods. The following facilities were implemented: (i) the semiempirical MOPAC 6 quantum chemistry package was included as a subroutine of the main MMC simulation program; (ii) alternati...

  18. Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study

    OpenAIRE

    Madelene Larsson; Camilla Pettersson; Therése Skoog; Charli Eriksson

    2016-01-01

    Abstract Background Mental health problems among young women aged 16–24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone...

  19. Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency.

    Science.gov (United States)

    Mees, Soeren Torge; Palmes, Daniel; Mennigen, Rudolf; Senninger, Norbert; Haier, Joerg; Bruewer, Matthias

    2008-04-01

    Anastomotic insufficiency in patients with colorectal anastomosis is a major complication with high morbidity and mortality. Local treatment with transrectal lavage and drainage can be considered in patient without peritonitis. In order to prevent prolonged wound closure and secondary complications during conservative treatment we investigated the vacuum assisted closure (VAC) in this setting. Ten patients with anastomotic insufficiency after colorectal resections, who did not require transabdominal interventions, were treated with an Endo-vacuum assisted closure dressing (Group A; n = 5) or by transrectal lavage (Group B; n = 5). Time for wound healing, duration of hospitalization and pain assessment were compared in both groups. The Endo-vacuum assisted closure treatment was performed for a median time of 27 days without any vacuum assisted closure associated complications. Wound healing was significantly accelerated in Group A compared to Group B. Time in hospital was slightly shortened in patients with Endo-vacuum assisted closure. Pain assessment in both groups did not show any significant differences. Endo-vacuum assisted closure therapy is a novel approach that can be considered in diverted patients with failed colorectal anastomoses. Larger randomized trials that include complete cost-benefit analyses are needed to establish its role in this setting.

  20. Closure report for N Reactor

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

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

  1. 300 Area waste acid treatment system closure plan

    Energy Technology Data Exchange (ETDEWEB)

    LUKE, S.N.

    1999-05-17

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

  2. Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing.

    Science.gov (United States)

    Yoshimi, Kaku; Ueki, Jun; Seyama, Kuniaki; Takizawa, Makiko; Yamaguchi, Seiko; Kitahara, Eriko; Fukazawa, Shinji; Takahama, Yukiko; Ichikawa, Masako; Takahashi, Kazuhisa; Fukuchi, Yoshinosuke

    2012-06-01

    Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients' expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide "respiratory conditioning", a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization. Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation. In participants ages 68±7 years, the FEV(1)% predicted was 39.3±15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV(1)% predicted nor FEV(1)/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest. The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced.

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

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Management

    2007-09-01

    cover has been placed on unit U-3ax/bl (Corrective Action Unit 110) at the Area 3 RWMS. Monolayer-evapotranspirative closure cover designs for the U-3ah/at and U-3bh units are provided in this plan. The current-design closure cover thickness is 3 meters (10 feet). The final design cover will have an optimized cover thickness, which is expected to be less than 3 m (10 ft). Although waste operations at the Area 3 RWMS have ceased at the end of June 2006, disposal capacity is available for future disposals at the U-3ah/at and U-3bh units. The Area 3 RWMS is expected to start closure activities in fiscal year 2025, which include the development of final performance assessment and composite analysis documents, closure plan, closure cover design for construction, cover construction, and initiation of the post-closure care and monitoring activities. Current monitoring at the Area 3 RWMS includes monitoring the cover of the closed mixed waste unit U-3ax/bl as required by the Nevada Department of Environmental Protection, and others required under federal regulations and DOE orders. Monitoring data, collected via sensors and analysis of samples, are needed to evaluate radiation doses to the general public, for performance assessment maintenance, to demonstrate regulatory compliance, and to evaluate the actual performance of the RWMSs. Monitoring provides data to ensure the integrity and performance of waste disposal units. The monitoring program is designed to forewarn management and regulators of any failure and need for mitigating actions. The plan describes the program for monitoring direct radiation, air, vadose zone, biota, groundwater, meteorology, and subsidence. The requirements of post-closure cover maintenance and monitoring will be determined in the final closure plan.

  4. A project-based Mine Closure Model (MCM) for sustainable asset Life Cycle Management

    Energy Technology Data Exchange (ETDEWEB)

    A. Fourie; A.C. Brent [University of Pretoria, Pretoria (South Africa). Life Cycle Engineering, Department of Engineering and Technology Management

    2006-07-01

    Responsible Life Cycle Management (LCM) of mines has received much attention in the South African legislation. However, there is currently a mis-alignment between the mining industry and the various government authorities pertaining to the issue of mine closure or end-of-life management. The main reasons for this are unclear and unformulated approaches to rehabilitation with a subsequent legacy of unsuccessful mine closures that have wrongly been issued by the government from a sustainability perspective; this has posed an excessive economical burden for the mining industry. In this paper, a Mine Closure Model (MCM) based on project management principles, including risk management and concurrent engineering, is proposed to manage the closure process and assist the governing body with the effective evaluation of closures and the issuance of certificates. Mine closure or rehabilitation objectives can be achieved whilst managing the resources (of industry) optimally and aligning the closure process to meet the end requirements of stakeholder groups.

  5. Application of electron closures in extended MHD

    Science.gov (United States)

    Held, Eric; Adair, Brett; Taylor, Trevor

    2017-10-01

    Rigorous closure of the extended MHD equations in plasma fluid codes includes the effects of electron heat conduction along perturbed magnetic fields and contributions of the electron collisional friction and stress to the extended Ohms law. In this work we discuss application of a continuum numerical solution to the Chapman-Enskog-like electron drift kinetic equation using the NIMROD code. The implementation is a tightly-coupled fluid/kinetic system that carefully addresses time-centering in the advance of the fluid variables with their kinetically-computed closures. Comparisons of spatial accuracy, computational efficiency and required velocity space resolution are presented for applications involving growing magnetic islands in cylindrical and toroidal geometry. The reduction in parallel heat conduction due to particle trapping in toroidal geometry is emphasized. Work supported by DOE under Grant Nos. DE-FC02-08ER54973 and DE-FG02-04ER54746.

  6. 32 CFR Appendix B to Part 80 - Procedures for Special Educational Programs (Including Related Services) for Preschool Children...

    Science.gov (United States)

    2010-07-01

    ... (Including Related Services) for Preschool Children and Children With Disabilities (3-21 years Inclusive) B... Related Services) for Preschool Children and Children With Disabilities (3-21 years Inclusive) A... of a parent of each preschool child or child, evaluate all preschool children or children who are...

  7. RCRA closure of mixed waste impoundments

    Energy Technology Data Exchange (ETDEWEB)

    Blaha, F.J. [Doty and Associates (United States); Greengard, T.C.; Arndt, M.B. [Rockwell International (United States)

    1989-11-01

    A case study of a RCRA closure action at the Rocky Flats Plant is presented. Closure of the solar evaporation ponds involves removal and immobilization of a mixed hazardous/radioactive sludge, treatment of impounded water, groundwater monitoring, plume delineation, and collection and treatment of contaminated groundwater. The site closure is described within the context of regulatory negotiations, project schedules, risk assessment, clean versus dirty closure, cleanup levels, and approval of closure plans and reports. Lessons learned at Rocky Flats are summarized.

  8. 20 CFR 664.410 - Must local programs include each of the ten program elements listed in WIA section 129(c)(2) as...

    Science.gov (United States)

    2010-04-01

    ... school completion, including dropout prevention strategies; (2) Alternative secondary school offerings... 664.470; (5) Occupational skill training; (6) Leadership development opportunities, which include... individual service strategy. (WIA sec. 129(c)(2).) ...

  9. Stabilization of in-tank residual wastes and external tank soil contamination for the Hanford tank closure program: application to the AX tank farm

    Energy Technology Data Exchange (ETDEWEB)

    SONNICHSEN, J.C.

    1998-10-12

    Mixed high-level waste is currently stored in underground tanks at the US Department of Energy's (DOE's) Hanford Site. The plan is to retrieve the waste, process the water, and dispose of the waste in a manner that will provide less long-term health risk. The AX Tank Farm has been identified for purposes of demonstration. Not all the waste can be retrieved from the tanks and some waste has leaked from these tanks into the underlying soil. Retrieval of this waste could result in additional leakage. During FY1998, the Sandia National Laboratory was under contract to evaluate concepts for immobilizing the residual waste remaining in tanks and mitigating the migration of contaminants that exist in the soil column. Specifically, the scope of this evaluation included: development of a layered tank fill design for reducing water infiltration; development of in-tank getter technology; mitigation of soil contamination through grouting; sequestering of specific radionuclides in soil; and geochemical and hydrologic modeling of waste-water-soil interactions. A copy of the final report prepared by Sandia National Laboratory is attached.

  10. Appraisal and analysis of opportunities for a joint DOE/DOD energy demonstration program. Final report. [Includes possible site information

    Energy Technology Data Exchange (ETDEWEB)

    Ziem, R.W.

    1980-05-01

    The basic objective of this study was to assess the potential for cooperative projects between the Department of Energy (DOE) and the Department of Defense (DOD) in areas concerned with the development of Total Energy (TE) Systems and to do the groundwork and liaison necessary to initiate those projects. The scope of the potential joint projects includes cooperative effort in the development and test of a variety of heat engines (prime movers) capable of utilizing coal as well as synthetic liquid fuels derived from coal and oil shale; as well as the indication of potential Military Department sites which would be suitable for the demonstration of TE systems based on a variety of such prime movers. In order to accomplish the objective of the study, it was necessary to review a large number of DOD studies and plans and to discuss the objective of the TETAS studies with a large number of Military Department people. The DOD recognizes the requirement for an assured energy supply and the need to learn how to use the synthetic fuels from coal and shale being developed by the DOE. The need to modify engine systems to adapt them to differing fuel characteristics and make those engines more flexible relative to the range of fuels they will accept is clear. What is not so clear is the fact that the DOD has a much greater opportunity to conserve energy in now inefficient facility operations than it has in mobility operations which must continue to stress mission and high performance. This report indicates guidelines for the conduct of joint projects between the DOE and the DOD which can aid both in meeting their energy objective.

  11. Thoracoscopic ASD closure is a reliable supplement for percutaneous treatment.

    Science.gov (United States)

    Casselman, F P; Dom, H; De Bruyne, B; Vermeulen, Y; Vanermen, H

    2005-06-01

    To determine the feasibility and effectiveness of endoscopic atrial septal defect (ASD) closure when percutaneous ASD closure is impossible or has failed. Between March 1997 and February 2003, 74 patients (63% female, mean (SD) age 44 (16) years) underwent an endoscopic ASD closure. Median preoperative New York Heart Association functional class was I. Clinical and echocardiographic follow up was obtained for all patients (mean (SD) 38 (19) months). Patients were assessed for scar aesthetics, procedure related pain, functional recovery, and overall patient satisfaction. ASD closure was successful in all patients (two primum ASD, 68 secundum ASD, four sinus venosus type). Patch repair was performed in 42%. Mean aortic cross clamp and cardiopulmonary bypass times were 54 (24) minutes and 98 (35) minutes, respectively. There were no in-hospital deaths and no conversions to sternotomy. Complications included one iliac vein stenting, one femoral arterioplasty, two revisions for suspected bleeding, and seven cases of atrial fibrillation. Two patients required late reoperation: one for atrial thrombus and another for tricuspid regurgitation. Echocardiographic control confirmed complete ASD closure in 71 patients and a small residual shunt in three patients. Ninety three per cent of the patients were highly satisfied with very low procedure related pain and 97% felt they had an aesthetically pleasing scar. Endoscopic ASD closure can be safely done with a high degree of patient satisfaction. It is now the authors' exclusive surgical approach whenever percutaneous treatment is not indicated or has failed.

  12. Transcutaneous closure of chronic broncho-pleuro-cutaneous fistula by duct occluder device

    Directory of Open Access Journals (Sweden)

    Vikas Marwah

    2016-01-01

    Full Text Available Bronchopleural fistula (BPF is a well known complication of several pulmonary conditions posing challenging management problem and is often associated with high morbidity and mortality. Though no consensus exists on a definite closure management algorithm, strategies for closure widely include various methods like tube thoracostomy with suction, open surgical closure, bronchoscopy directed glue, coiling and sealants which now also includes use of occlusion devices. We report a case in which a novel method of delivery and closure of recurrent post-operative broncho-pleuro-cutaneous fistula by a duct occluder device was done transcutaneously which has not been previously described in literature.

  13. International Programs and Centers for Instruction, Research and Public Service in the Western States (Including Instruction in Less Common Foreign Languages).

    Science.gov (United States)

    Abbott, Frank C., Ed.

    Programs of education and research on international economy and trade, foreign cultures and languages, and other aspects of international affairs and located in the western states are listed in an annotated directory. The units are of varying types and include informal interdepartmental committees within academic institutions, well-established…

  14. [Endoscopic vacuum-assisted closure].

    Science.gov (United States)

    Wedemeyer, J; Lankisch, T

    2013-03-01

    Anastomotic leakage in the upper and lower intestinal tract is associated with high morbidity and mortality. Within the last 10 years endoscopic treatment options have been accepted as sufficient treatment option of these surgical complications. Endoscopic vacuum assisted closure (E-VAC) is a new innovative endoscopic therapeutic option in this field. E-VAC transfers the positive effects of vacuum assisted closure (VAC) on infected cutaneous wounds to infected cavities that can only be reached endoscopically. A sponge connected to a drainage tube is endoscopically placed in the leakage and a continuous vacuum is applied. Sponge and vacuum allow removal of infected fluids and promote granulation of the leakage. This results in clean wound grounds and finally allows wound closure. Meanwhile the method was also successfully used in the treatment of necrotic pancreatitis.

  15. DOD Base Realignment and Closure. Part 3 (BRAC 93). Department of the Air Force, FY 1997 Budget Estimates Submission. Justification Data Submitted to OSD: March 1996.

    Science.gov (United States)

    1996-03-01

    this objective. Those requirements generated by the 1993 Base Closure Commission changes to previous Base Closure Commission recommendations are...Program Manangement Base Closure Account requirement: $18.2 Million Funding is for one time implementation costs which are not categorized by

  16. Outcome of colostomy closure with different skin closure techniques ...

    African Journals Online (AJOL)

    Background: Colostomy site, which is a potentially contaminated wound, is traditionally closed with interrupted skin stitches and placement of intraperitoneal or parietal or both drains; often with poor cosmetic outcome in our country. This study aims at prospective evaluation of colostomy closure wounds by different ...

  17. TOPOGRAPHIC CHANGES OF THE MACULA AFTER CLOSURE OF IDIOPATHIC MACULAR HOLE.

    Science.gov (United States)

    Pak, Kang Yeun; Park, Keun Heung; Kim, Kyong Ho; Park, Sung Who; Byon, Ik Soo; Kim, Hyun Woong; Chung, In Young; Lee, Joo Eun; Lee, Sang Joon; Lee, Ji Eun

    2017-04-01

    To investigate retinal displacement in the macula after surgical closure of idiopathic macular hole and to identify factors correlated with displacement. This retrospective multicenter study included 73 eyes of 73 patients having idiopathic macular hole. A custom program was developed to compare the position of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of a 6 mm × 6 mm optical coherence tomography volume scans were registered to calculate the scale. A grid comprising 16 sectors in 2 rings (inner; 2-4 mm and outer; 4-6 mm) was superimposed. The displacement of the retinal vessels was measured as a vector value by comparing the location of the retinal vessels in each sector. The correlation between displacement and various clinical parameters was analyzed. The average displacement was 57.2 μm at an angle of -3.3° (nasal and slightly inferior). Displacement was larger in the inner ring (79.2 μm) than in the outer ring (35.3 μm, P macula was displaced centripetally, nasally, and slightly inferiorly after surgical closure of idiopathic macular hole. Hole closure, contraction of the nerve fiber layer, and gravity are the suggested mechanisms of macular displacement caused by internal limiting membrane peeling.

  18. Prevention of diabetes in overweight/obese children through a family based intervention program including supervised exercise (PREDIKID project): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Arenaza, Lide; Medrano, María; Amasene, María; Rodríguez-Vigil, Beatriz; Díez, Ignacio; Graña, Manuel; Tobalina, Ignacio; Maiz, Edurne; Arteche, Edurne; Larrarte, Eider; Huybrechts, Inge; Davis, Catherine L; Ruiz, Jonatan R; Ortega, Francisco B; Margareto, Javier; Labayen, Idoia

    2017-08-10

    The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise. A total of 84 children, aged 8-12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry). Prevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity. ClinicalTrials.gov, ID: NCT03027726 . Registered on 16 January 2017.

  19. Moment Closure for the Stochastic Logistic Model

    National Research Council Canada - National Science Library

    Singh, Abhyudai; Hespanha, Joao P

    2006-01-01

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

  20. Telephone switchboard closure | 19 December

    CERN Multimedia

    2014-01-01

    Exceptionally, the telephone switchboard will close at 4 p.m. on Friday, 19 December, instead of the usual time of 6 p.m., to allow time for closing all systems properly before the annual closure. Therefore, switchboard operator assistance to transfer calls from/to external lines will stop. All other phone services will run as usual.

  1. An improvised wound closure system

    NARCIS (Netherlands)

    Lapid, Oren

    2006-01-01

    BACKGROUND: Skin stretching harnesses the same viscoelastic properties of the skin as expansion, with the difference that the forces are applied externally and not internally. An improvised system for wound closure is presented. METHOD: The system is assembled using silicone vascular loops used as

  2. Vacuum assisted closure in coloproctology

    NARCIS (Netherlands)

    Bemelman, W.A.

    2009-01-01

    Vacuum-assisted closure has earned its indications in coloproctology. It has been described with variable results in the treatment of large perineal defects after abdominoperineal excision, in the treatment of stoma dehiscence and perirectal abscesses. The most promising indication for

  3. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF

    2015-12-01

    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  4. Is there a need to include HIV, HBV and HCV viruses in the Saudi premarital screening program on the basis of their prevalence and transmission risk factors?

    Science.gov (United States)

    Alswaidi, F M; O'Brien, S J

    2010-11-01

    In January 2008, the Saudi Arabian health authority included mandatory testing for HIV, HBV and HCV viruses in the premarital screening program. Epidemiologically, there were few justifications for their inclusion as disease prevalences and distributions are poorly understood in the population. This study aims to provide information about HBV, HCV and HIV prevalences and risk factors for disease transmission and so produce evidence for informed decision-making on the inclusion of these infectious diseases in the screening program. This is a cross-sectional descriptive study embedded in the existing national premarital screening program for thalassaemia and sickle cell disease to estimate the prevalence of HIV, HBV and HCV infections (n=74,662 individuals), followed by a case-control study to identify risk factors responsible for infection transmission (n=540). The average HIV prevalence is 0.03%, 1.31% for HBV and 0.33% for HCV. Sharing personal belongings particularly razors, blood transfusions, cuts at barbershops and extramarital relationships showed the highest significant associations with the transmission of these viruses. The prevalences of HIV, HBV and HCV in Saudi Arabia are among the lowest worldwide. However, all the important risk factors associated with transmitting these viruses are significantly present in the Saudi community. Saudi Arabia is financially capable of screening for these infections in the mandatory premarital program and of providing medical care for the discovered cases, but focusing on the health education programs may offset the need to mandatory testing.

  5. 100-N Area underground storage tank closures

    Energy Technology Data Exchange (ETDEWEB)

    Rowley, C.A.

    1993-08-01

    This report describes the removal/characterization actions concerning underground storage tanks (UST) at the 100-N Area. Included are 105-N-LFT, 182-N-1-DT, 182-N-2-DT, 182-N-3-DT, 100-N-SS-27, and 100-N-SS-28. The text of this report gives a summary of remedial activities. In addition, correspondence relating to UST closures can be found in Appendix B. Appendix C contains copies of Unusual Occurrence Reports, and validated sampling data results comprise Appendix D.

  6. New skin closure system facilitates wound healing after cardiovascular implantable electronic device surgery.

    Science.gov (United States)

    De Maria, Elia

    2015-08-16

    The manuscript describes the efficacy of a new skin closure system (ZipLine™) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healing is difficult with traditional methods and in patients at high risk for surgical site infections (SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.

  7. Dynamic Iris Changes as a Risk Factor in Primary Angle Closure Disease.

    Science.gov (United States)

    Zhang, Ye; Li, Si Zhen; Li, Lei; He, Ming Guang; Thomas, Ravi; Wang, Ning Li

    2016-01-01

    We studied the association between dynamic iris changes and the spectrum of primary angle closure disease (PACD), using the anterior segment optical coherence tomography (ASOCT). Eligible primary angle closure (PAC), primary angle closure glaucoma (PACG), age, and sex comparable primary angle closure suspects (PACS) and normal subjects from the 5-year follow-up of the Handan Eye Study underwent ASOCT testing in dark and light conditions. The right eye of each subject was analyzed and biometric parameters including iris cross-sectional area (IA), lens vault (LV), pupil diameter (PD), and centroid-to-centroid distance (CCD) were calculated using the Zhongshan Angle Assessment Program. Totals of 31 PACS, 31 PAC/PACG, and 31 normal eyes were eligible for analysis. Loss of IA per mm PD increase in the dark compared to light was 0.18 mm in PACS, 0.13 mm in PAC/PACG, and 0.24 mm in normal (P = 0.015 between groups) groups. Diagnoses of normal (P = 0.001) and a smaller PD in light (P = 0.003) were statistically significant determinants of a larger IA loss per mm PD increase in the dark compared to light. Logistic regression analysis showed that LV (P = 0.002) and IA loss per mm PD increase (P = 0.017) were risk factors for an occludable angle. Significant differences in iris behavior in the dark compared to light in PACS, PACD, and normal eyes add to the evidence that dynamic iris change has a role in the pathogenesis of PAC in a rural Chinese population.

  8. 27 CFR 27.62 - Affixing closures.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY LIQUORS IMPORTATION OF DISTILLED SPIRITS, WINES, AND BEER General Requirements Closures for Containers of Distilled Spirits § 27.62 Affixing closures. Closures or other devices on containers of imported distilled spirits having a capacity of 1 gallon (3.785 liters) or less shall be...

  9. The impact of rolling theatre closures on core urology training.

    Science.gov (United States)

    Good, D W; Khan, N; Kiely, E; Brady, C

    2013-05-01

    Since 2008, government funding of the Health Service Executive (HSE) has decreased significantly. Our hospital, Cork University Hospital (CUH), implemented "cost saving" measures including scheduled operating theatre closures. We studied their affect on urological surgical activity at the hospital. A retrospective review was performed using theatre log books and theatre records to determine the number, type and training status of procedures performed for years 2009 and 2011. Scheduled theatre closures in 2011 resulted in 33 more theatre session cancelations compared to 2009. There was a reduction in the total number of procedures performed from 555 cases in 2009 to 443 in 2011 a 20.2(%) reduction. The number of "training" cases reduced from 325 (58.9%) in 2009 to 216 (48.7%) in 2011 a 10.2% reduction (Table 2). Eight out of the nine "core urology training" procedures reduced in number from 2009 to 2011 (Table 1). We have shown that scheduled theatre closures have reduced the number of procedures performed and have impacted on urology training. Scheduled theatre closures are expected to become more frequent in the future. Potential solutions to lessen the impact include providing simulation training using the Royal College of Surgeons in Ireland (RCSI) mobile skills unit during these theatre closures.

  10. Design, production and initial state of the closure

    Energy Technology Data Exchange (ETDEWEB)

    2010-12-15

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

  11. A water-based training program that include perturbation exercises to improve stepping responses in older adults: study protocol for a randomized controlled cross-over trial

    Directory of Open Access Journals (Sweden)

    Tsedek Irit

    2008-08-01

    Full Text Available Abstract Background Gait and balance impairments may increase the risk of falls, the leading cause of accidental death in the elderly population. Fall-related injuries constitute a serious public health problem associated with high costs for society as well as human suffering. A rapid step is the most important protective postural strategy, acting to recover equilibrium and prevent a fall from initiating. It can arise from large perturbations, but also frequently as a consequence of volitional movements. We propose to use a novel water-based training program which includes specific perturbation exercises that will target the stepping responses that could potentially have a profound effect in reducing risk of falling. We describe the water-based balance training program and a study protocol to evaluate its efficacy (Trial registration number #NCT00708136. Methods/Design The proposed water-based training program involves use of unpredictable, multi-directional perturbations in a group setting to evoke compensatory and volitional stepping responses. Perturbations are made by pushing slightly the subjects and by water turbulence, in 24 training sessions conducted over 12 weeks. Concurrent cognitive tasks during movement tasks are included. Principles of physical training and exercise including awareness, continuity, motivation, overload, periodicity, progression and specificity were used in the development of this novel program. Specific goals are to increase the speed of stepping responses and improve the postural control mechanism and physical functioning. A prospective, randomized, cross-over trial with concealed allocation, assessor blinding and intention-to-treat analysis will be performed to evaluate the efficacy of the water-based training program. A total of 36 community-dwelling adults (age 65–88 with no recent history of instability or falling will be assigned to either the perturbation-based training or a control group (no training

  12. Association of iris crypts with acute primary angle closure.

    Science.gov (United States)

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

    2017-10-01

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

  13. Closure Plan for Active Low Level Burial Grounds

    Energy Technology Data Exchange (ETDEWEB)

    SKELLY, W.A.

    2000-11-16

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

  14. Beginning Swift programming

    CERN Document Server

    Lee, Wei-Meng

    2014-01-01

    Enter the Swift future of iOS and OS X programming Beginning Swift Programming is your ideal starting point for creating Mac, iPhone, and iPad apps using Apple's new Swift programming language. Written by an experienced Apple developer and trainer, this comprehensive guide explains everything you need to know to jumpstart the creation of your app idea. Coverage includes data types, strings and characters, operators and functions, arrays and dictionaries, control flow, and looping, with expert guidance on classes, objects, class inheritance, closures, protocols, and generics. This succinct - ye

  15. Tonopah Test Range Post-Closure Inspection Annual Report, Tonopah Test Range, Nevada, Calendar Year 2002

    Energy Technology Data Exchange (ETDEWEB)

    R. B. Jackson

    2003-08-01

    This Post-Closure Inspection Annual Report provides documentation of the semiannual inspections conducted at the following Corrective Action Units (CAU)s: CAU 400: Bomblet Pit and Five Points Landfill; CAU 404: Roller Coaster Lagoons and Trench; CAU 407: Roller Coaster RadSafe Area; CAU 424: Area 3 Landfill Complexes; CAU 426: Cactus Spring Waste Trenches; CAU 427: Septic Waste Systems 2, 6; and CAU 453: Area 9 UXO Landfill, all located at the Tonopah Test Range, Nevada. Post-closure inspections are not required at CAU 400 but are conducted to monitor vegetation and fencing at the site. Site inspections were conducted in May and November 2002. All site inspections were made after Nevada Division of Environmental Protection (NDEP) approval of the appropriate Closure Report (CR), excluding CAU 400 which did not require a CR, and were conducted in accordance with the Post-Closure Inspection Plans in the NDEP-approved CRs. Post-closure inspections conducted during 2002 identified several areas requiring maintenance/repairs. Maintenance work and proposed additional monitoring are included in the appropriate section for each CAU. This report includes copies of the Post-Closure Inspection Plans, Post-Closure Inspection Checklists, copies of the field notes, photographs, and the Post-Closure Vegetative Monitoring Report. The Post-Closure Inspection Plan for each CAU is located in Attachment A. Post-Closure Inspection Checklists are in Attachment B. Copies of the field notes from each inspection are included in Attachment C. Attachment D consists of the photographic logs and photographs of the sites. The post-closure vegetative monitoring report for calendar year 2002 is included in Attachment E.

  16. 34 CFR 303.15 - Include; including.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH...

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

    Directory of Open Access Journals (Sweden)

    R. W. Knackstedt

    2015-01-01

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

  18. Closure Plan for the Area 5 Radioactive Waste Management Site at the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Management

    2008-09-01

    The Area 5 Radioactive Waste Management Site (RMWS) at the Nevada Test Site (NTS) is managed and operated by National Security Technologies, LLC (NSTec), for the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO). This document is the first update of the preliminary closure plan for the Area 5 RWMS at the NTS that was presented in the Integrated Closure and Monitoring Plan (DOE, 2005a). The major updates to the plan include a new closure schedule, updated closure inventory, updated site and facility characterization data, the Title II engineering cover design, and the closure process for the 92-Acre Area of the RWMS. The format and content of this site-specific plan follows the Format and Content Guide for U.S. Department of Energy Low-Level Waste Disposal Facility Closure Plans (DOE, 1999a). This interim closure plan meets closure and post-closure monitoring requirements of the order DOE O 435.1, manual DOE M 435.1-1, Title 40 Code of Federal Regulations (CFR) Part 191, 40 CFR 265, Nevada Administrative Code (NAC) 444.743, and Resource Conservation and Recovery Act (RCRA) requirements as incorporated into NAC 444.8632. The Area 5 RWMS accepts primarily packaged low-level waste (LLW), low-level mixed waste (LLMW), and asbestiform low-level waste (ALLW) for disposal in excavated disposal cells.

  19. Closure report for housekeeping category, Corrective Action Unit 344, Nevada Test Site. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    This Closure Report summarizes the corrective actions which were completed at the Corrective Action Sites within Corrective Action Unit 344 at the Nevada Test Site. Current site descriptions, observations and identification of wastes removed are included on FFACO Corrective Action Site housekeeping closure verification forms.

  20. The open abdomen: temporary closure with a modified negative pressure therapy technique

    DEFF Research Database (Denmark)

    Hougaard, Helene T.; Pedersen, Mark Ellebæk; Holst, U. T.

    2014-01-01

    of applying the system - the narrowing technique - over a 5-year period. Endpoints included fascial closure and 30-day mortality rates and presence of enteroatmospheric fistulas. Secondary closure of the fascia was obtained in 92% (106/115) of the patients with a mortality rate of 17% (20/115) and a fistula...

  1. Groups as Epistemic Providers: Need for Closure and the Unfolding of Group-Centrism

    Science.gov (United States)

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

    2006-01-01

    Theory and research are presented relating the need for cognitive closure to major facets of group behavior. It is suggested that a high need for closure, whether it is based on members' disposition or the situation, contributes to the emergence of a behavioral syndrome describable as group-centrism--a pattern that includes pressures to opinion…

  2. Cutaneous wound closure materials: An overview and update

    Directory of Open Access Journals (Sweden)

    Luluah Al-Mubarak

    2013-01-01

    Full Text Available Introduction: On a daily basis, dermasurgeons are faced with different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness can be difficult, if not tricky. Objectives: We aimed to review the available skin closure materials over the past 20 years and the scientific claims behind their effectiveness in repairing various kinds of wounds. Materials and Methods: The two authors independently searched and scrutinised the literature. The search was performed electronically using Pub Med, the Cochrane Database, Google Scholar and Ovid as search engines to find articles concerning skin closure materials written since 1990. Conclusion: Many factors are involved in the choice of skin closure material, including the type and place of the wound, available materials, physician expertise and preferences, and patient age and health. Evidence-based main uses of different skin closure materials are provided to help surgeons choose the appropriate material for different wounds.

  3. Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.

    Science.gov (United States)

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

    2013-10-15

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

  4. Low-level radioactive waste disposal facility closure

    Energy Technology Data Exchange (ETDEWEB)

    White, G.J.; Ferns, T.W.; Otis, M.D.; Marts, S.T.; DeHaan, M.S.; Schwaller, R.G.; White, G.J. (EG and G Idaho, Inc., Idaho Falls, ID (USA))

    1990-11-01

    Part I of this report describes and evaluates potential impacts associated with changes in environmental conditions on a low-level radioactive waste disposal site over a long period of time. Ecological processes are discussed and baselines are established consistent with their potential for causing a significant impact to low-level radioactive waste facility. A variety of factors that might disrupt or act on long-term predictions are evaluated including biological, chemical, and physical phenomena of both natural and anthropogenic origin. These factors are then applied to six existing, yet very different, low-level radioactive waste sites. A summary and recommendations for future site characterization and monitoring activities is given for application to potential and existing sites. Part II of this report contains guidance on the design and implementation of a performance monitoring program for low-level radioactive waste disposal facilities. A monitoring programs is described that will assess whether engineered barriers surrounding the waste are effectively isolating the waste and will continue to isolate the waste by remaining structurally stable. Monitoring techniques and instruments are discussed relative to their ability to measure (a) parameters directly related to water movement though engineered barriers, (b) parameters directly related to the structural stability of engineered barriers, and (c) parameters that characterize external or internal conditions that may cause physical changes leading to enhanced water movement or compromises in stability. Data interpretation leading to decisions concerning facility closure is discussed. 120 refs., 12 figs., 17 tabs.

  5. INTEC CPP-603 Basin Water Treatment System Closure: Process Design

    Energy Technology Data Exchange (ETDEWEB)

    Kimmitt, Raymond Rodney; Faultersack, Wendell Gale; Foster, Jonathan Kay; Berry, Stephen Michael

    2002-09-01

    This document describes the engineering activities that have been completed in support of the closure plan for the Idaho Nuclear Technology and Engineering Center (INTEC) CPP-603 Basin Water Treatment System. This effort includes detailed assessments of methods and equipment for performing work in four areas: 1. A cold (nonradioactive) mockup system for testing equipment and procedures for vessel cleanout and vessel demolition. 2. Cleanout of process vessels to meet standards identified in the closure plan. 3. Dismantlement and removal of vessels, should it not be possible to clean them to required standards in the closure plan. 4. Cleanout or removal of pipelines and pumps associated with the CPP-603 basin water treatment system. Cleanout standards for the pipes will be the same as those used for the process vessels.

  6. Effect of Orofacial Myofunctional Exercise Using an Oral Rehabilitation Tool on Labial Closure Strength, Tongue Elevation Strength and Skin Elasticity

    National Research Council Canada - National Science Library

    Ibrahim, Fatimah; Arifin, Nooranida; Rahim, Zubaidah H A

    2013-01-01

    [Purpose] This paper reports the effects of orofacial myofunctional exercise using an oral cavity rehabilitation device on physiological parameters that include labial closure strength, tongue elevation...

  7. Closure development for high-level nuclear waste containers for the tuff repository; Phase 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    Robitz, E.S. Jr.; McAninch, M.D. Jr.; Edmonds, D.P. [Babcock and Wilcox Co., Lynchburg, VA (USA). Nuclear Power Div.]|[Babcock and Wilcox Co., Alliance, OH (USA). Research and Development Div.

    1990-09-01

    This report summarizes Phase 1 activities for closure development of the high-level nuclear waste package task for the tuff repository. Work was conducted under U.S. Department of Energy (DOE) Contract 9172105, administered through the Lawrence Livermore National Laboratory (LLNL), as part of the Yucca Mountain Project (YMP), funded through the DOE Office of Civilian Radioactive Waste Management (OCRWM). The goal of this phase was to select five closure processes for further evaluation in later phases of the program. A decision tree methodology was utilized to perform an objective evaluation of 15 potential closure processes. Information was gathered via a literature survey, industrial contacts, and discussions with project team members, other experts in the field, and the LLNL waste package task staff. The five processes selected were friction welding, electron beam welding, laser beam welding, gas tungsten arc welding, and plasma arc welding. These are felt to represent the best combination of weldment material properties and process performance in a remote, radioactive environment. Conceptual designs have been generated for these processes to illustrate how they would be implemented in practice. Homopolar resistance welding was included in the Phase 1 analysis, and developments in this process will be monitored via literature in Phases 2 and 3. Work was conducted in accordance with the YMP Quality Assurance Program. 223 refs., 20 figs., 9 tabs.

  8. [Feasibility of device closure for multiple atrial septal defects using 3D printing and ultrasound-guided intervention technique].

    Science.gov (United States)

    Qiu, X; Lü, B; Xu, N; Yan, C W; Ouyang, W B; Liu, Y; Zhang, F W; Yue, Z Q; Pang, K J; Pan, X B

    2017-04-25

    Objective: To investigate the feasibility of trans-catheter closure of multiple atrial septal defects (ASD) monitored by trans-thoracic echocardiography (TTE) under the guidance of 3D printing heart model. Methods: Between April and August 2016, a total of 21 patients (8 male and 13 female) with multiple ASD in Fuwai Hospital of Chinese Academy of Medical Sciences underwent CT scan and 3-dimensional echocardiography for heart disease model produced by 3D printing technique. The best occlusion program was determined through the simulation test on the model. Percutaneous device closure of multiple ASD was performed follow the predetermined program guided by TTE. Clinical follow-up including electrocardiogram and TTE was arranged at 1 month after the procedure. Results: The trans-catheter procedure was successful in all 21 patients using a single atrial septal occluder. Mild residual shunt was found in 5 patient in the immediate postoperative period, 3 of them were disappeared during postoperative follow-up. There was no death, vascular damage, arrhythmia, device migration, thromboembolism, valvular dysfunction during the follow-up period. Conclusion: The use of 3D printing heart model provides a useful reference for transcatheter device closure of multiple ASD achieving through ultrasound-guided intervention technique, which appears to be safe and feasible with good outcomes of short-term follow-up.

  9. Proposed modifications to the RCRA post-closure permit for the Bear Creek Hydrogeologic Regime at the US Department of Energy Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

    This report presents proposed modifications to several conditions of the Resource Conservation and Recovery Act (RCRA) Post-Closure Permit (PCP) for the Bear Creek Hydrogeologic Regime (BCHR). These permit conditions define the requirements for RCRA post-closure corrective action groundwater monitoring at the S-3 Ponds, the Oil Landfarm, and the Bear Creek Burial Grounds (units A, C-West, and Walk-in Pits). Modification of these PCP conditions is requested to: (1) clarify the planned integration of RCRA post-closure corrective action groundwater monitoring with the monitoring program to be established in the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for the Bear Creek Valley (BCV) Watershed, (2) revise several of the current technical requirements for groundwater monitoring based on implementation of the RCRA post-closure corrective action monitoring program during 1996, and (3) update applicable technical procedures with revised versions recently issued by the Y-12 Plant Groundwater Protection Program (GWPP). With these modifications, the Y-12 Plant will continue to meet the full intent of all regulatory obligations for post-closure care of these facilities. Section 2.0 provides the technical justification for each proposed permit modification. The proposed changes to permit language are provided in Section 3.0 (S-3 Ponds), Section 4.0 (Oil Landfarm), and Section 5.0 (Bear Creek Burial Grounds). Sections 6.0 and 7.0 reference updated and revised procedures for groundwater sampling, and monitoring well plugging and abandonment, respectively. Appendix A includes all proposed revisions to the PCP Attachments.

  10. Comparison of surgical techniques for stoma closure: A retrospective study of purse-string skin closure versus conventional skin closure following ileostomy and colostomy reversal

    Science.gov (United States)

    WADA, YUMA; MIYOSHI, NORIKATSU; OHUE, MASAYUKI; NOURA, SHINGO; FUJINO, SHIKI; SUGIMURA, KEIJIROU; AKITA, HIROFUMI; MOTOORI, MASAAKI; GOTOH, KUNIHITO; TAKAHASHI, HIDENORI; KOBAYASHI, SHOGO; OHMORI, TAKESHI; FUJIWARA, YOSHIYUKI; YANO, MASAHIKO

    2015-01-01

    The aim of this study was to compare the incidence of postoperative complications, including superficial incisional surgical site infection (SSI) following purse-string skin closure (PS) and conventional skin closure with a drainage tube (CD) following stoma closure. A total of 55 consecutive patients who underwent loop colostomy and loop ileostomy closures in our hospital between October, 2011 and September, 2014 were retrospectively assessed. The patients were divided into two groups, namely the PS group (26 patients) and the CD group (29 patients). There were no significant differences in the characteristics of the patients between the two groups. The baseline and operative characteristics also did not differ significantly between the two groups. However the incidence of superficial incisional SSI was lower in the PS group compared to that in the CD group (0 vs. 13.8%, respectively; P=0.049). The overall incidence of complications did not differ significantly between the two groups (P=0.313). The duration of postoperative hospital stay in the PS group was shorter compared to that in the CD group. In conclusion, the results of this study suggest that PS may an effective technique to reduce the incidence of superficial incisional SSI. This technique appears to be superior to the conventional technique, allowing for better cosmesis. PMID:26137277

  11. The Role of Counseling in an Associate Degree in Labor Studies Program: Counseling in a Work Oriented Setting (The Importance of Including Counseling Courses within the Curriculum of the Associate Degree in Labor Studies Program at the Community College Level).

    Science.gov (United States)

    Kingery, Bruce

    This research had a two-fold purpose: (1) to assess the need for a labor studies program at the community college level; and (2) to consider the advisability of including within such a curriculum a cross-section of adult/family/worker-oriented counseling and guidance courses. The study employed a questionnaire completed by union delegates, which…

  12. Preparing a base realignment and closure cleanup plan

    Energy Technology Data Exchange (ETDEWEB)

    Diecidue, A.M.; Bandrowsky, M.; Wooldridge, P. [PRC Environmental Management, Inc., McLean, VA (United States)

    1994-12-31

    Every Department of Defense (DoD) installation subject to closure or realignment is evaluating and implementing strategies for environmental response actions to facilitate the transfer of real property at the installation. The closure and realignment process is conducted pursuant to the Base Closure and Realignment Act of 1988 (Public Law 100-526, 102 Stat. 2623) (BRAC 88) or the Defense Base Closure and Realignment Act of 1990 (Public Law 101-510, 104 Stat. 1808) (BRAC 91, 93, and 95). On July 2, 1993, the President announced a five-part program to speed the economic recovery of communities where military bases are slated to close. DoD subsequently issued a policy memorandum on September 9, 1993 that provides guidance on implementing ``fast-track`` cleanup initiatives at those bases. The guidance introduces the use of BRAC cleanup teams (BCT) and the development of BRAC cleanup plans (BCP) as part of fast-track cleanup. The BCT is responsible for developing the BCP. The BCP serves as the road map for expeditious cleanup. This paper will focus on two areas: forming and working with the BCT and preparing the BCP. The paper will discuss the make-up of the BCT and how to build trust and achieve early consensus on the many issues to be addressed by the BCT. The paper also will discuss tips for forming the BCT and preparing the BCP based on the authors` experiences.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hommel, S.; Fountain, D.

    2012-03-28

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

  14. Evaluation of a multi-faceted diabetes care program including community-based peer educators in Takeo province, Cambodia, 2007-2013.

    Directory of Open Access Journals (Sweden)

    Dawn Taniguchi

    Full Text Available Early detection and treatment for diabetes are essential for reducing disability and death from the disease. Finding effective screening and treatment for individuals living with diabetes in resource-limited countries is a challenge. MoPoTsyo, a Cambodian non-governmental organization, addressed this gap by utilizing a multi-pronged approach with community-based peer educators, access to laboratory procedures, local outpatient medical consultation, and a revolving drug fund. This study evaluated outcomes of MoPoTsyo's diabetes program in Takeo Province by assessing glycemic and blood pressure outcomes for individuals diagnosed with diabetes over a 24-month follow-up period between 2007-2013.This is a retrospective cohort analysis of records without a comparison group. We calculated the mean fasting blood glucose (FBG and blood pressure (BP at regular intervals of follow-up. The proportion of patients reaching recommended treatment targets for FBG and BP was assessed.Of the 3411 patients enrolled in the program, 2230 were included in the study. The cohort was predominantly female (68.9% with a median age of 54 years. Median follow-up time in the program was 16 months (4.9-38.4 months. Mean FBG decreased 63.9 mg/dl in mean FBG (95% CI 58.5 to 69.3 at one year of follow-up (p<0.001. After one year, 45% (321/708 of patients achieved goal FBG < 126. Of the 41.6% (927/2230 with elevated BP at enrollment, systolic and diastolic BP levels significantly decreased (p<0.001 by 16.9 mmHg (95% CI 1.2 to 22.9 and 10 mm Hg (95% CI 0.7 to 12.9 respectively between enrollment and one year of follow-up. At one year of follow-up, 51.1%% (183/355 of these patients reached the BP goal < 140/90.The improved outcome indicators of diabetes care for MoPoTsyo's Takeo program evaluation showed promise. The program demonstrated a reasonable and practical approach to delivering effective diabetes care in a rural area and may serve as a model for other low-income communities

  15. Evaluation of a multi-faceted diabetes care program including community-based peer educators in Takeo province, Cambodia, 2007-2013.

