The Epidemiology of Revision Anterior Cruciate Ligament Reconstruction in Adults from Ontario, Canada

Science.gov (United States)

Leroux, Timothy; Wasserstein, David; Dwyer, Tim; Ogilvie-Harris, Darrell; Marks, Paul H.; Bach, Bernard R.; Townley, John; Mahomed, Nizar; Chahal, Jaskarndip

2015-01-01

Objectives: The morbidity associated with revision anterior cruciate ligament reconstruction (ACLR) is largely unknown. The objective of this study was to determine the rate of and risk factors for re-revision, re-operation, and re-admission following revision ACLR in the general population. Methods: All patients who underwent first revision ACLR in Ontario, Canada from January 2004 to December 2010 were identified and followed to December 2012. Exclusions included age (<16 years), previous osteotomy, or multi-ligament knee reconstruction. The main outcome was re-revision ACLR. Secondary outcomes included re-operation [irrigation and debridement (I&D), meniscectomy, manipulation under anesthesia (MUA), contralateral ACLR, and total knee arthroplasty (TKA)], and re-admission within 90 days of surgery. Survival to re-revision was determined using the Kaplan-Meier (KM) approach. A Cox proportional hazards model or logistic regression were used to determine the influence of patient factors (age, sex, neighborhood income quintile, and comorbidity), surgical factors (graft choice, concurrent meniscal procedure, and fixation method), and provider factors (surgeon volume, surgeon years in practice, and hospital status) on outcomes. A post-hoc analysis was performed to determine the influence of the aforementioned factors on overall post-operative infection risk, including both operative and non-operative cases. Results: Overall, 827 patients were included (median age: 30 years; 58.8% males). Single stage revisions comprised 92.9% of cases, and a meniscal procedure (repair or debridement) was performed in 45.3% of cases. The re-revision rate at a mean follow-up of 4.8±2.2 years was 4.4%, and the five-year survival rate was 95.4% (Figure 1). The rates of I&D, meniscectomy, contralateral ACLR, and re-admission were 0.8%, 3.1%, 3.4%, and 4.1%, respectively. MUA and TKA were rare. Young age significantly increased contralateral ACLR risk (risk decreased by 5.1% with each year

Application of the polystyrene model made by 3-D printing rapid prototyping technology for operation planning in revision lumbar discectomy.

Science.gov (United States)

Li, Chao; Yang, Mingyuan; Xie, Yang; Chen, Ziqiang; Wang, Chuanfeng; Bai, Yushu; Zhu, Xiaodong; Li, Ming

2015-05-01

The objective was to evaluate the effectiveness of 3-D rapid prototyping technology in revision lumbar discectomy. 3-D rapid prototyping technology has not been reported in the treatment of revision lumbar discectomy. Patients with recurrent lumbar disc herniation who were preparing to undergo revision lumbar discectomy from a single center between January 2011 and 2013 were included in this analysis. Patients were divided into two groups. In group A, 3-D printing technology was used to create subject-specific lumbar vertebral models in the preoperative planning process. Group B underwent lumbar revision as usual. Preoperative and postoperative clinical outcomes were compared between groups included operation time, perioperative blood loss, postoperative complications, Oswestry Disability Index (ODI), Japan Orthopaedics Association (JOA) scores, and visual analogue scale (VAS) scores for back pain and leg pain. A total of 37 patients were included in this study (Group A = 15, Group B = 22). Group A had a significantly shorter operation time (106.53 ± 11.91 vs. 131.92 ± 10.81 min, P < 0.001) and significantly less blood loss (341.67 ± 49.45 vs. 466.77 ± 71.46 ml, P < 0.001). There was no difference between groups for complication rate. There were also no differences between groups for any clinical metric. Using the 3-D printing technology before revision lumbar discectomy may reduce the operation time and the perioperative blood loss. There does not appear to be a benefit to using the technology with respect to clinical outcomes. Future prospective studies are needed to further elucidate the efficacy of this emerging technology.

Analysis of failed rotator cuff repair – Retrospective survey of revisions after open rotator cuff repair

Directory of Open Access Journals (Sweden)

Rupert Schupfner

2017-07-01

Full Text Available Background Rotator cuff defects are frequently occurring shoulder pathologies associated with pain and movement impairment. Aims The aim of the study was to analyse the pathologies that lead to operative revisions after primary open rotator cuff repair. Methods In 216 patients who underwent primary rotator cuff repair and later required operative revision between 1996 to 2005, pathologies found intraoperatively during the primary operation and during revision surgery were collected, analysed and compared. Results The average age at the time of revision surgery was 54.3 years. The right shoulder (61.6 per cent was more often affected than the left, males (63.4 per cent more often than females. At primary operation – apart from rotator cuff repair – there were the following surgical procedures performed: 190 acromioplasty, 86 Acromiclavicular joint resections, 68 tenodesis, 40 adhesiolysis and 1 tenotomy. If an ACJ-resection had been performed in the primary operation, ACJ-problems were rare in revision surgery (p<0.01. Primary gleno-humeral adhesions were associated with a significant rise in re-tearing rate (p=0.049. Primary absence of adhesions went along with a significant lower rate of adhesions found at revision (p=0.018. Primary performed acromioplasty had no influence on re-tearing rate (p=0.408 or on the rate of subacromial impingement at revision surgery (p=0.709. Conclusion To avoid operative revision after rotator cuff repair relevant copathologies of the shoulder have to be identified before or during operation and treated accordingly. Therefore, even during open rotator cuff repair, the surgeon should initially start with arthroscopy of the shoulder joint and subacromial space to recognise co-pathologies.

Impact of the Revised 10 CFR 835 on the Neutron Dose Rates at LLNL

International Nuclear Information System (INIS)

Radev, R.

2009-01-01

In June 2007, 10 CFR 835 (1) was revised to include new radiation weighting factors for neutrons, updated dosimetric models, and dose terms consistent with the newer ICRP recommendations. A significant aspect of the revised 10 CFR 835 is the adoption of the recommendations outlined in ICRP-60 (2). The recommended new quantities demand a review of much of the basic data used in protection against exposure to sources of ionizing radiation. The International Commission on Radiation Units and Measurements has defined a number of quantities for use in personnel and area monitoring (3,4,5) including the ambient dose equivalent H*(d) to be used for area monitoring and instrument calibrations. These quantities are used in ICRP-60 and ICRP-74. This report deals only with the changes in the ambient dose equivalent and ambient dose rate equivalent for neutrons as a result of the implementation of the revised 10 CFR 835. In the report, the terms neutron dose and neutron dose rate will be used for convenience for ambient neutron dose and ambient neutron dose rate unless otherwise stated. This report provides a qualitative and quantitative estimate of how much the neutron dose rates at LLNL will change with the implementation of the revised 10 CFR 835. Neutron spectra and dose rates from selected locations at the LLNL were measured with a high resolution spectroscopic neutron dose rate system (ROSPEC) as well as with a standard neutron rem meter (a.k.a., a remball). The spectra obtained at these locations compare well with the spectra from the Radiation Calibration Laboratory's (RCL) bare californium source that is currently used to calibrate neutron dose rate instruments. The measurements obtained from the high resolution neutron spectrometer and dose meter ROSPEC and the NRD dose meter compare within the range of ±25%. When the new radiation weighting factors are adopted with the implementation of the revised 10 CFR 835, the measured dose rates will increase by up to 22%. The

78 FR 59981 - Proposed Revision to Physical Security-Standard Design Certification and Operating Reactors

Science.gov (United States)

2013-09-30

... Design Certification and Operating Reactors AGENCY: Nuclear Regulatory Commission. ACTION: Standard... Design Certification and Operating Reactors.'' The NRC seeks comments on the proposed revised section of... subject): Federal Rulemaking Web site: Go to http://www.regulations.gov and search for Docket ID NRC-2013...

Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers.

Science.gov (United States)

Romanò, C L; Gala, L; Logoluso, N; Romanò, D; Drago, L

2012-12-01

The best method for treating chronic periprosthetic knee infection remains controversial. Randomized, comparative studies on treatment modalities are lacking. This systematic review of the literature compares the infection eradication rate after two-stage versus one-stage revision and static versus articulating spacers in two-stage procedures. We reviewed full-text papers and those with an abstract in English published from 1966 through 2011 that reported the success rate of infection eradication after one-stage or two-stage revision with two different types of spacers. In all, 6 original articles reporting the results after one-stage knee exchange arthoplasty (n = 204) and 38 papers reporting on two-stage revision (n = 1,421) were reviewed. The average success rate in the eradication of infection was 89.8% after a two-stage revision and 81.9% after a one-stage procedure at a mean follow-up of 44.7 and 40.7 months, respectively. The average infection eradication rate after a two-stage procedure was slightly, although significantly, higher when an articulating spacer rather than a static spacer was used (91.2 versus 87%). The methodological limitations of this study and the heterogeneous material in the studies reviewed notwithstanding, this systematic review shows that, on average, a two-stage procedure is associated with a higher rate of eradication of infection than one-stage revision for septic knee prosthesis and that articulating spacers are associated with a lower recurrence of infection than static spacers at a comparable mean duration of follow-up. IV.

Three or more preoperative injections is the most significant risk factor for revision surgery after operative treatment of lateral epicondylitis: an analysis of 3863 patients.

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Degen, Ryan M; Cancienne, Jourdan M; Camp, Christopher L; Altchek, David W; Dines, Joshua S; Werner, Brian C

2017-04-01

This study was conducted to identify the rate of failure of operative treatment of lateral epicondylitis, defined as progression to ipsilateral revision surgery, and associated patient-specific risk factors for failure. A national database was used to identify patients undergoing surgical treatment of lateral epicondylitis from 2005 to 2012. Patients undergoing concomitant procedures were excluded. Patients who then required subsequent ipsilateral extensor carpi radialis brevis débridement or release within 2 years were identified using similar methods. A multivariate binomial logistic regression analysis was used to evaluate patient-related risk factors for revision surgery. In addition, the number of preoperative injections (1, 2, or ≥3) in the ipsilateral elbow was identified and included in the regression analysis. Adjusted odds ratios (OR) and 95% confidence intervals were calculated for each risk factor. Of 3863 patients who underwent operative treatment of lateral epicondylitis, 58 (1.5%) required ipsilateral revision surgery. Risk factors for revision surgery included age lateral epicondylitis in the studied population is low (1.5%). Risk factors for revision surgery include younger age, male gender, morbid obesity, tobacco use, and inflammatory arthritis. The most significant risk factor for revision surgery is having ≥3 ipsilateral preoperative injections. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The impact of electrocautery method on post-operative bleeding complications after non-newborn circumcision and revision circumcision.

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Harty, Niall J; Nelson, Caleb P; Cendron, Marc; Turner, Shaunna; Borer, Joseph G

2013-10-01

We evaluated post-operative bleeding complications in non-newborns following use of monopolar versus bipolar electrocautery for circumcision or revision circumcision. We retrospectively reviewed sequentially performed cases of circumcision and revision circumcision performed by nine pediatric urologists at our institution from 2005 to 2010. In order to incorporate both the monopolar and bipolar electrocautery experience for a single surgeon employing bipolar technique, sequential cases from 2002 to 2010 were reviewed. Variables assessed included age, procedure, method of electrocautery, skin approximation and dressing, and bleeding complications. 1810 patients that underwent either circumcision or revision circumcision were reviewed. Complete data was available for 1617 patients. Age at operation was a mean 3.7 ± 4.9 yrs and median 1.5 yrs. Return for bleeding complication for all surgeons, was 2/336 (0.6%) for bipolar and 28/1281 (2.2%) for monopolar (p = 0.0545). For the single surgeon using bipolar technique, returns were 2/336 (0.6%) for bipolar and 5/309 (1.6%) for monopolar (p = 0.2133). Returns per procedure type were 1/200 (0.5%) bipolar and 24/844 (2.8%) monopolar for primary circumcision (p = 0.0513), and 1/136 (0.7%) bipolar and 4/437 (0.9%) monopolar (p = 0.84) for revision. Four of 1617 (0.2%) patients returned to the operating room [4/1281 (0.3%) monopolar (p = 0.31)]. There was no difference in return to the operating room for circumcision versus revision. Return for bleeding complications after circumcision and revision circumcision occurred more frequently after monopolar electrocautery compared to bipolar. However, there was no significant difference between the two electrocautery methods. Either form of electrocautery appears to be effective for this common pediatric urologic procedure. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

EPRI PWR primary water chemistry guidelines revision

International Nuclear Information System (INIS)

McElrath, Joel; Fruzzetti, Keith

2014-01-01

EPRI periodically updates the PWR Primary Water Chemistry Guidelines as new information becomes available and as required by NEI 97-06 (Steam Generator Program Guidelines) and NEI 03-08 (Guideline for the Management of Materials Issues). The last revision of the PWR water chemistry guidelines identified an optimum primary water chemistry program based on then-current understanding of research and field information. This new revision provides further details with regard to primary water stress corrosion cracking (PWSCC), fuel integrity, and shutdown dose rates. A committee of industry experts, including utility specialists, nuclear steam supply system (NSSS) and fuel vendor representatives, Institute of Nuclear Power Operations (INPO) representatives, consultants, and EPRI staff collaborated in reviewing the available data on primary water chemistry, reactor water coolant system materials issues, fuel integrity and performance issues, and radiation dose rate issues. From the data, the committee updated the water chemistry guidelines that all PWR nuclear plants should adopt. The committee revised guidance with regard to optimization to reflect industry experience gained since the publication of Revision 6. Among the changes, the technical information regarding the impact of zinc injection on PWSCC initiation and dose rate reduction has been updated to reflect the current level of knowledge within the industry. Similarly, industry experience with elevated lithium concentrations with regard to fuel performance and radiation dose rates has been updated to reflect data collected to date. Recognizing that each nuclear plant owner has a unique set of design, operating, and corporate concerns, the guidelines committee has retained a method for plant-specific optimization. Revision 7 of the Pressurized Water Reactor Primary Water Chemistry Guidelines provides guidance for PWR primary systems of all manufacture and design. The guidelines continue to emphasize plant

Confirmatory Factor Analysis of the Delirium Rating Scale Revised-98 (DRS-R98).

Science.gov (United States)

Thurber, Steven; Kishi, Yasuhiro; Trzepacz, Paula T; Franco, Jose G; Meagher, David J; Lee, Yanghyun; Kim, Jeong-Lan; Furlanetto, Leticia M; Negreiros, Daniel; Huang, Ming-Chyi; Chen, Chun-Hsin; Kean, Jacob; Leonard, Maeve

2015-01-01

Principal components analysis applied to the Delirium Rating Scale-Revised-98 contributes to understanding the delirium construct. Using a multisite pooled international delirium database, the authors applied confirmatory factor analysis to Delirium Rating Scale-Revised-98 scores from 859 adult patients evaluated by delirium experts (delirium, N=516; nondelirium, N=343). Confirmatory factor analysis found all diagnostic features and core symptoms (cognitive, language, thought process, sleep-wake cycle, motor retardation), except motor agitation, loaded onto factor 1. Motor agitation loaded onto factor 2 with noncore symptoms (delusions, affective lability, and perceptual disturbances). Factor 1 loading supports delirium as a single construct, but when accompanied by psychosis, motor agitation's role may not be solely as a circadian activity indicator.

Analysis of intraoperative difficulties and management of operative complications in revision anterior exposure of the lumbar spine: a report of 25 consecutive cases.

Science.gov (United States)

Flouzat-Lachaniette, Charles-Henri; Delblond, William; Poignard, Alexandre; Allain, Jérôme

2013-04-01

After a first anterior approach to the lumbar spine, formation of adhesions of soft tissues to the spine increases the surgical difficulties and potential for iatrogenic injury during the revision exposure. The objective of this study was to identify the intraoperative difficulties and postoperative complications associated with revision anterior lumbar spine procedures in a single institution. This is a retrospective review of 25 consecutive anterior revision lumbar surgeries in 22 patients (7 men and 15 women) operated on between 1998 and 2011. Patients with trauma or malignancies were excluded. The mean age of the patients at the time of revision surgery was 56 years (range 20-80 years). The complications were analyzed depending on the operative level and the time between the index surgery and the revision. Six major complications (five intraoperatively and one postoperatively) occurred in five patients (20 %): three vein lacerations (12 %) and two ureteral injuries (8 %), despite the presence of a double-J ureteral stent. The three vein damages were repaired or ligated by a vascular surgeon. One of the two ureteral injuries led to a secondary nephrectomy after end-to-end anastomosis failure; the other necessitated secondary laparotomy for small bowel obstruction. Anterior revision of the lumbar spine is technically challenging and is associated with a high rate of vascular or urologic complications. Therefore, the potential complications of the procedure must be weighted against its benefits. When iterative anterior lumbar approach is mandatory, exposure should be performed by an access surgeon in specialized centers that have ready access to vascular and urologic surgeons.

Frontal sinus revision rate after nasal polyposis surgery including frontal recess clearance and middle turbinectomy: A long-term analysis.

Science.gov (United States)

Benkhatar, Hakim; Khettab, Idir; Sultanik, Philippe; Laccourreye, Ollivier; Bonfils, Pierre

2018-08-01

To determine the frontal sinus revision rate after nasal polyposis (NP) surgery including frontal recess clearance (FRC) and middle turbinectomy (MT), to search for predictive factors and to analyse surgical management. Longitudinal analysis of 153 patients who consecutively underwent bilateral sphenoethmoidectomy with FRC and MT for NP with a minimum follow-up of 7 years. Decision of revision surgery was made in case of medically refractory chronic frontal sinusitis or frontal mucocele. Univariate and multivariate analysis incorporating clinical and radiological variables were performed. The frontal sinus revision rate was 6.5% (10/153). The mean time between the initial procedure and revision surgery was 3 years, 10 months. Osteitis around the frontal sinus outflow tract (FSOT) was associated with a higher risk of frontal sinus revision surgery (p=0.01). Asthma and aspirin intolerance did not increase the risk, as well as frontal sinus ostium diameter or residual frontoethmoid cells. Among revised patients, 60% required multiple procedures and 70% required frontal sinus ostium enlargement. Our long-term study reports that NP surgery including FRC and MT is associated with a low frontal sinus revision rate (6.5%). Patients developing osteitis around the FSOT have a higher risk of frontal sinus revision surgery. As mucosal damage can lead to osteitis, FSOT mucosa should be preserved during initial NP surgery. However, as multiple procedures are common among NP patients requiring frontal sinus revision, frontal sinus ostium enlargement should be considered during first revision in the hope of reducing the need of further revisions. Copyright © 2018 Elsevier B.V. All rights reserved.

Perioperative Serum Lipid Status and Statin Use Affect the Revision Surgery Rate After Arthroscopic Rotator Cuff Repair.

Science.gov (United States)

Cancienne, Jourdan M; Brockmeier, Stephen F; Rodeo, Scott A; Werner, Brian C

2017-11-01

Recent animal studies have demonstrated that hyperlipidemia is associated with poor tendon-bone healing after rotator cuff repair; however, these findings have not been substantiated in human studies. To examine any association between hyperlipidemia and the failure of arthroscopic rotator cuff repair requiring revision surgery and to investigate whether the use of statin lipid-lowering agents had any influence on observed associations. Cohort study; Level of evidence, 3. From a national insurance database, patients who underwent arthroscopic rotator cuff repair with perioperative lipid levels (total cholesterol, low-density lipoprotein [LDL], and triglycerides) recorded were reviewed. For each lipid test, patients were stratified into normal, moderate, and high groups based on published standards. For the total cholesterol and LDL cohorts, a subgroup analysis of patients stratified by statin use was performed. The primary outcome measure was ipsilateral revision rotator cuff surgery, including revision repair or debridement. A logistic regression analysis controlling for patient demographics and comorbidities was utilized for comparison. There were 30,638 patients included in the study. The rate of revision rotator cuff surgery was significantly increased in patients with moderate (odds ratio [OR], 1.20; 95% CI, 1.03-1.40; P = .022) and high total cholesterol levels (OR, 1.36; 95% CI, 1.10-1.55; P = .006) compared with patients with normal total cholesterol levels perioperatively. Within each of these groups, patients without statin use had significantly higher rates of revision surgery, while those with statin prescriptions did not. The absolute risk reduction for statin use ranged from 0.24% to 1.87% when stratified by the total cholesterol level, yielding a number needed to treat from 54 to 408 patients. The rate of revision surgery was significantly increased in patients with moderate (OR, 1.24; 95% CI, 1.10-1.41; P = .001) and high LDL levels (OR, 1.46; 95

High proximal migration in cemented acetabular revisions operated with bone impaction grafting; 47 revision cups followed with RSA for 17 years.

Science.gov (United States)

Mohaddes, Maziar; Herberts, Peter; Malchau, Henrik; Johanson, Per-Erik; Kärrholm, Johan

2017-05-12

Bone impaction grafting is a biologically and mechanically appealing option in acetabular revision surgery, allowing restitution of the bone stock and restoration of the biomechanics. We analysed differences in proximal migration of the revision acetabular components when bone impaction grafting is used together with a cemented or an uncemented cup. 43 patients (47 hips), revised due to acetabular loosening and judged to have less than 50% host bone-implant contact were included. The hips were randomised to either an uncemented (n = 20) or a cemented (n = 27) revision cup. Radiostereometry and radiography was performed postoperatively, at 3 and 6 months, 1, 2, 3, 5, 7, 10 and 13 and 17 years postoperatively. Clinical follow-up was performed at 1, 2 and 5 years postoperatively and thereafter at the same interval as in the radiographic follow-up. There were no differences in the base line demographic data between the 2 groups. At the last follow-up (17 years) 14 hips (10 cemented, 4 uncemented) had been re-revised due to loosening. 3 additional cups (1 uncemented and 2 cemented) were radiographically loose. There was a higher early proximal migration in the cemented cups. Cups operated on with cement showed a higher early migration measured with RSA and also a higher number of late revisions. The reason for this is not known, but factors such as inclusion of cases with severe bone defects, use of smaller bone chips and issues related to the impaction technique might have had various degrees of influence.

Early postoperative fluoroquinolone use is associated with an increased revision rate after arthroscopic rotator cuff repair.

Science.gov (United States)

Cancienne, Jourdan M; Brockmeier, Stephen F; Rodeo, Scott A; Young, Chris; Werner, Brian C

2017-07-01

To evaluate the association of postoperative fluoroquinolone use following arthroscopic primary rotator cuff repair with failure requiring revision rotator cuff repair. An insurance database was queried for patients undergoing rotator cuff repair from 2007 to 2015. These patients were divided into three groups: (1) patients prescribed fluoroquinolones within 6 months postoperatively (divided into 0-2, 2-4, and 4-6 months), (2) a matched negative control cohort of patients not prescribed fluoroquinolones, and (3) a matched positive control cohort of patients prescribed fluoroquinolones between 6 and 18 months following rotator cuff repair. Rates of failure requiring revision rotator cuff repair were compared within 2 years. A total of 1292 patients were prescribed fluoroquinolones within 6 months after rotator cuff repair, including 442 within 2 months, 433 within 2 to 4 months, and 417 within 4 to 6 months, and were compared to 5225 matched negative controls and 1597 matched positive controls. The rate of revision rotator cuff repair was significantly higher in patients prescribed fluoroquinolones within 2 months (6.1 %) compared to matched negative (2.2 %, P = 0.0009) and positive controls (2.4 %, P = 0.0026). There were no significant differences in the rate of revision rotator cuff repair when fluoroquinolones were prescribed >2 months after rotator cuff repair. Early use of fluoroquinolones following rotator cuff repair was independently associated with significantly increased rates of failure requiring revision rotator cuff repair. This is the first clinical study examining the association of postoperative fluoroquinolone use with failure following arthroscopic rotator cuff repair. III.

Revision of failed hip resurfacing to total hip arthroplasty rapidly relieves pain and improves function in the early post operative period

Directory of Open Access Journals (Sweden)

Muirhead-Allwood Sarah K

2010-11-01

Full Text Available Abstract We reviewed the results of 25 consecutive patients who underwent revision of a hip resurfacing prosthesis to a total hip replacement. Revisions were performed for recurrent pain and effusion, infection and proximal femoral fractures. Both components were revised in 20 cases. There were 12 male and 13 female patients with average time to revision of 34.4 and 26.4 months respectively. The mean follow up period was 12.7 months (3 to 31. All patients reported relief of pain and excellent satisfaction scores. Two patients experienced stiffness up to three months post operatively. Pre operative Oxford, Harris and WOMAC hip scores were 39.1, 36.4 and 52.2 respectively. Mean post operative scores at last follow up were 17.4, 89.8 and 6.1 respectively (p

The revised program for measurements in intense operation mode according to AVV-IMIS

International Nuclear Information System (INIS)

Bieringer, J.; Wirth, E.; Buehling, A.; Mueller-Neumann, M.; Haase, G.; Heinrich, T.; Steinkopff, T.; Wiezorek, C.

2007-01-01

The monitoring program for measurements in intense operation mode has been revised recently by a working group at the Federal Ministry for Environment, Nature Conservation and Reactor Safety (BMU). The major issues of the revision are reported in this contribution. Measurements in intense operation must be appropriate for fast assessment of the radiological situation, for estimating the dose to the population and for decisions on countermeasures to minimize the dose. In order to meet these requirements the structure of the measurement program in intense operation mode was divided into three phases when different exposition paths are relevant: before and during dispersion of radioactive material, immediately after dispersion of radioactive material has ended and a late phase when contamination values have decreased in different environmental media. For each of these phases a special measurement program was defined that is tailored to achieve the above mentioned objectives. Minimum detectable activity concentrations were introduced similar to the measurement program in routine operation mode. They follow the intervention levels in the catalogue of countermeasures and maximum permitted values given by the European Union (EU) for food and animal feed. The minimum detectable activity concentrations were defined such that the detection of 1/10 of the intervention levels for countermeasures is ensured. (orig.)

Conceptual design report for a remotely operated cask handling system. Revision 1

International Nuclear Information System (INIS)

Yount, J.A.; Berger, J.D.

1984-09-01

Recent advances in remote handling utilizing commercial robotics are conceptually applied to lowering operator cumulative radiation exposure and increasing throughput during cask handling operations in nuclear shipping and receiving facilities. Revision 1 incorporates functional criteria for facility equipment, equipment technical outline specifications, and interface control drawings to assist Architect Engineers in the application of remote handling to waste shipping and receiving facilities. The document has also been updated to show some of the equipment used in proof-of-principle testing during fiscal year 1984. 10 references, 50 figures, 1 table

77 FR 45599 - CED Rock Springs, Inc.; Supplemental Notice That Revised Market-Based Rate Tariff Filing Includes...

Science.gov (United States)

2012-08-01

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket Nos. ER02-2546-000; ER02-2546-001] CED Rock Springs, Inc.; Supplemental Notice That Revised Market- Based Rate Tariff Filing...-referenced proceeding of CED Rock Springs, Inc.'s tariff revision filing, noting that such filing includes a...

Cotrel-dubousset instrumentation for the correction of adolescent idiopathic scoliosis. Long-term results with an unexpected high revision rate

Directory of Open Access Journals (Sweden)

Mueller Franz J

2012-06-01

Full Text Available Abstract Background For many years, the CD instrumentation has been regarded as the standard device for the surgical correction of adolescent idiopathic scoliosis (AIS. Nevertheless, scientific long-term results on this procedure are rare. Therefore, we conducted a retrospective follow-up study of patients treated for AIS with CD instrumentation and spondylodesis. Methods A total of 40 patients with AIS underwent CD instrumentation in our department within 3 years and between 1990 and 1992. For the retrospective analysis, first all the patient documents were reviewed, and pre-/postoperative X-ray images as well as those at the latest follow-up were analysed. Furthermore, it was attempted to conduct a clinical survey using the SRS-24 questionnaire, which was sent to the patients after a preceding announcement on the phone. Results Radiologically, the frontal main curvature was improved from a preoperative angle of 69.2° to a postoperative angle of 35.4°, and the secondary curvature was improved from a preoperative angle of 42.6° to a postoperative angle of 20.5°. The latest radiological follow-up at average 57.4 months post surgery showed an average loss of correction of 9.6° (main curvature and 4.6° (secondary curvature, respectively. Within the first 30 days post surgery, 3 out of 40 patients (7.5% received early operative revision for the dislocation of hooks or rods. At an average of 45.7 months (range 11 to 142 months, 19 out of 40 patients (47.5%; including 2 patients with early revision received late operative revisions: The reasons were late infection (10 out of 40 patients; 25% with the development of fistulae (7 cases or putrid secretion (3 cases, which was resolved with the complete removal of instrumentation after all. The average time until revision was 35.5 months (range 14 to 56 months after CD instrumentation. Furthermore, complete implant removal was necessary in 8 out of 40 patients (20% for late operate site

Knowledge and abilities catalog for nuclear power plant operators: Boiling water reactors, Revision 1

International Nuclear Information System (INIS)

1995-08-01

The Knowledge and Abilities Catalog for Nuclear Power Plant Operators: Boiling-Water Reactors (BWRs) (NUREG-1123, Revision 1) provides the basis for the development of content-valid licensing examinations for reactor operators (ROs) and senior reactor operators (SROs). The examinations developed using the BWR Catalog along with the Operator Licensing Examiner Standards (NUREG-1021) and the Examiner's Handbook for Developing Operator Licensing Written Examinations (NUREG/BR-0122), will cover the topics listed under Title 10, Code of Federal Regulations, Part 55 (10 CFR 55). The BWR Catalog contains approximately 7,000 knowledge and ability (K/A) statements for ROs and SROs at BWRs. The catalog is organized into six major sections: Organization of the Catalog, Generic Knowledge and Ability Statements, Plant Systems grouped by Safety Functions, Emergency and Abnormal Plant Evolutions, Components, and Theory. Revision 1 to the BWR Catalog represents a modification in form and content of the original catalog. The K/As were linked to their applicable 10 CFR 55 item numbers. SRO level K/As were identified by 10 CFR 55.43 item numbers. The plant-wide generic and system generic K/As were combined in one section with approximately one hundred new K/As. Component Cooling Water and Instrument Air Systems were added to the Systems Section. Finally, High Containment Hydrogen Concentration and Plant Fire On Site evolutions added to the Emergency and Abnormal Plant Evolutions section

Risk factors for total hip arthroplasty aseptic revision.

Science.gov (United States)

Khatod, Monti; Cafri, Guy; Namba, Robert S; Inacio, Maria C S; Paxton, Elizabeth W

2014-07-01

The purpose of this study was to evaluate patient, operative, implant, surgeon, and hospital factors associated with aseptic revision after primary THA in patients registered in a large US Total Joint Replacement Registry. A total of 35,960 THAs registered from 4/2001-12/2010 were evaluated. The 8-year survival rate was 96.7% (95% CI 96.4%-97.0%). Females had a higher risk of aseptic revision than males. Hispanic and Asian patients had a lower risk of revision than white patients. Ceramic-on-ceramic, ceramic-on-conventional polyethylene, and metal-on-conventional polyethylene bearing surfaces had a higher risk of revision than metal-on-highly cross-linked polyethylene. Body mass index, health status, diabetes, diagnosis, fixation, approach, bilateral procedures, head size, surgeon fellowship training, surgeon and hospital volume were not revision risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

Revision Total Hip Arthoplasty: Factors Associated with Re-Revision Surgery

OpenAIRE

Khatod, M; Cafri, G; Inacio, MCS; Schepps, AL; Paxton, EW; Bini, SA

2015-01-01

The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty.A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revi...

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status

International Nuclear Information System (INIS)

1979-03-01

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

Comparing Cultural Differences in Two Quality Measures in Chinese Kindergartens: The Early Childhood Environment Rating Scale-Revised and the Kindergarten Quality Rating System

Science.gov (United States)

Hu, Bi Ying

2015-01-01

This study examined the degrees of congruence between two early childhood evaluation systems on various quality concepts: the Early Childhood Environment Rating Scale-Revised (ECERS-R) and Zhejiang's Kindergarten Quality Rating System (KQRS). Analysis of variance and post hoc least significant difference tests were employed to show the extent to…

Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.

Science.gov (United States)

Erestam, Sofia; Haglind, Eva; Bock, David; Andersson, Annette Erichsen; Angenete, Eva

2017-01-01

Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure. There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. NCT02329691.

Revision rates for metal-on-metal hip resurfacing and metal-on-metal total hip arthroplasty – a systematic review

DEFF Research Database (Denmark)

Ras Sørensen, Sofie-amalie L.; Jørgensen, Henrik L.; Sporing, Sune L.

2016-01-01

Purpose To compare revision rates of metal-on-metal (MoM) hip resurfacing (HRS) and MoM total hip arthroplasty (THA), as well as the primary causes for revisions. Methods The PubMed database was queried for potentially relevant articles addressing MoMTHA and MoMHRS, a total of 51 articles were....... The odds ratio was 1.25 (1.03:1.53) 95% CI (p = 0.03) (MoMHRS vs. MoMTHA). The studies of hip prostheses were separated into 2 categories of short- and long-term (more or less than 5 years). Short-term revision rate for MoMTHA was 4.5% after 4.8 years, and for MoMHRS 4.0% after 4.2 years. The odds ratio...

A revised mineral nutrient supplement increases biomass and growth rate in Chlamydomonas reinhardtii.

Science.gov (United States)

Kropat, Janette; Hong-Hermesdorf, Anne; Casero, David; Ent, Petr; Castruita, Madeli; Pellegrini, Matteo; Merchant, Sabeeha S; Malasarn, Davin

2011-06-01

Interest in exploiting algae as a biofuel source and the role of inorganic nutrient deficiency in inducing triacylglyceride (TAG) accumulation in cells necessitates a strategy to efficiently formulate species-specific culture media that can easily be manipulated. Using the reference organism Chlamydomonas reinhardtii, we tested the hypothesis that modeling trace element supplements after the cellular ionome would result in optimized cell growth. We determined the trace metal content of several commonly used Chlamydomonas strains in various culture conditions and developed a revised trace element solution to parallel these measurements. Comparison of cells growing in the revised supplement versus a traditional trace element solution revealed faster growth rates and higher maximum cell densities with the revised recipe. RNA-seq analysis of cultures growing in the traditional versus revised medium suggest that the variation in transcriptomes was smaller than that found between different wild-type strains grown in traditional Hutner's supplement. Visual observation did not reveal defects in cell motility or mating efficiency in the new supplement. Ni²⁺-inducible expression from the CYC6 promoter remained a useful tool, albeit with an increased requirement for Ni²⁺ because of the introduction of an EDTA buffer system in the revised medium. Other advantages include more facile preparation of trace element stock solutions, a reduction in total chemical use, a more consistent batch-to-batch formulation and long-term stability (tested up to 5 years). Under the new growth regime, we analyzed cells growing under different macro- and micronutrient deficiencies. TAG accumulation in N deficiency is comparable in the new medium. Fe and Zn deficiency also induced TAG accumulation, as suggested by Nile Red staining. This approach can be used to efficiently optimize culture conditions for other algal species to improve growth and to assay cell physiology. © 2011 The Authors

Flight Test Guide (Part 61 Revised): Instrument Pilot: Helicopter.

Science.gov (United States)

Federal Aviation Administration (DOT), Washington, DC. Flight Standards Service.

The guide provides an outline of the skills required to pass the flight test for an Instrument Pilot Helicopter Rating under Part 61 (revised) of Federal Aviation Regulations. General procedures for flight tests are described and the following pilot operations outlined: maneuvering by reference to instruments, IFR navigation, instrument…

Single-stage revision for fungal peri-prosthetic joint infection: a single-centre experience.

Science.gov (United States)

Klatte, T O; Kendoff, D; Kamath, A F; Jonen, V; Rueger, J M; Frommelt, L; Gebauer, M; Gehrke, T

2014-04-01

Fungal peri-prosthetic infections of the knee and hip are rare but likely to result in devastating complications. In this study we evaluated the results of their management using a single-stage exchange technique. Between 2001 and 2011, 14 patients (ten hips, four knees) were treated for a peri-prosthetic fungal infection. One patient was excluded because revision surgery was not possible owing to a large acetabular defect. One patient developed a further infection two months post-operatively and was excluded from the analysis. Two patients died of unrelated causes. After a mean of seven years (3 to 11) a total of ten patients were available for follow-up. One patient, undergoing revision replacement of the hip, had a post-operative dislocation. Another patient, undergoing revision replacement of the knee, developed a wound infection and required revision 29 months post-operatively following a peri-prosthetic femoral fracture. The mean Harris hip score increased to 74 points (63 to 84; p prosthetic infection is feasible, with an acceptable rate of a satisfactory outcome.

Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance.

Science.gov (United States)

Ari, Seyhmus; Kürşat Cingü, Abdullah; Sahin, Alparslan; Gün, Ramazan; Kiniş, Vefa; Caça, Ihsan

2012-01-01

To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocystorhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance. Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success. Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28). Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates.

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Arabic Edition)

International Nuclear Information System (INIS)

1979-03-01

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Chinese Edition)

Energy Technology Data Exchange (ETDEWEB)

NONE

1979-03-15

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Spanish Edition)

International Nuclear Information System (INIS)

1979-03-01

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [es

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Russian Edition)

International Nuclear Information System (INIS)

1979-03-01

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [ru

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Chinese Edition)

International Nuclear Information System (INIS)

1979-03-01

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (French Edition)

International Nuclear Information System (INIS)

1979-03-01

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [fr

Failure of aseptic revision total knee arthroplasties.

Science.gov (United States)

Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

2015-02-01

In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties.

Low interest rates - do they revise household saving motives in the Euro area?

Directory of Open Access Journals (Sweden)

Katarzyna Kochaniak

2016-07-01

Full Text Available This paper presents the impact of decreasing MFI interest rates on household deposits and saving goals in 12 Monetary Union member countries in the years 2009-2015. It analyses tendencies in household deposits (overnight, with agreed maturity and redeemable at notice, and attempts to link them with certain household saving motives (target, retirement and precautionary. The paper identifies those deposit categories which appeared as sensitive to declining interest rates and indicates the Eurozone countries whose populations are expected to revise their savings plans. Precise implications are drawn for target saving motives of households in Austria, Cyprus and Malta. However, in the case of two other motives, the analysis does not conclude on the impact of decreasing MFI interest rates.

The Impact of use of Double Set-up on Infection Rates in Revision Total Knee Replacement and Limb Salvage Procedures

Directory of Open Access Journals (Sweden)

Jennifer Waterman

2015-03-01

Full Text Available A retrospective analysis was performed to determine the impact of utilizing a double set-up procedure on reducing infection rates revision total knee and limb salvage procedures in patients with known joint infection.  Eighteen cases fit selection criteria.  The recurrence rate of infection was 5.5% which is less than reported recent literature review.   This suggests the use of a double set-up in combination with other infection reducing protocols may help further reduce recurrent infection.  Keywords: double set-up, infection, revision total knee arthroplasty, limb-salvage

Evaluation of the revised electrolytic reduction reactor from a remote operability aspect

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyo Jik; Yoon, K. H.; Kim, K. H. (and others)

2008-01-15

This report presents an evaluation of the remote operability of the revised electrolytic reduction (ER) reactor installed in the ACP at KAERI. All operations have to be implemented in a fully remote manner since the ACPF is a hotcell for handling highly radioactive materials such as spent nuclear fuels. In particular, the ER process is a key process of the Advanced spent fuel Conditioning Process (ACP) and it needs a lot of other auxiliary equipment to perform it. Also, since the ER equipment is too big and complicated, and contrarily the ACPF is not big enough, and one common rail is allotted for a bridge transported servo manipulator, an in-cell crane and a gate crane, a remote handling of the ER reactor is accompanied by a difficulty for a remote operation. For an easy understanding, short overview of the ER process, the remote handling equipment, the structural configuration of the ACPF and the detail drawings of the ER equipment are presented. Through 4 month-remote operational tests, detailed operational procedures are presented along with pictures. The remote handling equipment and tools required in each operation are addressed in detail. Also, the procedure to implement each remote operation, and a task difficulty are evaluated from a remote operability aspect. All the remote tasks are distinguished according to whether a remote operation can be performed or not. Finally, partial improvement or an idea to solve the suggested problems is presented. This report will assist in modifying or scaling up the ER reactor.

Fatigue failure of the cephalomedullary nail: revision options, outcomes and review of the literature.

Science.gov (United States)

Tucker, Adam; Warnock, Michael; McDonald, Sinead; Cusick, Laurence; Foster, Andrew P

2018-04-01

Cephalomedullary nail (CMN) failure is a rare entity following hip fracture treatment. However, it poses significant challenges for revision surgery, both mechanically and biologically. Nail failure rates have been reported at failure, compared to "adequate" and "good" (p = 0.027). Tip-Apex Distance (TAD) mean was 23.2 ± 8.3 mm, and an adequate TAD with three-point fixation was seen in only 35% of cases. Mean time to failure was 401.0 ± 237.2 days, with mean age at failure of 74.0 ± 14.8 years. Options after failure included revision CMN nail, proximal femoral locking plate (PFLP), long-stem or restoration arthroplasty, or femoral endoprosthesis. Barthel Functional Index scores showed no significant difference at 3 and 12 months post-operatively, nor any difference between treatment groups. Mean 12-month mortality was 30%, akin to a primary hip fracture mortality risk according to NICE guidelines. Mortality rates were lowest in revision nails. Subsequent revision rates were higher in the PFLP group. There is no reported evidence on the best surgical technique for managing the failed CMN, with no clear functional benefit in the options above. Good surgical technique at the time of primary CMN surgery is critical in minimising fatigue failure. After revision, overall mortality rates were equivalent to reported primary hip fracture mortality rates. Further multicentre evaluations are required to assess which technique convey the best functional outcomes without compromising 12-month mortality rates.

Trochanteric entry femoral nails yield better femoral version and lower revision rates-A large cohort multivariate regression analysis.

Science.gov (United States)

Yoon, Richard S; Gage, Mark J; Galos, David K; Donegan, Derek J; Liporace, Frank A

2017-06-01

Intramedullary nailing (IMN) has become the standard of care for the treatment of most femoral shaft fractures. Different IMN options include trochanteric and piriformis entry as well as retrograde nails, which may result in varying degrees of femoral rotation. The objective of this study was to analyze postoperative femoral version between three types of nails and to delineate any significant differences in femoral version (DFV) and revision rates. Over a 10-year period, 417 patients underwent IMN of a diaphyseal femur fracture (AO/OTA 32A-C). Of these patients, 316 met inclusion criteria and obtained postoperative computed tomography (CT) scanograms to calculate femoral version and were thus included in the study. In this study, our main outcome measure was the difference in femoral version (DFV) between the uninjured limb and the injured limb. The effect of the following variables on DFV and revision rates were determined via univariate, multivariate, and ordinal regression analyses: gender, age, BMI, ethnicity, mechanism of injury, operative side, open fracture, and table type/position. Statistical significance was set at pregression analysis revealed that a lower BMI was significantly associated with a lower DFV (p=0.006). Controlling for possible covariables, multivariate analysis yielded a significantly lower DFV for trochanteric entry nails than piriformis or retrograde nails (7.9±6.10 vs. 9.5±7.4 vs. 9.4±7.8°, pregression analysis. However, this is not to state that the other nail types exhibited abnormal DFV. Translation to the clinical impact of a few degrees of DFV is also unknown. Future studies to more in-depth study the intricacies of femoral version may lead to improved technology in addition to potentially improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Non-operative diagnosis - effect on repeat-operation rates in the UK breast screening programme

International Nuclear Information System (INIS)

Wallis, M.G.; Cheung, S.; Kearins, O.; Lawrence, G.M.

2009-01-01

Non-operative diagnosis rates in the UK breast screening programme have improved dramatically from 48.8% in 1994/95 (only nine units achieved the then minimum standard of 70%) to 94% in 2005/06 (only seven units failed to achieve the target of 90%). Preoperative and operative history of all 120,550 women diagnosed with screen-detected breast cancer in the UK between April 1994 and March 2006 was derived from different national databases. In 2005/06, 2,790 (17.8%) of the 15,688 women having surgery needed two or more operations. In 2001/02 (non-operative diagnosis rate 87%), the re-operation rate was 23.8% (2,377 of 9,969). Extrapolation backwards to 1994/95 (non-operative diagnosis rate 48.8%) suggests a re-operation rate of 62%. Analysis over the 4 years from April 2002 (n=34,198) demonstrates that 4,089 (12%) women with a correct non-operative diagnosis of invasive disease required additional surgery compared to 1,166 (48%) of women who were under-staged (diagnosed as non-invasive based on core biopsy, but actually suffering from invasive disease). Failure to achieve a non-operative diagnosis of invasive disease (n=1,542) or non-invasive disease (n=2,247) resulted in re-operation rates of 65 and 43% respectively. Given the impact of not having a diagnosis pre-operatively, or of under-staging invasive carcinoma, it seems timely to introduce more sophisticated standards. (orig.)

78 FR 20423 - Oil and Gas and Sulphur Operations in the Outer Continental Shelf-Revisions to Safety and...

Science.gov (United States)

2013-04-05

... Enforcement (BSEE); Interior. ACTION: Final rule. SUMMARY: This final rule will revise and add several new... 63610). That rule established a new Subpart S in 30 CFR part 250, requiring all OCS operators to have a... to developing and implementing stop work authority (SWA) and ultimate work authority (UWA), requiring...

Final Approval of California Air Plan Revision; Antelope Valley Air Quality Management District; VOCs From Motor Vehicle Assembly Coating Operations

Science.gov (United States)

EPA is taking final action to approve a revision to the Antelope Valley Air Quality Management District (AVAQMD) portion of the California SIP concerning the emissions of volatile organic compounds (VOCs) from motor vehicle assembly coating operations.

Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

DEFF Research Database (Denmark)

Engesæter, Lars B; Engesæter, Ingvild Ø; Fenstad, Anne Marie

2012-01-01

Background The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes' disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA.......9%) were operated due to pediatric hip diseases (3.1% for Denmark, 8.8% for Norway, and 1.9% for Sweden) and 288,435 THAs (77.8%) were operated due to OA. Unadjusted 10-year Kaplan-Meier survival of THAs after pediatric hip diseases (94.7% survival) was inferior to that after OA (96.6% survival......). Consequently, an increased risk of revision for hips with a previous pediatric hip disease was seen (risk ratio (RR) 1.4, 95% CI: 1.3-1.5). However, after adjustment for differences in sex and age of the patients, and in fixation of the prostheses, no difference in survival was found (93.6% after pediatric hip...

Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.

Science.gov (United States)

Olsen, Margaret A; Nickel, Katelin B; Wallace, Anna E; Mines, Daniel; Fraser, Victoria J; Warren, David K

2015-03-01

To investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. Retrospective cohort study. Patients Commercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010. SSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors. A total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], Poperative factors may facilitate accurate comparison of SSI rates between facilities.