    Science.gov (United States)

    Taniguchi, Dawn; LoGerfo, James; van Pelt, Maurits; Mielcarek, Bessie; Huster, Karin; Haider, Mahri; Thomas, Bernadette

    2017-01-01

    Early detection and treatment for diabetes are essential for reducing disability and death from the disease. Finding effective screening and treatment for individuals living with diabetes in resource-limited countries is a challenge. MoPoTsyo, a Cambodian non-governmental organization, addressed this gap by utilizing a multi-pronged approach with community-based peer educators, access to laboratory procedures, local outpatient medical consultation, and a revolving drug fund. This study evaluated outcomes of MoPoTsyo's diabetes program in Takeo Province by assessing glycemic and blood pressure outcomes for individuals diagnosed with diabetes over a 24-month follow-up period between 2007-2013. This is a retrospective cohort analysis of records without a comparison group. We calculated the mean fasting blood glucose (FBG) and blood pressure (BP) at regular intervals of follow-up. The proportion of patients reaching recommended treatment targets for FBG and BP was assessed. Of the 3411 patients enrolled in the program, 2230 were included in the study. The cohort was predominantly female (68.9%) with a median age of 54 years. Median follow-up time in the program was 16 months (4.9-38.4 months). Mean FBG decreased 63.9 mg/dl in mean FBG (95% CI 58.5 to 69.3) at one year of follow-up (p<0.001). After one year, 45% (321/708) of patients achieved goal FBG < 126. Of the 41.6% (927/2230) with elevated BP at enrollment, systolic and diastolic BP levels significantly decreased (p<0.001) by 16.9 mmHg (95% CI 1.2 to 22.9) and 10 mm Hg (95% CI 0.7 to 12.9) respectively between enrollment and one year of follow-up. At one year of follow-up, 51.1%% (183/355) of these patients reached the BP goal < 140/90. The improved outcome indicators of diabetes care for MoPoTsyo's Takeo program evaluation showed promise. The program demonstrated a reasonable and practical approach to delivering effective diabetes care in a rural area and may serve as a model for other low-income communities

  16. Limites e possibilidades dos programas de aceleração de aprendizagem The limits and possibilities of including students from remedial learning programs in regular schooling

    Directory of Open Access Journals (Sweden)

    Clarilza Prado de Sousa

    1999-11-01

    Full Text Available Pretendi neste trabalho analisar os limites e possibilidades da escola integrar alunos com atraso de escolaridade em processos de educação regular, que receberam apoio de programas de aceleração da aprendizagem. Baseada nas avaliações realizadas desses programas por professores do Programa de Estudos Pós-Graduados em Psicologia da Educação da PUCSP e por pesquisadores do Núcleo de Avaliação Educacional da Fundação Carlos Chagas, discuto os resultados efetivamente alcançados considerando duas categorias de análise. Na primeira categoria, analiso os efeitos da estratégia pedagógica promovida pelos programas, nas aprendizagens e progressos dos alunos participantes. Na segunda categoria, procuro analisar as possibilidades de integração/inclusão desses alunos no processo de educação regular. Finalmente, à guisa de conclusão, procuro fazer algumas considerações teórico-metodológicas. Distinguindo integração de inclusão, discuto os limites e possibilidades que as ações dos programas têm de realmente promoverem o desenvolvimento de uma escola sem exclusão.This article analyzes the limits and possibilities for schools to include students with schooling deficits who receive support from the accelerated learning programs, in their regular education processes. Based on evaluations of these programs done by professors from the Post Graduate Program in Educational Psychology of the Pontifical Catholic University of São Paulo and by researchers from the Nucleus for Educational Evaluation of the Carlos Chagas Foundation, the results will be discussed in two analytical categories. In the first category, I analyze the effects of the teaching strategies promoted by the programs on the learning and progress of the participating students. In the second category, I seek to analyze the possibilities for integration/inclusion of these students in the regular educational process. Finally by way of conclusion, I try to make some

  17. Morbidity after closure of a defunctioning loop ileostomy.

    Science.gov (United States)

    D'Haeninck, A; Wolthuis, A M; Penninckx, F; D'Hondt, M; D'Hoore, A

    2011-01-01

    A low pelvic anastomosis is associated with a substantial risk of leakage. A defunctioning stoma (DS) reduces the clinical anastomotic leak rate and the need for re-operation, but stoma closure has its own risk of morbidity and mortality. This study aims to audit morbidity and mortality after loop ileostomy (LI) closure. The medical records of 197 consecutive patients who underwent closure of a defunctioning LI between August 2003 and July 2008 were reviewed. Postoperative morbidity and mortality were recorded. Transverse closure of the enterotomy was performed in 149 patients (75.6%), segmental enterectomy with hand-sewn end-to-end anastomosis in 26 (13.2%) and stapled side-to-side anastomosis in 22 (11.2%). Overall postoperative morbidity and mortality were 32.0% and 0.5%, respectively. The surgical complication rate was 30.5%, including prolonged ileus (11.2%), small bowel obstruction (4.1%), anastomotic leak (3.0%) and wound infection (4.6%). Surgical complications were more frequent in male patients (p = 0.005). Prolonged ileus was more frequent when the interval to stoma reversal exceeded 12 weeks (14.3% versus 3.5% ; p = 0.02). The incidence of complications was not influenced by the closure technique. Nineteen patients (9.6%) required re-operation for anastomotic leak (n = 8), wound infection (n = 1), small bowel obstruction (n = 3) and incisional herniation (n = 7). LI closure is associated with clinically relevant morbidity and mortality. This association should be taken into account in the context of a routine DS policy and should be part of the patient's information.

  18. Benefits of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise on albuminuria in diabetic and non-diabetic Japanese populations.

    Science.gov (United States)

    Yamamoto-Kabasawa, Keiko; Hosojima, Michihiro; Yata, Yusuke; Saito, Mariko; Tanaka, Noriko; Tanaka, Junta; Tanabe, Naohito; Narita, Ichiei; Arakawa, Masaaki; Saito, Akihiko

    2015-12-01

    Albuminuria is a biomarker for chronic kidney disease and an independent predictor of cardiovascular and all-cause mortality. A recent meta-analysis concluded that these risks increase with urinary albumin concentration, even when below the microalbuminuria threshold. Thus, minimizing urinary albumin may be a valuable therapeutic goal regardless of disease status. We investigated the benefits and safety of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise for reducing albuminuria in 295 normoalbuminuric or microalbuminuric Japanese adults, including 30 with type 2 diabetes mellitus (T2DM), 104 with metabolic syndrome (MS), and 145 with hypertension (HT). In the study population, the urinary albumin:creatinine ratio (UACR) was reduced significantly (ΔUACR -3.8 ± 16.8 mg/g, P < 0.001) with no change in estimated glomerular filtration rate (eGFR) (ΔeGFR -0.4 ± 7.4 mL/min/1.73 m(2), P = 0.343). The reduction in UACR was associated with decreased fasting plasma glucose (P < 0.05). The UACR was also reduced in the T2DM, MS, and HT groups with no change in eGFR. Reduced UACR was associated with decreased fasting plasma glucose in the MS group and decreased systolic blood pressure in the HT group. The UACR was also reduced in 46 subjects using renin-angiotensin system inhibitors with no change in eGFR. Our 12-week lifestyle modification program reduced UACR, maintained eGFR, and improved multiple fitness findings in Japanese subjects including T2DM, MS, and HT patients.

  19. Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma

    Directory of Open Access Journals (Sweden)

    Kam JP

    2017-10-01

    Full Text Available Jason P Kam, Emily M Zepeda, Leona Ding, Joanne C Wen Department of Ophthalmology, University of Washington, Seattle, WA, USA Purpose: To investigate the power use and complication frequency of resident-performed laser peripheral iridotomy (LPI.Methods: A retrospective analysis of 196 eyes from 103 patients who underwent neodymium: yttrium-aluminum-garnet laser iridotomy performed by resident physicians from January 1, 2010 through April 30, 2015 at a university-based county hospital was done. All patients were treated for primary angle closure, primary angle closure suspects, and primary angle closure glaucoma. Data were collected on pre- and post-laser intraocular pressure (IOP, ethnicity, laser parameters and complications. Mean power use and frequency of complications were evaluated. Complications included elevated post-laser IOP at 30–45 minutes (≥8 mmHg, hyphema, aborted procedures, and lasering non-iris structures. The number of repeated LPI procedures, was also recorded.Results: Mean total power used for all residents was 78.2±68.7 mJ per eye. Power use by first-year trainees was significantly higher than second- and third-year trainees (103.5±75.5 mJ versus 73.7±73.8 mJ and 67.2±56.4 mJ, respectively, p=0.011. Complications included hyphema or microhyphema in 17.9% (35/196, IOP spikes in 5.1% (10/196, aborted procedures in 1.1% (3/196 and lasering non-iris structures in 0.5% (1/196. LPI was repeated in 22.4% of cases (44/196 with higher incidence of repeat LPI among non-Caucasian compared to the Caucasian subjects (p=0.02. Complication rates did not differ with increased training (p=0.16.Conclusion: Total power used for LPI decreased with increased resident training, while the complication rate did not differ significantly among resident classes. Complication rates were comparable to rates reported in the literature for attending-performed LPIs. Keywords: laser, iridotomy, resident, complications, power, energy

  20. Primary closure of equine laryngotomy incisions

    DEFF Research Database (Denmark)

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

    2016-01-01

    The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy...... after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane....

  1. FAR EAST TECHNICAL ASSISTANCE PROGRAMS OF U.S. NON-PROFIT ORGANIZATIONS (INCLUDING VOLUNTARY AGENCIES, MISSIONS, AND FOUNDATIONS), DIRECTORY - 1966.

    Science.gov (United States)

    BURGESS, MARY ELLEN, ED.

    PART 1 OF THIS PROGRAM GUIDE LISTS TECHNICAL ASSISTANCE AGENCIES AND OTHER ORGANIZATIONS FOR THE FAR EAST, TOGETHER WITH ADDRESSES, TELEPHONE NUMBERS, EXECUTIVE OFFICERS, PROGRAM DIRECTORS, COUNTRIES SERVED, AND ESTIMATED COSTS. PART 2 GIVES PROGRAM DATA (ORGANIZATIONS, OPERATING AND SUPPORT PROGRAMS, TYPES OF ASSISTANCE, REGIONAL REPRESENTATIVES,…

  2. Sustained eye closure slows saccades

    Science.gov (United States)

    Shaikh, Aasef G.; Wong, Aaron L.; Optican, Lance M.; Miura, Kenichiro; Solomon, David; Zee, David S.

    2010-01-01

    Saccadic eye movements rapidly orient the line of sight towards the object of interest. Pre-motor burst neurons (BNs) controlling saccades receive excitation from superior colliculus and cerebellum, but inhibition by omnipause neurons (OPNs) prevents saccades. When the OPNs pause, BNs begin to fire. It has been presumed that part of the BN burst comes from post-inhibitory rebound (PIR). We hypothesized that in the absence of prior inhibition from OPNs there would be no PIR, and thus the increase in initial firing rate of BNs would be reduced. Consequently, saccade acceleration would be reduced. We measured eye movements and showed that sustained eye closure, which inhibits the activity of OPNs and thus hypothetically should weaken PIR, reduced the peak velocity, acceleration, and deceleration of saccades in healthy human subjects. Saccades under closed eyelids also had irregular trajectories; the frequency of the oscillations underlying this irregularity was similar to that of high-frequency ocular flutter (back-to-back saccades) often seen in normal subjects during attempted fixation at straight ahead while eyes are closed. Saccades and quick phases of nystagmus are generated by the same pre-motor neurons, and we found that the quick-phase velocity of nystagmus was also reduced by lid closure. These changes were not due to a mechanical hindrance to the eyes, because lid closure did not affect the peak velocities or accelerations of the eyes in the “slow-phase” response to rapid head movements of comparable speeds to those of saccades. These results indicate a role for OPNs in generating the abrupt onset and high velocities of saccades. We hypothesize that the mechanism involved is PIR in pre-motor burst neurons. PMID:20573593

  3. Transiting Exoplanet Survey Satellite (TESS) Community Observer Program including the Science Enhancement Option Box (SEO Box) - 12 TB On-board Flash Memory for Serendipitous Science

    Science.gov (United States)

    Schingler, Robert; Villasenor, J. N.; Ricker, G. R.; Latham, D. W.; Vanderspek, R. K.; Ennico, K. A.; Lewis, B. S.; Bakos, G.; Brown, T. M.; Burgasser, A. J.; Charbonneau, D.; Clampin, M.; Deming, L. D.; Doty, J. P.; Dunham, E. W.; Elliot, J. L.; Holman, M. J.; Ida, S.; Jenkins, J. M.; Jernigan, J. G.; Kawai, N.; Laughlin, G. P.; Lissauer, J. J.; Martel, F.; Sasselov, D. D.; Seager, S.; Torres, G.; Udry, S.; Winn, J. N.; Worden, S. P.

    2010-01-01

    The Transiting Exoplanet Survey Satellite (TESS) will perform an all-sky survey in a low-inclination, low-Earth orbit. TESS's 144 GB of raw data collected each orbit will be stacked, cleaned, cut, compressed and downloaded. The Community Observer Program is a Science Enhancement Option (SEO) that takes advantage of the low-radiation environment, technology advances in flash memory, and the vast amount of astronomical data collected by TESS. The Community Observer Program requires the addition of a 12 TB "SEO Box” inside the TESS Bus. The hardware can be built using low-cost Commercial Off-The-Shelf (COTS) components and fits within TESS's margins while accommodating GSFC gold rules. The SEO Box collects and stores a duplicate of the TESS camera data at a "raw” stage ( 4.3 GB/orbit, after stacking and cleaning) and makes them available for on-board processing. The sheer amount of onboard storage provided by the SEO Box allows the stacking and storing of several months of data, allowing the investigator to probe deeper in time prior to a given event. Additionally, with computation power and data in standard formats, investigators can utilize data-mining techniques to investigate serendipitous phenomenon, including pulsating stars, eclipsing binaries, supernovae or other transient phenomena. The Community Observer Program enables ad-hoc teams of citizen scientists to propose, test, refine and rank algorithms for on-board analysis to support serendipitous science. Combining "best practices” of online collaboration, with careful moderation and community management, enables this `crowd sourced’ participatory exploration with a minimal risk and impact on the core TESS Team. This system provides a powerful and independent tool opening a wide range of opportunity for science enhancement and secondary science. Support for this work has been provided by NASA, the Kavli Foundation, Google, and the Smithsonian Institution.

  4. Corporate Social Responsibility in Connection with Business Closures and Downsizing: A Literature Review

    OpenAIRE

    Ahlstrand, Roland; Rydell, Alexis

    2017-01-01

    The aim of this paper was to review the research on corporate social responsibility (CSR) in connection with business closures and downsizing to identify gaps in our knowledge. The study consisted of a systematic review of 24 refereed articles. The review identified four themes in the literature on CSR in connection with business closure and downsizing, namely CSR, transition programs and the local community; CSR and business strategy; CSR, power and reputation; and lastly, other articles on ...

  5. 100-D Ponds closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, S.W.

    1997-09-01

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

  6. [Effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients after a myocardial infarction].

    Science.gov (United States)

    Kong, Jung-Hyeon; Ha, Yeongmi

    2013-08-01

    This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (pstages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

  7. Flap versus fascial closure for gastroschisis: a systematic review and meta-analysis.

    Science.gov (United States)

    Youssef, Fouad; Gorgy, Andrew; Arbash, Ghaidaa; Puligandla, Pramod S; Baird, Robert J

    2016-05-01

    Flap closure represents an alternative to fascial closure for gastroschisis. We performed a systematic review and meta-analysis of outcomes comparing these techniques. A registered systematic review ( CRD42015016745) of comparative studies was performed, querying multiple databases without language or date restrictions. Gray literature was sought. Outcomes analyzed included: mortality, ventilation days, feeding parameters, length of stay (LOS), wound infection, resource utilization, and umbilical hernia incidence. Multiple reviewers independently assessed study eligibility and literature quality. Meta-analysis of outcomes was performed where appropriate (Revman 5.2). Twelve studies met inclusion criteria, of which three were multi-institutional. Quality assessment revealed unbiased patient selection and exposure, but group comparability was suboptimal in four studies. Overall, 1124 patients were evaluated, of which 350 underwent flap closure (210 immediately; 140 post-silo). Meta-analysis revealed no significant differences in mortality, LOS, or feeding parameters between groups. Flap patients had less wound infections (OR 0.40 [95%CI 0.22-0.74], P=0.003). While flap patients had an increased risk of umbilical hernia, they were less likely to undergo repair (19% vs. 41%; P=0.01). Flap closure has equivalent or superior outcomes to fascial closure for patients with gastroschisis. Given potential advantages of bedside closure and reduced sedation requirements, flap closure may represent the preferred closure strategy. Copyright © 2016. Published by Elsevier Inc.

  8. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial.

    Science.gov (United States)

    Mouës, Chantal M; Vos, Margreet C; van den Bemd, Gert-Jan C M; Stijnen, Theo; Hovius, Steven E R

    2004-01-01

    Vacuum-assisted closure has become a new technique in the challenging management of contaminated, acute, and chronic wounds. Although promising clinical results have been described, scientific proof to substantiate the mechanism of action of this therapy is scarce. In the present study, we examined whether the positive effect on wound healing found in vacuum-assisted closure-treated wounds could be explained by an effect on the bacterial load. Fifty-four patients who needed open wound management before surgical closure were included in this study. Wounds were randomized to either vacuum-assisted closure therapy (n= 29) or treatment by conventional moist gauze therapy (n= 25). Healing was characterized by development of a clean granulating wound bed ("ready for surgical therapy") and reduction of wound surface area. To quantify bacterial load, biopsies were collected. No significant difference was found in time needed to reach "ready for surgical therapy" comparing both therapies. Wound surface area reduction was significantly larger in vacuum-assisted closure-treated wounds: 3.8 +/- 0.5 percent/day (mean +/- SEM) compared to conventional-treated wounds (1.7 +/- 0.6 percent/day; p vacuum-assisted closure-treated wounds (p vacuum-assisted closure-treated wounds (p vacuum-assisted closure therapy on wound healing, expressed as a significant reduction of wound surface area. However, this could not be explained by a significant quantitative reduction of the bacterial load.

  9. ICPP tank farm closure study. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Spaulding, B.C.; Gavalya, R.A.; Dahlmeir, M.M. [and others

    1998-02-01

    The disposition of INEEL radioactive wastes is now under a Settlement Agreement between the DOE and the State of Idaho. The Settlement Agreement requires that existing liquid sodium bearing waste (SBW), and other liquid waste inventories be treated by December 31, 2012. This agreement also requires that all HLW, including calcined waste, be disposed or made road ready to ship from the INEEL by 2035. Sodium bearing waste (SBW) is produced from decontamination operations and HLW from reprocessing of SNF. SBW and HLW are radioactive and hazardous mixed waste; the radioactive constituents are regulated by DOE and the hazardous constituents are regulated by the Resource Conservation and Recovery Act (RCRA). Calcined waste, a dry granular material, is produced in the New Waste Calcining Facility (NWCF). Two primary waste tank storage locations exist at the ICPP: Tank Farm Facility (TFF) and the Calcined Solids Storage Facility (CSSF). The TFF has the following underground storage tanks: four 18,400-gallon tanks (WM 100-102, WL 101); four 30,000-gallon tanks (WM 103-106); and eleven 300,000+ gallon tanks. This includes nine 300,000-gallon tanks (WM 182-190) and two 318,000 gallon tanks (WM 180-181). This study analyzes the closure and subsequent use of the eleven 300,000+ gallon tanks. The 18,400 and 30,000-gallon tanks were not included in the work scope and will be closed as a separate activity. This study was conducted to support the HLW Environmental Impact Statement (EIS) waste separations options and addresses closure of the 300,000-gallon liquid waste storage tanks and subsequent tank void uses. A figure provides a diagram estimating how the TFF could be used as part of the separations options. Other possible TFF uses are also discussed in this study.

  10. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program.

    Science.gov (United States)

    Pearson, Amber L; Kvizhinadze, Giorgi; Wilson, Nick; Smith, Megan; Canfell, Karen; Blakely, Tony

    2014-06-26

    Similar to many developed countries, vaccination against human papillomavirus (HPV) is provided only to girls in New Zealand and coverage is relatively low (47% in school-aged girls for dose 3). Some jurisdictions have already extended HPV vaccination to school-aged boys. Thus, exploration of the cost-utility of adding boys' vaccination is relevant. We modeled the incremental health gain and costs for extending the current girls-only program to boys, intensifying the current girls-only program to achieve 73% coverage, and extension of the intensive program to boys. A Markov macro-simulation model, which accounted for herd immunity, was developed for an annual cohort of 12-year-olds in 2011 and included the future health states of: cervical cancer, pre-cancer (CIN I to III), genital warts, and three other HPV-related cancers. In each state, health sector costs, including additional health costs from extra life, and quality-adjusted life-years (QALYs) were accumulated. The model included New Zealand data on cancer incidence and survival, and other cause mortality (all by sex, age, ethnicity and deprivation). At an assumed local willingness-to-pay threshold of US$29,600, vaccination of 12-year-old boys to achieve the current coverage for girls would not be cost-effective, at US$61,400/QALY gained (95% UI $29,700 to $112,000; OECD purchasing power parities) compared to the current girls-only program, with an assumed vaccine cost of US$59 (NZ$113). This was dominated though by the intensified girls-only program; US$17,400/QALY gained (95% UI: dominant to $46,100). Adding boys to this intensified program was also not cost-effective; US$128,000/QALY gained, 95% UI: $61,900 to $247,000).Vaccination of boys was not found to be cost-effective, even for additional scenarios with very low vaccine or program administration costs - only when combined vaccine and administration costs were NZ$125 or lower per dose was vaccination of boys cost-effective. These results suggest that

  11. Circular closure is associated with the lowest rate of surgical site infection following stoma reversal: a systematic review and multiple treatment meta-analysis.

    Science.gov (United States)

    Li, L T; Hicks, S C; Davila, J A; Kao, L S; Berger, R L; Arita, N A; Liang, M K

    2014-06-01

    Stoma reversal is frequently complicated by surgical site infection (SSI). To reduce SSI, several techniques for skin closure have been studied, with no agreement on which is best. The aim of this study was to identify the skin closure technique associated with the lowest rate of SSI following stoma reversal. We systematically searched MEDLINE (PubMed and OvidSP), Scopus and clinical registries from 1 January 1980 to 24 March 2012, and included original reports on adult patients following stoma reversal. A network of treatments was created to map the comparisons between skin closure techniques, including primary closure, primary closure with a drain, secondary closure, delayed primary closure, loose primary closure and circular closure. Pairwise meta-analyses were performed for all available direct comparisons of closure types and heterogeneity was assessed. A multiple-treatments meta-analysis was conducted to estimate relative treatment effects between competing closure types (reported as an odds ratio with 95% credible interval, and a probability that each treatment is best). Several sensitivity analyses were performed. Fifteen studies were identified with a total of 2921 cases of stoma reversal. Overall, study quality was poor with observed low (one study), moderate (seven studies) and high (seven studies) risk of bias. Circular closure was associated with the lowest SSI risk (OR 0.12; 95% CI 0.02-0.40) and was the best of six skin closure techniques (probability of being best = 68.9%). Circular closure remained the best after sensitivity analyses. This study showed that circular closure is the best skin closure technique after stoma reversal in terms of SSI rate, but the quality of supporting evidence is limited, precluding definite conclusions. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  12. A risk-stratified comparison of fascial versus flap closure techniques on the early outcomes of infants with gastroschisis.

    Science.gov (United States)

    Emami, Claudia N; Youssef, Fouad; Baird, Robert J; Laberge, Jean-Martin; Skarsgard, Erik D; Puligandla, Pramod S

    2015-01-01

    While fascial closure is traditionally used in gastroschisis (GS), flap closure (skin or umbilical cord) has gained popularity. We evaluated early outcomes and complications of the two techniques. A national, population-based gastroschisis data registry was analyzed from 2005 to 2011. We compared fascial to flap closures and stratified patients into low or high-risk groups using the Gastroschisis Prognostic Score (GPS), a validated marker of post-natal bowel injury. Demographic and outcome data, including length of stay, complications, and markers of resource utilization were analyzed using Fisher's exact and Student's t-tests for categorical and continuous variables, respectively (pfascial closures (344 [78.8%] low-risk, 92 high-risk) and 129 flap closures (112 [86.7%] low-risk, 17 high-risk; p=0.06). Demographics and birth weight did not differ between groups. In patients with low GPS, flap closure demonstrated significant decreases in resource utilization and failure of closure, without differences in complication rates. Analysis of high-risk patients revealed no statistically significant differences in outcome. Flap closure was not associated with an increase in patient morbidity and seemed suitable as a definitive closure method for gastroschisis patients irrespective of disease severity. Furthermore, flap closure reduced several markers of resource utilization in patients with low-risk disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. The archaeology of uncommon interventions: Articulating the rationale for transcatheter closure of congenital coronary artery fistulas in asymptomatic children.

    Science.gov (United States)

    McElhinney, Doff B

    2016-02-15

    Transcatheter closure of coronary artery fistulas can be executed successfully in infants and children with few serious procedural complications. Indications for and long-term outcomes of closure of coronary artery fistulas remain poorly defined. Registries may offer the best opportunity for advancing our knowledge about uncommon interventions such as coil or device closure of coronary artery fistulas, but to do so, they must include sufficient data and evaluate factors potentially associated with salutary or adverse outcome. © 2016 Wiley Periodicals, Inc.

  14. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

  15. 40 CFR 146.71 - Closure.

    Science.gov (United States)

    2010-07-01

    ... Director. (3) Prior to well closure, the well shall be flushed with a buffer fluid. (4) Upon closure, a... of fluids into or between USDWs. (5) Placement of the cement plugs shall be accomplished by one of... is completed. (7) The well to be closed shall be in a state of static equilibrium with the mud weight...

  16. Acute angle closure glaucoma following ileostomy surgery

    Directory of Open Access Journals (Sweden)

    Mariana Meirelles Lopes

    2015-02-01

    Full Text Available Angle-closure glaucoma can be induced by drugs that may cause pupillary dilatation. We report a case of a patient that developed bilateral angle closure glaucoma after an ileostomy surgery because of systemic atropine injection. This case report highlights the importance of a fast ophthalmologic evaluation in diseases with ocular involvement in order to make accurate diagnoses and appropriate treatments.

  17. Hospital closure: Phoenix, Hydra or Titanic?

    Science.gov (United States)

    Dunne, T; Davis, S

    1996-01-01

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

  18. Complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    East African Medical Journal ... Device closure of the ductus was first performed at the Mater hospital in 1999 in a ten year old male using a five millilitre detachable cook coil. In 2000 the ... We report this single centre experience of percutaneous PDA closure in a resource-limited setting; utilising the two techniques.

  19. Angle Closure Scoring System (ACSS-A Scoring System for Stratification of Angle Closure Disease.

    Directory of Open Access Journals (Sweden)

    Aparna Rao

    Full Text Available To evaluate the angle closure scoring system (ACSS for stratifying primary angle course disease.This observational cross sectional institutional study included patients with primary open angle glaucoma suspects (n = 21 and primary angle closure disease (primary angle closure, PAC, n = 63 and primary angle course glaucoma, PACG, n = 58 (defined by International society of Geographical and Epidemiological Ophthalmology, ISGEO. Two independent examiners blinded to clinical details, graded good quality pre-laser goniophotographs of the patients incorporating quadrants of peripheral anterior synechieae (PAS, non-visibility of posterior trabecular meshwork (PTM and blotchy pigments (ranging from 1-4 quadrants, iris configuration, angle recess (sum of above depicting ACSSg and lens thickness/axial length ratio (LT/AL, cup disc ratio and baseline intraocular pressure (IOP to give total score (ACSSt.There were significant differences in ACSSg scores within the same ISGEO stage of PAC and PACG between eyes that required nil or >1medicines after laser iridotomy, p1 medicines in both PAC and PACG eyes, p12 and 14 in PAC (odds ratio = 2.7(95% CI-1.7-5.9 and PACG (Odds ratio = 1.6(95%CI-1.19-2.2 predicted need for single medicines while ACSSg scores >14 and 19 predicted need for ≥2 medicines in PAC and PACG eyes, respectively. The LT/Al ratio, IOP score or cup disc score did not influence the need for medical treatment independently.The ACSS can be a useful clinical adjunct to the ISGEO system to predict need for medicines and prognosticate each stage more accurately.

  20. Angle Closure Scoring System (ACSS)-A Scoring System for Stratification of Angle Closure Disease

    Science.gov (United States)

    Rao, Aparna; Padhy, Debananda; Sarangi, Sarada; Das, Gopinath

    2016-01-01

    Purpose To evaluate the angle closure scoring system (ACSS) for stratifying primary angle course disease. Methods This observational cross sectional institutional study included patients with primary open angle glaucoma suspects (n = 21) and primary angle closure disease (primary angle closure, PAC, n = 63 and primary angle course glaucoma, PACG, n = 58 (defined by International society of Geographical and Epidemiological Ophthalmology, ISGEO). Two independent examiners blinded to clinical details, graded good quality pre-laser goniophotographs of the patients incorporating quadrants of peripheral anterior synechieae (PAS), non-visibility of posterior trabecular meshwork (PTM) and blotchy pigments (ranging from 1–4 quadrants), iris configuration, angle recess (sum of above depicting ACSSg) and lens thickness/axial length ratio (LT/AL), cup disc ratio and baseline intraocular pressure (IOP) to give total score (ACSSt). Result There were significant differences in ACSSg scores within the same ISGEO stage of PAC and PACG between eyes that required nil or >1medicines after laser iridotomy, p1 medicines in both PAC and PACG eyes, p12 and 14 in PAC (odds ratio = 2.7(95% CI-1.7–5.9) and PACG (Odds ratio = 1.6(95%CI-1.19–2.2) predicted need for single medicines while ACSSg scores >14 and 19 predicted need for ≥2 medicines in PAC and PACG eyes, respectively. The LT/Al ratio, IOP score or cup disc score did not influence the need for medical treatment independently. Conclusion The ACSS can be a useful clinical adjunct to the ISGEO system to predict need for medicines and prognosticate each stage more accurately. PMID:27788183

  1. Vacuum-Assisted Closure for Episiotomy Dehiscence.

    Science.gov (United States)

    Aviki, Emeline M; Batalden, Rebecca Posthuma; del Carmen, Marcela G; Berkowitz, Lori R

    2015-09-01

    Episiotomy dehiscence can result in a large vulvovaginal defect not amenable to delayed primary closure. A 26-year-old woman who underwent a forceps-assisted vaginal delivery with mediolateral episiotomy presented on postpartum day 5 with complete wound breakdown. Surgical exploration of the wound revealed a defect extending from the perineum into the vagina and deep into the ischiorectal fossa with poor tissue quality not amenable to a timely delayed primary closure. A vacuum-assisted closure device was used in lieu of traditional wound preparation and resulted in wound closure after 11 days of vacuum-assisted wound therapy. A vacuum-assisted closure device may be appropriate in cases of complex episiotomy breakdown and may expedite wound healing in the outpatient setting.

  2. Intermittent acute angle closure glaucoma and chronic angle closure following topiramate use with plateau iris configuration

    Directory of Open Access Journals (Sweden)

    Rajjoub LZ

    2014-07-01

    Full Text Available Lamise Z Rajjoub, Nisha Chadha, David A Belyea Department of Ophthalmology, The George Washington University, Washington, DC, USA Abstract: This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management. Keywords: angle closure glaucoma, plateau iris, topiramate, secondary glaucoma, drug-induced glaucoma

  3. Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

    Science.gov (United States)

    Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

    2018-01-01

    Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Greater Success of Primary Fascial Closure of the Open Abdomen: A Retrospective Study Analyzing Applied Surgical Techniques, Success of Fascial Closure, and Variables Affecting the Results.

    Science.gov (United States)

    Kääriäinen, M; Kuuskeri, M; Helminen, M; Kuokkanen, H

    2017-06-01

    The open abdomen technique is a standard procedure in the treatment of intra-abdominal catastrophe. Achieving primary abdominal closure within the initial hospitalization is a main objective. This study aimed to analyze the success of closure rate and the effect of negative pressure wound therapy, mesh-mediated medial traction, and component separation on the results. We present the treatment algorithm used in our institution in open abdomen situations based on these findings. Open abdomen patients (n = 61) treated in Tampere University Hospital from May 2005 until October 2013 were included in the study. Patient characteristics, treatment prior to closure, closure technique, and results were retrospectively collected and analyzed. The first group included patients in whom direct or bridged fascial closure was achieved, and the second group included those in whom only the skin was closed or a free skin graft was used. Background variables and variables related to surgery were compared between groups. Most of the open abdomen patients (72.1%) underwent fascial defect repair during the primary hospitalization, and 70.5% of them underwent direct fascial closure. Negative pressure wound therapy was used as a temporary closure method for 86.9% of the patients. Negative pressure wound therapy combined with mesh-mediated medial traction resulted in the shortest open abdomen time (p = 0.039) and the highest fascial repair rate (p = 0.000) compared to negative pressure wound therapy only or no negative pressure wound therapy. The component separation technique was used for 11 patients; direct fascial closure was achieved in 5 and fascial repair by bridging the defect with mesh was achieved in 6. A total of 8 of 37 (21.6%) patients with mesh repair had a mesh infection. The negative pressure wound therapy combined with mesh-mediated medial traction promotes definitive fascial closure with a high closure rate and a shortened open abdomen time. The component

  5. Closure of Microcosm for refurbishment

    CERN Multimedia

    2014-01-01

    Since 1994, the Microcosm exhibition has given the opportunity to visitors of all ages and backgrounds to have a first glimpse into the secrets of physics.   To ensure that Microcosm can continue fulfilling its educational aims at the same level of quality for many years to come, it is closing for renovation work on 8 December 2014 and is expected to reopen during Summer 2015. During the closure, the “Fun with Physics” workshop will not take place, but the Universe of Particles exhibition in the Globe and the Passport to the Big Bang circuit will remain accessible to the public, free of charge and with no need to book in advance.  Guided tours of CERN are also available (advance booking required via this page).

  6. Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial.

    Science.gov (United States)

    Engel, Roger Mark; Gonski, Peter; Beath, Ken; Vemulpad, Subramanyam

    2016-05-01

    Randomized clinical trial. To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wall mechanics, with an increase in chest wall rigidity (CWR) contributing to a decrease in lung function. As MT is known to increase joint mobility, administering MT to people with COPD carries with it the potential to influence CWR and lung function. Thirty-three participants with COPD, aged between 55 and 70 years (mean = 65·5±4 years), were randomly assigned to three groups: pulmonary rehabilitation (PR) only, soft tissue therapy (ST) and PR, and ST, spinal manipulative therapy (SM), and PR. Outcome measures including forced expiratory volume in the 1st second (FEV1), forced vital capacity (FVC), 6-minute walking test (6MWT), St. George's respiratory questionnaire (SGRQ), and the hospital anxiety and depression (HAD) scale were recorded at 0, 8, 16, and 24 weeks. There was a significant difference in FVC between the three groups at 24 weeks (P = 0·04). For the ST+SM+PR group versus PR only the increase was 0·40 l (CI: 0·02, 0·79; P = 0·03). No major or moderate adverse events (AE) were reported following the administration of 131 ST and 272 SM interventions. The increase in FVC is a unique finding. Although the underlying mechanisms responsible for this outcome are not yet understood, the most likely explanation is the synergistic effect resulting from the combination of interventions. These results support the call for a larger clinical trial in the use of MT for COPD.

  7. Complications in transcatheter closure of congenital portosystemic venous shunt using Amplatzer Vascular Plug

    Directory of Open Access Journals (Sweden)

    Jun Muneuchi

    2017-10-01

    Full Text Available Amplatzer Vascular Plug (AVP has been utilized to occlude a congenital portosystemic venous shunt (CPSVS that is a rare splanchnic venous anomaly. We present a case of a 12-year-old boy in whom device migration and portal vein thrombosis occurred after transcatheter closure of CPSVS using AVP type2. We reviewed the published literatures regarding with complications of CPSVS closure using AVP. Among 23 patients, we identified 5 complications including hypovolemic shock, hypoxia, liver dysfunction, device migration, and thrombosis. It is recommended to choose a device more than twice the diameter of the shunt, and to treat with an anticoagulant after closure.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. THE INFLUENCE OF COMBINATION NON-MEDICAL TREATMENT INCLUDING FUNCTIONAL PROGRAMMED ELECTRICAL STIMULATION ON THE CLINICAL AND INSTRUMENTAL PARAMETERS IN PATIENTS WITH CEREBRAL PALSY WITH SPASTIC DIPLEGIA

    Directory of Open Access Journals (Sweden)

    V. V. Eliseev

    2015-01-01

    Full Text Available Background: Cerebral palsy is the leading cause of physical disability in pediatric  age. The search for new methods and improvement of old rehabil- itation techniques is ongoing, due to low efficacy of the latter. Aim: To assess the efficacy of a func- tional programmed electrical muscle stimulation as a part  of combination treatment of patients with cerebral palsy in the form of spastic diplegia. Materials and methods: We analyzed the results of treatment of 71 children with cerebral palsy and spastic diplegia, who had  been  randomized  into two groups  depending on the type of treatment. In  the  first group,  the  patients  (n = 38 received a course of functional programmed electric stim- ulation  in combination with  other  non-medical treatment  methods.  The  second   group   (n = 33 underwent a usual  course  of electrical  stimula- tion in combination with non-medical  treatment, similar to that  in the first group. The third group (control   included   41   children   without    cere- bral palsy. Clinical and  instrumental parameters were  assessed  in all study  participants. Results: After the course of combination treatment in the group  1, the  tonus  of m. gastrocnemius was de- creased significantly by 41%, that of the posterior group  of femur muscles by 43%, adductor group of femur muscles by 36%. In the group  2, the re- spective parameters decreased by 24, 21 and 21%. Muscle power  endurance was  increased  signifi- cantly in patients of both groups: that of long back extensors by 12.5 and 6.2 sec, of m. rectus abdomi- nis by 10.6 sec and 5.2 sec, of gluteal muscles by 9.3 and 4.6 sec, of m. quadriceps  by 19.8 and 7.2 sec, of m. anterior  tibialis by 12.1 and 4.6 sec, respec- tively. After the  treatment, the  active movement volume in the large joints of lower extremities  in the group 1 patients  improved as follows: by 15.6° in hip joints, by 11.1° in knee joints and by

  10. Comparison between primary closure and T-tube drainage after open choledocotomy

    Directory of Open Access Journals (Sweden)

    Alireza Barband

    2015-10-01

    Full Text Available Background: Common Bile Duct (CBD exploration for choledocolithiasis is usually closed after T-tube insertion. However, complications of T-tube insertion limit its use. In the present study, we wanted to compare outcomes between primary repair of choledocotomy and traditional T-tube insertion. Material and methods: Thirty patients with CBD stones disease admitted at Sina and Imam Reza hospitals of Tabriz, from April 2012 to February 2013, were included in this study.  The patients were randomly divided into two groups: T-tube drainage group and primary closure group. Intraoperative findings and postoperative complications were recorded and analyzed. Results: There was no mortality and retained stones in both groups. Two of 15 patients in the T-tube group and four of 15 patients in primary closure group suffered from minor bile leakage. There was no major bile leakage in the T-tube group but one patient in the primary closure group had major bile leakage, which was treated conservatively without surgical or endoscopic intervention. Wound infection was seen in two patients in the T-tube group and one patient in the primary closure group. In follow up assessment, there was no intra-abdominal collection in both groups. Overall postoperative complications include biliary complications, wound infection and intra-abdominal collections, were seen in four patients in the T-tube group and six patients in primary closure group; that was not statically significant difference. Conclusion: primary closure of CBD after open choledocotomy is feasible and is as safe as T-tube insertion. In effect, primary closure avoids T-tube insertion and disadvantages associated with the use of T-tube. Primary closure can be recommended for selected patients with CBD stone disease.   Key words: common bile duct stones; choledocotomy; T-tube drainage; primary closure

  11. Draft environmental assessment -- Closure of the Waste Calcining Facility (CPP-633), Idaho National Engineering Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Braun, J.B.; Irving, J.S.; Staley, C.S.; Stanley, N.

    1996-04-01

    The DOE-Idaho Operations Office has prepared an environmental assessment (EA) to analyze the environmental impacts of closing the Waste Calcining Facility (WCF) at the Idaho National Engineering Laboratory (INEL). The purpose of the action is to reduce the risk of radioactive exposure and release of radioactive and hazardous constituents and eliminate the need for extensive long-term surveillance and maintenance. DOE has determined that the closure is needed to reduce these risks to human health and the environment and to comply with Resource Conservation and Recovery Act requirements. The WCF closure project is described in the DOE Programmatic Spent Nuclear Fuel Management and Idaho National Engineering Laboratory Environmental Restoration and Waste Management Programs Final Environmental Impact Statement (Programmatic EIS). DOE determined in the Programmatic EIS Record of Decision (ROD) that certain actions would be implemented and other actions deferred. The EA examined the potential environmental impacts of the proposed action and evaluated reasonable alternatives, including the no action alternative in accordance with the Council on Environmental Quality Regulations. Based on the analysis in the EA, the action will not have a significant effect on the human environment.

  12. Leaf-on canopy closure in broadleaf deciduous forests predicted during winter

    Science.gov (United States)

    Twedt, Daniel J.; Ayala, Andrea J.; Shickel, Madeline R.

    2015-01-01

    Forest canopy influences light transmittance, which in turn affects tree regeneration and survival, thereby having an impact on forest composition and habitat conditions for wildlife. Because leaf area is the primary impediment to light penetration, quantitative estimates of canopy closure are normally made during summer. Studies of forest structure and wildlife habitat that occur during winter, when deciduous trees have shed their leaves, may inaccurately estimate canopy closure. We estimated percent canopy closure during both summer (leaf-on) and winter (leaf-off) in broadleaf deciduous forests in Mississippi and Louisiana using gap light analysis of hemispherical photographs that were obtained during repeat visits to the same locations within bottomland and mesic upland hardwood forests and hardwood plantation forests. We used mixed-model linear regression to predict leaf-on canopy closure from measurements of leaf-off canopy closure, basal area, stem density, and tree height. Competing predictive models all included leaf-off canopy closure (relative importance = 0.93), whereas basal area and stem density, more traditional predictors of canopy closure, had relative model importance of ≤ 0.51.

  13. Ceftazidime-avibactam Versus Doripenem for the Treatment of Complicated Urinary Tract Infections, Including Acute Pyelonephritis: RECAPTURE, a Phase 3 Randomized Trial Program.

    Science.gov (United States)

    Wagenlehner, Florian M; Sobel, Jack D; Newell, Paul; Armstrong, Jon; Huang, Xiangning; Stone, Gregory G; Yates, Katrina; Gasink, Leanne B

    2016-09-15

    The global emergence of carbapenem-resistant Enterobacteriaceae highlights the urgent need to reduce carbapenem dependence. The phase 3 RECAPTURE program compared the efficacy and safety of ceftazidime-avibactam and doripenem in patients with complicated urinary tract infection (cUTI), including acute pyelonephritis. Hospitalized adults with suspected or microbiologically confirmed cUTI/acute pyelonephritis were randomized 1:1 to ceftazidime-avibactam 2000 mg/500 mg every 8 hours or doripenem 500 mg every 8 hours (doses adjusted for renal function), with possible oral antibiotic switch after ≥5 days (total treatment duration up to 10 days or 14 days for patients with bacteremia). Of 1033 randomized patients, 393 and 417 treated with ceftazidime-avibactam and doripenem, respectively, were eligible for the primary efficacy analyses; 19.6% had ceftazidime-nonsusceptible baseline pathogens. Noninferiority of ceftazidime-avibactam vs doripenem was demonstrated for the US Food and Drug Administration co-primary endpoints of (1) patient-reported symptomatic resolution at day 5: 276 of 393 (70.2%) vs 276 of 417 (66.2%) patients (difference, 4.0% [95% confidence interval {CI}, -2.39% to 10.42%]); and (2) combined symptomatic resolution/microbiological eradication at test of cure (TOC): 280 of 393 (71.2%) vs 269 of 417 (64.5%) patients (difference, 6.7% [95% CI, .30% to 13.12%]). Microbiological eradication at TOC (European Medicines Agency primary endpoint) occurred in 304 of 393 (77.4%) ceftazidime-avibactam vs 296 of 417 (71.0%) doripenem patients (difference, 6.4% [95% CI, .33% to 12.36%]), demonstrating superiority at the 5% significance level. Both treatments showed similar efficacy against ceftazidime-nonsusceptible pathogens. Ceftazidime-avibactam had a safety profile consistent with that of ceftazidime alone. Ceftazidime-avibactam was highly effective for the empiric treatment of cUTI (including acute pyelonephritis), and may offer an alternative to carbapenems in

  14. Proposed modifications to the RCRA post-closure permit for the Chestnut Ridge Hydrogeologic Regime at the U.S. Department of Energy Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

    This report presents proposed modifications to several conditions of the Resource Conservation and Recovery Act (RCRA) Post-Closure Permit (PCP) for the Chestnut Ridge Hydrogeologic Regime (CRHR) (permit number TNHW-088, EPA ID No. TN3 89 009 0001). These permit conditions define the requirements for RCRA post-closure detection groundwater monitoring at the Chestnut Ridge Sediment Disposal Basin (CRSDB) and Kerr Hollow Quarry (KHQ), and RCRA post-closure corrective action groundwater monitoring at the Chestnut Ridge Security Pits (CRSPs). Modification of these PCP conditions is requested to: (1) clarify the planned integration of RCRA post-closure corrective action groundwater monitoring at the CRSPs with the monitoring program to be established in the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) record of decision (ROD), (2) revise several of the current technical requirements for groundwater monitoring based on implementation of the RCRA monitoring programs during 1996, (3) replace several of the technical procedures included in the PCP with updated versions recently issued by the Y-12 Plant Groundwater Protection Program (GWPP), and (4) correct inaccurate regulatory citations and references to permit conditions and permit attachments. With these modifications, the Y- 12 Plant will continue to meet the full intent of all regulatory obligations for post-closure care of these facilities. Section 2 provides the technical justification for each proposed permit modification. Section 3.0 contains proposed changes to Section II of the PCP. Modifications to site-specific permit conditions are presented in Section 4.0 (CRSDB), Section 5.0 (CRSPs), and Section 6.0 (KHQ). Sections 7.0 and 8.0 reference updated and revised procedures for groundwater sampling, and monitoring well plugging and abandonment, respectively. Appendix A includes all proposed revisions to the permit attachments.

  15. A Sheaf Model of the Algebraic Closure

    Directory of Open Access Journals (Sweden)

    Bassel Mannaa

    2014-09-01

    Full Text Available In constructive algebra one cannot in general decide the irreducibility of a polynomial over a field K. This poses some problems to showing the existence of the algebraic closure of K. We give a possible constructive interpretation of the existence of the algebraic closure of a field in characteristic 0 by building, in a constructive metatheory, a suitable site model where there is such an algebraic closure. One can then extract computational content from this model. We give examples of computation based on this model.

  16. Integrated Closure and Monitoring Plan for the Area 3 and Area 5 Radioactive Waste Management Sites at the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    S. E. Rawlinson

    2001-09-01

    Bechtel Nevada (BN) manages two low-level Radioactive Waste Management Sites (RWMSs) (one site is in Area 3 and the other is in Area 5) at the Nevada Test Site (NTS) for the U.S. Department of Energy's (DOE's) National Nuclear Security Administration Nevada Operations Office (NNSA/NV). The current DOE Order governing management of radioactive waste is 435.1. Associated with DOE Order 435.1 is a Manual (DOE M 435.1-1) and Guidance (DOE G 435.1-1). The Manual and Guidance specify that preliminary closure and monitoring plans for a low-level waste (LLW) management facility be developed and initially submitted with the Performance Assessment (PA) and Composite Analysis (CA) for that facility. The Manual and Guidance, and the Disposal Authorization Statement (DAS) issued for the Area 3 RWMS further specify that the preliminary closure and monitoring plans be updated within one year following issuance of a DAS. This Integrated Closure and Monitoring Plan (ICMP) fulfills both requirements. Additional updates will be conducted every third year hereafter. This document is an integrated plan for closing and monitoring both RWMSs, and is based on guidance issued in 1999 by the DOE for developing closure plans. The plan does not follow the format suggested by the DOE guidance in order to better accommodate differences between the two RWMSs, especially in terms of operations and site characteristics. The modification reduces redundancy and provides a smoother progression of the discussion. The closure and monitoring plans were integrated because much of the information that would be included in individual plans is the same, and integration provides efficient presentation and program management. The ICMP identifies the regulatory requirements, describes the disposal sites and the physical environment where they are located, and defines the approach and schedule for both closing and monitoring the sites.

  17. Early Closure of a Temporary Ileostomy in Patients With Rectal Cancer

    DEFF Research Database (Denmark)

    Danielsen, Anne K; Park, Jennifer; Jansen, Jens E

    2017-01-01

    anastomotic dehiscence. However, the temporary ileostomy is afflicted with complications and requires a second surgical procedure (closure) with its own complications. Early closure of the temporary ileostomy could reduce complications for rectal cancer patients. METHODS: Early closure (8-13 days after stoma...... creation) of a temporary ileostomy was compared with late closure (>12 weeks) in a multicenter randomized controlled trial, EASY (www.clinicaltrials.gov, NCT01287637) including patients undergoing rectal resection for cancer. Patients with a temporary ileostomy without signs of postoperative complications......: The trial included 127 patients in eight Danish and Swedish surgical departments, and 112 patients were available for analysis. The mean number of complications after index surgery up to 12 months follow up was significantly lower in the intervention group (1.2) compared with the control group (2.9), P

  18. Scaling laws and turbulence closures for stable boundary layers

    Science.gov (United States)

    Zilitinkevich, S.; Esau, I.; Baklanov, A.; Djolov, G.

    2003-04-01

    This paper presents a recently developed theory of non-local turbulence in the stably stratified planetary boundary layers (PBLs): basic theoretical results, new LES code specifically designed for LES of stably stratified flows, and comparison of theoretical predictions with LES and experimental data. The paper includes improved formulations for the PBL depth and resistance laws and outlines an advanced turbulence closure accounting for the transport properties of internal gravity waves.

  19. Underground storage tank 431-D1U1, Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    Mancieri, S.

    1993-09-01

    This document contains information about the decommissioning of Tank 431-D1U1. This tank was installed in 1965 for diesel fuel storage. This tank will remain in active usage until closure procedures begin. Soils and ground water around the tank will be sampled to check for leakage. Appendices include; proof of proper training for workers, health and safety briefing record, task hazard analysis summary, and emergency plans.

  20. National Coral Reef Monitoring Program: Stratified Random Surveys (StRS) of Reef Fish, including Benthic Estimate Data of the Mariana Archipelago in 2014 (NCEI Accession 0157596)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data provided in this data set were collected as part of the NOAA Pacific Islands Fisheries Science Center (PIFSC), Coral Reef Ecosystem Program (CREP) led NCRMP...

  1. Proceedings of the tenth annual DOE low-level waste management conference: Session 6: Closure and decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    1988-12-01

    This document contains eight papers on various aspects of low-level radioactive waste management. Topics include: site closure; ground cover; alternate cap designs; performance monitoring of waste trenches; closure options for a mixed waste site; and guidance for environmental monitoring. Individual papers were processed separately for the data base. (TEM)

  2. Predicting Financial Distress and Closure in Rural Hospitals.

    Science.gov (United States)

    Holmes, George M; Kaufman, Brystana G; Pink, George H

    2017-06-01

    Annual rates of rural hospital closure have been increasing since 2010, and hospitals that close have poor financial performance relative to those that remain open. This study develops and validates a latent index of financial distress to forecast the probability of financial distress and closure within 2 years for rural hospitals. Hospital and community characteristics are used to predict the risk of financial distress 2 years in the future. Financial and community data were drawn for 2,466 rural hospitals from 2000 through 2013. We tested and validated a model predicting a latent index of financial distress (FDI), measured by unprofitability, equity decline, insolvency, and closure. Using the predicted FDI score, hospitals are assigned to high, medium-high, medium-low, and low risk of financial distress for use by practitioners. The FDI forecasts 8.01% of rural hospitals to be at high risk of financial distress in 2015, 16.3% as mid-high, 46.8% as mid-low, and 28.9% as low risk. The rate of closure for hospitals in the high-risk category is 4 times the rate in the mid-high category and 28 times that in the mid-low category. The ability of the FDI to discriminate hospitals experiencing financial distress is supported by a c-statistic of .74 in a validation sample. This methodology offers improved specificity and predictive power relative to existing measures of financial distress applied to rural hospitals. This risk assessment tool may inform programs at the federal, state, and local levels that provide funding or support to rural hospitals. © 2016 National Rural Health Association.

  3. Extender for securing a closure

    Science.gov (United States)

    Thomas, II, Patrick A.

    2012-10-02

    An apparatus for securing a closure such as door or a window that opens and closes by movement relative to a fixed structure such as a wall or a floor. Many embodiments provide a device for relocating a padlock from its normal location where it secures a fastener (such as a hasp) to a location for the padlock that is more accessible for locking and unlocking the padlock. Typically an extender is provided, where the extender has a hook at a first end that is disposed through the eye of the staple of the hasp, and at an opposing second end the extender has an annulus, such as a hole in the extender or a loop or ring affixed to the extender. The shackle of the padlock may be disposed through the annulus and may be disposed through the eye of a second staple to secure the door or window in a closed or open position. Some embodiments employ a rigid sheath to enclose at least a portion of the extender. Typically the rigid sheath has an open state where the hook is exposed outside the sheath and a closed state where the hook is disposed within the sheath.

  4. complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    2013-07-07

    Jul 7, 2013 ... We report this single centre experience of percutaneous. PDA closure in a ... Design: A descriptive retrospective cohort study. ... Three of the subjects in the coil group had the ducts embolised using the double technique while ...

  5. Cyanoacrylate for Intraoral Wound Closure: A Possibility?

    Directory of Open Access Journals (Sweden)

    Parimala Sagar

    2015-01-01

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

  6. Feasibility of lane closures using probe data.

    Science.gov (United States)

    2017-04-01

    To develop an adequate traffic operations management and congestion mitigation plan for every roadway : maintenance and construction project requiring lane closures, transportation agencies need accurate and : reliable estimates of traffic impacts as...

  7. Uterine incision cloSure at caesarean section: A randomised ...

    African Journals Online (AJOL)

    nylon suture size 0. The only difference between the two groups was on the method of closure of uterine incision i.e. intraperitoneal closure or closure after temporary exteriorisation. Intraperitoneal closure. After delivery of the baby and the placenta, the uterine incision is closed with the uterus within the abdominal cavity.

  8. Single-site neural tube closure in human embryos revisited

    NARCIS (Netherlands)

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

    2017-01-01

    Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent

  9. Residual Angle Closure One Year After Laser Peripheral Iridotomy in Primary Angle Closure Suspects.

    Science.gov (United States)

    Baskaran, Mani; Yang, Elizabeth; Trikha, Sameer; Kumar, Rajesh S; Wong, Hon Tym; He, Mingguang; Chew, Paul T K; Foster, Paul J; Friedman, David; Aung, Tin

    2017-11-01

    To determine the incidence and baseline clinical and anterior segment optical coherence tomography (AS-OCT) predictors associated with residual angle closure as assessed by gonioscopy 1 year after laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS). Subanalysis of randomized controlled trial data. AS-OCT images from 181 PACS subjects ≥50 years of age were analyzed using customized software before and 1 year after LPI. Other parameters assessed were intraocular pressure (IOP) and axial length (Axl). Residual angle closure was defined as the inability to see the posterior trabecular meshwork for at least 2 quadrants on gonioscopy after LPI. Multivariate regression analysis determined the baseline predictors of residual angle closure 1 year after LPI. The mean age of participants was 62.4 (standard deviation 9.9) years. The majority were female (137, 75.7%) and Chinese (174, 96.1%). At 1 year post LPI, 148 (81.8%) subjects had gonioscopic residual angle closure. Univariate analysis showed that baseline Axl, anterior chamber area, anterior chamber volume, angle opening distance at 750 μm from the scleral spur, and angle recess area were smaller while baseline lens vault and iris curvature were larger in residual angle closure subjects (all P angle closure. One year after LPI, >80% of PACS had gonioscopic residual angle closure. Greater baseline iris volume and higher IOP at baseline are independent risk factors for residual gonioscopic angle closure. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Why does acute primary angle closure happen? Potential risk factors for acute primary angle closure.

    Science.gov (United States)

    Zhang, Xiulan; Liu, Yaoming; Wang, Wei; Chen, Shida; Li, Fei; Huang, Wenbin; Aung, Tin; Wang, Ningli

    Acute primary angle closure is an ocular emergency and requires immediate management to avoid blindness. Narrow anterior chamber angle, advanced age, female gender, and Asian ethnic background are considered risk factors for acute primary angle closure. The predictive power of these factors is, however, relatively poor, and many questions remain unanswered because acute primary angle closure eventually develops in only a relatively small proportion of anatomically predisposed eyes. We summarize the potential roles of various factors in the pathogenesis of acute primary angle closure. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. [Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

    Science.gov (United States)

    Vieu, T; Beaurain, S; Angel, C; Leriche, H; Petit, J; Conso, J F; Planché, C; Losay, J

    1995-10-01

    The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used.

  12. Loop Ileostomy Closure as an Overnight Procedure: Institutional Comparison With the National Surgical Quality Improvement Project Data Set.

    Science.gov (United States)

    Berger, Nicholas G; Chou, Raymond; Toy, Elliot S; Ludwig, Kirk A; Ridolfi, Timothy J; Peterson, Carrie Y

    2017-08-01

    Enhanced recovery pathways have decreased length of stay after colorectal surgery. Loop ileostomy closure remains a challenge, because patients experience high readmission rates, and validation of enhanced recovery pathways has not been demonstrated. This study examined a protocol whereby patients were discharged on the first postoperative day and instructed to advance their diet at home with close telephone follow-up. The hypothesis was that patients can be safely discharged the day after loop closure, leading to shorter length of stay without increased rates of readmission or complications. Patients undergoing loop ileostomy closure were queried from the American College of Surgeons National Surgical Quality Improvement Project and compared with a single institution (2012-2015). Length of stay, 30-day readmission, and 30-day morbidity data were analyzed. The study was conducted at a tertiary university department. The study includes 1602 patients: 1517 from the National Surgical Quality Improvement Project database and 85 from a single institution. Length of stay and readmission rates were measured. Median length of stay was less at the single institution compared with control (2 vs 4 d; p < 0.001). Thirty-day readmission (15.3% vs 10.4%; p = 0.15) and overall 30-day complications (15.3% vs 16.7%; p = 0.73) were similar between cohorts. Estimated adjusted length of stay was less in the single institution (2.93 vs 5.58 d; p < 0.0001). There was no difference in the odds of readmission (p = 0.22). The main limitations of this study include its retrospective nature and limitations of the National Surgical Quality Improvement Program database. Next-day discharge with protocoled diet advancement and telephone follow-up is acceptable after loop ileostomy closure. Patients can benefit from decreased length of stay without an increase in readmission or complications. This has the potential to change the practice of postoperative management of loop ileostomy closure, as

  13. Exceptional closure of UNIQA office at CERN

    CERN Multimedia

    HR Department

    2009-01-01

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

  14. Theater gateway closure: a strategic level barricade

    Science.gov (United States)

    logistical planners at the strategic level can anticipate or mitigate the effects of a theater gateway closure on military operations. Through two...the national elements of power was used to find the strategic level effects of the anomaly, that is an unexpected theater gateway closure. It was found...operations. A detailed analysis of the theater gateways location is critical to mitigate or anticipate the sustainment impacts on military operations

  15. Integron, Plasmid and Host Strain Characteristics of Escherichia coli from Humans and Food Included in the Norwegian Antimicrobial Resistance Monitoring Programs.

    Directory of Open Access Journals (Sweden)

    Marianne Sunde

    Full Text Available Antimicrobial resistant Escherichia coli (n=331 isolates from humans with bloodstream infections were investigated for the presence of class 1 and class 2 integrons. The integron cassettes arrays were characterized and the findings were compared with data from similar investigations on resistant E. coli from meat and meat products (n=241 produced during the same time period. All isolates were obtained from the Norwegian monitoring programs for antimicrobial resistance in human pathogens and in the veterinary sector. Methods used included PCR, sequencing, conjugation experiments, plasmid replicon typing and subtyping, pulsed-field-gel-electrophoresis and serotyping. Integrons of class 1 and 2 occurred significantly more frequently among human isolates; 45.4% (95% CI: 39.9-50.9 than among isolates from meat; 18% (95% CI: 13.2 -23.3, (p<0.01, Chi-square test. Identical cassette arrays including dfrA1-aadA1, aadA1, dfrA12-orfF-aadA2, oxa-30-aadA1 (class 1 integrons and dfrA1-sat1-aadA1 (class 2 integrons were detected from both humans and meat. However, the most prevalent cassette array in human isolates, dfrA17-aadA5, did not occur in isolates from meat, suggesting a possible linkage between this class 1 integron and a subpopulation of E. coli adapted to a human host. The drfA1-aadA1 and aadA1 class 1 integrons were found frequently in both human and meat isolates. These isolates were subjected to further studies to investigate similarities with regard to transferability, plasmid and host strain characteristics. We detected incF plasmids with pMLST profile F24:A-:B1 carrying drfA1-aadA1 integrons in isolates from pork and in a more distantly related E. coli strain from a human with septicaemia. Furthermore, we showed that most of the class 1 integrons with aadA1 were located on incF plasmids with pMLST profile F51:A-:B10 in human isolates. The plasmid was present in unrelated as well as closely related host strains, demonstrating that dissemination

  16. Geometrical versus rheological transient creep closure in a salt cavern

    Science.gov (United States)

    Bérest, Pierre; Karimi-Jafari, Mehdi; Brouard, Benoît

    2017-11-01

    An in-situ test performed in a brine-filled cavern proves that, when brine pressure decreases rapidly, the creep closure rate increases drastically. Conversely, a rapid pressure increase leads to ;reverse; creep closure: cavern volume increases, even when, at cavern depth, fluid pressure is lower than geostatic pressure. It is tempting to explain these two phenomena by transient salt creep, a characteristic feature of salt rheological behavior commonly observed during laboratory creep tests. In fact, computations performed on an idealized cylindrical cavern excavated from a Norton-Hoff rock mass (a constitutive law that includes no transient component) prove that these two phenomena are, at least partly, of a structural nature: their origin is in the slow redistribution of stresses following any pressure change.

  17. CERN Services Availability during the CERN Annual Closure 2011

    CERN Multimedia

    IT & GS Departments

    2011-01-01

    General Services: Most of the services provided by the GS Department that do not depend on continuous human presence will remain available during the CERN annual closure. Support levels are reduced during this period, in general the target reaction time for problems will be ½ day. Apart from the heating system, no interruptions are scheduled. In case of failure, the reaction time for restoration of services depends on the arrangements that have been made on a service by service level. Incidents will be documented at http://gssb.web.cern.ch/ For more detailed information please consult the service-portal (http://cern.ch/service-portal). Computing Services Most of the services provided by the IT Department - including WLCG production services - will remain available during the CERN annual closure. No interruptions are scheduled but in case of failure, the restoration of services cannot be guaranteed. Problems will be dealt with on a best effort basis only. However, please note: Experts shoul...

  18. HWMA/RCRA Closure Plan for the CPP-602 Laboratory Lines

    Energy Technology Data Exchange (ETDEWEB)

    Idaho Cleanup Project

    2009-09-30

    This Hazardous Waste Management Act/Resource Conservation and Recovery Act Closure (HWMA/RCRA) Plan for the CPP-602 laboratory lines was developed to meet the tank system closure requirements of the Idaho Administrative Procedures Act 58.01.05.008 and 40 Code of Federal Regulations 264, Subpart G. CPP-602 is located at the Idaho Nuclear Technology and Engineering Center at the Idaho National Laboratory Site. The lines in CPP-602 were part of a liquid hazardous waste collection system included in the Idaho Nuclear Technology and Engineering Center Liquid Waste Management System Permit. The laboratory lines discharged to the Deep Tanks System in CPP-601 that is currently being closed under a separate closure plan. This closure plan presents the closure performance standards and the methods for achieving those standards. The closure approach for the CPP-602 laboratory lines is to remove the lines, components, and contaminants to the extent practicable. Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Site CPP-117 includes the CPP-602 waste trench and the area beneath the basement floor where waste lines are direct-buried. Upon completion of rinsing or mopping to remove contamination to the extent practicable from the waste trench and rinsing the intact buried lines (i.e., stainless steel sections), these areas will be managed as part of CERCLA Site CPP-117 and will not be subject to further HWMA/RCRA closure activities. The CPP-602 building is being decontaminated and decommissioned under CERCLA as a non-time critical removal action in accordance with the Federal Facility Agreement/Consent Order. As such, all waste generated by this CERCLA action, including closure-generated waste, will be managed in coordination with that CERCLA action in substantive compliance with HWMA/RCRA regulations. All waste will be subject to a hazardous waste determination for the purpose of supporting appropriate management and will be managed in accordance

  19. Comparison of Subcuticular Suture Materials in Cesarean Skin Closure

    Directory of Open Access Journals (Sweden)

    Pınar Solmaz Hasdemir

    2015-01-01

    Full Text Available Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.

  20. Galea-pericranium dural closure: can we safely avoid sealants?

    Science.gov (United States)

    Giovanni, Sabatino; Della Pepa, Giuseppe Maria; La Rocca, Giuseppe; Lofrese, Giorgio; Albanese, Alesso; Maria, Giulio; Marchese, Enrico

    2014-08-01

    Dural closure is one of the most critical steps in neurosurgical procedures as it prevents many common postoperative complications. Methods of dural closure include the use of allogenic, autogenic, xenogenic, absorbable or synthetic materials together with sealant/glues or hemostatic compounds. Most common autogenic graft is galea-pericranium. This study aims to demonstrate how the intrinsic properties of the galea-pericranium make effectively useless the application of any glue in order to ensure the watertight integrity of the graft. 276 cases were included in the study. Postoperative dural-closure related complication in patients subjected to duraplasty were analysed in three groups undergoing different duraplasty techniques: galea-pericranium graft without sealants, galea-pericranium graft plus sealant, non-autologous dural patch plus sealant. No statistically significant differences between the three groups were observed in terms of subcutaneous fluid collection rate, CSF fistulas, brain abscesses, subdural empyemas, wound dehiscence, radiotherapic sequelae. Our study shows that galea-pericranium alone (without sealants) is comparable to other duraplasty techniques that involve the use of sealants or of non-autologous pathches in terms of long term postoperative results. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. 77 FR 75186 - Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT

    Science.gov (United States)

    2012-12-19

    ... Bureau of Land Management Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains... shooting to protect public safety. This closure does not restrict other public activities or access to the Lake Mountains area. DATES: This target shooting closure within the described area will remain in...

  2. Transcatheter closure of atrial septal defect in a patient with Noonan syndrome after corrective surgery

    Directory of Open Access Journals (Sweden)

    Mangovski Ljupčo

    2015-01-01

    Full Text Available Introduction. Transcatheter atrial septal defect (ASD closure is considered to be a gold standard for patients with the suitable anatomy as compared to cardiac surgery. Reocurrence of ASD after surgical closure is a very rare late complication which can be successfully managed with transcatheter procedure. Case report. We reported a female patient with Noonan syndrome who presented with hemodinamically significant ASD 37 years after the corrective cardiac surgery. Due to numerous comorbidities which included severe kyphoscoliosis, pectus excavatum and multiple surgeries we decided to perform transcatheter closure of ASD. The procedure itself was very challenging due to the patient’s short stature and heart’s orientation in the chest, but was performed successfully. The subsequent follow-up was uneventful and the patient reported improvement in the symptoms. Conclusion. Transcatheter closure of ASD in a patient with Noonan syndrome with the history of surgically corrected ASD can be performed successfully, despite challenging chest anatomy.

  3. Closure of patent foramen ovale in "cryptogenic" stroke: Has the story come to an end?

    Science.gov (United States)

    Mas, Jean-Louis; Chatellier, Gilles

    2018-01-01

    Contrasting with three randomized trials that failed to show any superiority of patent foramen ovale closure over antithrombotic therapy, two trials recently reported lower rates of stroke recurrence among patients assigned to patent foramen ovale closure than among those assigned to antiplatelet therapy. In addition, one of the initially negative trials concluded in favor of patent foramen ovale closure after an extended follow-up period. A better selection of patients, the use of reference treatment groups that included patients who received antiplatelet therapy alone (rather than antiplatelet drugs or oral anticoagulants, according to physician preference), and a longer follow-up of patients, may explain the divergent findings across studies. Procedural complications were reported in 1.5% to 5.9% of the patients, none of which led to permanent disability or death. Patent foramen ovale closure was associated with an increased risk of new-onset atrial fibrillation in several studies and of venous thromboembolism in one study.

  4. Compilation of current literature on seals, closures, and leakage for radioactive material packagings

    Energy Technology Data Exchange (ETDEWEB)

    Warrant, M.M.; Ottinger, C.A.

    1989-01-01

    This report presents an overview of the features that affect the sealing capability of radioactive material packagings currently certified by the US Nuclear Regulatory Commission. The report is based on a review of current literature on seals, closures, and leakage for radioactive material packagings. Federal regulations that relate to the sealing capability of radioactive material packagings, as well as basic equations for leakage calculations and some of the available leakage test procedures are presented. The factors which affect the sealing capability of a closure, including the properties of the sealing surfaces, the gasket material, the closure method and the contents are discussed in qualitative terms. Information on the general properties of both elastomer and metal gasket materials and some specific designs are presented. A summary of the seal material, closure method, and leakage tests for currently certified packagings with large diameter seals is provided. 18 figs., 9 tabs.

  5. 40 CFR 265.113 - Closure; time allowed for closure.

    Science.gov (United States)

    2010-07-01

    ... appropriate to reflect any changes due to the presence of hazardous constituents in the non-hazardous wastes... corrective action program, compile all ground-water monitoring data, and evaluate the effect of the continued...

  6. [Education reform with the support of the faculty--introduction of a supplementary education program including teacher support and individual guidance].

    Science.gov (United States)

    Wada, Keiji; Yoshimura, Teruki

    2015-01-01

      To deal with declining levels of academic ability and motivation among students (a situation attributable to fewer high school graduates, a greater number of universities, and the diversification of entrance examination methods), one must comprehend the conditions of faculties collectively, and take appropriate measures. Using the results of examinations carried out in each grade as indices, we examined levels of academic ability and established various support programs based on the results. Basic chemistry, biology, and physics courses were designed to help first-year students acquire essential academic skills. For second, third, and fourth-year students, two types of support programs were implemented: supplementary instruction to help students improve their understanding of basic topics in pharmaceutical sciences, and an e-learning system to promote self-study, requiring minimal assistance from teachers. Although educational benefits were observed in many students, the number of learners whose understanding failed to improve as a result of the support programs continued to increase. Consequently, The Support Section for Pharmaceutical Education opened in October 2011 to address these concerns. The support section functions mainly to provide individual assistance to students who lack strong academic abilities, and provides teachers with information useful for educational reform. Here, we describe the educational support provided by our faculty and its effectiveness.

  7. Corporate social responsibility for regional sustainability after mine closure: a case study of mining company in Indonesia

    Science.gov (United States)

    Syarif, Andi Erwin; Hatori, Tsuyoshi

    2017-06-01

    Creating a soft-landing path for mine closure is key to the sustainability of the mining region. In this research, we presents a case of mine closure in Soroako, a small mining town in the north-east of South Sulawesi province, in the center of Sulawesi Island in Indonesia. Especially we investigates corporate social responsibility (CSR) programs of a mining company, PT Vale Indonesia Tbk (PTVI), towards a soft-landing of mine closure in this region. The data of the CSR programs are gathered from in-depth interviews, the annual reports and managerial reports. Furthermore we presents an integrated view of CSR to close mining in a sustainable manner. We then evaluate CSR strategies of the company and its performance from this viewpoint. Based on these steps, the way to improve the CSR mine closure scenario for enhancing the regional sustainability is discussed and recommended.

  8. Altering Practices to Include Bimodal-bilingual (ASL-Spoken English) Programming at a Small School for the Deaf in Canada.

    Science.gov (United States)

    Priestley, Karen; Enns, Charlotte; Arbuckle, Shauna

    2018-01-01

    Bimodal-bilingual programs are emerging as one way to meet broader needs and provide expanded language, educational and social-emotional opportunities for students who are deaf and hard of hearing (Marschark, M., Tang, G. & Knoors, H. (Eds). (2014). Bilingualism and bilingual Deaf education. New York, NY: Oxford University Press; Paludneviciene & Harris, R. (2011). Impact of cochlear implants on the deaf community. In Paludneviciene, R. & Leigh, I. (Eds.), Cochlear implants evolving perspectives (pp. 3-19). Washington, DC: Gallaudet University Press). However, there is limited research on students' spoken language development, signed language growth, academic outcomes or the social-emotional factors associated with these programs (Marschark, M., Tang, G. & Knoors, H. (Eds). (2014). Bilingualism and bilingual Deaf education. New York, NY: Oxford University Press; Nussbaum, D & Scott, S. (2011). The cochlear implant education center: Perspectives on effective educational practices. In Paludneviciene, R. & Leigh, I. (Eds.) Cochlear implants evolving perspectives (pp. 175-205). Washington, DC: Gallaudet University Press. The cochlear implant education center: Perspectives on effective educational practices. In Paludnevicience & Leigh (Eds). Cochlear implants evolving perspectives (pp. 175-205). Washington, DC: Gallaudet University Press; Spencer, P. & Marschark, M. (Eds.) (2010). Evidence-based practice in educating deaf and hard-of-hearing students. New York, NY: Oxford University Press). The purpose of this case study was to look at formal and informal student outcomes as well as staff and parent perceptions during the first 3 years of implementing a bimodal-bilingual (ASL and spoken English) program within an ASL milieu at a small school for the deaf. Speech and language assessment results for five students were analyzed over a 3-year period and indicated that the students made significant positive gains in all areas, although results were variable. Staff and parent

  9. Presumed Furosemide-associated Bilateral Angle-Closure Glaucoma.

    Science.gov (United States)

    Boundaoui, Oussama N; Woodruff, Todd E

    2016-08-01

    To report a case of presumed furosemide-associated bilateral angle-closure glaucoma. Retrospective case report with spectral domain anterior segment optical coherence tomography imaging. A 21-year-old African American woman in her 17th week of pregnancy presented with acute angle-closure glaucoma in both eyes after being started on furosemide in her first trimester for fluid overload. Intraocular pressures were elevated in the low 40s mm Hg bilateral (OU) and anterior chambers were shallow with narrow grade 1 angles on gonioscopy (Schaffer classification). Medical history included type 1 diabetes mellitus, chronic kidney disease, and 2 prior failed pregnancies complicated by fluid overload. She was started on 60 mg of prednisone daily along with topical brimonidine in both eyes twice daily. After 3 days, her intraocular pressures normalized. At 1 week, slit-lamp examination showed deepened anterior chambers and gonioscopy confirmed widened angles. Oral prednisone was titrated down slowly for the remainder of her uneventful pregnancy. On follow-up 1 month after delivery, intraocular pressures and best-corrected visual acuities reached preterm baseline values of 15 mm Hg OU and 20/30 OU. This is the first reported case of furosemide-associated bilateral angle-closure glaucoma. Similar idiosyncratic reactions following exposure to other sulphonamide-containing drugs have been described. We propose discontinuation of the offending agent and treatment with oral prednisone in similar clinical settings.

  10. [A mental health awareness anti-stigma program including user-trainers has a significant impact on knowledge, beliefs and attitudes of job centre professionals in Paris].

    Science.gov (United States)

    Jouet, E; Moineville, M; Favriel, S; Leriche, P; Greacen, T

    2014-04-01

    Developing programs and actions to fight stigma and discrimination against people living with mental disorders is a priority both internationally and in France. Involving mental health service users in these anti-stigma programs has proved to be a key element for effective programs. The present study evaluates the impact of user-trainers in an anti-stigma campaign with job counselors on their knowledge, beliefs, and desire for social distance with regard to mental illness and the mentally ill. Eighty-nine professionals participated in eight mental health awareness days from December 2008 to June 2009. Each training day was built around two pedagogical units: firstly, a psychiatrist providing a theoretical overview of mental illness and care and secondly, user-trainers describing their point of view on mental illness and exchanging with participants. A questionnaire administered at the beginning and at the end of the mental health awareness day assessed the impact of the day on participants' knowledge, beliefs, and desire for social distance. Answers to open questions were evaluated using thematic qualitative analysis. The intervention had statistically significant positive effects on all three training objectives: knowledge, beliefs and desire for social distance. Analysis of qualitative data confirmed participants' need for information and training with regard to providing support to clients with mental health problems; participants frequently attributed their improved self-confidence at the end of the day with regard to providing job coaching for this population group to the presence of user-trainers. A mental health awareness day using mental health service users and psychiatrists as trainers had significant positive effects in terms of reducing stigma with regard to people with mental illness. Further research is needed to understand whether the impact of such awareness approaches can be maintained in everyday professional practice over time. Copyright © 2013

  11. Attempted eyelid closure affects intraocular pressure measurement.

    Science.gov (United States)

    Gandhi, P D; Gürses-Ozden, R; Liebmann, J M; Ritch, R

    2001-04-01

    To evaluate the effect of attempted eyelid closure on intraocular pressure measurement. Normal subjects underwent intraocular pressure measurement in both eyes using Goldmann applanation tonometry and Tono-pen XL (Mentor, Inc, Norwell, Massachusetts) by the same examiner holding the eyelids open, both with and without the subject simultaneously attempting forced eyelid closure. Subjects were seated during all measurements and waited 5 minutes between measurements with each instrument; the order of measurement was randomized. Thirty eyes of 15 subjects (six men, nine women) were enrolled. Mean age was 30.5 +/- 5.2 years (range, 24 to 40 years). With Goldmann applanation tonometry, intraocular pressure increased in both eyes with attempted eyelid closure by a mean of 1.5 +/- 2.0 mm Hg (P =.0002, paired t test; range, -2 to 8 mm Hg). With the Tono-pen XL, intraocular pressure also increased in both eyes with attempted eyelid closure by a mean of 1.9 +/- 2.7 mm Hg (P =.0002, paired t test; range, -2 to 9 mm Hg). Tono-pen XL mean intraocular pressure values in both eyes (14.4 +/- 2.3 mm Hg) consistently overestimated those of Goldmann applanation tonometry (13.0 +/- 2.2 mm Hg) by a mean of 1.4 +/- 2.3 mm Hg. Attempted forced eyelid closure is a common and statistically significant source of error in routine outpatient measurement of intraocular pressure and could influence clinical management of glaucoma.

  12. [Investigation of the educational effectiveness of including small group discussion as part of a drug abuse prevention program for junior high school students].

    Science.gov (United States)

    Yamada, Junichi; Takayanagi, Risa; Yokoyama, Haruko; Suzuki, Yasuhiro; Sinohara, Satomi; Yamada, Yasuhiko

    2014-01-01

    We evaluated the effectiveness of small group discussion (SGD) in association with a drug abuse prevention program for junior high school students. The students first received a lecture about drug abuse prevention, then participated in SGD. The discussion focused on how to take action when tempted to abuse drugs. We gave a questionnaire 3 times; before and after the lecture (before SGD), and after SGD. Seventy-seven students replied to these questionnaires. After the lecture, knowledge about drug abuse was improved and all students answered that they had never abused drugs. However, in answer to a different question, a few students noted that they might use drugs in some situations. We consider it necessary to give more consideration to this problem. After the lecture, 35.5% of the students felt that they had definitely acquired skills for drug abuse prevention, whereas after the SGD this was increased to 73.7%. In addition, more than 75% of the students answered that the SGD program was useful since the opinions of other students could be heard. These results suggest that more students acquired skills to prevent drug abuse by participation in SGD. Our findings showed that SGD was useful and that the students were able to more effectively understand important concepts related to drug abuse prevention.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

  14. Timing and rate of spheno-occipital synchondrosis closure and its relationship to puberty.

    Directory of Open Access Journals (Sweden)

    Anwar Alhazmi

    Full Text Available This study examines the relationship between spheno-occipital synchondrosis (SOS closure and puberty onset in a modern American population. It also investigates the timing and the rate of SOS closure in males and females.The sample includes cross-sectional and longitudinal 3D Cone Beam Computed Tomography (CBCT scans of 741 individuals (361 males and 380 females aged 6-20 years. Each CBCT scan is visualized in the mid-sagittal plane, and the spheno-occipital synchondrosis (SOS is scored as completely open, partially fused, mostly fused, and completely fused. The Menarche commencement is used as an indicator of puberty onset in females.Mean ages of open, partially-fused, mostly-fused, and completely fused SOS were 11.07, 12.95, 14.44, and 16.41 years in males, and 9.75, 11.67, 13.25, and 15.25 in females, respectively. The results show there is a significant association between the SOS closure stage and the commencement of menarche (Fisher's Exact Test p < 0.001. It was found that females had a higher SOS closure rate (38.60% per year than males at the age of 10 years. The closure rate in males appears slower than females at age 10, but it lasts a longer time, ranging between 22 and 26% per year from age 11 to 14 years.There is a significant relationship between puberty onset and SOS closure, suggesting its closure is at least partially affected by systemic, hormonal changes in the growing adolescent. Also, SOS closure occurs at a faster rate and at an earlier age in females compared to males.

  15. School closures during the 2009 influenza pandemic: national and local experiences

    Science.gov (United States)

    2014-01-01

    Background School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives. Methods Data were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data. Results Our review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area. Conclusions The single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries. PMID:24739814

  16. Wound closure and tissue adhesives in clear corneal incision cataract surgery.

    Science.gov (United States)

    Tong, Amy Y; Gupta, Preeya K; Kim, Terry

    2018-01-01

    Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to seal clear corneal incisions in cataract surgery. Stromal hydration and sutured closure of clear corneal incisions remain viable options for wound closure. Wound sealants, particularly polyethylene glycol (PEG)-based hydrogels, have been found to provide watertight wound seal with less foreign-body sensation and surgically induced astigmatism compared with sutures, and less adverse effects and greater ease of use compared with cyanoacrylate and fibrin glues. Stromal hydration, sutured closure, and use of a corneal adhesive are all wound closure options for clear corneal incisions. Of the currently available tissue adhesives, PEG hydrogel sealants have become the most widely accepted, with an improved side-effect and biocompatibility profile.

  17. Timing and rate of spheno-occipital synchondrosis closure and its relationship to puberty.

    Science.gov (United States)

    Alhazmi, Anwar; Vargas, Eduardo; Palomo, J Martin; Hans, Mark; Latimer, Bruce; Simpson, Scott

    2017-01-01

    This study examines the relationship between spheno-occipital synchondrosis (SOS) closure and puberty onset in a modern American population. It also investigates the timing and the rate of SOS closure in males and females. The sample includes cross-sectional and longitudinal 3D Cone Beam Computed Tomography (CBCT) scans of 741 individuals (361 males and 380 females) aged 6-20 years. Each CBCT scan is visualized in the mid-sagittal plane, and the spheno-occipital synchondrosis (SOS) is scored as completely open, partially fused, mostly fused, and completely fused. The Menarche commencement is used as an indicator of puberty onset in females. Mean ages of open, partially-fused, mostly-fused, and completely fused SOS were 11.07, 12.95, 14.44, and 16.41 years in males, and 9.75, 11.67, 13.25, and 15.25 in females, respectively. The results show there is a significant association between the SOS closure stage and the commencement of menarche (Fisher's Exact Test p puberty onset and SOS closure, suggesting its closure is at least partially affected by systemic, hormonal changes in the growing adolescent. Also, SOS closure occurs at a faster rate and at an earlier age in females compared to males.

  18. Vacuum-assisted closure for sternal wounds: a first-line therapeutic management approach.

    Science.gov (United States)

    Agarwal, Jayant P; Ogilvie, Michael; Wu, Liza C; Lohman, Robert F; Gottlieb, Lawrence J; Franczyk, Mietka; Song, David H

    2005-09-15

    Vacuum-assisted closure therapy has gained widespread use since its introduction in 1997. Previous studies have attributed significant benefit to its use for treatment of sternal wounds with or without mediastinitis. Management of sternal wounds with this therapy has been shown to decrease the number of dressing changes, reduce the time between débridement and definitive closure, and reduce costs associated with a protracted course of in-hospital dressing changes. The therapy has been used both as a bridge between débridement and definitive closure and as a catalyst to secondary sternal-wound healing. The authors performed a retrospective review of 103 patients who underwent vacuum-assisted closure therapy after median sternotomy between June of 1999 and March of 2004 at a single institution. The wounds were classified as sterile wounds, superficial sternal infections, and mediastinitis. The wound closure device, consisting of a polyurethane sponge and evacuation tube with in-line suction, was applied sterilely to all wounds over a layer of Acticoat. Vacuum-assisted closure was utilized in the treatment of sternal wounds for 103 patients (67 male patients and 36 female patients) whose mean age was 52 years (range, 3 months to 91 years). Patient comorbidities included diabetes, chronic obstructive pulmonary disease, end-stage renal disease, immunosuppression, and others. Sixty-four percent of the patients had a diagnosis of mediastinitis; 36 percent had either superficial infections or a sterile wound. The therapy was utilized for an average period of 11 days per patient. Sixty-eight percent of the patients (70 of 103) had definitive chest closure with open reduction internal fixation and/or flap closure. The remaining 32 percent had no definitive closure method. The overall mortality rate was 28 percent (29 of 103 patients), although no deaths were directly related to use of the therapy, and only four deaths resulted from sepsis as a consequence of mediastinitis

  19. Mixed Waste Management Facility (MWMF) closure, Savannah River Plant: Clay cap test section construction report

    Energy Technology Data Exchange (ETDEWEB)

    1988-02-26

    This report contains appendices 3 through 6 for the Clay Cap Test Section Construction Report for the Mixed Waste Management Facility (MWMF) closure at the Savannah River Plant. The Clay Cap Test Program was conducted to evaluate the source, lab. permeability, in-situ permeability, and compaction characteristics, representative of kaolin clays from the Aiken, South Carolina vicinity. (KJD)

  20. Glottal closure instant and voice source analysis using time-scale ...

    Indian Academy of Sciences (India)

    For each period, the optimal LoMA is computed by linking amplitude maxima at each scale of a wavelet transform, using a dynamic programming algorithm. A time-scale analysis of the linear acoustic model of speech production shows several interesting properties. The LoMA points to the glottal closure instants. The LoMA ...

  1. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, A. J. [National Security Technologies, LLC, Las Vegas, NV (United States). Nevada Test Site; Lantow, Tiffany A. [National Security Technologies, LLC, Las Vegas, NV (United States). Nevada Test Site

    2015-03-25

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2014 and includes inspection and repair activities completed at the following CAUs; CAU 400: Bomblet Pit and Five Points Landfill (TTR); CAU 407: Roller Coaster RadSafe Area (TTR); CAU 424: Area 3 Landfill Complexes (TTR); CAU 453: Area 9 UXO Landfill (TTR); and CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports and subsequent correspondence with the Nevada Division of Environmental Protection. The post-closure inspection plans and subsequent correspondence modifying the requirements for each CAU are included in Appendix B. The inspection checklists are included in Appendix C. Photographs taken during inspections are included in Appendix D. The annual post-closure inspections were conducted on May 28, 2014. Maintenance was required at CAU 407. Animal burrows were backfilled and erosion repairs were performed. Vegetation monitoring was performed at CAU 407 in June 2014. The vegetation monitoring report is included in Appendix E.