Ventriculoperitoneal shunt complications needing shunt revision in children: A review of 5 years of experience with 48 revisions

Directory of Open Access Journals (Sweden)

Rajendra K Ghritlaharey

2012-01-01

Full Text Available Background: The aim of this study was to review the management of ventriculoperitoneal (VP shunt complications in children. Patients and Methods: During the last 5 years (January 1, 2006 to December 31, 2010, 236 VP shunt operations were performed in children under 12 years of age; of these, 40 (16.94% developed shunt complications and those who underwent VP shunt revisions were studied. Results: This prospective study included 40 (28 boys and 12 girls children and required 48 shunt revisions. Complications following VP shunts that required shunt revisions were peritoneal catheter/peritoneal end malfunction (18, shunt/shunt tract infections (7, extrusion of peritoneal catheter through anus (5, ventricular catheter malfunction (4, cerebrospinal fluid (CSF leak from abdominal wound (4, shunt system failure (2, ventricular end/shunt displacement (2, CSF pseudocysts peritoneal cavity (2, extrusion of peritoneal catheter from neck, chest, abdominal scar and through umbilicus, one each. Four-fifth of these shunt complications occurred within 6 months of previous surgery. Surgical procedures done during shunt revisions in order of frequency were revision of peritoneal part of shunt (27, 56.25%, revision of entire shunt system (6, 12.5%, extra ventricular drainage and delayed re-shunt (5, 10.41%, shunt removal and delayed re-shunt (5, 10.41%, opposite side shunting (2, 4.16%, cysts excision and revision of peritoneal catheter (2, 4.16% and revision of ventricular catheter (1, 2.08%. The mortalities following VP shunt operations were 44 (18.64% and following shunt revisions were 4 (10%. Conclusions: VP shunt done for hydrocephalus in children is not only prone for complications and need for revision surgery but also associated with considerable mortality.

Team interaction skills evaluation criteria for nuclear power plant control room operators

International Nuclear Information System (INIS)

Montgomery, J.C.; Hauth, J.T.

1991-01-01

Team interaction skills are an essential aspect of safe nuclear power plant control room operations. Previous research has shown that, when a group works together, rather than as individuals, more effective operations are possible. However, little research has addressed how such team interaction skills can be measured. In this study rating scales were developed specifically for such a measurement purpose. Dimensions of team skill performance were identified from previous research and experience in the area, incorporating the input of Pacific Northwest Laboratory (PNL) contract operator licensing examiners. Rating scales were developed on the basis of these dimensions, incorporating a modified Behaviorally Anchored Rating Scale (BARS) as well as Behavioral Frequency formats. After a pilot-testing/revision process, rating data were collected using 11 control room crews responding to simulator scenarios at a boiling water and a pressurized water reactor. Statistical analyses of the resulting data revealed moderate inter-rater reliability using the Behavioral Frequency scales, relatively low inter-rater reliability using the BARS, and moderate support for convergent and discriminant validity of the scales. It was concluded that the scales show promise psychometrically and in terms of user acceptability, but that additional scale revision is needed before field implementation. Recommendations for scale revision and directions for future research were presented

Revision total hip arthoplasty: factors associated with re-revision surgery.

Science.gov (United States)

Khatod, Monti; Cafri, Guy; Inacio, Maria C S; Schepps, Alan L; Paxton, Elizabeth W; Bini, Stefano A

2015-03-04

The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty. A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revision total hip arthroplasty for aseptic reasons from April 1, 2001, to December 31, 2010. The end point of interest was re-revision total hip arthroplasty. Risk factors evaluated for re-revision total hip arthroplasty included: patient risk factors (age, sex, body mass index, race, and general health status), implant risk factors (fixation type, bearing surface, femoral head size, and component replacement), and surgeon risk factors (volume and experience). A multivariable Cox proportional hazards model was used. Six hundred and twenty-nine revision total hip arthroplasties with sixty-three (10%) re-revisions were evaluated. The mean cohort age (and standard deviation) was 57.0 ± 12.4 years, the mean body mass index (and standard deviation) was 29.5 ± 6.1 kg/m(2), and most of the patients were women (64.5%) and white (81.9%) and had an American Society of Anesthesiologists score of associated with the risk of re-revision. For every ten-year increase in patient age, the hazard ratio for re-revision decreases by a factor of 0.72 (95% confidence interval, 0.58 to 0.90). For every five revision surgical procedures performed by a surgeon, the risk of revision decreases by a factor of 0.93 (95% confidence interval, 0.86 to 0.99). At the time of revision, a new or retained cemented femoral implant or all-cemented hip implant increases the risk of revision by a factor of 3.19 (95% confidence interval, 1.22 to 8.38) relative to a retained or new uncemented hip implant. A ceramic on a

75 FR 3639 - Revisions to Rules Authorizing the Operation of Low Power Auxiliary Stations in the 698-806 MHz...

Science.gov (United States)

2010-01-22

.... 10-24; DA 10-92] Revisions to Rules Authorizing the Operation of Low Power Auxiliary Stations in the... Auxiliary Stations, Including Wireless Microphones, and the Digital Television Transition AGENCY: Federal... language that must be used in the consumer disclosure that is required by Section 15.216 of Appendix B in...

Calculation code revised MIXSET for Purex process

International Nuclear Information System (INIS)

Gonda, Kozo; Oka, Koichiro; Fukuda, Shoji.

1979-02-01

Revised MIXSET is a FORTRAN IV calculation code developed to simulate steady and transient behaviors of the Purex extraction process and calculate the optimum operating condition of the process. Revised MIXSET includes all the functions of MIXSET code as shown below. a) Maximum chemical system of eight components can be handled with or without mutual dependence of the distribution of components. b) The flowrate and concentration of feed can be renewed successively at any state, transient or steady, for searching optimum operating conditions. c) Optimum inputs of feed concentrations and flowrates can be calculated to satisfy both of specification and recovery rate of a product. d) Radioactive decay reactions can be handled on each component. Besides these functions, the following chemical reactions concerned in Purex process are newly-included in Revised MIXSET code and the quantitative changes of components such as H + , U(IV), U(VI), Pu(III), Pu(IV), NH 2 OH, N 2 H 4 can be simulated. 1st Gr. (i) reduction of Pu(IV); U 4+ + 2Pu 4+ + 2H 2 O → UO 2 2+ + 2Pu 3+ + 4H + . (ii) oxidation of Pu(III); 2Pu 3+ + 3H + + NO 3 - → 2Pu 4+ + HNO 2 + H 2 O. (iii) oxidation of U(IV); U 4+ + NO 3 - + H 2 O → UO 2 2+ + H + + HNO 2 2U 4+ + O 2 + 2H 2 O → 2UO 2 2+ + 4H + . (iv) decomposition of HNO 2 ; HNO 2 + N 2 H 5 + → HN 3 + 2H 2 O + H + . (author)

Description of the rates, trends and surgical burden associated with revision for prosthetic joint infection following primary and revision knee replacements in England and Wales: an analysis of the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man.

Science.gov (United States)

Lenguerrand, Erik; Whitehouse, Michael R; Beswick, Andrew D; Toms, Andrew D; Porter, Martyn L; Blom, Ashley W

2017-07-10

To describe the prevalence rates of revision surgery for the treatment of prosthetic joint infection (PJI) for patients undergoing knee replacement, their time trends, the cumulative incidence function of revision for PJI and estimate the burden of PJI at health service level. We analysed revision knee replacements performed due to a diagnosis of PJI and the linked index procedures recorded in the National Joint Registry from 2003 to 2014 for England and Wales. The cohort analysed consisted of 679 010 index primary knee replacements, 33 920 index revision knee replacements and 8247 revision total knee replacements performed due to a diagnosis of PJI. The prevalence rates, their time trends investigated by time from index surgery to revision for PJI, cumulative incidence functions and the burden of PJI (total procedures) were calculated. Overall linear trends were investigated with log-linear regression. The incidence of revision total knee replacement due to PJI at 2 years was 3.2/1000 following primary and 14.4/1000 following revision knee replacement, respectively. The prevalence of revision due to PJI in the 3 months following primary knee replacement has risen by 2.5-fold (95% CI 1.2 to 5.3) from 2005 to 2013 and 7.5-fold (95% CI 1.0 to 56.1) following revision knee replacement. Over 1000 procedures per year are performed as a consequence of knee PJI, an increase of 2.8 from 2005 to 2013. Overall, 75% of revisions were two-stage with an increase in use of single-stage from 7.9% in 2005 to 18.8% in 2014. Although the risk of revision due to PJI following knee replacement is low, it is rising, and coupled with the established and further predicted increased incidence of both primary and revision knee replacements, this represents an increasing and substantial treatment burden for orthopaedic service delivery in England and Wales. This has implications for future service design and the funding of individual and specialist centres. © Article author

Revision of the design model for a cryogenic falling liquid film helium separator

International Nuclear Information System (INIS)

Kinoshita, Masahiro; Bartlit, J.R.; Sherman, R.H.

1983-05-01

The present paper reports revision of the design model previously developed by the authors for the cryogenic falling liquid film helium separator. The revised design procedure is composed of three steps : 1) calculation of distributions of phase flow rates, temperature and phase compositions within the refrigerated section and the packed section ; 2) calculation of more detailed distributions of these variables within the refrigerated section ; and 3) estimation of column dimensions and determination of operating conditions. It is assumed that the vacant refrigerated section has two theoretical stages for hydrogen isotope separation. The mixture within the refrigerated section is considered in step 2) as two component system of He-HD. (author)

Introductory Business Textbook Revision Cycles: Are They Getting Shorter?

Science.gov (United States)

Zinser, Brian; Brunswick, Gary

2010-01-01

The rate of textbook revision cycles is examined in light of the recent trend towards more rapid revisions (and adoptions of textbooks). The authors conduct background research to better understand the context for textbook revision cycles and the environmental forces that have been influencing what appears to be more rapid textbook revisions. A…

Delirium subtype identification and the validation of the Delirium Rating Scale--Revised-98 (Dutch version) in hospitalized elderly patients

NARCIS (Netherlands)

de Rooij, Sophia E.; van Munster, Barbara C.; Korevaar, Johanna C.; Casteelen, Gerty; Schuurmans, Marieke J.; van der Mast, Roos C.; Levi, Marcel

2006-01-01

BACKGROUND: Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. The Dutch version of the Delirium Rating Scale-Revised-98 (DRS-R-98) appears to be a reliable method to classify delirium. The aim of this study was to determine the validity and reliability of the

Revised licensee event report system

International Nuclear Information System (INIS)

Mays, G.T.; Poore, W.P.

1985-01-01

Licensee Event Reports (LERs) provide the basis for evaluating and assessing operating experience information from nuclear power plants. The reporting requirements for submitting LERs to the Nuclear Regulatory Commission have been revised. Effective Jan. 1, 1984, all events were to be submitted in accordance with 10 CFR 50.73 of the Code of Federal Regulations. Report NUREG-1022, Licensee Event Report System-Description of System and Guidelines for Reporting, describes the guidelines on reportability of events. This article summarizes the reporting requirements as presented in NUREG-1022, high-lights differences in data reported between the revised and previous LER systems, and presents results from a preliminary assessment of LERs submitted under the revised LER reporting system

How to Revise, and Revise Really Well, for Premier Academic Journals

DEFF Research Database (Denmark)

LaPlaca, Peter J.; Lindgreen, Adam; Vanhamme, Joelle

2018-01-01

Most of the premier academic journals in all fields routinely have rejection rates of 80%, 95%, or higher. All journals prefer articles that make significant contributions to the field. Revising a manuscript and responding properly to the comments of reviewers and editors often is challenging....... This article discusses how to revise effectively a manuscript according to the (minor or major) comments of reviewers and editors for premier academic journals. We provide a series of tips for helping the authors in their endeavor, making the process less arduous and improving the possibility of a positive...

Korean Version of the Delirium Rating Scale-Revised-98: Reliability and Validity

Science.gov (United States)

Ryu, Jian; Lee, Jinyoung; Kim, Hwi-Jung; Shin, Im Hee; Kim, Jeong-Lan; Trzepacz, Paula T.

2011-01-01

Objective The aims of the present study were 1) to standardize the validity and reliability of the Korean version of Delirium Rating Scale-Revised-98 (DRS-R98-K) and 2) to establish the optimum cut-off value, sensitivity, and specificity for discriminating delirium from other non-delirious psychiatric conditions. Methods Using DSM-IV criteria, 157 subjects (69 delirium, 29 dementia, 32 schizophrenia, and 27 other psychiatric patients) were enrolled. Subjects were evaluated using DRS-R98-K, DRS-K, Mini-Mental State Examination (MMSE-K), and Clinical Global Impression-Severity (CGI-S) scale. Results DRS-R98-K total and severity scores showed high correlations with DRS-K. They were significantly different across all groups (p=0.000). However, neither MMSE-K nor CGI-S distinguished delirium from dementia. All DRS-R98-K diagnostic items (#14-16) and items #1 and 2 significantly discriminated delirium from dementia. Cronbach's alpha coefficient revealed high internal consistency for DRS-R98-K total (r=0.91) and severity (r=0.89) scales. Interrater reliability (ICC between 0.96 and 1) was very high. Using receiver operating characteristic analysis, the area under the curve of DRS-R98-K total score was 0.948 between the delirium group and all other groups and 0.873 between the delirium and dementia groups. The best cut-off scores in DRS-R98-K total score were 18.5 and 19.5 between the delirium and the other three groups and 20.5 between the delirium and dementia groups. Conclusion We demonstrated that DRS-R98-K is a valid and reliable instrument for assessing delirium severity and diagnosis and discriminating delirium from dementia and other psychiatric disorders in Korean patients. PMID:21519534

PSA-based evaluation and rating of operational events

International Nuclear Information System (INIS)

Gomez Cobo, A.

1997-01-01

The presentation discusses the PSA-based evaluation and rating of operational events, including the following: historical background, procedures for event evaluation using PSA, use of PSA for event rating, current activities

Revision of the DELFIC Particle Activity Module

Energy Technology Data Exchange (ETDEWEB)

Hooper, David A [ORNL; Jodoin, Vincent J [ORNL

2010-09-01

The Defense Land Fallout Interpretive Code (DELFIC) was originally released in 1968 as a tool for modeling fallout patterns and for predicting exposure rates. Despite the continual advancement of knowledge of fission yields, decay behavior of fission products, and biological dosimetry, the decay data and logic of DELFIC have remained mostly unchanged since inception. Additionally, previous code revisions caused a loss of conservation of radioactive nuclides. In this report, a new revision of the decay database and the Particle Activity Module is introduced and explained. The database upgrades discussed are replacement of the fission yields with ENDF/B-VII data as formatted in the Oak Ridge Isotope Generation (ORIGEN) code, revised decay constants, revised exposure rate multipliers, revised decay modes and branching ratios, and revised boiling point data. Included decay logic upgrades represent a correction of a flaw in the treatment of the fission yields, extension of the logic to include more complex decay modes, conservation of nuclides (including stable nuclides) at all times, and conversion of key variables to double precision for nuclide conservation. Finally, recommended future work is discussed with an emphasis on completion of the overall radiation physics upgrade, particularly for dosimetry, induced activity, decay of the actinides, and fractionation.

Addenbrooke's Cognitive Examination-Revised for mild cognitive impairment in Parkinson's disease.

Science.gov (United States)

McColgan, Peter; Evans, Jonathan R; Breen, David P; Mason, Sarah L; Barker, Roger A; Williams-Gray, Caroline H

2012-08-01

Cognitive impairment is common in Parkinson's disease (PD), even in the early stages, and appropriate screening tools are needed. We investigated the utility of the Addenbrooke's Cognitive Examination-Revised for detecting mild cognitive impairment (MCI) in PD in an incident population-representative cohort (n = 132) and investigated the relationship between performance on this instrument and behavior and quality of life (n = 219). Twenty-two percent met criteria for MCI. Receiver operating curve analysis revealed an area under the curve of 0.81. A cutoff Cognitive Rating Scale, and there were significant correlations with the Cambridge Behavioral Inventory-Revised and Parkinson's Disease Questionnaire 39. This instrument is a useful screening tool for PD-MCI, and poor performance is significantly related to impaired behavior and quality of life. Copyright © 2012 Movement Disorder Society.

Operations program plan: Revision 3

International Nuclear Information System (INIS)

1988-07-01

This document, the Operations Program Plan (OPP), has been developed as the seven-year master plan for operation of WIPP. The OPP was authorized by the Albuquerque Field Office of the Department of Energy (DOE-AL) and that organization's WIPP Project Office (DOE-WPO) in Carlsbad, New Mexico. The OPP is the directive from the DOE-WPO Project Manager as to how the WIPP is to be managed, operated, and administered. As the top tier management document for WIPP, the OPP establishes organizational responsibilities and an organizational structure for the Waste Isolation Division (WID) of Westinghouse Electric Corporation. The OPP sets policy and tone for conducting WIPP operations; it requires and specifically authorizes implementing documents (e.g., manuals). It has also proven instrumental in the budgeting and planning process, most particularly in expediting the preparation of specific budgets and detailed schedules for each of the numerous work packages. The OPP is also used to communicate information about WIPP operations

NPP License Renewal and Aging Management: Revised Guidance

International Nuclear Information System (INIS)

Hull, A.B.; Hiser, A.L.; Lindo-Talin, S.E.

2012-01-01

Based on the Atomic Energy Act, the NRC issues licenses for commercial power reactors to operate for up to 40 years and allows these licenses to be renewed for up to another 20 years. NRC has approved license renewal for well over 50% of U.S. located reactors originally licensed to operate for 40 years. Of these 104 reactors (69 PWRs, 35 BWRs), the NRC has issued renewed licenses for 71 units and is currently reviewing applications for another 15 units. As of May 1, 2012, ten plants at nine sites had entered their 41st year of operation and thus are in their first period of extended operation (PEO). Five more plants will enter the PEO by the end of 2012. One foundation of the license renewal process has been license renewal guidance documents (LRGDs). The U.S. Nuclear Regulatory Commission (NRC) revised key guidance documents used for nuclear power license renewal in 2010 and 2011. These include NUREG-1800, 'Standard Review Plan for Review of License Renewal Applications,' revision 2 (SRP-LR), and NUREG-1801, 'Generic Aging Lessons Learned (GALL) Report,' revision 2 (GALL Report). The guidance documents were updated to reflect lessons learned and operating experience gained since the guidance documents were last issued in 2005. (author)

Fast-track revision knee arthroplasty

DEFF Research Database (Denmark)

Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

2011-01-01

Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery....... Methods 29 patients were operated with 30 revision arthroplasties. Median age was 67 (34-84) years. All patients followed a standardized fast-track set-up designed for primary TKA. We determined the outcome regarding LOS, morbidity, mortality, and satisfaction. Results Median LOS was 2 (1-4) days...

EPRI BWR Water Chemistry Guidelines Revision

International Nuclear Information System (INIS)

Garcia, Susan E.; Giannelli, Joseph F.

2014-01-01

BWRVIP-190: BWR Water Chemistry Guidelines – 2008 Revision has been revised. The revision committee consisted of U.S. and non-U.S. utilities (members of the BWR Vessel and Internals Protection (BWRVIP) Mitigation Committee), reactor system manufacturers, fuel suppliers, and EPRI and industry experts. The revised document, BWRVIP-190 Revision 1, was completely reformatted into two volumes, with a simplified presentation of water chemistry control, diagnostic and good practice parameters in Volume 1 and the technical bases in Volume 2, to facilitate use. The revision was developed in parallel and in coordination with preparation of the Fuel Reliability Guidelines Revision 1: BWR Fuel Cladding Crud and Corrosion. Guidance is included for plants operating under normal water chemistry (NWC), moderate hydrogen water chemistry (HWC-M), and noble metal application (GE-Hitachi NobleChem™) plus hydrogen injection. Volume 1 includes significant changes to BWR feedwater and reactor water chemistry control parameters to provide increased assurance of intergranular stress corrosion cracking (IGSCC) mitigation of reactor materials and fuel reliability during all plant conditions, including cold shutdown (≤200°F (93°C)), startup/hot standby (>200°F (93°C) and ≤ 10%) and power operation (>10% power). Action Level values for chloride and sulfate have been tightened to minimize environmentally assisted cracking (EAC) of all wetted surfaces, including those not protected by hydrogen injection, with or without noble metals. Chemistry control guidance has been enhanced to minimize shutdown radiation fields by clarifying targets for depleted zinc oxide (DZO) injection while meeting requirements for fuel reliability. Improved tabular presentations of parameter values explicitly indicate levels at which actions are to be taken and required sampling frequencies. Volume 2 provides the technical bases for BWR water chemistry control for control of EAC, flow accelerated corrosion

Revision of Krsko NPP Quality Assurance Plan

International Nuclear Information System (INIS)

Biscan, R.; Fifnja, I.; Kavsek, D.

2012-01-01

International standards from nuclear power plant operation area are being frequently upgraded and revised in accordance with the continuous improvement philosophy. This philosophy applies also to the area of Quality Assurance, which has also undergone significant improvement since the early 1950s. Besides just nuclear industry, there are also other international quality standards that are being continuously developed and revised, bringing needs for upgrades also in the nuclear application. Since the beginning of Krsko NPP construction, the overall Quality Assurance program and its applicable procedures were in place to assure that all planned and systematic actions necessary to provide adequate confidence that an item or service will satisfy given requirements to quality, are in place. The overall requirements for quality as one of the major objectives for Krsko NPP operation are also set forth in the Updated Safety Analyses Report, the document that serves as a base for operating license. During more than 30 years of Krsko NPP operation, the quality requirements and related documents were revised and upgraded in several attempts. The latest revision 6 of QD-1, Quality Assurance Plan was issued during the year 2011. The bases for the revision were: Changes of the Slovenian regulatory requirements (ZVISJV, JV5, JV9?), Changes of Krsko NPP licensing documents (USAR section 13?), SNSA inspection requirements, Changes of international standards (IAEA, ISO?), Conclusions of first PSR, Implementation of ISO standards in Krsko NPP (ISO14001, ISO17025), Changes of plant procedures, etc. One of the most obvious changes was the enlargement of the QA Plan scope to cover interdisciplinary areas defined in the plant management program MD-1, such as Safety culture, Self-assessment, Human performance, Industrial Safety etc. The attachment of the QA Plan defining relationships between certain standards was also updated to provide matrix for better correlation of requirements of

Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

Science.gov (United States)

Schwarzkopf, Ran; Baghoolizadeh, Mahta

2015-01-01

Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

Letter of Map Revision

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The National Flood Hazard Layer (NFHL) data incorporates all Digital Flood Insurance Rate Map(DFIRM) databases published by FEMA, and any Letters Of Map Revision...

Trends in Revision Elbow Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers.

Science.gov (United States)

Wilson, Alexander T; Pidgeon, Tyler S; Morrell, Nathan T; DaSilva, Manuel F

2015-11-01

To determine the frequency of revision elbow ulnar collateral ligament (UCL) reconstruction in professional baseball pitchers. Data were collected on 271 professional baseball pitchers who underwent primary UCL reconstruction. Each player was evaluated retrospectively for occurrence of revision UCL reconstructive surgery to treat failed primary reconstruction. Data on players who underwent revision UCL reconstruction were compiled to determine total surgical revision incidence and revision rate by year. The incidence of early revision was analyzed for trends. Average career length after primary UCL reconstruction was calculated and compared with that of players who underwent revision surgery. Logistic regression analysis was performed to assess risk factors for revision including handedness, pitching role, and age at the time of primary reconstruction. Between 1974 and 2014, the annual incidence of primary UCL reconstructions among professional pitchers increased, while the proportion of cases being revised per year decreased. Of the 271 pitchers included in the study, 40 (15%) required at least 1 revision procedure during their playing career. Three cases required a second UCL revision reconstruction. The average time from primary surgery to revision was 5.2 ± 3.2 years (range, 1-13 years). The average length of career following primary reconstruction for all players was 4.9 ± 4.3 years (range, 0-22 years). The average length of career following revision UCL reconstruction was 2.5 ± 2.4 years (range, 0-8 years). No risk factors for needing revision UCL reconstruction were identified. The incidence of primary UCL reconstructions among professional pitchers is increasing; however, the rate of primary reconstructions requiring revision is decreasing. Explanations for the decreased revision rate may include improved surgical technique and improved rehabilitation protocols. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by

Circumcision revision in male children

Directory of Open Access Journals (Sweden)

Mohammed A. Al-Ghazo

2006-08-01

Full Text Available OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004. Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years. RESULTS: Most of unsatisfactory primary circumcisions (86.7% were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

Recurrent instability after revision anterior shoulder stabilization surgery.

Science.gov (United States)

Friedman, Lisa Genevra Mandeville; Griesser, Michael J; Miniaci, Anthony A; Jones, Morgan H

2014-03-01

The purpose of this study was to perform a systematic review of the literature to compare outcomes of revision anterior stabilization surgeries based on technique. This study also sought to compare the impact of bone defects on outcomes. A systematic review of the electronic databases PubMed, Cochrane Central Register of Controlled Trials, and Scopus was performed in July 2012 and March 2013. Of 345 articles identified in the search, 17 studies with Level I to IV Evidence satisfied the inclusion criteria and were analyzed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Recurrent instability was defined as redislocation, resubluxation, or a positive apprehensive test after revision surgery. Procedures were categorized as arthroscopic Bankart repair, open Bankart repair, Bristow-Latarjet procedure, and other open procedures. In total, 388 shoulders were studied. Male patients comprised 74.1% of patients, 66.7% of cases involved the dominant shoulder, the mean age was 28.2 years, and the mean follow-up period was 44.2 months. The surgical procedures classified as "other open procedures" had the highest rate of recurrent instability (42.7%), followed by arthroscopic Bankart repair (14.7%), the Bristow-Latarjet procedure (14.3%), and open Bankart repair (5.5%). Inconsistent reporting of bone defects precluded drawing significant conclusions. A number of different procedures are used to address recurrent instability after a primary operation for anterior shoulder instability has failed. There is significant variability in the rate of recurrent instability after revision anterior shoulder stabilization surgery. Level IV, systematic review of Level I to IV studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Cost Implications of Primary Versus Revision Surgery in Adult Spinal Deformity.

Science.gov (United States)

Qureshi, Rabia; Puvanesarajah, Varun; Jain, Amit; Kebaish, Khaled; Shimer, Adam; Shen, Francis; Hassanzadeh, Hamid

2017-08-01

Adult spinal deformity (ASD) is an important problem to consider in the elderly. Although studies have examined the complications of ASD surgery and have compared functional and radiographic results of primary surgery versus revision, no studies have compared the costs of primary procedures with revisions. We assessed the in-hospital costs of these 2 surgery types in patients with ASD. The PearlDiver Database, a database of Medicare records, was used in this study. Mutually exclusive groups of patients undergoing primary or revision surgery were identified. Patients in each group were queried for age, sex, and comorbidities. Thirty-day readmission rates, 30-day and 90-day complication rates, and postoperative costs of care were assessed with multivariate analysis. For analyses, significance was set at P average reimbursement of the primary surgery cohort was $57,078 ± $30,767. Reimbursement of revision surgery cohort was $52,999 ± $27,658. The adjusted difference in average costs between the 2 groups is $4773 ± $1069 (P day and 90-day adjusted difference in cost of care when sustaining any of the major medical complications in primary surgery versus revision surgery was insignificant. Patients undergoing primary and revision corrective procedures for ASD have similar readmission rates, lengths of stays, and complication rates. Our data showed a higher cost of primary surgery compared with revision surgery, although costs of sustaining postoperative complications were similar. This finding supports the decision to perform revision procedures in patients with ASD when indicated because neither outcomes nor costs are a hindrance to correction. Copyright © 2017 Elsevier Inc. All rights reserved.

Results of revision anterior shoulder stabilization surgery in adolescent athletes.

Science.gov (United States)

Blackman, Andrew J; Krych, Aaron J; Kuzma, Scott A; Chow, Roxanne M; Camp, Christopher; Dahm, Diane L

2014-11-01

The purpose of this study was to determine failure rates, functional outcomes, and risk factors for failure after revision anterior shoulder stabilization surgery in high-risk adolescent athletes. Adolescent athletes who underwent primary anterior shoulder stabilization were reviewed. Patients undergoing subsequent revision stabilization surgery were identified and analyzed. Failure rates after revision surgery were assessed by Kaplan-Meier analysis. Failure was defined as recurrent instability requiring reoperation. Functional outcomes included the Marx activity score; American Shoulder and Elbow Surgeons score; and University of California, Los Angeles score. The characteristics of patients who required reoperation for recurrent instability after revision surgery were compared with those of patients who required only a single revision to identify potential risk factors for failure. Of 90 patients who underwent primary anterior stabilization surgery, 15 (17%) had failure and underwent revision surgery (mean age, 16.6 years; age range, 14 to 18 years). The mean follow-up period was 5.5 years (range, 2 to 12 years). Of the 15 revision patients, 5 (33%) had recurrent dislocations and required repeat revision stabilization surgery at a mean of 50 months (range, 22 to 102 months) after initial revision. No risk factors for failure were identified. The Kaplan-Meier reoperation-free estimates were 86% (95% confidence interval, 67% to 100%) at 24 months and 78% (95% confidence interval, 56% to 100%) at 48 months after revision surgery. The mean final Marx activity score was 14.8 (range, 5 to 20); American Shoulder and Elbow Surgeons score, 82.1 (range, 33 to 100); and University of California, Los Angeles score, 30.8 (range, 16 to 35). At 5.5 years' follow-up, adolescent athletes had a high failure rate of revision stabilization surgery and modest functional outcomes. We were unable to convincingly identify specific risk factors for failure of revision surgery. Level IV

Revision washout decreases implant capsule tissue culture positivity: a multicenter study.

Science.gov (United States)

Henry, Gerard D; Carson, Culley C; Wilson, Steven K; Wiygul, Jeremy; Tornehl, Chris; Cleves, Mario A; Simmons, Caroline J; Donatucci, Craig F

2008-01-01

Positive cultures, visible biofilm and confocal micrography confirm bacterial presence on clinically uninfected inflatable penile prostheses at revision surgery. Salvage irrigation has been proved to rescue patients with clinically infected inflatable penile prostheses. Similar washout at revision for noninfectious reasons significantly lowers subsequent infection rates. We investigated a larger series of patients for positive culture rates and evaluated implant capsule tissue culture rates before and after revision washout. At 4 institutions a total of 148 patients with inflatable penile prostheses underwent revision surgery for noninfectious reasons between June 2001 and September 2005. Swab cultures of the fluid around the pump and visible biofilm were obtained. Also, in 65 patients a wedge of tissue from the capsule that forms around the pump was cultured. After implant removal revision washout of the implant spaces was performed and a second wedge of tissue was cultured. Of the 148 patients 97 (66%) had positive bacterial swab cultures of the fluid around the pump or biofilm. A total of 124 isolates were cultured. Of the 65 implant capsule tissue cultures obtained before washout 28 (43%) were positive for bacteria, while 16 (25%) obtained after revision washout were positive. Positive cultures and visible bacterial biofilm are present on clinically uninfected inflatable penile prostheses at revision surgery in most patients. Revision washout appears to decrease the bacterial load on implant capsule tissue at revision surgery of inflatable penile prostheses for noninfectious reasons.

OPERABILITY RATE OF DISTAL GASTRIC CANCER AND THE EFFECT OF GASTRIC OUTLET OBSTRUCTION IN THE OPERABILITY RATE AND POSTOPERATIVE OUTCOME- A RETROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Rajesh T. R

2017-10-01

Full Text Available BACKGROUND Stomach cancer is the fourth most common malignancy in the world. 1 Except in countries where screening for stomach cancer is prevalent, most of the distal stomach tumours are diagnosed at advanced stage. Gastric outlet obstruction is usually believed to be a sign of locally-advanced disease. Complete surgical removal of the disease (R0 is the only potentially curative treatment for resectable gastric cancer. The aim of the study is to finda The operability rate of gastric cancer in our institution and the incidence of Gastric Outlet Obstruction (GOO in patients undergoing gastrectomy for distal gastric cancer. b To compare the postoperative outcome in patients with gastric outlet obstruction and those without gastric outlet obstruction. c To see if the histology of the tumour has any role in the development of GOO. MATERIALS AND METHODS This is a retrospective study. The study includes patients who were admitted with carcinoma stomach and underwent operative or nonoperative treatment in our institution during 2013 to 2015. RESULTS Overall operability rate was 45.8%. Operable patients in the GOO group were 47%. Operability in the no outlet obstruction group were 45%. Data shows a slightly increased predilection for GOO in diffuse and mixed type of tumours (statistically not significant. Intestinal tumours had significant rate of anaemia compared to diffuse tumours (p <0.005. Overall mortality was 6.7%. Mortality is higher in the GOO group (8.8%. CONCLUSION (a. Operability rate of distal gastric cancer in our institution is 45.8%. (b. Incidence of gastric outlet obstruction in patients undergoing gastrectomy is 38.2%. (c. Presence of gastric outlet obstruction does not influence operability rate (47% vs. 45%. (d. Morbidity and mortality after distal radical gastrectomy is comparable in both groups. (e. Both intestinal and diffuse histology have equal incidence of GOO. (f. Chronic blood loss and incidence of anaemia is more in

ATLAS trigger operations: Monitoring with “Xmon” rate prediction system

CERN Document Server

Aukerman, Andrew Todd; The ATLAS collaboration

2017-01-01

We present the operations and online monitoring with the “Xmon” rate prediction system for the trigger system at the ATLAS Experiment. A two-level trigger system reduces the LHC’s bunch-crossing rate, 40 MHz at design capacity, to an average recording rate of about 1 kHz, while maintaining a high efficiency of selecting events of interest. The Xmon system uses the luminosity value to predict trigger rates that are, in turn, compared with incoming rates. The predictions rely on past runs to parameterize the luminosity dependency of the event rate for a trigger algorithm. Some examples are given to illustrate the performance of the tool during recent operations.

[APPLICATION OF COMPUTER-ASSISTED TECHNOLOGY IN ANALYSIS OF REVISION REASON OF UNICOMPARTMENTAL KNEE ARTHROPLASTY].

Science.gov (United States)

Jia, Di; Li, Yanlin; Wang, Guoliang; Gao, Huanyu; Yu, Yang

2016-01-01

To conclude the revision reason of unicompartmental knee arthroplasty (UKA) using computer-assisted technology so as to provide reference for reducing the revision incidence and improving the level of surgical technique and rehabilitation. The relevant literature on analyzing revision reason of UKA using computer-assisted technology in recent years was extensively reviewed. The revision reasons by computer-assisted technology are fracture of the medial tibial plateau, progressive osteoarthritis of reserved compartment, dislocation of mobile bearing, prosthesis loosening, polyethylene wear, and unexplained persistent pain. Computer-assisted technology can be used to analyze the revision reason of UKA and guide the best operating method and rehabilitation scheme by simulating the operative process and knee joint activities.

Do Rerevision Rates Differ After First-time Revision of Primary THA With a Cemented and Cementless Femoral Component?

DEFF Research Database (Denmark)

Gromov, Kirill; Pedersen, Alma B; Overgaard, Søren

2015-01-01

) and 2 years (range, 0-16 years), respectively. Survival of first revision THA, with second revision of the femur as outcome, was evaluated using hazard ratios (HRs) with 95% confidence interval (CI) adjusting for potential confounding. All patient- and surgery-related data are collected from Danish...... for the most likely confounding factors. Our data suggest that increased use of cementless fixation in primary THA may lead to inferior survivorship of first revision THA. Level III, therapeutic study....... the results of future revision procedures; however, this has not been documented. The purpose of this study was to compare (1) the risk for rerevision of first revision THA; (2) the patterns of femoral bone loss at the time of first revision of primary THA; (3) the reasons for first revision of primary THA...

Recurrens Rates and Affecting Factors in Patients Operated for Endometrioma

Directory of Open Access Journals (Sweden)

Cüneyt Eftal Taner

2008-09-01

Full Text Available OBJECTIVE: Our aim was to investigate reurrens rates and affecting factors in patients operated for endometrioma.\tMATERIAL-METHOD: The cases operated for over cyst diagnosis and pathologically endometrioma diagnosis between the years 2000-2004 has been reviewed retrospectively. Cases’s age, cyst diameter, endometriosis stage and operation procedure have been recorded and the cases that have recurrence and factors affecting recurrence are evaluated.\tRESULTS: Results: 51 of 137 (37.3% cases with endometrioma that have average age of 29.1 in course of operation ± 5.4 had left side, 37 of 137(27% had right side and 49 of 137 (35.7% had bilateral endometrioma. Average diameter of endometriomas was 5.1 ±1.9 cm (1-1.5 cm. After average 3.3±1.8 years from first operation time in 42 cases(30.6% had recurrence. in the left over recurrence rate was signifciantly high (10.8% to 41.2% than right over. For recurrence rate There were no significiant diference between the 102 cases that had laparoscopy and 35 cases that had laparotomy according to cyst diameter, case ages and type of operation.\tWhen the cases were reviewed according to endometriozis staging, There were significiantly high recurrence rate at stage III (28.9% and stage IV(46.0%. With respect to the operation type, patients that had one-sided ooferektomi,relapse is not seen. Patients that had fenestration and ablation as operation, relapse rate is 52.9% significiantly higher than patients that had kistektomi (26.9%.Despite decrease in preoperative complaints (dysmenorrhea, dyspareunia, chronic pelvic pain in early postoperative period, they recurred in late postoperative period. 47(56% of 84 patients who have fertility desire gave live birth unfortunately 12(14.3% of them.\tCONCLUSION: Recurrence rates were signifiantly higher in cases with lift sided endometrioma, advanced stafe of endometriosis and in patient udergone fenestration and ablation for treatment.

Improvement of rate of operation of LWRs, (2)

International Nuclear Information System (INIS)

Makiura, Ryutaro

1978-01-01

In the first part, the growing importance of improving the rate of operation of nuclear power plants is expressed in view of the big unit capacity of the present plants. The following parts of this report are devoted to the description of various measures for improving the reliability and the rate of operation of BWR plants from the standpoint of plant makers. The first subject is the early solution of ''singular troubles'', for example, the channel wear due to the oscillation of LPRM strings. The second subject is ''ordinary troubles'' such as valve leak and malfunction, deterioration of various parts, and vibration of pipes. The improvement of load factor is discussed in the third part in connection with the present efforts to abolish the PCIOMR operation and to employ the fine motion of control rod-driving mechanism. The final subject concerns with the efforts for shortening the time required for regular inspection. Review of inspection items and shortening of their required time, reduction of radiation exposure automated and remote-controlled operation, and intensive training of operators are the main subjects discussed here. (Aoki, K.)

NPP License Renewal and Aging Management: Revised Guidance

International Nuclear Information System (INIS)

Hull, A.B.; Hiser, A.L.; Lindo-Talin, S.E.

2012-01-01

Based on the Atomic Energy Act, the NRC issues licenses for commercial power reactors to operate for up to 40 years and allows these licenses to be renewed for up to another 20 years. NRC has approved license renewal (LR) for well over 50% of U.S. located reactors originally licensed to operate for 40 years. Of these 104 reactors (69 PWRs, 35 BWRs), the NRC has issued renewed licenses for 71 units and is currently reviewing applications for another 15 units. As of May 1, 2012, ten plants at nine sites had entered their 41st year of operation and thus are in their first period of extended operation (PEO). Five more plants will enter the PEO by the end of 2012. One foundation of the license renewal process has been license renewal guidance documents (LRGDs). The U.S. Nuclear Regulatory Commission (NRC) revised key guidance documents used for nuclear power LR in 2010 and 2011. These include NUREG-1800, 'Standard Review Plan for Review of License Renewal Applications,' revision 2 (SRP-LR), and NUREG-1801, 'Generic Aging Lessons Learned (GALL) Report,' revision 2 (GALL Report). The guidance documents were updated to reflect lessons learned and operating experience gained since the guidance documents were last issued in 2005. The reactor LRGDs referenced in this poster can all be accessed at http://www.nrc.gov/reactors/operating/licensing/renewal/guidance.html (author)

Revised Paris and Vienna Nuclear Liability Conventions - Challenges for Nuclear Insurers

International Nuclear Information System (INIS)

Tetley, M.

2006-01-01

The revisions recently implemented to both the Vienna and Paris nuclear liability Conventions are intended to widen significantly the amount and scope of compensation payable in the event of a nuclear accident. Whilst this is a laudable objective, the final extent of the revisions leaves nuclear site operators and their insurers with greater uncertainty as a result of the wider and unquantifiable nature of some aspects of the revised nuclear damage definition, in particular where reference is made to environmental reinstatement and extended prescription periods. Incorporating broader definitions in the Convention revisions will therefore leave gaps in the insurance cover where insurers are unable to insure the new, wider scope of cover. If no insurance is available, then the liability for the revised scope of cover must fall upon either the operator or the national Government. This presentation will give an overview of where and why the major gaps in nuclear liability insurance cover will occur in the revised Conventions; it will also examine the problems in defining the revised scope of cover and will look at where these unquantifiable risks should now reside, to ensure there is equity between the liabilities imposed on the nuclear industry and those imposed on other industrial sectors. (author)

Comparison of mode of failure between primary and revision total knee arthroplasties.

Science.gov (United States)

Liang, H; Bae, J K; Park, C H; Kim, K I; Bae, D K; Song, S J

2018-04-01

Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA. Data from a consecutive cohort comprising 1606 knees (1174 patients) of primary TKA patients, and 258 knees (224 patients) of revision TKA patients, in all of whom surgery involved a P.F.C ® prosthesis (Depuy, Johnson & Johnson, Warsaw, IN), was retrospectively reviewed. The mean follow-up periods of primary and revision TKAs were 9.2 and 9.8 years, respectively. The average 10- and 15-year survival rates for primary TKA were 96.7% (CI 95%,±0.7%) and 85.4% (CI 95%,±2.0%), and for revision TKA 91.4% (CI 95%,±2.5%) and 80.5% (CI 95%,±4.5%). Common modes of failure included polyethylene wear, loosening, and infection. The most common mode of failure was polyethylene wear in primary TKA, and infection in revision TKA. The mean periods (i.e., latencies) of polyethylene wear and loosening did not differ between primary and revision TKAs, but the mean period of infection was significantly longer for revision TKA (1.2 vs. 4.8 years, P=0.003). Survival rates decreased with time, particularly more than 10 years post-surgery, for both primary and revision TKAs. Continuous efforts are required to prevent and detect the various modes of failure during long-term follow-up. Greater attention is necessary to detect late infection-induced failure following revision TKA. Case-control study, Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Complexity rating of abnormal events and operator performance

International Nuclear Information System (INIS)

Oeivind Braarud, Per

1998-01-01

The complexity of the work situation during abnormal situations is a major topic in a discussion of safety aspects of Nuclear Power plants. An understanding of complexity and its impact on operator performance in abnormal situations is important. One way to enhance understanding is to look at the dimensions that constitute complexity for NPP operators, and how those dimensions can be measured. A further step is to study how dimensions of complexity of the event are related to performance of operators. One aspect of complexity is the operator 's subjective experience of given difficulties of the event. Another related aspect of complexity is subject matter experts ratings of the complexity of the event. A definition and a measure of this part of complexity are being investigated at the OECD Halden Reactor Project in Norway. This paper focus on the results from a study of simulated scenarios carried out in the Halden Man-Machine Laboratory, which is a full scope PWR simulator. Six crews of two licensed operators each performed in 16 scenarios (simulated events). Before the experiment subject matter experts rated the complexity of the scenarios, using a Complexity Profiling Questionnaire. The Complexity Profiling Questionnaire contains eight previously identified dimensions associated with complexity. After completing the scenarios the operators received a questionnaire containing 39 questions about perceived complexity. This questionnaire was used for development of a measure of subjective complexity. The results from the study indicated that Process experts' rating of scenario complexity, using the Complexity Profiling Questionnaire, were able to predict crew performance quite well. The results further indicated that a measure of subjective complexity could be developed that was related to crew performance. Subjective complexity was found to be related to subjective work load. (author)

Revision of infected knee arthroplasties in Denmark

DEFF Research Database (Denmark)

Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Bagger, Jens

2016-01-01

Background and purpose - The surgical treatment of periprosthetic knee infection is generally either a partial revision procedure (open debridement and exchange of the tibial insert) or a 2-stage exchange arthroplasty procedure. We describe the failure rates of these procedures on a nationwide...... basis. Patients and methods - 105 partial revisions (100 patients) and 215 potential 2-stage revision procedures (205 patients) performed due to infection from July 1, 2011 to June 30, 2013 were identified from the Danish Knee Arthroplasty Register (DKR). Failure was defined as surgically related death...

Rhinoplasty for the multiply revised nose.

Science.gov (United States)

Foda, Hossam M T

2005-01-01

To evaluate the problems encountered on revising a multiply operated nose and the methods used in correcting such problems. The study included 50 cases presenting for revision rhinoplasty after having had 2 or more previous rhinoplasties. An external rhinoplasty approach was used in all cases. Simultaneous septal surgery was done whenever indicated. All cases were followed for a mean period of 32 months (range, 1.5-8 years). Evaluation of the surgical result depended on clinical examination, comparison of pre- and postoperative photographs, and degree of patients' satisfaction with their aesthetic and functional outcome. Functionally, 68% suffered nasal obstruction that was mainly caused by septal deviations and nasal valve problems. Aesthetically, the most common deformities of the upper two thirds of the nose included pollybeak (64%), dorsal irregularities (54%), dorsal saddle (44%), and open roof deformity (42%), whereas the deformities of lower third included depressed tip (68%), tip contour irregularities (60%), and overrotated tip (42%). Nasal grafting was necessary in all cases; usually more than 1 type of graft was used in each case. Postoperatively, 79% of the patients, with preoperative nasal obstruction, reported improved breathing; 84% were satisfied with their aesthetic result; and only 8 cases (16%) requested further revision to correct minor deformities. Revision of a multiply operated nose is a complex and technically demanding task, yet, in a good percentage of cases, aesthetic as well as functional improvement are still possible.

Clinical Outcomes of Reoperation for Failed Antireflux Operations.

Science.gov (United States)

Wilshire, Candice L; Louie, Brian E; Shultz, Dale; Jutric, Zeljka; Farivar, Alexander S; Aye, Ralph W

2016-04-01

Up to 18% of patients undergoing antireflux operations will require reoperation. Authors caution that with each additional reoperation, fewer patients achieve satisfaction. The quality of life in patients who underwent revision operations was compared with patients who underwent primary antireflux operations to determine the effectiveness of revision operations. We retrospectively reviewed patients who underwent revision after failed antireflux operations from 2004 to 2014. Patients were divided into two groups: first reoperation (Reop[1]) and more than one reoperation (Reop[>1]). For comparison, a control group of patients who underwent primary antireflux operations was included. Patients underwent quality of life assessment preoperatively and postoperatively. We identified 105 reoperative patients: 94 Reop(1), 11 Reop(>1), and 112 controls. The primary reason for failure was combined fundoplication herniation and slippage. Morbidity, mortality, and readmission rates were similar in all groups. Postoperative outcomes were improved in all groups but to a lesser degree in subsequent reoperations. Gastroesophageal Reflux Disease Health-Related Quality of Life: controls, 20.0 to 2.0; Reop(1), 26.5 to 4.0; and Reop(>1), 13.0 to 2.0. Quality of Life in Reflux and Dyspepsia: controls, 4.5 to 7.0; Reop(1), 3.7 to 6.7; and Reop(>1), 3.5 to 5.8. Dysphagia Severity Score: controls, 44.0 to 45.0; Reop(1), 36.0 to 45.0; and Reop(>1), 30.8 to 45.0. Patients undergoing revision antireflux operations have improved quality of life, relatively normal swallowing, and primary symptom resolution at a median of 20 months postoperatively. However, patients who undergo more than one reoperation have lower quality of life scores and less improvement in dysphagia, suggesting that other procedures such as Roux-en-Y or short colon interposition, should be considered after a failed initial reoperation. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights

75 FR 36126 - Office of New Reactors; Proposed Revision to Standard Review Plan Section 13.6.1, Revision 1 on...

Science.gov (United States)

2010-06-24

... Standard Review Plan Section 13.6.1, Revision 1 on Physical Security--Combined License and Operating...), Section 13.6.1 on ``Physical Security--Combined License and Operating Reactors,'' (Agencywide Documents Access and Management System (ADAMS) Accession No. ML100350158). The Office of Nuclear Security and...