  2. CLOSURE REPORT FOR CORRECTIVE ACTION UNIT 115: AREA 25 TEST CELL A FACILITY, NEVADA TEST SITE, NEVADA

    Energy Technology Data Exchange (ETDEWEB)

    NA

    2006-03-01

    This Closure Report (CR) describes the activities performed to close CAU 115, Area 25 Test Cell A Facility, as presented in the NDEP-approved SAFER Plan (NNSA/NSO, 2004). The SAFER Plan includes a summary of the site history, process knowledge, and closure standards. This CR provides a summary of the completed closure activities, documentation of waste disposal, and analytical and radiological data to confirm that the remediation goals were met and to document final site conditions. The approved closure alternative as presented in the SAFER Plan for CAU 115 (NNSA/NSO, 2004) was clean closure; however, closure in place was implemented under a Record of Technical Change (ROTC) to the SAFER Plan when radiological surveys indicated that the concrete reactor pad was radiologically activated and could not be decontaminated to meet free release levels. The ROTC is included as Appendix G of this report. The objectives of closure were to remove any trapped residual liquids and gases, dispose regulated and hazardous waste, decontaminate removable radiological contamination, demolish and dispose aboveground structures, remove the dewar as a best management practice (BMP), and characterize and restrict access to all remaining radiological contamination. Radiological contaminants of concern (COCs) included cobalt-60, cesium-137, strontium-90, uranium-234/235/236/238, and plutonium-239/240. Additional COCs included Resource Conservation and Recovery Act (RCRA) metals, polychlorinated biphenyls (PCBs), and asbestos.

  3. Parallel closure theory for toroidally confined plasmas

    Science.gov (United States)

    Ji, Jeong-Young; Held, Eric D.

    2017-10-01

    We solve a system of general moment equations to obtain parallel closures for electrons and ions in an axisymmetric toroidal magnetic field. Magnetic field gradient terms are kept and treated using the Fourier series method. Assuming lowest order density (pressure) and temperature to be flux labels, the parallel heat flow, friction, and viscosity are expressed in terms of radial gradients of the lowest-order temperature and pressure, parallel gradients of temperature and parallel flow, and the relative electron-ion parallel flow velocity. Convergence of closure quantities is demonstrated as the number of moments and Fourier modes are increased. Properties of the moment equations in the collisionless limit are also discussed. Combining closures with fluid equations parallel mass flow and electric current are also obtained. Work in collaboration with the PSI Center and supported by the U.S. DOE under Grant Nos. DE-SC0014033, DE-SC0016256, and DE-FG02-04ER54746.

  4. Hanford Patrol Academy demolition sites closure plan

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-30

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

  5. Biological constraints do not entail cognitive closure.

    Science.gov (United States)

    Vlerick, Michael

    2014-12-01

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

  6. Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial.

    Science.gov (United States)

    Pelaez, Mireia; Gonzalez-Cerron, Silvia; Montejo, Rocío; Barakat, Rubén

    2014-01-01

    To investigate the effect of pelvic floor muscle training (PFMT) taught in a general exercise class during pregnancy on the prevention of urinary incontinence (UI) in nulliparous continent pregnant women. This was a unicenter two armed randomized controlled trial. One hundred sixty-nine women were randomized by a central computer system to an exercise group (EG) (exercise class including PFMT) (n = 73) or a control group (CG) (n = 96). 10.1% loss to follow-up: 10 from EG and 7 from CG. The intervention consisted of 70-75 sessions (22 weeks, three times per week, 55-60 min/session including 10 min of PFMT). The CG received usual care (which included follow up by midwifes including information about PFMT). Questions on prevalence and degree of UI were posed before (week 10-14) and after intervention (week 36-39) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). At the end of the intervention, there was a statistically significant difference in favor of the EG. Reported frequency of UI [Never: CG: 54/60.7%, EG: 60/95.2% (P prevention of UI in primiparous pregnant women. © 2013 Wiley Periodicals, Inc.

  7. Closure properties of Watson-Crick grammars

    Science.gov (United States)

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

    2015-12-01

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

  8. Straight line closure of congenital macrostomia

    Directory of Open Access Journals (Sweden)

    Schwarz Richard

    2004-01-01

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

  9. Uncertainty Quantification of Multi-Phase Closures

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-10-27

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

  10. Comparison of LC–MS-MS and GC–MS Analysis of Benzodiazepine Compounds Included in the Drug Demand Reduction Urinalysis Program

    Science.gov (United States)

    Perez, Erick Roman; Knapp, Joshua A.; Horn, Carl K.; Stillman, Stedra L.; Evans, James E.; Arfsten, Darryl P.

    2016-01-01

    Liquid chromatography–tandem mass spectrometry (LC–MS-MS) offers specific advantages over gas chromatography–mass spectrometry (GC–MS) such as the ability to identify and measure a broader range of compounds with minimal sample preparation. Comparative analysis of LC–MS-MS versus GC–MS was performed for urinalysis detection of five benzodiazepine compounds currently part of the Department of Defense (DoD) Drug Demand Reduction Program (DDRP) testing panel; alpha-hydroxyalprazolam, oxazepam, lorazepam, nordiazepam and temazepam. In the analyses of internally prepared control urine samples at concentrations around the DDRP administrative decision point for benzodiazepines (100 ng/mL), both technologies produced comparable results with average accuracies between 99.7 and 107.3% and average coefficients of variation (%CV) MS-MS analysis. However, the effects were controlled by using deuterated internal standards (ISTDs). Additionally, there was a 39% increase in nordiazepam mean concentration analyzed by LC–MS-MS due to suppression of the ISTD ion by the flurazepam metabolite 2-hydroxyethylflurazepam. The ease and speed of sample extraction, the broader range of compounds that can be analyzed and shorter run time make the LC–MS-MS technology a suitable and expedient alternative confirmation technology for benzodiazepine testing. PMID:26755538

  11. Tomato Ribonuclease LX with the Functional Endoplasmic Reticulum Retention Motif HDEF Is Expressed during Programmed Cell Death Processes, Including Xylem Differentiation, Germination, and Senescence1

    Science.gov (United States)

    Lehmann, Karin; Hause, Bettina; Altmann, Dorit; Köck, Margret

    2001-01-01

    We have studied the subcellular localization of the acid S-like ribonuclease (RNase) LX in tomato (Lycopersicon esculentum Mill.) cells using a combination of biochemical and immunological methods. It was found that the enzyme, unexpectedly excluded from highly purified vacuoles, accumulates in the endoplasmic reticulum. The evidence that RNase LX is a resident of the endoplasmic reticulum (ER) is supported by an independent approach showing that the C-terminal peptide HDEF of RNase LX acts as an alternative ER retention signal in plants. For functional testing, the cellular distribution of chimeric protein constructs based on a marker protein, Brazil nut (Bertholletia excelsa) 2S albumin, was analyzed immunochemically in transgenic tobacco (Nicotiana tabacum) plants. Here, we report that the peptide motif is necessary and sufficient to accumulate 2S albumin constructs of both vacuolar and extracellular final destinations in the ER. We have shown immunochemically that RNase LX is specifically expressed during endosperm mobilization and leaf and flower senescence. Using immunofluorescence, RNase LX protein was detected in immature tracheary elements, suggesting a function in xylem differentiation. These results support a physiological function of RNase LX in selective cell death processes that are also thought to involve programmed cell death. It is assumed that RNase LX accumulates in an ER-derived compartment and is released by membrane disruption into the cytoplasma of those cells that are intended to undergo autolysis. These processes are accompanied by degradation of cellular components supporting a metabolic recycling function of the intracellular RNase LX. PMID:11598219

  12. A New Method for Closure of Total Laryngectomy Wound

    Directory of Open Access Journals (Sweden)

    M R Fathol Olomi

    2008-06-01

    Full Text Available Background: Total laryngectomy is the mainstay of treatment for laryngeal cancer. Fistula is one of the most common complications after total laryngectomy. In patients without risk factors such as prior radiotherapy, diabetes mellitus or chronic renal disease, the incidence of pharyngocutaneous fistula is related to wound healing and duration of operation. We have developed a new method that is both simple and without the complication of pharangocutaneous fistula. Herein, we report the efficacy of this innovative method for the closure of total laryngectomy compared to the conventional method for closure.Methods: In this clinical trial, we included 40 patients with grade T3 or T4 squamous cell carcinoma of the larynx. The total laryngectomy of all patients was performed by the standard method. Twenty patients (case group were repaired by the new method for closure and 20 patients (control group were repaired by the standard method. Duration of surgery and hospital stay, bleeding, hematoma, seroma and fistula formation were characterized for every patient and statistically analyzed.Results: The mean age was 59.8 ±7.8 years for the control group and 61.3 ±6.4 years for the case group. Duration of surgery was 150 ±23.2 minutes and 130 ±18.7 minutes for the control and case groups, respectively (p<0.001. Duration of hospital stay was 10.5 ±1.6 and 3.1 ±0.2 days in the control and case groups, respectively (p<0.002. Bleeding, hematoma or seroma were not seen in either group. Pharyngocutaneous fistula occurred in three patients in control group and was not observed in case group.Conclusion: This new method for closure shortens the duration of surgery and hospital stay. Furthermore, the patients in the case group avoided the psychological and traumatic side effects of tube feeding associated with fistula. In addition, no other complications were observed with this method. We recommend the use of this simple and efficient method for wound closure

  13. Closure Report for Corrective Action Unit 139: Waste Disposal Sites, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2009-07-31

    Corrective Action Unit (CAU) 139 is identified in the Federal Facility Agreement and Consent Order (FFACO) as 'Waste Disposal Sites' and consists of the following seven Corrective Action Sites (CASs), located in Areas 3, 4, 6, and 9 of the Nevada Test Site: CAS 03-35-01, Burn Pit; CAS 04-08-02, Waste Disposal Site; CAS 04-99-01, Contaminated Surface Debris; CAS 06-19-02, Waste Disposal Site/Burn Pit; CAS 06-19-03, Waste Disposal Trenches; CAS 09-23-01, Area 9 Gravel Gertie; and CAS 09-34-01, Underground Detection Station. Closure activities were conducted from December 2008 to April 2009 according to the FFACO (1996, as amended February 2008) and the Corrective Action Plan for CAU 139 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2007b). The corrective action alternatives included No Further Action, Clean Closure, and Closure in Place with Administrative Controls. Closure activities are summarized. CAU 139, 'Waste Disposal Sites,' consists of seven CASs in Areas 3, 4, 6, and 9 of the NTS. The closure alternatives included No Further Action, Clean Closure, and Closure in Place with Administrative Controls. This CR provides a summary of completed closure activities, documentation of waste disposal, and confirmation that remediation goals were met. The following site closure activities were performed at CAU 139 as documented in this CR: (1) At CAS 03-35-01, Burn Pit, soil and debris were removed and disposed as LLW, and debris was removed and disposed as sanitary waste. (2) At CAS 04-08-02, Waste Disposal Site, an administrative UR was implemented. No postings or post-closure monitoring are required. (3) At CAS 04-99-01, Contaminated Surface Debris, soil and debris were removed and disposed as LLW, and debris was removed and disposed as sanitary waste. (4) At CAS 06-19-02, Waste Disposal Site/Burn Pit, no work was performed. (5) At CAS 06-19-03, Waste Disposal Trenches, a native soil cover was installed

  14. Impact of Biological Feedback and Incentives on Blood Fatty Acid Concentrations, Including Omega-3 Index, in an Employer-Based Wellness Program.

    Science.gov (United States)

    McBurney, Michael I; Bird, Julia K

    2017-08-05

    Eicosapentaenoic acid (EPA, C20:5n-3) and docosahexaenoic acid (DHA, C22:6n-3) are important fatty acids for the retina and brain. More than 95% of Americans have suboptimal EPA + DHA blood concentrations. This cross-sectional employer-based study assessed whole blood fatty acid levels of volunteers participating in an onsite wellness biometric screening program and was designed to determine if an incentive, a $5 coupon for a 90-day supply of fish oil supplement typically costing $18-30, stimulated incremental dietary behavior change relative to nutritional status assessment alone to increase EPA + DHA concentrations. Volunteers completed a dietary survey and finger stick blood samples were collected to be analyzed for fatty acid composition. In addition, 636 individuals participated in the initial onsite biometric screening. Three months later, and without prior knowledge, all employees were invited to a second screening. At the second screening, 198 employees volunteered for the first time and 149 employees had a second test (17.9%). At baseline, the average age (n = 834) was 45 year and omega-3 index was 5.0% with 41% female. EPA + DHA concentration, i.e., omega-3 index, was significantly lower in men (4.8%) than women (5.2%), as were DHA and linoleic acid (LA) concentrations (p omega-3 index was positively and linearly associated with omega-3 intake. Only 4% of volunteers had an omega-3 index >8% on initial screening. Among the 149 individuals with two measurements, omega-3 intake from supplements, but not food, increased significantly from 258 to 445 mg/d (p omega-3 index (+0.21, p omega-3 supplement.

  15. Impact of Biological Feedback and Incentives on Blood Fatty Acid Concentrations, Including Omega-3 Index, in an Employer-Based Wellness Program

    Directory of Open Access Journals (Sweden)

    Michael I. McBurney

    2017-08-01

    Full Text Available Eicosapentaenoic acid (EPA, C20:5n-3 and docosahexaenoic acid (DHA, C22:6n-3 are important fatty acids for the retina and brain. More than 95% of Americans have suboptimal EPA + DHA blood concentrations. This cross-sectional employer-based study assessed whole blood fatty acid levels of volunteers participating in an onsite wellness biometric screening program and was designed to determine if an incentive, a $5 coupon for a 90-day supply of fish oil supplement typically costing $18–30, stimulated incremental dietary behavior change relative to nutritional status assessment alone to increase EPA + DHA concentrations. Volunteers completed a dietary survey and finger stick blood samples were collected to be analyzed for fatty acid composition. In addition, 636 individuals participated in the initial onsite biometric screening. Three months later, and without prior knowledge, all employees were invited to a second screening. At the second screening, 198 employees volunteered for the first time and 149 employees had a second test (17.9%. At baseline, the average age (n = 834 was 45 year and omega-3 index was 5.0% with 41% female. EPA + DHA concentration, i.e., omega-3 index, was significantly lower in men (4.8% than women (5.2%, as were DHA and linoleic acid (LA concentrations (p < 0.05. Baseline omega-3 index was positively and linearly associated with omega-3 intake. Only 4% of volunteers had an omega-3 index >8% on initial screening. Among the 149 individuals with two measurements, omega-3 intake from supplements, but not food, increased significantly from 258 to 445 mg/d (p < 0.01 at the second test as did the omega-3 index (+0.21, p < 0.02. In this employed population, only 1% redeemed a coupon for an omega-3 supplement.

  16. Variability in school closure decisions in response to 2009 H1N1: a qualitative systems improvement analysis

    Directory of Open Access Journals (Sweden)

    Kraemer John D

    2011-02-01

    Full Text Available Abstract Background School closure was employed as a non-pharmaceutical intervention against pandemic 2009 H1N1, particularly during the first wave. More than 700 schools in the United States were closed. However, closure decisions reflected significant variation in rationales, decision triggers, and authority for closure. This variability presents the opportunity for improved efficiency and decision-making. Methods We identified media reports relating to school closure as a response to 2009 H1N1 by monitoring high-profile sources and searching Lexis-Nexis and Google news alerts, and reviewed reports for key themes. News stories were supplemented by observing conference calls and meetings with health department and school officials, and by discussions with decision-makers and community members. Results There was significant variation in the stated goal of closure decision, including limiting community spread of the virus, protecting particularly vulnerable students, and responding to staff shortages or student absenteeism. Because the goal of closure is relevant to its timing, nature, and duration, unclear rationales for closure can challenge its effectiveness. There was also significant variation in the decision-making authority to close schools in different jurisdictions, which, in some instances, was reflected in open disagreement between school and public health officials. Finally, decision-makers did not appear to expect the level of scientific uncertainty encountered early in the pandemic, and they often expressed significant frustration over changing CDC guidance. Conclusions The use of school closure as a public health response to epidemic disease can be improved by ensuring that officials clarify the goals of closure and tailor closure decisions to those goals. Additionally, authority to close schools should be clarified in advance, and decision-makers should expect to encounter uncertainty disease emergencies unfold and plan

  17. Early abdominal closure using component separation in patients with an open abdomen after trauma: a pilot study

    Directory of Open Access Journals (Sweden)

    Chopra K

    2015-02-01

    Full Text Available Karan Chopra,1 Kashyap Komarraju Tadisina,1 Jamil A Matthews,1 Jennifer Sabino,1 Devinder P Singh,1 Wassim Habre2 1University of Maryland Medical Center, Baltimore, MD, 2Crozer-Chester Medical Center, Upland, PA, USA Background: Permanent abdominal wall closure in patients undergoing damage-control laparotomy is achieved using techniques involving separation and advancement of abdominal wall components along with surgical mesh. However, these techniques are costly, morbid, and time-consuming. We compared outcomes following permanent abdominal closure using component separation (CS with non-cross-linked porcine acellular dermal matrix (PADM versus temporizing split-thickness skin graft (STSG closure. Materials and methods: A retrospective review identified eleven patients who underwent damage-control laparotomies from January 2010 to June 2011. Outcomes assessed included hospital length of stay (LOS, days on ventilator, size of defect and tissue matrix, and postoperative functionality. Results: Of the eleven patients identified, primary closure was achieved in five, CS/PADM closure in four, and STSG closure in two. Those with primary closure were excluded from the study. In the CS/PADM group, large defects (>24×20 cm were successfully closed using CS with PADM. Patients in the CS/PADM group had reduced third-space fluid loss, less difficulty in managing the open abdominal wound, and decreased risks for potential enterocutaneous fistulae, and intra-abdominal abscess formation. Total hospital LOS and days on the ventilator were also significantly reduced in the CS/PADM group compared with the STSG group. Conclusion: Early abdominal closure using CS/PADM was safe and effective in these patients, and may be cost-effective because only one operation is required. The shorter hospital LOS and days on the ventilator observed versus STSG closure appear promising, although further study is required. Keywords: acellular dermal matrix, laparotomy, abdominal

  18. Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen.

    Science.gov (United States)

    Salman, A E; Yetişir, F; Aksoy, M; Tokaç, M; Yildirim, M B; Kiliç, M

    2014-02-01

    Definitive abdominal closure may not be possible for several days or weeks after laparotomy in damage-control surgery, abdominal compartment syndrome and intraabdominal sepsis, until the patient has stabilized. Vacuum-assisted closure (VAC therapy(®), KCI, San Antonio, TX, USA) and abdominal re-approximation anchor system (ABRA, Canica, Almonte, Ontario, Canada) are novel techniques in delayed closure of open abdomen. Our aim is to present the use of these strategies in the management of 7 patients with open abdomen. Between August 2010 and December 2011, 7 patients with severe peritonitis were stabilized by laparotomy and treated with either ABRA system or ABRA system in conjunction with VAC dressing. VAC dressing applied to 4 patients initially and followed by ABRA. ABRA was applied alone to remaining 3 patients. Demographic data and patient characteristics, timing of VAC dressing and ABRA system were recorded. ICU and hospital stay and development of incisional hernia were also recorded. Stage of open abdomen, width of abdominal defect, extent to damage to fascia, and pressure sores were staged. The mean duration with VAC dressing before ABRA application was 18 days. The mean duration of ABRA application was 53 days. The average width of the abdominal defect was 18 cm. The average length of defect was 20.8 cm. Delayed primary abdominal closure was accomplished in 6 patients without further surgery. Incisional hernia with a small abdominal defect developed in 2 patients. Abdominal re-approximation anchor system and VAC dressing can be used separately or in conjunction with each other for closure of delayed open abdomen successfully.

  19. Scalping of light volatile sulfur compounds by wine closures.

    Science.gov (United States)

    Silva, Maria A; Jourdes, Michaël; Darriet, Philippe; Teissedre, Pierre-Louis

    2012-11-07

    Closures have an important influence on wine quality during aging in a bottle. Closures have a direct impact on oxygen exposure and on volatiles scavenging in wine. Model wine solution soaking assays of several types of closures (i.e., natural and technical cork stoppers, synthetic closures, screw caps) with two important wine volatile sulfur compounds led to a considerable reduction in their levels. After 25 days, cork closures and synthetic closures, to a lesser extent, have significantly scavenged hydrogen sulfide and dimethyl sulfide. These compounds have a determinant impact on wine aging bouquet, being largely responsible for "reduced off-flavors". Hydrogen sulfide levels are often not well correlated with the exposure of wine to oxygen or with the permeability of the closure. Its preferential sorption by some types of closures may explain that behavior. Scalping phenomenon should be taken into account when studying wine post-bottling development.

  20. Use of Sodium Hyaluronate/Carboxymethylcellulose Bioresorbable Membrane in Loop Ileostomy Construction Facilitates Stoma Closure.

    Science.gov (United States)

    Bertoni, Danielle M; Hammond, Kerry L; Beck, David E; Hicks, Terry C; Whitlow, Charles B; Vargas, H David; Margolin, David A

    2017-01-01

    Loop ileostomy is a common adjunct to surgical procedures for low rectal cancers and inflammatory bowel disease. Ileostomy closure through a limited incision can be technically challenging. We hypothesized that placing a sodium hyaluronate/carboxymethylcellulose (SH/CMC) bioresorbable membrane at loop ileostomy creation would decrease stoma closure time without increasing morbidity. In a retrospective review at a single institution with 6 board-certified colorectal surgeons, patients with loop ileostomy creation and closure between September 1999 and December 2011 were grouped based on SH/CMC placement at ileostomy creation. Data were abstracted for age, sex, body mass index (BMI), primary diagnosis, length of surgery, staff surgeon, interval between surgeries, and postoperative morbidity. The primary endpoint was the length of the surgery for ileostomy closure. Secondary outcome measures were length of stay, wound infection rate, and other complications. A total of 293 patients were identified. Group 1 (with SH/CMC) included 146 patients, and Group 2 (without SH/CMC) included 147 patients. The groups were matched according to age, sex, BMI, interval between creation and closure, and indication for surgery. The average surgical time for closure was significantly shorter in Group 1 (46.4 minutes ± 2.7) compared to Group 2 (60 minutes ± 2.3) (P=0.0001). We found no difference between the groups in length of stay, wound infection rate, or complication rate. The use of SH/CMC in loop ileostomy creation significantly decreases the operative time required for stoma closure with no increase in the complication rate.

  1. Use of Sodium Hyaluronate/Carboxymethylcellulose Bioresorbable Membrane in Loop Ileostomy Construction Facilitates Stoma Closure

    Science.gov (United States)

    Bertoni, Danielle M.; Hammond, Kerry L.; Hicks, Terry C.; Whitlow, Charles B.; Vargas, H. David; Margolin, David A.

    2017-01-01

    Background: Loop ileostomy is a common adjunct to surgical procedures for low rectal cancers and inflammatory bowel disease. Ileostomy closure through a limited incision can be technically challenging. We hypothesized that placing a sodium hyaluronate/carboxymethylcellulose (SH/CMC) bioresorbable membrane at loop ileostomy creation would decrease stoma closure time without increasing morbidity. Methods: In a retrospective review at a single institution with 6 board-certified colorectal surgeons, patients with loop ileostomy creation and closure between September 1999 and December 2011 were grouped based on SH/CMC placement at ileostomy creation. Data were abstracted for age, sex, body mass index (BMI), primary diagnosis, length of surgery, staff surgeon, interval between surgeries, and postoperative morbidity. The primary endpoint was the length of the surgery for ileostomy closure. Secondary outcome measures were length of stay, wound infection rate, and other complications. Results: A total of 293 patients were identified. Group 1 (with SH/CMC) included 146 patients, and Group 2 (without SH/CMC) included 147 patients. The groups were matched according to age, sex, BMI, interval between creation and closure, and indication for surgery. The average surgical time for closure was significantly shorter in Group 1 (46.4 minutes ± 2.7) compared to Group 2 (60 minutes ± 2.3) (P=0.0001). We found no difference between the groups in length of stay, wound infection rate, or complication rate. Conclusion: The use of SH/CMC in loop ileostomy creation significantly decreases the operative time required for stoma closure with no increase in the complication rate. PMID:28638287

  2. Profile of angle closure in a tertiary care center in north India

    Directory of Open Access Journals (Sweden)

    Ichhpujani Parul

    2010-01-01

    Full Text Available Purpose: To study the demographic and clinical profile of the types of primary angle closure patients presenting at a tertiary care center in North India. Materials and Methods: Clinic records of patients diagnosed as primary angle closure were reviewed. International Society of Geographical and Epidemiological Ophthalmology (ISGEO classification scheme was used to categorize patients. Demographic and clinical data including prior management was collected and analyzed. Main Outcome measures were age, sex, symptomatology, best corrected visual acuity (BCVA, intraocular pressure (IOP, gonioscopy, optic disc assessment and visual field defects. Logistic regression model and receiver operating curve (ROC were calculated for predictors of type of glaucoma. Results: Eight hundred and fourteen patients (1603 eyes; males: 380, females: 434 were diagnosed to have various subtypes of angle closure. Mean (±SD age at presentation was significantly higher for males (57.57 ± 11.62 years as compared to females (53.64 ± 10.67 years ( P < 0001. Primary angle closure glaucoma (PACG was most frequently diagnosed subtype (49.38% followed by Primary angle closure (PAC (39.68% and Primary angle closure suspect (PACS (10.93% respectively. The three subtypes differed significantly among their mean IOP (on ANOVA, F = 14.04; P < 0001 using Greenhouse-Geisser correction. Univariate analysis was done to find significant predictors for the outcome of PACG. Logistic regression model and ROC containing the significant predictors yielded a very high AUC of 0.93 with strong discriminatory ability for PACG. Conclusion: In our hospital-based study, the significant predictors for the outcome of PACG included male gender, diminution of vision, the presence of pain and worsening grades of BCVA. Nearly half of PACG presented with advanced disease. In spite of one-third of the patients being diagnosed as angle closure prior to referral, only 8.34% had iridotomy (laser or surgical

  3. Military Base Closures: Time for Another Round?

    Science.gov (United States)

    2002-11-01

    context and background, see CRS Report 97-305, Military Base Closures: A Brief Historical Review since 1988, by George Siehl , 16 p. 2“Realignment” is...official, to encourage Lockheed Martin Corporation to go after some of the depot maintenance work at McClellan Air Force Base and keep the work in

  4. complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    2013-07-07

    Jul 7, 2013 ... Background: Patent Ductus Arteriosus (PDA) is a common cardiac malformation whose treatment locally has been surgical ligation via a lateral thoracotomy. Device closure of the ductus was first performed at the Mater hospital in 1999 in a ten year old male using a five millilitre detachable cook coil. In 2000 ...

  5. 50 CFR 622.43 - Closures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Closures. 622.43 Section 622.43 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION... hind, rock hind, yellowmouth grouper, tiger grouper, yellowfin grouper, graysby, and coney. (6...

  6. 300 Area Process Trenches Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    Luke, S.N.

    1994-08-15

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

  7. Spontaneous closure of traumatic CSF otorrhoea following ...

    African Journals Online (AJOL)

    ... the temporal bone extending in to the tympanomastoid area. Patient was managed conservatively with closure of the fistula and resolution of the leakage within 8 days after injury. We report this to further buttress the role of conservative management in CSF fistula. African Journal of Health Sciences Vol. 13 (3-4) 2006: pp.

  8. Opening up closure. Semiotics across scales

    Science.gov (United States)

    Lemke

    2000-01-01

    The dynamic emergence of new levels of organization in complex systems is related to the semiotic reorganization of discrete/continuous variety at the level below as continuous/discrete meaning for the level above. In this view both the semiotic and the dynamic closure of system levels is reopened to allow the development and evolution of greater complexity.

  9. Individual Consequences of Plant Closures and Cutbacks

    DEFF Research Database (Denmark)

    Andersen, Steen

    1991-01-01

    This thesis describes the segment of unemployment which has its origin in major closures and cutbacks. The argument for this is to make it possible to describe and to analyse a flow into and a flow out of a population of unemployed. Given a major dismissal the following questions are to be answered...

  10. The Story of a Charter School Closure.

    Science.gov (United States)

    Flynn, Susan L.; Arguelles, Lourdes

    2001-01-01

    The story of a charter school closure is told from the perspectives of students, parents, teachers, and community members, who felt that the sponsoring district revoked the charter for political reasons despite broad local support. The experience underscores the necessity of publicly subjecting the relationship of the public school system and the…

  11. Collective Protection (COLPRO) Novel Closures Testing

    Science.gov (United States)

    2013-03-28

    miosis level) or a predetermined exposure value, as specified by the test requirement document. MINICAMS®-like instruments have a detection range of...Performance. Candidate novel closures must pass user-defined requirements. The pass/fail requirements may depend on miosis hazard level, inhalation

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

    Science.gov (United States)

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

    2017-03-01

    Percutaneous patent foramen ovale (PFO) closure is a therapeutic option to prevent recurrent cerebral ischaemia in patients with cryptogenic stroke and transient cerebral ischaemia (TIA). The apparent lack of benefit seen in previous randomised trials has, in part, reflected inclusion of patients with alternate mechanisms of stroke. The role of formal neurology involvement in accurately delineating the likely aetiology of stroke or TIA is crucial in appropriate identification of patients for device closure. Furthermore, as the benefits of device closure may accrue over time, long-term follow-up is essential to define the role of device closure in management of presumed cryptogenic stroke. We retrospectively reviewed our experience with percutaneous PFO device closure since 2005. All subjects who underwent PFO closure at John Hunter and Lake Macquarie Private Hospitals were included in the study. All patients referred for device closure following cryptogenic stroke or TIA had first undergone formal neurology review with appropriate imaging and exclusion of paroxysmal atrial arrhythmia. Patients with a history of transient ischaemic attack (TIA) are frequently referred to a specialised clinic, aimed to identify patients with conditions not referable to cerebral ischaemia, with investigations initiated by the specialist clinic to elucidate an underlying aetiology. Outcome data was derived from the Hunter New England Area Local Health District Cardiac and Stroke Outcomes Unit, in addition to review of the medical record. The Cardiac and Stroke Outcomes Unit prospectively identified all patients presenting with stroke, TIA and atrial fibrillation. One hundred and twelve consecutive patients undergoing percutaneous patent foramen ovale closure between 2005 and 2015 were identified. The average age was 42.7 years and 57 (50.9%) patients were male. Cryptogenic stroke (68.8%) and transient cerebral ischaemia (23.2%) were the most common indications for PFO closure, with the

  13. Closure certification report for the Bear Creek burial grounds B area and walk-in pits at the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    On July 5, 1993, the revised RCRA Closure Plan for the Bear Creek Burial Grounds B Area and Walk-In Pits at the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee, DOE/OR/01-1100&D3 and Y/ER-53&D3, was approved by the Tennessee Department of Environment and Conservation (TDEC). The closure activities described in that closure plan have been performed. The purpose of this document is to summarize the closure activities for B Area and Walk-In Pits (WIPs), including placement of the Kerr Hollow Quarry debris at the WIPs.

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

    Science.gov (United States)

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

    2016-09-01

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

  15. Application system for invoice closure

    OpenAIRE

    Ribić, Siniša

    2011-01-01

    Company CREA d.o.o. where I did my practical training was in charge of making a complete information solution for one of the biggest real-estate agencies in Ljubljana. Within the thesis I was involved in development of complete information solution whose main part was eBusiness. The application was developed on .NET platform in programming language C#. An important part of the application was its database – Microsoft SQL, where all data was stored. Business process management was performed...

  16. Permanent Closure of the TAN-664 Underground Storage Tank

    Energy Technology Data Exchange (ETDEWEB)

    Bradley K. Griffith

    2011-12-01

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

  17. Evolution of Fascial Closure Optimization in Damage Control Laparotomy.

    Science.gov (United States)

    Lauerman, Margaret H; Dubose, Joseph J; Stein, Deborah M; Galvagno, Samuel M; Bradley, Matthew J; Diaz, Jose; Scalea, Thomas M

    2016-12-01

    Management of patients undergoing damage control laparotomy (DCL) involves many surgical, medical, and logistical factors. Ideal patient management optimizing fascial closure with regard to timing and closure techniques remains unclear. A retrospective review of patients undergoing DCL from 2000 to 2012 at an urban Level I trauma center was undertaken. Mortality of DCL decreased over the study period from 62.5 to 34.6 per cent, whereas enterocutaneous fistula rate decreased from 12.5 to 3.8 per cent. Delayed primary fascial closure rate improved from 22.2 to 88.2 per cent. Time to closure (P fascial closure. In subgroup analysis, achievement of delayed primary fascial closure was decreased with time to closure after one week (91.7% vs 52.0%, P = 0.002) and time to first attempted closure after two days (86.5% vs 70.0%, P = 0.042). In multivariate analysis, time to closure (odds ratio: 0.13, 95% confidence interval: 0.04-0.39; P fascial closure. Timing of attempted closure plays a significant role in attaining delayed primary fascial closure, highlighting the importance of early re-exploration.

  18. 9 CFR 381.301 - Containers and closures.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Containers and closures. 381.301... Containers and closures. (a) Examination and cleaning of empty containers. (1) Empty containers, closures... and free of structural defects and damage that may affect product or container integrity. Such an...

  19. 9 CFR 318.301 - Containers and closures.

    Science.gov (United States)

    2010-01-01

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

  20. The potential migration effect of rural hospital closures

    DEFF Research Database (Denmark)

    Sørensen, Jens Fyhn Lykke

    2008-01-01

    Rural hospital closures are high on the current health care agenda in Denmark. One raised concern is that rural hospital closures may further decrease population numbers in rural areas, as closures may induce some residents to move away from affected areas, i.e. closer to health care services els...

  1. The Rising Rate of Rural Hospital Closures.

    Science.gov (United States)

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

    2016-01-01

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

  2. Project HAPI (Handicapped Achievement Program Improvement): Assessment plus Intervention equal I.E.P. A Handbook on How To Write an Individualized Education Program for Severe Disorders of Language, Including Aphasia and Other Speech-Language Handicapped (Communication Disorders). Book One.

    Science.gov (United States)

    Chapman, Jean

    The first of five handbooks developed by Project HAPI (Handicapped Achievement Program Improvement), a multimedia staff development program to help teachers and specialists write effective individualized education programs (IEPs), is in looseleaf workbook format and focuses on children with severe disorders of language, including aphasia and other…

  3. Economic evaluation of different suture closure methods: barbed versus traditional interrupted sutures.

    Science.gov (United States)

    Elmallah, Randa K; Khlopas, Anton; Faour, Mhamad; Chughtai, Morad; Malkani, Arthur L; Bonutti, Peter M; Roche, Martin; Harwin, Steven F; Mont, Michael A

    2017-12-01

    Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs. Therefore, the purpose of this review was to compare: (I) the cost of using barbed vs. conventional interrupted sutures; (II) the additional cost of differences in complications, if any; (III) to extrapolate cost savings on a hospital and national level; and (IV) to discuss the role of these findings on hospital savings and the effect on bundled payments. It was found that the main factors affecting differences in overall costs between barbed and standard interrupted suture were material cost and closure time. Many studies have demonstrated greater cost savings with the barbed suture due to shorter operative times, despite the higher material costs. The majority of studies also demonstrated similar complication rates between the suture types, and thus these are unlikely to affect the cost difference. However, to the best of our knowledge, there are no TKA studies in the literature evaluating the effect of suture type and associated complications on lengths of stay and readmission rates. Thus, it is unclear how these cost savings will translate to reimbursements rates and the role that they might play in bundled payments. Several studies in other specialties demonstrate decreased infection rates with the use of barbed sutures, which, if found to be true for TKA can be extrapolated to 3 million dollars of savings in revision TKA costs. Further studies on this topic are needed to define these

  4. Field test of a post-closure radiation monitor

    Energy Technology Data Exchange (ETDEWEB)

    Reed, S.E. [Babcock & Wilcox, Alliance, OH (United States); Christy, C.E. [Department of Energy, Morgantown, WV (United States); Heath, R.E. [FERMCO, Cincinnati, OH (United States)

    1995-10-01

    The DOE is conducting remedial actions at many sites contaminated with radioactive materials. After closure of these sites, long-term subsurface monitoring is typically required by law. This monitoring is generally labor intensive and expensive using conventional sampling and analysis techniques. The U.S. Department of Energy`s Morgantown Energy Technology Center (METC) has contracted with Babcock and Wilcox to develop a Long-Term Post-Closure Radiation Monitoring System (LPRMS) to reduce these monitoring costs. The system designed in Phase I of this development program monitors gamma radiation using a subsurface cesium iodide scintillator coupled to above-ground detection electronics using optical waveguide. The radiation probe can be installed to depths up to 50 meters using cone penetrometer techniques, and requires no downhole electrical power. Multiplexing, data logging and analysis are performed at a central location. A prototype LPRMS probe was built, and B&W and FERMCO field tested this monitoring probe at the Fernald Environmental Management Project in the fall of 1994 with funding from the DOE`s Office of Technology Development (EM-50) through METC. The system was used measure soil and water with known uranium contamination levels, both in drums and in situ depths up to 3 meters. For comparison purposes measurements were also performed using a more conventional survey probe with a sodium iodide scintillator directly butt-coupled to detection electronics.

  5. Incorporating Sustainability into Site Closure - A Field Example

    Science.gov (United States)

    Austrins, L. M.; West, J.

    2013-12-01

    Long term management of former chemical production facilities can be a costly and time consuming element of site closure, however, implementation of creative measures to introduce sustainability and reduce the need for onsite presence can be successfully incorporated into the site closure process. A case study demonstrating this involves a facility located in Sarnia, Ontario, which was an active multi chemical production facility from the 1940s, until it was decommissioned and sold between 2005 and 2010. The facility consisted of 322 acres of production areas. Several elements which allowed for reduced onsite presence and lower management costs were incorporated into the site decommissioning plan, including; phased remediation planning, and selection of sustainable components as part of remediation, surface water management, and groundwater management. The sustainability and management modifications were successfully negotiated and approved by the local regulatory agency. Due to the size and complexity of the site, a holistic approach for the facility was needed and included the development of a comprehensive decision matrix. Each remediation alternative incorporated sustainable practices. Ex-situ remediation consisted of excavation of contaminated subsurface medium and consolidation at a 4.7 acre onsite soil treatment area designed specifically for the site closure process. In-situ remediation consisted of injection of amendment into the native soils using hydraulic fracture and injection. When the plant was an active operating facility, groundwater management required active pumping and groundwater treatment through a series of carbon treatment units. Active pumping has been replaced by passive hydraulic control through the use of tree plantations.

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

    DEFF Research Database (Denmark)

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

    2018-01-01

    was to compare health-related quality of life (HRQOL) following early versus late closure of a temporary ileostomy. METHODS: Early closure of a temporary ileostomy (at 8-13 days) was compared with late closure (at more than 12 weeks) in a multicentre RCT (EASY) that included patients who underwent rectal...... resection for cancer. Inclusion of participants was made after index surgery. Exclusion criteria were signs of anastomotic leakage, diabetes mellitus, steroid treatment, and signs of postoperative complications at clinical evaluation 1-4 days after rectal resection. HRQOL was evaluated at 3, 6 and 12 months...

  7. Secondary plastic closure of gastroschisis is associated with a lower incidence of mechanical ventilation.

    Science.gov (United States)

    Dariel, Anne; Poocharoen, Wannisa; de Silva, Nicole; Pleasants, Hazel; Gerstle, Justin Ted

    2015-02-01

    Nonsurgical closure after primary silo placement, secondary plastic closure (SPC), has been used as an alternative to secondary surgical closure (SSC) in gastroschisis. The benefits described were closure without formal surgical procedure, cosmetic aspect, and minimization of intra-abdominal pressures. This study compared requirements for mechanical ventilation and general anesthesia, nutritional care, and outcomes between SPC and SSC. We included patients with primary staged-silo reduction with a 1-year minimum follow-up. SPC was performed at bedside with sedation using a nonadherent dressing. SSC was performed in operating room under general anesthesia using standard surgical techniques. This retrospective study included 64 patients, 23 SPC and 41 SSC. The characteristics of the two groups were comparable. Mechanical ventilation was used for 15 SPC and 41 SSC (p=0.0001) with a comparable median duration (5.5 and 6.0 days, not significant [NS]). General anesthesia was required for 9 SPC and 41 SSC (p<0.0001). Complications included one SPC and six SSC with necrotizing enterocolitis, zero SPC and four SSC with intestinal atresia, two SPC and four SSC with small bowel obstruction, zero SPC and one SSC with abdominal compartment syndrome resulting in a short bowel syndrome (NS). Median duration of parenteral nutrition (30 and 27 days), time to first feeds (14 and 14 days), time at or above minimal enteral feeding (22 and 17 days), time to full feeds (31 and 28 days), length of stay (LOS) in neonatal intensive care unit (24 and 23.5 days) and overall hospital LOS (37 and 36 days) were not statistically different between SPC and SSC patients without complications, respectively. These data were comparable for SPC and SSC patients with complications. Five SPC and six SSC developed an umbilical hernia (NS); two patients in each group required a surgical repair (NS). Plastic closure of gastroschisis after primary silo reduction is simple, safe, reproducible, and associated

  8. Use of a furosemide drip does not improve earlier primary fascial closure in the open abdomen

    Directory of Open Access Journals (Sweden)

    Leland H Webb

    2012-01-01

    Full Text Available Background: The furosemide drip (FD, in addition to improving volume overload respiratory failure, has been used to decrease fluid in attempts to decrease intra-abdominal and abdominal wall volumes to facilitate fascial closure. The purpose of this study is to evaluate the FD and the associated rate of primary fascial closure following trauma damage control laparotomy (DCL. Materials and Methods: From January 2004 to September 2008, a retrospective review from a single institution Trauma Registry of the American College of Surgeons dataset was performed. All DCLs greater than 24 h who had a length of stay for 3 or more days were identified. The study group (FD+ and control group (FD- were compared. Demographic data including age, sex, probability of survival, red blood cell transfusions, initial lactate, and mortality were collected. Primary outcomes included primary fascial closure and primary fascial closure within 7 days. Secondary outcomes included total ventilator days and LOS. Results: A total of 139 patients met inclusion criteria: 25 FD+ and 114 FD-. The 25 FD+ patients received the drug at a median 4 days post DCL. Demographic differences between the groups were not significantly different, except that initial lactate was higher for FD- (1.7 vs 4.0; P=0.03. No differences were noted between groups regarding successful primary fascial closure (FD+ 68.4% vs FD- 64.0%; P=0.669, or closure within 7 days (FD+13.2% vs FD- 28.0%; P=0.066 of original DCL. FD+ patients suffered more open abdomen days (4 [2-7] vs 2 [1-4]; P=0.001. FD+ did not demonstrate an association with primary fascial closure [Odds ratio (OR 1.5, 95% confidence interval (CI 0.260-8.307; P=0.663]. FD+ patients had more ventilator days and longer Intensive Care Unit (ICU/hospital LOS (P<0.01. Conclusion: FD use may remove excess volume; however, forced diuresis with an FD is not associated with an increased rate of primary closure after DCL. Further studies are warranted to

  9. Closure Report for Corrective Action Unit 516: Septic Systems and Discharge Points

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-02-01

    Corrective Action Unit (CAU) 516 is located in Areas 3, 6, and 22 of the Nevada Test Site. CAU 516 is listed in the Federal Facility Agreement and Consent Order of 1996 as Septic Systems and Discharge Points, and is comprised of six Corrective Action Sites (CASs): {sm_bullet} CAS 03-59-01, Bldg 3C-36 Septic System {sm_bullet} CAS 03-59-02, Bldg 3C-45 Septic System {sm_bullet} CAS 06-51-01, Sump and Piping {sm_bullet} CAS 06-51-02, Clay Pipe and Debris {sm_bullet} CAS 06-51-03, Clean Out Box and Piping {sm_bullet} CAS 22-19-04, Vehicle Decontamination Area The Nevada Division of Environmental Protection (NDEP)-approved corrective action alternative for CASs 06-51-02 and 22-19-04 is no further action. The NDEP-approved corrective action alternative for CASs 03-59-01, 03-59-02, 06-51-01, and 06-51-03 is clean closure. Closure activities included removing and disposing of total petroleum hydrocarbon (TPH)-impacted septic tank contents, septic tanks, distribution/clean out boxes, and piping. CAU 516 was closed in accordance with the NDEP-approved CAU 516 Corrective Action Plan (CAP). The closure activities specified in the CAP were based on the recommendations presented in the CAU 516 Corrective Action Decision Document (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2004). This Closure Report documents CAU 516 closure activities. During closure activities, approximately 186 tons of hydrocarbon waste in the form of TPH-impacted soil and debris, as well as 89 tons of construction debris, were generated and managed and disposed of appropriately. Waste minimization techniques, such as field screening of soil samples and the utilization of laboratory analysis to characterize and classify waste streams, were employed during the performance of closure work.

  10. Closure Report for Corrective Action Unit 536: Area 3 Release Site, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-06-01

    Corrective Action Unit (CAU) 536 is located in Area 3 of the Nevada Test Site. CAU 536 is listed in the Federal Facility Agreement and Consent Order of 1996 as Area 3 Release Site, and comprises a single Corrective Action Site (CAS): {sm_bullet} CAS 03-44-02, Steam Jenny Discharge The Nevada Division of Environmental Protection (NDEP)-approved corrective action alternative for CAS 03-44-02 is clean closure. Closure activities included removing and disposing of total petroleum hydrocarbon (TPH)- and polyaromatic hydrocarbon (PAH)-impacted soil, soil impacted with plutonium (Pu)-239, and concrete pad debris. CAU 536 was closed in accordance with the NDEP-approved CAU 536 Corrective Action Plan (CAP), with minor deviations as approved by NDEP. The closure activities specified in the CAP were based on the recommendations presented in the CAU 536 Corrective Action Decision Document (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2004). This Closure Report documents CAU 536 closure activities. During closure activities, approximately 1,000 cubic yards (yd3) of hydrocarbon waste in the form of TPH- and PAH-impacted soil and debris, approximately 8 yd3 of Pu-239-impacted soil, and approximately 100 yd3 of concrete debris were generated, managed, and disposed of appropriately. Additionally, a previously uncharacterized, buried drum was excavated, removed, and disposed of as hydrocarbon waste as a best management practice. Waste minimization techniques, such as the utilization of laboratory analysis to characterize and classify waste streams, were employed during the performance of closure

  11. Test of small-scale central-core-cavity closure for a 300-MW(e) GCFR

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-01-01

    Under the Prestressed Concrete Reactor Vessel (PCRV) Program at the Oak Ridge National Laboratory, model tests are conducted to verify the design of the PCRV for a 300 MW(e) Gas-Cooled Fast Reactor (GCFR). Prominent features of the 1:20-scale central core cavity model included a close pitched array of fifty-five penetration tubes, forty-four segmented gusset/bearing plate assemblies, and intermeshed reinforcing steel. The closure model which was designed for a maximum cavity pressure (MCP) of 10.08 MPa was initially tested by applying 10 pressurization cycles from essentially no load to the MCP with strain and deflection data obtained during each cycle. This was followed by pressurization cycles to 32.8 MPa, 41.3 MPa, 48.3 MPa, 58.4 MPa and 79.3 MPa. At a pressure of 79.3 MPa an end cap on a penetration tube developed leaks and the test was terminated. An inelastic analysis was conducted to provide an estimate of the ultimate strength of the closure plug and to determine the potential mode of failure.

  12. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2007

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2008-06-01

    This report provides the results of the semiannual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2007 and includes inspection and repair activities completed at the following nine CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 404: Roller Coaster Lagoons and Trench (TTR); (3) CAU 407: Roller Coaster RadSafe Area (TTR); (4) CAU 423: Area 3 Underground Discharge Point, Building 0360 (TTR); (5) CAU 424: Area 3 Landfill Complexes (TTR); (6) CAU 426: Cactus Spring Waste Trenches (TTR); (7) CAU 427: Area 3 Septic Waste Systems 2, 6 (TTR); (8) CAU 453: Area 9 UXO Landfill (TTR); and (9) CAU 487: Thunderwell Site (TTR). In a letter from the Nevada Division of Environmental Protection (NDEP) dated December 5, 2006, NDEP concurred with the request to reduce the frequency of post-closure inspections of CAUs at TTR to an annual frequency. This letter is included in Attachment B. Post-closure inspections were conducted on May 15-16, 2007. All inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Attachment B, with the exception of CAU 400. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. The inspection checklists for each site inspection are included in Attachment C, the field notes are included in Attachment D, and the site photographs are included in Attachment E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in May 2007, and the vegetation monitoring report is included in Attachment F. Maintenance and/or repairs were performed at CAU 453. Animal burrows observed during the annual inspection at CAU 453 were backfilled on August 1, 2007. At this time, the TTR post-closure site inspections should continue as

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

    NARCIS (Netherlands)

    Boele van Hensbroek, P.; Wind, J.; Dijkgraaf, M.G.W.; Busch, O.R.C.; Goslings, J.C.

    2009-01-01

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

  14. Closure Report for Corrective Action Unit 547: Miscellaneous Contaminated Waste Sites, Nevada National Security Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2012-07-17

    This Closure Report (CR) presents information supporting closure of Corrective Action Unit (CAU) 547, Miscellaneous Contaminated Waste Sites, and provides documentation supporting the completed corrective actions and confirmation that closure objectives for CAU 547 were met. This CR complies with the requirements of the Federal Facility Agreement and Consent Order (FFACO) that was agreed to by the State of Nevada; the U.S. Department of Energy (DOE), Environmental Management; the U.S. Department of Defense; and DOE, Legacy Management (FFACO, 1996 as amended). CAU 547 consists of the following three Corrective Action Sites (CASs), located in Areas 2, 3, and 9 of the Nevada National Security Site: (1) CAS 02-37-02, Gas Sampling Assembly; (2) CAS 03-99-19, Gas Sampling Assembly; AND (3) CAS 09-99-06, Gas Sampling Assembly Closure activities began in August 2011 and were completed in June 2012. Activities were conducted according to the Corrective Action Decision Document/Corrective Action Plan (CADD/CAP) for CAU 547 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office [NNSA/NSO], 2011). The recommended corrective action for the three CASs in CAU 547 was closure in place with administrative controls. The following closure activities were performed: (1) Open holes were filled with concrete; (2) Steel casings were placed over vertical expansion joints and filled with cement; (3) Engineered soil covers were constructed over piping and exposed sections of the gas sampling system components; (4) Fencing, monuments, Jersey barriers, radiological postings, and use restriction (UR) warning signs were installed around the perimeters of the sites; (5) Housekeeping debris was picked up from around the sites and disposed; and (6) Radiological surveys were performed to confirm final radiological postings. UR documentation is included in Appendix D. The post-closure plan was presented in detail in the CADD/CAP for CAU 547 and is included as

  15. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2009

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2010-05-28

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Unit (CAU) sites located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2009 and includes inspection and repair activities completed at the following seven CAUs: · CAU 400: Bomblet Pit and Five Points Landfill (TTR) · CAU 407: Roller Coaster RadSafe Area (TTR) · CAU 424: Area 3 Landfill Complexes (TTR) · CAU 426: Cactus Spring Waste Trenches (TTR) · CAU 453: Area 9 UXO Landfill (TTR) · CAU 484: Surface Debris, Waste Sites, and Burn Area (TTR) · CAU 487: Thunderwell Site (TTR) The annual post-closure inspections were conducted May 5–6, 2009. All inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Attachment B, with the exception of CAU 400. CAU 400 does not require post-closure inspections, but inspections of the vegetation and fencing are conducted as a best management practice. The inspection checklists for each site inspection are included in Attachment C, the field notes are included in Attachment D, and the site photographs are included in Attachment E. Vegetation monitoring of CAU 400, CAU 404, CAU 407, and CAU 426 was performed in June 2009, and the vegetation monitoring report is included in Attachment F. Maintenance was performed at CAU 453. Animal burrows observed during the annual inspection were backfilled, and a depression was restored to grade on June 25, 2009. Post-closure site inspections should continue as scheduled. Vegetation survey inspections have been conducted annually at CAUs 400, 404, 407, and 426. Discontinuation of vegetation surveys is recommended at the CAU 400 Bomblet Pit and CAU 426, which have been successfully revegetated. Discontinuation of vegetation surveys is also recommended at CAU 404, which has been changed to an administrative closure with no inspections required. Vegetation

  16. Four-fold benefit of wound closure under high magnification.

    Science.gov (United States)

    Kivelev, Juri; Hernesniemi, Juha

    2013-01-01

    Unaffected wound healing and good cosmetic result after a neurosurgical procedure are important factors measuring a level of care. The usefulness of high magnification of the operating microscope during closure of neurosurgical wounds is evaluated. During a one-year microneurosurgical fellowship, the first author (JK) performed wound closure under the microscope in 200 of 524 neurosurgical operations carried out by the senior author (JH) at the Department of Neurosurgery, Helsinki University Central Hospital. Supratentorial approaches were employed most frequently in 143 patients (72%). Surgeries for infratentorial lesions and the spinal canal comprised 48 (24%) and 9 procedures (4%), respectively. Mean duration of the surgery from skin to skin was 1.8 (range 0.5-6.2) hours. After intradural hemostasis was completed by the senior author, further steps including dural suturing, bone flap fixation, and wound closure were performed by the first author. Wound condition was assessed during the early and late postoperative period. Mean follow-up was 3.2 (range 1-10) months. Early postoperative healing of the wound was uneventful in 180 patients (90%). No wound rupture or postoperative hematoma occurred. In five patients (2.5%), lumbar puncture or spinal drainage was necessary due to significant subcutaneous liquor collection. No wound revision was required. At follow-up, in 196 patients (98%) the postoperative scar was in perfect condition. Neither skin necrosis nor healing problems occurred. Based on our results, we found the high magnification of operating microscope to be beneficial when closing neurosurgical wounds; it allows (1) better hemostasis, (2) precise wound margin approximation, (3) atraumatic handling of the tissues, and (4) improvement of the manual dexterity of the neurosurgeon.

  17. Utilizing Divers in Support of Spent Fuel Basin Closure Subproject

    Energy Technology Data Exchange (ETDEWEB)

    Allen Nellesen

    2005-01-01

    A number of nuclear facilities in the world are aging and with this comes the fact that we have to either keep repairing them or decommission them. At the Department of Energy Idaho Site (DOEID) there are a number of facilities that are being decommissioned, but the facilities that pose the highest risk to the large aquifer that flows under the site are given highest priorities. Aging spent nuclear fuel pools at DOE-ID are among the facilities that pose the highest risk, therefore four pools were targeted for decommissioning in Fiscal Year 2004. To accomplish this task the Idaho Completion Project (ICP) of Bechtel BWXT Idaho, LLC, put together an integrated Basin Closure Subproject team. The team was assigned a goal to look beyond traditional practices at the Idaho National Engineering and Environmental Laboratory (INEEL) to find ways to get the basin closure work done safer and more efficiently. The Idaho Completion Project (ICP) was faced with a major challenge – cleaning and preparing aging spent nuclear fuel basins for closure by removing sludge and debris, as necessary, and removing water to eliminate a potential risk to the Snake River Plain Aquifer. The project included cleaning and removing water from four basins. Two of the main challenges to a project like this is the risk of contamination from the basin walls and floors becoming airborne as the water is removed and keeping personnel exposures ALARA. ICP’s baseline plan had workers standing at the edges of the basins and on rafts or bridge cranes and then using long-handled tools to manually scrub the walls of basin surfaces. This plan had significant risk of skin contamination events, workers falling into the water, or workers sustaining injuries from the awkward working position. Analysis of the safety and radiation dose risks presented by this approach drove the team to look for smarter ways to get the work done.

  18. Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

    Energy Technology Data Exchange (ETDEWEB)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Ruppert, Volker [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-15

    Purpose. To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery. Methods. In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36 h after angiography to check for vascular complications. Results. In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery. Conclusion. The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.

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

    Directory of Open Access Journals (Sweden)

    Josh Cinner

    2006-06-01

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

  20. Efficient algorithms and implementations of entropy-based moment closures for rarefied gases

    Energy Technology Data Exchange (ETDEWEB)

    Schaerer, Roman Pascal, E-mail: schaerer@mathcces.rwth-aachen.de; Bansal, Pratyuksh; Torrilhon, Manuel

    2017-07-01

    We present efficient algorithms and implementations of the 35-moment system equipped with the maximum-entropy closure in the context of rarefied gases. While closures based on the principle of entropy maximization have been shown to yield very promising results for moderately rarefied gas flows, the computational cost of these closures is in general much higher than for closure theories with explicit closed-form expressions of the closing fluxes, such as Grad's classical closure. Following a similar approach as Garrett et al. (2015) , we investigate efficient implementations of the computationally expensive numerical quadrature method used for the moment evaluations of the maximum-entropy distribution by exploiting its inherent fine-grained parallelism with the parallelism offered by multi-core processors and graphics cards. We show that using a single graphics card as an accelerator allows speed-ups of two orders of magnitude when compared to a serial CPU implementation. To accelerate the time-to-solution for steady-state problems, we propose a new semi-implicit time discretization scheme. The resulting nonlinear system of equations is solved with a Newton type method in the Lagrange multipliers of the dual optimization problem in order to reduce the computational cost. Additionally, fully explicit time-stepping schemes of first and second order accuracy are presented. We investigate the accuracy and efficiency of the numerical schemes for several numerical test cases, including a steady-state shock-structure problem.

  1. G-protein-coupled receptor signaling and neural tube closure defects.

    Science.gov (United States)

    Shimada, Issei S; Mukhopadhyay, Saikat

    2017-01-30

    Disruption of the normal mechanisms that mediate neural tube closure can result in neural tube defects (NTDs) with devastating consequences in affected patients. With the advent of next-generation sequencing, we are increasingly detecting mutations in multiple genes in NTD cases. However, our ability to determine which of these genes contribute to the malformation is limited by our understanding of the pathways controlling neural tube closure. G-protein-coupled receptors (GPCRs) comprise the largest family of transmembrane receptors in humans and have been historically favored as drug targets. Recent studies implicate several GPCRs and downstream signaling pathways in neural tube development and closure. In this review, we will discuss our current understanding of GPCR signaling pathways in pathogenesis of NTDs. Notable examples include the orphan primary cilia-localized GPCR, Gpr161 that regulates the basal suppression machinery of sonic hedgehog pathway by means of activation of cAMP-protein kinase A signaling in the neural tube, and protease-activated receptors that are activated by a local network of membrane-tethered proteases during neural tube closure involving the surface ectoderm. Understanding the role of these GPCR-regulated pathways in neural tube development and closure is essential toward identification of underlying genetic causes to prevent NTDs. Birth Defects Research 109:129-139, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. The Role of Barbed Sutures in Wound Closure Following Knee and Hip Arthroplasty: A Review.

    Science.gov (United States)

    Faour, Mhamad; Khlopas, Anton; Elmallah, Randa K; Chughtai, Morad; Kolisek, Frank R; Barrington, John W; Mont, Michael A

    2018-01-02

    Lower extremity joint arthroplasty procedures often require a large incision to have an adequate exposure, which subsequently leads to lengthy wounds that may contribute to long closure, anesthesia, and overall operative times. The recently introduced knotless barbed suture may provide better outcomes, faster closure time, and decreased material utilization. Therefore, the aim of this study was to review the impact of barbed sutures on: (1) wound-related complications; (2) closure and operative time; (3) patient outcomes (range of motion and Knee Society Scores [KSS]); and (4) effects on cosmesis and patients' satisfaction. A literature search was performed using up to February 2017. Barbed sutures were associated with shorter closure times, shorter operative times, and larger cost savings per procedure as well as comparable wound complication rates after total joint arthroplasty. Although the current review is limited by the number of studies included, it demonstrates that overall, barbed sutures contribute to surgical efficiency when compared with conventional skin closure modalities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Alterations of papilla dimensions after orthodontic closure of the maxillary midline diastema: a retrospective longitudinal study.

    Science.gov (United States)

    Jeong, Jin-Seok; Lee, Seung-Youp; Chang, Moontaek

    2016-06-01

    The aim of this study was to evaluate alterations of papilla dimensions after orthodontic closure of the diastema between maxillary central incisors. Sixty patients who had a visible diastema between maxillary central incisors that had been closed by orthodontic approximation were selected for this study. Various papilla dimensions were assessed on clinical photographs and study models before the orthodontic treatment and at the follow-up examination after closure of the diastema. Influences of the variables assessed before orthodontic treatment on the alterations of papilla height (PH) and papilla base thickness (PBT) were evaluated by univariate regression analysis. To analyze potential influences of the 3-dimensional papilla dimensions before orthodontic treatment on the alterations of PH and PBT, a multiple regression model was formulated including the 3-dimensional papilla dimensions as predictor variables. On average, PH decreased by 0.80 mm and PBT increased after orthodontic closure of the diastema (Pdiastema width (P=0.045) and PBT (P=0.000) were found to be influential factors. PBT before the orthodontic treatment significantly influenced the alteration of PBT in the multiple regression model. PH decreased but PBT increased after orthodontic closure of the diastema. The papilla dimensions before orthodontic treatment influenced the alterations of PH and PBT after closure of the diastema. The PBT increased more when the diastema width before the orthodontic treatment was larger.

  4. Efficient algorithms and implementations of entropy-based moment closures for rarefied gases

    Science.gov (United States)

    Schaerer, Roman Pascal; Bansal, Pratyuksh; Torrilhon, Manuel

    2017-07-01

    We present efficient algorithms and implementations of the 35-moment system equipped with the maximum-entropy closure in the context of rarefied gases. While closures based on the principle of entropy maximization have been shown to yield very promising results for moderately rarefied gas flows, the computational cost of these closures is in general much higher than for closure theories with explicit closed-form expressions of the closing fluxes, such as Grad's classical closure. Following a similar approach as Garrett et al. (2015) [13], we investigate efficient implementations of the computationally expensive numerical quadrature method used for the moment evaluations of the maximum-entropy distribution by exploiting its inherent fine-grained parallelism with the parallelism offered by multi-core processors and graphics cards. We show that using a single graphics card as an accelerator allows speed-ups of two orders of magnitude when compared to a serial CPU implementation. To accelerate the time-to-solution for steady-state problems, we propose a new semi-implicit time discretization scheme. The resulting nonlinear system of equations is solved with a Newton type method in the Lagrange multipliers of the dual optimization problem in order to reduce the computational cost. Additionally, fully explicit time-stepping schemes of first and second order accuracy are presented. We investigate the accuracy and efficiency of the numerical schemes for several numerical test cases, including a steady-state shock-structure problem.

  5. Analytic Closure Relations in M1 Neutrino Radiation Transport in Core-Collapse Supernovae

    Science.gov (United States)

    Murchikova, Elena; Ott, Christian D.; Abdikamalov, Ernazar; O'Connor, Evan; Wendell, John; Urbatsch, Todd

    2015-04-01

    Neutrinos play a crucial role in core-collapse supernova explosions. They deposit energy in the region behind the stalled shock and aid its revival. Moreover, together with gravitational waves, they are the only messengers that provide us with information from the supernova core. Full neutrino transport is a 6+1 dimensional problem and efficient yet accurate approximations are necessary to include neutrino transport in simulations. One approximation that has recently become popular is the M1 radiation transport scheme, which solves equations for the first two angular moments of the transport equation and closes the expansion with an analytic closure based on values of the first two moments. The quality of the M1 approximation depends on the quality of the chosen closure relation and it is not a priori clear, which closure to chose under which circumstances. We carry out an extensive study of closure relations available in the literature and compare M1 results to full Monte Carlo transport solutions in the context of spherically-symmetric core-collapse supernovae. We consider post-core-bounce configurations at multiple different times and study the dependence of the physical closure relation (obtained with Monte Carlo) on neutrino energy, species, and the background matter. This research was partially supported by the Institute of Geophysics, Planetary Physics, and Signatures at Los Alamos National Laboratory.

  6. Current concept of transcatheter closure of atrial septal defect in adults.

    Science.gov (United States)

    Akagi, Teiji

    2015-01-01

    After the introduction of catheter intervention for atrial septal defect (ASD) in the pediatric population, therapeutic advantages of this less invasive procedure were focused on adult through geriatric populations. The most valuable clinical benefits of this procedure are the significant improvement of symptoms and daily activities, which result from the closure of left to right shunt without thoracotomy and cardiopulmonary bypass surgery. These benefits contribute to increase the number of adult patients of this condition who have hesitated over surgical closure. In terms of technical point of view for catheter closure of ASD, the difficulties still exist in some morphological features of defect, or hemodynamic features in the adult population. Morphological features of difficult ASD closure are (1) large (≥30 mm) ASD, (2) wide rim deficiency, and (3) multiple defects. Hemodynamic features of difficult ASD are (1) severe pulmonary hypertension, (2) ventricular dysfunction, and (3) restrictive left ventricular compliance (diastolic dysfunction) after ASD closure. To complete the catheter ASD closure under these difficult conditions, various procedural techniques have been introduced. These are new imaging modalities such as real-time three-dimensional imaging, new technical modifications, and new concepts for hemodynamic evaluation. Especially, real-time three-dimensional transesophageal echocardiography can provide the high quality imaging for anatomical evaluation including maximum defect size, surrounding rim morphology, and the relationship between device and septal rim. In adult patients, optimal management for their comorbidities is an important issue, which includes cardiac function, atrial arrhythmias, respiratory function, and renal function. Management of atrial arrhythmias is a key issue for the long-term outcome in adult patients. Because the interventional procedures are not complication-free techniques, the establishment of a surgical back

  7. A systematic literature review on the use of vacuum assisted closure for enterocutaneous fistula.

    Science.gov (United States)

    Misky, A; Hotouras, A; Ribas, Y; Ramar, S; Bhan, C

    2016-09-01

    Enterocutaneous fistula (ECF) is considered to be one of the most challenging complications a general surgeon can encounter. The current mainstay of treatment is surgical closure, associated with significant morbidity and mortality. Vacuum assisted closure (VAC) has been successfully used for closure of persistent abdominal wounds for a number of years. This study aims to investigate whether current literature supports the use of VAC for ECF. A PubMed search of the search terms 'enterocutaneous fistula' and 'vacuum assisted closure/therapy' was performed in December 2014. Results were restricted to articles involving human subjects with an available abstract and full text written between 1950 and 2014. The end-points analysed included rate of fistula closure, duration of follow-up, and morbidity and mortality where available. Ten studies (all level IV) including 151 patients were examined. In all except one, surgery was the underlying aetiology with median number of fistulae per patient of one. The median rate of closure with VAC was 64.6% (7.7-100%) with healing occurring within 58 (12-90) days. Follow-up was only mentioned in three of the 10 studies, in which the patients were followed for 3, 20 and 28.5 months. No complications were reported in all but one of the studies, in which abdominal wall disruption and intestinal obstruction were identified in a minority of patients. The included studies suggest that VAC therapy may be considered a safe treatment for ECF. The current evidence is generally of low level and characterized by heterogeneity. Definitive recommendations based on this information cannot therefore be made. Further studies are necessary to establish any proven benefit over standard surgical or conservative therapy. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  8. Closure measurements of naturally initiating small cracks

    Science.gov (United States)

    Sharpe, W. N., Jr.; Su, X.

    1988-01-01

    The initiation and growth of cracks in smooth 2024-T3 aluminum specimens have been investigated using acetate replicas. Crack opening displacements were measured as a function of load at several positions along the crack as it grew across the thickness of the specimen and became a through-the-thickness crack of a few millimeters in length. Tests run for R-ratios of 0.5, 0.0 and -1.0 showed that closure loads were well predicted by Newman's (1984) model. It is noted that small cracks grow slightly faster than would be predicted by long-crack data, and it is suggested that effects other than plasticity-induced closure must be taken into account.

  9. Moles: Tool-Assisted Environment Isolation with Closures

    Science.gov (United States)

    de Halleux, Jonathan; Tillmann, Nikolai

    Isolating test cases from environment dependencies is often desirable, as it increases test reliability and reduces test execution time. However, code that calls non-virtual methods or consumes sealed classes is often impossible to test in isolation. Moles is a new lightweight framework which addresses this problem. For any .NET method, Moles allows test-code to provide alternative implementations, given as .NET delegates, for which C# provides very concise syntax while capturing local variables in a closure object. Using code instrumentation, the Moles framework will redirect calls to provided delegates instead of the original methods. The Moles framework is designed to work together with the dynamic symbolic execution tool Pex to enable automated test generation. In a case study, testing code programmed against the Microsoft SharePoint Foundation API, we achieved full code coverage while running tests in isolation without an actual SharePoint server. The Moles framework integrates with .NET and Visual Studio.

  10. The Galois closure of Drinfeld modular towers

    DEFF Research Database (Denmark)

    Bassa, Alp; Beelen, Peter

    2011-01-01

    In this article we study Drinfeld modular curves X0(pn) associated to congruence subgroups Γ0(pn) of GL(2,Fq[T]) where p is a prime of Fq[T]. For n>r>0 we compute the extension degrees and investigate the structure of the Galois closures of the covers X0(pn)→X0(pr) and some of their variations...

  11. Calcined solids storage facility closure study

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-02-01

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

  12. Optical closure study on light-absorbing aerosols

    Science.gov (United States)

    Petzold, Andreas; Bundke, Ulrich; Freedman, Andrew; Onasch, Timothy B.; Massoli, Paola; Andrews, Elizabeth; Hallar, Anna G.

    2014-05-01

    The in situ measurement of atmospheric aerosol optical properties is an important component of quantifying climate change. In particular, the in-situ measurement of the aerosol single-scattering albedo (SSA), which is the ratio of aerosol scattering to aerosol extinction, is identified as a key challenge in atmospheric sciences and climate change research. Ideally, the complete set of aerosol optical properties is measured through optical closure studies which simultaneous measure aerosol extinction, scattering and absorption coefficients. The recent development of new optical instruments have made real-time in situ optical closure studies attainable, however, many of these instruments are state-of-the-art but not practical for routine monitoring. In our studies we deployed a suit of well-established and recently developed instruments including the cavity attenuated phase shift (CAPS) method for aerosol light extinction, multi-angle absorption photometer (MAAP) and particle soot absorption photometer (PSAP) for aerosol light absorption, and an integrating nephelometer (NEPH) for aerosol light scattering measurements. From these directly measured optical properties we calculated light absorption from extinction minus scattering (difference method), light extinction from scattering plus absorption, and aerosol single-scattering albedo from combinations CAPS + MAAP, NEPH + PSAP, NEPH + MAAP, CAPS + NEPH. Closure studies were conducted for laboratory-generated aerosols composed of various mixtures of black carbon (Regal 400R pigment black, Cabot Corp.) and ammonium sulphate, urban aerosol (Billerica, MA), and background aerosol (Storm Peak Lab.). Key questions addressed in our closure studies are: (1) how well can we measure aerosol light absorption by various methods, and (2) how well can we measure the aerosol single-scattering albedo by various instrument combinations? In particular we investigated (3) whether the combination of a CAPS and NEPH provides a reasonable

  13. Printing tattoo effect after use of Dermabond®Prineo® Skin closure system

    Directory of Open Access Journals (Sweden)

    Shabeer Ahmad Wani

    2017-03-01

    Full Text Available Abdominoplasty is a very common procedure in the plastic surgery practice and may lead to a variety of unfavorable results including incision site complications. The surgical adhesives system, which entered into daily practice to replace the need for subcuticular closure for skin, saves time and may have better wound appearance. Dermabond® Prineo® Skin Closure System (Ethicon Inc., Somerville, NJ, USA has two major components: 2–Octyl cyanoacrylate glue and a flexible, self-adhesive polyester mesh. It can be used with or without sutures, and has the added benefit of waterproofing, and microbial resistance. It also saves time. This case describes a male patient who experienced a “printing tattoo” effect following an elective procedure of abdominoplasty and the results after this closure system was used.

  14. Closure report for CAU No. 400: Bomblet Pit and Five Points Landfill, Tonopah test range

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    This Closure Reports presents the information obtained from corrective and investigative actions performed to affirm the decision for clean closure of Corrective Action Unit No. 400 which includes the Bomblet Pit and the Five Points Landfill, two sites used for disposal of unexploded ordnance (UXO) and other solid waste at the U.S. Department of Energy`s (DOE) Tonopah Test Range, located in south-central Nevada. The first phase, or corrective action, for clean closure was performed under the Voluntary Correction Action Work Plan for Ordnance Removal from Five Disposal Sites at the Tonopah Test Range, hereafter referred to as the VCA Work Plan. The second phase consisted of collecting verification samples under the Streamlined Approach for Environmental Restoration Plan, CA U No. 400: Bomblet Pit and Five Points Landfill, Tonopah Test Range, hereafter referred to as the SAFER Plan. Results of the two phases are summarized in this document.

  15. Clinical investigation on angle-closure glaucoma patients with cataract treated by phacoemulsification combined with trabeculectomy

    Directory of Open Access Journals (Sweden)

    Yu-Sheng Wang

    2013-11-01

    Full Text Available AIM: To investigate the effectiveness of phacoemulsification with intraocular lens(IOLimplantation combined with trabeculectomy in patients with cataract and angle-closure glaucoma.METHODS: In 36 cases(46 eyesof angle-closure glaucoma with cataract, phacoemulsification with foldable IOL implantation combined with trabeculectomy was performed. Data of pre- and post-operation, including visual acuity, intraocular pressure, filtering bleb, anterior chamber depth, chamber angle, and funds were all recorded and analyzed in detail.RESULTS: During the follow-up of 3 months to 2 years,visual acuity of 43 eyes(93.5%got improved, and intraocular pressure in 44 eyes(95.7%were controlled in normal range(CONCLUSION: Phacoemulsification with IOL implantation combined with trabeculectomy is an effective and safe surgical technique for patients with angle-closure glaucoma and cataract, with satisfied control of intraocular pressure, deepening of anterior chamber, opening of anterior chamber angle, and improving visual function.

  16. EFFECTIVENESS OF ND YAG LASER IRIDOTOMY IN PATIENTS WITH PRIMARY ANGLE CLOSURE GLAUCOMA

    Directory of Open Access Journals (Sweden)

    Venkateswarlu

    2015-04-01

    Full Text Available Primary angle closure glaucoma causes elevation of intra ocular pressure (IOP due to obstruction to aqueous outflow by partial or complete closure of angle by iris. Apart from medical management with topical drugs and filtration surgery, laser iridotomy is an effective primary treatment option in cases with primary angle closure. The present study was carried out in 81 patients presented with PACS, PAC and PACG who had Nd YAG laser iridotomy averaging 20 mj spread over 6 shots and also as prophylaxis in fellow eyes of patients with PACS and PAC. 93% of the patients with PAC and 71% of the patients with PACS had good control of IOP and none developed glaucomatous optic neuropathy. The complications were minimal and managed with medical treatment. Nd YAG la ser iridotomy is safe and minimally invasive procedure with least complications in our experience and follow up observations included uniformly good control of IOP and stable visual fields.

  17. An Analytical Model for Fatigue Life Prediction Based on Fracture Mechanics and Crack Closure

    DEFF Research Database (Denmark)

    Ibsø, Jan Behrend; Agerskov, Henning

    1996-01-01

    test specimens are compared with fatigue life predictions using a fracture mechanics approach. In the calculation of the fatigue life, the influence of the welding residual stresses and crack closure on the fatigue crack growth is considered. A description of the crack closure model for analytical...... determination of the fatigue life is included. Furthermore, the results obtained in studies of the various parameters that have an influence on the fatigue life, are given. A very good agreement between experimental and analytical results is obtained, when the crack closure model is used in determination...... of the analytical fatigue lives. Both the analytical and experimental results obtained show that the Miner rule may give quite unconservative predictions of the fatigue life for the types of stochastic loading studied....

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    INTRODUCTION: Closure of the hernia gap in laparoscopic ventral hernia repair before mesh reinforcement has gained increasing acceptance among surgeons despite creating a tension-based repair. Beneficial effects of this technique have been reported sporadically, but no evidence is available from...... randomised controlled trials. The primary purpose of this paper is to compare early post-operative activity-related pain in patients undergoing laparoscopic ventral hernia repair with closure of the gap with patients undergoing standard laparoscopic ventral hernia repair (non-closure of the gap). Secondary...... outcomes are patient-rated cosmesis and hernia-specific quality of life. METHODS: A randomised, controlled, double-blinded study is planned. Based on power calculation, we will include 40 patients in each arm. Patients undergoing elective laparoscopic umbilical, epigastric or umbilical trocar-site hernia...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    INTRODUCTION: Closure of the hernia gap in laparoscopic ventral hernia repair before mesh reinforcement has gained increasing acceptance among surgeons despite creating a tension-based repair. Beneficial effects of this technique have been reported sporadically, but no evidence is available from...... randomised controlled trials. The primary purpose of this paper is to compare early post-operative activity-related pain in patients undergoing laparoscopic ventral hernia repair with closure of the gap with patients undergoing standard laparoscopic ventral hernia repair (non-closure of the gap). Secondary...... outcomes are patient-rated cosmesis and hernia-specific quality of life. METHODS: A randomised, controlled, double-blinded study is planned. Based on power calculation, we will include 40 patients in each arm. Patients undergoing elective laparoscopic umbilical, epigastric or umbilical trocar-site hernia...

  20. Folate receptors and neural tube closure.

    Science.gov (United States)

    Saitsu, Hirotomo

    2017-09-01

    Neural tube defects (NTD) are among the most common human congenital malformations, affecting 0.5-8.0/1000 of live births. Human clinical trials have shown that periconceptional folate supplementation significantly decreases the occurrence of NTD in offspring. However, the mechanism by which folate acts on NTD remains largely unknown. Folate receptor (Folr) is one of the three membrane proteins that mediate cellular uptake of folates. Recent studies suggest that mouse Folr1 (formerly referred to as Fbp1) is essential for neural tube closure. Therefore, we examined spatial and temporal expression patterns of Folr1 in developing mouse embryos, showing a close association between Folr1 and anterior neural tube closure. Transient transgenic analysis was performed using lacZ as a reporter; we identified a 1.1-kb enhancer that directs lacZ expression in the neural tube and optic vesicle in a manner that is similar to endogenous Folr1. The 1.1-kb enhancer sequences were highly conserved between humans and mice, suggesting that human FOLR1 is associated with anterior neural tube closure in humans. Several experimental studies in mice and human epidemiological and genetics studies have suggested that folate receptor abnormalities are involved in a portion of human NTDs, although the solo defect of FOLR1 did not cause NTD. © 2017 Japanese Teratology Society.

  1. Phenomenology of convection-parameterization closure

    Directory of Open Access Journals (Sweden)

    J.-I. Yano

    2013-04-01

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

  2. Creativity & Cognitive Closure (Creatividad y cierre cognitivo

    Directory of Open Access Journals (Sweden)

    Melike Hazir

    2015-02-01

    Full Text Available Abstract The aim of this paper is to present the relationship between the need for cognitive closure (NFC and creativity. In light of previous research, a theoretical foundation is established for the term creativity. Next the social-cognitive phenomenon of the need for cognitive closure is explained based on the theory of Kruglanski and Webster, and considering the tendencies of urgency and permanency. Conclusion: The role of creativity is to control cognitive closure in order to solve problems that arise during the learning process and usually during the life. Resumen El objetivo de este trabajo es presentar la relación entre la necesidad de cierre cognitivo (NCC y la creatividad. A la luz de las investigaciones realizadas, se establece la base teórica para el término de creatividad y la explica del fenómeno socio-cognitivo de necesidad de cierre cognitivo en base a la teoría de Kruglanski y Webster, teniendo en cuenta las tendencias de urgencia y permanencia. Conclusión: La creatividad tiene un papel importante de control del cierre cognitivo con el fin de resolver los problemas que surjan durante el proceso de aprendizaje y en general durante la vida.

  3. EXPEDITING THE PATH TO CLOSURE THE CHEMICAL WASTE LANDFILL, SANDIA NATIONAL LABORATORIES, NEW MEXICO

    Energy Technology Data Exchange (ETDEWEB)

    Young, S.G.; Schofield, D.P.; Davis, M.J.; Methvin, R.; Mitchell, M.

    2003-02-27

    The Chemical Waste Landfill (CWL) at Sandia National Laboratories, New Mexico (SNL/NM) is undergoing closure subject to the requirements of Subtitle C of RCRA. This paper identifies regulatory mechanisms that have and continue to expedite and simplify the closure of the CWL. These include (1) the Environmental Restoration (ER) Programmatic effort to achieve progress quickly with respect to the standard regulatory processes, which resulted in the performance of voluntary corrective measures at the CWL years in advance of the standard process schedule, (2) the management and disposal of CWL remediation wastes and materials according to the risks posed, and (3) the combination of multiple regulatory requirements into a single submittal.

  4. Effect of wastewater treatment facility closure on endocrine disrupting chemicals in a Coastal Plain stream

    Science.gov (United States)

    Bradley, Paul M.; Journey, Celeste; Clark, Jimmy M.

    2016-01-01

    Wastewater treatment facility (WWTF) closures are rare environmental remediation events; offering unique insight into contaminant persistence, long-term wastewater impacts, and ecosystem recovery processes. The U.S. Geological Survey assessed the fate of select endocrine disrupting chemicals (EDC) in surface water and streambed sediment one year before and one year after closure of a long-term WWTF located within the Spirit Creek watershed at Fort Gordon, Georgia. Sample sites included a WWTF-effluent control located upstream from the outfall, three downstream effluent-impacted sites located between the outfall and Spirit Lake, and one downstream from the lake's outfall. Prior to closure, the 2.2-km stream segment downstream from the WWTF outfall was characterized by EDC concentrations significantly higher (α = 0.05) than at the control site; indicating substantial downstream transport and limited in-stream attenuation of EDC, including pharmaceuticals, estrogens, alkylphenol ethoxylate (APE) metabolites, and organophosphate flame retardants (OPFR). Wastewater-derived pharmaceutical, APE metabolites, and OPFR compounds were also detected in the outflow of Spirit Lake, indicating the potential for EDC transport to aquatic ecosystems downstream of Fort Gordon under effluent discharge conditions. After the WWTF closure, no significant differences in concentrations or numbers of detected EDC compounds were observed between control and downstream locations. The results indicated EDC pseudo-persistence under preclosure, continuous supply conditions, with rapid attenuation following WWTF closure. Low concentrations of EDC at the control site throughout the study and comparable concentrations in downstream locations after WWTF closure indicated additional, continuing, upstream contaminant sources within the Spirit Creek watershed. 

  5. Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant

    Science.gov (United States)

    Avalos-González, Jorge; Portilla-deBuen, Eliseo; Leal-Cortés, Caridad Aurea; Orozco-Mosqueda, Abel; del Carmen Estrada-Aguilar, María; Velázquez-Ramírez, Gabriela Abigail; Ambriz-González, Gabriela; Fuentes-Orozco, Clotilde; Guzmán-Gurrola, Aldo Emmerson; González-Ojeda, Alejandro

    2010-01-01

    AIM: To assess whether the use of fibrin sealant shortens the closure time of postoperative enterocutaneous fistulas (ECFs). METHODS: The prospective case-control study included 70 patients with postoperative ECFs with an output of 2 cm and without any local complication. They were divided into study (n = 23) and control groups (n = 47). Esophageal, gastric and colocutaneous fistulas were monitored under endoscopic visualization, which also allowed fibrin glue application directly through the external hole. Outcome variables included closure time, time to resume oral feeding and morbidity related to nutritional support. RESULTS: There were no differences in mean age, fistula output, and follow-up. Closure-time for all patients of the study group was 12.5 ± 14.2 d and 32.5 ± 17.9 d for the control group (P < 0.001), and morbidity related to nutritional support was 8.6% and 42.5%, respectively (P < 0.01). In patients with colonic fistulas, complete closure occurred 23.5 ± 19.5 d after the first application of fibrin glue, and spontaneous closure was observed after 36.2 ± 22.8 d in the control group (P = 0.36). Recurrences were observed in 2 patients because of residual disease. One patient of each group died during follow-up as a consequence of septic complications related to parenteral nutrition. CONCLUSION: Closure time was significantly reduced with the use of fibrin sealant, and oral feeding was resumed faster. We suggest the use of fibrin sealant for the management of stable enterocutaneous fistulas. PMID:20533600

  6. Umbilical trocar site closure with Berci's needle after laparoscopic cholecystectomy.

    Science.gov (United States)

    Calik, Adnan; Yucel, Yusuf; Topaloglu, Serdar; Hos, Gultekin; Aktas, Aydin; Piskin, Burhan

    2008-01-01

    The umbilical region is particularly susceptible for development of incisional hernia after laparoscopic cholecystectomy (LC). To evaluate the effects of port-closure techniques on the complications seen after umbilical port-site closure, we compared closure with Berci's needle and the standard technique of a hand-sutured closure. A hundred patients underwent LC were randomly divided into two groups. We evaluated the required time for closure, the security of techniques and the factors affecting postoperative complications for both closure groups in a prospective manner. Closure of the umbilical port site was performed faster with the Berci's needle compared to standard hand-sutured technique. Postoperative hospital stay and complication rates were not altered significantly depend on the closure technique. Skin dimpling on the trocar site was observed predominantly after closure with Berci's needle. Spontaneous improvement on skin dimpling was observed within the 2 weeks after operation in all patients. During the follow-up period, there was no trocar site hernia observed in the study group. Closure of the umbilical port site with Berci's needle is found as an effective and safe method for laparoscopic cholecystectomy.

  7. Active glottal closure during anoxic gasping in lambs.

    Science.gov (United States)

    Thuot, F; Lemaire, D; Dorion, D; Létourneau, P; Praud, J P

    2001-11-01

    The present study was aimed at assessing laryngeal dynamics and their consequences during anoxic gasping in ketamine-sedated lambs. We first verified that the glottis was closed between gasps during anoxic gasping in seven chronically instrumented lambs, aged 11-15 days. Recording of glottal constrictor muscle electrical activity, subglottal pressure and lung volume, together with endoscopic observation, confirmed the presence of active glottal closure with maintenance of a high lung volume between gasps. Secondly, we tested whether maintenance of a high lung volume between gasps improved autoresuscitation efficiency. Six sedated lambs aged 8-11 days underwent two anoxic runs, including one with an open tracheostomy to prevent maintenance of a high lung volume. Access back to air was allowed for gasping. No significant difference was found in time to eupnea resumption, hemodynamic parameters or arterial blood gases. We conclude that a high lung volume is actively maintained by glottal closure between anoxic gasps in sedated lambs. Further studies are however needed to define the importance of laryngeal dynamics during gasping.

  8. Child center closures: Does nonprofit status provide a comparative advantage?

    Science.gov (United States)

    Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E

    2013-03-01

    Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy.

  9. 75 FR 12746 - Difenzoquat; Registration Review Case Closure; Notice of Availability

    Science.gov (United States)

    2010-03-17

    ... each pesticide's registration is based on current scientific and other knowledge, including its effects... registration review case closure for the pesticide difenzoquat, case 0223. Registration review is EPA's periodic review of pesticide registrations to ensure that each pesticide continues to satisfy the statutory...

  10. 75 FR 57782 - Clofencet; Registration Review Case Closure; Notice of Availability

    Science.gov (United States)

    2010-09-22

    ... each pesticide's registration is based on current scientific and other knowledge, including its effects... registration review case closure for the pesticide clofencet, case 7015. Registration review is EPA's periodic review of pesticide registrations to ensure that each pesticide continues to satisfy the statutory...

  11. Energy budget closure observed in paired Eddy Covariance towers with increased and continuous daily turbulence

    Science.gov (United States)

    The lack of energy closure has been a longstanding issue with Eddy Covariance (EC). Multiple mechanisms have been proposed to explain the discrepancies in energy balance including diurnal energy storage changes, advection of energy, and larger scale turbulent processes that cannot be resolved by fi...

  12. Colour coding for blood collection tube closures - a call for harmonisation

    DEFF Research Database (Denmark)

    Simundic, Ana-Maria; Cornes, Michael P; Grankvist, Kjell

    2015-01-01

    including errors in sampling, reporting and decision-making have received much less attention. Proper sampling and additives to the samples are essential. Tubes and additives are identified not only in writing on the tubes but also by the colour of the tube closures. Unfortunately these colours have...

  13. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, for Calendar Year 2013

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, A. J.