Closed cooling water chemistry guidelines revision

International Nuclear Information System (INIS)

McElrath, Joel; Breckenridge, Richard

2014-01-01

This second revision of the Closed Cooling Water Chemistry Guideline addresses the use of chemicals and monitoring methods to mitigate corrosion, fouling, and microbiological growth in the closed cooling-water (CCW) systems of nuclear and fossil-fueled power plants. This revision has been endorsed by the utility chemistry community and represents another step in developing a more proactive chemistry program to limit or control closed cooling system degradation with increased consideration of corporate resources and plant-specific design and operating concerns. These guidelines were developed using laboratory data, operating experience, and input from organizations and utilities within and outside of the United States of America. It is the intent of the Revision Committee that these guidelines are applicable to all nuclear and fossil-fueled generating stations around the world. A committee of industry experts—including utility specialists, Institute of Nuclear Power Operations representatives, water-treatment service-company representatives, consultants, a primary contractor, and EPRI staff—collaborated in reviewing available data on closed cooling-water system corrosion and microbiological issues. Recognizing that each plant owner has a unique set of design, operating, and corporate concerns, the Guidelines Committee developed a methodology for plant-specific optimization. The guideline provides the technical basis for a reasonable but conservative set of chemical treatment and monitoring programs. The use of operating ranges for the various treatment chemicals discussed in this guideline will allow a power plant to limit corrosion, fouling, and microbiological growth in CCW systems to acceptable levels. The guideline now includes closed cooling chemistry regimes proven successful in use in the international community. The guideline provides chemistry constraints for the use of phosphates control, as well as pure water with pH control. (author)

Cross-cultural adaptation and validation of als Functional Rating Scale-Revised in Portuguese language.

Science.gov (United States)

Guedes, Keyte; Pereira, Cecília; Pavan, Karina; Valério, Berenice Cataldo Oliveira

2010-02-01

The aim of this study is the cross-cultural, as well as to validate in Portuguese language the Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (ALSFRS-R). We performed a prospective study of individuals with amyotrophic lateral sclerosis (ALS) clinically defined. The scale, after obtaining the final version in Portuguese, was administered in 22 individuals and three weeks after re-applied. There were no significant differences between the application and reapplication of the scale (p=0.069). The linear regression and internal consistency measured by Pearson correlation and alpha Conbrach were significant with r=0.975 e alpha=0.934. The reliability test-retest demonstrated by intraclass correlation coefficient was strong with ICC=0.975. Therefore, this version proved to be applicable, reliable and easy to be conducted in clinical practice and research.

Revision of migrated pelvic acetabular components in THA with or without vascular involvement

Directory of Open Access Journals (Sweden)

Ștefan Cristea

2016-05-01

Full Text Available Purpose. The literature describes a high rate of mortality in cases of intrapelvic acetabular component migration, which is a rare but serious complication. Our aim is to establish and propose a treatment protocol according to our results and experience. Material and Methods. We performed eight (8 total hip revisions with acetabular cup migration between 2006 and 2012. A vascular graft was needed in four (4 of these cases. Two (2 cases were revisions after a spacer for infected arthroplasties. The protocol included the following: X-Ray examination (frontal and lateral views, CT angiography, a biological evaluation, a suitable pre-operative plan, at least six (6 units of blood stock, an experienced anesthesiologist, an experienced surgical team that included a vascular surgeon and a versatile arsenal of revision prostheses, bone grafts and vascular grafts. The anterolateral approach was generally used for hip revisions and the retroperitoneal approach in the dorsal decubitus position was used when vascular risk was involved. Results: The acetabular defect was reconstructed using bone grafts and tantalum revision cups in 4 cases, Burch-Schneider cages in 2 cases, a Kerboull ring in 1 case and a cementless oblong cup (Cotyle Espace in 1 case. In 4 cases, an iliac vessel graft procedure was conducted by the vascular surgeon. All patients survived the revision procedures and returned regularly for subsequent check-ups, during which they did not show any septic complications. Conclusions: Intrapelvic acetabular cup migration is a rare but serious complication that can occur after total hip arthroplasty in either septic or aseptic cases. An experienced, multidisciplinary team of surgeons should be involved in planning and conducting such complicated revisions.

Descriptor revision belief change through direct choice

CERN Document Server

Hansson, Sven Ove

2017-01-01

This book provides a critical examination of how the choice of what to believe is represented in the standard model of belief change. In particular the use of possible worlds and infinite remainders as objects of choice is critically examined. Descriptors are introduced as a versatile tool for expressing the success conditions of belief change, addressing both local and global descriptor revision. The book presents dynamic descriptors such as Ramsey descriptors that convey how an agent’s beliefs tend to be changed in response to different inputs. It also explores sentential revision and demonstrates how local and global operations of revision by a sentence can be derived as a special case of descriptor revision. Lastly, the book examines revocation, a generalization of contraction in which a specified sentence is removed in a process that may possibly also involve the addition of some new information to the belief set.

Rate of revisions or conversion after bariatric surgery over 10 years in the state of New York.

Science.gov (United States)

Altieri, Maria S; Yang, Jie; Nie, Lizhou; Blackstone, Robin; Spaniolas, Konstantinos; Pryor, Aurora

2018-04-01

A primary measure of the success of a procedure is the whether or not additional surgery may be necessary. Multi-institutional studies regarding the need for reoperation after bariatric surgery are scarce. The purpose of this study is to evaluate the rate of revisions/conversions (RC) after 3 common bariatric procedures over 10 years in the state of New York. University Hospital, involving a large database in New York State. The Statewide Planning and Research Cooperative System database was used to identify all patients undergoing laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) between 2004 and 2010. Patients were followed for RC to other bariatric procedures for at least 4 years (up to 2014). Multivariable cox proportional hazard regression analysis was performed to identify risk factors for additional surgery after each common bariatric procedure. Multivariable logistic regression was used to check the factors associated with having ≥2 follow-up procedures. There were 40,994 bariatric procedures with 16,444 LAGB, 22,769 RYGB, and 1781 SG. Rate of RC was 26.0% for LAGB, 9.8% for SG, and 4.9% for RYGB. Multiple RC ( = />2) were more common for LAGB (5.7% for LAGB, .5% for RYGB, and .2% for LSG). Band revision/replacements required further procedures compared with patients who underwent conversion to RYGB/SG (939 compared with 48 procedures). Majority of RC were not performed at initial institution (68.2% of LAGB patients, 75.9% for RYGB, 63.7% of SG). Risk factors for multiple procedures included surgery type, as LAGB was more likely to have multiple RC. Reoperation was common for LAGB, but less common for RYGB (4.9%) and SG (9.8%). RC rate are almost twice after SG than after RYGB. LAGB had the highest rate (5.7%) of multiple reoperations. Conversion was the procedure of choice after a failed LAGB. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Poorer survival after a primary implant during revision total knee arthroplasty

NARCIS (Netherlands)

Meijer, Marrigje F.; Reininga, Inge H. F.; Boerboom, Alexander L.; Stevens, Martin; Bulstra, Sjoerd K.

Revision total knee arthroplasty (rTKA) is a complex procedure. Depending on the degree of ligament and bone damage, either primary or revision implants are used. The purpose of this study was to compare survival rates of primary implants with revision implants when used during rTKA. A retrospective

Prediction of the time-dependent failure rate for normally operating components taking into account the operational history

International Nuclear Information System (INIS)

Vrbanic, I.; Simic, Z.; Sljivac, D.

2008-01-01

The prediction of the time-dependent failure rate has been studied, taking into account the operational history of a component used in applications such as system modeling in a probabilistic safety analysis in order to evaluate the impact of equipment aging and maintenance strategies on the risk measures considered. We have selected a time-dependent model for the failure rate which is based on the Weibull distribution and the principles of proportional age reduction by equipment overhauls. Estimation of the parameters that determine the failure rate is considered, including the definition of the operational history model and likelihood function for the Bayesian analysis of parameters for normally operating repairable components. The operational history is provided as a time axis with defined times of overhauls and failures. An example for demonstration is described with prediction of the future behavior for seven different operational histories. (orig.)

Prolonged operative time increases infection rate in tibial plateau fractures.

Science.gov (United States)

Colman, Matthew; Wright, Adam; Gruen, Gary; Siska, Peter; Pape, Hans-Christoph; Tarkin, Ivan

2013-02-01

Fractures of the tibial plateau present a treatment challenge and are susceptible to both prolonged operative times and high postoperative infection rates. For those fractures treated with open plating, we sought to identify the relationship between surgical site infection and prolonged operative time as well as to identify other surgical risk factors. We performed a retrospective controlled analysis of 309 consecutive unicondylar and bicondylar tibial plateau fractures treated with open plate osteosynthesis at our institution's level I trauma centre during a recent 5-year period. We recorded operative times, injury characteristics, surgical treatment, and need for operative debridement due to infection. Operative times of infected cases were compared to uncomplicated surgical cases. Multivariable logistic regression analysis was performed to identify independent risk factors for postoperative infection. Mean operative time in the infection group was 2.8h vs. 2.2h in the non-infected group (p=0.005). 15 fractures (4.9%) underwent four compartment fasciotomies as part of their treatment, with a significantly higher infection rate than those not undergoing fasciotomy (26.7% vs. 6.8%, p=0.01). Open fracture grade was also significantly related to infection rate (closed fractures: 5.3%, grade 1: 14.3%, grade 2: 40%, grade 3: 50%, pinfection rates (13.9% vs. 8.7%, p=0.36). Multivariable logistic regression analysis of the entire study group identified longer operative times (OR 1.78, p=0.013) and open fractures (OR 7.02, psite infection. Operative times approaching 3h and open fractures are related to an increased overall risk for surgical site infection after open plating of the tibial plateau. Dual incision approaches with bicolumnar plating do not appear to expose the patient to increased risk compared to single incision approaches. Copyright © 2012 Elsevier Ltd. All rights reserved.

23 CFR 636.409 - Can offerors revise their proposals during communications?

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Can offerors revise their proposals during communications? 636.409 Section 636.409 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS DESIGN-BUILD CONTRACTING Exchanges § 636.409 Can offerors revise their...

Complications Following Primary and Revision Transsphenoidal Surgeries for Pituitary Tumors

Science.gov (United States)

Krings, James G.; Kallogjeri, Dorina; Wineland, Andre; Nepple, Kenneth G.; Piccirillo, Jay F.; Getz, Anne E.

2014-01-01

Objective This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications, respiratory failure, and death. Secondarily, this study aimed to examine factors associated with the occurrence of complications. Study Design Retrospective cohort analysis of California and Florida all-payer databases from 2005-2008. Methods The major complication rate following both primary and revision transsphenoidal pituitary surgery was calculated. Bivariate analyses were performed to investigate the relationship of patient characteristics with complication occurrence, and a multivariate model was constructed to determine risk factors associated with these complications. Results 5,277 primary cases and 192 revision cases met inclusion criteria. There was a non-significant absolute difference of 3.09% (95% CI −11.00 to 16.14) between the rate of complications following primary (n=443; 8.39%) and revision (n=22; 11.46%) surgeries. Multivariate analyses showed that patients with Medicare (OR=1.74; 95% CI 1.17 to 2.61), Medicaid (OR=2.13; 95% CI 1.59 to 2.86), or a malignant neoplasm (OR=3.10; 95% CI 1.62 to 5.93) were more likely to have complications. Conclusions The rate of major complications following transsphenoidal pituitary surgery is lower than earlier retrospective reports. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications. PMID:25263939

Analysis of gross error rates in operation of commercial nuclear power stations

International Nuclear Information System (INIS)

Joos, D.W.; Sabri, Z.A.; Husseiny, A.A.

1979-01-01

Experience in operation of US commercial nuclear power plants is reviewed over a 25-month period. The reports accumulated in that period on events of human error and component failure are examined to evaluate gross operator error rates. The impact of such errors on plant operation and safety is examined through the use of proper taxonomies of error, tasks and failures. Four categories of human errors are considered; namely, operator, maintenance, installation and administrative. The computed error rates are used to examine appropriate operator models for evaluation of operator reliability. Human error rates are found to be significant to a varying degree in both BWR and PWR. This emphasizes the import of considering human factors in safety and reliability analysis of nuclear systems. The results also indicate that human errors, and especially operator errors, do indeed follow the exponential reliability model. (Auth.)

Microbiological diagnosis in revision of infected knee arthroplasties in Denmark

DEFF Research Database (Denmark)

Lindberg-Larsen, Martin; Pitter, Frederik Taylor; Voldstedlund, Marianne

2017-01-01

. METHODS: One hundred and two partial revisions (open debridement and exchange of tibial insert) and 213 two-stage procedures performed due to infection in 275 patients from 1 July 2011 to 30 June 2013 were included and analysed by linkage to data from a nationwide registry on microbiological test results....... RESULTS: 78 (24.8%) revisions were culture negative, 192 (60.9%) showed monomicrobial growth and 43 (14.3%) polymicrobial growth. Staphylococcus aureus was the most frequent isolate in mono-culture in 70 (22.2%) revisions and in polymicrobial culture in 15 revisions with a total frequency of 27.0%. Only...... one case (1.4%) of methicillin-resistance was registered. Coagulase-negative staphylococci (CoNS) were frequent, sole pathogen in 65 revisions and in polymicrobial cultures in 28 revisions with a total frequency of 29.5%. A pre-operative knee aspiration was performed in 50% and preoperative blood...

Revision of failed hemiarthroplasty for painful glenoid arthrosis to anatomic total shoulder arthroplasty.

Science.gov (United States)

Sheth, Mihir M; Sholder, Daniel; Abboud, Joseph; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Namdari, Surena

2018-05-10

The impending burden of revision shoulder arthroplasty has increased interest in outcomes of revision procedures. Painful glenoid arthrosis following hemiarthroplasty is a common cause of reoperation, and conversion to anatomic total shoulder arthroplasty is one option. We identified patients who underwent revision of painful hemiarthroplasty to total shoulder arthroplasty over a 15-year period in a single tertiary-care health system. Presurgical and operative data were analyzed for 28 patients who met the inclusion and exclusion criteria. Patients were contacted at a minimum of 2 years' follow-up after revision surgery for functional outcome scores, reoperations, and implant survival. The 2- and 5-year implant survival rates were 93% and 86%, respectively. Functional outcomes were obtained from 21 patients with surviving implants. The mean American Shoulder and Elbow Surgeons score, visual analog scale score for pain, and Single Assessment Numerical Evaluation score were 78 ± 20, 2.3 ± 2.6, and 71 ± 24, respectively. The mean Short Form 12 mental and physical scores were 49 ± 10 and 43 ± 9, respectively. Of the patients, 17 (81%) were either satisfied or very satisfied with their outcome. Complications were seen in 10 patients (36%), and 6 patients (21%) required reoperation. Anatomic total shoulder arthroplasty following hemiarthroplasty can achieve successful outcomes and implant survival rates. Given our poor understanding of reverse shoulder arthroplasty longevity, this procedure should remain an option for patients with glenoid arthrosis and an intact rotator cuff. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Age and Early Revision After Primary Total Hip Arthroplasty for Osteoarthritis.

Science.gov (United States)

Meyer, Zachary; Baca, Geneva; Rames, Richard; Barrack, Robert; Clohisy, John; Nam, Denis

2017-11-01

Prior reports have noted an increased risk of early revision among younger patients undergoing total hip arthroplasty (THA) but have been confounded by the inclusion of various diagnoses. The purpose of this study was to assess the revision rate and the time to revision for patients undergoing THA for osteoarthritis based on age. Patients with a diagnosis of osteoarthritis who underwent both primary and revision THA at the same institution were identified. The time between primary and revision surgery and the indication for revision were collected. Patients were stratified into 2 groups based on age at the time of primary THA: 64 years or younger (group 1) or 65 years or older (group 2). Between 1996 and 2016, a total of 4662 patients (5543 hips) underwent primary THA for a diagnosis of osteoarthritis. Of these, 100 patients (104 hips) received a revision THA (62 in group 1 and 42 in group 2). Mean age was 52.7±8.4 years in group 1 vs 73.4±6.3 years in group 2 (Pprimary to revision surgery was 3.0±3.2 years for group 1 and 1.1±2.1 years for group 2 (P=.001). Among patients undergoing primary THA for a diagnosis of osteoarthritis, younger age is not associated with an increased rate of early failure or revision. [Orthopedics. 2017; 40(6):e1069-e1073.]. Copyright 2017, SLACK Incorporated.

New and revised standards for coke production

Energy Technology Data Exchange (ETDEWEB)

G.A. Kotsyuba; M.I. Alpatov; Y.G. Shapoval [Giprokoks, the State Institute for the Design of Coke-Industry Enterprises, Kharkov (Ukraine)

2009-07-15

The need for new and revised standards for coke production in Ukraine and Russia is outlined. Such standards should address improvements in plant operation, working conditions, environmental protection, energy conservation, fire and explosion safety, and economic indices.

Plastic surgeons' self-reported operative infection rates at a Canadian academic hospital.

Science.gov (United States)

Ng, Wendy Ky; Kaur, Manraj Nirmal; Thoma, Achilleas

2014-01-01

Surgical site infection rates are of great interest to patients, surgeons, hospitals and third-party payers. While previous studies have reported hospital-acquired infection rates that are nonspecific to all surgical services, there remain no overall reported infection rates focusing specifically on plastic surgery in the literature. To estimate the reported surgical site infection rate in plastic surgery procedures over a 10-year period at an academic hospital in Canada. A review was conducted on reported plastic surgery surgical site infection rates from 2003 to 2013, based on procedures performed in the main operating room. For comparison, prospective infection surveillance data over an eight-year period (2005 to 2013) for nonplastic surgery procedures were reviewed to estimate the overall operative surgical site infection rates. A total of 12,183 plastic surgery operations were performed from 2003 to 2013, with 96 surgical site infections reported, corresponding to a net operative infection rate of 0.79%. There was a 0.49% surgeon-reported infection rate for implant-based procedures. For non-plastic surgery procedures, surgical site infection rates ranged from 0.04% for cataract surgery to 13.36% for high-risk abdominal hysterectomies. The plastic surgery infection rate at the study institution was found to be site infection rates. However, these results do not report patterns of infection rates germane to procedures, season, age groups or sex. To provide more in-depth knowledge of this topic, multicentre studies should be conducted.

Revising Translations

DEFF Research Database (Denmark)

Rasmussen, Kirsten Wølch; Schjoldager, Anne

2011-01-01

The paper explains the theoretical background and findings of an empirical study of revision policies, using Denmark as a case in point. After an overview of important definitions, types and parameters, the paper explains the methods and data gathered from a questionnaire survey and an interview...... survey. Results clearly show that most translation companies regard both unilingual and comparative revisions as essential components of professional quality assurance. Data indicate that revision is rarely fully comparative, as the preferred procedure seems to be a unilingual revision followed by a more...... or less comparative rereading. Though questionnaire data seem to indicate that translation companies use linguistic correctness and presentation as the only revision parameters, interview data reveal that textual and communicative aspects are also considered. Generally speaking, revision is not carried...

The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R). A Validation Study of a Rating Scale for Adults

Science.gov (United States)

Andersen, Lisa M. J.; Naswall, Katharina; Manouilenko, Irina; Nylander, Lena; Edgar, Johan; Ritvo, Riva Ariella; Ritvo, Edward; Bejerot, Susanne

2011-01-01

There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75…

Operator licensing examiner standards

International Nuclear Information System (INIS)

1983-10-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience

Problems of rotator cuff re-tear cases. Examination of operative findings

International Nuclear Information System (INIS)

Ishitani, Eiichi; Matsuura, Komei; Shin, Kunichika; Kawamoto, Taisaku; Hosokawa, Akira

2007-01-01

High re-tear rate is reported after rotator cuff repair in large and massive tear cases. Previously, we reported that 15% of patients after rotator cuff repair showed re-tear in MRI findings. In this study, 116 consecutive rotator cuff repaired patients who had been operated arthroscopically since 2003 were evaluated for size, torn site, fixation methods, mobility, and tendon quality. In addition, rehabilitation methods and occupation after revision were also evaluated. There were four patients who underwent re-operation. Rotator cuff repairs by revision surgery failed mechanically due to two reasons: the main factor of failure was suture material breakage in three cases and the second was tendon pulling through sutures in one case. The lack of thread strength was suggested. In addition, it is important to pull cuff stump to greater tubercle without excessive tension. Of re-operated cases, three engaging in manual labor suffered large and massive tear. In two cases, premature return to manual labor suggested cause of re-tear. (author)

W-087 Operational test report. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Joshi, A.W.

1997-06-10

This Acceptance Test Procedure/Operational Test Procedure (ATP/OTP) has been prepared to demonstrate that the Electrical/Instrumentation and Mechanical systems function as required by project criteria and to verify proper operation of the integrated system including the interlocks. The equipment to be tested includes the following: a. Leak detection system operation and controls. b. Electrical interlocks.- C. Transfer pump oper ation. d. Vacuum breaker system interlocks.

Lower rates of symptom recurrence and surgical revision after primary compared with secondary endoscopic third ventriculostomy for obstructive hydrocephalus secondary to aqueductal stenosis in adults.

Science.gov (United States)

Sankey, Eric W; Goodwin, C Rory; Jusué-Torres, Ignacio; Elder, Benjamin D; Hoffberger, Jamie; Lu, Jennifer; Blitz, Ari M; Rigamonti, Daniele

2016-05-01

OBJECT Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus; however, the success of ETV in patients who have previously undergone shunt placement remains unclear. The present study analyzed 103 adult patients with aqueductal stenosis who underwent ETV for obstructive hydrocephalus and evaluated the effect of previous shunt placement on post-ETV outcomes. METHODS This study was a retrospective review of 151 consecutive patients who were treated between 2007 and 2013 with ETV for hydrocephalus. One hundred three (68.2%) patients with aqueductal stenosis causing obstructive hydrocephalus were included in the analysis. Postoperative ETV patency and aqueductal and cisternal flow were assessed by high-resolution, gradient-echo MRI. Post-ETV Mini-Mental State Examination, Timed Up and Go, and Tinetti scores were compared with preoperative values. Univariate and multivariate analyses were performed comparing the post-ETV outcomes in patients who underwent a primary (no previous shunt) ETV (n = 64) versus secondary (previous shunt) ETV (n = 39). RESULTS The majority of patients showed significant improvement in symptoms after ETV; however, no significant differences were seen in any of the quantitative tests performed during follow-up. Symptom recurrence occurred in 29 (28.2%) patients after ETV, after a median of 3.0 (interquartile range 0.8-8.0) months post-ETV failure. Twenty-seven (26.2%) patients required surgical revision after their initial ETV. Patients who received a secondary ETV had higher rates of symptom recurrence (p = 0.003) and surgical revision (p = 0.003), particularly in regard to additional shunt placement/revision post-ETV (p = 0.005). These differences remained significant after multivariate analysis for both symptom recurrence (p = 0.030) and surgical revision (p = 0.043). CONCLUSIONS Patients with obstructive hydrocephalus due to aqueductal stenosis exhibit symptomatic improvement after ETV, with a

Containment leakage rate testing requirements

International Nuclear Information System (INIS)

Arndt, E.G.

1992-01-01

This report presents the status of several documents under revision or development that provide requirements and guidance for testing nuclear power plant containment systems for leakage rates. These documents include the general revision to 10 CFR Part 50, Appendix J; the regulatory guide affiliated with the revision to Appendix J; the national standard that the regulatory guide endorses, ANSI/ANS-56.8, 'Containment System Leakage Rate Testing Requirements'; and the draft industry Licensing Topical Report, 'Standardized Program for Primary Containment Integrity Testing'. The actual or potential relationships between these documents are also explored

Revision surgery for failed thermal capsulorrhaphy.

Science.gov (United States)

Park, Hyung Bin; Yokota, Atsushi; Gill, Harpreet S; El Rassi, George; McFarland, Edward G

2005-09-01

With the failure of thermal capsulorrhaphy for shoulder instability, there have been concerns with capsular thinning and capsular necrosis affecting revision surgery. To report the findings at revision surgery for failed thermal capsulorrhaphy and to evaluate the technical effects on subsequent revision capsular plication. Case series; Level of evidence, 4. Fourteen patients underwent arthroscopic evaluation and open reconstruction for a failed thermal capsulorrhaphy. The cause of the failure, the quality of the capsule, and the ability to suture the capsule were recorded. The patients were evaluated at follow-up for failure, which was defined as recurrent subluxations or dislocations. The origin of the instability was traumatic (n = 6) or atraumatic (n = 8). At revision surgery in the traumatic group, 4 patients sustained failure of the Bankart repair with capsular laxity, and the others experienced capsular laxity alone. In the atraumatic group, all patients experienced capsular laxity as the cause of failure. Of the 14 patients, the capsule quality was judged to be thin in 5 patients and ablated in 1 patient. A glenoid-based capsular shift could be accomplished in all 14 patients. At follow-up (mean, 35.4 months; range, 22 to 48 months), 1 patient underwent revision surgery and 1 patient had a subluxation, resulting in a failure rate of 14%. Recurrent capsular laxity after failed thermal capsular shrinkage is common and frequently associated with capsular thinning. In most instances, the capsule quality does not appear to technically affect the revision procedure.

Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes.

Science.gov (United States)

Borzych-Duzalka, Dagmara; Aki, T Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A

2017-01-06

Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk

Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

Science.gov (United States)

Aki, T. Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A.

2017-01-01

Background and objectives Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Design, setting, participants, & measurements Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. Results In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1

78 FR 59982 - Revisions to Radiation Protection

Science.gov (United States)

2013-09-30

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0268] Revisions to Radiation Protection AGENCY: Nuclear..., ``Radiation Sources,'' Section 12.3 -12.4, ``Radiation Protection Design Features,'' and Section 12.5, ``Operational Radiation Protection Program.'' DATES: The effective date of this Standard Review Plan update is...

Maximum surgical blood ordering schedules for revision lower limb arthroplasty.

Science.gov (United States)

Mahadevan, Devendra; Challand, Christopher; Clarke, Andrew; Keenan, Jonathan

2011-05-01

Effective utilisation of blood products is fundamental. The introduction of maximum surgical blood ordering schedules (MSBOS) for operations has been shown to improve transfusion services. A retrospective analysis was undertaken to establish an evidence-based MSBOS for revision total hip replacement (THR) and total knee revision (TKR). The impact of this schedule on blood conservation was analysed. A retrospective analysis was undertaken on 397 patients who underwent revision THR and TKR over a 4-year period. The cross-match-to-transfusion ratio (CTR) and transfusion index (TI) were calculated. A MSBOS protocol was created based on the TIs and its' impact on transfusion services was assessed prospectively on 125 patients by comparing CTRs. In revision THR, TI was 1.19 for elective cases, 1.55 for emergency cases and 2.35 for infected cases. There was no difference in TI for revisions of cemented and uncemented components. Single component THR revision required less transfusion. In revision TKR, TI was 0.31 for elective cases, 2.0 for emergency cases and 1.23 for cases with infection. The introduction of the MSBOS protocol had resulted in a considerable improvement in blood ordering. Reductions in the CTR were seen for all types of revision surgery, but most evident in elective revision THR (3.24-2.18) and elective revision TKR (7.95-1.2). Analysis confirmed that excessive cross-matching occurred for revision lower limb arthroplasty. The introduction of our MSBOS protocol promoted blood conservation and compliance with established national guidelines.

Revision of the recommended international general standard for irradiated foods and of the recommended international code of practice for the operation of radiation facilities used for the treatment of foods

International Nuclear Information System (INIS)

1981-11-01

In view of the findings and statements of the Joint FAO/IAEA/WHO Expert Committee on the Wholesomeness of Irradiated Food, convened in Geneva from 27 October to 3 November 1980, a Consultation Group, convened in Geneva from 1 to 3 July 1981 suggested the revision of the Recommended International General Standard for Irradiated Foods and of the Recommended International Code of Practice for the Operation of Radiation Facilities. The proposed changes are given and justified and the revised wording of the documents presented

[Design of Oxygen Saturation, Heart Rate, Respiration Rate Detection System Based on Smartphone of Android Operating System].

Science.gov (United States)

Zhu, Mingshan; Zeng, Bixin

2015-03-01

In this paper, we designed an oxygen saturation, heart rate, respiration rate monitoring system based on smartphone of android operating system, physiological signal acquired by MSP430 microcontroller and transmitted by Bluetooth module.

Operational waste volume projection. Revision 20

International Nuclear Information System (INIS)

Koreski, G.M.; Strode, J.N.

1994-01-01

Waste receipts to the double-shell tank system are analyzed and wastes through the year 2015 are projected based on generation trends of the past 12 months. A computer simulation of site operations is performed, which results in projections of tank fill schedules, tank transfers, evaporator operations, tank retrieval, and aging waste tank usage. This projection incorporates current budget planning and the clean-up schedule of the Tri-Party Agreement. Assumptions were current as of July 1994

77 FR 23244 - Atmos Energy Colorado/Kansas Division; Notice of Revised Baseline Filing

Science.gov (United States)

2012-04-18

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR12-22-000] Atmos Energy Colorado/Kansas Division; Notice of Revised Baseline Filing Take notice that on April 10, 2012, Atmos Energy Colorado/Kansas Division (Atmos) filed a revised baseline filing of their Statement of Operating...

Outcomes of Ahmed Glaucoma Valve Revision in Pediatric Glaucoma.

Science.gov (United States)

Al-Omairi, Ahmed Mansour; Al Ameri, Aliah H; Al-Shahwan, Sami; Khan, Arif O; Al-Jadaan, Ibrahim; Mousa, Ahmed; Edward, Deepak P

2017-11-01

Encapsulation of the Ahmed glaucoma valve (AGV) plate is a common cause for postoperative elevation of intraocular pressure, especially in children. Many reports have described the outcomes of AGV revision in adults. However, the outcomes of AGV revision in children are poorly documented. The aim of this study was to determine the outcomes of AGV revision in children. Retrospective cross-sectional study. A retrospective chart review of patients less than 15 years of age who underwent AGV revision with a minimum postoperative follow-up of 6 months was conducted. Outcome measures included reduction in intraocular pressure from baseline, survival analysis, and reduction in the number of antiglaucoma medications. Postoperative complications were also noted. Complete success was defined as an IOP of 21 mm Hg or less without medications, while qualified success was defined as having an IOP of 21 mm Hg or less with medications. A total of 44 eyes met the inclusion criteria. Primary congenital glaucoma was present in 39 eyes (88.6%), aphakic glaucoma in 4 eyes (9.1%), and Peters anomaly-associated glaucoma in 1 eye (2.3%). The mean number of previous surgeries was 1.4, and the mean age was 6.7 years (range, 1.9-13 years) with a median follow-up of 12 months (range, 6-24 months). The IOP was reduced from a preoperative mean of 30.4 (± 10.3) to 24.9 (± 10.6) mm Hg at 6 months postoperatively. Kaplan-Meier analysis showed that the complete success rate at 1 month was 100% followed by a rapid decline at 6 months to 38.6%, 27.7% at 1 year, and 5.5% at 2 years. Qualified success rate was 100% at 1 month followed by a 6-month and 1-year survival rate of approximately 50% and a 2-year survival rate of approximately 16%. The median survival time was 14 months. No specific risk factors for failure were identified. Visual acuity remained unchanged following revision. The most common complication was recurrence of encapsulation with elevated IOP (15.9%). Other

Operator licensing examiner standards

International Nuclear Information System (INIS)

1994-06-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes. Revision 7 was published in January 1993 and became effective in August 1993. Supplement 1 is being issued primarily to implement administrative changes to the requalification examination program resulting from the amendment to 10 CFR 55 that eliminated the requirement for every licensed operator to pass an NRC-conducted requalification examination as a condition for license renewal. The supplement does not substantially alter either the initial or requalification examination processes and will become effective 30 days after its publication is noticed in the Federal Register. The corporate notification letters issued after the effective date will provide facility licensees with at least 90 days notice that the examinations will be administered in accordance with the revised procedures

The nuclear liability conventions revised

International Nuclear Information System (INIS)

Reyners, P.

2004-01-01

The signature on 12 February 2004 of the Protocols amending respectively the 1960 Paris Convention and the 1963 Brussels Supplementary Convention was the second step of the process of modernisation of the international nuclear liability regime after the adoption in September 1997 of a Protocol revising the 1963 Vienna Convention and of a new Convention on Supplementary Compensation for Nuclear Damage. The common objective of the new instruments is to provide more funds to compensate a larger number of potential victims in respect of a broader range of damage. Another goal of the revision exercise was to maintain the compatibility between the Paris and Vienna based systems, a commitment enshrined in the 1988 Joint Protocol, as well as to ascertain that Paris/Brussels countries could also become a Party to the Convention on Supplementary Compensation. However, while generally consistent vis a vis the Joint Protocol, the provisions of the Paris and Vienna Conventions, as revised, differ on some significant aspects. Another remaining issue is whether the improved international nuclear liability regime will succeed in attracting in the future a larger number of countries, particularly outside Europe, and will so become truly universal. Therefore, the need for international co-operation to address these issues, to facilitate the adoption of new implementing legislation and to ensure that this special regime keeps abreast of economic and technological developments, is in no way diminished after the revision of the Conventions.(author)

Predicting Agency Rating Migrations with Spread Implied Ratings

OpenAIRE

Jianming Kou; Dr Simone Varotto

2005-01-01

Investors traditionally rely on credit ratings to price debt instruments. However, rating agencies are known to be prudent in their approach to rating revisions, which results in delayed ratings adjustments to mutating credit conditions. For a large set of eurobonds we derive credit spread implied ratings and compare them with the ratings issued by rating agencies. Our results indicate that spread implied ratings often anticipate future movement of agency ratings and hence could help track cr...

Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

DEFF Research Database (Denmark)

Palm, Henrik; Jacobsen, Steffen; Krasheninnikoff, Michael

2006-01-01

rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior......OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal...... registrars operated on 23% (137/600) of all and 15% (56/365) of technically demanding proximal femoral fractures. The latter had a higher re-operation rate within 6 months, compared with the rate when more experienced surgeons were present. In logistic regression analysis combining age, gender, American...

Effect of ventilation rate on air cleanliness and energy consumption in operation rooms at rest.

Science.gov (United States)

Lee, Shih-Tseng; Liang, Ching-Chieh; Chien, Tsung-Yi; Wu, Feng-Jen; Fan, Kuang-Chung; Wan, Gwo-Hwa

2018-02-27

The interrelationships between ventilation rate, indoor air quality, and energy consumption in operation rooms at rest are yet to be understood. We investigate the effect of ventilation rate on indoor air quality indices and energy consumption in ORs at rest. The study investigates the air temperature, relative humidity, concentrations of carbon dioxide, particulate matter (PM), and airborne bacteria at different ventilation rates in operation rooms at rest of a medical center. The energy consumption and cost analysis of the heating, ventilating, and air conditioning (HVAC) system in the operation rooms at rest were also evaluated for all ventilation rates. No air-conditioned operation rooms had very highest PM and airborne bacterial concentrations in the operation areas. The bacterial concentration in the operation areas with 6-30 air changes per hour (ACH) was below the suggested level set by the United Kingdom (UK) for an empty operation room. A 70% of reduction in annual energy cost by reducing the ventilation rate from 30 to 6 ACH was found in the operation rooms at rest. Maintenance of operation rooms at ventilation rate of 6 ACH could save considerable amounts of energy and achieve the goal of air cleanliness.

Prototype Operational Advances for Atmospheric Radiation Dose Rate Specification

Science.gov (United States)

Tobiska, W. K.; Bouwer, D.; Bailey, J. J.; Didkovsky, L. V.; Judge, K.; Garrett, H. B.; Atwell, W.; Gersey, B.; Wilkins, R.; Rice, D.; Schunk, R. W.; Bell, D.; Mertens, C. J.; Xu, X.; Crowley, G.; Reynolds, A.; Azeem, I.; Wiltberger, M. J.; Wiley, S.; Bacon, S.; Teets, E.; Sim, A.; Dominik, L.

2014-12-01

Space weather's effects upon the near-Earth environment are due to dynamic changes in the energy transfer processes from the Sun's photons, particles, and fields. The coupling between the solar and galactic high-energy particles, the magnetosphere, and atmospheric regions can significantly affect humans and our technology as a result of radiation exposure. Space Environment Technologies (SET) has developed innovative, new space weather observations that will become part of the toolset that is transitioned into operational use. One prototype operational system for providing timely information about the effects of space weather is SET's Automated Radiation Measurements for Aerospace Safety (ARMAS) system. ARMAS will provide the "weather" of the radiation environment to improve aircraft crew and passenger safety. Through several dozen flights the ARMAS project has successfully demonstrated the operation of a micro dosimeter on commercial aviation altitude aircraft that captures the real-time radiation environment resulting from Galactic Cosmic Rays and Solar Energetic Particles. The real-time radiation exposure is computed as an effective dose rate (body-averaged over the radiative-sensitive organs and tissues in units of microsieverts per hour); total ionizing dose is captured on the aircraft, downlinked in real-time via Iridium satellites, processed on the ground into effective dose rates, compared with NASA's Langley Research Center (LaRC) most recent Nowcast of Atmospheric Ionizing Radiation System (NAIRAS) global radiation climatology model runs, and then made available to end users via the web and smart phone apps. We are extending the dose measurement domain above commercial aviation altitudes into the stratosphere with a collaborative project organized by NASA's Armstrong Flight Research Center (AFRC) called Upper-atmospheric Space and Earth Weather eXperiment (USEWX). In USEWX we will be flying on the ER-2 high altitude aircraft a micro dosimeter for

PWR secondary water chemistry guidelines: Revision 3

International Nuclear Information System (INIS)

Lurie, S.; Bucci, G.; Johnson, L.; King, M.; Lamanna, L.; Morgan, E.; Bates, J.; Burns, R.; Eaker, R.; Ward, G.; Linnenbom, V.; Millet, P.; Paine, J.P.; Wood, C.J.; Gatten, T.; Meatheany, D.; Seager, J.; Thompson, R.; Brobst, G.; Connor, W.; Lewis, G.; Shirmer, R.; Gillen, J.; Kerns, M.; Jones, V.; Lappegaard, S.; Sawochka, S.; Smith, F.; Spires, D.; Pagan, S.; Gardner, J.; Polidoroff, T.; Lambert, S.; Dahl, B.; Hundley, F.; Miller, B.; Andersson, P.; Briden, D.; Fellers, B.; Harvey, S.; Polchow, J.; Rootham, M.; Fredrichs, T.; Flint, W.

1993-05-01

An effective, state-of-the art secondary water chemistry control program is essential to maximize the availability and operating life of major PWR components. Furthermore, the costs related to maintaining secondary water chemistry will likely be less than the repair or replacement of steam generators or large turbine rotors, with resulting outages taken into account. The revised PWR secondary water chemistry guidelines in this report represent the latest field and laboratory data on steam generator corrosion phenomena. This document supersedes Interim PWR Secondary Water Chemistry Recommendations for IGA/SCC Control (EPRI report TR-101230) as well as PWR Secondary Water Chemistry Guidelines--Revision 2 (NP-6239)

Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants.

Science.gov (United States)

Merolla, Giovanni; Wagner, Eric; Sperling, John W; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe

2018-01-01

There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 "at-risk" glenoid components. Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Limb Salvage After Failed Initial Operative Management of Bimalleolar Ankle Fractures in Diabetic Neuropathy.

Science.gov (United States)

Vaudreuil, Nicholas J; Fourman, Mitchell S; Wukich, Dane K

2017-03-01

Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of different procedures performed for limb salvage in this population. This study retrospectively reviewed 17 patients with DM complicated by peripheral neuropathy who sustained a bimalleolar ankle fracture and failed initial operative management. Patients were treated with revision open reduction internal fixation (ORIF) (3/17), closed reduction external fixation (CREF) (8/17), or primary ankle joint fusion (3/17 tibiotalocalcaneal fusion with hindfoot nail [TTCN] and 3/17 with tibiotalar arthrodesis using plates and screws [TTA]). Median follow-up was 20 months. The overall rate of limb salvage was 82.3% (14/17). All patients who went on to amputation presented with infection and were treated initially with CREF (3/3). All patients who achieved successful limb salvage ended up with a clinically fused ankle joint (14/14); 9 underwent a primary or delayed formal fusion and 5 had a clinically fused ankle joint at study conclusion after undergoing revision ORIF or CREF with adjunctive procedures. This small study suggests that in this complicated group of patients it is difficult to achieve limb salvage with an end result of a functional ankle joint. CREF can be a viable option in cases where underlying infection or poor bone quality is present. Treatment with revision ORIF frequently requires supplementary external fixator or tibiotalar Steinman pin placement for additional stability. All patients who underwent revision ORIF ended up with clinically fused ankle joints at the end of the study period. Primary fusion procedures (TTA, TTCN) were associated with a high rate of limb salvage and a decreased number of operations. Level III, retrospective case series.

[The Use of Jumbo Cups in Revision Total Hip Arthroplasty].

Science.gov (United States)

von Roth, Philipp; Wassilew, Georgi I

2017-10-01

Extra-large uncemented jumbo cups are among the most common methods of acetabular revision. Jumbo cups do not contribute to bone stock restoration, and in the case of a subsequent revision, an even larger bone defect is to be expected. Thus, understanding long-term survival is essential. The present article discusses the literature relevant to this topic and addresses technical and implant-specific characteristics of jumbo cups. In summary, jumbo cups show an acceptable long-term survival rate, with aseptic loosening as the most common reason for revision and dislocation being the most common complication. Through the development of alternative revision systems, jumbo cups have lost their importance in today's practice. However, they can serve as a benchmark for studies of newer technologies in revision total hip arthroplasty. Georg Thieme Verlag KG Stuttgart · New York.

Self-inserted foreign body and attention-deficit/hyperactivity disorder: evaluated by the Conners' Parent Rating Scales-Revised.

Science.gov (United States)

Özcan, Kemal; Özcan, Özlem; Muluk, Nuray Bayar; Cingi, Cemal; Durukan, Kübra

2013-12-01

We aimed to evaluate the relationship between attention-deficit/hyperactivity disorder (ADHD) and self-inserted foreign bodies (SIFBs) in children by the Conners' Parent Rating Scales-Revised (CPRS-R). Forty-five children (31 males and 14 females) with self-inserted foreign body of ear/nose and 37 healthy children (22 males and 15 females) included into the study. They were all between 3 and 9 years old. The parents filled the socio-demographic information form including age, gender, demographic data, previous medical history of the child and features of the family; and completed the Conners' Parent Rating Scales-Revised (CPRS-R) questionnaire. In the SIFB group (study), 55.6% of the children were not attending to the school, 31.1% of them were attending to the primary school and 13.3% of them were the pre-school student. These rates were 37.8%, 32.4% and 29.7%, respectively, in the control group. The all CPRS-R subscale values (CG/I, H, ADHD-I, CGI-DI, DSMIV SS-I, DSM-IV SS-HI and DSM-IV SS-T) were significantly higher in the study group than the control group. There was no significant correlation between gender of the children and CPRS-R subscales. Children with lower school success, and having previous psychiatric problems were related to higher CPRS-R values in all subscales. In older children, hyperactivity scores were lower; and in younger children and the children, not going to the school, hyperactivity scores were higher. CPRS-R scores decreased as the child grown. It was concluded that children with ADHD were more likely to have conditions that might damage himself/herself such as self-inserted foreign body or trauma than normal children. To avoid this condition, these families should closely observe the child; and the child should be provided to participate in activities such as group games and activities that contribute to the development of the child. Warning the children properly and close follow-up of the young children are required to prevent this

Electric rate operations

International Nuclear Information System (INIS)

Maillard, D.

1993-01-01

The share of nuclear power in EDF production implies multiple rate structures. How are these rates determined. What are the new applications of electricity, and in particular those that make use of the especially low summer prices for electricity. These are topics of interest to the man in the street (witness EDF's recent 'red-white-blue' rates). This prompted the 'Nuclear Power in the Financial, Energy and Economic situation' department of France's nuclear power company to organize a conference bringing together an expert on rates - M.P. Bernard, head of the rate fixing service at the EDF's headquarters - and representatives from suppliers of equipment taking advantage of the various EDF rate options

Pre-operative antiseptic shower and bath policy decreases the rate of S. aureus and methicillin-resistant S. aureus surgical site infections in patients undergoing joint arthroplasty.

Science.gov (United States)

Colling, Kristin; Statz, Catherine; Glover, James; Banton, Kaysie; Beilman, Greg

2015-04-01

Surgical site infection (SSI) following joint arthroplasty increases length of stay, hospital cost, and leads to patient and healthcare provider dissatisfaction. Due to the presence of non-biologic implants (the prosthetic joint) in these procedures, infection is often devastating and treatment of the infection is more difficult. For this reason, prevention of SSI is of crucial importance in this population. Staphylococcus aureus colonizes the nares of approximately 30-40% of the population, is the most common pathogen causing SSI, and is associated with high morbidity and mortality rate. A pre-operative shower or bath with an antiseptic is an inexpensive and effective method of removal of these transient skin pathogens prior to the procedure and may be used to decrease SSI. We hypothesize that a preoperative antiseptic shower or bath will decrease the rate of SSI. A retrospective review was performed at two affiliated hospitals within the same system, one with a hospital-wide policy enforcing pre-operative antiseptic shower or bath and the other with no policy, with cases included from January 2010 to June 2012. International Classification of Disease-Ninth Revision-Clinical Modification (ICD-9-CM) codes and chart review were used to identify patients undergoing joint arthroplasty and to identify those with SSI. Two thousand three-hundred forty-nine arthroplasties were performed at the University of Minnesota Medical Center, a tertiary-care hospital with a pre-operative antiseptic shower or bath policy in place. An additional 1,693 procedures were performed at Fairview Ridges Hospital, a community hospital with no pre-operative policy. There was no difference in the rate of SSI between the two hospitals (1.96% vs. 1.95%; p=1.0). However, the rate of SSI caused by S. aureus was significantly decreased by pre-operative antiseptic shower/bath (17% vs. 61%; p=0.03), as was the rate of methicillin-resistant S. aureus (MRSA) infections (2% vs. 24% p=0.002). A pre-operative

Rating of intra-operative neuro-monitoring results in operative correction of the spinal deformities

Directory of Open Access Journals (Sweden)

A. A. Skripnikov

2015-01-01

Full Text Available Purpose of the work was filing the electrophysiological phenomena observed in the process of intra-operative neuromonitoring followed by development of the results’ scale of intra-operative neuro-physiological testing of the pyramidal tract. Materials and мethods. The selection for evaluation included data of 147 protocols of intra-operative neuromonitoring in 135 patients (53 males, 82 females, aged from 1 y. 5 m. to 52 years (14,1±0,7 years with spinal deformities of different etiology who underwent instrumentation spinal correction followed by fixation of thoracic / thoracolumbar spine segments using various variants of internal systems of trans-pedicular fixation. Intra-operative neuro-monitoring was performed using system «ISIS IOM» (Inomed Medizintechnik GmbH, Germany. The changes of motor evoked potentials were evaluated according to this scale. Results. Five types of pyramidal system reaction to operative invasion were revealed. According to neurophysiological criteria three grades of the risk of neurological disorders development during operative spinal deformity correction and, correspondingly, three levels of anxiety for the surgeon were defined. Conclusion. Intra-operative neurophysiological monitoring is the effective highly technological instrument to prevent neurological disorders in the spinal deformity. Offered rating scale of the risk of neurological complications gives the possibility to highlight three levels of anxiety during operative invasion.