    2014-03-03

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2013 and includes inspection and repair activities completed at the following CAUs: • CAU 400: Bomblet Pit and Five Points Landfill (TTR) • CAU 407: Roller Coaster RadSafe Area (TTR) • CAU 424: Area 3 Landfill Complexes (TTR) • CAU 453: Area 9 UXO Landfill (TTR) • CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports and subsequent correspondence with the Nevada Division of Environmental Protection. The post-closure inspection plans and subsequent correspondence modifying the requirements for each CAU are included in Appendix B. The inspection checklists are included in Appendix C. Field notes are included in Appendix D. Photographs taken during inspections are included in Appendix E. The annual post-closure inspections were conducted on May 14, 2013. Maintenance was performed at CAU 400, CAU 424, and CAU 453. At CAU 400, animal burrows were backfilled. At CAU 424, erosion repairs were completed at Landfill Cell A3-3, subsidence was repaired at Landfill Cell A3-4, and additional lava rock was placed in high-traffic areas to mark the locations of the surface grade monuments at Landfill Cell A3-3 and Landfill Cell A3-8. At CAU 453, two areas of subsidence were repaired and animal burrows were backfilled. Vegetation monitoring was performed at the CAU 400 Five Points Landfill and CAU 407 in June 2013. The vegetation monitoring report is included in Appendix F.

  14. Post-Closure Inspection Report for the Tonopah Test Range, Nevada, For Calendar Year 2011

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2012-02-21

    This report provides the results of the annual post-closure inspections conducted at the closed Corrective Action Units (CAUs) located on the Tonopah Test Range (TTR), Nevada. This report covers calendar year 2011 and includes inspection and repair activities completed at the following CAUs: (1) CAU 400: Bomblet Pit and Five Points Landfill (TTR); (2) CAU 407: Roller Coaster RadSafe Area (TTR); (3) CAU 424: Area 3 Landfill Complexes (TTR); (4) CAU 453: Area 9 UXO Landfill (TTR); and (5) CAU 487: Thunderwell Site (TTR) Inspections were conducted according to the post-closure plans in the approved Closure Reports. The post-closure inspection plan for each CAU is included in Appendix B. The inspection checklists are included in Appendix C, field notes are included in Appendix D, and photographs taken during inspections are included in Appendix E. The annual post-closure inspections were conducted May 3 and 4, 2011. Maintenance was performed at CAU 424, CAU 453, and CAU 487. At CAU 424, two surface grade monuments at Landfill Cell A3-3 could not be located during the inspection. The two monuments were located and marked with lava rock on July 13, 2011. At CAU 453, there was evidence of animal burrowing. Animal burrows were backfilled on July 13, 2011. At CAU 487, one use restriction warning sign was missing, and wording was faded on the remaining signs. A large animal burrow was also present. The signs were replaced, and the animal burrow was backfilled on July 12, 2011. As a best management practice, the use restriction warning signs at CAU 407 were replaced with standard Federal Facility Agreement and Consent Order signs on July 13, 2011. Vegetation monitoring was performed at the CAU 400 Five Points Landfill and CAU 407 in June 2011, and the vegetation monitoring report is included in Appendix F.

  15. Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure-A Review.

    Science.gov (United States)

    Huang, Qian; Li, Jieshou; Lau, Wan-Yee

    2016-01-01

    Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient's physiological condition allows.

  16. Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature.

    Science.gov (United States)

    Suwa, Katsuhito; Okamoto, Tomoyoshi; Yanaga, Katsuhiko

    2016-07-01

    The laparoscopic technique for repairing ventral and incisional hernias (VIH) is now well established. However, several issues related to laparoscopic VIH repair, such as the high recurrence rate for hernias with large fascial defects and in extremely obese patients, are yet to be resolved. Additional problems include seroma formation, mesh bulging/eventration, and non-restoration of the abdominal wall rigidity/function with only bridging of the hernial orifice using standard laparoscopic intraperitoneal onlay mesh repair (sIPOM). To solve these problems, laparoscopic fascial defect closure with IPOM reinforcement (IPOM-Plus) has been introduced in the past decade, and a few studies have reported satisfactory outcomes. Although detailed techniques for fascial defect closure and handling of the mesh have been published, standardized techniques are yet to be established. We reviewed the literature on IPOM-Plus in the PubMed database and identified 16 reports in which the recurrence rate, incidence of seroma formation, and incidence of mesh bulging were 0-7.7, 0-11.4, and 0 %, respectively. Several comparison studies between sIPOM and IPOM-Plus seem to suggest that IPOM-Plus is associated with more favorable surgical outcomes; however, larger-scale studies are essential.

  17. A field evaluation of the Eye-Closure Interview with witnesses of serious crimes.

    Science.gov (United States)

    Vredeveldt, Annelies; Tredoux, Colin G; Nortje, Alicia; Kempen, Kate; Puljević, Cheneal; Labuschagne, Gérard N

    2015-04-01

    Laboratory research shows that eye-closure during memory retrieval improves both the amount and the factual accuracy of memory reports about witnessed events. Based on these findings, we developed the Eye-Closure Interview, and examined its feasibility (in terms of compliance with the instructions) and effectiveness (in terms of the quantity and quality of reported information) in eyewitness interviews conducted by the South African Police Service. Police interviewers from the Facial Identification Unit were randomly assigned to receive Eye-Closure Interview training or no training. We analyzed 95 interviews with witnesses of serious crimes (including robbery, rape, and murder), some of whom were instructed to close their eyes during salient parts of the interview. Witnesses in the control condition rarely spontaneously closed their eyes, but witnesses in the Eye-Closure Interview condition kept their eyes closed during 97% of their descriptions, suggesting that the Eye-Closure Interview would be easy to implement in a field setting. Although witnesses who closed their eyes did not remember more information overall, the information they provided was considered to be of significantly greater forensic relevance (as reflected in 2 independent blind assessments, 1 by a senior police expert and 1 by a senior researcher). Thus, based on the findings from this field study and from previous laboratory research, we conclude that implementation of the Eye-Closure Interview in witness interviews would help police interviewers to elicit more valuable information from witnesses, which could be relevant to the police investigation and/or in court. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  18. Timing and outcome of stoma closure in very low birth weight infants with surgical intestinal disorders.

    Science.gov (United States)

    Mochizuki, Kyoko; Hayakawa, Masahiro; Urushihara, Naoto; Miyake, Hiromu; Yokoi, Akiko; Shiraishi, Jun; Fujinaga, Hideshi; Ohashi, Kensuke; Esumi, Genshiro; Ohfuji, Satoko; Amae, Shintaro; Yanai, Toshihiro; Furukawa, Taizo; Tazuke, Yuko; Minagawa, Kyoko; Okuyama, Hiroomi

    2017-08-01

    Very low birth weight infants (VLBWIs) are at risk of surgical intestinal disorders including necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI). We conducted this study to verify whether the timing of stoma closure and that of enteral nutrition establishment after stoma closure in VLBWIs differ among the most common disorders. A retrospective multicenter study was conducted at 11 institutes. We reviewed the timing of stoma closure and enteral nutrition establishment in VLBWIs who underwent stoma creation for intestinal disorders. We reviewed the medical records of 73 infants: 21 with NEC, 24 with FIP, and 25 with MRI. The postnatal age at stoma closure was 107 (28-359) days for NEC, 97 (25-302) days for FIP, and 101 (15-264) days for MRI (p = 0.793), and the postnatal age at establishment of enteral nutrition was 129 (42-381) days for NEC, 117 (41-325) days for FIP, and 128 (25-308) days for MRI (p = 0.855). The body weights at stoma closure were 1768 (620-3869) g for NEC, 1669 (1100-3040) g for FIP, and 1632 (940-3776) g (p = 0.614) for MRI. There were no significant differences among the three groups. The present study revealed that the time and body weights at stoma closure and the postoperative restoration of bowel function in VLBWIs did not differ among the three diseases.

  19. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1991-12-01

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

  20. Prospective Evaluation of Vacuum-Assisted Fascial Closure After Open Abdomen

    Science.gov (United States)

    Miller, Preston R.; Meredith, J Wayne; Johnson, James C.; Chang, Michael C.

    2004-01-01

    Objective: The goal of this report is to examine the success of vacuum-assisted fascial closure (VAFC) under a carefully applied protocol in abdominal closure after open abdomen. Summary Background Data: With the development of damage control techniques and the understanding of abdominal compartment syndrome, the open abdomen has become commonplace in trauma patients. If the abdomen is not closed in the early postoperative period, the combination of adhesions and fascial retraction frequently make primary fascial closure impossible and creation of a planned ventral hernia is required. We have previously reported our experience with the development of a technique for VAFC that allowed for closure of the fascia in many such patients long after initial operation. During this previous study, during which the technique was being developed, VAFC was successful in 69% of patients in whom it was applied, and 22 patients were successfully closed at ≥ 9 days after initial surgery (range, 9 to 49 days). A protocol for the use of VAFC in patients with open abdomen was developed on the basis of these data and has been employed since October 2001. The outcome of this protocol's use is examined. Methods: This is a prospective evaluation of all trauma patients admitted to Wake Forest University Baptist Medical Center over a 19-month period who required management with an open abdomen. VAFC employs suction applied to a large polyurethane sponge under an occlusive dressing in the wound and allows for constant medial traction of the abdominal fascia. It is attempted in all patients in whom the rectus muscles and fascia are intact. Studied variables include fascial closure rate, time to closure, incidence of wound dehiscence, and hernia development after closure. Results: From November 1, 2001, through May 31, 2003, 212 laparotomies were performed in injured patients; 53 (25%) of these patients required open abdomen management. Mean injury severity score for the group was 34, with

  1. 105-DR Large Sodium Fire Facility closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    The Hanford Site, located northwest of the city of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials, and activities associated with nuclear energy development. The 105-DR Large Sodium Fire Facility (LSFF), which was in operation from about 1972 to 1986, was a research laboratory that occupied the former ventilation supply room on the southwest side of the 105-DR Reactor facility. The LSFF was established to provide a means of investigating fire and safety aspects associated with large sodium or other metal alkali fires in the liquid metal fast breeder reactor (LMFBR) facilities. The 105-DR Reactor facility was designed and built in the 1950`s and is located in the 100-D Area of the Hanford Site. The building housed the 105-DR defense reactor, which was shut down in 1964. The LSFF was initially used only for engineering-scale alkali metal reaction studies. In addition, the Fusion Safety Support Studies program sponsored intermediate-size safety reaction tests in the LSFF with lithium and lithium lead compounds. The facility has also been used to store and treat alkali metal waste, therefore the LSFF is subject to the regulatory requirements for the storage and treatment of dangerous waste. Closure will be conducted pursuant to the requirements of the Washington Administrative Code (WAC) 173-303-610. This closure plan presents a description of the facility, the history of waste managed, and the procedures that will be followed to close the LSFF as an Alkali Metal Treatment Facility. No future use of the LSFF is expected.

  2. Multiple coil closure of isolated aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Padhi Sumanta

    2010-01-01

    Full Text Available A 7-month-old girl was diagnosed to have large aortopulmonary collateral during evaluation for congestive heart failure. There was no other evidence of cardiopulmonary disease. The collateral was successfully closed with multiple coils delivered sequentially. We describe the issues associated during closure of the aortopulmonary collateral in this case. To the best of our knowledge, this is the first reported case of large aortopulmonary collateral presenting with heart failure in an otherwise structurally normal heart that was closed successfully with multiple coils delivered sequentially.

  3. Defense Base Closure and Realignment Commission

    Science.gov (United States)

    1993-01-01

    34A (mnor)Organlizar ion, Kansas City vInformat ion (C) Trideni Refit Fdily a Rii vinos \\VAy. Ulinr PceinCnirNIt(inr Organizat ion , CIlevelianid...the Gulf of Mexico was questionable. The Naval Station Ingleside, Fleet Training Center community also stated the closure of the Naval Mayport, and...EvlainFacility, VI,10 01t(NkEAlljU:jlNeMexico, inl Crder_ to IrIOVItLe 1iaisonl with the Albuquerque, N~ew Mexico Sandia L~ahorator)’ Of the DvIlepariucrt

  4. Simple Case Treatment Planning: Diastema Closure.

    Science.gov (United States)

    Calamia, Vincent; Pantzis, Alexandria

    2015-07-01

    This article demonstrates the use of a smile evaluation form as an adjunct in arriving at diagnosis and developing a treatment plan for a patient desiring Diastema closure. It also shows the importance of the diagnostic wax-up for temporization and visualization of case outcome. The case also demonstrates the use of soft tissue lasers to create a gingival harmony that enhanced the resulting esthetics. Feldspathic porcelain was used for the final restorations because they provide optimal esthetics and translucency. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Narrative Intelligibility and Closure in Interactive Systems

    DEFF Research Database (Denmark)

    Bruni, Luis Emilio; Baceviciute, Sarune

    2013-01-01

    ), which in turn can be seen as a function of Narrative Intelligibility. AAD can also be influenced by the intended or unintended level of abstractedness or didascalicity (i.e. figurativeness) of a given narrative. We define narrative intelligibility in complementarity with the related notion of Narrative...... Closure. We also make a distinction between the goals of the system and the goals of the narrative that it mediates, and consider the proposed parameters at two interrelated levels of analysis: the system level and the embedded narrative level, as the normative values and goals of these two levels should...

  6. Post Closure Safety of the Morsleben Repository

    Energy Technology Data Exchange (ETDEWEB)

    Preuss, J.; Eilers, G.; Mauke, R.; Moeller-Hoeppe, N.; Engelhardt, H.-J.; Kreienmeyer, M.; Lerch, C.; Schrimpf, C.

    2002-02-26

    After the completion of detailed studies of the suitability the twin-mine Bartensleben-Marie, situated in the Federal State of Saxony-Anhalt (Germany), was chosen in 1970 for the disposal of low and medium level radioactive waste. The waste emplacement started in 1978 in rock cavities at the mine's fourth level, some 500 m below the surface. Until the end of the operational phase in 1998 in total about 36,800 m{sup 3} of radioactive waste was disposed of. The Morsleben LLW/ILW repository (ERAM) is now under licensing for closure. After completing the licensing procedure the repository will be sealed and backfilled to exclude any undue future impact onto man or the environment. The main safety objective is to protect the biosphere from the harmful effects of the disposed radionuclides. Furthermore, classical or conventional requirements call for ruling out or minimizing other unfavorable environmental effects. The ERAM is an abandoned rock salt and potash mine. As a consequence it has a big void volume, however small parts of the cavities are backfilled with crushed salt rocks. Other goals of the closure concept are therefore a long-term stabilization of the cavities to prevent a dipping or buckling of the ground surface. In addition, groundwater protection shall be assured. For the sealing of the repository a closure concept was developed to ensure compliance with the safety protection objectives. The concept anticipates the backfilling of the cavities with hydraulically setting backfill materials (salt concretes). The reduction of the remaining void volume in the mine causes in the case of brine intrusions a limitation of the leaching processes of the exposed potash seams. However, during the setting process the hydration heat of the concrete will lead to an increase of the temperature and hence to thermally induced stresses of the concrete and the surrounding rocks. Therefore, the influence of these stresses and deformations on the stability of the salt body

  7. U.S. Small Business HUBZone Base Closure Areas

    Data.gov (United States)

    Small Business Administration — HUBZone Qualitified Base Closure Areas - the lands within the boundaries of a military installation that was closed through a privatization process under the Federal...

  8. Simulating school closure policies for cost effective pandemic decision making

    Directory of Open Access Journals (Sweden)

    Araz Ozgur M

    2012-06-01

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

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

    Science.gov (United States)

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

  10. Risk and Performance Analyses Supporting Closure of WMA C at the Hanford Site in Southeast Washington

    Energy Technology Data Exchange (ETDEWEB)

    Eberlein, Susan J.; Bergeron, Marcel P.; Kemp, Christopher J.

    2013-11-11

    The Office of River Protection under the U.S. Department of Energy (DOE) is pursuing closure of the Single-Shell Tank (SST) Waste Management Area (WMA) C as stipulated by the Hanford Federal Facility Agreement and Consent Order (HFFACO) under federal requirements and work tasks will be done under the State-approved closure plans and permits. An initial step in meeting the regulatory requirements is to develop a baseline risk assessment representing current conditions based on available characterization data and information collected at the WMA C location. The baseline risk assessment will be supporting a Resource Conservation and Recovery Act of 1976 (RCRA) Field Investigation (RFI)/Corrective Measures Study (CMS) for WMA closure and RCRA corrective action. Complying with the HFFACO conditions also involves developing a long-term closure Performance Assessment (PA) that evaluates human health and environmental impacts resulting from radionuclide inventories in residual wastes remaining in WMA C tanks and ancillary equipment. This PA is being developed to meet the requirements necessary for closure authorization under DOE Order 435.1 and Washington State Hazardous Waste Management Act. To meet the HFFACO conditions, the long-term closure risk analysis will include an evaluation of human health and environmental impacts from hazardous chemical inventories along with other performance Comprehensive Environmental Response, Compensation, and Liability Act Appropriate and Applicable Requirements (CERCLA ARARs) in residual wastes left in WMA C facilities after retrieval and removal. This closure risk analysis is needed to needed to comply with the requirements for permitted closure. Progress to date in developing a baseline risk assessment of WMA C has involved aspects of an evaluation of soil characterization and groundwater monitoring data collected as a part of the RFI/CMS and RCRA monitoring. Developing the long-term performance assessment aspects has involved the

  11. Evaluation of pelvic floor muscular redistribution after primary closure of classic bladder exstrophy by 3-dimensional magnetic resonance imaging.

    Science.gov (United States)

    Stec, Andrew A; Tekes, Aylin; Ertan, Gulhan; Phillips, Timothy M; Novak, Tom E; Solaiyappan, Meiyappan; Huisman, Thierry A G M; Sponseller, Paul D; Gearhart, John P

    2012-10-01

    We used 3-dimensional magnetic resonance imaging reconstruction to generate models of the pelvic floor musculature in classic bladder exstrophy, allowing for statistical analysis of changes seen in the anatomy after primary closure. Patients with classic bladder exstrophy underwent pelvic magnetic resonance imaging before and after primary closure. Contours of the levator ani were mapped and measured in 3-dimensional space. In addition, 2-dimensional angles and measurements were used to make a quantitative and qualitative analysis of the pelvic floor before and after closure. A total of 19 cases of classic bladder exstrophy were included in the study, with 12 closed as newborns without osteotomy and 7 closed later with osteotomy. In both groups the pre-closure exstrophy pelvic floor in the axial plane was box-like and after closure it had a more inward rotation. The steepness and angulation of the levator ani muscle remained relatively unchanged in both groups. The levator ani muscle group, with and without osteotomy, was redistributed into the anterior compartment of the pelvis after closure. Postoperatively a successfully closed exstrophy had the bladder positioned deeply within the pelvis. After closure the levator ani muscle regained the expected smooth contoured shape. Primary closure of bladder exstrophy 1) reshapes the pelvis from a box-like configuration to a more inwardly rotated hammock, 2) redistributes a significant portion of the levator ani muscle into the anterior compartment and 3) facilitates a smooth uniform contouring to the pelvic floor. Closing the bony pelvic ring by pubic reapproximation in the newborn or by osteotomy in an infant produces similar changes in the pelvic floor. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Long-term effects of arteriovenous fistula closure on echocardiographic functional and structural findings in hemodialysis patients: a prospective study.

    Science.gov (United States)

    Movilli, Ezio; Viola, Battista Fabio; Brunori, Giuliano; Gaggia, Paola; Camerini, Corrado; Zubani, Roberto; Berlinghieri, Nicola; Cancarini, Giovanni

    2010-04-01

    The arteriovenous fistula (AVF) provides an effective vascular access for hemodialysis; however, the associated hemodynamic effects may alter cardiac structure and function. The objective of this study is to evaluate the effect of AVF closure on functional and structural echocardiographic findings. Prospective observational study. In a single center between 2003 and 2006, we enrolled 25 consecutive hemodialysis patients with AVF malfunction who underwent AVF closure and conversion to a tunneled central venous catheter because of exhaustion of alternative vascular sites and 36 matched controls with a well-functioning AVF. AVF closure. Outcomes were changes in findings on echocardiograms obtained before and 6 months after AVF closure for patients in the AVF-closure group and at baseline and 6 months later for controls. Echocardiographic measurements included left ventricular (LV) internal diastolic diameter, interventricular septum thickness, diastolic posterior wall thickness, LV mass (LVM), LVM index (LVMi), and LV ejection fraction (LVEF). Dialysis modality and scheme were unchanged. In the AVF-closure group, LVM decreased from 225 +/- 55 to 206 +/- 51 g (P < 0.001) and LVMi decreased from 135 +/- 40 to 123 +/- 35 g/m(2) (P < 0.001). LV internal diastolic diameter, interventricular septum thickness, and diastolic posterior wall thickness decreased significantly, whereas LVEF increased from 56% +/- 7% to 59% +/- 6% (P < 0.001). No significant changes were observed in controls. In patients with AVF closure, LV morphologic characteristics showed a decrease in both eccentric and concentric hypertrophy in favor of normalization or a pattern of concentric remodeling. No significant changes were observed in controls. Use of matched rather than randomized controls. Closure of an AVF determines a significant decrease in LV internal diastolic diameter, interventricular septum thickness, and diastolic posterior wall thickness. This is associated with significant improvement

  13. Protecting an island nation from extreme pandemic threats: Proof-of-concept around border closure as an intervention.

    Science.gov (United States)

    Boyd, Matt; Baker, Michael G; Mansoor, Osman D; Kvizhinadze, Giorgi; Wilson, Nick

    2017-01-01

    Countries are well advised to prepare for future pandemic risks (e.g., pandemic influenza, novel emerging agents or synthetic bioweapons). These preparations do not typically include planning for complete border closure. Even though border closure may not be instituted in time, and can fail, there might still plausible chances of success for well organized island nations. To estimate costs and benefits of complete border closure in response to new pandemic threats, at an initial proof-of-concept level. New Zealand was used as a case-study for an island country. An Excel spreadsheet model was developed to estimate costs and benefits. Case-study specific epidemiological data was sourced from past influenza pandemics. Country-specific healthcare cost data, valuation of life, and lost tourism revenue were imputed (with lost trade also in scenario analyses). For a new pandemic equivalent to the 1918 influenza pandemic (albeit with half the mortality rate, "Scenario A"), it was estimated that successful border closure for 26 weeks provided a net societal benefit (e.g., of NZ$11.0 billion, USD$7.3 billion). Even in the face of a complete end to trade, a net benefit was estimated for scenarios where the mortality rate was high (e.g., at 10 times the mortality impact of "Scenario A", or 2.75% of the country's population dying) giving a net benefit of NZ$54 billion (USD$36 billion). But for some other pandemic scenarios where trade ceased, border closure resulted in a net negative societal value (e.g., for "Scenario A" times three for 26 weeks of border closure-but not for only 12 weeks of closure when it would still be beneficial). This "proof-of-concept" work indicates that more detailed cost-benefit analysis of border closure in very severe pandemic situations for some island nations is probably warranted, as this course of action might sometimes be worthwhile from a societal perspective.

  14. The Timing of Stoma Closure in Infants with Necrotizing Enterocolitis: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zani, Augusto; Lauriti, Giuseppe; Li, Qi; Pierro, Agostino

    2017-02-01

    Aim Some infants with necrotizing enterocolitis (NEC) undergoing surgery require the formation of a stoma. The timing of stoma closure in these patients remains controversial. Our aim was to determine whether the different timing of closure had an impact on patient outcome. Methods Using a defined search strategy (PubMed, Embase, and Web of Science), two investigators (Q.L. and G.L.) independently identified studies comparing early stoma closure (ESC, before 8 weeks from stoma formation) versus late stoma closure (LSC, after 8 weeks) in infants with NEC. Outcome measures included the duration of parenteral nutrition, the length of hospital stay, and complications. Meta-analysis was performed using RevMan 5.3 (The Cochrane Collaboration, Copenhagen, Denmark). Data are expressed as mean ± standard deviation. Results Of the 505 articles screened, 6 articles met the inclusion criteria (280 infants). All studies but one were retrospective. The total duration on parenteral nutrition was similar in infants with ESC versus LSC, and the total length of hospital stay (pre- plus poststoma closure) was not influenced by the timing of stoma closure. Three studies (79 infants) reported similar complication rates after stoma closure between ESC (5/16, 31%) and LSC infants (13/63, 19%; p = 0.5). Conclusions This systematic review demonstrates that there is no difference between different timings for stoma closure in post-NEC infants. With the current supporting evidence, ESC seems to be as safe and feasible as LSC. Studies with a higher level of evidence are needed to confirm these conclusions. Georg Thieme Verlag KG Stuttgart · New York.

  15. Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy - a systematic review.

    Science.gov (United States)

    Acosta, Stefan; Björck, Martin; Petersson, Ulf

    2017-01-01

    The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias. A high primary fascial closure rate can be achieved with the vacuum-assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-trauma patients, in need of prolonged open abdomen therapy.

  16. Post-Closure Inspection Report for Corrective Action Unit 426: Cactus Spring Waste Trenches Tonopah Test Range, Nevada Calendar Year 2000

    Energy Technology Data Exchange (ETDEWEB)

    K. B. Campbell

    2001-06-01

    Post-closure monitoring requirements for the Cactus Spring Waste Trenches (Corrective Action Unit [CAW 426]) (Figure 1) are described in Closure Report for corrective Action Unit 426, Cactus Spring Waste Trenches. Tonopah Test Range, Nevada, report number DOE/NV--226. The Closure Report (CR) was submitted to the Nevada Division of Environmental Protection (NDEP) on August 14, 1998. Permeability results of soils adjacent to the engineered cover and a request for closure of CAU 404 were transmitted to the NDEP on April 29, 1999. The CR (containing the Post-Closure Monitoring Plan) was approved by the NDEP on May 13, 1999. Post-closure monitoring at CAU 426 consists of the following: (1) Site inspections done twice a year to evaluate the condition of the unit; (2) Verification that the site is secure; (3) Notice of any subsidence or deficiencies that may compromise the integrity of the unit; (4) Remedy of any deficiencies within 90 days of discovery; and (5) Preparation and submittal of an annual report. Site inspections were conducted on June 19, 2000, and November 21, 2000. All inspections were made after NDEP approval of the CR, and were conducted in accordance with the Post-Closure Monitoring Plan in the NDEP-approved CR. This report includes copies of the inspection checklists, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in Attachment A, a copy of the field notes is found in Attachment B, and copies of the inspection photographs are found in Attachment C.

  17. Final closure plan for the high-explosives open burn treatment facility at Lawrence Livermore National Laboratory Experimental Test Site 300

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, S.

    1997-04-01

    This document addresses the interim status closure of the HE Open Bum Treatment Facility, as detailed by Title 22, Division 4.5, Chapter 15, Article 7 of the Califonia Code of Regulations (CCR) and by Title 40, Code of Federal Regulations (CFR) Part 265, Subpart G, ``Closure and Post Closure.`` The Closure Plan (Chapter 1) and the Post- Closure Plan (Chapter 2) address the concept of long-term hazard elimination. The Closure Plan provides for capping and grading the HE Open Bum Treatment Facility and revegetating the immediate area in accordance with applicable requirements. The Closure Plan also reflects careful consideration of site location and topography, geologic and hydrologic factors, climate, cover characteristics, type and amount of wastes, and the potential for contaminant migration. The Post-Closure Plan is designed to allow LLNL to monitor the movement, if any, of pollutants from the treatment area. In addition, quarterly inspections will ensure that all surfaces of the closed facility, including the cover and diversion ditches, remain in good repair, thus precluding the potential for contaminant migration.

  18. Why is school closed today? Unplanned K-12 school closures in the United States, 2011-2013.

    Directory of Open Access Journals (Sweden)

    Karen K Wong

    Full Text Available INTRODUCTION: We describe characteristics of unplanned school closures (USCs in the United States over two consecutive academic years during a non-pandemic period to provide context for implementation of school closures during a pandemic. METHODS: From August 1, 2011 through June 30, 2013, daily systematic internet searches were conducted for publicly announced USCs lasting ≥ 1 day. The reason for closure and the closure dates were recorded. Information on school characteristics was obtained from the National Center for Education Statistics. RESULTS: During the two-year study period, 20,723 USCs were identified affecting 27,066,426 students. Common causes of closure included weather (79%, natural disasters (14%, and problems with school buildings or utilities (4%. Only 771 (4% USCs lasted ≥ 4 school days. Illness was the cause of 212 (1% USCs; of these, 126 (59% were related to respiratory illnesses and showed seasonal variation with peaks in February 2012 and January 2013. CONCLUSIONS: USCs are common events resulting in missed school days for millions of students. Illness causes few USCs compared with weather and natural disasters. Few communities have experience with prolonged closures for illness.

  19. Prevalence of surgical site infection at the stoma site following four skin closure techniques: a retrospective cohort study.

    Science.gov (United States)

    Li, Linda T; Brahmbhatt, Reshma; Hicks, Stephanie C; Davila, Jessica A; Berger, David H; Liang, Mike K

    2014-01-01

    Surgical site infection (SSI) is a common complication of stoma reversal. Studies have suggested that different skin closures affect SSI rates. Our aim was to determine which skin closure technique following stoma reversal leads to the lowest rate of SSI. We conducted a retrospective review of all adult patients undergoing stoma reversal at a single institution (2005-2011) and compared the rate of SSI following four skin closure techniques: primary closure (PC), secondary closure (SC), loose PC (LPC), and circular closure (CC). Univariate analysis included χ(2) or Fisher's exact test and ANOVA or Kruskal-Wallis H test for categorical and continuous data, respectively. A multivariate logistic regression model was created to identify predictors of SSI. One hundred and forty-six patients were identified: 40 (27%) PC, 68 (47%) SC, 20 (14%) LPC, and 18 (12%) CC. CC was less likely to have SSI (6%) compared to PC (43%), SC (16%), and LPC (15%; p stomas that were closed with CC. © 2014 S. Karger AG, Basel.

  20. Evaluation of morphological characteristics of septal rims affecting successful transcatheter atrial septal defect closure in children and adults.

    Science.gov (United States)

    Oflaz, Mehmet Burhan; Pac, Feyza Aysenur; Kibar, Ayse Esin; Balli, Sevket; Ece, Ibrahim

    2013-01-01

    Determining other echocardiographic predictors along with the measured atrial septal defect (ASD) size and evaluating the closure together with these predictors would increase the chance of success for transcatheter closure of ASD. To evaluate echocardiographic parameters affecting defect closure in children and adult patients with secundum ASD. In all patients, size of ASD, total length of atrial septum (TS), superior-posterior, inferior-posterior, superior-anterior and inferior-anterior rims surrounding the defect were measured by transesophageal echocardiography (TEE), and several measurement ratios were derived on the basis of TEE parameters. A total 216 patients with secundum ASD were included in this study. The device was successfully implanted in 65 children and 65 adults. Both in pediatric and adult cases, the ratio of successful closure was found to be significantly higher when the ratio of defect size to TS was ≤ 0.35, the ratio of superior-anterior (SA) rim to the defect size was > 0.75 and the ratio of inferior-posterior (IP) rim to the defect size was > 1.0. It was found that having more than one of these predictors in a single case increased the chance of closure success significantly (p rim to defect size > 0.75 and a ratio of IP rim to defect size > 1.0 were found to be echocardiographic predictors that could be used in successful transcatheter ASD closure both in children and adults.

  1. 324 Building radiochemical engineering cells, high-level vault, low-level vault, and associated areas closure plan

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, J.M.

    1998-03-25

    The Hanford Site, located adjacent to and north of Richland, Washington, is operated by the US Department of Energy, Richland Operations Office (RL). The 324 Building is located in the 300 Area of the Hanford Site. The 324 Building was constructed in the 1960s to support materials and chemical process research and development activities ranging from laboratory/bench-scale studies to full engineering-scale pilot plant demonstrations. In the mid-1990s, it was determined that dangerous waste and waste residues were being stored for greater than 90 days in the 324 Building Radiochemical Engineering Cells (REC) and in the High-Level Vault/Low-Level Vault (HLV/LLV) tanks. [These areas are not Resource Conservation and Recovery Act of 1976 (RCRA) permitted portions of the 324 Building.] Through the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-89, agreement was reached to close the nonpermitted RCRA unit in the 324 Building. This closure plan, managed under TPA Milestone M-20-55, addresses the identified building areas targeted by the Tri-Party Agreement and provides commitments to achieve the highest degree of compliance practicable, given the special technical difficulties of managing mixed waste that contains high-activity radioactive materials, and the physical limitations of working remotely in the areas within the subject closure unit. This closure plan is divided into nine chapters. Chapter 1.0 provides the introduction, historical perspective, 324 Building history and current mission, and the regulatory basis and strategy for managing the closure unit. Chapters 2.0, 3.0, 4.0, and 5.0 discuss the detailed facility description, process information, waste characteristics, and groundwater monitoring respectively. Chapter 6.0 deals with the closure strategy and performance standard, including the closure activities for the B-Cell, D-Cell, HLV, LLV; piping and miscellaneous associated building areas. Chapter 7.0 addresses the

  2. Transcatheter closure of patent ductus arteriosus: report of the first case in Nigeria.

    Science.gov (United States)

    Animasahun, B A; Johnson, A; Ogunkunle, O O; Idowu, S; Bode-Thomas, F; Maheshwari, S; Njokanma, O F; Omokhodion, S I

    2012-09-01

    Since the first report on device closure of patent ductus arteriosus (PDA) by Porstmann et al in 1967, the procedure has gained wide acceptance and has been used all over the world, including parts of Africa. The advantages when compared to surgical closure include shorter procedure time and hospital stay and no scar being left. This mode of treatment was not available in Nigeria prior to this with patients having to travel abroad to benefit. Cardiac catheterisation laboratory became available in Lagos, Nigeria in 2009 and in October 2010, the laboratory collaborated with Lagos State University College of Medicine (LASUCOM) and Lagos State University Teaching Hospital (LASUTH), to perform a device closure on a 3-year old girl with PDA who had presented to LASUTH with heart failure at the age of 6 months. To the best of our knowledge, this is the first time the procedure has been performed in Nigeria The patient made a successful recovery and is haemodynamically stable, on no medications. Device closure of PDA is now safe and available in Nigeria.

  3. Closure plan for Corrective Action Unit 109: U-2bu subsidence crater, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    The U-2bu subsidence crater, Corrective Action Unit 109, will be closed in accordance with the Resource Conservation and Recovery Act, the Nevada Division of Environmental Protection operational permit, and the Federal Facility Agreement and Consent Order. The U-2bu subsidence crater is located in Area 2 of the Nevada Test Site. It was created in 1971 by an underground nuclear test with the name Miniata. The crater has a diameter of 288 meters (944 feet) and an approximate depth of 35 meters (115 feet). Based on the results of the analyses reported in the site characterization report, the only constituents of concern in the U-2bu subsidence crater include leachable lead and total petroleum hydrocarbons. Closure activities will include the excavation and disposal of impacted soil from the top of the crater. Upon completion of excavation, verification samples will be collected to show that the leachable lead has been removed to concentrations below the regulatory action level. After sample results show that the lead has been removed, the excavated area will be backfilled and a soil flood diversion berm will be constructed as a best management practice. An independent registered professional engineer will certify the site was closed following the approved Closure Plan. Post-closure care is not warranted for this site because closure activities will involve removal of the Resource Conservation and Recovery Act constituents of concern.

  4. Vacuum-Assisted Abdominal Closure Is Safe and Effective: A Cohort Study in 74 Consecutive Patients.

    Science.gov (United States)

    Jensen, R O; Buchbjerg, T; Simonsen, R M; Eckardt, R; Qvist, N

    2017-01-01

    Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes. This study describes the use and outcome of ABThera KCI® VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants. A prospective multicenter study including all patients treated with VAC during an eleven-month period. A total of 74 consecutive patients were included. Median age was 64.4 (9-89) years, 64% were men, and median body mass index was 25 (17-42). Duration of VAC treatment was median 4.5 (0-39) days with median 1 (0-16) dressing changes. Seventy per cent of the patients attended the intensive care unit. The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p closure when possible has yet to be proven in a randomized study.

  5. Post-Closure Report for Closed Resource Conservation and Recovery Act Corrective Action Units, Nevada National Security Site, Nevada, for Fiscal Year 2014

    Energy Technology Data Exchange (ETDEWEB)

    Silvas, Alissa J. [Nevada Field Office, Las Vegas, NV (United States)

    2015-01-01

    This report serves as the combined annual report for post-closure activities for several Corrective Action Units (CAUs). The locations of the sites are shown in Figure 1. This report covers fiscal year 2014 (October 2013–September 2014). The post-closure requirements for these sites are described in Resource Conservation and Recovery Act Permit Number NEV HW0101 and summarized in each CAU-specific section in Section 1.0 of this report. The results of the inspections, a summary of maintenance activities, and an evaluation of monitoring data are presented in this report. Site inspections are conducted semiannually at CAUs 90 and 91 and quarterly at CAUs 92, 110, 111, and 112. Additional inspections are conducted at CAU 92 if precipitation occurs in excess of 0.50 inches (in.) in a 24-hour period and at CAU 111 if precipitation occurs in excess of 1.0 in. in a 24-hour period. Inspections include an evaluation of the condition of the units, including covers, fences, signs, gates, and locks. In addition to visual inspections, soil moisture monitoring, vegetation evaluations, and subsidence surveys are conducted at CAU 110. At CAU 111, soil moisture monitoring, vegetation evaluations, subsidence surveys, direct radiation monitoring, air monitoring, radon flux monitoring, and groundwater monitoring are conducted. The results of the vegetation surveys and an analysis of the soil moisture monitoring data at CAU 110 are presented in this report. Results of additional monitoring at CAU 111 are documented annually in the Nevada National Security Site Waste Management Monitoring Report Area 3 and Area 5 Radioactive Waste Management Sites and in the Nevada National Security Site Data Report: Groundwater Monitoring Program Area 5 Radioactive Waste Management Site, which will be prepared in approximately June 2015. All required inspections, maintenance, and monitoring were conducted in accordance with the post-closure requirements of the permit. It is recommended to continue

  6. Tank waste remediation system vadose zone program plan

    Energy Technology Data Exchange (ETDEWEB)

    Fredenburg, E.A.

    1998-07-27

    The objective of the vadose zone characterization under this program is to develop a better conceptual geohydrologic model of identified tank farms which will be characterized so that threats to human health and the environment from past leaks and spills, intentional liquid discharges, potential future leaks during retrieval, and from residual contaminants that may remain in tank farms at closure can be explicitly addressed in decision processes. This model will include geologic, hydrologic, and hydrochemical parameters as defined by the requirements of each of the TWRS programs identified here. The intent of this TWRS Vadose Zone Program Plan is to provide justification and an implementation plan for the following activities: Develop a sufficient understanding of subsurface conditions and transport processes to support decisions on management, cleanup, and containment of past leaks, spills, and intentional liquid discharges; Develop a sufficient understanding of transport processes to support decisions on controlling potential retrieval leaks; Develop a sufficient understanding of transport processes to support decisions on tank farm closure, including allowable residual waste that may remain at closure; and Provide new information on geotechnical properties in the 200 Area to supplement data used for design and performance assessment for immobilized low-activity waste disposal facilities.

  7. Risk factors for surgical site infection after stoma closure comparison between pursestring wound closure and conventional linear wound closure: Propensity score matching analysis.

    Science.gov (United States)

    Yamamoto, Masashi; Tanaka, Keitaro; Masubuchi, Shinsuke; Ishii, Masatsugu; Hamamoto, Hiroki; Suzuki, Shigenori; Ueda, Yasuhiko; Okuda, Junji; Uchiyama, Kazuhisa

    2018-01-01

    Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensity score matching analysis. We analysed the data of 360 patients who underwent stoma closure with CC or PC between January 2000 and December 2014. The propensity score was calculated from age, gender, body mass index, primary disease, type of stoma, diabetes mellitus, history of smoking, steroid use, the American Society of Anesthesiologists score, Prognostic Nutritional Index and modified Glasgow Prognostic Score. There was no difference in operative variables between the two groups. The CC group and the PC group were comparable with regards to overall SSI (25.0 vs. 7.8%; P = 0.007), superficial SSI (21.9 vs. 4.7%; P = 0.003). Significant risk factor for SSI was conventional linear closure (OR, 4.14; 95% CI, 1.448-13.91). Our study suggests that a pursestring stoma closure leads to less SSI. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The impact of a temporary recurrent street closure on physical activity in New York City.

    Science.gov (United States)

    Wolf, Sarah A; Grimshaw, Victoria E; Sacks, Rachel; Maguire, Thomas; Matera, Catherine; Lee, Karen K

    2015-04-01

    At least 70 US cities have now introduced ciclovías-large-scale street closures to promote physical activity-joining numerous other cities worldwide that have implemented ciclovías in efforts to improve population health. We assessed the impact of Summer Streets, a New York City program in which 6.9 contiguous miles of urban streets were closed to traffic and opened for walking, cycling, and group activities, such as dancing and yoga, on population physical activity levels. Screen line counts were used to estimate attendance, and a street intercept survey was conducted to assess demographic characteristics of participants, baseline adherence to physical activity recommendations, and type and duration of physical activity at Summer Streets. In addition, a traffic study was used to determine if there were vehicular traffic delays as a result of the program. About 50,000 people participated in Summer Streets; among participating New Yorkers, bicyclists averaged 6.7 miles, runners 4.3 miles, and walkers 3.6 miles, equivalent to 72-86 min of moderate physical activity. Among New Yorkers attending Summer Streets, 24 % reported that they did not routinely engage in moderate- or vigorous-intensity physical activity. These non-routine exercisers engaged in the equivalent of 26-68 min of moderate-intensity physical activity at Summer Streets. Summer Streets served as an enticement for New Yorkers, including those who did not ordinarily meet physical activity recommendations, to engage in physical activity. There were no significant vehicular traffic delays during the program.

  9. SRS tank closure. Innovative technology summary report

    Energy Technology Data Exchange (ETDEWEB)

    1999-08-01

    High-level waste (HLW) tank closure technology is designed to stabilize any remaining radionuclides and hazardous constituents left in a tank after bulk waste removal. Two Savannah River Site (SRS) HLW tanks were closed after cleansing and then filling each tank with three layers of grout. The first layer consists of a chemically reducing grout. The fill material has chemical properties that retard the movement of some radionuclides and chemical constituents. A layer of controlled low-strength material (CLSM), a self-leveling fill material, is placed on top of the reducing grout. CLSM provides sufficient strength to support the overbearing weight. The final layer is a free-flowing, strong grout similar to normal concrete. After the main tank cavity is filled, risers are filled with grout, and all waste transfer piping connected to the tank is isolated. The tank ventilation system is dismantled, and the remaining systems are isolated. Equipment that remains with the tank is filled with grout. The tank and ancillary systems are left in a state requiring only limited surveillance. Administrative procedures are in place to control land use and access. DOE eventually plans to remove all of its HLW storage tanks from service. These tanks are located at SRS, Hanford, and Idaho National Engineering and Environmental Laboratory. Low-activity waste storage tanks at Oak Ridge Reservation are also scheduled for closure.

  10. Vascular Closure Devices in Interventional Radiology Practice

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk [John Radcliffe Hospital, Department of Radiology (United Kingdom); Muller-Hulsbeck, Stefan, E-mail: muehue@diako.de [Diakonissen Hospital, Diagnostic and Interventional Radiology/Neuroradiology (Germany); Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom); Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliffe Hospital, Department of Radiology (United Kingdom)

    2015-08-15

    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

  11. IT SERVICES AVAILABILITY DURING CERN ANNUAL CLOSURE

    CERN Multimedia

    2002-01-01

    Mail, NICE 2000, Web, EDMS (in collaboration with EST Division), General purpose databases, lxbatch, lxplus, Automated tape devices, Castor, Backups, Campus Network, Remedy, Security and VPN services will be available during the CERN annual closure. Problems developing on these services should be addressed within about half a day except on Christmas and New Year evenings, December 25, 2002 and January 1st, 2003. All other services will be left running mostly unattended. No interruptions are scheduled but restoration of the service in case of failure cannot be guaranteed. It should be noted that the Helpdesk will be closed, that no file restores from backups will be possible and damaged tapes will not be processed. An operator service will be maintained and can be reached at extension 75011 or by email to computer.operations@cern.ch. Please remember to shutdown and power off any equipment in your office which is not foreseen to be used during the annual closure before you leave for the holiday.

  12. Thesaurus Building With Transitive Closures For Kadre

    Science.gov (United States)

    Biswas, Gautam; Bezdek, J. C.; Huang, Li-ya

    1987-05-01

    Currently there is a big thrust towards the development of automated, user-friendly online information retrieval systems, which are software packages that allow a user population to query and receive appropriate information that is stored in a computer data-base. Our research adopts a knowledge based approach to the design and development of KADRE (Knowledge Assisted Document Retrieval Expert), an experimental online document retrieval system. Knowledge based techniques allow us to incorporate some of an expert librarian's heuristic techniques into the retrieval process. We present the mathematical model of the retrieval system as a five step process and discuss the system thesaurus in some detail. Six different transitive closures of the relational matrix of term pairs are used to compute the thesaurus, and the retrieval output produced by these techniques are compared. Representation of the thesaurus as a transitive closure offers two very significant advan-tages: this method provides a means for completion of partial knowledge which is represented as numerical relational data; and the ensuing completion has a well defined property of (mathemati-cal) consistency.

  13. CLOSURE WELD DEVELOPMENT FOR 3013 OUTER CONTAINERS

    Energy Technology Data Exchange (ETDEWEB)

    Daugherty, W.; Howard, S.; Peterson, K.; Stokes, M.

    2009-11-10

    Excess plutonium materials in the DOE complex are packaged and stored in accordance with DOE-STD-3013. This standard specifies requirements for the stabilization of such materials and subsequent packaging in dual nested seal-welded containers. Austenitic stainless steels have been selected for container fabrication. The inner 3013 container provides contamination control while the outer 3013 container is the primary containment vessel and is the focus of this paper. Each packaging site chose a process for seal welding the outer 3013 containers in accordance with its needs and expertise. The two processes chosen for weld closure were laser beam welding (LBW) and gas tungsten arc welding (GTAW). Following development efforts, each system was qualified in accordance with DOE-STD-3013 prior to production use. The 3013 outer container closure weld joint was designed to accommodate the characteristics of a laser weld. This aspect of the joint design necessitated some innovative process and equipment considerations in the application of the GTAW process. Details of the weld requirements and the development processes are presented and several potential enhancements for the GTAW system are described.

  14. Availability of IT services during the 2009 CERN annual closure

    CERN Multimedia

    IT Department

    2009-01-01

    Most of the services provided by the IT Department - including WLCG (EGEE) production services - will remain available during the CERN annual closure. No interruptions are scheduled but in the event of a failure, the restoration of services cannot be guaranteed. Problems will be dealt with on a best effort basis only. However, for the following services: Network, Databases, Mail, Web, Windows & Terminal Services, Authentication Services, Indico, CDS, Grid (SAM, FTS, VOMS, GridView): experts should be reachable to start investigations within about half a day except on Christmas Eve and Christmas Day (24 and 25 December) and New Year’s Eve and New Year’s Day (31 December and 1 January). Incidents will be documented at http://cern.ch/ssb. The backup service will remain operational, but backups cannot be guaranteed and file restores may not be possible. Castor: damaged tapes will not be processed. Please note that the Helpdesk will be closed but an operator service will ...

  15. IT Services Availability during the CERN Annual Closure 2010

    CERN Multimedia

    2010-01-01

    Most of the services provided by the IT Department - including WLCG production services - will remain available during the CERN annual closure. No interruptions are scheduled but in case of failure, the restoration of services cannot be guaranteed. Problems will be dealt with on a best effort basis only. However, please note:   •\tExperts should be reachable to start investigations on the following services within about half a day except around Christmas Eve and Christmas Day (24 and 25 December) and New Year's Eve and New Year's Day (31 December and 1 January) -- Network, Databases, Linux, Mail, Printing, Telecom, Web, Windows & Windows Terminal Services, Account Management, Castor, Indico, Inspire, Invenio, Grid (SAM, Gridview, Nagios, messaging), and the room booking system, Incidents will be documented at http://cern.ch/ssb. •\tThe backup service will remain operational, but backups cannot be guaranteed and file restores may not be possible. •\tFor the Castor serv...

  16. Homogeneous, isotropic turbulence phenomenology, renormalization, and statistical closures

    CERN Document Server

    McComb, W David

    2014-01-01

    Fluid turbulence is often referred to as 'the unsolved problem of classical physics'. Yet, paradoxically, its mathematical description resembles quantum field theory. The present book addresses the idealised problem posed by homogeneous, isotropic turbulence, in order to concentrate on the fundamental aspects of the general problem. It is written from the perspective of a theoretical physicist, but is designed to be accessible to all researchers in turbulence, both theoretical and experimental, and from all disciplines. The book is in three parts, and begins with a very simple overview of the basic statistical closure problem, along with a summary of current theoretical approaches. This is followed by a precise formulation of the statistical problem, along with a complete set of mathematical tools (as needed in the rest of the book), and a summary of the generally accepted phenomenology of the subject. Part 2 deals with current issues in phenomenology, including the role of Galilean invariance, the physics of...

  17. Shuttle Planning for Link Closures in Urban Public Transport Networks

    DEFF Research Database (Denmark)

    van der Hurk, Evelien; Koutsopoulos, Haris N.; Wilson, Nigel

    2016-01-01

    cost, which includes transfers and frequency-dependent waiting time costs. This model is applied to a shuttle design problem based on a real-world case study of the Massachusetts Bay Transportation Authority network of Boston, Massachusetts. The results show that additional shuttle routes can reduce......Urban public transport systems must periodically close certain links for maintenance, which can have significant effects on the service provided to passengers. In practice, the effects of closures are mitigated by replacing the closed links with a simple shuttle service. However, alternative...... passenger delay compared to the standard industry practice, while also distributing delay more equally over passengers, at the same operating budget. The results are robust under different assumptions about passenger route choice behavior. Computational experiments show that the proposed formulation...

  18. IT Services Availability during the 2007 Annual CERN Closure

    CERN Multimedia

    IT Department

    2007-01-01

    Most of the physics, technical, administrative and communications services provided by the IT Department - including LCG (EGEE) production services - will remain available during the CERN annual closure (although EDH requests will stay queued). No interruptions are scheduled but in the event of failure, the restoration of services cannot be guaranteed. Problems will be dealt with on a best effort basis only. However, for the following services: Network, Databases, Mail, Web, Windows & Terminal Services, Indico, CDS, Grid (SAM, FTS, VOMS, GridView, Resource Brokers): experts should be reachable to start investigations within about half a day except around Christmas Eve and Christmas Day (24 and 25 December) and New Year’s Eve and New Year’s Day (31 December and 1 January). Incidents will be documented at http://cern.ch/ssb; The backup service: will remain operational, but backups cannot be guaranteed and file restores will not be possible; Castor: damaged tapes wi...

  19. Availability of services during CERN's Annual Closure 2012/2013

    CERN Multimedia

    2012-01-01

    General Services As every year, all the services provided by the GS Department requiring human presence (like the CERN hotel, car sharing service, shuttle service, etc.) will ceased during the annual closure. Services that do not depend on continuous human presence will remain available.  Support levels are reduced during this period. In general, the target reaction time for problems will be half a day (no guaranteed). In case of failure, the reaction time for restoration of services depends on the arrangements that have been made on a service-by-service basis. Service outages will be documented on the status board. For more detailed information please consult the service portal. Please also note that this year, unlike previous years, the heating will not be cut but idle. This reduced level is equal to weekend operation and should be relatively comfortable. Computing Services Most of the services provided by the IT Department - including WLCG production services - will rem...

  20. Characterization ReportOperational Closure Covers for the Area 5 Radioactive Waste Management Site at the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Bechtel Nevada Geotechnical Sciences

    2005-06-01

    Bechtel Nevada (BN) manages two low-level Radioactive Waste Management Sites (RWMSs) at the Nevada Test Site (NTS) for the U.S. Department of Energy (DOE) National Nuclear Security Administration Nevada Site Office (NNSA/NSO). The Area 3 RWMS is located in south-central Yucca Flat and the Area 5 RWMS is located about 15 miles south, in north-central Frenchman Flat. Though located in two separate topographically closed basins, they are similar in climate and hydrogeologic setting. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste, while the Area 3 RWMS uses subsidence craters formed from underground testing of nuclear weapons for the disposal of packaged and unpackaged bulk waste. Over the next several decades, most waste disposal units at both the Area 3 and Area 5 RWMSs are anticipated to be closed. Closure of the Area 3 and Area 5 RWMSs will proceed through three phases: operational closure, final closure, and institutional control. Many waste disposal units at the Area 5RWMS are operationally closed and final closure has been placed on one unit at the Area 3 RWMS (U-3ax/bl). Because of the similarities between the two sites (e.g., type of wastes, environmental factors, operational closure cover designs, etc.), many characterization studies and data collected at the Area 3 RWMS are relevant and applicable to the Area 5 RWMS. For this reason, data and closure strategies from the Area 3 RWMS are referred to as applicable. This document is an interim Characterization Report – Operational Closure Covers, for the Area 5 RWMS. The report briefly describes the Area 5 RWMS and the physical environment where it is located, identifies the regulatory requirements, reviews the approach and schedule for closing, summarizes the monitoring programs, summarizes characterization studies and results, and then presents conclusions and recommendations.

  1. Closure Report for Corrective Action Unit 151: Septic Systems and Discharge Area, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2008-04-01

    Corrective Action Unit (CAU) 151 is identified in the Federal Facility Agreement and Consent Order (FFACO) as Septic Systems and Discharge Area. CAU 151 consists of the following eight Corrective Action Sites (CASs), located in Areas 2, 12, and 18 of the Nevada Test Site, approximately 65 miles northwest of Las Vegas, Nevada: (1) CAS 02-05-01, UE-2ce Pond; (2) CAS 12-03-01, Sewage Lagoons (6); (3) CAS 12-04-01, Septic Tanks; (4) CAS 12-04-02, Septic Tanks; (5) CAS 12-04-03, Septic Tank; (6) CAS 12-47-01, Wastewater Pond; (7) CAS 18-03-01, Sewage Lagoon; and (8) CAS 18-99-09, Sewer Line (Exposed). CAU 151 closure activities were conducted according to the FFACO (FFACO, 1996; as amended February 2008) and the Corrective Action Plan for CAU 151 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2007) from October 2007 to January 2008. The corrective action alternatives included no further action, clean closure, and closure in place with administrative controls. CAU 151 closure activities are summarized in Table 1. Closure activities generated liquid remediation waste, sanitary waste, hydrocarbon waste, and mixed waste. Waste generated was appropriately managed and disposed. Waste that is currently staged onsite is being appropriately managed and will be disposed under approved waste profiles in permitted landfills. Waste minimization activities included waste characterization sampling and segregation of waste streams. Some waste exceeded land disposal restriction limits and required offsite treatment prior to disposal. Other waste meeting land disposal restrictions was disposed of in appropriate onsite or offsite landfills. Waste disposition documentation is included as Appendix C.

  2. Anomalous Scaling from Controlled Closure in a Shell Model of Turbulence

    CERN Document Server

    Lvov, V S; Pomyalov, A; Procaccia, I; L'vov, Victor S.; Pierotti, Daniela; Pomyalov, Anna; Procaccia, Itamar

    1998-01-01

    We present a model of hydrodynamic turbulence for which the program of computing the scaling exponents from first principles can be developed in a controlled fashion. The model consists of $N$ suitably coupled copies of the "Sabra" shell model of turbulence. The couplings are chosen to include two components: random and deterministic, with a relative importance that is characterized by a parameter called $\\epsilon$. It is demonstrated, using numerical simulations of up to 25 copies and 28 shells that in the $N\\to functions whose scaling exponents are anomalous. The theoretical calculation of the scaling exponents follows verbatim the closure procedure suggested recently for the Navier-Stokes problem, with the additional advantage that in the $N\\to procedure. The main result of this paper is a finite and closed set of scale-invariant equations for the 2nd and 3rd order statistical objects of the theory. This set of equations takes into account terms up to order $\\epsilon^4$ and neglects terms of order $\\epsilo...

  3. Prolonged Eyelid Closure Episodes during Sleep Deprivation in Professional Drivers.

    Science.gov (United States)

    Alvaro, Pasquale K; Jackson, Melinda L; Berlowitz, David J; Swann, Philip; Howard, Mark E

    2016-08-15

    Real life ocular measures of drowsiness use average blink duration, amplitude and velocity of eyelid movements to reflect drowsiness in drivers. However, averaged data may conceal the variability in duration of eyelid closure episodes, and more prolonged episodes that indicate higher levels of drowsiness. The current study aimed to describe the frequency and duration of prolonged eyelid closure episodes during acute sleep deprivation. Twenty male professional drivers (mean age ± standard deviation = 41.9 ± 8.3 years) were recruited from the Transport Workers Union newsletter and newspaper advertisements in Melbourne, Australia. Each participant underwent 24 hours of sleep deprivation and completed a simulated driving task (AusEd), the Psychomotor Vigilance Task, and the Karolinska Sleepiness Scale. Eyelid closure episodes during the driving task were recorded and analyzed manually from digital video recordings. Eyelid closure episodes increased in frequency and duration with a median of zero s/h of eyelid closure after 3 h increasing to 34 s/h after 23 h awake. Eyelid closure episodes were short and infrequent from 3 to 14 h of wakefulness. After 17 h of sleep deprivation, longer and more frequent eyelid closure episodes began to occur. Episodes lasting from 7 seconds up to 18 seconds developed after 20 h of wakefulness. Length of eyelid closure episodes was moderately to highly correlated with the standard deviation of lateral lane position, braking reaction time, crashes, impaired vigilance, and subjective sleepiness. The frequency and duration of episodes of prolonged eyelid closure increases during acute sleep deprivation, with very prolonged episodes after 17 hours awake. Automated devices that assess drowsiness using averaged measures of eyelid closure episodes need to be able to detect prolonged eyelid closure episodes that occur during more severe sleep deprivation. © 2016 American Academy of Sleep Medicine.

  4. Laser Peripheral Iridotomy in Primary Angle Closure: A Report by the American Academy of Ophthalmology.

    Science.gov (United States)

    Radhakrishnan, Sunita; Chen, Philip P; Junk, Anna K; Nouri-Mahdavi, Kouros; Chen, Teresa C

    2018-02-23

    To examine the efficacy and complications of laser peripheral iridotomy (LPI) in subjects with primary angle closure (PAC). Literature searches in the PubMed and Cochrane databases were last conducted in August 2017 and yielded 300 unique citations. Of these, 36 met the inclusion criteria and were rated according to the strength of evidence; 6 articles were rated level I, 11 articles were rated level II, and 19 articles were rated level III. Reported outcomes were change in angle width, effect on intraocular pressure (IOP) control, disease progression, and complications. Most of the studies (29/36, 81%) included only Asian subjects. Angle width (measured by gonioscopy, ultrasound biomicroscopy, and anterior segment OCT) increased after LPI in all stages of angle closure. Gonioscopically defined persistent angle closure after LPI was reported in 2% to 57% of eyes across the disease spectrum. Baseline factors associated with persistent angle closure included narrower angle and parameters representing nonpupillary block mechanisms of angle closure, such as a thick iris, an anteriorly positioned ciliary body, or a greater lens vault. After LPI, further treatment to control IOP was reported in 0%-8% of PAC suspect (PACS), 42% to 67% of PAC, 21% to 47% of acute PAC (APAC), and 83%-100% of PAC glaucoma (PACG) eyes. Progression to PACG ranged from 0% to 0.3% per year in PACS and 0% to 4% per year in PAC. Complications after LPI included IOP spike (8-17 mmHg increase from baseline in 6%-10%), dysphotopsia (2%-11%), anterior chamber bleeding (30%-41%), and cataract progression (23%-39%). Laser peripheral iridotomy increases angle width in all stages of primary angle closure and has a good safety profile. Most PACS eyes do not receive further intervention, whereas many PAC and APAC eyes, and most PACG eyes, receive further treatment. Progression to PACG is uncommon in PACS and PAC. There are limited data on the comparative efficacy of LPI versus other treatments for the

  5. Simulation studies to evaluate the effect of fracture closure on the performance of naturally fractured reservoirs. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    1992-11-01

    The second year of this three-year research program to evaluate the effect of fracture closure on the recovery of oil and gas from naturally fractured reservoirs has been completed. The overall objectives of the study are to: (1) evaluate the reservoir conditions where fracture closure is significant, and (2) evaluate innovative fluid injection techniques capable of maintaining pressure within the reservoir. Simulation studies have been conducted with a dual porosity simulator capable of simulating the performance of vertical and horizontal wells. Each simulation model has been initialized with properties typical of the Austin Chalk reservoir in Pearsall Field, Texas. During year one, simulations of both vertical and horizontal well performance were made assuming that fracture permeability was insensitive to pressure charge. The results confirmed that horizontal wells could increase both rate of oil recovery and total oil recovery from naturally fractured reservoirs. During the second year the performances of the same vertical and horizontal wells were evaluated with the assumption that fracture permeability was a function of reservoir pressure. This required repetition of most of the natural depletion cases simulated in year one while invoking the pressure-sensitive fracture permeability option. To investigate sensitivity to in situ stress, two stress conditions were simulated for each primary variable. The water injection cases, begun in year one, were extended to include most of the reservoir parameters investigated for natural depletion, including fracture permeability as a function of net stress and the use of horizontal wells. The results thus far confirm that pressure-sensitive fractures degrade well performance and that the degradation is reduced by water injection pressure maintenance. Furthermore, oil recovery can be significantly increased by water injection pressure maintenance.

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

    Science.gov (United States)

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

    1972-01-01

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

  7. On the normality of orbit closures which are hypersurfaces

    Indian Academy of Sciences (India)

    quiver representations). It is an interesting task to study geometric properties of the Zariski closures – being affine varieties – of GL(d)-orbits in repQ(d), as well as their connections with representation-theoretic properties of the quiver Q and its representations. Among the geometric properties of orbit closures that have ...

  8. On the normality of orbit closures which are hypersurfaces

    Indian Academy of Sciences (India)

    Let be a quiver representation with non-zero admissible annihilator. In this paper, we prove the normality of the orbit closure O ¯ N when it is a hypersurface. The result thus gives new examples of normal orbit closures of quiver representations.

  9. A Simple Technique for Safe Mesenteric Defect Closure Following ...

    African Journals Online (AJOL)

    laparoscopic-assisted sigmoid colectomy. JSLS 1999;3:79-81. 6. Causey MW, Oguntoye M, Steele SR. Incidence of complications following colectomy with mesenteric closure versus no mesenteric closure: Does it really matter? J Surg Res 2011;171:571-5. 7. Cabot JC, Lee SA, Yoo J, Nasar A, Whelan RL, Feingold DL.

  10. Which Patent Foramen Ovales Need Closure to Prevent Cryptogenic Strokes?

    Science.gov (United States)

    Dalen, James E; Alpert, Joseph S

    2018-03-01

    Patients with cryptogenic strokes are more likely to have a patent foremen ovale than in the general population. It is speculated that these strokes are due to paradoxical embolism, that is, passage of a venous thrombus across the patent foremen ovale to enter the arterial circulation, resulting in an embolic stroke. Venous thromboembolism is rarely present in these cases of cryptogenic stroke. Thousands of patients with cryptogenic strokes have undergone transcatheter closure of their patent foremen ovale via a variety of devices. The first 3 randomized clinical trials comparing patent foremen ovale closure with medical therapy failed to show a significant advantage of patent foremen ovale closure. Three additional trials reported in 2017 had longer years of follow-up and demonstrated an advantage of patent foremen ovale closure versus medical therapy. Analysis of their data indicated that patent foremen ovale closure in patients with an atrial septal aneurysm in addition to a patent foremen ovale had a very significant decrease in cryptogenic strokes (P patent foremen ovale closure (P = .37). Aneurysms of the atrial septum are easily recognized by echocardiography and are present in approximately one-third of patients with patent foremen ovales. These data suggest that closure of patent foremen ovales in patients with an atrial septal aneurysm is indicated. In patients with a patent foremen ovale without an aneurysm of the atrial septum, patent foremen ovale closure is not indicated. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND: The efficacy of closure of a patent foramen ovale (PFO) in the prevention of recurrent stroke after cryptogenic stroke is uncertain. We investigated the effect of PFO closure combined with antiplatelet therapy versus antiplatelet therapy alone on the risks of recurrent stroke and new...

  12. Surgical Experience with Closure of an Isolated PDA at Muhimbili ...

    African Journals Online (AJOL)

    Background: This study describes our experience in the management of isolated patent ductus arteriosus; complications and mortality rate. Further it describes the innovative technique for the closure of the duct. Methods: We retrospectively recruited all patients' files that underwent PDA closure from May 2008 to July 2011 ...

  13. Localization of tight closure in two-dimensional rings

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    localization in a general situation. There are some related conjectures that a positive answer to each of them will yield solution to the localization problem. For example, it is an open question that for any ideal I of a domain R, I∗ = IR+ ∩ R, where R+ denote the integral closure of R in an algebraic closure of its fraction field.

  14. The Impact of Mine Closures on Rural Population Dynamics: The ...

    African Journals Online (AJOL)

    The paper examines the demographic and socio-cultural impact of spontaneous population inflows into Zhombe following the closure of the Empress Mine in 1982. Data was collected using a questionnaire survey. Results of the study show that mine closures cause rural population change. The population directly grows ...

  15. 40 CFR 265.112 - Closure plan; amendment of plan.

    Science.gov (United States)

    2010-07-01

    ... contaminated soils, methods for sampling and testing surrounding soils, and criteria for determining the extent... partial and final closure. (For example, in the case of a landfill unit, estimates of the time required to... all hazardous wastes at closure, but are required to close as landfills in accordance with § 265.310...

  16. Morbidity of Colostomy Closure in Children | Nasir | African Journal ...

    African Journals Online (AJOL)

    The care of colostomy remains a burden to the family while complications associated with its construction and closure can be tasking to the surgeon. The aim of this study was to evaluate the outcome of colostomy closure in children in our setting. A prospective review of 31 consecutive children undergoing colostomy ...

  17. 21 CFR 211.94 - Drug product containers and closures.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Drug product containers and closures. 211.94 Section 211.94 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... and closures shall be clean and, where indicated by the nature of the drug, sterilized and processed...

  18. 77 FR 55895 - Permanent Closure of Cincinnati Blue Ash Airport

    Science.gov (United States)

    2012-09-11

    ... Federal Aviation Administration Permanent Closure of Cincinnati Blue Ash Airport AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of permanent closure of Cincinnati Blue Ash Airport (ISZ). SUMMARY: The... Cincinnati advising that on August 29, 2012, it was permanently closing Cincinnati Blue Ash Airport (ISZ...

  19. Vacuum-Assisted Abdominal Closure Is Safe and Effective

    DEFF Research Database (Denmark)

    Jensen, R O; Buchbjerg, T; Simonsen, R M

    2017-01-01

    with median 1 (0-16) dressing changes. Seventy per cent of the patients attended the intensive care unit. The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were...

  20. Management of open abdomen with an absorbable mesh closure.

    Science.gov (United States)

    Prichayudh, Supparerk; Sriussadaporn, Suvit; Samorn, Pasurachate; Pak-Art, Rattaplee; Sriussadaporn, Sukanya; Kritayakirana, Kritaya; Capin, Allan

    2011-01-01

    To examine the methods and results of treatment in patients with an open abdomen (OA) at a single institution where an absorbable mesh closure (AMC) is most commonly used. A retrospective study was performed in OA patients from January 2001 to June 2007. Outcomes were analyzed in terms of enteroatmospheric fistula (EAF) formation and survival. There were 73 OA patients receiving definitive closures (40 trauma and 33 nontrauma). Twenty-four patients were able to undergo a delayed primary fascial closure (DPFC) after initial vacuum pack closure (DPFC rate 33%). The DPFC rate was significantly lower in patients with an associated infection or contamination (9% vs 44%, P = 0.002). The EAF and mortality rates of the DPFC group were 0% and 13%, respectively. Absorbable mesh closure was used in 41 of 49 patients who failed DPFC (84%). There were 9 patients who had EAF (overall EAF rate 12%), 6 of whom were in the AMC group (EAF rate 15%). The overall and AMC group mortality rates were 29% and 37%, respectively. Absorbable mesh closure carries high EAF and mortality rates. Therefore, DPFC should be considered as the primary closure method. Absorbable mesh closure should be reserved for patients who fail DPFC, especially those with peritonitis or contamination.

  1. On the fixed point of the iterated pseudopalindromic closure

    OpenAIRE

    Jamet, D.; Paquin, G.; Richomme, G.; Vuillon, L.

    2009-01-01

    First introduced in the study of the Sturmian words, the iterated palindromic closure was recently generalized to pseudopalindromes. This operator allows one to construct words with an infinity of pseudopalindromic prefixes, called pseudostandard words. We provide here several combinatorial properties of the fixed points under the iterated pseudopalindromic closure.

  2. Outcome of primary closure of abdominal wounds following typhoid ...

    African Journals Online (AJOL)

    Background: Abdominal wounds following surgery for typhoid perforation are classifi ed as dirty, with an infection rate of over 40%. To date, the optimal method for closure of these wounds remains controversial. Delayed primary closure which was conventionally recommended as standard practice, is now considered to be ...

  3. Object grasping by combining caging and force closure

    NARCIS (Netherlands)

    Lei, Q.; Wisse, M.

    2016-01-01

    The current research trends of object grasping can be summarized as caging grasping and force closure grasping. The motivation of this paper is to combine the advantage of caging grasping and force closure grasping to enable under-actuated grippers like the Lacquey gripper and the parallel

  4. Closure Report for Corrective Action Unit 540: Spill Sites, Nevada Test Site, Nevada, Rev. No.: 0

    Energy Technology Data Exchange (ETDEWEB)

    McClure, Lloyd

    2006-10-01

    This Closure Report (CR) presents information supporting the closure of Corrective Action Unit (CAU) 540: Spill Sites, Nevada Test Site, Nevada. This CR complies with the requirements of the 'Federal Facility Agreement and Consent Order' (1996) that was agreed to by the State of Nevada, the U.S. Department of Energy, and the U.S. Department of Defense. Corrective Action Unit 540 is located within Areas 12 and 19 of the Nevada Test Site and is comprised of the following Corrective Action Sites (CASs): CAS 12-44-01, ER 12-1 Well Site Release; CAS 12-99-01, Oil Stained Dirt; CAS 19-25-02, Oil Spill; CAS 19-25-04, Oil Spill; CAS 19-25-05, Oil Spill; CAS 19-25-06, Oil Spill; CAS 19-25-07, Oil Spill; CAS 19-25-08, Oil Spills (3); and CAS 19-44-03, U-19bf Drill Site Release. The purpose of this CR is to provide documentation supporting recommendations of no further action for the CASs within CAU 540. To achieve this, the following actions were performed: (1) Reviewed the current site conditions, including the concentration and extent of contamination; (2) Performed closure activities to address the presence of substances regulated by 'Nevada Administrative Code' 445A.2272 (NAC, 2002); and (3) Documented Notice of Completion and closure of CAU 540 issued by the Nevada Division of Environmental Protection.

  5. Summary of Group Development and Testing for Single Shell Tank Closure at Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Harbour, John, R.

    2005-04-28

    This report is a summary of the bench-scale and large scale experimental studies performed by Savannah River National Laboratory for CH2M HILL to develop grout design mixes for possible use in producing fill materials as a part of Tank Closure of the Single-Shell Tanks at Hanford. The grout development data provided in this report demonstrates that these design mixes will produce fill materials that are ready for use in Hanford single shell tank closure. The purpose of this report is to assess the ability of the proposed grout specifications to meet the current requirements for successful single shell tank closure which will include the contracting of services for construction and operation of a grout batch plant. The research and field experience gained by SRNL in the closure of Tanks 17F and 20F at the Savannah River Site was leveraged into the grout development efforts for Hanford. It is concluded that the three Hanford grout design mixes provide fill materials that meet the current requirements for successful placement. This conclusion is based on the completion of recommended testing using Hanford area materials by the operators of the grout batch plant. This report summarizes the regulatory drivers and the requirements for grout mixes as tank fill material. It is these requirements for both fresh and cured grout properties that drove the development of the grout formulations for the stabilization, structural and capping layers.

  6. Migraine and percutaneous patent foramen ovale closure: a systematic review and meta-analysis.

    Science.gov (United States)

    Shi, Yu-Jie; Lv, Jun; Han, Xing-Ting; Luo, Guo-Gang

    2017-07-26

    The association between patent foramen ovale (PFO) and migraine with aura (MA) is well established. However, the benefits of PFO closure are less certain in patients with migraine without aura (MwoA). We systematically searched Pubmed for pertinent clinical studies published from January 2000 to July 2015. The primary end-point was the elimination or significant improvement of migraine symptoms after PFO closure. Upon screening an initial list of 315 publications, we identified eight studies that included 546 patients. Overall, our analysis indicated a significant improvement of migraine in 81% of MA cases compared to only 63% of MwoA cases. The summary odds ratio was 2.5 (95% confidence interval 1.09-5.73), and the benefits of PFO closure were significantly greater for patients with MA compared to patients with MwoA (P = 0.03). The presence of aura provides a reference standard for the clinical selection of patients with migraine for PFO closure intervention.

  7. Bilateral Angle-Closure Glaucoma in a Young Female Receiving Cabergoline: A Case Report

    Directory of Open Access Journals (Sweden)

    Hasan Razmjoo

    2011-01-01

    Full Text Available Purpose: To report a case of bilateral acute angle-closure glaucoma after oral administration of cabergoline for the treatment of galactorrhea. Methods: A diagnosis of secondary drug-induced angle-closure glaucoma was made in a patient with elevated intraocular pressure (IOP and myopic refractive shift, which was confirmed by ultrasound biomicroscopy (UBM of the ciliary body and anterior segment, sonography, and optical coherence tomography. The treatment included the discontinuation of the culprit drug and the administration of topical anti-glaucoma drops. The treatment course was followed with serial measurements of the IOP and refraction, and with performing UBM. Results: Five hours after he received a single 0.5-mg oral cabergoline tablet, the patient suffered from acute secondary angle-closure glaucoma and myopic refractive error. UBM demonstrated both effusion of the ciliary body and an anterior rotation of the iris-ciliary body. IOP was reduced 8 h after cessation of the causative agent and administration of anti-glaucoma drops. Refractive errors returned to normal levels after 8 days. Conclusion: Secondary acute angle-closure glaucoma has been reported to occur after the administration of some drugs. In this report, an attempt has been made to describe this adverse reaction after oral cabergoline intake.

  8. Post-closure permit application for the Kerr Hollow Quarry at the Y-12 plant

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    The Kerr Hollow Quarry (KHQ) is located on U.S. Department of Energy (DOE) property at the Y-12 Plant, Oak Ridge, Tennessee. The Oak Ridge Y-12 Plant was built by the U.S. Army Corps of Engineers in 1943 as part of the Manhattan Project. Until 1992, the primary mission of the Y-12 Plant was the production and fabrication of nuclear weapons components. Activities associated with these functions included production of lithium compounds, recovery of enriched uranium from scrap material, and fabrication of uranium and other materials into finished parts for assemblies. The Kerr Hollow Quarry was used for waste disposal of a variety of materials including water-reactive and shock-sensitive chemicals and compressed gas cylinders. These materials were packaged in various containers and sank under the water in the quarry due to their great weight. Disposal activities were terminated in November, 1988 due to a determination by the Tennessee Department of Environment and Conservation that the quarry was subject to regulations under the Resource Conservation and Recovery Act of 1993. Methods of closure for the quarry were reviewed, and actions were initiated to close the quarry in accordance with closure requirements for interim status surface impoundments specified in Tennessee Rules 1200-1-11-.05(7) and 1200-1-11-.05(11). As part of these actions, efforts were made to characterize the physical and chemical nature of wastes that had been disposed of in the quarry, and to remove any containers or debris that were put into the quarry during waste disposal activities. Closure certification reports (Fraser et al. 1993 and Dames and Moore 1993) document closure activities in detail. This report contains the post-closure permit application for the Kerr Hollow Quarry site.

  9. Accelerated Wound Closure - Differently Organized Nanofibers Affect Cell Migration and Hence the Closure of Artificial Wounds in a Cell Based In Vitro Model.

    Directory of Open Access Journals (Sweden)

    Maximilian Ottosson

    Full Text Available Nanofiber meshes holds great promise in wound healing applications by mimicking the topography of extracellular matrix, hence providing guidance for crucial cells involved in the regenerative processes. Here we explored the influence of nanofiber alignment on fibroblast behavior in a novel in vitro wound model. The model included electrospun poly-ε-caprolactone scaffolds with different nanofiber orientation. Fibroblasts were cultured to confluency for 24h before custom-made inserts were removed, creating cell-free zones serving as artificial wounds. Cell migration into these wounds was evaluated at 0-, 48- and 96h. Cell morphological analysis was performed using nuclei- and cytoskeleton stainings. Cell viability was assessed using a biochemical assay. This study demonstrates a novel in vitro wound assay, for exploring of the impact of nanofibers on wound healing. Additionally we show that it's possible to affect the process of wound closure in a spatial manner using nanotopographies, resulting in faster closure on aligned fiber substrates.

  10. Need for closure and youths' leisure time preferences.

    Science.gov (United States)

    Vermeir, Iris; Geuens, Maggie

    2006-04-01

    The Need for Closure is an individual characteristic which may help explain individual differences in engagement in leisure activities. Both a leisure engagement inventory and a validated Dutch version of the Need for Closure Scale were administered to a convenient sample of 1,035 young adults ages 15 to 24 years of whom 552 were female. Leisure engagement was hypothesized to differ for groups differing in Need for Closure. More specifically, youngsters who score high (versus low) on Need for Closure engaged more in structured, cognitively effortless, and predictable leisure activities like shopping for fun and going to the cinema, while young adults scoring low (versus high) on Need for Closure more often participated in unstructured, unpredictable, cognitively effortful or challenging leisure activities like going to a party, a pub, or a pop concert, idly lazing away, visiting or hosting friends, attending an evening class and playing computer games.

  11. Stapler versus scalpel resection followed by hand-sewn closure of the pancreatic remnant for distal pancreatectomy.

    Science.gov (United States)

    Probst, Pascal; Hüttner, Felix J; Klaiber, Ulla; Knebel, Phillip; Ulrich, Alexis; Büchler, Markus W; Diener, Markus K

    2015-11-06

    Resections of the pancreatic body and tail reaching to the left of the superior mesenteric vein are defined as distal pancreatectomy. Most distal pancreatectomies are elective treatments for chronic pancreatitis, benign or malignant diseases, and they have high morbidity rates of up to 40%. Pancreatic fistula formation is the main source of postoperative morbidity, associated with numerous further complications. Researchers have proposed several surgical resection and closure techniques of the pancreatic remnant in an attempt to reduce these complications. The two most common techniques are scalpel resection followed by hand-sewn closure of the pancreatic remnant and stapler resection and closure. To compare the rates of pancreatic fistula in people undergoing distal pancreatectomy using scalpel resection followed by hand-sewn closure of the pancreatic remnant versus stapler resection and closure. We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Biosis and Science Citation Index from database inception to October 2015. We included randomised controlled trials (RCTs) comparing stapler versus scalpel resection followed by hand-sewn closure of the pancreatic remnant for distal pancreatectomy (irrespective of language or publication status). Two authors independently assessed trials for inclusion and extracted the data. Taking into consideration the clinical heterogeneity between the trials (e.g. different endpoint definitions), we analysed data using a random-effects model with Review Manager (RevMan), calculating risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI). In two eligible trials, a total of 381 participants underwent distal pancreatic resection and were randomised to closure of the pancreatic remnant either with stapler (n = 191) or scalpel resection followed by hand-sewn closure (n = 190). One was a single centre pilot RCT and the other was a multicentre blinded RCT. The single centre pilot RCT

  12. Tacks, staples, or suture: method of peritoneal closure in laparoscopic transabdominal preperitoneal inguinal hernia repair effects early quality of life.

    Science.gov (United States)

    Ross, Samuel W; Oommen, Bindhu; Kim, Mimi; Walters, Amanda L; Augenstein, Vedra A; Heniford, B Todd; Todd Heniford, B

    2015-07-01

    TAPP inguinal hernia repair (IHR) entails the development of a peritoneal flap (PF) in order to reduce the hernia sac and create a preperitoneal space in which to place mesh. Many methods for closure of the PF exist including sutures, tacks, and staples. We hypothesized that patients who had PF closure with suture would have better short-term QOL outcomes. A prospective institutional hernia-specific database was queried for all adult, TAPP IHRs from July 2012 to August 2013. Unilateral and bilateral patients were included and each hernia was analyzed separately. The main outcome of interest was quality of life (QOL) at two- and four-week follow-up, as measured by the Carolinas Comfort Scale. There were 227 patients who underwent TAPP, with 99 bilateral and 128 unilateral IHR, for a total of 326 IHR. PF closure was performed using tacks in 45.1%, suture in 19.0%, and staples in 35.9%. Patient characteristics were statistically similar between the tack, suture, and staple group. There were 32.9% direct, 46.5% indirect, and 20.6% pantaloon hernias, which were not significantly different when compared by PF closure method. Post-operative complications and length of stay were same for the three groups. There were no hernia recurrences. Post-operative activity limitation at two weeks was significantly better in the suture group when compared to the stapled group (p = 0.005). Additionally, sutured PF closure had less early post-operative pain when compared to the tack group (p = 0.038). Following TAPP IHR, suture closure of the PF significantly improves 2-week post-operative movement limitation compared to stapled and tacked PF closure. Continued randomized studies are needed to determine the best surgical hernia repair methods for ideal post-op QOL.

  13. The Ruby programming language

    CERN Document Server

    Flanagan, David

    2008-01-01

    This book begins with a quick-start tutorial to the language, and then explains the language in detail from the bottom up: from lexical and syntactic structure to datatypes to expressions and statements and on through methods, blocks, lambdas, closures, classes and modules. The book also includes a long and thorough introduction to the rich API of the Ruby platform, demonstrating -- with heavily-commented example code -- Ruby's facilities for text processing, numeric manipulation, collections, input/output, networking, and concurrency. An entire chapter is devoted to Ruby's metaprogramming capabilities. The Ruby Programming Language documents the Ruby language definitively but without the formality of a language specification. It is written for experienced programmers who are new to Ruby, and for current Ruby programmers who want to challenge their understanding and increase their mastery of the language.

  14. Single-site neural tube closure in human embryos revisited.

    Science.gov (United States)

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

    2017-10-01

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

  15. Midline abdominal wall closure: a new prophylactic mesh concept.

    Science.gov (United States)

    Bellón, Juan M; López-Hervás, Pedro; Rodríguez, Marta; García-Honduvilla, Natalio; Pascual, Gemma; Buján, Julia

    2006-10-01

    Despite intense research efforts, incisional hernias continue to be a problem in patients who undergo laparotomy. This study was designed to reinforce the midline laparotomy closure by including a new prosthetic design between the edges of the surgical wound. A midline incision was made in New Zealand white rabbits and closed by inserting a polypropylene strip, T-shaped in cross-section, between the incisional borders. The T was placed upside down such that the horizontal arm of the T, whose surface is coated with extra-low pore size expanded polytetrafluoroethylene, made contact with the visceral peritoneum. The mesh was secured by a mass polypropylene 3/0 running suture. Surgery outcomes in these animals were compared with those in which the surgical wound was closed by simple suture and with control, nonoperated animals. The T-mesh induced an increased amount of scar tissue at the midline, where neoformed recipient tissue appeared around the polypropylene mesh filaments. The expanded polytetrafluoroethylene lamina became appropriately mesothelialized. Compared with the simple suture, the T-mesh provided a significant gain in biomechanical strength at postoperative week 6 (43.99+/-4.17 Newtons and 56.96+/-10.94 Newtons, respectively, p abdominal wall (82.25+/-7.60 Newtons versus 79.55+/-11.46 Newtons). Data were expressed as mean +/- standard deviation. The use of a nonabsorbable biomaterial for midline laparotomy closure significantly improves its biomechanical resistance. Used in high-risk patients or even prophylactically, this technique could reduce the incidence of incisional hernia.

  16. A novel approach for the closure of challenging giant omphalocele

    Directory of Open Access Journals (Sweden)

    Barkat Ali

    2015-11-01

    Full Text Available Omphalocele is a congenital condition characterized by midline defect of the anterolateral abdominal wall whereby intra-abdominal contents covered by peritoneal sac are found herniated. It can be defined by size of defect or visceral contents. There are various ways of surgical management of omphalocele. Giant omphalocele presents particular challenge in reconstructing the abdominal wall. In this regard the use of tissues expansion as an adjunct in an attempt to recreate functional abdominal wall domain has been emerging. We are presenting a case of giant omphalocele that was closed with the help of extra peritoneal inter muscular tissue expanders.The patient was born at 37 weeks to a 33 year old healthy gravida 3, para 0 G3P0 mother via planned cesarean section. There were no prenatal, natal or postnatal complications. The giant omphalocele was diagnosed prenatally on screening Ultrasound. The patient remained in the neonatal intensive care unit for 6 weeks. The sac was large with abdominal contents including the entire liver. The sac was allowed to epithelialize completely over the course of two years. Due to the small size of the abdominal wall defect contents of the sac, loss of abdominal domain and inability of the abdominal cavity to accommodate the liver, we chose for rectangular tissue expander placement at age 30 months. 3 months later the patient was planned for tissue expander removal and abdominal wall closure. The tissue expanders were removed and omphalocele closure was performed. The patient has been followed up at 6 months and without recurrence of hernia.The management of giant omphalocele is technically challenging. Use of tissue expansion helps in recreating functional abdominal wall domain. There is growing evidence in the literature supporting the use of intra-abdominal tissue expansion in the management of giant omphalocele however because of hemodynamic consequences we think that the use of rectangular shaped, extra

  17. Spontaneous closure of midline diastema following frenectomy.

    Science.gov (United States)

    Koora, Kiran; Muthu, M S; Rathna, Prabhu V

    2007-03-01

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

  18. Spontaneous closure of midline diastema following frenectomy

    Directory of Open Access Journals (Sweden)

    Koora Kiran

    2007-03-01

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

  19. The tibial bayonet method of wound closure.

    Science.gov (United States)

    O'Farrell, Peter; Barnard, Annette-Christi; Birkholtz, Franz

    2018-01-24

    Management of open lower limb fractures with soft tissue defects can be a technically challenging orthopaedic problem. Limited availability of orthoplastic services means that alternatives to the fix and flap concept are required in order to prevent infected non-unions from developing. The proposed 'bayonet apposition' allows the surgeon to temporarily shorten the limb without angulating the limb or creating a bone defect and removing viable bone. The viable bone edges are overlapped in a bayonet-like manner in order to appose the wound and skin edges. The limb length is restored by gradually distracting the bone segments once the soft tissues have healed. This is facilitated with a hexapod fixator for stabilization of the fracture and distraction. Prerequisites for utilizing this method are circumferential soft tissue damage to the lower limb with viable distal tissue. The bayonet method allows primary closure of a wound and rapid restoration of the native length of the limb.

  20. Occupational closure in nursing work reconsidered

    DEFF Research Database (Denmark)

    Traynor, Michael; Nissen, Nina; Lincoln, Carol

    2015-01-01

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

  1. Frictionless segmented mechanics for controlled space closure

    Directory of Open Access Journals (Sweden)

    Ildeu Andrade Jr

    Full Text Available ABSTRACT Extraction spaces may be needed to achieve specific orthodontic goals of positioning the dentition in harmony with the craniofacial complex. However, the fundamental reality that determines the occlusion final position is the control exerted by the orthodontist while closing the extraction spaces. A specific treatment objective may require the posterior teeth to remain in a constant position anteroposteriorly as well as vertically, while the anterior teeth occupy the entire extraction site. Another treatment objective may require the opposite, or any number of intentional alternatives of extraction site closure. The present case report describes a simple controlled segmented mechanic system that permitted definable and predictable force systems to be applied and allowed to predict the treatment outcome with confidence. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO in partial fulfillment of the requirements for Diplomate certification.