Bulletin 2005-12 : revised Alberta pipeline regulation issued

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-05-31

A revised Pipeline Regulation has been issued and is currently available on the Alberta Energy and Utilities Board (EUB) website. Changes to the regulation reflect bothchanges in EUB regulatory policy and processes and technological improvements. Goals of the revision include improvements in overall pipeline performance, and the implementation of recommendations derived from the Public Safety and Sour Gas Committee concerning sour gas pipeline safety. The regulation was re-organized for greater clarity, and structured into 11 parts. Issues concerning the transition to the revised regulation were presented. The summary of notable administrative changes included clarifications of when a pipeline application is not required; when ABSA approval is required for steam lines; situations for which low-pressure natural gas lines must be licensed; and emergency response requirements. Technical clarifications include requirements for pipeline operations and maintenance manuals; composite materials; limitations on amounts of H{sub 2}S in polymeric pipe; pressure mismatches; approval for testing with gaseous media; venting of small volumes of raw gas; right-of-way surveillance; inspection of surface construction activities; annual corrosion evaluations; registering of pipelines and excavators in controlled areas with Alberta One-Call; ground disturbance training; restoration and signage maintenance on abandoned pipelines; sour service steel pipelines; unused pipelines and abandoned pipelines; and remediation of stub ends in operating pipelines.

Pain and Function Following Revision Cubital Tunnel Surgery.

Science.gov (United States)

Davidge, Kristen M; Ebersole, Gregory C; Mackinnon, Susan E

2017-11-01

The purpose of this study was to determine pain and functional outcomes following revision cubital tunnel surgery and to identify predictors of poor postoperative outcome. A retrospective cohort study was conducted of all patients undergoing revision cubital tunnel surgery over a 5-year period at a high-volume peripheral nerve center. Intraoperative findings, demographic and injury factors, and outcomes were reviewed. Average pain, worst pain, and impact of pain on self-perceived quality of life were each measured using a 10-cm visual analog scale (VAS). Function was evaluated using pinch and grip strength, as well as the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Differences in preoperative and postoperative pain, strength, and DASH were analyzed using nonparametric tests. Predictors of postoperative average pain were evaluated using odds ratios and linear regression analyses. The final cohort consisted of 50 patients (mean age: 46.3 ± 12.5 years; 29 [68%] male) undergoing 52 revision ulnar nerve transpositions (UNTs). Pain VAS scores decreased significantly following revision UNT. Strength and DASH scores demonstrated nonsignificant improvements postoperatively. Worse preoperative pain and greater than 1 prior cubital tunnel procedure were significant predictors of worse postoperative average pain VAS scores. Patients can and do improve following revision cubital tunnel surgery, particularly as it relates to pain. Intraoperative findings during the revision procedure suggest that adherence to specific principles in the primary operation is key to prevention of secondary cubital tunnel syndrome.

Concerning partial revision of regulations on installation, operation, etc., of nuclear reactor, etc., for test and research

International Nuclear Information System (INIS)

1989-01-01

To enforce the rules relating to nuclear material protection at nuclear power facilities as covered by the Nuclear Reactor Control Law, which was revised in May last year, orders should be issued by the Prime Minister's Office (or Ministry of International Trade and Industry) to specify the following matters: (1) measures to be carried out by the operators of nuclear facilities to ensure the protection of specially designated nuclear fuel materials, (2) procedures for the application for permission as covered by nuclear material protection rules, and (3) requirements for managers in charge of nuclear material protection. The new regulations should cover the following: (1) rules relating to the business of refining of nuclear fuels, and raw materials for nuclear substances, (2) rules relating to the business of processing of nuclear fuels, (3) rules relating to the installation, operation, etc., of nuclear reactor, etc., for test and research, (4) rules relating to the business of reprocessing of spent fules, (5) rules relating to the business of management of nuclear fuels or waste contaminated with nuclear fuels, and (6) rules relating to the application of nuclear fuels. (N.K)

Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

Science.gov (United States)

Fink, Bernd; Schlumberger, Michael; Oremek, Damian

2017-08-01

patients were assessed before surgery, between stages, every 3 months during the first year after surgery, every 6 months during the second year postoperative, and at latest followup, and were retrospectively drawn from a longitudinally maintained institutional database. Thirty-four of 35 patients (97.2%; 95% CI, 85.4%-99.5%) appeared free of infection by criteria of Masri et al. and Zimmerli et al. at latest followup. The Harris hip score was 61 ± 13 points after the first operation and 82 ± 16 points 2 years after the second operation. This technique is a promising treatment option for periprosthetic infections of the hip in which substantial acetabular defects exclude implantation of a normal spacer and a two-stage revision of the femoral component is favored. Level IV, therapeutic study.

Revised

DEFF Research Database (Denmark)

Johannsen, Vivian Kvist; Nord-Larsen, Thomas; Riis-Nielsen, Torben

This report is a revised analysis of the Danish data on CO2 emissions from forest, afforestation and deforestation for the period 1990 - 2008 and a prognosis for the period until 2020. Revision have included measurements from 2009 in the estimations. The report is funded by the Ministry of Climate...

75 FR 15391 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revision to Control...

Science.gov (United States)

2010-03-29

... to control volatile organic compound (VOC) emissions from storage tanks, transport vessels and marine... Promulgation of Air Quality Implementation Plans; Texas; Revision to Control Volatile Organic Compound.... Specifically, this revision subjects owners or operators of VOC storage tanks, transport vessels, and marine...

Developing a model of competence in the operating theatre: psychometric validation of the perceived perioperative competence scale-revised.

Science.gov (United States)

Gillespie, Brigid M; Polit, Denise F; Hamlin, Lois; Chaboyer, Wendy

2012-01-01

This paper describes the development and validation of the Revised Perioperative Competence Scale (PPCS-R). There is a lack of a psychometrically tested sound self-assessment tools to measure nurses' perceived competence in the operating room. Content validity was established by a panel of international experts and the original 98-item scale was pilot tested with 345 nurses in Queensland, Australia. Following the removal of several items, a national sample that included all 3209 nurses who were members of the Australian College of Operating Room Nurses was surveyed using the 94-item version. Psychometric testing assessed content validity using exploratory factor analysis, internal consistency using Cronbach's alpha, and construct validity using the "known groups" technique. During item reduction, several preliminary factor analyses were performed on two random halves of the sample (n=550). Usable data for psychometric assessment were obtained from 1122 nurses. The original 94-item scale was reduced to 40 items. The final factor analysis using the entire sample resulted in a 40 item six-factor solution. Cronbach's alpha for the 40-item scale was .96. Construct validation demonstrated significant differences (pperceived competence scores relative to years of operating room experience and receipt of specialty education. On the basis of these results, the psychometric properties of the PPCS-R were considered encouraging. Further testing of the tool in different samples of operating room nurses is necessary to enable cross-cultural comparisons. Copyright © 2011 Elsevier Ltd. All rights reserved.

U.S. Btu tax plan revised; industry wary of results

International Nuclear Information System (INIS)

Crow, P.

1993-01-01

The Clinton administration has changed its U.S. energy tax proposal to remove some objection voiced by industry and consumers. The Treasury Department's revised plan will still tax oil products at double the rate of other types of energy except for home heating oil, which now is to be taxed at the lower rate for natural gas. Of major importance to California producers, the revision will not tax natural gas used in enhanced recovery for heavy oil. This paper describes exemptions; effects on natural gas; the credibility gap; inhibition of gas market recovery; tax on NGL; and forecasting the future

Draft revision of human factors guideline HF-010

International Nuclear Information System (INIS)

Lee, Hyun Chul; Lee, Yong Hee; Oh, In Seok; Lee, Jung Woon; Cha, Woo Chang; Lee, Dhong Ha

2003-05-01

The Application of Human Factors to the design of Man-Machine Interfaces System(MMIS) in the nuclear power plant is essential to the safety and productivity of the nuclear power plants, human factors standards and guidelines as well as human factors analysis methods and experiments are weightily used to the design application. A Korean engineering company has developed a human factors engineering guideline, so-call HF-010, and has used it for human factors design, however the revision of HF-010 is necessary owing to lack of the contents related to the advanced MMI(Man-Machine Interfaces). As the results of the reviews of HF-010, it is found out that the revision of Section 9. Computer Displays of HF-010 is urgent, thus the revision was drafted on the basis of integrated human factors design guidelines for VDT, human factors design guidelines for PMAS SPADES display, human factors design guidelines for PMAS alarm display, and human factors design guidelines for electronic displays developed by the surveillance and operation support project of KOICS. The draft revision of HF-010 Section 9 proposed in this report can be utilized for the human factors design of the advanced MMI, and the high practical usability of the draft can be kept up through the continuous revision according to the advancement of digital technology

Revised inspection program for nuclear power plants

International Nuclear Information System (INIS)

1978-01-01

The United States Nuclear Regulatory Commission (NRC) regulates nuclear power plants to assure adequate protection of the public and the environment from the dangers associated with nuclear materials. NRC fulfills this responsibility through comprehensive safety reviews of nuclear facilities, licensing of organizations that use nuclear materials, and continuing inspection. The NRC inspection program is currently conducted from the five regional offices in or near Philadelphia, Atlanta, Chicago, Dallas and San Francisco. Inspectors travel from the regional offices to nuclear power plants in various phases of construction, test and operation in order to conduct inspections. However, in June 1977 the Commission approved a revision to the inspection program that will include stationing inspectors at selected plants under construction and at all plants in operation. In addition, the revised program provides for appraising the performance of licensees on a national basis and involves more direct measurement and observation by NRC inspectors of work and tests in progress. The program also includes enhanced career management consisting of improved training and career development for inspectors and other professionals. The report was requested in the Conference Report on the NRC Authorization for Appropriations for Fiscal Year 1978. The report provides a discussion of the basis for both the current and revised inspection programs, describes these programs, and shows how the NRC inspection force will be trained and utilized. In addition, the report includes a discussion of the actions that will be taken to assure the objectivity of inspectors

Investigation of component failure rates for pulsed versus steady state tokamak operation

International Nuclear Information System (INIS)

Cadwallader, L.C.

1992-07-01

This report presents component failure rate data sources applicable to magnetic fusion systems, and defines multiplicative factors to adjust these data for specific use on magnetic fusion experiment designs. The multipliers address both long pulse and steady state tokamak operation. Thermal fatigue and radiation damage are among the leading reasons for large multiplier values in pulsed operation applications. Field failure rate values for graphite protective tiles are presented, and beryllium tile failure rates in laboratory testing are also given. All of these data can be used for reliability studies, safety analyses, design tradeoff studies, and risk assessments

What Is the Impact of Smoking on Revision Total Knee Arthroplasty?

Science.gov (United States)

Bedard, Nicholas A; Dowdle, S Blake; Wilkinson, Brandon G; Duchman, Kyle R; Gao, Yubo; Callaghan, John J

2018-07-01

There is a paucity of literature evaluating the impact of smoking on revision arthroplasty procedures. The purpose of this study was to identify the effect of smoking on complications after revision total knee arthroplasty (rTKA). We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database to identify patients who underwent rTKA between 2006 and 2014. Patients were divided into current smokers and nonsmokers according to the NSQIP definitions. Each cohort was compared in terms of demographic data, preoperative comorbidities, and operative time. Infection end points were created from composite surgical site infection variables defined by the NSQIP database. Multivariate logistic regression analysis was utilized to adjust for confounding variables and calculate adjusted odds ratios (ORs) and associated 95% confidence intervals (95% CIs). In total, 8776 patients underwent rTKA. Of these patients, 11.6% were current smokers. Univariate analyses demonstrated that smokers had a higher rate of any wound complication (3.8% vs 1.8%, P < .0001), deep infection (2.5% vs 1.0%, P < .0001), pneumonia (1.3% vs 0.4%, P < .0001), and reoperation (5.0% vs 3.1%, P = .001) compared to nonsmokers undergoing revision total knee arthroplasty. Multivariate analysis identified current smokers as being at a significantly increased risk of any wound complication (OR 2.1; 95% CI 1.4-3.1) and deep infection (OR 2.1, 95% CI 1.2-3.6) after rTKA. This study demonstrates that smoking significantly increases the risk of infection, wound complications, and reoperation after rTKA. The results are even more magnified for revision procedures compared to published effects of smoking on primary total knee arthroplasty complications. Further research is needed regarding the impact of smoking cessation on mitigation of these observed risks. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort

Science.gov (United States)

Wright, Rick W.; Huston, Laura J.; Haas, Amanda K.; Spindler, Kurt P.; Nwosu, Sam K.; Allen, Christina R.; Anderson, Allen F.; Cooper, Daniel E.; DeBerardino, Thomas M.; Dunn, Warren R.; Lantz, Brett (Brick) A.; Stuart, Michael J.; Garofoli, Elizabeth A.; Albright, John P.; Amendola, Annunziato (Ned); Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler, J. Brad; Campbell, John D.; Carey, James L.; Carpenter, James E.; Cole, Brian J.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O'Neill, Daniel F.; Owens, Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur C.; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Svoboda, Steven J.; Taft, Timothy N.; Tenuta, Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.

2015-01-01

Background Most surgeons believe that graft choice for ACL reconstruction is an important factor related to outcome. Although graft choice may be limited in the revision setting based on previously used grafts, it is still felt to be important. Hypothesis The purpose of this study was to determine if revision ACL graft choice predicts outcomes related to sports function, activity level, OA symptoms, graft re-rupture, and reoperation at two years following revision reconstruction. We hypothesized that autograft use would result in increased sports function, increased activity level, and decreased OA symptoms (as measured by validated patient reported outcome instruments). Additionally, we hypothesized that autograft use would result in decreased graft failure and reoperation rate 2 years following revision ACL reconstruction. Study Design Prospective cohort study; Level of evidence, 2. Methods Revision ACL reconstruction patients were identified and prospectively enrolled by 83 surgeons over 52 sites. Data collected included baseline demographics, surgical technique and pathology, and a series of validated patient reported outcome instruments (IKDC, KOOS, WOMAC, and Marx activity rating score). Patients were followed up at 2 years, and asked to complete the identical set of outcome instruments. Incidence of additional surgery and reoperation due to graft failure were also recorded. Multivariate regression models were used to determine the predictors (risk factors) of IKDC, KOOS, WOMAC, Marx scores, graft re-rupture, and reoperation rate at 2 years following revision surgery. Results 1205 patients were successfully enrolled with 697 (58%) males. Median age was 26. In 88% this was their first revision. 341 (28%) were undergoing revision by the surgeon that had performed the previous reconstruction. 583 (48%) underwent revision reconstruction utilizing an autograft, 590 (49%) allograft, and 32 (3%) both autograft and allograft. Median time since their last ACL

A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff.

Science.gov (United States)

Vanhegan, I S; Malik, A K; Jayakumar, P; Ul Islam, S; Haddad, F S

2012-05-01

Revision arthroplasty of the hip is expensive owing to the increased cost of pre-operative investigations, surgical implants and instrumentation, protracted hospital stay and drugs. We compared the costs of performing this surgery for aseptic loosening, dislocation, deep infection and peri-prosthetic fracture. Clinical, demographic and economic data were obtained for 305 consecutive revision total hip replacements in 286 patients performed at a tertiary referral centre between 1999 and 2008. The mean total costs for revision surgery in aseptic cases (n = 194) were £11 897 (sd 4629), for septic revision (n = 76) £21 937 (sd 10 965), for peri-prosthetic fracture (n = 24) £18 185 (sd 9124), and for dislocation (n = 11) £10 893 (sd 5476). Surgery for deep infection and peri-prosthetic fracture was associated with longer operating times, increased blood loss and an increase in complications compared to revisions for aseptic loosening. Total inpatient stay was also significantly longer on average (p < 0.001). Financial costs vary significantly by indication, which is not reflected in current National Health Service tariffs.

75% success rate after open debridement, exchange of tibial insert, and antibiotics in knee prosthetic joint infections.

Science.gov (United States)

Holmberg, Anna; Thórhallsdóttir, Valdís Gudrún; Robertsson, Otto; W-Dahl, Annette; Stefánsdóttir, Anna

2015-01-01

Prosthetic joint infection (PJI) is a leading cause of early revision after total knee arthroplasty (TKA). Open debridement with exchange of tibial insert allows treatment of infection with retention of fixed components. We investigated the success rate of this procedure in the treatment of knee PJIs in a nationwide material, and determined whether the results were affected by microbiology, antibiotic treatment, or timing of debridement. 145 primary TKAs revised for the first time, due to infection, with debridement and exchange of the tibial insert were identified in the Swedish Knee Arthroplasty Register (SKAR). Staphylococcus aureus was the most common pathogen (37%) followed by coagulase-negative staphylococci (CNS) (23%). Failure was defined as death before the end of antibiotic treatment, revision of major components due to infection, life-long antibiotic treatment, or chronic infection. The overall healing rate was 75%. The type of infecting pathogen did not statistically significantly affect outcome. Staphylococcal infections treated without a combination of antibiotics including rifampin had a higher failure rate than those treated with rifampin (RR = 4, 95% CI: 2-10). In the 16 cases with more than 3 weeks of symptoms before treatment, the healing rate was 62%, as compared to 77% in the other cases (p = 0.2). The few patients with a revision model of prosthesis at primary operation had a high failure rate (5 of 8). Good results can be achieved by open debridement with exchange of tibial insert. It is important to use an antibiotic combination including rifampin in staphylococcal infections.

Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

NARCIS (Netherlands)

Hartel, B.P.; Alta, T.D.; Sewnath, M.E.; Willems, W.J.H.

2015-01-01

INTRODUCTION: The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision

Graphic Display Development Program. Volume II, Revision 0. Appendices

International Nuclear Information System (INIS)

1984-12-01

The objective of this project is to demonstrate the feasibility and utility of developing a set of graphic displays to support symptom-based emergency operating procedures (EOPs). Development of generic graphic displays is based on Revision 3 of the symptomatic Emergency Procedure Guidelines (EPGs) prepared by the BWR Owners' Group (BWROG), and development of plant-specific graphic displays is based on a set of emergency operating procedures developed from these EPGs

Risk factors for revision of primary total hip arthroplasty: a systematic review

Directory of Open Access Journals (Sweden)

Prokopetz Julian JZ

2012-12-01

Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

One-stage Revision ACL reconstruction with hamstring autograft results in satisfactory outcome

Science.gov (United States)

Kejriwal, Ritwik; Buelow, Jens

2017-01-01

Objectives: Revision anterior cruciate ligament (ACL) reconstruction is associated with poorer outcomes and higher rerupture rates when compared to primary ACL reconstruction. There is also a significant heterogeneity in surgical technique, number of stages, and graft options. We report a large single surgeon case series with hamstring autograft as a graft option. Methods: Observational series of revision ACL reconstructions performed by the senior author between 2005 and 2015 was carried out. Chart reviews and clinic follow-ups were performed with the following recorded – re-rupture rate, radiographic grading of osteoarthritis, KT-1000 arthrometer test, IKDC outcome scores and knee range of motion. All patients underwent single bundle four-strand hamstring autograft performed in one stage with use of new tunnels in majority of the cases. Results: 66 patients underwent hamstring autograft one-stage revision ACL reconstruction by Dr Jens Buelow. Chart review was carried out on all patients, and 26 (39%) were followed up in clinic and/or by phone with a mean follow up of 4.7 years. Outcomes included re-rupture rate of 4.5%, reoperation rate of 12%, mean visual analogue scale score of 7.6, mean side-to-side difference of 2.6 mm for KT-1000 arthrometer test, and mean IKDC score of 79. Of the 17 patients with radiographs, 40% had moderate osteoarthritis (grade 2 or 3) at follow-up. Conclusion: Revision ACL reconstruction can result in a satisfactory outcome when performed with a hamstring autograft in one stage.

42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

Science.gov (United States)

2010-10-01

... determines national adjusted DRG prospective payment rates for operating costs, for each inpatient hospital... DRG prospective payment rates for inpatient operating costs for such discharges in each region, for... classifications. (1) For purposes of paragraph (e) of this section, the following definitions apply: (i) The term...

Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery

Science.gov (United States)

Blom, Ashley W; Whitehouse, Michael R; Gooberman-Hill, Rachael

2015-01-01

Objectives Around 1% of patients who have a hip replacement have deep prosthetic joint infection (PJI) afterwards. PJI is often treated with antibiotics plus a single revision operation (1-stage revision), or antibiotics plus a 2-stage revision process involving more than 1 operation. This study aimed to characterise the impact and experience of PJI and treatment on patients, including comparison of 1-stage with 2-stage revision treatment. Design Qualitative semistructured interviews with patients who had undergone surgical revision treatment for PJI. Patients were interviewed between 2 weeks and 12 months postdischarge. Data were audio-recorded, transcribed, anonymised and analysed using a thematic approach, with 20% of transcripts double-coded. Setting Patients from 5 National Health Service (NHS) orthopaedic departments treating PJI in England and Wales were interviewed in their homes (n=18) or at hospital (n=1). Participants 19 patients participated (12 men, 7 women, age range 56–88 years, mean age 73.2 years). Results Participants reported receiving between 1 and 15 revision operations after their primary joint replacement. Analysis indicated that participants made sense of their experience through reference to 3 key phases: the period of symptom onset, the treatment period and protracted recovery after treatment. By conceptualising their experience in this way, and through themes that emerged in these periods, they conveyed the ordeal that PJI represented. Finally, in light of the challenges of PJI, they described the need for support in all of these phases. 2-stage revision had greater impact on participants’ mobility, and further burdens associated with additional complications. Conclusions Deep PJI impacted on all aspects of patients’ lives. 2-stage revision had greater impact than 1-stage revision on participants’ well-being because the time in between revision procedures meant long periods of immobility and related psychological distress

Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Polk, Anne; Brorson, Stig

2014-01-01

PURPOSE: We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis. PATIENTS AND METHODS: We included all...... of presentation, the raw scores were converted to a percentage of the maximum score. Revision rates were calculated by checking reported revisions to the DSR until December 2011. WOOS and risk of revision were adjusted for age, sex, previous surgery, and type of osteoarthritis. RESULTS: There were 113 TSAs...... and 1096 HAs (837 RHAs and 259 SHAs). Patients treated with TSA generally had a better WOOS, exceeding the predefined minimal clinically important difference, at 1 year (mean difference 10, p

Revision of the ASME nuclear quality assurance standard and its historical background

International Nuclear Information System (INIS)

Suzuki, Tetsuya

2009-01-01

ASME NQA-1-2008 'Quality Assurance Requirements for Nuclear Facility Applications' will be endorsed by US NRC by the end of 2009. This standard will apply to design, construction and operation of nuclear power plants newly erected in USA. It is important to Japanese vendors developing nuclear business in USA. Historical background, significance of revision and main revised points of the ASME nuclear quality assurance standard are described in the present paper. (T. Tanaka)

Re-admissions, re-operations and length of stay in hospital after aseptic revision knee replacement in Denmark

DEFF Research Database (Denmark)

Lindberg-Larsen, M.; Jørgensen, C. C.; Hansen, Torben Bæk

2014-01-01

of hospital stay was four days (interquartile range: 3 to 5), with a 90 days re-admission rate of 9.9%, re-operation rate of 3.5% and mortality rate of 0.2%. The age ranges of 51 to 55 years (p = 0.018), 76 to 80 years (p re-admission...

Long-term Follow-up of Revision Osteochondral Allograft Transplantation of the Ankle.

Science.gov (United States)

Gaul, Florian; Tírico, Luís E P; McCauley, Julie C; Bugbee, William D

2018-05-01

Osteochondral allograft (OCA) transplantation is a useful alternative for treatment of posttraumatic ankle arthritis in young patients but has a relatively high failure rate and further procedures are often required. The purpose of this study was to evaluate outcomes of patients who underwent revision OCA transplantation of the ankle after failed primary OCA transplantation. Twenty patients underwent revision OCA transplantation of the ankle between 1988 and 2015. Mean age was 44 years, 55% (11 of 20) were female. The mean time from primary to revision OCA was 3.0 ± 1.7 years. All patients had a minimum follow-up of 2 years. Outcomes included the American Academy of Orthopaedic Surgeons Foot and Ankle Module (AAOS-FAM) and questionnaires evaluating pain and satisfaction. Failure of the revision OCA was defined as a conversion to arthroplasty, arthrodesis, or amputation. Ten of 20 ankles required further surgery, of which 30% (6 of 20) were considered OCA revision failures (4 arthrodeses, 1 arthroplasty, and 1 amputation). The mean time to failure was 6.7 (range, 0.6-13.1) years. Survivorship of the revision OCA was 84% at 5 years and 65% at 10 years. The 14 patients with grafts remaining in situ had an average follow-up of 10.3 years; mean AAOS-FAM Core Score was 70.5 (range, 42.3-99). Of the patients who answered the follow-up questions, 4 of 7 reported moderate to severe pain, and 5 of 12 were satisfied with the results of the procedure. Although the results of revision ankle OCA transplantation are not inferior to primary OCA transplantation, the high rates of persistent pain, further surgery, and graft failure suggest that the indications for OCA as a revision procedure should be carefully evaluated, with proper patient selection. Considering the treatment alternatives, revising a failed OCA transplantation can be a useful treatment option, especially for young and active patients who wish to avoid arthrodesis or arthroplasty. Level IV, case series.

Performance-based improvement of the leakage rate test program for the reactor containment of HTTR. Adoption of revised test programs containing 'Type A, Type B and Type C tests'

International Nuclear Information System (INIS)

Kondo, Masaaki; Emori, Koichi; Sekita, Kenji; Furusawa, Takayuki; Hayakawa, Masato; Kozawa, Takayuki; Aono, Tetsuya; Kuroha, Misao; Ouchi, Hiroshi; Kimishima, Satoru

2008-10-01

The reactor containment of HTTR is periodically tested to confirm leak-tight integrity by conducting overall integrated leakage rate tests, so-called 'Type A tests,' in accordance with a standard testing method provided in Japan Electric Association Code (JEAC) 4203. 'Type A test' is identified as a basic one for measuring whole leakage rates for reactor containments, it takes, however, much of cost and time of preparation, implementation and restoration of itself. Therefore, in order to upgrade the maintenance technology of HTTR, the containment leakage rate test program for HTTR was revised by adopting efficient and economical alternatives including Type B and Type C tests' which intend to measure leakage rates for containment penetrations and isolation valves, respectively. In JEAC4203-2004, following requirements are specified for adopting an alternative program: upward trend of the overall integrated leakage rate due to aging affection should not be recognized; performance criterion for combined leakage rate, that is a summation of local leakage rates evaluated by Type B and Type C tests and converted to whole leakage rates, should be established; the criterion of the combined leakage rate should be satisfied as well as of the overall integrated leakage rate; correlation between the overall integrated and combined leakage rates should be recognized. Considering the historical performances, policies of conforming to the forgoing requirements and of carrying out the revised test program were developed, which were accepted by the regulatory agency. This report presents an outline of the leakage rate tests for the reactor containment of HTTR, identifies practical issues of conventional Type A tests, and describes the conforming and implementing policies mentioned above. (author)

Operating and Assurance Program Plan. Revision 4

Energy Technology Data Exchange (ETDEWEB)

1994-07-01

The LBL Operating and Assurance Program (OAP) is a management system and a set of requirements designed to maintain the level of performance necessary to achieve LBL`s programmatic and administrative objectives effectively and safely through the application of quality assurance and related conduct of operations and maintenance management principles. Implement an LBL management philosophy that supports and encourages continual improvement in performance and quality at the Laboratory. Provide an integrated approach to compliance with applicable regulatory requirements and DOE orders. The OAP is intended to meet the requirements of DOE Order 5700.6C, Quality Assurance. The Program also contains management system elements of DOE Orders 5480.19, Conduct of Operations Requirements for DOE Facilities; 5480.25, Safety of Accelerator Facilities; and 4330.4A, Maintenance Management Program, and is meant to integrate these elements into the overall LBL approach to Laboratory management. The requirements of this program apply to LBL employees and organizations, and to contractors and facility users as managed by their LBL sponsors. They are also applicable to external vendors and suppliers as specified in procurement documents and contracts.

Nuclear Regulatory Commission Human Factors Program Plan. Revision 2

International Nuclear Information System (INIS)

1986-04-01

This document is the Second Annual Revision to the NRC Human Factors Program Plan. The first edition was published in August 1983. Revision 1 was published in July of 1984. Purpose of the NRC Human Factors Program is to ensure that proper consideration is given to human factors in the design and operation of nuclear power plants. This document describes the plans of the Office of Nuclear Reactor Regulation to address high priority human factors concerns of importance to reactor safety in FY 1986 and FY 1987. Revision 2 of the plan incorporates recent Commission decisions and policies bearing on the human factors aspects of reactor safety regulation. With a few exceptions, the principal changes from prior editions reflect a shift from developing new requirements to staff evaluation of industry progress in resolving human factors issues. The plan addresses seven major program elements: (1) Training, (2) Licensing Examinations, (3) Procedures, (4) Man-Machine Interface, (5) Staffing and Qualifications, (6) Management and Organization, and (7) Human Performance

Revision Hip Arthroscopy Indications and Outcomes: A Systematic Review.

Science.gov (United States)

Sardana, Vandit; Philippon, Marc J; de Sa, Darren; Bedi, Asheesh; Ye, Lily; Simunovic, Nicole; Ayeni, Olufemi R

2015-10-01

To identify the indications and outcomes in patients undergoing revision hip arthroscopy. The electronic databases Embase, Medline, HealthStar, and PubMed were searched from 1946 to July 19, 2014. Two blinded reviewers searched, screened, and evaluated the data quality of the studies using the Methodological Index for Non-Randomized Studies scale. Data were abstracted in duplicate. Agreement and descriptive statistics are presented. Six studies were included (3 prospective case series and 3 retrospective chart reviews), with a total of 448 hips examined. The most common indications for revision hip arthroscopy included residual femoroacetabular impingement (FAI), labral tears, and chondral lesions. The mean interval between revision arthroscopy and the index procedure was 25.6 months. Overall, the modified Harris Hip Score improved by a mean of 33.6% (19.3 points) from the baseline score at 1-year follow-up. In 14.6% of patients, further surgical procedures were required, including re-revision hip arthroscopy (8.0%), total hip replacement (5.6%), and hip resurfacing (1.0%). Female patients more commonly underwent revision hip arthroscopy (59.7%). The current evidence examined in this review supports revision hip arthroscopy as a successful intervention to improve functional outcomes (modified Harris Hip Score) and relieve pain in patients with residual symptoms after primary FAI surgery, although the outcomes are inferior when compared with a matched cohort of patients undergoing primary hip arthroscopy for FAI. The main indication for revision is a candidate who has symptoms due to residual cam- or pincer-type deformity that was either unaddressed or under-resected during the index operation. However, it is important to consider that the studies included in this review are of low-quality evidence. Surgeons should consider incorporating a minimum 2-year follow-up for individuals after index hip-preservation surgery because revisions tended to occur within this

Non-Power Reactor Operator Licensing Examiner Standards

International Nuclear Information System (INIS)

1994-06-01

The Non-Power Reactor Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR Part 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, this standard will be revised periodically to accommodate comments and reflect new information or experience

49 CFR 236.919 - Operations and Maintenance Manual.

Science.gov (United States)

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Standards for Processor-Based Signal and Train Control Systems § 236.919 Operations and Maintenance Manual. (a... identify all software versions, revisions, and revision dates. Plans must be legible and correct. (c...

49 CFR 236.1039 - Operations and Maintenance Manual.

Science.gov (United States)

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Positive Train Control Systems § 236.1039 Operations and Maintenance Manual. (a) The railroad shall catalog and... software versions, revisions, and revision dates. Plans must be legible and correct. (c) Hardware, software...

Determination of total flow rate and flow rate of every operating branch in commissioning of heavy water loop for ARR-2

International Nuclear Information System (INIS)

Han Yan

1997-01-01

The heavy water loop (i,e, RCS) for ARR-2 in Algeria is a complex loop. Flow regulating means are not provided by the design in order to operate the reactor safely and simplify operating processes. How to determine precisely the orifice diameters of resistance parts for the loop is a key point for decreasing deviation between practical and design flow rates. Commissioning tests shall ensure that under every one of combined operating modes for the pumps, total coolant flow rate is about the same (the number of pumps operating in parallel is the same) and is consistent with design requirement, as well as the distribution of coolant flow rate to every branch is uniform. The flow Determination is divided into two steps. First and foremost, corresponding resistance part at each pump outlet is determined in commissioning test of shorted heavy water loop with light water, so that the problem about uniform distribution of the flow rate to each branch is solved, Secondly, resistance part at the reactor inlet is determined in commissioning test of heavy water loop connected with the vessel, so that the problem about that total heavy water flow rate is within optimal range is solved. According to practical requirements of the project, a computer program of hydraulic calculation and analysis for heavy water loop has been developed, and hydraulic characteristics test for a part of loop has been conducted in order to correct calculation error. By means of program calculation combining with tests in site, orifice diameters of 9 resistance parts has been determined rapidly and precisely and requirements of design and operation has been met adequately

Revising and editing for translators

CERN Document Server

Mossop, Brian

2014-01-01

Revising and Editing for Translators provides guidance and learning materials for translation students learning to edit texts written by others, and professional translators wishing to improve their self-revision ability or learning to revise the work of others. Editing is understood as making corrections and improvements to texts, with particular attention to tailoring them to the given readership. Revising is this same task applied to draft translations. The linguistic work of editors and revisers is related to the professional situations in which they work. Mossop offers in-depth coverage of a wide range of topics, including copyediting, style editing, structural editing, checking for consistency, revising procedures and principles, and translation quality assessment. This third edition provides extended coverage of computer aids for revisers, and of the different degrees of revision suited to different texts. The inclusion of suggested activities and exercises, numerous real-world examples, a proposed gra...

Harmonized Tariff Schedule of the United States (2015) - Revision 1

Data.gov (United States)

US International Trade Commission — This dataset is the 2015 Harmonized Tariff Schedule Revision 1 effective July 1, 2015. It provides the applicable tariff rates and statistical categories for all...

Total hip arthroplasty revision due to infection: a cost analysis approach.

Science.gov (United States)

Klouche, S; Sariali, E; Mamoudy, P

2010-04-01

. The rate of transfer to a rehabilitation hospital (ORH) was 55% for primary THA, 77% in non infected revision cases and 65% in revisions due to infection. Moreover, 30% of these infected THA were prescribed HH. Non-infected THA revisions cost 1.4 times more than primary THA. THA revisions due to infection cost 3.6 times more than primary THA. The economic impact of THA infections is considerable. The extra costs are mainly due to an extended hospital stay and to longer rehabilitation consuming significant substantial human and material resources. The cost of treating infected THA is high. Treatment strategies should therefore be optimised to increase the success rate and minimise total costs. Level IV. Economic and decision analyses, retrospective study 2010 Elsevier Masson SAS. All rights reserved.

78 FR 21245 - Continuity of Operations Plan

Science.gov (United States)

2013-04-10

...; Order No. 778] Continuity of Operations Plan AGENCY: Federal Energy Regulatory Commission, DOE. ACTION: Final rule. SUMMARY: In this Final Rule the Commission revises its Continuity of Operations Plan... Commission's Continuity of Operations Plan (COOP) regulations to incorporate its regional offices into the...

Loosening After Acetabular Revision

DEFF Research Database (Denmark)

Beckmann, Nicholas A.; Weiss, Stefan; Klotz, Matthias C.M.

2014-01-01

The best method of revision acetabular arthroplasty remains unclear. Consequently, we reviewed the literature on the treatment of revision acetabular arthroplasty using revision rings (1541 cases; mean follow-up (FU) 5.7 years) and Trabecular Metal, or TM, implants (1959 cases; mean FU 3.7 years...

Fixation of revision implants is improved by a surgical technique to crack the sclerotic bone rim.

Science.gov (United States)

Kold, Søren; Bechtold, Joan E; Mouzin, Olivier; Elmengaard, Brian; Chen, Xinqian; Søballe, Kjeld

2005-03-01

Revision joint replacement has poorer outcomes compared with primary joint replacement, and these poor outcomes have been associated with poorer fixation. We investigated a surgical technique done during the revision operation to improve access from the marrow space to the implant interface by locally cracking the sclerotic bone rim that forms during aseptic loosening. Sixteen implants were inserted bilaterally by distal femur articulation of the knee joint of eight dogs, using our controlled experimental model that replicates the revision setting (sclerotic bone rim, dense fibrous tissue, macrophages, elevated cytokines) by pistoning a loaded 6.0-mm implant 500 microm into the distal femur with particulate PE. At 8 weeks, one of two revision procedures was done. Both revision procedures included complete removal of the membrane, scraping, lavaging, and inserting a revision plasma-spray Ti implant. The crack revision procedure also used a splined tool to circumferentially locally perforate the sclerotic bone rim before insertion of an identical revision implant. Superior fixation was achieved with the cracking procedure in this experimental model. Revision implants inserted with the rim cracking procedure had a significantly higher pushout strength (fivefold median increase) and energy to failure (sixfold median increase), compared with the control revision procedure. Additional evaluation is needed of local perforation of sclerotic bone rim as a simple bone-sparing means to improve revision implant fixation and thereby increase revision implant longevity.

77 FR 75362 - Funding and Fiscal Affairs, Loan Policies and Operations, and Funding Operations

Science.gov (United States)

2012-12-20

... FARM CREDIT ADMINISTRATION 12 CFR Part 615 Funding and Fiscal Affairs, Loan Policies and Operations, and Funding Operations CFR Correction 0 In Title 12 of the Code of Federal Regulations, Parts 600 to 899, revised as of January 1, 2012, on page 209, Subpart S, consisting of Sec. 615.5570, is...

Fixation of revision implants is improved by new surgical technique to crack the sclerotic endosteal rim.

Science.gov (United States)

Kold, S; Soballe, K; Mouzin, O; Chen, Xiangmei; Toft, M; Bechtold, J

2002-01-01

We used an experimental model producing a tissue response with a sclerotic endosteal neo-cortical rim associated with implant loosening in humans: a 6 mm PMMA cylinder pistoned 500 m concentrically in a 7.5 mm hole, with polyethylene particles. At a second operation at eight weeks, the standard revision procedure removed the fibrous membrane in one knee, and the crack revision procedure was used to crack the sclerotic endosteal rim in the contralateral knee. Once stability was achieved following the revision procedures, loaded Ti plasma sprayed implants were inserted into the revision cavities of 8 dogs for an additional 4 weeks. Revision implant fixation (ultimate shear strength and energy absorption) was significantly enhanced by cracking the sclerotic endosteal rim. In conclusion, we demonstrated a simple technique of cracking the sclerotic endosteal rim as an additional method for improving revision fixation. (Hip International 2002; 2: 77-9).

Psychometric properties of Conversion Disorder Scale- Revised (CDS) for children.

Science.gov (United States)

Ijaz, Tazvin; Nasir, Attikah; Sarfraz, Naema; Ijaz, Shirmeen

2017-05-01

To revise conversion disorder scale and to establish the psychometric properties of the revised scale. This case-control study was conducted from February to June, 2014, at the Government College University, Lahore, Pakistan, and comprised schoolchildren and children with conversion disorder. In order to generate items for revised version of conversion disorder scale, seven practising mental health professionals were consulted. A list of 42 items was finalised for expert ratings. After empirical validation, a scale of 40 items was administered on the participants and factor analysis was conducted. Of the240 participants, 120(50%) were schoolchildren (controls group) and 120(50%)were children with conversion disorder (clinical group).The results of factor analysis revealed five factors (swallowing and speech symptoms, motor symptoms, sensory symptoms, weakness and fatigue, and mixed symptoms) and retention of all 40 items of revised version of conversion disorder scale. Concurrent validity of the revised scale was found to be 0.81 which was significantly high. Similarly, discriminant validity of the scale was also high as both clinical and control groups had significant difference (pconversion disorder scale was 76% sensitive to predicting conversion disorder while specificity showed that the scale was 73% accurate in specifying participants of the control group. The revised version of conversion disorder scale was a reliable and valid tool to be used for screening of children with conversion disorder.

Lifelong Adaptability: A Cultural Literacy Perspective (Revised Edition)

Science.gov (United States)

Moyer, John Thayer

2011-01-01

This revised 1997 ex post facto study attempted to identify a lifelong adaptability curriculum from a cultural literacy perspective. It investigated students' lifelong adaptability ratings of 15 general school subjects as predicted by family structure, parental age, parental educational level, student cultural literacy, and student gender;…

Dose rate evaluation of workers on the operation floor in Fukushima-Daiichi Unit 3

Science.gov (United States)

Matsushita, Kaoru; Kurosawa, Masahiko; Shirai, Keisuke; Matsuoka, Ippei; Mukaida, Naoki

2017-09-01

At Fukushima Daiichi Nuclear Power Plant Unit 3, installation of a fuel handling machine is planned to support the removal of spent fuel. The dose rates at the workplace were calculated based on the source distribution measured using a collimator in order to confirm that the dose rates on the operation floor were within a manageable range. It was confirmed that the accuracy of the source distribution was C/M = 1.0-2.4. These dose rates were then used to plan the work on the operation floor.

Vault Safety and Inventory System users manual, PRIME 2350. Revision 1

International Nuclear Information System (INIS)

Downey, N.J.

1994-01-01

This revision is issued to request review of the attached document: VSIS User Manual, PRIME 2350, which provides user information for the operation of the VSIS (Vault Safety and Inventory System). It describes operational aspects of Prime 2350 minicomputer and vault data acquisition equipment. It also describes the User's Main Menu and menu functions, including REPORTS. Also, system procedures for the Prime 2350 minicomputer are covered

Vault Safety and Inventory System users manual, PRIME 2350. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Downey, N.J.

1994-12-14

This revision is issued to request review of the attached document: VSIS User Manual, PRIME 2350, which provides user information for the operation of the VSIS (Vault Safety and Inventory System). It describes operational aspects of Prime 2350 minicomputer and vault data acquisition equipment. It also describes the User`s Main Menu and menu functions, including REPORTS. Also, system procedures for the Prime 2350 minicomputer are covered.

Detailed analysis of the Japanese version of the Rapid Dementia Screening Test, revised version.

Science.gov (United States)

Moriyama, Yasushi; Yoshino, Aihide; Muramatsu, Taro; Mimura, Masaru

2017-11-01

The number-transcoding task on the Japanese version of the Rapid Dementia Screening Test (RDST-J) requires mutual conversion between Arabic and Chinese numerals (209 to , 4054 to , to 681, to 2027). In this task, question and answer styles of Chinese numerals are written horizontally. We investigated the impact of changing the task so that Chinese numerals are written vertically. Subjects were 211 patients with very mild to severe Alzheimer's disease and 42 normal controls. Mini-Mental State Examination scores ranged from 26 to 12, and Clinical Dementia Rating scores ranged from 0.5 to 3. Scores of all four subtasks of the transcoding task significantly improved in the revised version compared with the original version. The sensitivity and specificity of total scores ≥9 on the RDST-J original and revised versions for discriminating between controls and subjects with Clinical Dementia Rating scores of 0.5 were 63.8% and 76.6% on the original and 60.1% and 85.8% on revised version. The revised RDST-J total score had low sensitivity and high specificity compared with the original RDST-J for discriminating subjects with Clinical Dementia Rating scores of 0.5 from controls. © 2017 Japanese Psychogeriatric Society.

Knowledge and abilities catalog for nuclear power plant operators: boiling water reactors

International Nuclear Information System (INIS)

1986-09-01

The Knowledge and Abilities Catalog for Nuclear Power Plant Operators: Boiling-Water Reactors (BWR) (NUREG-1123) provides the basis for the development of content-valid licensing examinations for reactor operators (ROs) and senior reactor operators (SROs). The examinations developed using the BWR Catalog and Examiners' Handbook for Developing Operator Licensing Examinations (NUREG-1121) will cover those topics listed under Title 10, Code of Federal Regulations, Part 55. The BWR Catalog contains approximately 7000 knowledge and ability (K/A) statements for ROs and SROs at boiling water reactors. Each K/A statement has been rated for its importance to the safe operation of the plant in a manner ensuring personnel and public health and safety. The BWR K/A Catalog is organized into five major sections: Plant-wide Generic Knowledge and Ability Statements, Plant Systems grouped by Safety Function, Emergency and Abnormal Plant Evolutions, Components, and Theory. The BWR Catalog represents a modification of the form and content of the K/A Catalog for Nuclear Power Plant Operators: Pressurized Water Reactors (NUREG-1122). First, categories of knowledge and ability statements have been redefined. Second, the scope of the definition of emergency and abnormal plant evolutions has been revised in line with a symptom-based approach. Third, K/As related to the operational applications of theory have been incorporated into the delineations for both plant systems and emergency and abnormal plant evolutions, while K/As pertaining to theory fundamental to plant operation have been delineated in a separate theory section. Finally, the components section has been revised

NRC plan for cleanup operations at Three Mile Island Unit 2

International Nuclear Information System (INIS)

Lo, R.; Snyder, B.

1982-02-01

This NRC Plan, which defines NRC's functional role in cleanup operations at Three Mile Island Unit 2 and outlines NRC's regulatory responsibilities in fulfilling this role, is the first revision to the initial plan issued in July 1980 (NUREG-0698). Since 1980, a number of policy developments have occurred which will have an impact on the course of cleanup operations. This revision reflects these developments in the area of NRC's review and approval process with regard to cleanup operations as well as NRC's interface with the Department of Energy's involvement in the cleanup and waste disposal. This revision is also intended to update the cleanup schedule by presenting the cleanup progress that has taken place and NRC's role in ongoing and future cleanup activities

[Results of revision after failed surgical treatment for traumatic anterior shoulder instability].

Science.gov (United States)

Lópiz-Morales, Y; Alcobe-Bonilla, J; García-Fernández, C; Francés-Borrego, A; Otero-Fernández, R; Marco-Martínez, F

2013-01-01

Persistent or recurrent glenohumeral instability after a previous operative stabilization can be a complex problem. Our aim is to establish the incidence of recurrence and its revision surgery, and to analyse the functional results of the revision instability surgery, as well as to determine surgical protocols to perform it. A retrospective analysis was conducted on 16 patients with recurrent instability out of 164 patients operated on between 1999 and 2011. The mean follow-up was 57 months and the mean age was 29 years. To evaluate functional outcome we employed Constant, Rowe, UCLA scores and the visual analogue scale. Of the 12 patients who failed the initial arthroscopic surgery, 6 patients underwent an arthroscopic antero-inferior labrum repair technique, 4 using open labrum repair techniques, and 2 coracoid transfer. The two cases of open surgery with recurrences underwent surgery for coracoid transfer. Results of the Constant score were excellent or good in 64% of patients. Surgical revision of instability is a complex surgery essentially for two reasons: the difficulty in recognising the problem, and the technical demand (greater variety and the increasingly complex techniques). Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

User`s guide for the irradiation of experiments in the FTR. Revision 3

Energy Technology Data Exchange (ETDEWEB)

NONE

1990-07-01

This document provides Revision 3 updates the FTR Users Guide. Revision 3 updates Appendix 1 (FFTF Technical Specifications) to include the following: Documentation of the acceptability of handling metal fuel assemblies in the Closed Loop Ex-Vessel Handling Machine (CLEM) and storing them in the Interim Decay Storage (IDS) vessel. Reactivity limit version (utilizing existing FSAR analysis bounds) to allow for the larger beta-effective associated with the addition of enriched uranium metal and oxide experiments to the core. Operational temperature limits for Open Test Assemblies (OTAs) have been expanded to differentiate between 40-foot experiment test articles, 28-foot Post Irradiation Open Test Assemblies (PIOTAs) and the 28-foot Loose Parts Monitor Assemblies (LMPAs) operating under FFTF core Engineering cognizance.

Uranium hexafluoride: A manual of good practice ORO 651 revision 6

Energy Technology Data Exchange (ETDEWEB)

Dyer, R.H. [Department of Energy, Oak Ridge, TN (United States)

1991-12-31

The United States Department of Energy publishes a document containing UF{sub 6} handling procedures and descriptions of the approved UF{sub 6} cylinders. Since its initial publication in 1966, it has been frequently revised to provide more and better information. The principle additions to the sixth revision which will be discussed are: (1) more detail on the physical and chemical properties of UF{sub 6}; (2) cold trap description and operation; (3) cylinder emptying and filling concepts; (4) basis for cylinder fill limits; (5) short- and long-term cylinder storage; and (6) cylinder photographs and drawings showing major dimensions.

High rate operation of micro-strip gas chambers on diamond-coated glass

CERN Document Server

Bouclier, Roger; Million, Gilbert; Ropelewski, Leszek; Sauli, Fabio; Temmel, T; Cooke, R A; Donnel, S; Sastri, S A; Sonderer, N

1996-01-01

Very high rate operation of micro­strip gas chambers can be achieved using slightly conducting substrates. We describe preliminary measurements realized with detectors manufactured on boro-silicate glass coated, before the photo-lithographic processing, with a diamond layer having a surface resistivity of around 1014 ‡/o. Stable medium-term operation, and a rate capability largely exceeding the one obtained with identical plates manufactured on uncoated glass are demonstrated. If these results are confirmed by long-term measurements the diamond coating technology appears very attractive since it allows, with a moderate cost overhead, to use thin, commercially available glass with the required surface quality for the large-scale production of gas micro-strip detectors.

77 FR 64920 - Revisions to Reliability Standard for Transmission Vegetation Management

Science.gov (United States)

2012-10-24

... reliability of the Bulk Electric System.'' NERC defines ``System Operating Limit'' as ``[t]he value (such as... values or gives reason to revisit the Reliability Standard. Accordingly, consistent with the activity...] Revisions to Reliability Standard for Transmission Vegetation Management AGENCY: Federal Energy Regulatory...

Comparative Analysis of Direct Hospital Care Costs between Aseptic and Two-Stage Septic Knee Revision

Science.gov (United States)

Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen

2017-01-01

Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p costs of explantation stage ($4,540.46) were lower than aseptic revision TKA ($6,749.43) which were again lower than those of the septic implantation stage ($7,683.33). All mean costs of stays were not comparable as they differ significantly (p cost drivers were the cost of the implant and

Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

Science.gov (United States)

Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

2016-01-01

Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

Open-source hardware and software and web application for gamma dose rate network operation

International Nuclear Information System (INIS)

Luff, R.; Zaehringer, M.; Harms, W.; Bleher, M.; Prommer, B.; Stoehlker, U.

2014-01-01

The German Federal Office for Radiation Protection operates a network of about 1800 gamma dose rate stations as a part of the national emergency preparedness plan. Each of the six network centres is capable of operating the network alone. Most of the used hardware and software have been developed in-house under open-source license. Short development cycles and close cooperation between developers and users ensure robustness, transparency and fast maintenance procedures, thus avoiding unnecessary complex solutions. This also reduces the overall costs of the network operation. An easy-to-expand web interface has been developed to make the complete system available to other interested network operators in order to increase cooperation between different countries. The interface is also regularly in use for education during scholarships of trainees supported, e.g. by the 'international Atomic Energy Agency' to operate a local area dose rate monitoring test network. (authors)

Effect of pre operative heart rate on post spinal hypotension in obsteric patients

International Nuclear Information System (INIS)

Khan, S.; Zahoor, M.U.; Zaid, A.Y.; Buland, K.

2010-01-01

The purpose of the study was to determine the association between of preoperative heart rate and post spinal hypotension in women undergoing cesarean section, Two hundred patients undergoing caesarean were included in the study selected on non probability convenience sampling technique, The patients were divided into two groups depending upon their pre operative heart rate. Spinal anesthesia was administered and number of patients developing hypotension was noted. Among 200 patients, who were included in the study; 112 were placed in group A and 88 were placed in group B depending on mean heart rate of 90 beats per minute or less or 91 beats per minute or more respectively. In group A 14 (11.86%) patients developed hypotension where as in group B 28 (31,82%) patients developed hypotension. Pre operative heart rate is significantly associated with post spinal hypotension in obstetric patients undergoing cesarean section. (author)

Engineering work plan for container venting system drill press assembly troubleshooting. Revision 1

International Nuclear Information System (INIS)

Prather, M.C.

1994-11-01

This work plan is for troubleshooting the current CVS drill press to ensure that the drill bit assembly doesn't bind in the press plate. A drill press assembly has been fabricated for the Container Venting System (CVS). The drill bit assembly has bound in the press plate in previous revisions of this design. Initial troubleshooting of the drill press per Rev. 0 of this work plan was performed at the 200W Kaiser Machine Shop under Work Package 2H9401670F, Internal Work Order E20027. The drill press operated without jamming. Then, during the pre-operational test on 11/14/17 and the operational test on 11/17/94, two drum lids were drilled. Immediately after the test on 11/17/94, the drill was again operated, and it jammed. An inspection found shavings at the bottom of the drill bit assembly, between the drill bit sleeve and the press plate bore. This revised work plan provides direction for the machine shop to diagnose and correct this recent problem

Thermonuclear reaction rates. III

International Nuclear Information System (INIS)

Harris, M.J.; Fowler, W.A.; Caughlan, G.R.; Zimmerman, B.A.

1983-01-01

Stellar thermonuclear reaction rates are revised and updated, adding a number of new important reaction rates. Several reactions with large negative Q-values are included, and examples of them are discussed. The importance of the decay rates for Mg-26(p,n) exp 26 Al and Al-26(n,p) exp 26 Mg for stellar studies is emphasized. 19 references

77 FR 55817 - Panther Creek Power Operating, LLC; Supplemental Notice that Initial Market-Based Rate Filing...

Science.gov (United States)

2012-09-11

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER12-2570-000] Panther Creek Power Operating, LLC; Supplemental Notice that Initial Market-Based Rate Filing Includes Request for... Panther Creek Power Operating, LLC's application for market-based rate authority, with an accompanying...

Gender, renal function, and outcomes on the liver transplant waiting list: assessment of revised MELD including estimated glomerular filtration rate.

Science.gov (United States)

Myers, Robert P; Shaheen, Abdel Aziz M; Aspinall, Alexander I; Quinn, Robert R; Burak, Kelly W

2011-03-01

The Model for End-Stage Liver Disease (MELD) allocation system for liver transplantation (LT) may present a disadvantage for women by including serum creatinine, which is typically lower in females. Our objectives were to investigate gender disparities in outcomes among LT candidates and to assess a revised MELD, including estimated glomerular filtration rate (eGFR), for predicting waiting list mortality. Adults registered for LT between 2002 and 2007 were identified using the UNOS database. We compared components of MELD, MDRD-derived eGFR, and the 3-month probability of LT and death between genders. Discrimination of MELD, MELDNa, and revised models including eGFR for mortality were compared using c-statistics. A total of 40,393 patients (36% female) met the inclusion criteria; 9% died and 24% underwent LT within 3 months of listing. Compared with men, women had lower median serum creatinine (0.9 vs. 1.0 mg/dl), eGFR (72 vs. 83 ml/min/1.73 m(2)), and mean MELD (16.5 vs. 17.2; all p discrimination for 3-month mortality (c-statistics: MELD 0.896, MELD-eGFR 0.894, MELDNa 0.911, MELDNa-eGFR 0.905). Women are disadvantaged under MELD potentially due to its inclusion of creatinine. However, since including eGFR in MELD does not improve mortality prediction, alternative refinements are necessary. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Automation-aided Task Loads Index based on the Automation Rate Reflecting the Effects on Human Operators in NPPs

International Nuclear Information System (INIS)

Lee, Seungmin; Seong, Poonghyun; Kim, Jonghyun

2013-01-01

Many researchers have found that a high automation rate does not guarantee high performance. Therefore, to reflect the effects of automation on human performance, a new estimation method of the automation rate that considers the effects of automation on human operators in nuclear power plants (NPPs) was suggested. These suggested measures express how much automation support human operators but it cannot express the change of human operators' workload, whether the human operators' workload is increased or decreased. Before considering automation rates, whether the adopted automation is good or bad might be estimated in advance. In this study, to estimate the appropriateness of automation according to the change of the human operators' task loads, automation-aided task loads index is suggested based on the concept of the suggested automation rate. To insure plant safety and efficiency on behalf of human operators, various automation systems have been installed in NPPs, and many works which were previously conducted by human operators can now be supported by computer-based operator aids. According to the characteristics of the automation types, the estimation method of the system automation and the cognitive automation rate were suggested. The proposed estimation method concentrates on the effects of introducing automation, so it directly express how much the automated system support human operators. Based on the suggested automation rates, the way to estimate how much the automated system can affect the human operators' cognitive task load is suggested in this study. When there is no automation, the calculated index is 1, and it means there is no change of human operators' task load

Acetabular Cup Revision.

Science.gov (United States)

Kim, Young-Ho

2017-09-01

The use of acetabular cup revision arthroplasty is on the rise as demands for total hip arthroplasty, improved life expectancies, and the need for individual activity increase. For an acetabular cup revision to be successful, the cup should gain stable fixation within the remaining supportive bone of the acetabulum. Since the patient's remaining supportive acetabular bone stock plays an important role in the success of revision, accurate classification of the degree of acetabular bone defect is necessary. The Paprosky classification system is most commonly used when determining the location and degree of acetabular bone loss. Common treatment options include: acetabular liner exchange, high hip center, oblong cup, trabecular metal cup with augment, bipolar cup, bulk structural graft, cemented cup, uncemented cup including jumbo cup, acetabular reinforcement device (cage), trabecular metal cup cage. The optimal treatment option is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable fixation upon supportive host bone. To achieve successful acetabular cup revision, accurate evaluation of bone defect preoperatively and intraoperatively, proper choice of method of acetabular revision according to the evaluation of acetabular bone deficiency, proper technique to get primary stability of implant such as precise grafting technique, and stable fixation of implant are mandatory.

Developments in UK defect assessment procedures R6 revision 4 and BS7910

International Nuclear Information System (INIS)

Sharples, J.K.; Ainsworth, R.A.; Budden, P.J.

2003-01-01

The R6 defect assessment procedures have been developed over many years by the UK nuclear power generation industry. The procedures are updated on a regular basis, taking into account the information resulting from the R6 development programme and other available information worldwide. A major revision, Revision 4, of the R6 procedures was released in 2000. Just prior to that release, in 1999, the British Standards flaw assessment procedure BS7910 was issued and combined and updated the previous published documents PD6493 and PD6539, for components operating at temperatures where creep was negligible and important, respectively. BS79l0 is also under constant development. This paper provides a brief overview of the BS7910 and R6 Revision 4 procedures and describes updates to the respective documents since they were first issued. Some ongoing developments which will lead to future revisions to the documents are also described. (author)

Application of revised procedure on determining large excess reactivity of operating reactor. Fuel addition method

International Nuclear Information System (INIS)

Nagao, Yoshiharu

2002-01-01

The fuel addition method or the neutron absorption substitution method have been used for determination of large excess multiplication factor of large sized reactors. It has been pointed out, however, that all the experimental methods are possibly not free from the substantially large systematic error up to 20%, when the value of the excess multiplication factor exceeds about 15%Δk. Then, a basic idea of a revised procedure was proposed to cope with the problem, which converts the increase of multiplication factor in an actual core to that in a virtual core by calculation, because its value is in principle defined not for the former but the latter core. This paper proves that the revised procedure is able to be applicable for large sized research and test reactors through the theoretical analyses on the measurements undertaken at the JMTRC and JMTR cores. The values of excess multiplication factor are accurately determined utilizing the whole core calculation by the Monte Carlo code MCNP4A. (author)

A revision of the cask designers guide for the '90s

International Nuclear Information System (INIS)

Shappert, L.B.; Green, V.M.

1993-01-01

DOE has requested that ORNL initiate a revision to NSIC-68, A Guide for the Design, Fabrication, and Operation of Shipping Casks for Nuclear Applications, commonly called the Cask Designers Guide. This revision, called the Cask Handbook, has two goals: (1) to improve the quality of SARPs that are submitted to DOE, and (2) to provide up-to-date information on the design of spent fuel shipping casks, including information on fabrication, quality assurance, SARP preparation, certification, use, maintenance, and other general topics. The revision provides guidance that will help engineers through the cask licensing process, in part, by providing as much regulator-approved data and 'lessons-learned' information as possible. The effort is sponsored by DOE-Environmental, Safety and Health (EH), guided by Transportation Technology staff members at ORNL, and the information is being generated by experts in the various technical fields. (J.P.N.)

Expanded Operational Temperature Range for Space Rated Li-Ion Batteries, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — Quallion's response to this solicitation calls for expanding the nominal operation range of its space rated lithium ion cells, while maintaining their long life...

Investigation of the growth rate for joint fast breeder reactor and light water reactor operation

International Nuclear Information System (INIS)

Hanan, N.A.; Borg, C.R.; Ott, K.O.

1977-07-01

An investigation of fuel consumption and breeding characteristics of FBR-LWR joint operation is presented. The FBR operates in a closed cycle with joint-reprocessing of core and blanket material. The LWR-portion that runs on FBR plutonium operates in an open cycle. The growth rate of the system is defined based upon the fact that the discharge from the system will make up a fraction of an identical system; the system growth rate is found to have an almost linear dependence on the fraction of the LWR fed by plutonium from the FBR. The LWR growth rate, which is negative, is a constant and represents the fraction of the fuel burnt in the LWR-fraction that runs on FBR plutonium per year

High-rate operant behavior in two mouse strains: a response-bout analysis.

Science.gov (United States)

Johnson, Joshua E; Pesek, Erin F; Newland, M Christopher

2009-06-01

Operant behavior sometimes occurs in bouts characterized by an initiation rate, within-bout response rate, and bout length. The generality of this structure was tested using high-rate nose-poking in mice. Reinforcement of short interresponse times produced high response rates while a random-interval schedule held reinforcement rates constant. BALB/c mice produced bouts that were more frequent, longer, and contained a higher within-bout rate of responding (nine nose-pokes/s) than did the C57BL/6 mice (five nose-pokes/s). Adding a running wheel decreased total nose-pokes and bout length, and increased bout-initiation rate. Free-feeding reduced nose-poking by decreasing bout-initiation rate. Photoperiod reversal decreased bout-initiation rate but not total nose-poke rate. Despite strain differences in bout structure, both strains responded similarly to the interventions. The three bout measures were correlated with overall rate but not with each other. Log-survival analyses provided independent descriptors of the structure of high-rate responding in these two strains.

Expanded Operational Temperature Range for Space Rated Li-Ion Batteries, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — Quallion's Phase II proposal calls for expanding the nominal operation range of its space rated lithium ion cells, while maintaining their long life capabilities. To...

Persistent pain and comorbidity among Operation Enduring Freedom/Operation Iraqi Freedom/operation New Dawn veterans.

Science.gov (United States)

Higgins, Diana M; Kerns, Robert D; Brandt, Cynthia A; Haskell, Sally G; Bathulapalli, Harini; Gilliam, Wesley; Goulet, Joseph L

2014-05-01

Chronic pain is a significant concern for the Veterans Health Administration (VHA), with chronic pain conditions among those most frequently reported by Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans. The current study examined VHA electronic medical record data to examine variation in demographics and high prevalence and high impact medical and mental health conditions in order to characterize the differences between patients with persistent pain and no pain. A conservative operational definition of chronic or "persistent pain" based on multiple indicators of pain (i.e., pain intensity ratings, prescription opioids, pain clinic visits, International Classification of Diseases, Ninth Revision codes) was employed. Analyses included the entire roster of longitudinal clinical data on OEF/OIF/OND veterans who used VHA care to compare those with persistent pain with those with no clinical evidence of pain. Results of logistic regression models suggest that sex, race, education, military variables, body mass index (BMI), traumatic brain injury (TBI), and mental health conditions, but not age, reliably discriminate the two groups. Those with persistent pain were more likely to be Black, female, on active duty, enlisted, Army service members, have a high school education or less, and have diagnoses of mood disorders, post-traumatic stress disorder, substance use disorders, anxiety disorders, TBI, and have a BMI consistent with overweight and obesity. The operational definition of chronic pain used in this study may have research implications for examining predictors of incident and chronic pain. These data have important clinical implications in that addressing comorbid conditions of persistent pain may improve adaptive coping and functioning in these patients. Wiley Periodicals, Inc.

Automation-aided Task Loads Index based on the Automation Rate Reflecting the Effects on Human Operators in NPPs

Energy Technology Data Exchange (ETDEWEB)

Lee, Seungmin; Seong, Poonghyun [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2013-05-15

Many researchers have found that a high automation rate does not guarantee high performance. Therefore, to reflect the effects of automation on human performance, a new estimation method of the automation rate that considers the effects of automation on human operators in nuclear power plants (NPPs) was suggested. These suggested measures express how much automation support human operators but it cannot express the change of human operators' workload, whether the human operators' workload is increased or decreased. Before considering automation rates, whether the adopted automation is good or bad might be estimated in advance. In this study, to estimate the appropriateness of automation according to the change of the human operators' task loads, automation-aided task loads index is suggested based on the concept of the suggested automation rate. To insure plant safety and efficiency on behalf of human operators, various automation systems have been installed in NPPs, and many works which were previously conducted by human operators can now be supported by computer-based operator aids. According to the characteristics of the automation types, the estimation method of the system automation and the cognitive automation rate were suggested. The proposed estimation method concentrates on the effects of introducing automation, so it directly express how much the automated system support human operators. Based on the suggested automation rates, the way to estimate how much the automated system can affect the human operators' cognitive task load is suggested in this study. When there is no automation, the calculated index is 1, and it means there is no change of human operators' task load.

Loose glenoid components in revision shoulder arthroplasty: is there an association with positive cultures?

Science.gov (United States)

Lucas, Robert M; Hsu, Jason E; Whitney, Ian J; Wasserburger, Jory; Matsen, Frederick A

2016-08-01

Glenoid loosening is one of the most common causes of total shoulder failure. High rates of positive cultures of Propionibacterium and coagulase-negative staphylococcus have been found among shoulders having surgical revision for glenoid loosening. This study reviewed the culture results in a series of surgical revisions for failed total shoulder arthroplasty to determine the relationship between glenoid loosening and positive cultures. The medical records of 221 patients without obvious evidence of infection who underwent revision total shoulder arthroplasty were reviewed to examine the association between the security of fixation of the glenoid component and the results of cultures obtained at revision surgery. Of the revised shoulders, 53% had positive cultures; 153 of the shoulders (69%) had a loose glenoid component, whereas 68 (31%) had secure glenoid component fixation. Of the 153 loose glenoid components, 82 (54%) had at least 1 positive culture and 44 (29%) had 2 or more positive cultures of the same microorganism. Similarly, of the 68 secure glenoid components, 35 (51%) had at least 1 positive culture (P = .77) and 14 (21%) had 2 or more positive cultures of the same microorganism (P = .25). Explanted glenoid components that were loose had a higher rate of culture positivity (56% [24/43]) in comparison to explanted glenoid components that were well fixed (13% [1/8]) (P = .05). Propionibacterium and coagulase-negative staphylococcus are commonly recovered in revision shoulder arthroplasty, whether or not the glenoid components are loose. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2016 National Census of Ferry Operators (Revised 03/18)

Data.gov (United States)

Department of Transportation — The 2016 NCFO dataset is comprised of the responses of all operators who completed the 2016 Census, reporting 2015 calendar year ferry operations. The NCFO Flat File...

76 FR 39357 - Revisions to the California State Implementation Plan, Imperial County Air Pollution Control...

Science.gov (United States)

2011-07-06

...EPA is proposing to approve revisions to the Imperial County Air Pollution Control District (ICAPCD), Kern County Air Pollution Control District (KCAPCD), and Ventura County Air Pollution Control District (VCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from architectural coating operations. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

Proposed revision of the Cumberland System Power Marketing Policy and subsequent contracts

International Nuclear Information System (INIS)

1992-01-01

Southeastern Power Administration has prepared an Environmental Assessment (DOE/EA-0811) evaluating the proposed revision of the Cumberland System Power Marketing Policy and Subsequent Contracts. The findings of the Environmental Assessment (EA) are: the only significant change from the existing policy will be the term of the contracts executed under the revised policy; and there will be no addition of major new generation resources; there will be no new loads; there will be no major changes in the operating parameters of power generation resources. This paper discusses the need for action, the alternative and the environmental impacts

LANDSAT-D ground segment operations plan, revision A

Science.gov (United States)

Evans, B.

1982-01-01

The basic concept for the utilization of LANDSAT ground processing resources is described. Only the steady state activities that support normal ground processing are addressed. This ground segment operations plan covers all processing of the multispectral scanner and the processing of thematic mapper through data acquisition and payload correction data generation for the LANDSAT 4 mission. The capabilities embedded in the hardware and software elements are presented from an operations viewpoint. The personnel assignments associated with each functional process and the mechanisms available for controlling the overall data flow are identified.

Bibliocable. Revised Edition.

Science.gov (United States)

Cable Television Information Center, Washington, DC.

This selective, annotated bibliography is a revision of the original published in 1972 (ED 071 402). Some 104 books, articles, and reports included here deal with access, applications, franchising, regulation, technology, and other aspects of cable television. The listings are of two types in each category. First are revisions of the original…

Updated and revised neutron reaction data for 237Np

Directory of Open Access Journals (Sweden)

Chen Guochang

2017-01-01

Full Text Available Nuclear data with high accuracy for minor actinides play an important role in nuclear technology applications, including reactor design and operation, fuel cycle, estimation of the amount of minor actinides in high burn-up reactors and the minor actinides transmutation. Based on the evaluated experimental data, the updated and revised evaluation of a full set of n+237Np nuclear data from 10−5 eV ∼ 20 MeV are carried out and recommended. Mainly revised quantities are neutron multiplicities from fission reaction, inelastic, fission, (n, 2n and (n, γ reaction cross sections as well as angular distribution and so on. The promising results are obtained when the renewal evaluated data of 237Np will be used to instead of the evaluated data in CENDL-3.1 database.

75 FR 65365 - Disaster Temporary Housing Operational Guide

Science.gov (United States)

2010-10-22

... guide does not have the force or effect of law. FEMA seeks comment on the proposed operational guide... comments received, FEMA may make appropriate revisions to the proposed operational guide. Although FEMA... http://www.regulations.gov . The final operational guide will not have the force or effect of law...

Analysis of the influence of operating conditions on fouling rates in fired heaters

International Nuclear Information System (INIS)

Morales-Fuentes, A.; Picón-Núñez, M.; Polley, G.T.; Méndez-Díaz, S.

2014-01-01

Fouling due to chemical reaction in preheat trains for the processing of crude oil plays a key role in the operation and maintenance costs and on greenhouse emissions to atmosphere in crude processing plants. A preheat train consists of a set of heat transfer units that provide the crude oil stream the required amount of thermal energy to reach its target temperature either by heat recovery or by direct firing. Fired heaters supply external high temperature heating through the burning of fuel which result in complex heat transfer processes due to the large temperature and pressure changes and vaporization that takes place inside the unit. In this work, a thermo-hydraulic analysis of the performance of fired heaters is carried out through the application of commercial software to solve the mathematical models using finite difference methods; the analysis is applied to the crude side of a vertical fired heater in order to evaluate the impact of process conditions such as throughput and crude inlet temperature (CIT) on the fouling that take place at the early stages of operation. Using a fouling rate model based on thermo-hydraulic parameters, fouling rates are predicted assuming steady state operation and clean conditions. Although variations in process conditions are known to influence fouling rates, little work has been done on the subject. In this work excess air and steam injection are studied as a means to mitigate fouling. Results show that throughput reduction brings about a marked increase in the fouling rates. A decrease in CIT affects only the convection zone and it is found that this effect is negligible. In terms of excess air, it is found that although it affects negatively the heater efficiency it can be used to balance heat transfer between the convection and radiation zone in a way that fouling rates are reduced; however this strategy should be considered right from the design stage. Finally it is observed that steam injection is an effective method

MAR Assessments Of The High Level Waste System Plan Revision 16

International Nuclear Information System (INIS)

Peeler, D.; Edwards, T.

2011-01-01

High-level waste (HLW) throughput (i.e., the amount of waste processed per unit of time) is primarily a function of two critical parameters: waste loading (WL) and melt rate. For the Defense Waste Processing Facility (DWPF), increasing HLW throughput would significantly reduce the overall mission life cycle costs for the Department of Energy (DOE). Significant increases in waste throughput have been achieved at DWPF since initial radioactive operations began in 1996. Key technical and operational initiatives that supported increased waste throughput included improvements in facility attainment, the Chemical Processing Cell (CPC) flowsheet, process control models and frit formulations. As a result of these key initiatives, DWPF increased WLs from a nominal 28% for Sludge Batch 2 (SB2) to ∼34 to 38% for SB3 through SB6 while maintaining or slightly improving canister fill times. Although considerable improvements in waste throughput have been obtained, future contractual waste loading targets are nominally 40%, while canister production rates are also expected to increase (to a rate of 325 to 400 canisters per year). Although implementation of bubblers have made a positive impact on increasing melt rate for recent sludge batches targeting WLs in the mid30s, higher WLs will ultimately make the feeds to DWPF more challenging to process. Savannah River Remediation (SRR) recently requested the Savannah River National Laboratory (SRNL) to perform a paper study assessment using future sludge projections to evaluate whether the current Process Composition Control System (PCCS) algorithms would provide projected operating windows to allow future contractual WL targets to be met. More specifically, the objective of this study was to evaluate future sludge batch projections (based on Revision 16 of the HLW Systems Plan) with respect to projected operating windows using current PCCS models and associated constraints. Based on the assessments, the waste loading interval over

Operability test procedure for 244-U DCRT. Revision 1

International Nuclear Information System (INIS)

Erhart, M.F.

1995-01-01

This OPT will insure the operability of various systems and their general equipment, used in the operation of the 244-U DCRT. Systems that will be tested include the following: Leak Detection Systems; Heat Trace System; Vessel Temperature Measurement System; Dip Tube Water System; Weight Factor and Specific Gravity System; Instrument Air System; Vessel Liquid Level System; Vessel Liquid Transfer System; and Exhauster Differential Pressure Indicating Controller System. The tests will cover checks on equipment operation and electrical interlocks, but will not cover checks on associated annunciator alarms which are covered in a separate OTP

One-stage or two-stage revision surgery for prosthetic hip joint infection--the INFORM trial: a study protocol for a randomised controlled trial.

Science.gov (United States)

Strange, Simon; Whitehouse, Michael R; Beswick, Andrew D; Board, Tim; Burston, Amanda; Burston, Ben; Carroll, Fran E; Dieppe, Paul; Garfield, Kirsty; Gooberman-Hill, Rachael; Jones, Stephen; Kunutsor, Setor; Lane, Athene; Lenguerrand, Erik; MacGowan, Alasdair; Moore, Andrew; Noble, Sian; Simon, Joanne; Stockley, Ian; Taylor, Adrian H; Toms, Andrew; Webb, Jason; Whittaker, John-Paul; Wilson, Matthew; Wylde, Vikki; Blom, Ashley W

2016-02-17

Periprosthetic joint infection (PJI) affects approximately 1% of patients following total hip replacement (THR) and often results in severe physical and emotional suffering. Current surgical treatment options are debridement, antibiotics and implant retention; revision THR; excision of the joint and amputation. Revision surgery can be done as either a one-stage or two-stage operation. Both types of surgery are well-established practice in the NHS and result in similar rates of re-infection, but little is known about the impact of these treatments from the patient's perspective. The main aim of this randomised controlled trial is to determine whether there is a difference in patient-reported outcome measures 18 months after randomisation for one-stage or two-stage revision surgery. INFORM (INFection ORthopaedic Management) is an open, two-arm, multi-centre, randomised, superiority trial. We aim to randomise 148 patients with eligible PJI of the hip from approximately seven secondary care NHS orthopaedic units from across England and Wales. Patients will be randomised via a web-based system to receive either a one-stage revision or a two-stage revision THR. Blinding is not possible due to the nature of the intervention. All patients will be followed up for 18 months. The primary outcome is the WOMAC Index, which assesses hip pain, function and stiffness, collected by questionnaire at 18 months. Secondary outcomes include the following: cost-effectiveness, complications, re-infection rates, objective hip function assessment and quality of life. A nested qualitative study will explore patients' and surgeons' experiences, including their views about trial participation and randomisation. INFORM is the first ever randomised trial to compare two widely accepted surgical interventions for the treatment of PJI: one-stage and two-stage revision THR. The results of the trial will benefit patients in the future as the main focus is on patient-reported outcomes: pain, function

Preliminary hazards analysis of thermal scrap stabilization system. Revision 1

International Nuclear Information System (INIS)

Lewis, W.S.

1994-01-01

This preliminary analysis examined the HA-21I glovebox and its supporting systems for potential process hazards. Upon further analysis, the thermal stabilization system has been installed in gloveboxes HC-21A and HC-21C. The use of HC-21C and HC-21A simplified the initial safety analysis. In addition, these gloveboxes were cleaner and required less modification for operation than glovebox HA-21I. While this document refers to glovebox HA-21I for the hazards analysis performed, glovebox HC-21C is sufficiently similar that the following analysis is also valid for HC-21C. This hazards analysis document is being re-released as revision 1 to include the updated flowsheet document (Appendix C) and the updated design basis (Appendix D). The revised Process Flow Schematic has also been included (Appendix E). This Current revision incorporates the recommendations provided from the original hazards analysis as well. The System Design Description (SDD) has also been appended (Appendix H) to document the bases for Safety Classification of thermal stabilization equipment

Operators and scales: diagnostic and rating issues in psychiatric PET research

International Nuclear Information System (INIS)

Aagren, H.

1992-01-01

In psychiatric research that for various reasons has to restrict itself to a limited number of subjects, such as studies involving expensive positron emission tomography techniques, issues concerning the parsimonious description of patients gain in importance. The number of descriptive variables must be optimally small. This paper offers a conceptual back-ground for the choice of operators in operational diagnostic systems designed to delimit pathological types, and of rating scales designed to measure syndromal severity in a dimensional way. A practical suggestion in five tenets for the organization of clinical research of this kind is presented. (author)

Operation and Thermal Modeling of the ISIS H– Source from 50 to 2 Hz Repetition Rates

CERN Document Server

Pereira, H; Lettry, J

2013-01-01

CERN’s Linac4 accelerator H− ion source, currently under construction, will operate at a 2 Hz repetition rate, with pulse length of 0.5 ms and a beam current of 80 mA. Its reliability must exceed 99 % with a mandatory 3 month uninterrupted operation period. A Penning ion source is successfully operated at ISIS; at 50 Hz repetition rate it reliably provides 55 mA H− pulses of 0.25 ms duration over 1 month. The discharge plasma ignition is very sensitive to the temperatures of the discharge region, especially of its cathode. The investigation by modeling and measurement of operation parameters suitable for arc ignition and H− production at 2 Hz is of paramount importance and must be understood prior to the implementation of discharge ion sources in the Linac4 accelerator. In its original configuration, the ISIS H− source delivers beam only if the repetition rate is above 12.5 Hz, this paper describes the implementation of a temperature control of the discharge region aiming at lower repetition rate op...

Innovative Telemonitoring System for Cardiology: From Science to Routine Operation

Science.gov (United States)

Kastner, P.; Morak, J.; Modre, R.; Kollmann, A.; Ebner, C.; Fruhwald, FM.; Schreier, G.

2010-01-01

Objective Results of the Austrian MOBITEL (MOBIle phone based TELemonitoring for heart failure patients) trial indicate that home-based telemonitoring improves outcome of chronic heart failure (CHF) patients and reduces both frequency and duration of hospitalizations. Based on lessons learned, we assessed the weak points to clear the way for routine operations. Methods We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements. The following components have been identified: a patient terminal with highest usability, integrated way to document drug-intake and well-being, and automated event detection for worsening of CHF. As a consequence the system was extended by Near Field Communication (NFC) technology and by an event management tool. Results Usability evaluation with 30 adults (14f, median 51y. IQR[45-65]) showed that 21 (8f) were able to immediately operate the system after reading a step-by-step manual. Eight (6f) needed one time demonstration and one man (80y) failed to operate the blood pressure meter. Routine operation of the revised system started in March 2009. Within 9 months, 15 patients (4f, median 74y. IQR[71-83], all NYHA-III) transmitted 17,149 items. 43 events were detected because of body weight gain of more then 2kg within 2 days. 49 therapy adjustments were documented. Three patients stopped using the system, two (1f) because of non-compliance and one (m, 82y) because of death. Overall, the rate of adherence to daily data transfer was 78%. Conclusion First results confirm the applicability of the revised telemonitoring system in routine operation. PMID:23616835

Revision to DOE Order 450.1 [1] and How it affects DOE Sites

International Nuclear Information System (INIS)

Birchfield, J.W.

2009-01-01

On June 4, 2008, DOE finalized the latest technical revision of DOE Order 450.1A. The latest revision of the order contains many new EMS requirements that can have a dramatic effect on what and how activities are conducted at the various DOE sites. The latest revision of the order contains many new Environmental Management System (EMS) requirements that can have a dramatic effect on what and how activities are conducted at the various DOE sites. DOE Order 450.1 contains some major technical revisions that will directly affect each DOE site. The exact extent of the changes to the order will vary at each site depending on the status of EMS implementation utilizing the ISO 14001:2004 (2004 denotes the latest version in effect) Standard and Executive Order 13423. ISO 14001:2004 contains a total of 17 elements (i.e., requirements) that are required for EMS programs. Because the original DOE Order 450.1 did not require conformance to the original ISO 14001:1996 Standard, this is a significant addition to EMS program management. Some EMS program elements will require effort, some significant, depending upon the complexity of the operations conducted at the various DOE sites. Significant EMS elements added include audit programs (e.g., internal and external), operational controls (e.g., procedures, personnel and equipment), monitoring and measurement (e.g., key environmental metrics tracking and equipment calibration), document controls, communication and preventive actions. DOE has also drastically altered its approach to sustainable development and environmental stewardship by specifying departmental goals through: - Reduction or elimination of the toxicity of waste through pollution prevention; - Reduction or elimination of the acquisition, use and release of toxic/hazardous materials and chemicals; - Maximizing the purchase of environmental friendly chemicals and materials in the conduct of operations; - Reduction or elimination of environmental impacts from electronic

76 FR 39303 - Revisions to the California State Implementation Plan, Imperial County Air Pollution Control...

Science.gov (United States)

2011-07-06

...EPA is taking direct final action to approve revisions to the Imperial County Air Pollution Control District (ICAPCD), Kern County Air Pollution Control District (KCAPCD), and Ventura County Air Pollution Control District (VCAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from architectural coating operations. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

High mid-term revision rate after treatment of large, full-thickness cartilage lesions and OA in the patellofemoral joint using a large inlay resurfacing prosthesis

DEFF Research Database (Denmark)

Laursen, Jens Ole

2017-01-01

PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant...... pain but high mid-term revision rate after patellofemoral inlay resurfacing using the HemiCAP-Wave® implant. Patellofemoral resurfacing implantation treatment with a large inlay prosthesis can offer temporary treatment for large isolated patellofemoral cartilage lesions or OA in younger patients...

76 FR 53344 - Funding and Fiscal Affairs, Loan Policies and Operations, and Funding Operations; Capital...

Science.gov (United States)

2011-08-26

... Risk-Weighting Revisions: Alternatives to Credit Ratings AGENCY: Farm Credit Administration. ACTION... risk-weighting investments in recourse obligations, residual interests (other than credit-enhancing....\\7\\ Under the RBA, the risk weighting of such assets increases as the credit rating declines. \\4\\ See...

Operator licensing examiner standards

International Nuclear Information System (INIS)

1987-05-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes

Operator licensing examiner standards

International Nuclear Information System (INIS)

1993-01-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes

Safety of Nuclear Power Plants: Commissioning and Operation

International Nuclear Information System (INIS)

2011-01-01

This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

Towards Revised Step IV MICE Optics in the Absence of M1 SSD

Energy Technology Data Exchange (ETDEWEB)

Bayes, R. [Univ. of Glasgow, Scotland (United Kingdom); Berg, J. S. [Brookhaven National Lab. (BNL), Upton, NY (United States); Blackmore, V. [Imperial College, London (United Kingdom); Hunt, C. [Imperial College, London (United Kingdom); Liu, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Pasternak, J. [Imperial College, London (United Kingdom); Rogers, C. T. [Science and Technology Facilities Council (STFC), Oxford (United Kingdom). Rutherford Appleton Lab. (RAL)

2015-10-01

During magnet commissioning in September 2015, the leads on coil M1 of the downstream spectrometer solenoid failed. The coil will not be operational for MICE Step IV. Revised optics settings for the Step IV data taking are reviewed.

Towards Revised Step IV MICE Optics in the Absence of M1 SSD

International Nuclear Information System (INIS)

Bayes, R.; Berg, J. S.; Blackmore, V.; Hunt, C.; Liu, A.; Pasternak, J.; Rogers, C. T.

2015-01-01

During magnet commissioning in September 2015, the leads on coil M1 of the downstream spectrometer solenoid failed. The coil will not be operational for MICE Step IV. Revised optics settings for the Step IV data taking are reviewed.

Waste Management Program management plan. Revision 1

International Nuclear Information System (INIS)

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management's objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL

Guidance document for revision of DOE Order 5820.2A, Radioactive Waste Technical Support Program. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Kudera, D.E.; McMurtrey, C.D.; Meagher, B.G.

1993-04-01

This document provides guidance for the revision of DOE Order 5820.2A, ``Radioactive Waste Management.`` Technical Working Groups have been established and are responsible for writing the revised order. The Technical Working Groups will use this document as a reference for polices and procedures that have been established for the revision process. The overall intent of this guidance is to outline how the order will be revised and how the revision process will be managed. In addition, this document outlines technical issues considered for inclusion by a Department of Energy Steering Committee.

BWR Water Chemistry Guidelines: 1993 Revision, Normal and hydrogen water chemistry

International Nuclear Information System (INIS)

Karlberg, G.; Goddard, C.; Fitzpatrick, S.

1994-02-01

The goal of water chemistry control is to extend the operating life of the reactor and rector coolant system, balance-of-plant components, and turbines while simultaneously controlling costs to safeguard the continued economic viability of the nuclear power generation investment. To further this goal an industry committee of chemistry personnel prepared guidelines to identify the benefits, risks, and costs associated with water chemistry in BWRs and to provide a template for an optimized water chemistry program. This document replaces the BWR Normal Water Chemistry Guidelines - 1986 Revision and the BWR Hydrogen Water Chemistry Guidelines -- 1987 Revision. It expands on the previous guidelines documents by covering the economic implications of BWR water chemistry control

76 FR 37021 - Louisiana: Final Authorization of State Hazardous Waste Management Program Revision

Science.gov (United States)

2011-06-24

...: Final Authorization of State Hazardous Waste Management Program Revision AGENCY: Environmental... implement its base Hazardous Waste Management Program. We granted authorization for changes to their program... opportunity to apply for final authorization to operate all aspects of their hazardous waste management...

Feasibility study of tank leakage mitigation using subsurface barriers. Revision 1

International Nuclear Information System (INIS)

Treat, R.L.; Peters, B.B.; Cameron, R.J.

1995-01-01

This document reflects the evaluations and analyses performed in response to Tri-Party Agreement Milestone M-45-07A - open-quotes Complete Evaluation of Subsurface Barrier Feasibilityclose quotes (September 1994). In addition, this feasibility study was revised reflecting ongoing work supporting a pending decision by the DOE Richland Operations Office, the Washington State Department of Ecology, and the US Environmental Protection Agency regarding further development of subsurface barrier options for SSTs and whether to proceed with demonstration plans at the Hanford Site (Tri-Party Agreement Milestone M-45-07B). Analyses of 14 integrated SST tank farm remediation alternatives were conducted in response to the three stated objectives of Tri-Party Agreement Milestone M-45-07A. The alternatives include eight with subsurface barriers and six without. Technologies used in the alternatives include three types of tank waste retrieval, seven types of subsurface barriers, a method of stabilizing the void space of emptied tanks, two types of in situ soil flushing, one type of surface barrier, and a clean-closure method. A no-action alternative and a surface-barrier-only alternative were included as nonviable alternatives for comparison. All other alternatives were designed to result in closure of SST tank farms as landfills or in clean-closure. Revision 1 incorporates additional analyses of worker safety, large leak scenarios, and sensitivity to the leach rates of risk controlling constituents. The additional analyses were conducted to support TPA Milestone M-45-07B

Prediction of critical flow rates through power-operated relief valves

International Nuclear Information System (INIS)

Abdollahian, D.; Singh, A.

1983-01-01

Existing single-phase and two-phase critical flow models are used to predict the flow rates through the power-operated relief valves tested in the EPRI Safety and Relief Valve test program. For liquid upstream conditions, Homogeneous Equilibrium Model, Moody, Henry-Fauske and Burnell two-phase critical flow models are used for comparison with data. Under steam upstream conditions, the flow rates are predicted either by the single-phase isentropic equations or the Homogeneous Equilibrium Model, depending on the thermodynamic condition of the fluid at the choking plane. The results of the comparisons are used to specify discharge coefficients for different valves under steam and liquid upstream conditions and evaluate the existing approximate critical flow relations for a wide range of subcooled water and steam conditions

[Revision of the drinking water regulations].

Science.gov (United States)

Hauswirth, S

2011-11-01

The revision the Drinking Water Regulations will come into effect on 01.11.2011. Surveillance authorities and owners of drinking water supply systems had hoped for simplifications and reductions because of the new arrangements. According to the official statement for the revision the legislature intended to create more clarity, consider new scientific findings, to change regulations that have not been proved to close regulatory gaps, to deregulate and to increase the high quality standards. A detailed examination of the regulation text, however, raises doubts. The new classification of water supply systems requires different modalities of registration, water analyses and official observation, which will complicate the work of the authorities. In particular, the implementation of requirements of registration and examination for the owners of commercial and publicly-operated large hot-water systems in accordance with DVGW Worksheet W 551 requires more effort. According to the estimated 30 000 cases of legionellosis in Germany the need for a check of such systems for Legionella, however, is not called into question. Furthermore, the development of sampling plans and the monitoring of mobile water supply systems requires more work for the health authorities. © Georg Thieme Verlag KG Stuttgart · New York.

[Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].

Science.gov (United States)

Schwabe, P; Märdian, S; Perka, C; Schaser, K-D

2016-04-01

Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup. Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation. Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening. Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition. Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups. Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.

No impact of repeated extinction exposures on operant responding maintained by different reinforcer rates.

Science.gov (United States)

Bai, John Y H; Podlesnik, Christopher A

2017-05-01

Greater rates of intermittent reinforcement in the presence of discriminative stimuli generally produce greater resistance to extinction, consistent with predictions of behavioral momentum theory. Other studies reveal more rapid extinction with higher rates of reinforcers - the partial reinforcement extinction effect. Further, repeated extinction often produces more rapid decreases in operant responding due to learning a discrimination between training and extinction contingencies. The present study examined extinction repeatedly with training with different rates of intermittent reinforcement in a multiple schedule. We assessed whether repeated extinction would reverse the pattern of greater resistance to extinction with greater reinforcer rates. Counter to this prediction, resistance to extinction was consistently greater across twelve assessments of training followed by six successive sessions of extinction. Moreover, patterns of responding during extinction resembled those observed during satiation tests, which should not alter discrimination processes with repeated testing. These findings join others suggesting operant responding in extinction can be durable across repeated tests. Copyright © 2017 Elsevier B.V. All rights reserved.

Safety assessment for the 118-B-1 Burial Ground excavation treatability tests. Revision 2

International Nuclear Information System (INIS)

Zimmer, J.J.; Frain, J.M.

1994-12-01

This revision of the Safety Assessment provides an auditable safety analysis of the hazards for the proposed treatability test activities per DOE-EM-STD-5502-94, DOE Limited Standard, Hazard Baseline Documentation (DOE 1994). The proposed activities are classified as radiological activities and as such, no longer require Operational Safety Limits (OSLs). The OSLS, Prudent Actions, and Institutional and Organization Controls have been removed from this revision and replaced with ''Administrative Actions Important to Safety,'' as determined by the hazards analysis. Those Administrative Actions Important to Safety are summarized in Section 1.1, ''Assessment Summary.''

Mixed Waste Management Facility, revised FY94 Plan

International Nuclear Information System (INIS)

Streit, R.

1994-01-01

This revision of the FY94 Plan incorporates changes to work during FY94 in response to the DOE request in the DOE KD-1 decision letter of June 28,1994. This letter provided guidance of both scope and budget profile in response to the Conceptual Design Report (CDR) issued by the MWMF Project in April, 1994. This work plan only addresses work for the remainder of FY94. A revised plan for the complete project is in development and will be issued separately. Since February, 1994, the MWMF Project has been operating on DOE guidance directing that work on the CDR be completed, that only other essential work be continued to maintain the project, and that costs be maintained at approximately the January, 1994 spending levels until a KD-1 decision was made. This has formed the basis for monthly reports through June, 1994. The baseline contained in this report will become the basis for reports during the remainder of FY94

Deep Borehole Emplacement Mode Hazard Analysis Revision 0

Energy Technology Data Exchange (ETDEWEB)

Sevougian, S. David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-08-07

This letter report outlines a methodology and provides resource information for the Deep Borehole Emplacement Mode Hazard Analysis (DBEMHA). The main purpose is identify the accident hazards and accident event sequences associated with the two emplacement mode options (wireline or drillstring), to outline a methodology for computing accident probabilities and frequencies, and to point to available databases on the nature and frequency of accidents typically associated with standard borehole drilling and nuclear handling operations. Risk mitigation and prevention measures, which have been incorporated into the two emplacement designs (see Cochran and Hardin 2015), are also discussed. A key intent of this report is to provide background information to brief subject matter experts involved in the Emplacement Mode Design Study. [Note: Revision 0 of this report is concentrated more on the wireline emplacement mode. It is expected that Revision 1 will contain further development of the preliminary fault and event trees for the drill string emplacement mode.

Manpower development for safe operation of nuclear power plant. China. Revision of final safety analysis report. Activity: 5.1.3-Task-08. Technical report

International Nuclear Information System (INIS)

Almeida, C.; Elias, D.

1994-01-01

The objectives of this mission included providing assistance for the revision of the FSAR including: national practices, administrative procedures, required staffing level, other resources, planning, scheduling, content, and organization of the revision. Activities included several days of lectures regarding worldwide practices including the United States and Commonwealth Edison Company (ComEd), interaction with Chinese counterparts re. their FSAR and Technical Specification revision and two visits to the Qin Shan NPP

Strategies for revision surgery after primary double-bundle anterior cruciate ligament (ACL) reconstruction

NARCIS (Netherlands)

Hofbauer, Marcus; Muller, Bart; Murawski, Christopher D.; Baraga, Michael; van Eck, Carola Franziska; Fu, Freddie H.