  2. Closure Report for the 92-Acre Area and Corrective Action Unit 111: Area 5 WMD Retired Mixed Waste Pits, Nevada National Security Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2012-02-21

    This Closure Report (CR) presents information supporting closure of the 92-Acre Area, which includes Corrective Action Unit (CAU) 111, 'Area 5 WMD Retired Mixed Waste Pits.' This CR provides documentation supporting the completed corrective actions and confirmation that the closure objectives were met. This CR complies with the requirements of the Federal Facility Agreement and Consent Order (FFACO) (FFACO, 1996 [as amended March 2010]). Closure activities began in January 2011 and were completed in January 2012. Closure activities were conducted according to Revision 1 of the Corrective Action Decision Document/Corrective Action Plan (CADD/CAP) for the 92-Acre Area and CAU 111 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office [NNSA/NSO], 2010). The following closure activities were performed: (1) Construct an engineered evapotranspiration cover over the boreholes, trenches, and pits in the 92-Acre Area; (2) Install use restriction (UR) warning signs, concrete monuments, and subsidence survey monuments; and (3) Establish vegetation on the covers. UR documentation is included as Appendix C of this report. The post-closure plan is presented in detail in Revision 1 of the CADD/CAP for the 92-Acre Area and CAU 111, and the requirements are summarized in Section 5.2 of this document. When the next request for modification of Resource Conservation and Recovery Act Permit NEV HW0101 is submitted to the Nevada Division of Environmental Protection (NDEP), the requirements for post-closure monitoring of the 92-Acre Area will be included. NNSA/NSO requests the following: (1) A Notice of Completion from NDEP to NNSA/NSO for closure of CAU 111; and (2) The transfer of CAU 111 from Appendix III to Appendix IV, Closed Corrective Action Units, of the FFACO.

  3. Department of the Navy, FY 1999 Amended Budget Estimates (BRAC 93). Base Closure and Realignment, III

    National Research Council Canada - National Science Library

    1998-01-01

    .... The Navy budget to implement the closures and realignments resulting from these decisions was formulated based on experience gained from closures and realignments achieved thus far and comprehensive...

  4. Middlesex FUSRAP Site - A Path to Site-Wide Closure - 13416

    Energy Technology Data Exchange (ETDEWEB)

    Miller, David M. [ECC, 110 Fieldcrest Ave, Ste 31, Edison, NJ, 08837 (United States); Edge, Helen [US Army Corps of Engineers - NYD, 26 Federal Plaza, Room 1811, New York, NY, 10278 (United States)

    2013-07-01

    The road-map to obtaining closure of the Middlesex Sampling Plant FUSRAP site in Middlesex, New Jersey (NJ) has required a multi-faceted approach, following the CERCLA Process. Since 1998, the US ACE, ECC, and other contractors have completed much of the work required for regulatory acceptance of site closure with unrestricted use. To date, three buildings have been decontaminated, demolished, and disposed of. Two interim storage piles have been removed and disposed of, followed by the additional removal and disposal of over 87,000 tons of radiologically and chemically-impacted subsurface soils by the summer of 2008. The US ACE received a determination from the EPA for the soils Operable Unit, (OU)-1, in September 2010 that the remedial excavations were acceptable, and meet the criteria for unrestricted use as required by the 2004 Record of Decision (ROD) for OU-1. Following the completion of OU-1, the project delivery team performed additional field investigation of the final Operable Unit for Middlesex, OU-2, Groundwater. As of December 2012, the project delivery team has completed a Supplemental Remedial Investigation, which will be followed with a streamlined Feasibility Study, Proposed Plan, and ROD. Several years of historical groundwater data was available from previous investigations and the FUSRAP Environmental Surveillance Program. Historical data indicated sporadic detections of Volatile Organic Compounds (VOCs), primarily trichloroethylene (TCE), carbon tetrachloride (CT), and methyl tert-butyl ether (MTBE), with no apparent trend or pattern indicating extent or source of the VOC impact. In 2008, the project delivery team initiated efforts to re-assess the Conceptual Site Model (CSM) for groundwater. The bedrock was re-evaluated as a leaky multi-unit aquifer, and a plan was developed for additional investigations for adequate bedrock characterization and delineation of groundwater contaminated primarily by CT, TCE, and tetrachloroethene (PCE). The

  5. Closure Report for Corrective Action Unit 562: Waste Systems, Nevada National Security Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2012-08-15

    This Closure Report (CR) presents information supporting closure of Corrective Action Unit (CAU) 562, Waste Systems, and provides documentation supporting the completed corrective actions and confirmation that closure objectives for CAU 562 were met. This CR complies with the requirements of the Federal Facility Agreement and Consent Order (FFACO) that was agreed to by the State of Nevada; the U.S. Department of Energy (DOE), Environmental Management; the U.S. Department of Defense; and DOE, Legacy Management (FFACO, 1996 as amended). CAU 562 consists of the following 13 Corrective Action Sites (CASs), located in Areas 2, 23, and 25 of the Nevada National Security Site: · CAS 02-26-11, Lead Shot · CAS 02-44-02, Paint Spills and French Drain · CAS 02-59-01, Septic System · CAS 02-60-01, Concrete Drain · CAS 02-60-02, French Drain · CAS 02-60-03, Steam Cleaning Drain · CAS 02-60-04, French Drain · CAS 02-60-05, French Drain · CAS 02-60-06, French Drain · CAS 02-60-07, French Drain · CAS 23-60-01, Mud Trap Drain and Outfall · CAS 23-99-06, Grease Trap · CAS 25-60-04, Building 3123 Outfalls Closure activities began in October 2011 and were completed in April 2012. Activities were conducted according to the Corrective Action Plan for CAU 562 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office [NNSA/NSO], 2011). The corrective actions included No Further Action and Clean Closure. Closure activities generated sanitary waste and hazardous waste. Some wastes exceeded land disposal limits and required offsite treatment prior to disposal. Other wastes met land disposal restrictions and were disposed in appropriate onsite or offsite landfills. NNSA/NSO requests the following: · A Notice of Completion from the Nevada Division of Environmental Protection to NNSA/NSO for closure of CAU 562 · The transfer of CAU 562 from Appendix III to Appendix IV, Closed Corrective Action Units, of the FFACO

  6. Closure Report for Corrective Action Unit 224: Decon Pad and Septic Systems, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-10-01

    Corrective Action Unit (CAU) 224 is located in Areas 02, 03, 05, 06, 11, and 23 of the Nevada Test Site, which is situated approximately 65 miles northwest of Las Vegas, Nevada. CAU 224 is listed in the Federal Facility Agreement and Consent Order (FFACO) of 1996 as Decon Pad and Septic Systems and is comprised of the following nine Corrective Action Sites (CASs): CAS 02-04-01, Septic Tank (Buried); CAS 03-05-01, Leachfield; CAS 05-04-01, Septic Tanks (4)/Discharge Area; CAS 06-03-01, Sewage Lagoons (3); CAS 06-05-01, Leachfield; CAS 06-17-04, Decon Pad and Wastewater Catch; CAS 06-23-01, Decon Pad Discharge Piping; CAS 11-04-01, Sewage Lagoon; and CAS 23-05-02, Leachfield. The Nevada Division of Environmental Protection (NDEP)-approved corrective action alternative for CASs 02-04-01, 03-05-01, 06-03-01, 11-04-01, and 23-05-02 is no further action. As a best management practice, the septic tanks and distribution box were removed from CASs 02-04-01 and 11-04-01 and disposed of as hydrocarbon waste. The NDEP-approved correction action alternative for CASs 05-04-01, 06-05-01, 06-17-04, and 06-23-01 is clean closure. Closure activities for these CASs included removing and disposing of radiologically and pesticide-impacted soil and debris. CAU 224 was closed in accordance with the NDEP-approved CAU 224 Corrective Action Plan (CAP). The closure activities specified in the CAP were based on the recommendations presented in the CAU 224 Corrective Action Decision Document (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, 2005). This Closure Report documents CAU 224 closure activities. During closure activities, approximately 60 cubic yards (yd3) of mixed waste in the form of soil and debris; approximately 70 yd{sup 3} of sanitary waste in the form of soil, liquid from septic tanks, and concrete debris; approximately 10 yd{sup 3} of hazardous waste in the form of pesticide-impacted soil; approximately 0.5 yd{sup 3} of universal waste in

  7. Closure Report for Corrective Action Unit 300: Surface Release Areas Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-07-01

    Corrective Action Unit (CAU) 300 is located in Areas 23, 25, and 26 of the Nevada Test Site, which is located approximately 65 miles northwest of Las Vegas, Nevada. CAU 300 is listed in the Federal Facility Agreement and Consent Order of 1996 as Surface Release Areas and is comprised of the following seven Corrective Action Sites (CASs), which are associated with the identified Building (Bldg): {sm_bullet} CAS 23-21-03, Bldg 750 Surface Discharge {sm_bullet} CAS 23-25-02, Bldg 750 Outfall {sm_bullet} CAS 23-25-03, Bldg 751 Outfall {sm_bullet} CAS 25-60-01, Bldg 3113A Outfall {sm_bullet} CAS 25-60-02, Bldg 3901 Outfall {sm_bullet} CAS 25-62-01, Bldg 3124 Contaminated Soil {sm_bullet} CAS 26-60-01, Bldg 2105 Outfall and Decon Pad The Nevada Division of Environmental Protection (NDEP)-approved corrective action alternative for CASs 23-21-03, 23-25-02, and 23-25-03 is no further action. As a best management practice, approximately 48 feet of metal piping was removed from CAS 23-25-02 and disposed of as sanitary waste. The NDEP-approved corrective action alternative for CASs 25-60-01, 25-60-02, 25-62-01, and 26-60-01, is clean closure. Closure activities for these CASs included removing and disposing of soil impacted with total petroleum hydrocarbons-diesel range organics (TPH-DRO), polychlorinated biphenyls (PCBs), semivolatile organic compounds (SVOCs), and cesium (Cs)-137, concrete impacted with TPH-DRO, and associated piping impacted with TPH-DRO. CAU 300 was closed in accordance with the NDEP-approved CAU 300 Corrective Action Plan (CAP) (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office [NNSA/NSO], 2006). The closure activities specified in the CAP were based on the recommendations presented in the CAU 300 Corrective Action Decision Document (NNSA/NSO, 2005). This Closure Report documents CAU 300 closure activities. During closure activities, approximately 40 cubic yards (yd3) of low-level waste consisting of TPH-DRO-, PCB

  8. Closure Report for Corrective Action Unit 130: Storage Tanks Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Alfred Wickline

    2009-03-01

    This Closure Report (CR) presents information supporting the closure of Corrective Action Unit (CAU) 130: Storage Tanks, Nevada Test Site, Nevada. This CR complies with the requirements of the Federal Facility Agreement and Consent Order that was agreed to by the State of Nevada; U.S. Department of Energy (DOE), Environmental Management; U.S. Department of Defense; and DOE, Legacy Management. The corrective action sites (CASs) within CAU 130 are located within Areas 1, 7, 10, 20, 22, and 23 of the Nevada Test Site. Corrective Action Unit 130 is comprised of the following CASs: • 01-02-01, Underground Storage Tank • 07-02-01, Underground Storage Tanks • 10-02-01, Underground Storage Tank • 20-02-03, Underground Storage Tank • 20-99-05, Tar Residue • 22-02-02, Buried UST Piping • 23-02-07, Underground Storage Tank This CR provides documentation supporting the completed corrective action investigations and provides data confirming that the closure objectives for CASs within CAU 130 were met. To achieve this, the following actions were performed: • Reviewed the current site conditions, including the concentration and extent of contamination. • Implemented any corrective actions necessary to protect human health and the environment. • Properly disposed of corrective action and investigation-derived wastes. From August 4 through September 30, 2008, closure activities were performed as set forth in the Streamlined Approach for Environmental Restoration Plan for CAU 130, Storage Tanks, Nevada Test Site, Nevada. The purposes of the activities as defined during the data quality objectives process were: • Determine whether contaminants of concern (COCs) are present. • If COCs are present, determine their nature and extent, implement appropriate corrective actions, confirm that no residual contamination is present, and properly dispose of wastes. Constituents detected during the closure activities were evaluated against final action levels to identify

  9. Preclinical study evaluating a novel trocar site closure system

    Directory of Open Access Journals (Sweden)

    Walker PA

    2016-04-01

    Full Text Available Peter A Walker,1 Shinil K Shah,1,2 Erik B Wilson11Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA; 2Michael E DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USAIntroduction: Novel trocar closure devices using subperitoneal anchor placement avoid the need for a closed loop suture, and could allow faster trocar site closure with less risk derived from less instrument penetration into the abdominal cavity while decreasing fascial ischemia and tension. We completed a series of animal experiments to compare the Carter-Thomason® suture closure device and neoClose® AnchorGuide device in order to evaluate device safety, efficacy, and ease of utilization.Methods: A porcine model was utilized where 12 mm port sites were closed with either the Carter-Thomason® device or neoClose® AnchorGuide device. Animals were sacrificed at 14 and 56 days after trocar site closure followed by macroscopic and microscopic wound examination. A second group of animals underwent video analysis to evaluate the time required for fascial closure as well as depth of needle passage into the abdomen.Results: All animals survived to the endpoints (14 and 56 days without mortality or trocar site hernia. A trend towards decreased closure times was identified when using the neoClose® device (t=18.5±2.3 seconds compared to closure with the Carter-Thomason® device (t=32.0±8.9 seconds (P=0.153. A significant decrease in the depth of needle penetration was seen with the neoClose® device (t=31.22±1.45 mm compared to closure with the Carter-Thomason device (t=51.0±3.1 mm (P<0.001. Microscopic analysis showed subperitoneal anchor location at 56 days with minimal fibrosis (neoClose® device compared to nearly complete suture degradation with deep intramuscular location (Carter-Thomason device.Conclusion: Novel trocar closure devices could offer decreased deployment

  10. Single Centre Experience for Percutaneous Closure of Secundum Atrial Septal Defect

    Directory of Open Access Journals (Sweden)

    Ramazan Aydemir

    2011-12-01

    Full Text Available Introduction: Atrial septal defect (ASD is the most common congenital heart disease in adults and constitutes 5-10% of all congenital heart disease. Primary surgical closure has been the standard approach for many years with high success rate. Transcatheter closure of ASD in selected patients has became the contemprorary practice that has the advantages of short hospital stay and relative ease of prosedure. In this article, we reported the results of percutaneous closure of ASD in our center.
Methods: Between 2009-2011, thirty-two patients (mean age 36±18 years and 24 females who had secundum type ASD which detected by transthoracic echocardiography (TTE and transesophageal echocardiography (TEE were included in this study. Twenty-nine (90,6% patients were closed percutaneously. Tree patients were referred for surgery because of failure of percutaneous closure. Amplatzer Septal Occluder was used in 25 (86,2% patients and Occlutech device was used in other patients. All procedures were performed under local anesthesia. All of the patients were examined with TTE before the procedure and, at the 1st, 3rd, 6th and 12th month follow-up visits.
Results: Pre-operative mean pulmonary artery pressure was 33,3±7,5 mmHg and mean pulmonary to systemic flow (Qp/Qs ratio was 2,9±1,1. Mean ASD diameter measured by TEE was 20,1±6,6 mm and mean streched diameter measured by balloon catheter was 22,1±5,9 mm. Mean device size 24±6 mm (range 12-36 mm. In the follow-up period no major complication was observed, but mild to moderate residual shunt flow was detected in two patients (% 6,8.
Conclusion: Percutaneous ASD closure has been performed with high success and low complication rates in patients with secundum atrial septal defect in our center.

  11. Performance of four turbulence closure models implemented using a generic length scale method

    Science.gov (United States)

    Warner, J.C.; Sherwood, C.R.; Arango, H.G.; Signell, R.P.

    2005-01-01

    A two-equation turbulence model (one equation for turbulence kinetic energy and a second for a generic turbulence length-scale quantity) proposed by Umlauf and Burchard [J. Marine Research 61 (2003) 235] is implemented in a three-dimensional oceanographic model (Regional Oceanographic Modeling System; ROMS v2.0). These two equations, along with several stability functions, can represent many popular turbulence closures, including the k-kl (Mellor-Yamada Level 2.5), k-??, and k-?? schemes. The implementation adds flexibility to the model by providing an unprecedented range of turbulence closure selections in a single 3D oceanographic model and allows comparison and evaluation of turbulence models in an otherwise identical numerical environment. This also allows evaluation of the effect of turbulence models on other processes such as suspended-sediment distribution or ecological processes. Performance of the turbulence models and sediment-transport schemes is investigated with three test cases for (1) steady barotropic flow in a rectangular channel, (2) wind-induced surface mixed-layer deepening in a stratified fluid, and (3) oscillatory stratified pressure-gradient driven flow (estuarine circulation) in a rectangular channel. Results from k-??, k-??, and gen (a new closure proposed by Umlauf and Burchard [J. Marine Research 61 (2003) 235]) are very similar for these cases, but the k-kl closure results depend on a wall-proximity function that must be chosen to suit the flow. Greater variations appear in simulations of suspended-sediment concentrations than in salinity simulations because the transport of suspended-sediment amplifies minor variations in the methods. The amplification is caused by the added physics of a vertical settling rate, bottom stress dependent resuspension, and diffusive transport of sediment in regions of well mixed salt and temperature. Despite the amplified sensitivity of sediment to turbulence models in the estuary test case, the four

  12. Surgical site infection after stoma closure in children: outcomes and predictors.

    Science.gov (United States)

    Gonzalez, Dani O; Ambeba, Erica; Minneci, Peter C; Deans, Katherine J; Nwomeh, Benedict C

    2017-03-01

    Surgical site infection (SSI) is a burdensome complication following intestinal stoma closure, with reported rates ranging from 0% to 40%. We aimed to identify risk factors for SSI in children undergoing stoma closure. Using 2012-2014 NSQIP Pediatric data, we identified patients aged 0-18 years undergoing stoma closure. Demographic, clinical, and 30-day outcome characteristics between children with and without SSI were compared. A multivariable logistic model was used to identify predictors of SSI. Among 2110 children who underwent stoma closure, 7.6% developed SSI. Patients who developed SSI had significantly longer time in the operating room, longer anesthesia times, longer total operation times, and longer lengths of stay (all P ≤ 0.01). Patients who developed SSI postoperatively had significantly higher rates of postoperative complications, including need for postoperative ventilation, sepsis, need for nutritional support on discharge, unplanned reoperation, unplanned readmission, postoperative lengths of stay >30 days, and transfusion within 72 hours after the start of surgery (all P ≤ 0.018). There was a significant relationship between operation time and SSI probability. Specifically, operation time greater than 105 minutes was associated with a higher SSI risk. On adjusted multivariable analyses, age, cardiac risk factors, Hirschsprung disease, and operation time greater than 105 minutes were independently predictive of SSI. Longer operation time, age, Hirschsprung disease, and cardiac risk factors are associated with an increased risk for SSI after stoma closure. Studies of perioperative adjuncts to reduce SSI in high-risk children based on expected procedure length and other preoperative characteristics are warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Suture Closure versus Non-Closure of Subcutaneous Fat and Cosmetic Outcome after Cesarean Section: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Heinrich Husslein

    Full Text Available To investigate the effect of subcutaneous fat suture closure versus non-closure at cesarean section (CS on long-term cosmetic outcome.Women undergoing planned or unplanned CS were randomized to either subcutaneous fat suture closure or non-closure using a 1∶1 allocation algorithm. Participants and outcome assessors were blinded to group allocation. Scar evaluation was performed after two and six months. Primary outcome measures were Patient and Observer Scar Assessment Scale (POSAS summary scores six months after surgery. Secondary outcome measures were Vancouver Scar Scale (VSS summary scores, retraction of the scar below the level of the surrounding skin, duration of surgery, and development of hematoma, seroma, surgical site infection (SSI or wound disruption. Data were analyzed according to the intention to treat principle.A total of 116 women were randomized and 91 participants, 47 in the closure and 44 in the non-closure group, completed the trial and were analyzed. There were no differences in patient morphometrics or surgery indications between groups. At two and six months no significant differences were found with respect to POSAS or VSS scores between groups. After two months significantly more women in the non-closure group described their scar as being retracted below the level of the skin (36% vs. 15%, p = 0.02 whereas no difference was observed at six months. There were significantly more hematomas in the non-closure (25% compared to the closure group (4% (p = 0.005. There was no difference in duration of surgery, SSI, seroma formation or wound disruption between groups.Suture closure of the subcutaneous fat at CS does not affect long-term cosmetic outcome. (Level I evidence.ClinicalTrials.gov NCT01542346.

  14. Transcatheter closure of secundum atrial septal defect in adults: report of our first experience in a developing country

    Directory of Open Access Journals (Sweden)

    Animasahun BA

    2014-04-01

    Full Text Available B Adeola Animasahun,1 Yele Aluko,2 Adeyemi Johnson,3 Kofo Ogunyankin,3 Sunita Maheshwari41Department of Paediatrics and Child Health, Lagos State University College of Medicine, Lagos, Nigeria; 2Mid Carolina Cardiology, Charlotte, NC, USA; 3First Cardiology Consultants, Lagos, Nigeria; 4Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, IndiaBackground: Since the first report on device closure of atrial septal defect (ASD in 1976, the procedure has gained wide acceptance and has been used worldwide, including parts of Africa. The advantages when compared to surgical closure include a shorter procedure time and hospital stay and no scarring. This mode of treatment was not available in Nigeria prior to the cases reported here, requiring patients to travel abroad for the procedure.Methods: A cardiac catheterization laboratory became available in Lagos, Nigeria in 2009, and in December 2010 the laboratory collaborated with Lagos State University College of Medicine and Lagos State University Teaching Hospital to perform the device closure on two women (aged 34 and 62 years with secundum ASD. To the best of our knowledge, these are the first times the procedure has been performed in Nigeria.Results: Both patients made successful recovery and are stable.Conclusion: Transcatheter closure of ASD is now safe and available in Nigeria.Keywords: atrial septal defect, transcatheter closure, Nigeria

  15. Common side closure type, but not stapler brand or oversewing, influences side-to-side anastomotic leak rates.

    Science.gov (United States)

    Fleetwood, V A; Gross, K N; Alex, G C; Cortina, C S; Smolevitz, J B; Sarvepalli, S; Bakhsh, S R; Poirier, J; Myers, J A; Singer, M A; Orkin, B A

    2017-03-01

    Anastomotic leak (AL) increases costs and cancer recurrence. Studies show decreased AL with side-to-side stapled anastomosis (SSA), but none identify risk factors within SSAs. We hypothesized that stapler characteristics and closure technique of the common enterotomy affect AL rates. Retrospective review of bowel SSAs was performed. Data included stapler brand, staple line oversewing, and closure method (handsewn, HC; linear stapler [Barcelona technique], BT; transverse stapler, TX). Primary endpoint was AL. Statistical analysis included Fisher's test and logistic regression. 463 patients were identified, 58.5% BT, 21.2% HC, and 20.3% TX. Covidien staplers comprised 74.9%, Ethicon 18.1%. There were no differences between stapler types (Covidien 5.8%, Ethicon 6.0%). However, AL rates varied by common side closure (BT 3.7% vs. TX 10.6%, p = 0.017), remaining significant on multivariate analysis. Closure method of the common side impacts AL rates. Barcelona technique has fewer leaks than transverse stapled closure. Further prospective evaluation is recommended. Copyright © 2017. Published by Elsevier Inc.

  16. Does staged closure have a worse prognosis in gastroschisis?

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    Augusto Frederico Schmidt

    2011-01-01

    Full Text Available INTRODUCTION: Correction of gastroschisis can be accomplished by primary or staged closure. There is, however, no consensus regarding the best approach or criteria to favor one method over the other has been established. OBJECTIVE: To compare the outcome of primary and staged closure in newborns with gastroschisis using intravesical pressure (IVP as the decision criterion. PATIENTS & METHODS: We prospectively analyzed 45 newborns with gastroschisis. An IVP with a threshold of 20 cm H2O was used to indicate primary or staged closure, and the outcomes between the two methods were compared. RESULTS AND DISCUSSION: Newborns in whom primary closure was feasible were born at a lower gestational age. There was no significant difference in the frequency of complications, time to begin oral feeding, length of parenteral nutrition or length of hospital stay. Compared with previous reports, our data showed higher rates of prenatal diagnosis and cesarean delivery, a lower average birth weight, a higher rate of small gestational age babies and a more frequent association with intestinal atresia. Conversely, our data showed a lower rate of postoperative necrotizing enterocolitis and a lower average length of hospital stay. CONCLUSION: No significant difference was observed in the outcome of newborns who underwent primary closure or staged closure of gastroschisis when using an IVP below 20 cm H2O as the criterion for primary closure.

  17. ASSESSMENT OF LENS THICKNESS IN ANGLE CLOSURE DISEASE

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    Nishat Sultana Khayoom

    2016-08-01

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

  18. Evaluation of a new wound closure device for linear surgical incisions: 3M Steri-Strip S Surgical Skin Closure versus subcuticular closure.

    Science.gov (United States)

    Kerrigan, Carolyn L; Homa, Karen

    2010-01-01

    Technological innovations are often adopted before scientific comparison to an accepted standard. The authors' study compared suture with a new coaptive film device, 3M Steri-Strip S Surgical Skin Closure, on linear incisions. Patients undergoing Wise-pattern breast reduction or abdominal procedures had paired incisions randomly assigned to Steri-Strip S or suture closure. Key outcome measures were closure time, patient comfort, and scar quality at 6 months by patients and surgeons using a new scar evaluation tool, visual assessment of linear scars. Statistical differences between the two closure techniques were assessed by Wilcoxon signed rank test. Of 59 patients, eight were excluded from randomization (a surgeon judged Steri-Strip S to be a nonviable closure technique for mismatched wound edges). Fifty-one patients (breast, n = 24; abdomen, n = 27) were randomized. Operative time with Steri-Strip S for breast was 2.0 minutes (SD = 1.1) versus suture closure at 4.6 minutes (SD = 1.5; p Strip S versus suture for the abdomen was faster (p Strip S and better at 2.6 (SD = 2.9) for suture (p = 0.008). One surgeon rated breast Steri-Strip S scars worse than suture scars (4.3 versus 3.7; p = 0.014). For abdominal scars, there was no difference in the patient or surgeon ratings. Steri-Strip S permits faster wound closure than suture. On the basis of patient reports of comfort and scar quality, surgeons increase efficiency and maintain quality with the use of Steri-Strip S on abdominal wounds but not on breast wounds.

  19. Eigenspace perturbations for structural uncertainty estimation of turbulence closure models

    Science.gov (United States)

    Jofre, Lluis; Mishra, Aashwin; Iaccarino, Gianluca

    2017-11-01

    With the present state of computational resources, a purely numerical resolution of turbulent flows encountered in engineering applications is not viable. Consequently, investigations into turbulence rely on various degrees of modeling. Archetypal amongst these variable resolution approaches would be RANS models in two-equation closures, and subgrid-scale models in LES. However, owing to the simplifications introduced during model formulation, the fidelity of all such models is limited, and therefore the explicit quantification of the predictive uncertainty is essential. In such scenario, the ideal uncertainty estimation procedure must be agnostic to modeling resolution, methodology, and the nature or level of the model filter. The procedure should be able to give reliable prediction intervals for different Quantities of Interest, over varied flows and flow conditions, and at diametric levels of modeling resolution. In this talk, we present and substantiate the Eigenspace perturbation framework as an uncertainty estimation paradigm that meets these criteria. Commencing from a broad overview, we outline the details of this framework at different modeling resolution. Thence, using benchmark flows, along with engineering problems, the efficacy of this procedure is established. This research was partially supported by NNSA under the Predictive Science Academic Alliance Program (PSAAP) II, and by DARPA under the Enabling Quantification of Uncertainty in Physical Systems (EQUiPS) project (technical monitor: Dr Fariba Fahroo).

  20. Isotretinoin-induced Angle Closure and Myopic Shift.

    Science.gov (United States)

    Park, Young-Myoung; Lee, Tae-Eun

    2017-11-01

    To report and describe the management a rare case of transient bilateral angle closure with increased intraocular pressure (IOP) and myopic shift while on isotretinoin therapy for acne. A 28-year-old woman presented with bilateral myopic shift, angle closure with IOP increase, and supraciliary effusion 1 week after acne therapy with isotretinoin. Two weeks after stopping isotretinoin, and treatment with topical prednisolone acetate, atropine, and fixed combination of timolol and dorzolamide, refraction, IOP returned to normal and supraciliary effusions was decreased on ultrasound biomicroscopy. Oral isotretinoin for acne treatment may be associated with an adverse reaction, resulting in bilateral transient myopia and angle closure with IOP elevation.

  1. Use of bipedicular advancement flaps for intrauterine closure of myeloschisis.

    Science.gov (United States)

    Mangels, K J; Tulipan, N; Bruner, J P; Nickolaus, D

    2000-01-01

    Several groups have begun to explore the feasibility and utility of intrauterine closure of myelomeningocele. A subset of these fetuses have defects which fall into the category of myeloschisis, and therefore have inadequate skin to enable primary closure. After considerable discussion, it was decided to utilize bipedicular flaps to close these lesions. The procedure is described, and representative examples are shown. To date, 13 of 56 fetuses have required this approach for closure in utero. While this technique generally provides adequate coverage of the dural sac, the cosmetic results have been less than optimal. Copyright 2000 S. Karger AG, Basel

  2. The use of chicken legs for teaching wound closure skills

    Directory of Open Access Journals (Sweden)

    Khalil PN

    2009-09-01

    Full Text Available Abstract Objective Training models are required to impart surgical skills, like wound closure techniques, prior to practice in patients. In an ideal case, the tissue characteristics of the model are close to those of humans, easy to create and of low cost. Methods Here, we describe a model to train students in wound closure technique using conventional chicken legs obtained from the supermarket. Results The described model has good tissue characteristics, does not require any lavish preparation and is of minimal cost (0.62 Euro or 0.78 USD. Conclusions Chicken legs appear to be an appropriate tool for teaching wound closure techniques.

  3. Predictors of successful closure of patent ductus arteriosus with indomethacin.

    Science.gov (United States)

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

    2015-09-01

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

  4. Assessment of consistent two-equation closure for forest flows

    DEFF Research Database (Denmark)

    Sogachev, Andrey; Cavar, Dalibor; Bechmann, Andreas

    of grid turbulence and wall-bounded flow, the closure suggested is also valid for homogeneous shear flows commonly observed inside tall vegetative canopies. The present work assess the plant drag closure by comparing results of two different CFD models against observations derived over the forested area...... of Østerild in Denmark. Part of the forest was cut in 2011, and this provided a unique opportunity for testing models allowing two scenarios for land use and corresponding observation datasets (2008 – 2013). The numerical experiments show that the treatment of plant drag in the closure has universality...

  5. VAWCM-Instillation Improves Delayed Primary Fascial Closure of Open Septic Abdomen

    OpenAIRE

    Qingsong Tao; Jianan Ren; Zhenling Ji; Shengli Liu; Baochai Wang; Yu Zheng; Guosheng Gu; Xinbo Wang; Jieshou Li

    2014-01-01

    Background. Failure to achieve delayed primary fascial closure (DPFC) is one of the main complications of open abdomen (OA), certainly when abdominal sepsis is present. This retrospective cohort study aims to evaluate the effect of combined therapy of vacuum-assisted mesh-mediated fascial traction and topical instillation (VAWCM-instillation) on DPFC in the open septic abdomen. Methods. The patients with abdominal sepsis who underwent OA using VAWCM were included and divided into the instilla...

  6. Technical Review of Retrieval and Closure Plans for the INEEL INTEC Tank Farm Facility

    Energy Technology Data Exchange (ETDEWEB)

    Bamberger, Judith A; Burks, Barry L; Quigley, Keith D; Falter, Diedre D

    2001-09-28

    The purpose of this report is to document the conclusions of a technical review of retrieval and closure plans for the Idaho National Energy and Environmental Laboratory (INEEL) Idaho Nuclear Technology and Engineering Center (INTEC) Tank Farm Facility. In addition to reviewing retrieval and closure plans for these tanks, the review process served as an information exchange mechanism so that staff in the INEEL High Level Waste (HLW) Program could become more familiar with retrieval and closure approaches that have been completed or are planned for underground storage tanks at the Oak Ridge National Laboratory (ORNL) and Hanford sites. This review focused not only on evaluation of the technical feasibility and appropriateness of the approach selected by INEEL but also on technology gaps that could be addressed through utilization of technologies or performance data available at other DOE sites and in the private sector. The reviewers, Judith Bamberger of Pacific Northwest National Laboratory (PNNL) and Dr. Barry Burks of The Providence Group Applied Technology, have extensive experience in the development and application of tank waste retrieval technologies for nuclear waste remediation.

  7. Optical modulator including grapene

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  8. Visual Impairment, Including Blindness

    Science.gov (United States)

    ... Who Knows What? (log-in required) Select Page Visual Impairment, Including Blindness Mar 31, 2017 Links updated, ... doesn’t wear his glasses. Back to top Visual Impairments in Children Vision is one of our ...

  9. Online Work Force Analyzes Social Media to Identify Consequences of an Unplanned School Closure - Using Technology to Prepare for the Next Pandemic.

    Science.gov (United States)

    Rainey, Jeanette J; Kenney, Jasmine; Wilburn, Ben; Putman, Ami; Zheteyeva, Yenlik; O'Sullivan, Megan

    During an influenza pandemic, the United States Centers for Disease Control and Prevention (CDC) may recommend school closures. These closures could have unintended consequences for students and their families. Publicly available social media could be analyzed to identify the consequences of an unplanned school closure. As a proxy for an unplanned, pandemic-related school closure, we used the district-wide school closure due to the September 10-18, 2012 teachers' strike in Chicago, Illinois. We captured social media posts about the school closure using the Radian6 social media-monitoring platform. An online workforce from Amazon Mechanical Turk categorized each post into one of two groups. The first group included relevant posts that described the impact of the closure on students and their families. The second group included irrelevant posts that described the political aspects of the strike or topics unrelated to the school closure. All relevant posts were further categorized as expressing a positive, negative, or neutral sentiment. We analyzed patterns of relevant posts and sentiment over time and compared our findings to household surveys conducted after other unplanned school closures. We captured 4,546 social media posts about the district-wide school closure using our search criteria. Of these, 930 (20%) were categorized as relevant by the online workforce. Of the relevant posts, 619 (67%) expressed a negative sentiment, 51 (5%) expressed a positive sentiment, and 260 (28%) were neutral. The number of relevant posts, and especially those with a negative sentiment, peaked on day 1 of the strike. Negative sentiment expressed concerns about childcare, missed school lunches, and the lack of class time for students. This was consistent with findings from previously conducted household surveys. Social media are publicly available and can readily provide information on the impact of an unplanned school closure on students and their families. Using social media to

  10. Online Work Force Analyzes Social Media to Identify Consequences of an Unplanned School Closure – Using Technology to Prepare for the Next Pandemic

    Science.gov (United States)

    Rainey, Jeanette J.; Kenney, Jasmine; Wilburn, Ben; Putman, Ami; Zheteyeva, Yenlik; O’Sullivan, Megan

    2016-01-01

    Background During an influenza pandemic, the United States Centers for Disease Control and Prevention (CDC) may recommend school closures. These closures could have unintended consequences for students and their families. Publicly available social media could be analyzed to identify the consequences of an unplanned school closure. Methods As a proxy for an unplanned, pandemic-related school closure, we used the district-wide school closure due to the September 10–18, 2012 teachers’ strike in Chicago, Illinois. We captured social media posts about the school closure using the Radian6 social media-monitoring platform. An online workforce from Amazon Mechanical Turk categorized each post into one of two groups. The first group included relevant posts that described the impact of the closure on students and their families. The second group included irrelevant posts that described the political aspects of the strike or topics unrelated to the school closure. All relevant posts were further categorized as expressing a positive, negative, or neutral sentiment. We analyzed patterns of relevant posts and sentiment over time and compared our findings to household surveys conducted after other unplanned school closures. Results We captured 4,546 social media posts about the district-wide school closure using our search criteria. Of these, 930 (20%) were categorized as relevant by the online workforce. Of the relevant posts, 619 (67%) expressed a negative sentiment, 51 (5%) expressed a positive sentiment, and 260 (28%) were neutral. The number of relevant posts, and especially those with a negative sentiment, peaked on day 1 of the strike. Negative sentiment expressed concerns about childcare, missed school lunches, and the lack of class time for students. This was consistent with findings from previously conducted household surveys. Conclusion Social media are publicly available and can readily provide information on the impact of an unplanned school closure on students

  11. Online Work Force Analyzes Social Media to Identify Consequences of an Unplanned School Closure - Using Technology to Prepare for the Next Pandemic.

    Directory of Open Access Journals (Sweden)

    Jeanette J Rainey

    Full Text Available During an influenza pandemic, the United States Centers for Disease Control and Prevention (CDC may recommend school closures. These closures could have unintended consequences for students and their families. Publicly available social media could be analyzed to identify the consequences of an unplanned school closure.As a proxy for an unplanned, pandemic-related school closure, we used the district-wide school closure due to the September 10-18, 2012 teachers' strike in Chicago, Illinois. We captured social media posts about the school closure using the Radian6 social media-monitoring platform. An online workforce from Amazon Mechanical Turk categorized each post into one of two groups. The first group included relevant posts that described the impact of the closure on students and their families. The second group included irrelevant posts that described the political aspects of the strike or topics unrelated to the school closure. All relevant posts were further categorized as expressing a positive, negative, or neutral sentiment. We analyzed patterns of relevant posts and sentiment over time and compared our findings to household surveys conducted after other unplanned school closures.We captured 4,546 social media posts about the district-wide school closure using our search criteria. Of these, 930 (20% were categorized as relevant by the online workforce. Of the relevant posts, 619 (67% expressed a negative sentiment, 51 (5% expressed a positive sentiment, and 260 (28% were neutral. The number of relevant posts, and especially those with a negative sentiment, peaked on day 1 of the strike. Negative sentiment expressed concerns about childcare, missed school lunches, and the lack of class time for students. This was consistent with findings from previously conducted household surveys.Social media are publicly available and can readily provide information on the impact of an unplanned school closure on students and their families. Using

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

    Directory of Open Access Journals (Sweden)

    William C. Kethman

    2016-06-01

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

  13. Turbulence Closure for Mixing Length Theories

    Science.gov (United States)

    Jermyn, Adam S.; Lesaffre, Pierre; Tout, Christopher A.; Chitre, Shashikumar M.

    2018-01-01

    We present an approach to turbulence closure based on mixing length theory with three-dimensional fluctuations against a two-dimensional background. This model is intended to be rapidly computable for implementation in stellar evolution software and to capture a wide range of relevant phenomena with just a single free parameter, namely the mixing length. We incorporate magnetic, rotational, baroclinic and buoyancy effects exactly within the formalism of linear growth theories with nonlinear decay. We treat differential rotation effects perturbatively in the corotating frame using a novel controlled approximation which matches the time evolution of the reference frame to arbitrary order. We then implement this model in an efficient open source code and discuss the resulting turbulent stresses and transport coefficients. We demonstrate that this model exhibits convective, baroclinic and shear instabilities as well as the magnetorotational instability (MRI). It also exhibits non-linear saturation behaviour, and we use this to extract the asymptotic scaling of various transport coefficients in physically interesting limits.

  14. Don’t call it a closure!

    CERN Multimedia

    Rosaria Marraffino

    2015-01-01

    During the Laboratory’s annual closure, some members of the personnel joined their families, others seized the chance to travel the world. The Restaurants were closed, the corridors were dark and the heating was turned off in most of the buildings. However, a lot of people spent the Christmas break working on site and the Bulletin would like to dedicate this first article of the new year to them all!   In the CERN Control Centre (CCC), each shift had two people in position to guarantee regular 24/7 service and to intervene in case of need. Gildas Langlois and Rodolphe Maillet, CCC operators from the Beams Department, spent Christmas Eve there and celebrated it with a cake. “I volunteered to work during the holidays in order to allow colleagues to stay with their families,” says Maillet. On New Year’s Eve, it was Julien Pache and Jean-Michel Nonglaton’s turn to spend the night at work. They had a nice dinner with a CCC-made fondue and some desse...

  15. IT Services availability during CERN annual closure

    CERN Multimedia

    2003-01-01

    Mail, Cern Windows (NICE ),  Web services,  LXPLUS, LXBATCH, Automated tape devices, Castor, Backups, software license servers, Sundev, CVS and Print Servers, CDS and Agenda-Maker, EDMS (in collaboration with EST Division), CMS disc servers, Campus Network,  Remedy, Security and VPN services will be available during the CERN annual closure. The physics database cluster, replication location service as well as accdb, cerndb and admsdb are the only databases available, CCDB will be closed for public access. Problems developing on scheduled services should be addressed within about half a day except around  Christmas Eve and Christmas Day ( 24 and 25th December ) and New Year's Eve and New Years Day (31st December and 1st Janauary. All other services will be left running mostly unattended. No interruptions are scheduled but restoration of the service in case of failure cannot be guaranteed. Please note that the Helpdesk will be closed, that no file restores from backups will be possible and damaged tapes wi...

  16. Neural tube closure: cellular, molecular and biomechanical mechanisms.

    Science.gov (United States)

    Nikolopoulou, Evanthia; Galea, Gabriel L; Rolo, Ana; Greene, Nicholas D E; Copp, Andrew J

    2017-02-15

    Neural tube closure has been studied for many decades, across a range of vertebrates, as a paradigm of embryonic morphogenesis. Neurulation is of particular interest in view of the severe congenital malformations - 'neural tube defects' - that result when closure fails. The process of neural tube closure is complex and involves cellular events such as convergent extension, apical constriction and interkinetic nuclear migration, as well as precise molecular control via the non-canonical Wnt/planar cell polarity pathway, Shh/BMP signalling, and the transcription factors Grhl2/3, Pax3, Cdx2 and Zic2. More recently, biomechanical inputs into neural tube morphogenesis have also been identified. Here, we review these cellular, molecular and biomechanical mechanisms involved in neural tube closure, based on studies of various vertebrate species, focusing on the most recent advances in the field. © 2017. Published by The Company of Biologists Ltd.

  17. Estimation of crown closure from AVIRIS data using regression analysis

    Science.gov (United States)

    Staenz, K.; Williams, D. J.; Truchon, M.; Fritz, R.

    1993-01-01

    Crown closure is one of the input parameters used for forest growth and yield modelling. Preliminary work by Staenz et al. indicates that imaging spectrometer data acquired with sensors such as the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) have some potential for estimating crown closure on a stand level. The objectives of this paper are: (1) to establish a relationship between AVIRIS data and the crown closure derived from aerial photography of a forested test site within the Interior Douglas Fir biogeoclimatic zone in British Columbia, Canada; (2) to investigate the impact of atmospheric effects and the forest background on the correlation between AVIRIS data and crown closure estimates; and (3) to improve this relationship using multiple regression analysis.

  18. Closure modeling using field inversion and machine learning

    Science.gov (United States)

    Duraisamy, Karthik

    2015-11-01

    The recent acceleration in computational power and measurement resolution has made possible the availability of extreme scale simulations and data sets. In this work, a modeling paradigm that seeks to comprehensively harness large scale data is introduced, with the aim of improving closure models. Full-field inversion (in contrast to parameter estimation) is used to obtain corrective, spatially distributed functional terms, offering a route to directly address model-form errors. Once the inference has been performed over a number of problems that are representative of the deficient physics in the closure model, machine learning techniques are used to reconstruct the model corrections in terms of variables that appear in the closure model. These machine-learned functional forms are then used to augment the closure model in predictive computations. The approach is demonstrated to be able to successfully reconstruct functional corrections and yield predictions with quantified uncertainties in a range of turbulent flows.

  19. IDP camp closure and gender inequality in Timor-Leste

    Directory of Open Access Journals (Sweden)

    Phyllis Ferguson

    2010-02-01

    Full Text Available The goal of humanitarian assistance in Timor-Leste during a seriesof crises from 2006 to 2008 became increasingly focused on IDPcamp closure, with the assisted return of IDPs to their communitiesor to alternative living situations.

  20. 300 Area waste acid treatment system closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    This section provides a description of the Hanford Site, identifies the proposed method of 300 Area Waste Acid Treatment System (WATS) closure, and briefly summarizes the contents of each chapter of this plan.