2013-01-01

The purpose of this article was to discuss pre- and intra-operative considerations as well as surgical strategies for different femoral and tibial tunnel scenarios in revision surgery following primary double-bundle anterior cruciate ligament (ACL) reconstruction. Based on the current literature of

78 FR 46781 - Federal Acquisition Regulation; Definition of Contingency Operation

Science.gov (United States)

2013-08-01

... Federal Acquisition Regulation; Definition of Contingency Operation AGENCY: Department of Defense (DoD... the Federal Acquisition Regulation (FAR) to revise the definition of ``contingency operation'' to... ``contingency operation'' at FAR 2.101 in accordance with the statutory change to the definition made by...

Revision open Bankart surgery after arthroscopic repair for traumatic anterior shoulder instability.

Science.gov (United States)

Cho, Nam Su; Yi, Jin Woong; Lee, Bong Gun; Rhee, Yong Girl

2009-11-01

Only a few studies have provided homogeneous analysis of open revision surgery after a failed arthroscopic Bankart procedure. Open Bankart revision surgery will be effective in a failed arthroscopic anterior stabilization but inevitably results in a loss of range of motion, especially external rotation. Case series; Level of evidence, 4. Twenty-six shoulders that went through traditional open Bankart repair as revision surgery after a failed arthroscopic Bankart procedure for traumatic anterior shoulder instability were enrolled for this study. The mean patient age at the time of revision surgery was 24 years (range, 16-38 years), and the mean duration of follow-up was 42 months (range, 25-97 months). The preoperative mean range of motion was 173 degrees in forward flexion and 65 degrees in external rotation at the side. After revision surgery, the ranges measured 164 degrees and 55 degrees, respectively (P = .024 and .012, respectively). At the last follow-up, the mean Rowe score was 81 points, with 88.5% of the patients reporting good or excellent results. After revision surgery, redislocation developed in 3 shoulders (11.5%), all of which had an engaging Hill-Sachs lesion and associated hyperlaxity (2+ or greater laxity on the sulcus sign). Open revision Bankart surgery for a failed arthroscopic Bankart repair can provide a satisfactory outcome, including a low recurrence rate and reliable functional return. In open revision Bankart surgery after failed stabilization for traumatic anterior shoulder instability, the surgeon should keep in mind the possibility of a postoperative loss of range of motion and a thorough examination for not only a Bankart lesion but also other associated lesions, including a bone defect or hyperlaxity, to lower the risk of redislocation.

Optimizing the data acquisition rate for a remotely controllable structural monitoring system with parallel operation and self-adaptive sampling

International Nuclear Information System (INIS)

Sheng, Wenjuan; Guo, Aihuang; Liu, Yang; Azmi, Asrul Izam; Peng, Gang-Ding

2011-01-01

We present a novel technique that optimizes the real-time remote monitoring and control of dispersed civil infrastructures. The monitoring system is based on fiber Bragg gating (FBG) sensors, and transfers data via Ethernet. This technique combines parallel operation and self-adaptive sampling to increase the data acquisition rate in remote controllable structural monitoring systems. The compact parallel operation mode is highly efficient at achieving the highest possible data acquisition rate for the FBG sensor based local data acquisition system. Self-adaptive sampling is introduced to continuously coordinate local acquisition and remote control for data acquisition rate optimization. Key issues which impact the operation of the whole system, such as the real-time data acquisition rate, data processing capability, and buffer usage, are investigated. The results show that, by introducing parallel operation and self-adaptive sampling, the data acquisition rate can be increased by several times without affecting the system operating performance on both local data acquisition and remote process control

High bacterial contamination rate of electrocautery tips during total hip and knee arthroplasty.

Science.gov (United States)

Abdelaziz, Hussein; Zahar, Akos; Lausmann, Christian; Gehrke, Thorsten; Fickenscher, Helmut; Suero, Eduardo M; Gebauer, Matthias; Citak, Mustafa

2018-04-01

The aim of the study was to quantify the bacterial contamination rate of electrocautery tips during primary total joint replacement (TJR), as well as during aseptic and septic revision TJR. A total of 150 electrocautery tips were collected between April and July 2017. TJR surgeries were divided into three groups: (1) primary, (2) aseptic and (3) septic revisions. In each group, a total of 50 electrocautery tips were collected. A monopolar electrocautery with a reusable stainless-steel blade tip was used in all cases. The rate of bacterial contamination was determined for all groups. Correlation of exposure time and type of surgery was analyzed. The overall bacterial contamination rate was 14.7% (95% CI 9.4 to 21.4%). The highest contamination rate occurred in the septic revision group (30.0%; 95% CI 17.9 to 44.6%), followed by the primary cases group (10.0%; 95% CI 3.3 to 21.8%) and the aseptic revision group (4.0%; 95% CI 0.5 to 13.7%). Exposure time did not affect the bacterial contamination rate. In 12 out of 15 (80%) contaminations identified in the septic group, we found the same causative microorganism of the prosthetic joint infection on the electrocautery tip. The bacterial contamination of the electrocautery tips is relatively high, especially during septic hip revision arthroplasty. Electrocautery tips should be changed after debridement of infected tissue.

Composition operators between Bloch type spaces and Zygmund ...

Indian Academy of Sciences (India)

MS received 1 September 2009; revised 31 March 2011. Abstract. The boundedness and compactness of composition operators between. Bloch type spaces and Zygmund spaces of holomorphic functions in the unit ball are characterized in the paper. Keywords. Composition operator; Bloch type space; Zygmund space. 1.

Performance assessment for continuing and future operations at solid waste storage area 6

International Nuclear Information System (INIS)

1997-09-01

This revised performance assessment (PA) for the continued disposal operations at Solid Waste Storage Area (SWSA) 6 on the Oak Ridge Reservation (ORR) has been prepared to demonstrate compliance with the performance objectives for low-level radioactive waste (LLW) disposal contained in the US Department of Energy (DOE) Order 5820.2A. This revised PA considers disposal operations conducted from September 26, 1988, through the projects lifetime of the disposal facility

Performance assessment for continuing and future operations at solid waste storage area 6

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-09-01

This revised performance assessment (PA) for the continued disposal operations at Solid Waste Storage Area (SWSA) 6 on the Oak Ridge Reservation (ORR) has been prepared to demonstrate compliance with the performance objectives for low-level radioactive waste (LLW) disposal contained in the US Department of Energy (DOE) Order 5820.2A. This revised PA considers disposal operations conducted from September 26, 1988, through the projects lifetime of the disposal facility.

Revision allograft reconstruction of the lateral collateral ligament complex in elbows with previous failed reconstruction and persistent posterolateral rotatory instability.

Science.gov (United States)

Baghdadi, Yaser M K; Morrey, Bernard F; O'Driscoll, Shawn W; Steinmann, Scott P; Sanchez-Sotelo, Joaquin

2014-07-01

Primary reconstruction of the lateral collateral ligament complex (LCLC) using graft tissue restores elbow stability in many, but not all, elbows with acute or chronic posterolateral rotatory instability (PLRI). Revision reconstruction using a tendon allograft is occasionally considered for persistent PLRI, but the outcome of revision ligament reconstruction in this setting is largely unknown. We determined whether revision allograft ligament reconstruction can (1) restore the stability and (2) result in improved elbow scores for patients with persistent PLRI of the elbow after a previous failed primary reconstructive attempt and in the context of the diverse pathology being addressed. Between 2001 and 2011, 160 surgical elbow procedures were performed at our institution for the LCLC reconstruction using allograft tissue. Only patients undergoing revision allograft reconstruction of the LCLC for persistent PLRI with a previous failed primary reconstructive attempt using graft tissue and at least I year of followup were included in the study. Eleven patients (11 elbows) fulfilled our inclusion criteria and formed our study cohort. The cohort consisted of six female patients and five male patients. The mean age at the time of revision surgery was 36 years (range, 14-59 years). The revision allograft reconstruction was carried out after a mean of 3 years (range, 2.5 months to 9 years) from a failed attempted reconstruction of the LCLC. Osseous deficiency to some extent was identified in the preoperative radiographs of eight elbows. Mean followup was 5 years (range, 1-12 years). Revision allograft reconstruction of the LCLC restored elbow stability in eight of the 11 elbows; two of the three elbows with persistent instability were operated on a third time (at 6 and 7 months after allograft revision reconstruction). For elbows with no persistent instability, the mean Mayo Elbow Performance Score at most recent followup was 83 points (range, 60-100 points), and

Operation of high rate microstrip gas chambers

CERN Document Server

Barr, A J; Bouclier, Roger; Capéans-Garrido, M; Dominik, Wojciech; Manzin, G; Million, Gilbert; Hoch, M; Ropelewski, Leszek; Sauli, Fabio; Sharma, A

1996-01-01

We describe recent measurements carried out in well controlled and reproducible conditions to help understanding the factors affecting the short and long term behaviour of Microstrip Gas Chambers. Special care has been taken concerning the gas purity and choice of materials used in the system and for the detectors construction. Detectors built on glasses with surface resistivity in the range $10^{13}-10^{15} \\Omega/\\Box$ have shown satisfactory performance as they do not show charging-up process at high rate and stand the large doses required for the future high luminosity experiments (~10 mC·cm-1·yr-1). Concerning the lifetime measurements, it has been observed that chambers manufactured on high-resistivity glass are far more susceptible of suffering ageing than detectors made on low resistivity, electron-conducting supports, independently of the metal used for the artwork (chromium or gold) at least in clean gas conditions. The successfully operation in the laboratory of detectors manufactured on diamond-...

WRAP TRUPACT loading systems operational test report

International Nuclear Information System (INIS)

DOSRAMOS, E.V.

1999-01-01

This Operational Test Report documents the operational testing of the TRUPACT process equipment HNF-3918, Revision 0, TRUPACT Operational Test Procedure. The test accomplished the following: Procedure validation; Facility equipment interface; Facility personnel support; and Subcontractor personnel support interface. Field changes are documented as test exceptions with resolutions. All resolutions are completed or a formal method is identified to track the resolution through to completion

77 FR 26475 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

Science.gov (United States)

2012-05-04

...EPA is proposing to approve revisions to the Antelope Valley Air Quality Management District (AVAQMD), Eastern Kern Air Pollution Control District (EKAPCD), and Santa Barbara County Air Pollution Control District (SBCAPCD) portions of the California State Implementation Plan (SIP). We are proposing to approve revisions to local rules that define terms used in other air pollution regulations in these areas and a rule rescission that address Petroleum Coke Calcining Operations--Oxides of Sulfur, under the Clean Air Act as amended in 1990 (CAA or the Act).

76 FR 60376 - Revisions to the California State Implementation Plan, Santa Barbara Air Pollution Control...

Science.gov (United States)

2011-09-29

...EPA is taking direct final action to approve revisions to the Santa Barbara Air Pollution Control District (SBAPCD), Sacramento Municipal Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from solvent cleaning machines and solvent cleaning operations and oil and gas production wells. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

76 FR 60405 - Revisions to the California State Implementation Plan, Santa Barbara Air Pollution Control...

Science.gov (United States)

2011-09-29

...EPA is proposing to approve revisions to the Santa Barbara Air Pollution Control District (SBAPCD), Sacramento Municipal Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from solvent cleaning machines and solvent cleaning operations and oil and gas production wells. We are proposing to approve local rules to regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

High-Rate Communications Outage Recorder Operations for Optimal Payload and Science Telemetry Management Onboard the International Space Station

Science.gov (United States)

Shell, Michael T.; McElyea, Richard M. (Technical Monitor)

2002-01-01

All International Space Station (ISS) Ku-band telemetry transmits through the High-Rate Communications Outage Recorder (HCOR). The HCOR provides the recording and playback capability for all payload, science, and International Partner data streams transmitting through NASA's Ku-band antenna system. The HCOR is a solid-state memory recorder that provides recording capability to record all eight ISS high-rate data during ISS Loss-of-Signal periods. NASA payloads in the Destiny module are prime users of the HCOR; however, NASDA and ESA will also utilize the HCOR for data capture and playback of their high data rate links from the Kibo and Columbus modules. Marshall Space Flight Center's Payload Operations Integration Center manages the HCOR for nominal functions, including system configurations and playback operations. The purpose of this paper is to present the nominal operations plan for the HCOR and the plans for handling contingency operations affecting payload operations. In addition, the paper will address HCOR operation limitations and the expected effects on payload operations. The HCOR is manifested for ISS delivery on flight 9A with the HCOR backup manifested on flight 11A. The HCOR replaces the Medium-Rate Communications Outage Recorder (MCOR), which has supported payloads since flight 5A.1.

"Diamond" over-coated Microstrip Gas Chambers for high rate operation

CERN Document Server

Barr, A J; Bouclier, Roger; Capéans-Garrido, M; Dominik, Wojciech; Hoch, M; Manzin, G; Million, Gilbert; Ropelewski, Leszek; Sauli, Fabio; Sharma, A

1997-01-01

We describe the recent developments on the diamond-like carbon (DLC) over-coated Microstrip Gas Chambers made on drawn glass substrates. MSGC surface coating with thin DLC layer of stable and controlled resistivity was proposed to overcome the limitation of detector operation due to surface charging-up under avalanches. This brings also advantages for the detector manufacturing technology. The thin layer, deposited on top of a manufactured MSGC (over-coating), demonstrates excellent mechanical properties and very good stability. We report on recent measurements with DLC over-coated MSGCs of various surface resistivities (ranging from 1013W/r to 1016W/r) on D-263 and AF45 glass substrates. Over-coated MSGCs exhibit good rate capability for the resistivity of the surface around 1015W/r. Stable operation up to 50 mC/cm of accumulated charge from avalanches has been demonstrated.

Waste Management Program management plan. Revision 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management`s objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL.

48 CFR 15.307 - Proposal revisions.

Science.gov (United States)

2010-10-01

... AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Source Selection 15.307 Proposal revisions. (a) If an... allow proposal revisions to clarify and document understandings reached during negotiations. At the... submit a final proposal revision. The contracting officer is required to establish a common cut-off date...

Revision of the Paris and Brussels Conventions of Nuclear Liability

International Nuclear Information System (INIS)

Reyners, P.

2002-01-01

The Contracting Parties to the 1960 Paris Convention on Third Party Liability in the Field of Nuclear Energy and to the 1963 Brussels Convention Supplementary to the Paris Convention, have concluded this Spring four years of negotiation on the revision of these instruments. This exercise was itself started as a logical consequence of the adoption in 1997 of a revised Vienna Convention on Civil Liability for Nuclear Damage and of a Convention on Supplementary Compensation for Nuclear Damage. The Contracting Parties have concluded that the existing regime established by these Conventions remains viable and sound but that it also warrants improvements to ensure that greater financial security will be available to compensate a potentially larger number of victims in respect of a broader range of nuclear damage. A number of more technical amendments have also been agreed, in particular to ensure compatibility with other existing Conventions in this field. When the revised Paris and Brussels Conventions come into force, the total amount of funds available for compensation, provided by the liable nuclear operator and by the States concerned, will be 1.5 billion euros. (author)

Anthropogenic seismicity rates and operational parameters at the Salton Sea Geothermal Field.

Science.gov (United States)

Brodsky, Emily E; Lajoie, Lia J

2013-08-02

Geothermal power is a growing energy source; however, efforts to increase production are tempered by concern over induced earthquakes. Although increased seismicity commonly accompanies geothermal production, induced earthquake rate cannot currently be forecast on the basis of fluid injection volumes or any other operational parameters. We show that at the Salton Sea Geothermal Field, the total volume of fluid extracted or injected tracks the long-term evolution of seismicity. After correcting for the aftershock rate, the net fluid volume (extracted-injected) provides the best correlation with seismicity in recent years. We model the background earthquake rate with a linear combination of injection and net production rates that allows us to track the secular development of the field as the number of earthquakes per fluid volume injected decreases over time.

Upgraded safety analysis document including operations policies, operational safety limits and policy changes. Revision 2

International Nuclear Information System (INIS)

Batchelor, K.

1996-03-01

The National Synchrotron Light Source Safety Analysis Reports (1), (2), (3), BNL reports number-sign 51584, number-sign 52205 and number-sign 52205 (addendum) describe the basic Environmental Safety and Health issues associated with the department's operations. They include the operating envelope for the Storage Rings and also the rest of the facility. These documents contain the operational limits as perceived prior or during construction of the facility, much of which still are appropriate for current operations. However, as the machine has matured, the experimental program has grown in size, requiring more supervision in that area. Also, machine studies have either verified or modified knowledge of beam loss modes and/or radiation loss patterns around the facility. This document is written to allow for these changes in procedure or standards resulting from their current mode of operation and shall be used in conjunction with the above reports. These changes have been reviewed by NSLS and BNL ES and H committee and approved by BNL management

7 CFR 3015.115 - Budget revisions.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Budget revisions. 3015.115 Section 3015.115..., DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Programmatic Changes and Budget Revisions § 3015.115 Budget revisions. (a) Nonconstruction projects. (1) Except as provided in paragraph (a)(2) of...

A study on scar revision

Directory of Open Access Journals (Sweden)

Ashutosh Talwar

2016-04-01

Full Text Available Introduction: Scars are psychologically distressing for the patients and have an impact on the quality of life and self esteem of the patients. Scar revision is an aesthetic skill which is mastered by plastic surgeons and encroached now by dermatosurgeons. Scars on the face are aesthetically unacceptable and various techniques have been improvised for making a scar aesthetically acceptable. Various types of techniques are used for scar revision like W plasty, Z plasty and VY plasty. Aims: To see the efficacy of various scar revision techniques including Z plasty, VY plasty and W plasty in 30 patients with disfiguring scars. Methods: We selected twenty patients of disfiguring scars for the study. The scars from various causes including trauma and burns were included in our study. Various techniques of scar revision include Z plasty, W plasty and VY plasty were performed according to the type and site of scar. Results: Male: female was 1.5: 1. The scar revision surgery yielded excellent results with minimal complications including haematoma formation, secondary infection and delayed healing seen in 5% patients each. Regarding the efficacy of scar revision, excellent improvement was seen in 60% patients, moderate improvement was seen in 30% patients and mild improvement was seen in 10% patients. Conclusions: Dermatologists can employ a number of surgical scar revision techniques. While some are better suited to treat specific types of scars, they can be used in combination with each other or with adjunctive therapies to achieve optimal results.

Recent developments in the IAEA safety standards: design and operation of nuclear power plants

International Nuclear Information System (INIS)

Saito, Takehiko

2004-01-01

The IAEA has been publishing a wide variety of safety standards for nuclear and radiation related facilities and activities since 1978. In 1996, a more rigorously structured approach for the preparation and review of its safety standards was introduced. Currently, based on the approach, revision of most of the standards is in completion or near completion. The latest versions of the Safety Requirements for ''Design'' and ''Operation'' of nuclear power plants were respectively published in 2000. Currently, along with this revision of the Safety Requirements, many Safety Guides have been revised. In order to clarify the complicated revision procedure, an example of the entire revision process for a Safety Guide is provided. Through actual example of the revision process, enormous amount of work involved in the revision work is clearly indicated. The current status of all of the Safety Standards for Design and that for Operation of nuclear power plants are summarized. Summary of other IAEA safety standards currently revised and available related IAEA publications, together with information on the IAEA Web Site from where these documents can be downloaded, is also provided. The standards are reviewed to determine whether revision (or new issue) is necessary in five years following publication. The IAEA safety standards will continue to be updated through comprehensive and structured approach, collaboration of many experts of the world, and reflecting good practices of the world. The IAEA safety standards will serve to provide high level of safety assurance. (author)

78 FR 13765 - Federal Acquisition Regulation; Definition of Contingency Operation

Science.gov (United States)

2013-02-28

... Federal Acquisition Regulation; Definition of Contingency Operation AGENCY: Department of Defense (DoD... Regulation (FAR) to revise the definition of ``contingency operation'' to address the statutory change to the... ``contingency operation'' at FAR 2.101 in accordance with the statutory change to the definition made by...

Revision after shoulder replacement for acute fracture of the proximal humerus

DEFF Research Database (Denmark)

Brorson, Stig; Salomonsson, Björn; Jensen, Steen L

2017-01-01

Background and purpose - For more than half a century, stemmed hemiarthroplasty (SHA) has been used in the treatment of comminuted and displaced fractures of the proximal humerus. Reverse shoulder arthroplasty (RSA) has been increasingly popular in cases where it is difficult to obtain satisfactory...... to the national shoulder arthroplasty registries in Denmark, Sweden, and Norway. We included 6,756 shoulder arthroplasties performed for acute fractures between 2004 and 2013. Results - There were 6,112 SHAs (90%) and 565 RSAs (8.4%). The cumulative arthroplasty survival rate after 5 years was 0.96 for both SHA...... and RSA. The relative risk of revision of RSA was 1.4 (95% CI: 0.9-2.2) with SHA as reference. For both types of arthroplasty, the most common reason for revision was infection (SHA 0.8%, RSA 2.1%). The relative risk of revision due to infection was 3.1 (95% CI: 1.6-5.9) for RSA with SHA as reference...

200 Area Treated Effluent Disposal Facility operational test specification. Revision 2

International Nuclear Information System (INIS)

Crane, A.F.

1995-01-01

This document identifies the test specification and test requirements for the 200 Area Treated Effluent Disposal Facility (200 Area TEDF) operational testing activities. These operational testing activities, when completed, demonstrate the functional, operational and design requirements of the 200 Area TEDF have been met. The technical requirements for operational testing of the 200 Area TEDF are defined by the test requirements presented in Appendix A. These test requirements demonstrate the following: pump station No.1 and associated support equipment operate both automatically and manually; pump station No. 2 and associated support equipment operate both automatically and manually; water is transported through the collection and transfer lines to the disposal ponds with no detectable leakage; the disposal ponds accept flow from the transfer lines with all support equipment operating as designed; and the control systems operate and status the 200 Area TEDF including monitoring of appropriate generator discharge parameters

77 FR 37359 - Revisions to the California State Implementation Plan, South Coast Air Quality Management...

Science.gov (United States)

2012-06-21

...EPA is proposing to approve revisions to the South Coast Air Quality Management District (SCAQMD) and the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portions of the California State Implementation Plan (SIP). These revisions concern volatile organic compound (VOC) emissions from chipping and grinding activities, and composting operations. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act). We are taking comments on this proposal and plan to follow with a final action.

Regulations for the Safe Transport of Radioactive Materials. 1964 Revised Edition

International Nuclear Information System (INIS)

1965-01-01

In 1961 the International Atomic Energy Agency, within the framework of its statutory functions and in accordance with recommendations made by its Preparatory Commission and by the Economic and Social Council of the United Nations, published safety regulations which could be applied to the national and international transport of radio active materials by all means of transport. At the same time, the Director General of the Agency indicated that these regulations would be revised at appropriate intervals in consultation with Member States and the organizations concerned and invited suggestions for their improvement in the light of experience and increased knowledge. In preparing the revised regulations presented in this document, the Agency has received considerable support from its Member States and the organizations concerned, which have made extensive studies and suggestions in order to assist in its work. The Agency also convened several meetings of experts from its Member States and of representatives of a number of international organizations, and has been represented in several meetings convened by those organizations. In publishing the revised transport regulations which result from that co-ordinated effort, the Agency aims at proposing a lasting framework of principles and rules, complemented by appropriate technical data, acceptable for the safe transport of radio active materials by air, land and water. In particular, the developments which have been introduced concerning the packaging requirements, the nuclear safety criteria for the transport of fissile materials and the methods for testing packages should facilitate the international acceptance of packages by the authorities concerned. The Board of Governors of the Agency approved the revised regulations in June and September 1964. It authorized the Director General to apply them, as appropriate, to Agency operations and Agency assisted operations and to recommend to Member States and to the

76 FR 54499 - In the Matter of Entergy Operations, Inc. and Entergy Nuclear Operations, Inc.; Confirmatory...

Science.gov (United States)

2011-09-01

... to review corrective actions; 6. Reviewing all closed ECP retaliation type concerns fleet-wide from... Required'' rating; 9. Completing benchmarking evaluation of ECP practices and procedures; 10. Revising...

Assessing the effectiveness of quality management for nuclear power plant operation

International Nuclear Information System (INIS)

1991-06-01

The development of a methodology for assessing the effectiveness of quality management for nuclear power plant operation has been under way by the IAEA for some time. The preparation of this document was based on understandings developed at a series of advisory group and consultant meetings which used the experience accumulated at operating plants in Member States. The information collected from the use of this document will help to prepare a revision as soon as the proposed methodology, or a revised methodology, can be agreed as generally appropriate by Member States. 16 refs, figs

Modular to Monoblock: Difficulties of Detaching the M(2)a-Magnum(TM) Head Are Common in Metal-on-metal Revisions.

Science.gov (United States)

Mäntymäki, Heikki; Mäkelä, Keijo T; Vahlberg, Tero; Hirviniemi, Joni; Niinimäki, Tuukka

2016-09-01

Modern hip implants typically feature modular heads, which allow for easy exchange and removal from the femoral stem at the time of revision. However, owing to fretting, corrosion, or cold welding, the modular head may be difficult or impossible to separate from the underlying trunnion, especially if the implant has titanium interfaces between the head and the stem. We have repeatedly encountered difficulty removing the titanium sleeve adapter in the M(2)a-Magnum(TM) implant. Although the manufacturer warns about this complication and cases with these difficulties have been reported to the United States FDA, we believed this topic is important to study, because the frequency of difficulties in head removal is unknown and the complications related to this event have not been characterized. We asked: (1) Do revisions of M(2)a-Magnum(TM) implants differ from those of M(2)a-38(TM) implants in terms of ease of removal of the femoral head? (2) In cases where difficulty with M(2)a-Magnum(TM) head removal occurred, was the operative time, bleeding, risk of periprosthetic fracture, or joint infection increased compared with cases where the M(2)a-Magnum(TM) head was removed without difficulties? Between 2004 and 2014, we revised 296 THAs with metal-on-metal implants that involved M(2)a-Magnum(TM) (123) or M(2)a-38(TM) heads (88); of those, 84 were planned to include a femoral stem revision and insufficient data were available for three operations, so they were excluded from this analysis, leaving 124 THAs in the current retrospective study (70 THAs with M(2)a-Magnum(TM) and 54 THAs with M(2)a-38(TM) heads).The method of modular head removal, any difficulties removing the femoral head from the trunnion, operation time, and complications were recorded based on chart review. All the observed problems of detaching the head or taper adapter were among M(2)a-Magnum(TM) heads; there were no problems detaching the head in revisions of the M(2)a-38(TM) implant. In 29% (20 of 70) of

Overview of FRMAC Operations. Revision 2

International Nuclear Information System (INIS)

1994-07-01

The purpose of this overview of the Federal Radiological Monitoring and Assessment Center (FRMAC) operations is to describe the FRMAC response to a major radiological emergency and to describe the subsequent response activities which provide radiological monitoring and assessment outside the immediate boundaries of the radiological emergency site. In the event of a major radiological emergency, Federal agencies with various statutory responsibilities have agreed to coordinate their efforts at the emergency scene under the umbrella of the Federal Radiological emergency Response Plan (FRERP). This cooperative effort will assure the State(s) and a designed Lead Federal Agency (LFA) that all Federal radiological assistance is fully supporting their efforts to protect the public and will provide monitoring and assessment results for their immediate use in decision making. The Federal agencies do not relinquish their statutory responsibilities. However, the mandated Federal cooperation ensures that each agency can obtain the data critical to its specific responsibilities

75 FR 81187 - South Dakota: Final Authorization of State Hazardous Waste Management Program Revision

Science.gov (United States)

2010-12-27

...: Final Authorization of State Hazardous Waste Management Program Revision AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed Rule. SUMMARY: The Solid Waste Disposal Act, as amended, commonly... Agency (EPA) to authorize states to operate their hazardous waste management programs in lieu of the...

Wavelet and receiver operating characteristic analysis of heart rate variability

Science.gov (United States)

McCaffery, G.; Griffith, T. M.; Naka, K.; Frennaux, M. P.; Matthai, C. C.

2002-02-01

Multiresolution wavelet analysis has been used to study the heart rate variability in two classes of patients with different pathological conditions. The scale dependent measure of Thurner et al. was found to be statistically significant in discriminating patients suffering from hypercardiomyopathy from a control set of normal subjects. We have performed Receiver Operating Characteristc (ROC) analysis and found the ROC area to be a useful measure by which to label the significance of the discrimination, as well as to describe the severity of heart dysfunction.

Cochlear implant revision surgeries in children.

Science.gov (United States)

Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

2018-02-16

The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Operational readiness of EFAD systems

International Nuclear Information System (INIS)

Kabat, M.J.

1992-02-01

An assessment of the operational readiness of the Emergency Filtered Air Discharge (EFAD) systems, installed in Canadian CANDU multi-unit nuclear power plants, was performed in this project. Relevant Canadian and foreign standards and regulatory requirements have been reviewed and documentation on EFAD system design, operation, testing and maintenance have been assessed to identify likely causes and potential failures of EFAD systems and their components under both standby and accident conditions. Recommendations have also been provided in this report for revisions which are needed to achieve and maintain appropriate operational readiness of EFAD systems

Early subsidence of shape-closed hip arthroplasty stems is associated with late revision. A systematic review and meta-analysis of 24 RSA studies and 56 survival studies.

Science.gov (United States)

van der Voort, Paul; Pijls, Bart G; Nieuwenhuijse, Marc J; Jasper, Jorrit; Fiocco, Marta; Plevier, Josepha W M; Middeldorp, Saskia; Valstar, Edward R; Nelissen, Rob G H H

2015-01-01

Few studies have addressed the association between early migration of femoral stems and late aseptic revision in total hip arthroplasty. We performed a meta-regression analysis on 2 parallel systematic reviews and meta-analyses to determine the association between early migration and late aseptic revision of femoral stems. Of the 2 reviews, one covered early migration data obtained from radiostereometric analysis (RSA) studies and the other covered long-term aseptic revision rates obtained from survival studies with endpoint revision for aseptic loosening. Stems were stratified according to the design concept: cemented shape-closed, cemented force-closed, and uncemented. A weighted regression model was used to assess the association between early migration and late aseptic revision, and to correct for confounders. Thresholds for acceptable and unacceptable migration were determined in accordance with the national joint registries (≤ 5% revision at 10 years) and the NICE criteria (≤ 10% revision at 10 years). 24 studies (731 stems) were included in the RSA review and 56 studies (20,599 stems) were included in the survival analysis review. Combining both reviews for the 3 design concepts showed that for every 0.1-mm increase in 2-year subsidence, as measured with RSA, there was a 4% increase in revision rate for the shape-closed stem designs. This association remained after correction for age, sex, diagnosis, hospital type, continent, and study quality. The threshold for acceptable migration of shape-closed designs was defined at 0.15 mm; stems subsiding less than 0.15 mm in 2 years had revision rates of less than 5% at 10 years, while stems exceeding 0.15 mm subsidence had revision rates of more than 5%. There was a clinically relevant association between early subsidence of shape-closed femoral stems and late revision for aseptic loosening. This association can be used to assess the safety of shape-closed stem designs. The published research is not sufficient

24 CFR 968.225 - Budget revisions.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Budget revisions. 968.225 Section... Fewer Than 250 Units) § 968.225 Budget revisions. (a) A PHA shall not incur any modernization cost in excess of the total HUD-approved CIAP budget. A PHA shall submit a budget revision, in a form prescribed...

Monitored Geologic Repository Concept of Operations

International Nuclear Information System (INIS)

Curry, P.M.

1999-01-01

This updated document provides the top level guidance for development of the individual systems for the MGR which will be further developed in the System Description Documents. This document will serve as guidance for the development of functional interface and operational requirements. However, the data and engineering values presented in Monitored Geologic Repository Concept of Operations are provided as estimates or summaries of the current design. The original analyses or supporting documents must be utilized if the data or engineering values are used for design inputs. The concepts presented will be utilized as inputs for the development of operational concepts for the individual systems. It is recognized that the references listed may contain existing data or data which are to be verified. However, the data and engineering values presented will not impact the concepts presented in this technical document. As such, the data and engineering values are not being tracked as To Be Verified data. This revision was created to incorporate changes resulting from Enhanced Design Alternative II and Revision 3, DCN 01, of the Monitored Geologic Repository Requirements (YMP 1999)

Computer Program of SIE ASME-NH (Revision 1.0) Code

Energy Technology Data Exchange (ETDEWEB)

Koo, Gyeong Hoi; Lee, J. H

2008-01-15

In this report, the SIE ASME (Structural Integrity Evaluations by ASME-NH) (Revision 1.0), which has a computerized implementation of ASME Pressure Vessels and Piping Code Section III Subsection NH rules, is developed to apply to the next generation reactor design subjecting to the elevated temperature operations over 500 .deg. C and over 30 years design lifetime, and the user's manual for this program is described in detail.

Computer Program of SIE ASME-NH (Revision 1.0) Code

International Nuclear Information System (INIS)

Koo, Gyeong Hoi; Lee, J. H.

2008-01-01

In this report, the SIE ASME (Structural Integrity Evaluations by ASME-NH) (Revision 1.0), which has a computerized implementation of ASME Pressure Vessels and Piping Code Section III Subsection NH rules, is developed to apply to the next generation reactor design subjecting to the elevated temperature operations over 500 .deg. C and over 30 years design lifetime, and the user's manual for this program is described in detail

Preoperative diagnostic for periprosthetic joint infection prior to total knee revision arthroplasty

Directory of Open Access Journals (Sweden)

Leif Claassen

2014-08-01

Full Text Available Periprosthetic joint infection (PJI after total knee arthroplasty remains a challenging problem. The aim of this study was to evaluate the accuracy of diagnostic knee aspiration and serum inflammatory markers in diagnostic of a PJI after total knee arthroplasty. Within 2011 and 2012, 46 patients received a one- or two-stage revision arthroplasty of the knee joint. These patients received a total number of 77 operations. A preoperative aspiration was performed in each case. We analyzed the microbiological and histological examinations of the samples from the aspiration and from the revision operation and additionally estimated serum inflammatory markers. The diagnostic aspiration had a specificity of 0.87, a sensitivity of 0.39, a positive predictive value of 0.67 and a negative predictive value of 0.68. For C-reactive protein the specificity was 0.61 and the sensitivity was 0.48, the serum white blood cell count had a specificity of 0.98 and a sensitivity of 0.23. Our data queries whether diagnostic joint aspiration or serum inflammatory markers are sufficient to verify or exclude a PJI.

Library Automation Alternatives in 1996 and User Satisfaction Ratings of Library Users by Operating System.

Science.gov (United States)

Cibbarelli, Pamela

1996-01-01

Examines library automation product introductions and conversions to new operating systems. Compares user satisfaction ratings of the following library software packages: DOS/Windows, UNIX, Macintosh, and DEC VAX/VMS. Software is rated according to documentation, service/support, training, product reliability, product capabilities, ease of use,…

A non-linear dynamical approach to belief revision in cognitive behavioral therapy

Science.gov (United States)

Kronemyer, David; Bystritsky, Alexander

2014-01-01

Belief revision is the key change mechanism underlying the psychological intervention known as cognitive behavioral therapy (CBT). It both motivates and reinforces new behavior. In this review we analyze and apply a novel approach to this process based on AGM theory of belief revision, named after its proponents, Carlos Alchourrón, Peter Gärdenfors and David Makinson. AGM is a set-theoretical model. We reconceptualize it as describing a non-linear, dynamical system that occurs within a semantic space, which can be represented as a phase plane comprising all of the brain's attentional, cognitive, affective and physiological resources. Triggering events, such as anxiety-producing or depressing situations in the real world, or their imaginal equivalents, mobilize these assets so they converge on an equilibrium point. A preference function then evaluates and integrates evidentiary data associated with individual beliefs, selecting some of them and comprising them into a belief set, which is a metastable state. Belief sets evolve in time from one metastable state to another. In the phase space, this evolution creates a heteroclinic channel. AGM regulates this process and characterizes the outcome at each equilibrium point. Its objective is to define the necessary and sufficient conditions for belief revision by simultaneously minimizing the set of new beliefs that have to be adopted, and the set of old beliefs that have to be discarded or reformulated. Using AGM, belief revision can be modeled using three (and only three) fundamental syntactical operations performed on belief sets, which are expansion; revision; and contraction. Expansion is like adding a new belief without changing any old ones. Revision is like adding a new belief and changing old, inconsistent ones. Contraction is like changing an old belief without adding any new ones. We provide operationalized examples of this process in action. PMID:24860491

The multiple sclerosis rating scale, revised (MSRS-R: Development, refinement, and psychometric validation using an online community

Directory of Open Access Journals (Sweden)

Wicks Paul

2012-06-01

Full Text Available Abstract Background In developing the PatientsLikeMe online platform for patients with Multiple Sclerosis (MS, we required a patient-reported assessment of functional status that was easy to complete and identified disability in domains other than walking. Existing measures of functional status were inadequate, clinician-reported, focused on walking, and burdensome to complete. In response, we developed the Multiple Sclerosis Rating Scale (MSRS. Methods We adapted a clinician-rated measure, the Guy’s Neurological Disability Scale, to a self-report scale and deployed it to an online community. As part of our validation process we reviewed discussions between patients, conducted patient cognitive debriefing, and made minor improvements to form a revised scale (MSRS-R before deploying a cross-sectional survey to patients with relapsing-remitting MS (RRMS on the PatientsLikeMe platform. The survey included MSRS-R and comparator measures: MSIS-29, PDDS, NARCOMS Performance Scales, PRIMUS, and MSWS-12. Results In total, 816 RRMS patients responded (19% response rate. The MSRS-R exhibited high internal consistency (Cronbach’s alpha = .86. The MSRS-R walking item was highly correlated with alternative walking measures (PDDS, ρ = .84; MSWS-12, ρ = .83; NARCOMS mobility question, ρ = .86. MSRS-R correlated well with comparison instruments and differentiated between known groups by PDDS disease stage and relapse burden in the past two years. Factor analysis suggested a single factor accounting for 51.5% of variance. Conclusions The MSRS-R is a concise measure of MS-related functional disability, and may have advantages for disease measurement over longer and more burdensome instruments that are restricted to a smaller number of domains or measure quality of life. Studies are underway describing the use of the instrument in contexts outside our online platform such as clinical practice or trials. The MSRS-R is released for use under

Safety of Nuclear Power Plants: Commissioning and Operation (Spanish Edition)

International Nuclear Information System (INIS)

2012-01-01

This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

Safety of Nuclear Power Plants: Commissioning and Operation (French Edition)

International Nuclear Information System (INIS)

2012-01-01

This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

Safety of Nuclear Power Plants: Commissioning and Operation. Arabic Edition

International Nuclear Information System (INIS)

2011-01-01

This publication is a revision of Safety Requirements No. NS-R-2, Safety of Nuclear Power Plants: Operation, and has been extended to cover the commissioning stage. It describes the requirements to be met to ensure the safe operation of nuclear power plants. Over recent years there have been developments in areas such as long term operation, plant ageing, periodic safety review, probabilistic safety analysis and risk informed decision making processes. It became necessary to revise the IAEA's safety requirements in these areas and to correct and/or improve the publication on the basis of feedback from its application by both the IAEA and its Member States. In addition, the requirements are governed by, and must apply, the safety objective and safety principles that are established in the Fundamental Safety Principles. Contents: 1. Introduction; 2. Safety objectives and principles; 3. The management and organizational structure of the operating organization; 4. Management of operational safety; 5. Operational safety programmes; 6. Plant commissioning; 7. Plant operations; 8. Maintenance, testing, surveillance and inspection; 9. Preparation for decommissioning.

Environmental dosimetry for normal operations at SRP. Revision 1

International Nuclear Information System (INIS)

Marter, W.L.

1984-01-01

The radiological effect of environmental releases from SRP during normal operations has been assessed annually since 1972 with a dosimetry model developed by SRL in 1971 to 1972, as implemented in the MREM code for atmospheric releases and RIVDOSE code for liquid releases. Starting in 1978, SRL started using environmental models and dose commitment factors developed by Nuclear Regulatory Commission (NRC) for all other environmental dose calculations. The NRC models are more flexible than the older SRL models, use more up-to-date methodologies, cover more exposure pathways, and permit more detailed analysis of effects of normal operations. It is recommended that the NRC models, as implemented in the computer codes X0QD0Q and GASPAR for atmospheric releases and LADTAP for liquid releases, and NRC dose commitment factors be used as the standard method at SRP for assessing offsite dose from normal operations in Health Protection Department annual environmental monitoring reports, and in National Environmental Policy Act documents and Safety Analysis Reports for SRP facilities. 23 references, 3 figures, 9 tables

Project W-320, operational test procedure OTP-320-003 test report

International Nuclear Information System (INIS)

Bevins, R.R.

1998-01-01

This report documents and summarizes the results of OTP-320-003 Project W-320 Operational Testing of the WRSS Supernate Transfer System. Project W-320 Operational Test OTP-320-003 was performed to verify components of the Waste Retrieval Sluicing System (WRSS) supernate transfer system functioned as designed following construction completion and turnover to operations. All equipment operation was performed by Tank Farms Operations personnel following the operational test procedure and referenced operating procedures. Supernate Transfer line Flushing System Testing was completed over the course of approximately 4 weeks as tank farm conditions and configuration, equipment availability, and operations resources allowed. All testing was performed with the 702-AZ ventilation system and the 296-P-16 ventilation systems in operation. Test procedure OTP-320-003 required two revisions during testing to incorporate Procedure Changes Authorizations (PCAs) necessary to facilitate testing. Various sections of testing are documented on each procedure revision. The completed test procedure is included as Attachment A. Exception Reports generated during the course of testing are included as Attachment B

Two-dimensional optoelectronic interconnect-processor and its operational bit error rate

Science.gov (United States)

Liu, J. Jiang; Gollsneider, Brian; Chang, Wayne H.; Carhart, Gary W.; Vorontsov, Mikhail A.; Simonis, George J.; Shoop, Barry L.

2004-10-01

Two-dimensional (2-D) multi-channel 8x8 optical interconnect and processor system were designed and developed using complementary metal-oxide-semiconductor (CMOS) driven 850-nm vertical-cavity surface-emitting laser (VCSEL) arrays and the photodetector (PD) arrays with corresponding wavelengths. We performed operation and bit-error-rate (BER) analysis on this free-space integrated 8x8 VCSEL optical interconnects driven by silicon-on-sapphire (SOS) circuits. Pseudo-random bit stream (PRBS) data sequence was used in operation of the interconnects. Eye diagrams were measured from individual channels and analyzed using a digital oscilloscope at data rates from 155 Mb/s to 1.5 Gb/s. Using a statistical model of Gaussian distribution for the random noise in the transmission, we developed a method to compute the BER instantaneously with the digital eye-diagrams. Direct measurements on this interconnects were also taken on a standard BER tester for verification. We found that the results of two methods were in the same order and within 50% accuracy. The integrated interconnects were investigated in an optoelectronic processing architecture of digital halftoning image processor. Error diffusion networks implemented by the inherently parallel nature of photonics promise to provide high quality digital halftoned images.

78 FR 26300 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revisions to Control of Air...

Science.gov (United States)

2013-05-06

.... First, we are proposing to approve revisions to Texas SIP, Chapter 117 emissions specifications for lean... curing ovens used in wet-laid non-woven fiber mat manufacturing operations when nitrogen containing...

Revised models of interstellar nitrogen isotopic fractionation

Science.gov (United States)

Wirström, E. S.; Charnley, S. B.

2018-03-01

Nitrogen-bearing molecules in cold molecular clouds exhibit a range of isotopic fractionation ratios and these molecules may be the precursors of 15N enrichments found in comets and meteorites. Chemical model calculations indicate that atom-molecular ion and ion-molecule reactions could account for most of the fractionation patterns observed. However, recent quantum-chemical computations demonstrate that several of the key processes are unlikely to occur in dense clouds. Related model calculations of dense cloud chemistry show that the revised 15N enrichments fail to match observed values. We have investigated the effects of these reaction rate modifications on the chemical model of Wirström et al. (2012) for which there are significant physical and chemical differences with respect to other models. We have included 15N fractionation of CN in neutral-neutral reactions and also updated rate coefficients for key reactions in the nitrogen chemistry. We find that the revised fractionation rates have the effect of suppressing 15N enrichment in ammonia at all times, while the depletion is even more pronounced, reaching 14N/15N ratios of >2000. Taking the updated nitrogen chemistry into account, no significant enrichment occurs in HCN or HNC, contrary to observational evidence in dark clouds and comets, although the 14N/15N ratio can still be below 100 in CN itself. However, such low CN abundances are predicted that the updated model falls short of explaining the bulk 15N enhancements observed in primitive materials. It is clear that alternative fractionating reactions are necessary to reproduce observations, so further laboratory and theoretical studies are urgently needed.

Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System.

Science.gov (United States)

Edsberg, Laura E; Black, Joyce M; Goldberg, Margaret; McNichol, Laurie; Moore, Lynn; Sieggreen, Mary

Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development.

Primary versus revision arthroscopic reconstruction with remplissage for shoulder instability with moderate bone loss.

Science.gov (United States)

McCabe, Michael P; Weinberg, Douglas; Field, Larry D; O'Brien, Michael J; Hobgood, E Rhett; Savoie, Felix H

2014-04-01

This study aims to evaluate our outcomes of arthroscopic remplissage in this setting. A retrospective review was performed to identify patients who underwent arthroscopic remplissage of an engaging Hill-Sachs lesion along with anterior capsulolabral reconstruction for anterior glenohumeral instability with moderate glenohumeral bone loss at our institution. Thirty-five patients, with a minimum of 2 years' follow-up, were identified. We assessed the American Shoulder and Elbow Surgeons score, incidence of recurrent instability, and postoperative Rowe instability score. Follow-up was available for 30 patients (31 shoulders). The mean age was 24.6 years, with a mean follow-up period of 41 months. Prior instability surgery had failed in 11 patients, and they underwent capsulolabral reconstruction and remplissage ("revision surgery"). The failure rate in revision cases (36%) was significantly higher than the failure rate in primary surgery cases (0%) (P = .01). Failure resulted from trauma in all 4 patients, and none required further surgery. The mean American Shoulder and Elbow Surgeons score for all patients improved from 50 preoperatively to 91 postoperatively (P instability patients with moderate bone loss and engaging humeral Hill-Sachs lesions yields acceptable outcomes for primary instability surgery. However, a significantly higher failure rate occurred when arthroscopic reconstruction with remplissage was performed in the revision setting. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. All rights reserved.

Microcomputers and the Improvement of Revision Skills.

Science.gov (United States)

Balajthy, Ernest; And Others

1987-01-01

Discusses use of word processing software as an effective tool in writing and revision instruction, and describes the role of the teacher. Examples of exercises that encourage revision and of software designed to teach effective revision skills are reviewed. (MBR)

Individual questions of financial control and revision

Directory of Open Access Journals (Sweden)

В. М. Глібко

2015-05-01

Full Text Available Problem setting. In modern conditions at investigation and gathering of proofs in criminal proceedings according to item 93 CPC of Ukraine collecting of proofs which is carried out by the criminal proceedings parties, victim is important, the representative of the legal person, in which relation carries out manufacture, including a way истребования and receptions from public authorities, local governments, the enterprises, establishments and organisations, official and physical persons of things, documents, data, conclusions of experts, conclusions of revisions and certificates of checks. Recent research and publications analisis. In scientific sources questions of carrying out of revisions S. B.Zhivko, V.V.Akimov, G.Demjanchuk, J.Buzdugan is considered. Paper objective. Article purpose is studying and definition of a place of revision among forms of inspection of the state control and use of results of revision in criminal proceedings. Paper main body. Off-schedule exit revision that is revision which is not provided in plans of work of body of the state financial control is considered and is spent at presence at least one of the circumstances listed in item 11 of the Law of Ukraine «About main principles of realisation of the state financial control in Ukraine». If revision is carried out on request of investigating bodies it is spent on the basis of the petition of the inspector and accepted by the results of consideration of this petition of the decision of the investigatory judge. The primary goal of revision on request of investigating bodies or on the basis of court definition is reception of proofs on business. Therefore the revision certificate admits the written proof as on the basis of its conclusion of the inspector, the public prosecutor receives the information on a perfect crime, abusing, and also on the persons who have committed a crime, on the period of commission of crime and an amount of damage. In criminal

Operator training and requalification at GPU Nuclear

International Nuclear Information System (INIS)

Long, R.L.; Barrett, R.J.; Newton, S.L.

1982-01-01

The operator training and requalification programs at GPU Nuclear's Oyster Creek (650 MWe BWR) and Three Mile Island-1 (776 MWe PWR) nuclear plants have undergone significant revisions since the Three Mile Island-2 accident. This paper describes the Training and Education organization, the expanded training facilities, including basic principle trainers and replica simulators, and the present operator training and requalification programs

Expedited technology demonstration project (Revised mixed waste management facility project) Project baseline revision 4.0 and FY98 plan

International Nuclear Information System (INIS)

Adamson, M. G.

1997-01-01

The re-baseline of the Expedited Technology Demonstration Project (Revised Mixed Waste Facility Project) is designated as Project Baseline Revision 4.0. The last approved baseline was identified as Project Baseline Revision 3.0 and was issued in October 1996. Project Baseline Revision 4.0 does not depart from the formal DOE guidance followed by, and contained in, Revision 3.0. This revised baseline document describes the MSO and Final Forms testing activities that will occur during FY98, the final year of the ETD Project. The cost estimate for work during FY98 continues to be $2.OM as published in Revision 3.0. However, the funds will be all CENRTC rather than the OPEX/CENTRC split previously anticipated. LLNL has waived overhead charges on ETD Project CENRTC funds since the beginning of project activities. By requesting the $2.OM as all CENTRC a more aggressive approach to staffing and testing can be taken. Due to a cost under- run condition during FY97 procurements were made and work was accomplished, with the knowledge of DOE, in the Feed Preparation and Final Forms areas that were not in the scope of Revision 3.0. Feed preparation activities for FY98 have been expanded to include the drum opening station/enclosure previously deleted

Allogenic bone graft viability after hip revision arthroplasty assessed by dynamic [18F]fluoride ion positron emission tomography

International Nuclear Information System (INIS)

Piert, M.; Becker, H.D.; Winter, E.; Becker, G.A.; Bilger, K.; Machulla, H.J.; Mueller-Schauenburg, W.; Bares, R.

1999-01-01

The biological fate of allogenic bone grafts in the acetabular cavity and their metabolic activity after acetabular augmentation is uncertain but is most important for the stability of hip implants after hip revision arthroplasty. The aim of this study was to quantify regional bone metabolism after hip replacement operations. Dynamic [ 18 F]fluoride ion positron emission tomography (PET) was used to investigate the metabolic activity of acetabular allogenic bone grafts and genuine bone, either 3-6 weeks (short-term group, n = 9) or 5 months to 9 years (long-term group, n = 10) after hip revision arthroplasty. Applying a three-compartment model, the fluoride influx constant was calculated from individually fitted rate constants (K nlf ) and by Patlak graphical analysis (K pat ). The results were compared with genuine cancellous and cortical acetabular bone of contralateral hips without surgical trauma (n = 7). In genuine cortical bone, K nlf was significantly increased in short- (+140.9%) and long-term (+100.0%) groups compared with contralateral hips. Allogenic bone grafts were characterised by a significantly increased K nlf in the short-term group (+190.9%) compared with contralateral hips, but decreased almost to the baseline levels of contralateral hips (+45.5%) in the long-term. Values of K nlf cor-related with the rate constant K 1 in genuine (r = 0.89, P pat values were highly correlated with K nlf measurements in all regions. (orig.)

12 CFR 702.306 - Revised business plans for new credit unions.

Science.gov (United States)

2010-01-01

... exposure to risk (including credit risk, interest-rate risk, and other types of risk). (d) Consideration of... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Revised business plans for new credit unions. 702.306 Section 702.306 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING...

75 FR 2796 - Revisions to the California State Implementation Plan, San Joaquin Valley Air Pollution Control...

Science.gov (United States)

2010-01-19

...EPA is finalizing approval of revisions to the San Joaquin Valley Air Pollution Control District portion of the California State Implementation Plan (SIP). These revisions were proposed in the Federal Register on June 16, 2009 and concern volatile organic compound (VOC) emissions from coating of metal parts, large appliances, metal furniture, motor vehicles, mobile equipment, cans, coils, organic solvent cleaning, and storage and disposal related to such operations. We are approving local rules that regulate these emission sources under the Clean Air Act as amended in 1990 (CAA or the Act).

Development of the EU Ecolabel Criteria and Revision of the EU Green Public Procurement Criteria for Cleaning Services

OpenAIRE

DE ALMEIDA FERREIRA NETO BELMIRA; WOLF Oliver; FIELD Bethany; JENKIN Nicola; TAM Max; BENJAMIN Oscar

2016-01-01

The objective of this project is to develop a new EU Ecolabel and revise the existing EU Green Public Procurement (GPP) criteria for professional cleaning services (hereafter referred to as cleaning services). This preliminary report investigates the market, operational and sustainability aspects of cleaning services, with a goal to develop a robust evidence base and prioritise key environmental and social issues to support the development of EU Ecolabel criteria and the revision of the EU GP...

Outcomes of Revision Hip Arthroscopy: 2-Year Clinical Follow-up.

Science.gov (United States)

Gupta, Asheesh; Redmond, John M; Stake, Christine E; Dunne, Kevin F; Hammarstedt, Jon E; Domb, Benjamin G

2016-05-01

To evaluate clinical outcomes, pain, and patient satisfaction following revision hip arthroscopy with a minimum 2-year follow-up. From April 2008 to October 2011, data were prospectively collected on all patients undergoing revision hip arthroscopy. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures: the modified Harris hip score (mHHS), nonarthritic hip score (NAHS), hip outcome score-activities of daily living (HOS-ADL), and hip outcome score-sport-specific subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. The number of patients who underwent subsequent revision arthroscopy or total hip arthroplasty during the study period is also reported. Eighty-seven patients underwent revision hip arthroscopy during the study period. Seventy (80.5%) patients were included in our study. Average follow-up time was 28 months (range, 20 to 47.4 months). In terms of residual femoroacetabular impingement morphology, 45.7% of patients had preoperative alpha angles ≥ 55°, and 7.14% of patients had a lateral center-edge angle ≥ 40°. The score improvement from preoperative to 2-year follow-up was 57.84 to 73.65 for mHHS, 62.79 to 83.04 for HOS-ADL, 37.33 to 54.93 for HOS-SSS, and 55.65 to 70.79 for NAHS. VAS decreased from 6.72 to 4.08. All scores demonstrated statistically significant improvement (P arthroscopy during the study period. We found an overall minor complication rate of 10%. Revision hip arthroscopy for all procedures performed on aggregate has improved clinical outcomes for all PROs, high survivorship, and high patient satisfaction scores at short-term follow-up. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty and the potential for revision surgery. Level IV retrospective case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc

Modern operating systems

CERN Document Server

Tanenbaum, Andrew S

2015-01-01

Modern Operating Systems, Fourth Edition, is intended for introductory courses in Operating Systems in Computer Science, Computer Engineering, and Electrical Engineering programs. It also serves as a useful reference for OS professionals ' The widely anticipated revision of this worldwide best-seller incorporates the latest developments in operating systems (OS) technologies. The Fourth Edition includes up-to-date materials on relevant'OS. Tanenbaum also provides information on current research based on his experience as an operating systems researcher. ' Modern Operating Systems, Third Editionwas the recipient of the 2010 McGuffey Longevity Award. The McGuffey Longevity Award recognizes textbooks whose excellence has been demonstrated over time.'http://taaonline.net/index.html " Teaching and Learning Experience This program will provide a better teaching and learning experience-for you and your students. It will help: ' *Provide Practical Detail on the Big Picture Concepts: A clear and entertaining writing s...

The economic impact of revision otologic surgery.

Science.gov (United States)

Nadimi, Sahar; Leonetti, John P; Pontikis, George

2016-03-01

Revision otologic surgery places a significant economic burden on patients and the healthcare system. We conducted a retrospective chart analysis to estimate the economic impact of revision canal-wall-down (CWD) mastoidectomy. We reviewed the medical records of all 189 adults who had undergone CWD mastoidectomy performed by the senior author between June 2006 and August 2011 at Loyola University Medical Center in Maywood, Ill. Institutional charges and collections for all patients were extrapolated to estimate the overall healthcare cost of revision surgery in Illinois and at the national level. Of the 189 CWD mastoidectomies, 89 were primary and 100 were revision procedures. The total charge for the revision cases was $2,783,700, and the net reimbursement (collections) was $846,289 (30.4%). Using Illinois Hospital Association data, we estimated that reimbursement for 387 revision CWD mastoidectomies that had been performed in fiscal year 2011 was nearly $3.3 million. By extrapolating our data to the national level, we estimated that 9,214 patients underwent revision CWD mastoidectomy in the United States during 2011, which cost the national healthcare system roughly $76 million, not including lost wages and productivity. Known causes of failed CWD mastoidectomies that often result in revision surgery include an inadequate meatoplasty, a facial ridge that is too high, residual diseased air cells, and recurrent cholesteatoma. A better understanding of these factors can reduce the need for revision surgery, which could have a positive impact on the economic strain related to this procedure at the local, state, and national levels.

Corporate financing and anticipated credit rating changes

OpenAIRE

Hung, Chi-Hsiou D.; Banerjee, Anurag; Meng, Qingrui

2017-01-01

Firm circumstances change but rating agencies may not make timely revisions to their\\ud ratings, increasing information asymmetry between firms and the market. We examine\\ud whether firms time the securities market before a credit rating agency publicly reveals\\ud its decision to downgrade a firm's credit rating. Using quarterly data, we show that\\ud firms adjust their financing structures before credit rating downgrades are publicly\\ud revealed. More specifically, firms on average increase t...

A taxonomic revision of the genus Podocarpus

NARCIS (Netherlands)

Laubenfels, de D.J.

1985-01-01

In connection with the forthcoming revision of the Coniferae for the Flora Malesiana, the author thought it necessary to revise the genus Podocarpus. Although this genus has a substantial representation in Malesia (30 species), the revision is too involved to be appropriate with the Flora Malesiana

Nevada Test Site Radiological Control Manual. Revision 1

Energy Technology Data Exchange (ETDEWEB)

None, None

2010-02-09

This document supersedes DOE/NV/25946--801, “Nevada Test Site Radiological Control Manual,” Revision 0 issued in October 2009. Brief Description of Revision: A minor revision to correct oversights made during revision to incorporate the 10 CFR 835 Update; and for use as a reference document for Tenant Organization Radiological Protection Programs.

76 FR 68811 - Notice of Request for the Revision of Currently Approved Information Collection

Science.gov (United States)

2011-11-07

... operating information from the nation's public transportation systems. Congress created the NTD to be the... request the Office of Management and Budget (OMB) to approve the revision of the currently approved information collection: 49 U.S.C. 5335(a) and (b) National Transit Database (NTD). DATES: Comments must be...

Children's high-level writing skills: development of planning and revising and their contribution to writing quality.

Science.gov (United States)

Limpo, Teresa; Alves, Rui A; Fidalgo, Raquel

2014-06-01

It is well established that the activity of producing a text is a complex one involving three main cognitive processes: Planning, translating, and revising. Although these processes are crucial in skilled writing, beginning and developing writers seem to struggle with them, mainly with planning and revising. To trace the development of the high-level writing processes of planning and revising, from Grades 4 to 9, and to examine whether these skills predict writing quality in younger and older students (Grades 4-6 vs. 7-9), after controlling for gender, school achievement, age, handwriting fluency, spelling, and text structure. Participants were 381 students from Grades 4 to 9 (age 9-15). Students were asked to plan and write a story and to revise another story by detecting and correcting mechanical and substantive errors. From Grades 4 to 9, we found a growing trend in students' ability to plan and revise despite the observed decreases and stationary periods from Grades 4 to 5 and 6 to 7. Moreover, whereas younger students' planning and revising skills made no contribution to the quality of their writing, in older students, these high-level skills contributed to writing quality above and beyond control predictors. The findings of this study seem to indicate that besides the increase in planning and revising, these skills are not fully operational in school-age children. Indeed, given the contribution of these high-level skills to older students' writing, supplementary instruction and practice should be provided from early on. © 2013 The British Psychological Society.

Continuously revised assurance cases with stakeholders’ cross-validation: a DEOS experience

Directory of Open Access Journals (Sweden)

Kimio Kuramitsu

2016-12-01

Full Text Available Recently, assurance cases have received much attention in the field of software-based computer systems and IT services. However, software changes very often, and there are no strong regulations for software. These facts are two main challenges to be addressed in the development of software assurance cases. We propose a method of developing assurance cases by means of continuous revision at every stage of the system life cycle, including in operation and service recovery in failure cases. Instead of a regulator, dependability arguments are validated by multiple stakeholders competing with each other. This paper reported our experience with the proposed method in the case of Aspen education service. The case study demonstrates that continuous revisions enable stakeholders to share dependability problems across software life cycle stages, which will lead to the long-term improvement of service dependability.

Failure rate modeling using fault tree analysis and Bayesian network: DEMO pulsed operation turbine study case

International Nuclear Information System (INIS)

Dongiovanni, Danilo Nicola; Iesmantas, Tomas

2016-01-01

Highlights: • RAMI (Reliability, Availability, Maintainability and Inspectability) assessment of secondary heat transfer loop for a DEMO nuclear fusion plant. • Definition of a fault tree for a nuclear steam turbine operated in pulsed mode. • Turbine failure rate models update by mean of a Bayesian network reflecting the fault tree analysis in the considered scenario. • Sensitivity analysis on system availability performance. - Abstract: Availability will play an important role in the Demonstration Power Plant (DEMO) success from an economic and safety perspective. Availability performance is commonly assessed by Reliability Availability Maintainability Inspectability (RAMI) analysis, strongly relying on the accurate definition of system components failure modes (FM) and failure rates (FR). Little component experience is available in fusion application, therefore requiring the adaptation of literature FR to fusion plant operating conditions, which may differ in several aspects. As a possible solution to this problem, a new methodology to extrapolate/estimate components failure rate under different operating conditions is presented. The DEMO Balance of Plant nuclear steam turbine component operated in pulse mode is considered as study case. The methodology moves from the definition of a fault tree taking into account failure modes possibly enhanced by pulsed operation. The fault tree is then translated into a Bayesian network. A statistical model for the turbine system failure rate in terms of subcomponents’ FR is hence obtained, allowing for sensitivity analyses on the structured mixture of literature and unknown FR data for which plausible value intervals are investigated to assess their impact on the whole turbine system FR. Finally, the impact of resulting turbine system FR on plant availability is assessed exploiting a Reliability Block Diagram (RBD) model for a typical secondary cooling system implementing a Rankine cycle. Mean inherent availability

Radiographic failure and rates of re-operation after acromioclavicular joint reconstruction: a comparison of surgical techniques.

Science.gov (United States)

Spencer, H T; Hsu, L; Sodl, J; Arianjam, A; Yian, E H

2016-04-01

To compare radiographic failure and re-operation rates of anatomical coracoclavicular (CC) ligament reconstructional techniques with non-anatomical techniques after chronic high grade acromioclavicular (AC) joint injuries. We reviewed chronic AC joint reconstructions within a region-wide healthcare system to identify surgical technique, complications, radiographic failure and re-operations. Procedures fell into four categories: (1) modified Weaver-Dunn, (2) allograft fixed through coracoid and clavicular tunnels, (3) allograft loop coracoclavicular fixation, and (4) combined allograft loop and synthetic cortical button fixation. Among 167 patients (mean age 38.1 years, (standard deviation (sd) 14.7) treated at least a four week interval after injury, 154 had post-operative radiographs available for analysis. Radiographic failure occurred in 33/154 cases (21.4%), with the lowest rate in Technique 4 (2/42 4.8%, p = 0.001). Half the failures occurred by six weeks, and the Kaplan-Meier survivorship at 24 months was 94.4% (95% confidence interval (CI) 79.6 to 98.6) for Technique 4 and 69.9% (95% CI 59.4 to 78.3) for the other techniques when combined. In multivariable survival analysis, Technique 4 had better survival than other techniques (Hazard Ratio 0.162, 95% CI 0.039 to 0.068, p = 0.013). Among 155 patients with a minimum of six months post-operative insurance coverage, re-operation occurred in 9.7% (15 patients). However, in multivariable logistic regression, Technique 4 did not reach a statistically significant lower risk for re-operation (odds ratio 0.254, 95% CI 0.05 to 1.3, p = 0.11). In this retrospective series, anatomical CC ligament reconstruction using combined synthetic cortical button and allograft loop fixation had the lowest rate of radiographic failure. Anatomical coracoclavicular ligament reconstruction using combined synthetic cortical button and allograft loop fixation had the lowest rate of radiographic failure. ©2016 The British Editorial

Failure rate modeling using fault tree analysis and Bayesian network: DEMO pulsed operation turbine study case

Energy Technology Data Exchange (ETDEWEB)

Dongiovanni, Danilo Nicola, E-mail: danilo.dongiovanni@enea.it [ENEA, Nuclear Fusion and Safety Technologies Department, via Enrico Fermi 45, Frascati 00040 (Italy); Iesmantas, Tomas [LEI, Breslaujos str. 3 Kaunas (Lithuania)

2016-11-01

Highlights: • RAMI (Reliability, Availability, Maintainability and Inspectability) assessment of secondary heat transfer loop for a DEMO nuclear fusion plant. • Definition of a fault tree for a nuclear steam turbine operated in pulsed mode. • Turbine failure rate models update by mean of a Bayesian network reflecting the fault tree analysis in the considered scenario. • Sensitivity analysis on system availability performance. - Abstract: Availability will play an important role in the Demonstration Power Plant (DEMO) success from an economic and safety perspective. Availability performance is commonly assessed by Reliability Availability Maintainability Inspectability (RAMI) analysis, strongly relying on the accurate definition of system components failure modes (FM) and failure rates (FR). Little component experience is available in fusion application, therefore requiring the adaptation of literature FR to fusion plant operating conditions, which may differ in several aspects. As a possible solution to this problem, a new methodology to extrapolate/estimate components failure rate under different operating conditions is presented. The DEMO Balance of Plant nuclear steam turbine component operated in pulse mode is considered as study case. The methodology moves from the definition of a fault tree taking into account failure modes possibly enhanced by pulsed operation. The fault tree is then translated into a Bayesian network. A statistical model for the turbine system failure rate in terms of subcomponents’ FR is hence obtained, allowing for sensitivity analyses on the structured mixture of literature and unknown FR data for which plausible value intervals are investigated to assess their impact on the whole turbine system FR. Finally, the impact of resulting turbine system FR on plant availability is assessed exploiting a Reliability Block Diagram (RBD) model for a typical secondary cooling system implementing a Rankine cycle. Mean inherent availability

CREME96 and Related Error Rate Prediction Methods

Science.gov (United States)

Adams, James H., Jr.

2012-01-01

Predicting the rate of occurrence of single event effects (SEEs) in space requires knowledge of the radiation environment and the response of electronic devices to that environment. Several analytical models have been developed over the past 36 years to predict SEE rates. The first error rate calculations were performed by Binder, Smith and Holman. Bradford and Pickel and Blandford, in their CRIER (Cosmic-Ray-Induced-Error-Rate) analysis code introduced the basic Rectangular ParallelePiped (RPP) method for error rate calculations. For the radiation environment at the part, both made use of the Cosmic Ray LET (Linear Energy Transfer) spectra calculated by Heinrich for various absorber Depths. A more detailed model for the space radiation environment within spacecraft was developed by Adams and co-workers. This model, together with a reformulation of the RPP method published by Pickel and Blandford, was used to create the CR ME (Cosmic Ray Effects on Micro-Electronics) code. About the same time Shapiro wrote the CRUP (Cosmic Ray Upset Program) based on the RPP method published by Bradford. It was the first code to specifically take into account charge collection from outside the depletion region due to deformation of the electric field caused by the incident cosmic ray. Other early rate prediction methods and codes include the Single Event Figure of Merit, NOVICE, the Space Radiation code and the effective flux method of Binder which is the basis of the SEFA (Scott Effective Flux Approximation) model. By the early 1990s it was becoming clear that CREME and the other early models needed Revision. This revision, CREME96, was completed and released as a WWW-based tool, one of the first of its kind. The revisions in CREME96 included improved environmental models and improved models for calculating single event effects. The need for a revision of CREME also stimulated the development of the CHIME (CRRES/SPACERAD Heavy Ion Model of the Environment) and MACREE (Modeling and

Development of the Self-Esteem Rating Scale for Children (Revised).

Science.gov (United States)

Chiu, Lian-Hwang

1987-01-01

Developed a teacher's rating scale of self-esteem for children. Participants were 231 school children in grades K-7. Used sociometric measures, popularity ranking by teachers, and the Coopersmith Self-Esteem Inventory to estimate validity. The Self-Esteem Rating Scale for Children (SERSC) included 12 behavioral characteristics rated most…

Operational electricity transmission rates

International Nuclear Information System (INIS)

Roggen, M.

1997-01-01

In a liberalized electricity market both the consumers and the producers of electricity must pay for the use of the power transmission network. Thus, the net manager has unlimited options to realize efficiency improvements. A neutral and transparent management of the power grid is necessary to avoid disturbance of the market. KEMA Consulting translated abstract ideas and strategic advices to operational concepts in its report 'A framework for the determination of tariffs of the transport in the Dutch electricity sector'

78 FR 9016 - Approval and Promulgation of Air Quality Implementation Plans; Massachusetts; Revisions to Fossil...

Science.gov (United States)

2013-02-07

... efficiency. This will improve boiler operation and reduce overall emissions. The emission decrease will more... Source Registration Regulations and Boiler Industrial Standards AGENCY: Environmental Protection Agency... standards for new boilers. The intended effect of this action is to propose approval of the state's revised...

Radiation protection planning and management during revision

International Nuclear Information System (INIS)

Gewehr, K.

1984-01-01

During the operation of nuclear power plants it is normally possible for the in-house personnel to take care of arising radiation protection problems. However, in the comparatively short revision phases, the duties of radiation protection become much more varied. Additional trained radiation protection crews are needed at short notice. This is also the time in which the largest contributions are made to the annual cumulated doses of the personnel. Recent guidelines and rules trying to reduce the radiation exposure of personnel concentrate on this very point. The article outlines the radiation protection activities performed by the service personnel in the course of a steam generator check. (orig.) [de

Hospital volume and the risk of revision in Oxford unicompartmental knee arthroplasty in the Nordic countries -an observational study of 14,496 cases

DEFF Research Database (Denmark)

Badawy, Mona; Fenstad, Anne M.; Bartz-Johannessen, Christoffer A.

2017-01-01

Background: High procedure volume and dedication to unicompartmental knee arthroplasty (UKA) has been suggested to improve revision rates. This study aimed to quantify the annual hospital volume effect on revision risk in Oxfordu? nicompartmental knee arthroplasty in the Nordic countries. Methods......). The outcome was revision risk after 2 and 10 years calculated using Kaplan Meier method. Multivariate Cox regression analysis was used to assess the Hazard Ratio (HR) of any revision due to specific reasons with 95% confidence intervals (CI). Results: The implant survival was 80% at 10 years in the volume...

[An overview on the collation and revision of medical books by the Bureau for Revising Medical Books in the Northern Song Dynasty].

Science.gov (United States)

Meng, Yongliang; Liang, Yongxuan

2014-07-01

The Bureau for Revising Medical Books was a temporary agency established by the government of the Northern Song Dynasty in 1057, the 2nd year of Jiayou of Emperor Renzong, exclusively for the edition, revision and publishing of ancient medical books. 11 medical books were revised and edited by 13 Bureau members in a period of 12 years until 1069, the 2nd year of Xining of Emperor ShenZong, which eventually became the final versions until today. 8 medical books were initially planned for the revision, but 11 were actually completed in the end. The time for completing a revision varied from over 10 years at most to less than 1 year at least. Instead of working in the office, the officers of the Bureau for Revising Medical Books did their works at home. The members of the said Bureau came from the Tiju officer of the Bureau for Revising Medical Books and the officials of revising medical books, consisting of both Confucian ministers and medical officers. Confucian ministers played an important role in revising medical books. The Bureau had a strict workflow in electing revising officials, making the project, and the determination of the principles and arrangements of the tasks of editing and proofreading.

Stem cell engineered bone with calcium-phosphate coated porous titanium scaffold or silicon hydroxyapatite granules for revision total joint arthroplasty.

Science.gov (United States)

García-Gareta, Elena; Hua, Jia; Rayan, Faizal; Blunn, Gordon W

2014-06-01

Aseptic loosening in total joint replacements (TJRs) is mainly caused by osteolysis which leads to a reduction of the bone stock necessary for implant fixation in revision TJRs. Our aim was to develop bone tissue-engineered constructs based on scaffolds of clinical relevance in revision TJRs to reconstitute the bone stock at revision operations by using a perfusion bioreactor system (PBRS). The hypothesis was that a PBRS will enhance mesenchymal stem cells (MSCs) proliferation and osteogenic differentiation and will provide an even distribution of MSCs throughout the scaffolds when compared to static cultures. A PBRS was designed and implemented. Scaffolds, silicon substituted hydroxyapatite granules and calcium-phosphate coated porous TiAl6V4 cylinders, were seeded with MSCs and cultured either in static conditions or in the PBRS at 0.75 mL/min. Statistically significant increased cell proliferation and alkaline phosphatase activity was found in samples cultured in the PBRS. Histology revealed a more even cell distribution in the perfused constructs. SEM showed that cells arranged in sheets. Long cytoplasmic processes attached the cells to the scaffolds. We conclude that a novel tissue engineering approach to address the issue of poor bone stock at revision operations is feasible by using a PBRS.

Emotion Processes in Knowledge Revision

Science.gov (United States)

Trevors, Gregory J.; Kendeou, Panayiota; Butterfuss, Reese

2017-01-01

In recent years, a number of insights have been gained into the cognitive processes that explain how individuals overcome misconceptions and revise their previously acquired incorrect knowledge. The current study complements this line of research by investigating the moment-by-moment emotion processes that occur during knowledge revision using a…

75 FR 57597 - Revised Proposal for Revisions to the Schedules of Civil Penalties for a Violation of a Federal...

Science.gov (United States)

2010-09-21

... Revisions to the Schedules of Civil Penalties for a Violation of a Federal Railroad Safety Law or Federal... railroad safety laws and regulations are necessary because many of FRA's civil penalties have not been..., et al. Revised Proposal for Revisions to the Schedules of Civil Penalties for a Violation of a...

High strength semi-active energy absorbers using shear- and mixedmode operation at high shear rates

Science.gov (United States)

Becnel, Andrew C.

This body of research expands the design space of semi-active energy absorbers for shock isolation and crash safety by investigating and characterizing magnetorheological fluids (MRFs) at high shear rates ( > 25,000 1/s) under shear and mixed-mode operation. Magnetorheological energy absorbers (MREAs) work well as adaptive isolators due to their ability to quickly and controllably adjust to changes in system mass or impact speed while providing fail-safe operation. However, typical linear stroking MREAs using pressure-driven flows have been shown to exhibit reduced controllability as impact speed (shear rate) increases. The objective of this work is to develop MREAs that improve controllability at high shear rates by using pure shear and mixed shear-squeeze modes of operation, and to present the fundamental theory and models of MR fluids under these conditions. A proof of concept instrument verified that the MR effect persists in shear mode devices at shear rates corresponding to low speed impacts. This instrument, a concentric cylinder Searle cell magnetorheometer, was then used to characterize three commercially available MRFs across a wide range of shear rates, applied magnetic fields, and temperatures. Characterization results are presented both as flow curves according to established practice, and as an alternate nondimensionalized analysis based on Mason number. The Mason number plots show that, with appropriate correction coefficients for operating temperature, the varied flow curve data can be collapsed to a single master curve. This work represents the first shear mode characterization of MRFs at shear rates over 10 times greater than available with commercial rheometers, as well as the first validation of Mason number analysis to high shear rate flows in MRFs. Using the results from the magnetorheometer, a full scale rotary vane MREA was developed as part of the Lightweight Magnetorheological Energy Absorber System (LMEAS) for an SH-60 Seahawk helicopter

75 FR 14097 - Revision to Electric Reliability Organization Definition of Bulk Electric System

Science.gov (United States)

2010-03-24

... electrical failure of a 138 kV motor operated switch on a 138 kV-13 kV transformer located in the ReliabilityFirst region resulted in the tripping of two transformers, one due to the electrical failure and the... Commission 18 CFR Part 40 [Docket No. RM09-18-000; 130 FERC ] 61,204] Revision to Electric Reliability...

44 CFR 208.12 - Maximum Pay Rate Table.

Science.gov (United States)

2010-10-01

...) Physicians. DHS uses the latest Special Salary Rate Table Number 0290 for Medical Officers (Clinical... Personnel, in which case the Maximum Pay Rate Table would not apply. (3) Compensation for Sponsoring Agency... organizations, e.g., HMOs or medical or engineering professional associations, under the revised definition of...

Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

DEFF Research Database (Denmark)

Palm, Henrik; Jacobsen, Steffen; Krasheninnikoff, Michael

2006-01-01

OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal...... Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should...

Gunner's Mate G 3 and 2; Rate Training Manual. Revised.

Science.gov (United States)

Naval Education and Training Command, Pensacola, FL.

The rate training manual has been prepared for men of the regular Navy and of the Naval Reserve for the purpose of advancement to increase knowledge in the various aspects of the Gunner's Mate rating (G 3 and 2). Chapters 1 through 14 deal with the following topics: the requirements of the Gunner's Mate G Rating, explosives and pyrotechnics,…

Relatively High Complication and Revision Rates of the Mayo® Metaphysical Conservative Femoral Stem in Young Patients.

Science.gov (United States)

Rutenberg, Tal Frenkel; Warshevski, Yaniv; Gold, Aviram; Shasha, Nadav; Snir, Nimrod; Chechik, Ofir; Dolkart, Oleg; Eilig, Dynai; Herman, Amir; Rath, Ehud; Kramer, Moti; Drexler, Michael

2018-05-08

The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013. All patients underwent clinical assessment, radiological evaluation for the presence and development of radiolucent lines, and functional assessment (numerical analog scale, Harris hip score, and Short Form-12 questionnaire). Ninety-five hips (79 patients) were available for analysis. The patients' mean age was 43 years (range, 18-64 years), and the mean follow-up was 97 months (range, 26.9-166 months). The postoperative clinical assessments and functional assessments revealed significant improvements. Sixteen patients (20.3%) had 18 orthopedic complications, the most common of which were an intraoperative femoral fracture and implant dislocation requiring revision surgeries in 10 hips (10.5%). Radiological analysis revealed evidence of femoral remodeling in 64 (67.4%) implants, spot welds (neocortex) in 35 (36.8%), and osteolysis in 3 (3.2%). These results suggest that the conservative hip femoral implant has an unacceptable complication rate for non-elderly patients. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

Test plan for determining breathing rates in single shell tanks using tracer gases. Revision 1

International Nuclear Information System (INIS)

Andersen, J.A.

1997-01-01

This test plan specifies the requirements and conditions for the injection of tracer gas (Helium (He)) into single shell tanks to determine breathing rates using periodic sampling. The eight tanks which have been selected at the time this Test Plan was developed are A-101, AX-102, AX-103, BY-105, C-107, U-103 (U-103 is counted twice, once during the winter months and once during the summer), and U-105. Other tanks to be sampled will be assigned by Pacific Northwest National Laboratory (PNNL) at a later date in the study process as resources allow, the document shall be revised as required. The sampling of headspace for each of these tanks shall be performed using available risers or the Standard Hydrogen Monitoring System (SHMS) cabinet as available. The tank farm vapor cognizant engineer shall assign the injection and sample testing point for each tank and document the point in the field work package. SUMMA TMI canisters, equipped in-line with dual particulate air filters and two silica gel sorbent traps will be used to collect the gas samples. The purpose of dual particulate air filters is to ensure no radioactive particulates are transferred to the SUMMA TMI canisters. The silica gel sorbent traps will effectively eliminate any tritiated water vapor that may be present in the sample gas stream. PNNL shall supply the tracer gases injection system and shall perform the analysis on the headspace samples. TWRS Characterization project shall inject the tracer gas and perform the sampling. Refer to Engineering Task Plan HNF-SD-TWR-ETP-002 for a detailed description of the responsibilities for this task

The association between metal allergy, total hip arthroplasty, and revision

DEFF Research Database (Denmark)

Thyssen, Jacob Pontoppidan; Jakobsen, Stig Storgaard; Engkilde, Kåre

2009-01-01

BACKGROUND AND PURPOSE: It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following total hip arthroplasty (THA) in dermatitis patients suspected to have contact allergy and in patients...... in general with THA. Furthermore, we compared the prevalence of metal allergy in dermatitis patients with and without THA. MATERIALS AND METHODS: The Danish Hip Arthroplasty Registry (DHAR) contained detailed information on 90,697 operations. The Gentofte patch-test database contained test results...... was similar in cases (12%) and in patients from the DHAR (13%). The prevalence of metal allergy was similar in cases and controls. However, the prevalence of metal allergy was lower in cases who were patch-tested after operation (6%) than in those who were patch-tested before operation (16%) (OR = 2.9; 95% CI...

Student-initiated revision in child health.

Science.gov (United States)

Alfaham, M; Gray, O P; Davies, D P

1994-03-01

Most teaching of child health in Cardiff takes place in block attachments of 8 weeks. There is an introductory seminar of 2 days followed by a 6-week clinical attachment in a district general hospital in Wales, and then a revision period of one week designed to help students formalize and structure their basic knowledge and to clarify aspects of child health which they may have had difficulty in understanding. The revision programme has to take into account: the short time available, the small number of teaching staff, the most relevant basic knowledge and active participation by the student. This paper describes how this week has been improved through the use of student-initiated revision (SIR). The students' appraisal of this revision and in particular SIR is presented.

General properties of astrophysical reaction rates in explosive nucleosynthesis

International Nuclear Information System (INIS)

Rauscher, Thomas

2013-01-01

Fundamental differences in the prediction of reaction rates with intermediate and heavy target nuclei compared to the ones with light nuclei are discussed, with special emphasis on stellar modifications of the rates. Ground and excited state contributions to the stellar rates are quantified, deriving a linear weighting of excited state contributions despite of a Boltzmann population of the nuclear states. A Coulomb suppression effect of the excited state contributions is identified, acting against the usual Q-value rule in some reactions. The proper inclusion of experimental data in revised stellar rates is shown, containing revised uncertainties. An application to the s-process shows that the actual uncertainties in the neutron capture rates are larger than would be expected from the experimental errors alone. Sensitivities of reaction rates and cross sections are defined and their application in reaction studies is discussed. The conclusion provides a guide to experiment as well as theory on how to best improve the rates used in astrophysical simulations and how to assess their uncertainties.

Motor operated valve testing and the 'rate of loading' phenomenon

International Nuclear Information System (INIS)

Black, B.R.

1991-01-01

This paper discusses valve design features which affect the ability to predict motor operated valve (MOV) performance and reviews factors which should be considered when selecting switch settings to limit stem loads. Considerable attention is given to the rate of loading phenomenon which affects the relationship between valve stem thrust and actuator spring pack deflection. Equations are developed, and testing is discussed which permit the construction of an MOV dynamic model. Factors which must be considered when maintaining switch settings correct throughout the life of the plant are discussed. And switch setting acceptance criteria for use with baseline Static and Design Basis testing are suggested

Nevada Test Site Radiological Control Manual, Revision 1

International Nuclear Information System (INIS)

2010-01-01

This document supersedes DOE/NV/25946--801, 'Nevada Test Site Radiological Control Manual,' Revision 0 issued in October 2009. Brief Description of Revision: A minor revision to correct oversights made during revision to incorporate the 10 CFR 835 Update; and for use as a reference document for Tenant Organization Radiological Protection Programs. This manual contains the radiological control requirements to be used for all radiological activities conducted by programs under the purview of the U.S. Department of Energy (DOE) and the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). Compliance with these requirements will ensure compliance with Title 10 Code of Federal Regulations (CFR) Part 835, 'Occupational Radiation Protection.' Programs covered by this manual are located at the Nevada Test Site (NTS); Nellis Air Force Base and North Las Vegas, Nevada; Santa Barbara and Livermore, California; and Andrews Air Force Base, Maryland. In addition, fieldwork by NNSA/NSO at other locations is covered by this manual. The NTS is located in Nye County, Nevada. The NTS is located approximately 105 kilometers (65 miles) northwest of Las Vegas. It is a remote facility that covers approximately 3,500 square kilometers (1,375 square miles) of land. The dimensions of the NTS vary from 46 to 56 kilometers (28 to 35 miles) in width (eastern to western border) and from 64 to 88 kilometers (40 to 55 miles) in length (northern to southern border). The NTS is surrounded to the west, north, and east by additional thousands of acres of land withdrawn from the public domain for use as a protected wildlife range and as a military gunnery range. These public exclusion areas comprise the Nellis Air Force Range complex, previously designated as the Nellis Air Force Base Bombing and Gunnery Range, and the Tonopah Test Range. These two areas provide a buffer zone between the test areas and public lands administered by the Federal Bureau of Land

Nuclear safety guide. TID-7016, Revision 2

International Nuclear Information System (INIS)

Thomas, J.T.

1978-01-01

The Nuclear Safety Guide was first issued in 1956 as classified AEC report LA-2063 and was reprinted the next year, unclassified, as TID-7016. Revision 1, published in 1961, extended the scope and refined the guiding information. The present revision of the Guide differs significantly from its predecessor in that the latter was intentionally conservative in its recommendations. Firmly based on experimental evidence of criticality, the original Guide and the first revision were considered to be of most value to organizations whose activities with fissionable materials were not extensive and, secondarily, that it would serve as a point of departure for members of established nuclear safety teams, experienced in the field. The reader will find a significant change in the character of information presented in this version. Nuclear Criticality Safety has matured in the past twelve years. The advance of calculational capability has permitted validated calculations to extend and substitute for experimental data. The broadened data base has enabled better interpolation, extension, and understanding of available information, especially in areas previously addressed by undefined but adequate factors of safety. The content has been thereby enriched in qualitative guidance. The information inherently contains, and the user can recapture, the quantitative guidance characteristic of the formerGuides by employing appropriate safety factors. In fact, it becomes incumbent on the Criticality Safety Specialist to necessarily impose safety factors consistent with the possible normal and abnormal credible contingencies of an operation as revealed by his evaluation. In its present form the Guide easily becomes a suitable module in any compendium or handbook tailored for internal use by organizations. It is hoped the Guide will continue to serve immediate needs and will encourage continuing and more comprehensive efforts toward organizing nuclear criticality safety information

Nuclear safety guide. TID-7016, Revision 2

Energy Technology Data Exchange (ETDEWEB)

Thomas, J T [ed.

1978-05-01

The Nuclear Safety Guide was first issued in 1956 as classified AEC report LA-2063 and was reprinted the next year, unclassified, as TID-7016. Revision 1, published in 1961, extended the scope and refined the guiding information. The present revision of the Guide differs significantly from its predecessor in that the latter was intentionally conservative in its recommendations. Firmly based on experimental evidence of criticality, the original Guide and the first revision were considered to be of most value to organizations whose activities with fissionable materials were not extensive and, secondarily, that it would serve as a point of departure for members of established nuclear safety teams, experienced in the field. The reader will find a significant change in the character of information presented in this version. Nuclear Criticality Safety has matured in the past twelve years. The advance of calculational capability has permitted validated calculations to extend and substitute for experimental data. The broadened data base has enabled better interpolation, extension, and understanding of available information, especially in areas previously addressed by undefined but adequate factors of safety. The content has been thereby enriched in qualitative guidance. The information inherently contains, and the user can recapture, the quantitative guidance characteristic of the formerGuides by employing appropriate safety factors. In fact, it becomes incumbent on the Criticality Safety Specialist to necessarily impose safety factors consistent with the possible normal and abnormal credible contingencies of an operation as revealed by his evaluation. In its present form the Guide easily becomes a suitable module in any compendium or handbook tailored for internal use by organizations. It is hoped the Guide will continue to serve immediate needs and will encourage continuing and more comprehensive efforts toward organizing nuclear criticality safety information.

Failure rate evaluation for different components operating in sodium, based on operating experience of the RAPSODIE and the PHENIX reactors and the test loops

International Nuclear Information System (INIS)

Boisseau, J.; Dorey, J.; Hedin, F.; Le Floch, C.

1982-01-01

The failure rates of the following components, valves operating in sodium, mechanical and electromagnetic pumps, and heat exchangers including intermediate heat exchangers, cold traps, steam generators, are evaluated by analysing the main incidents which occurred on these components. Therefore, this paper contains an evaluation of the operating experience of components working in sodium and of the reliability of these components

Theoretical determination of spectrum-exposure rate conversion operator of HPGe detector and its application to the measurement of environmental gamma-ray exposure rate

International Nuclear Information System (INIS)

Park, Ch.M.; Choi, B.I.; Kwak, S.S.; Ji, P.K.; Kim, T.W.; Park, Y.W.; Yoon, B.K.

1993-01-01

A conversion operator between spectrum and exposure rate, using a portable HPGe detector for environmental radiation monitoring, was determined theoretically under the assumption of uniform distribution of radiation source on the ground surface. The measurement results were compared with those of a pressurized ionization chamber. The results obtained with the HPGe detector were slightly lower. The method can be easily applied to any gamma ray detector to obtain a spectrum - exposure-rate conversion factor for computing the exposure rate of environmental gamma radiation. (N.T.) 15 refs.; 6 figs.; 3 tabs

Polarized proton target-III. Operations manual, revision B

International Nuclear Information System (INIS)

Hill, D.; Moretti, A.; Onesto, F.; Rynes, P.

1978-01-01

The manual presented contains certain standard operating procedures for the vacuum, cryogenic, and electronic systems of PPT-III. In total, these systems comprise the following major divisions: (1) the target cryostat; (2) the 4 He pumping system; (3) the 3 He pumping system; (4) the remote monitors and controls; (5) the microwave system; (6) the magnet and power supply; (7) the computerized polarization monitor; (8) the 4 He liquefier and gas recovery system; and (9) miscellaneous auxiliary equipment

Clinical and Economic Burden of Revision Knee Arthroplasty

Directory of Open Access Journals (Sweden)

Mohit Bhandari

2012-01-01

Full Text Available Surgery is indicated for symptomatic knee osteoarthritis (OA when conservative measures are unsuccessful. High tibial osteotomy (HTO, unicompartmental knee arthroplasty (UKA, and total knee arthroplasty (TKA are surgical options intended to relieve knee OA pain and dysfunction. The choice of surgical intervention is dependent on several factors such as disease location, patient age, comorbidities, and activity levels. Regardless of surgical treatment, complications such as infection, loosening or lysis, periprosthetic fracture, and postoperative pain are known risks and are indications for revision surgery. The clinical and economic implications for revision surgery are underappreciated. Over 55,000 revision surgeries were performed in 2010 in the US, with 48% of these revisions in patients under 65 years. Total costs associated with each revision TKA surgery have been estimated to be in excess of $49,000. The current annual economic burden of revision knee OA surgery is $2.7 billion for hospital charges alone. By 2030, assuming a 5-fold increase in the number of revision procedures, this economic burden will exceed $13 billion annually. It is appealing to envision a therapy that could delay or obviate the need for arthroplasty. From an actuarial standpoint, this would have the theoretical downstream effect of substantially reducing the number of revision procedures. Although no known therapies currently meet these criteria, such a breakthrough would have a tremendous impact in lessening the clinical and economic burden of knee OA revision surgery.

MEA [Municipal Electric Association] declares opposition to 1991 Ontario Hydro rate increase

International Nuclear Information System (INIS)

Anon.

1991-01-01

In hearings before the Ontario Energy Board, the Municipal Electric Association (MEA) called for an average 1992 rate increase of 10.3%, lower than Ontario Hydro's revised figure of 10.4%, and a $129 million reduction in its operations, maintenance and administration budget. As it has been noted that Hydro pays considerably higher wages than the surrounding reference community, MEA recommended that the utility reduce and eventually eliminate the premium paid to employees, and also called for staff reductions and layoffs for 1991 and 1992. In the area of transmission reliability, MEA stated that Ontario Hydro's transmission maintenance is suffering at the expense of other priorities, and called for reorganizing its transmission plan to achieve target performance by 1996 rather than 1999. In 1991, only 65-70% of maintenance targets were being achieved. MEA also accused Hydro of deferring operational expenditures into deferment and capitalization, creating a false picture of the utility's financial condition. Also discussed at the hearing were the possible overestimating of the effects of Ontario Hydro's demand management programs, the possibility that a shift to time-of-use rates for industrial customers may increase demand, a downgrading of the province's and the utility's credit rating, and the unpleasant side effects of the non-utility generation program

Humeral windows in revision total elbow arthroplasty.

Science.gov (United States)

Peach, Chris A; Salama, Amir; Stanley, David

2016-04-01

The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery.

Outcomes of cup revision for ilio-psoas impingement after total hip arthroplasty: Retrospective study of 46 patients.

Science.gov (United States)

Batailler, C; Bonin, N; M Wettstein; Nogier, A; Martres, S; Ollier, E; May, O; Lustig, S

2017-12-01

Impingement of the ilio-psoas tendon on the acetabular component is a cause of pain after total hip arthroplasty (THA). Studies of cup revision for ilio-psoas impingement (IPI) are scarce and limited in size. We therefore conducted a large multicentre retrospective study with the following objectives: to assess the effectiveness of cup replacement in resolving the impingement syndrome, to determine the frequency and nature of complications after cup revision for IPI, and to identify pre-operative factors associated with good outcomes of cup revision for IPI. Cup revision is effective in resolving the pain due to IPI in selected patients. This retrospective multicentre study included 46 patients who underwent cup revision because of IPI. Before the revision, 38 (83%) patients had prominence of the anterior cup rim (mean, 9.9±4.5mm (range, 2-22mm) by radiography and 35 (76%) had cup malposition (anteversion50°). Mean follow-up was 21months (range, 6months to 6 years) and no patient was lost to follow-up. Outcomes at last follow-up were assessed based on the Oxford Hip Score (OHS), patient satisfaction index, complications, and revisions. At last follow-up, 39 (85%) patients were satisfied with the revision procedure, a significant improvement versus baseline was noted in the OHS (mean, 43±6; range, 25-48; P<0.001), and 41 patients were free of pain during hip flexion (P<0.001 versus baseline). Complications occurred in 3 (6.5%) patients, but only one complication was severe (deep infection). Recurrent groin pain was reported by 4 (8.7%) patients at last follow-up. None of the factors studied predicted the outcome of revision surgery. Cup revision for IPI after THA is effective in relieving the groin pain in 80% of patients with anterior cup rim prominence and/or cup malposition. However, complications can occur. Tenotomy may be preferable when the diagnosis is in doubt and/or cup position is acceptable. IV, retrospective observational study. Published by Elsevier

Diet History Questionnaire: Database Revision History

Science.gov (United States)

The following details all additions and revisions made to the DHQ nutrient and food database. This revision history is provided as a reference for investigators who may have performed analyses with a previous release of the database.

Are Bundled Payments a Viable Reimbursement Model for Revision Total Joint Arthroplasty?

Science.gov (United States)

Courtney, P Maxwell; Ashley, Blair S; Hume, Eric L; Kamath, Atul F

2016-12-01

Alternative payment models, such as the Centers for Medicare & Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) initiative, aim to decrease overall costs for hip and knee arthroplasties. We asked: (1) Is there any difference in the CMS episode-of-care costs, hospital length of stay, and readmission rate from before and after implementation of our bundled-payment program? (2) Is there any difference in reimbursements and resource utilization between revision THA and TKA at our institution? (3) Are there any independent risk factors for patients with high costs who may not be appropriate for a bundled-payment system for revision total joint arthroplasty (TJA)? Between October 2013 and March 2015, 218 patients underwent revision TKA or THA in one health system. Two hundred seventeen patients were reviewed as part of this study, and one patient with hemophilia was excluded from the analysis as an outlier. Our institution began a BPCI program for revision TJA during this study period. Patients' procedures done before January 1, 2014 at one hospital and January 1, 2015 at another hospital were not included in the bundled-care arrangement (70 revision TKAs and 56 revision THAs), whereas 50 revision TKAs and 41 revision THAs were performed under the BPCI initiative. Patient demographics, medical comorbidities, episode-of-care reimbursement data derived directly from CMS, length of stay, and readmission proportions were compared between the bundled and nonbundled groups. Length of stay in the group that underwent surgery before the bundled-care arrangement was longer than for patients whose procedures were done under the BPCI (mean 4.02 [SD, 3.0 days] versus mean 5.27 days [SD, 3.6 days]; p = 0.001). Index hospitalization reimbursement for the bundled group was less than for the nonbundled group (mean USD 17,754 [SD, USD 2741] versus mean USD 18,316 [SD, USD 4732]; p = 0.030). There was no difference, with the numbers available, in total episode

RSA prediction of high failure rate for the uncoated Interax TKA confirmed by meta-analysis.

Science.gov (United States)

Pijls, Bart G; Nieuwenhuijse, Marc J; Schoones, Jan W; Middeldorp, Saskia; Valstar, Edward R; Nelissen, Rob G H H

2012-04-01

In a previous radiostereometric (RSA) trial the uncoated, uncemented, Interax tibial components showed excessive migration within 2 years compared to HA-coated and cemented tibial components. It was predicted that this type of fixation would have a high failure rate. The purpose of this systematic review and meta-analysis was to investigate whether this RSA prediction was correct. We performed a systematic review and meta-analysis to determine the revision rate for aseptic loosening of the uncoated and cemented Interax tibial components. 3 studies were included, involving 349 Interax total knee arthroplasties (TKAs) for the comparison of uncoated and cemented fixation. There were 30 revisions: 27 uncoated and 3 cemented components. There was a 3-times higher revision rate for the uncoated Interax components than that for cemented Interax components (OR = 3; 95% CI: 1.4-7.2). This meta-analysis confirms the prediction of a previous RSA trial. The uncoated Interax components showed the highest migration and turned out to have the highest revision rate for aseptic loosening. RSA appears to enable efficient detection of an inferior design as early as 2 years postoperatively in a small group of patients.

Network Operations Support Plan for the Spot 2 mission (revision 1)

Science.gov (United States)

Werbitzky, Victor

1989-01-01

The purpose of this Network Operations Support Plan (NOSP) is to indicate operational procedures and ground equipment configurations for the SPOT 2 mission. The provisions in this document take precedence over procedures or configurations in other documents.

Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty.

Science.gov (United States)

Desy, Nicholas M; Johnson, Joshua D; Sierra, Rafael J

2017-02-01

The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship. Twenty-nine patients (33 hips) underwent a hybrid THA using the smaller revision Exeter cemented femoral stem. Twenty-five patients (28 hips) had at least 2 years of follow-up and were assessed for clinical and radiographic outcomes. All 33 hips were included in the analysis of complications and survivorship. The Kaplan-Meier survivorship was performed using revision for all causes and for aseptic loosening as the end points. The average clinical follow-up was 4 years (range, 2-7). Harris Hip Scores improved from a mean preoperative value of 56 (range, 23-96) to 90 (range, 51-100) at the latest follow-up. All patients demonstrated superior cement mantles with no signs of loosening. One patient suffered a B2 periprosthetic fracture and 1 patient experienced 2 episodes of instability. The 5-year Kaplan-Meier survivorship was 96.7% for all causes of revision and was 100% using aseptic loosening as the end point. The shorter Exeter revision cemented femoral stem has favorable early to midterm clinical and radiographic outcomes when used for primary THA with a low complication rate and is a viable option in patients with narrow femoral canals where uncemented stem fixation is not desired. Copyright © 2016 Elsevier Inc. All rights reserved.

Defining freight rates as a contribution to the successful operation of container shipping companies

Directory of Open Access Journals (Sweden)

Renato Oblak

2016-12-01

Full Text Available The globalization of the world market and the flexibility of containerization to adjust to the constant changes in supply and demand of the international goods market, has led to a continuous increase in the portion of the container transport within the international maritime cargo transport. By the increase of the container transport level, the impact and importance of container freight rates have been growing, the variability of which directly reflects on the world economy. The aim of this paper is to analyze the efficiency of actual methods in establishing the container freight rates according to the problems which appear in the container shipping operation and refer to large differences in the weights of the actual transported cargo and the declared cargo in containers. The consequence of is lower freight rates and higher costs of the vessels exploitation, concerning the increase of the bunker oil consumption. The conducted research is based on actual data that have been collected and analyzed from particular container vessel liner services within period of 90 days and casting off from 16 container ports. The proposed measures could increase the level of usability of the transporting ships capacities and enable a more accurate and correct account of sea freight rates. The results of the research have shown that by increasing the control of accuracy of the cargo weight in containers and by improving the model of accounting, the freight rates can increase the incomes of shipping companies maintaining the same level of container traffic, which can have a direct influence on the efficiency of their successful operation.

Revision Vaginoplasty: A Comparison of Surgical Outcomes of Laparoscopic Intestinal versus Perineal Full-Thickness Skin Graft Vaginoplasty.

Science.gov (United States)

Van der Sluis, Wouter B; Bouman, Mark-Bram; Buncamper, Marlon E; Mullender, Margriet G; Meijerink, Wilhelmus J

2016-10-01

Vaginal (re)construction can greatly improve the quality of life of indicated patients. If primary vaginoplasty fails, multiple surgical approaches exist for revision. The authors compared surgical results of laparoscopic intestinal versus full-thickness skin graft revision vaginoplasty. A retrospective chart review of patients who underwent revision vaginoplasty at the authors' institution was conducted. Patient demographics, surgical characteristics, complications, hospitalization, reoperations, and neovaginal depth for both surgical techniques were recorded and compared. The authors studied a consecutive series of 50 transgender and three biological women who underwent revision vaginoplasty, of which 21 were laparoscopic intestinal and 32 were perineal full-thickness skin graft vaginoplasties, with a median clinical follow-up of 3.2 years (range, 0.5 to 19.7 years). Patient demographics did not differ significantly. There was no mortality. Two intraoperative rectal perforations (10 percent) occurred in the intestinal group versus six (19 percent) in the full-thickness skin graft group. Operative time was shorter for the full-thickness skin graft vaginoplasty group (131 ± 35 minutes versus 191 ± 45 minutes; p skin graft (81 percent) vaginoplasty procedures. A deeper neovagina was achieved with intestinal vaginoplasty (15.9 ± 1.4 cm versus 12.5 ± 2.8 cm; p skin graft vaginoplasty can be used as secondary vaginal reconstruction. Intraoperative and postoperative complications do not differ significantly, but rectal perforation was more prevalent in the full-thickness skin graft vaginoplasty group. Although the operative time of laparoscopic intestinal vaginoplasty is longer, adequate neovaginal depth was more frequently achieved than in secondary perineal full-thickness skin graft vaginoplasty. Therapeutic, III.

Revised Rules for Concrete Bridges

DEFF Research Database (Denmark)

Thoft-Christensen, Palle; Jensen, F. M.; Middleton, C.

This paper is based on research performed for the Highway Agency, London, UK under the project DPU/9/44 "Revision of Bridge Assessment Rules Based on Whole Life Performance: Concrete Bridges" It contains details of a methodology which can be used to generate Whole Life (WL) reliability profiles....... These WL reliability profiles may be used to establish revised rules for Concrete Bridges....

Inferential revision in narrative texts: An ERP study.

Science.gov (United States)

Pérez, Ana; Cain, Kate; Castellanos, María C; Bajo, Teresa

2015-11-01

We evaluated the process of inferential revision during text comprehension in adults. Participants with high or low working memory read short texts, in which the introduction supported two plausible concepts (e.g., 'guitar/violin'), although one was more probable ('guitar'). There were three possible continuations: a neutral sentence, which did not refer back to either concept; a no-revise sentence, which referred to a general property consistent with either concept (e.g., '…beautiful curved body'); and a revise sentence, which referred to a property that was consistent with only the less likely concept (e.g., '…matching bow'). Readers took longer to read the sentence in the revise condition, indicating that they were able to evaluate their comprehension and detect a mismatch. In a final sentence, a target noun referred to the alternative concept supported in the revise condition (e.g., 'violin'). ERPs indicated that both working memory groups were able to evaluate their comprehension of the text (P3a), but only high working memory readers were able to revise their initial incorrect interpretation (P3b) and integrate the new information (N400) when reading the revise sentence. Low working memory readers had difficulties inhibiting the no-longer-relevant interpretation and thus failed to revise their situation model, and they experienced problems integrating semantically related information into an accurate memory representation.

Programme for the Environmental Control at the Swedish Nuclear Facilities, Revision; Omgivningskontrollprogram foer de kaerntekniska anlaeggningarna, revision

Energy Technology Data Exchange (ETDEWEB)

Linden, Ann-Marie

2004-12-01

This report contains a revised version of the Environmental Monitoring Programme for the Swedish Nuclear Facilities. The revision is based on earlier experiences and evaluations. Some samples have been excluded. Some have been added, for example spruce cone and the food products apple and currant. The sediment samples of 2 cm length have been completed with samples of 10 cm length every fourth year to follow the migration of radio nuclides down the sediment layers over time. The revised Environmental Monitoring Programme is valid from the 1st of January 2005.

75 FR 34670 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Revision to Emission...

Science.gov (United States)

2010-06-18

... http://www.regulations.gov or e-mail. The http://www.regulations.gov Web site is an ``anonymous access... On December 15, 2009, the Maryland Department of the Environment (MDE) submitted a revision to the... through 2004, and that MDE review the operations of the facility, then adopt regulations to establish an...

78 FR 56742 - Revision of Approved Information Collection (Paperwork) Requirements for Office of Management and...

Science.gov (United States)

2013-09-13

... the causes and prevention of occupational injuries, illnesses, and accidents (29 U.S.C. 657). The OSH... construction. Accordingly, construction businesses with workers who operate or work in the vicinity of cranes... in construction work subject to 29 CFR part 1926 subpart V. OSHA revised the exemption in existing 29...

Local public document room directory. Revision 7

International Nuclear Information System (INIS)

1998-04-01

This directory (NUREG/BR-0088, Revision 7) lists local public document rooms (LPDRs) for commercial nuclear power plants with operating or possession-only licenses or under construction, plus the LPDRs for potential high-level radioactive waste repository sites, gaseous diffusion plants, certain fuel cycle facilities, certain low-level waste disposal facilities, and any temporary LPDRs established for the duration of licensing proceedings. In some instances, the LPDR libraries maintain document collections for more than one licensed facility. The library staff members listed are the persons most familiar with the LPDR collections. Reference librarians in the NRC Headquarters Public Document Room (PDR) are also available to assist the public in locating NRC documents

“Revising Nabokov Revising”

Directory of Open Access Journals (Sweden)

Marie Bouchet

2010-10-01

Full Text Available Nabokov revised his works as he translated them and, on another plane, canon revisionism has been having its backlash and provoked other refracting waves. The purpose of the conference was to advance Nabokov studies through the discussion of how our view of Nabokov’s standing and his works today should be revised, especially after the publication of The Original of Laura. However the conference was not confined to just this theme, since “revising” is a word rich with implications. To borrow s...

Numerical Study of Operating Pressure Effect on Carbon Nanotube Growth Rate and Length Uniformity

Directory of Open Access Journals (Sweden)

B. Zahed

2014-01-01

Full Text Available Chemical Vapor Deposition (CVD is one of the most popular methods for producing Carbon Nanotubes (CNTs. The growth rate of CNTs based on CVD technique is investigated by using a numerical model based on finite volume method. Inlet gas mixture, including xylene as carbon source and mixture of argon and hydrogen as carrier gas enters into a horizontal CVD reactor at atmospheric pressure. In this article the operating pressure variations are studied as the effective parameter on CNT growth rate and length uniformity.

Operations Program Plan for the Waste Isolation Pilot Plant

International Nuclear Information System (INIS)

1990-09-01

This document, Revision 4 of the Operations Program Plan, has been developed as the seven-year master plan for operating of the Waste Isolation Pilot Plant (WIPP). Subjects covered include public and technical communications; regulatory and environmental programs; startup engineering; radiation handling, surface operations, and underground operations; waste certification and waste handling; transportation development; geotechnical engineering; experimental operations; engineering program; general maintenance; security program; safety, radiation, and regulatory assurance; quality assurance program; training program; administration activities; management systems program; and decommissioning. 243 refs., 19 figs., 25 tabs. (SM)

Operations and Maintenance Manual, Atmospheric Contaminant Sensor, Revision B.

Science.gov (United States)

National Aeronautics and Space Administration, Washington, DC.

The sensor is a mass spectrometer system which continuously monitors the atmospheric constituents of hydrogen, water vapor, nitrogen, oxygen, and carbon dioxide, and monitors the Freons on a demand sampling basis. The manual provides a system description, operational procedures, and maintenance and troubleshooting instructions. Circuit diagrams…

Insurance Cover for Revised Nuclear Liability

International Nuclear Information System (INIS)

Reitsma, S. M. S.

2008-01-01

The financial security to be provided to victims of an incident at a nuclear installation is the main objective of international nuclear liability conventions. As from the introduction of the Paris Convention on Third Party Liability in the Field of Nuclear Energy in 1960 and the Vienna Convention on Liability for Nuclear Damage in 1963 insurers have been prepared to provide the financial capacity needed to cover the liability under both conventions. They did so in close co-operation with the competent national and international authorities, which has resulted in the insurability of as much of the nuclear liability under the conventions as possible. This tradition of co-operation between authorities and insurers was extended to include the revision negotiations regarding the above conventions, which were concluded in 1997 and 2004 respectively. This has resulted in the insurability of by far the largest part of the convention based liability. However, some heads of damage have been introduced about which insurers had expressed concerns as to their likelihood to attract insurance support. In view of the explicit choice by Convention States to include the uninsurable heads of damage into the revised conventions one would expect that liability for them would fall upon national Governments. This would reflect practice in a number of States, which already assume liability for uninsurable mandatory liabilities for a long time. Nonetheless some other States now seem reluctant to do so, the resulting deadlock having a tendency to manifest itself in a negative perception of the insurance industry. Insurers are therefore appreciative of the forum provided by the CNS to once again explain the areas where problems as regards insurability have arisen and why this is the case. This presentation will show that those areas are few in number and notably relate to a limited number of environmental damages as well as the extension of prescription periods. Furthermore, thoughts will

Improved measurement of the glomerular filtration rate from Tc-99m DTPA scintigraphy in patients following nephrectomy

Energy Technology Data Exchange (ETDEWEB)

Kim, Yong-il; Ha, Seunggyun [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seongnam-si, Gyeonggi-do (Korea, Republic of); So, Young [Konkuk University School of Medicine, Department of Nuclear Medicine, Chungju (Korea, Republic of); Lee, Won Woo [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of); Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seongnam-si, Gyeonggi-do (Korea, Republic of); Byun, Seok-Soo [Seoul National University College of Medicine, Department of Urology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Sang Eun [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of)

2014-02-15

We aimed to improve Tc-99m DTPA glomerular filtration rate (GFR) scintigraphy (Gates' method) in a prospective study using Cr-51 EDTA GFR test as a gold standard. Fifty-seven Tc-99m DTPA GFR scintigrams in 45 subjects (male/female = 33:12, age = 45.9 ± 17.6 years, 14 healthy volunteers and 31 nephrectomised patients) were compared using Cr-51 EDTA GFR tests. Using the %renal uptake of Tc-99m DTPA and Cr-51 EDTA GFR, a revised equation for GFR was established through linear regression analysis. The revised equation for improved GFR was GFR(mL/min) = (%renal uptake x 11.7773) - 0.7354. Gates' original GFRs (70.1 ± 20.5 mL/min/1.73 m{sup 2}) were significantly lower than Cr-51 EDTA GFRs (97.0 ± 31.9 mL/min/1.73 m{sup 2}; P < 0.0001), but the improved GFRs (98.0 ± 26.3 mL/min/1.73 m{sup 2}) were not different from (P = 0.7360) and had a significant correlation with (r = 0.73, P < 0.0001) the Cr-51 EDTA GFRs. The revised GFR equation effectively demonstrated perioperative GFR changes in kidneys that were operated on and the contralateral kidneys at 3 and 6 months post-partial nephrectomy (n = 25). GFR measurement using Tc-99m DTPA scintigraphy could be significantly improved by a revised equation derived from the comparison with Cr-51 EDTA GFR. (orig.)

Sensitivity Studies on Revised PSA Model of KHNP Nuclear Power Plants

International Nuclear Information System (INIS)

Lee, Hyun-Gyo; Hwang, Seok-Won; Shin, Tae-Young

2016-01-01

Korea also performed safety revaluation for all nuclear power plants led by Korean regulatory and elicited 49 improvement factor for plants. One of those factors is Severe Accident Management Guidelines (SAMG) development, KHNP decided to develop Low Power and Shutdown(LPSD) Probabilistic Safety Assessment (PSA) models and upgrade full power PSA models of all operating plants for enhancement of guideline quality. In this paper we discuss about the effectiveness of post Fukushima equipment and improvements of each plant based on the results of revised full power PSA and newly developed LPSD PSA. Through sensitivity analysis based on revised PSA models we confirmed that the facilities installed or planned to installation as follow-up measures of Fukushima accident helped to enhance the safety of nuclear power plants. These results will provide various technical insights to scheduled studies which evaluate effectiveness of Fukushima post action items and develop accident management guideline. Also it will contribute to improve nuclear power plants safety

Sensitivity Studies on Revised PSA Model of KHNP Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyun-Gyo; Hwang, Seok-Won; Shin, Tae-Young [KHNP, Daejeon (Korea, Republic of)

2016-10-15

Korea also performed safety revaluation for all nuclear power plants led by Korean regulatory and elicited 49 improvement factor for plants. One of those factors is Severe Accident Management Guidelines (SAMG) development, KHNP decided to develop Low Power and Shutdown(LPSD) Probabilistic Safety Assessment (PSA) models and upgrade full power PSA models of all operating plants for enhancement of guideline quality. In this paper we discuss about the effectiveness of post Fukushima equipment and improvements of each plant based on the results of revised full power PSA and newly developed LPSD PSA. Through sensitivity analysis based on revised PSA models we confirmed that the facilities installed or planned to installation as follow-up measures of Fukushima accident helped to enhance the safety of nuclear power plants. These results will provide various technical insights to scheduled studies which evaluate effectiveness of Fukushima post action items and develop accident management guideline. Also it will contribute to improve nuclear power plants safety.

Integrating Relational Reasoning and Knowledge Revision during Reading

Science.gov (United States)

Kendeou, Panayiota; Butterfuss, Reese; Van Boekel, Martin; O'Brien, Edward J.

2017-01-01

Our goal in this theoretical contribution is to connect research on knowledge revision and relational reasoning. To achieve this goal, first, we review the "knowledge revision components framework" (KReC) that provides an account of knowledge revision processes, specifically as they unfold during reading of texts. Second, we review a…

No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls.

Science.gov (United States)

Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind; Troelsen, Anders; Husted, Henrik

2017-01-01

Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

Safety analysis report for the Mixed Waste Storage Facility and portable storage units at the Idaho National Engineering Laboratory. Revision 4

International Nuclear Information System (INIS)

Peatross, R.

1997-01-01

This revision contains Section 2 only which gives a description of the Mixed Waste Storage Facility (MWSF) and its operations. Described are the facility location, services and utilities, process description and operation, and safety support systems. The MWSF serves as a storage and repackaging facility for low-level mixed waste

Kaplan-Meier Survival Analysis Overestimates the Risk of Revision Arthroplasty: A Meta-analysis.

Science.gov (United States)

Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter D; Ghali, William A; Marshall, Deborah A

2015-11-01

Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the risk of revision in the presence of competing risks (such as death). Because the magnitude of overestimation is not well documented, the potential associated impact on clinical and policy decision-making remains unknown. We performed a meta-analysis to answer the following questions: (1) To what extent does the Kaplan-Meier method overestimate the cumulative incidence of revision after joint replacement compared with alternative competing-risks methods? (2) Is the extent of overestimation influenced by followup time or rate of competing risks? We searched Ovid MEDLINE, EMBASE, BIOSIS Previews, and Web of Science (1946, 1980, 1980, and 1899, respectively, to October 26, 2013) and included article bibliographies for studies comparing estimated cumulative incidence of revision after hip or knee arthroplasty obtained using both Kaplan-Meier and competing-risks methods. We excluded conference abstracts, unpublished studies, or studies using simulated data sets. Two reviewers independently extracted data and evaluated the quality of reporting of the included studies. Among 1160 abstracts identified, six studies were included in our meta-analysis. The principal reason for the steep attrition (1160 to six) was that the initial search was for studies in any clinical area that compared the cumulative incidence estimated using the Kaplan-Meier versus competing-risks methods for any event (not just the cumulative incidence of hip or knee revision); we did this to minimize the likelihood of missing any relevant studies. We calculated risk ratios (RRs) comparing the cumulative incidence estimated using the Kaplan-Meier method with the competing-risks method for each study and used DerSimonian and Laird random effects models to pool these RRs. Heterogeneity was explored using stratified meta-analyses and

Nevada Test Site waste acceptance criteria [Revision 1

Energy Technology Data Exchange (ETDEWEB)

None

1997-08-01

Revision one updates the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive and mixed waste for disposal; and transuranic and transuranic mixed waste for interim storage at the NTS. Review each section of this document. This document is not intended to include all of the requirements; rather, it is meant as a guide toward meeting the regulations. All references in this document should be observed to avoid omission of requirements on which acceptance or rejection of waste will be based. The Department of Energy/Nevada Operations Office (DOE/NV) and support contractors are available to assist you in understanding or interpreting this document.

Nevada Test Site waste acceptance criteria [Revision 1

International Nuclear Information System (INIS)

None

1997-01-01

Revision one updates the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive and mixed waste for disposal; and transuranic and transuranic mixed waste for interim storage at the NTS. Review each section of this document. This document is not intended to include all of the requirements; rather, it is meant as a guide toward meeting the regulations. All references in this document should be observed to avoid omission of requirements on which acceptance or rejection of waste will be based. The Department of Energy/Nevada Operations Office (DOE/NV) and support contractors are available to assist you in understanding or interpreting this document

The use of customized cages in revision total hip arthroplasty for Paprosky type III acetabular bone defects.

Science.gov (United States)

Mao, Yuanqing; Xu, Chen; Xu, Jiawei; Li, Huiwu; Liu, Fengxiang; Yu, Degang; Zhu, Zhenan

2015-10-01

Revision total hip arthroplasty (THA) is challenging if severe periacetabular bone loss is present. Here we describe a method that uses a customised cage to reconstruct an acetabulum with a massive bone defect. Designed with the aid of the rapid prototyping technique, a customised cage with a hook, crest and flange or braids was made, and then utilized to reconstruct severe compromised acetabulum in revision THA since 2001. Twenty-two patients (23 hips) were included in this study. The mean patient age at the time of surgery was 60.9 years (range, 38-80 years). Three hips had massive acetabular bone defects of Paprosky type IIIA and 20 of type IIIB. The Harris hip score was used to evaluate hip function. Radiographs were taken to evaluate loosening of the cage and resorption of allograft bone. The average follow up was 81.6 ± 24.9 months. The mean Harris hip score improved from 39.6 pre-operatively to 80.9 at the final follow-up. There were no instances of deep infection, severe venous thrombosis, and nerve palsy. One patient who had an intra-operative rupture of the superior acetabular artery was successfully treated using the haemostatic suturing technique. Two patients experienced dislocation at post-operative days four and six, respectively, and both were treated with closed reduction and skin traction for three weeks. The present study demonstrates that a customised cage may be a promising option for THA revision of severely compromised acetabula. Extended follow-up is necessary to evaluate the long-term performance of this approach.

Operational and Strategic Implementation of Dynamic Line Rating for Optimized Wind Energy Generation Integration

Energy Technology Data Exchange (ETDEWEB)

Gentle, Jake Paul [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2016-12-01

One primary goal of rendering today’s transmission grid “smarter” is to optimize and better manage its power transfer capacity in real time. Power transfer capacity is affected by three main elements: stability, voltage limits, and thermal ratings. All three are critical, but thermal ratings represent the greatest opportunity to quickly, reliably and economically utilize the grid’s true capacity. With the “Smarter Grid”, new solutions have been sought to give operators a better grasp on real time conditions, allowing them to manage and extend the usefulness of existing transmission infrastructure in a safe and reliable manner. The objective of the INL Wind Program is to provide industry a Dynamic Line Rating (DLR) solution that is state of the art as measured by cost, accuracy and dependability, to enable human operators to make informed decisions and take appropriate actions without human or system overloading and impacting the reliability of the grid. In addition to mitigating transmission line congestion to better integrate wind, DLR also offers the opportunity to improve the grid with optimized utilization of transmission lines to relieve congestion in general. As wind-generated energy has become a bigger part of the nation’s energy portfolio, researchers have learned that wind not only turns turbine blades to generate electricity, but can cool transmission lines and increase transfer capabilities significantly, sometimes up to 60 percent. INL’s DLR development supports EERE and The Wind Energy Technology Office’s goals by informing system planners and grid operators of available transmission capacity, beyond typical Static Line Ratings (SLR). SLRs are based on a fixed set of conservative environmental conditions to establish a limit on the amount of current lines can safely carry without overheating. Using commercially available weather monitors mounted on industry informed custom brackets developed by INL in combination with Computational

Operational and Strategic Implementation of Dynamic Line Rating for Optimized Wind Energy Generation Integration

International Nuclear Information System (INIS)

Gentle, Jake Paul

2016-01-01

One primary goal of rendering today's transmission grid 'smarter' is to optimize and better manage its power transfer capacity in real time. Power transfer capacity is affected by three main elements: stability, voltage limits, and thermal ratings. All three are critical, but thermal ratings represent the greatest opportunity to quickly, reliably and economically utilize the grid's true capacity. With the 'Smarter Grid', new solutions have been sought to give operators a better grasp on real time conditions, allowing them to manage and extend the usefulness of existing transmission infrastructure in a safe and reliable manner. The objective of the INL Wind Program is to provide industry a Dynamic Line Rating (DLR) solution that is state of the art as measured by cost, accuracy and dependability, to enable human operators to make informed decisions and take appropriate actions without human or system overloading and impacting the reliability of the grid. In addition to mitigating transmission line congestion to better integrate wind, DLR also offers the opportunity to improve the grid with optimized utilization of transmission lines to relieve congestion in general. As wind-generated energy has become a bigger part of the nation's energy portfolio, researchers have learned that wind not only turns turbine blades to generate electricity, but can cool transmission lines and increase transfer capabilities significantly, sometimes up to 60 percent. INL's DLR development supports EERE and The Wind Energy Technology Office's goals by informing system planners and grid operators of available transmission capacity, beyond typical Static Line Ratings (SLR). SLRs are based on a fixed set of conservative environmental conditions to establish a limit on the amount of current lines can safely carry without overheating. Using commercially available weather monitors mounted on industry informed custom brackets developed by INL in combination with Computational Fluid Dynamics (CFD

Porous metal cones: gold standard for massive bone loss in complex revision knee arthroplasty? A systematic review of current literature.

Science.gov (United States)

Divano, Stefano; Cavagnaro, Luca; Zanirato, Andrea; Basso, Marco; Felli, Lamberto; Formica, Matteo

2018-04-18

Revision knee arthroplasty is increasing, and in that case, bone loss management is still a challenging problem. In the last years, the body of literature and interest surrounding porous metal cones has grown, but few systematic evaluations of the existing evidence have been performed. The aim of our systematic review is to collect and critically analyze the available evidence about metal cones in revision knee arthroplasty especially focusing our attention on indications, results, complications, and infection rate of these promising orthopaedic devices. We performed a systematic review of the available English literature, considering the outcomes and the complications of tantalum cones. The combinations of keyword were "porous metal cones", "knee revision", "bone loss", "knee arthroplasty", "periprosthetic joint infection", and "outcome". From the starting 312 papers available, 20 manuscripts were finally included. Only one included study has a control group. The main indication for metal cones is type IIb and III defects according AORI classification. Most of the papers show good clinical and radiological outcomes with low rate of complications. The examined studies provide encouraging clinical and radiological short-to-mid-term outcomes. Clinical studies have shown a low rate of aseptic loosening, intraoperative fractures, infection rate and a lower failure rate than the previous treatment methods. Higher quality papers are needed to draw definitive conclusions about porous metal cones.

Water Treatment Plant Operation Volume 2. A Field Study Training Program. Revised.

Science.gov (United States)

California State Univ., Sacramento. School of Engineering.

The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…

40 CFR 60.4124 - Hg budget permit revisions.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Hg budget permit revisions. 60.4124... Coal-Fired Electric Steam Generating Units Permits § 60.4124 Hg budget permit revisions. Except as provided in § 60.4123(b), the permitting authority will revise the Hg Budget permit, as necessary, in...

77 FR 66432 - Request for Extension and Revision of a Currently Approved Information Collection for the...

Science.gov (United States)

2012-11-05

... opportunity to develop a personal relationship with their customers; and cultivate consumer loyalty with the... Management and Budget, for an extension of and revision to the currently approved information collection for... affiliated with a farm where transactions between a farm market operator and customers take place. A farm...

Operational amplifier circuits analysis and design

CERN Document Server

Nelson, J C C

1995-01-01

This book, a revised and updated version of the author's Basic Operational Amplifiers (Butterworths 1986), enables the non-specialist to make effective use of readily available integrated circuit operational amplifiers for a range of applications, including instrumentation, signal generation and processing.It is assumed the reader has a background in the basic techniques of circuit analysis, particularly the use of j notation for reactive circuits, with a corresponding level of mathematical ability. The underlying theory is explained with sufficient but not excessive, detail. A range of compu

Outcomes and Return to Sport After Revision Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

Science.gov (United States)

Saper, Michael; Pearce, Stephanie; Shung, Joseph; Zondervan, Robert; Ostrander, Roger; Andrews, James R.

2018-01-01

Background: The number of adolescent anterior cruciate ligament (ACL) injuries is rising with increased participation in higher level athletics at earlier ages. With an increasing number of primary ACL reconstructions (ACLRs) comes a rise in the incidence of revision ACLRs. Purpose: To evaluate the clinical results of revision ACLR across a group of high-level adolescent athletes with at least 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of 21 adolescent athletes (age range, 10-19 years) who underwent revision ACLR with at least 2-year follow-up was conducted. Patient-reported outcome measures (PROMs) included the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm knee scoring scale, Tegner activity level scale, and modified Cincinnati Knee Rating System. Return to sport (RTS) and overall patient satisfaction were also assessed. Results: The mean age at the time of surgery was 16.5 years (range, 14-19 years), and the mean follow-up was 46.4 months (range, 24-97 months); 42.9% of patients were female, and 52.4% of patients participated in collision sports. The mean time to failure after primary ACLR was 13.1 ± 8.0 months, and the most common mechanism of failure was noncontact in at least 66.7% of cases. The revision graft type included bone–patellar tendon–bone (BPTB) in 71.4% of cases; 26.7% of BPTB grafts were from the contralateral extremity. Concomitant procedures were performed for intra-articular lesions in 71.4% of patients. The mean patient satisfaction rate was 95.3%. There were 3 cases of a graft reinjury at a mean of 25 months postoperatively. The mean PROM scores were as follows: IKDC, 87.5 ± 12.7; Tegner, 7.2 ± 2.0; Lysholm, 93.7 ± 9.8; and Cincinnati, 93.4 ± 10.0. Of those attempting to RTS, 68.4% of patients successfully returned at the same level of competition. Patients with a lateral compartment chondral injury were less likely to RTS (P < .05

Performance Evaluation Report for Soil Vapor Extraction Operations at the Carbon Tetrachloride Site, February 1992 - September 1998

International Nuclear Information System (INIS)

Rohay, V. J.

1999-01-01

Soil vapor extraction (SVE) is being used to remove carbon tetrachloride from the vadose zone at the 200-ZP-2 Operable Unit. The purpose of this report is to evaluate both the SVE system operating data and the effectiveness of SVE in remediating the carbon tetrachloride contamination. This report has been revised to cover the operating period from February 25, 1992 through September 30, 1998. The scope of the report includes the history of SVE operations at 200-ZP-2, the efficiency of those operations over time, the volume of vapor processed per extraction system, the change in carbon tetrachloride concentrations with time, the mass of carbon tetrachloride removed per site, and recommendations for future operations and evaluations. This revision includes an update to the carbon tetrachloride conceptual model

Can arthroscopic revision surgery for shoulder instability be a fair option?

Science.gov (United States)

De Giorgi, Silvana; Garofalo, Raffaele; Tafuri, Silvio; Cesari, Eugenio; Rose, Giacomo Delle; Castagna, Alessandro

2014-04-01

the aim of this study was to evaluate the role of arthroscopic capsuloplasty in the treatment of failed primary arthroscopic treatment of glenohumeral instability. we retrospectively examined at a minimum of 3-years follow-up 22 patients who underwent arthroscopic treatment between 1999 and 2007 who had recurrent anterior shoulder instability with a post-surgical failure. A statistical analysis was performed to evaluate which variable could influence the definitive result and clinical outcomes at final follow-up. A p value of less than 0.05 was considered significant. we observed after revision surgery an overall failure rate of 8/22 (36.4%) including frank dislocations, subluxations and also apprehension that seriously inhibit the patient's quality of life. No significant differences were observed in the examined parameters. according to our outcomes we generally do not recommend an arthroscopic revision procedure for failed instability surgery.

Development of a new energy benchmark for improving the operational rating system of office buildings using various data-mining techniques

International Nuclear Information System (INIS)

Park, Hyo Seon; Lee, Minhyun; Kang, Hyuna; Hong, Taehoon; Jeong, Jaewook

2016-01-01

Highlights: • This study developed a new energy benchmark for office buildings. • Correlation analysis, decision tree, and analysis of variance were used. • The data from 1072 office buildings in South Korea were used. • As a result, six types of energy benchmarks for office buildings were developed. • The operational rating system can be improved by using the new energy benchmark. - Abstract: As improving energy efficiency in buildings has become a global issue today, many countries have adopted the operational rating system to evaluate the energy performance of a building based on the actual energy consumption. A rational and reasonable energy benchmark can be used in the operational rating system to evaluate the energy performance of a building accurately and effectively. This study aims to develop a new energy benchmark for improving the operational rating system of office buildings. Toward this end, this study used various data-mining techniques such as correlation analysis, decision tree (DT) analysis, and analysis of variance (ANOVA). Based on data from 1072 office buildings in South Korea, this study was conducted in three steps: (i) Step 1: establishment of the database; (ii) Step 2: development of the new energy benchmark; and (iii) Step 3: application of the new energy benchmark for improving the operational rating system. As a result, six types of energy benchmarks for office buildings were developed using DT analysis based on the gross floor area (GFA) and the building use ratio (BUR) of offices, and these new energy benchmarks were validated using ANOVA. To ensure the effectiveness of the new energy benchmark, it was applied to three operational rating systems for comparison: (i) the baseline system (the same energy benchmark is used for all office buildings); (ii) the conventional system (different energy benchmarks are used depending on the GFA, currently used in South Korea); and (iii) the proposed system (different energy benchmarks are

Effect of electromagnetic navigated ventriculoperitoneal shunt placement on failure rates.

Science.gov (United States)

Jung, Nayoung; Kim, Dongwon

2013-03-01

To evaluate the effect of electromagnetic (EM) navigation system on ventriculoperitoneal (VP) shunt failure rate through comparing the result of standard shunt placement. All patients undergoing VP shunt from October 2007 to September 2010 were included in this retrospective study. The first group received shunt surgery using EM navigation. The second group had catheters inserted using manual method with anatomical landmark. The relationship between proximal catheter position and shunt revision rate was evaluated using postoperative computed tomography by a 3-point scale. 1) Grade I; optimal position free-floating in cerebrospinal fluid, 2) Grade II; touching choroid or ventricular wall, 3) Grade III; tip within parenchyma. A total of 72 patients were participated, 27 with EM navigated shunts and 45 with standard shunts. Grade I was found in 25 patients from group 1 and 32 patients from group 2. Only 2 patients without use of navigation belonged to grade III. Proximal obstruction took place 7% in grade I, 15% in grade II and 100% in grade III. Shunt revision occurred in 11% of group 1 and 31% of group 2. Compared in terms of proximal catheter position, there was growing trend of revision rate according to increase of grade on each group. Although infection rate was similar between both groups, the result had no statistical meaning (p=0.905, chi-square test). The use of EM navigation in routine shunt surgery can eliminate poor shunt placement resulting in a dramatic reduction in failure rates.

Safety Evaluation Report on Tennessee Valley Authority: Revised Corporate Nuclear Performance Plan

International Nuclear Information System (INIS)

1987-07-01

The TVA Corporate Nuclear Performance Plan addresses those corporate concerns identified by the NRC staff. Because much of the TVA corporate plan is programmatic, its effectiveness depends on its implementation, and the NRC staff plans to closely monitor this implementation. The NRC staff will address site-specific concerns in subsequent SERs on each volume of the Nuclear Performance Plan. On the basis of its review, the NRC staff finds TVA's revised Corporate Nuclear Performance Plan (Revision 4) acceptable. The NRC staff concludes that the organization and staffing of TVA's Office of Nuclear Power and the programmatic improvements in place or under way are sufficient, if implemented properly, to resolve the problems at the corporate level that led to issuance of the 10 CFR 50.54(f) letter dated September 17, 1985, and to support continuing TVA nuclear activities, including plant operations. 19 refs., 3 figs

Predictors of unsuccessful outcome in cemented femoral revisions using bone impaction grafting; Cox regression analysis of 208 cases.

Science.gov (United States)

Te Stroet, Martijn A J; Rijnen, Wim H C; Gardeniers, Jean W M; Schreurs, B Willem; Hannink, Gerjon

2016-09-29

Despite improvements in the technique of femoral impaction bone grafting, reconstruction failures still can occur. Therefore, the aim of our study was to determine risk factors for the endpoint re-revision for any reason. We used prospectively collected demographic, clinical and surgical data of all 202 patients who underwent 208 femoral revisions using the X-change Femoral Revision System (Stryker-Howmedica), fresh-frozen morcellised allograft and a cemented polished Exeter stem in our department from 1991 to 2007. Univariable and multivariable Cox regression analyses were performed to identify potential factors associated with re-revision. The mean follow-up was 10.6 (5-21) years. The cumulative re-revision rate was 6.3% (13/208). After univariable selection, sex, age, body mass index (BMI), American Association of Anesthesiologists (ASA) classification, type of removed femoral component, and mesh used for reconstruction were included in multivariable regression analysis.In the multivariable analysis, BMI was the only factor that was significantly associated with the risk of re-revision after bone impaction grafting (BMI ≥30 vs. BMI <30, HR = 6.54 [95% CI 1.89-22.65]; p = 0.003). BMI was the only factor associated with the risk of re-revision for any reason. Besides BMI also other factors, such as Endoklinik score and the type of removed femoral component, can provide guidance in the process of preclinical decision making. With the knowledge obtained from this study, preoperative patient selection, informed consent, and treatment protocols can be better adjusted to the individual patient who needs to undergo a femoral revision with impaction bone grafting.

Revised IAEA Code of Conduct on the Safety and Security of Radioactive Sources

International Nuclear Information System (INIS)

Wheatley, J. S.

2004-01-01

The revised Code of Conduct on the Safety and Security of Radioactive Sources is aimed primarily at Governments, with the objective of achieving and maintaining a high level of safety and security of radioactive sources through the development, harmonization and enforcement of national policies, laws and regulations; and through the fostering of international co-operation. It focuses on sealed radioactive sources and provides guidance on legislation, regulations and the regulatory body, and import/export controls. Nuclear materials (except for sources containing 239Pu), as defined in the Convention on the Physical Protection of Nuclear Materials, are not covered by the revised Code, nor are radioactive sources within military or defence programmes. An earlier version of the Code was published by IAEA in 2001. At that time, agreement was not reached on a number of issues, notably those relating to the creation of comprehensive national registries for radioactive sources, obligations of States exporting radioactive sources, and the possibility of unilateral declarations of support. The need to further consider these and other issues was highlighted by the events of 11th September 2001. Since then, the IAEA's Secretariat has been working closely with Member States and relevant International Organizations to achieve consensus. The text of the revised Code was finalized at a meeting of technical and legal experts in August 2003, and it was submitted to IAEA's Board of Governors for approval in September 2003, with a recommendation that the IAEA General Conference adopt it and encourage its wide implementation. The IAEA General Conference, in September 2003, endorsed the revised Code and urged States to work towards following the guidance contained within it. This paper summarizes the history behind the revised Code, its content and the outcome of the discussions within the IAEA Board of Governors and General Conference. (Author) 8 refs

Comparison of dual mobility cup and other surgical construts used for three hundred and sixty two first time hip revisions due to recurrent dislocations: five year results from Lithuanian arthroplasty register.

Science.gov (United States)

Stucinskas, Justinas; Kalvaitis, Tomas; Smailys, Alfredas; Robertsson, Otto; Tarasevicius, Sarunas

2018-05-01

Recently, there has been increasing interest in the use of dual mobility systems in the treatment of hip instability. The aim of this study was to investigate the re-revision rate of dual mobility cup compared to different surgical concepts when used for first-time hip revisions due to recurrent dislocations. The data were derived from the Lithuanian Arthroplasty Register. For survival analysis, we used both re-revision for all reasons and for dislocations as an end-point. Cox proportional hazards models were used to analyze the influence of various covariates (age, gender, and implant concept). A total of 1388 revisions were recorded from 2011 to 2015, of which 362 were performed due to recurrent dislocation. Of the revisions, 247 were performed using dual mobility cups, while 115 were performed using a variety of other surgical constructs including constrained acetabular cups, conventional cups, femoral head exchanges, stem exchanges or anti-luxation rings. There were 27 re-revisions of which 15 were for additional dislocations. There were only 2% re-revisions due to dislocation with dual mobility vs 9% when using other surgical constructs. Cox regression adjusting for age and gender showed that in the short-term, dual mobility cup had a lower risk of revision due to dislocation as well as for all reasons compared to the other surgical constructs. In revision of total hip arthroplasties for dislocation, significantly lower short-term re-revision rate was observed for patients revised with dual mobility cup.

1997 annual ground control operating plan for the Waste Isolation Pilot Plant

International Nuclear Information System (INIS)

1997-02-01

This plan presents background information and a working guide to assist Mine Operations and Engineering in developing strategies for addressing ground control issues at the Waste Isolation Pilot Plant (WIPP). With the anticipated receipt of waste in late 1997, this document provides additional detail to Panel 1 activities and options. The plan also serves as a foundation document for development and revision of the annual long-term ground control plan. Section 2.0 documents the current status of all underground excavations with respect to location, geology, geometry, age, ground support, operational use, projected life, and physical conditions. Section 3.0 presents the methods used to evaluate ground conditions, including visual observations of the roof, ribs, and floor, inspection of observation holes, and review of instrumentation data. Section 4.0 lists several ground support options and specific applications of each. Section 5.0 discusses remedial ground control measures that have been implemented to date. Section 6.0 presents projections and recommendations for ground control actions based on the information in Sections 2.0 through 5.0 of this plan and on a rating of the critical nature of each specific area. Section 7.0 presents a summary statement, and Section 8.0 includes references. Appendix A provides an overview and critique of ground control systems that have been, or may be, used at the site. Because of the dynamic nature of the underground openings and associated geotechnical activities, this plan will be revised as additional data are incorporated

A taxonomic revision of the genus Podocarpus

OpenAIRE

Laubenfels, de, D.J.

1985-01-01

In connection with the forthcoming revision of the Coniferae for the Flora Malesiana, the author thought it necessary to revise the genus Podocarpus. Although this genus has a substantial representation in Malesia (30 species), the revision is too involved to be appropriate with the Flora Malesiana per se. One new subgenus and 17 new sections are described, and 94 species are enumerated, of which 11 species and 1 variety are described as new, and 3 varieties have been raised to specific rank....

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Spanish Edition); Texto Revisado de Los Principios Rectores n Normas Generales de Ejecucion Para la Prestacion de Asistencia Tecnica por el Organismo

Energy Technology Data Exchange (ETDEWEB)

NONE

1979-03-15

The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [Spanish] El 21 de febrero de 1979 la Junta de Gobernadores aprobo el texto revisado de los Principios rectores y normas generales de ejecucion para la prestacion de asistencia tecnica por el Organismo. Para informacion de todos los Estados Miembros, en el presente documento se transcribe dicho texto. En el Anexo del texto revisado de los Principios rectores y normas generales de ejecucion se transcriben tambien las disposiciones prescritas por la Junta de Gobernadores el 24 de septiembre de 1977 acerca de la aplicacion de salvaguardias en relacion con la asistencia tecnica.

Revised Human Health Risk Assessment on Chlorpyrifos

Science.gov (United States)

We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

REVISION PERMISSIABILITY IN CIVIL PROCEDURE IN REPUBLIC OF MACEDONIA

Directory of Open Access Journals (Sweden)

Marina Gligorova

2015-04-01

Full Text Available The revision as an extraordinary legal remedy is one more legal instrument for litigant in the effort to achieve protection of the rights or to defend against ungrounded claims of the other party. Litigants may declare revision of the litigation process due to substantive violations of the provisions of Civil Procedure and incorrect application of substantive law. Declaring revision because of a substantive violation of the provisions of Civil Procedure is limited. The purpose of this research paper is to investigate the most common reasons for filing revision of the litigation process in the period from June 2011 to June in 2012. The research includes what kind of reasons are often repeated, and the volume, or the number of reviews submitted to the Supreme Court of the Republic of Macedonia. As general hypothesis is that most of the adopted revisions are due to substantial violations of the provisions of civil procedure. Two-thirds of the stated revisions in front of the Supreme Court of Republic of Macedonia were rejected as unfounded and only one third of the submitted revisions from June 2011 to June 2012 were grounded. Since accepted revisions 59% due to incorrect application of substantive law, and 41% due to substantial violations of the provisions of Civil Procedure.

Primary and revision efficacy of cross-wired metallic stents for endoscopic bilateral stent-in-stent placement in malignant hilar biliary strictures.

Science.gov (United States)

Lee, T H; Moon, J H; Kim, J H; Park, D H; Lee, S S; Choi, H J; Cho, Y D; Park, S H; Kim, S J

2013-01-01

Endoscopic bilateral drainage for inoperable malignant hilar biliary strictures (HBS) using metal stents is considered to be technically difficult. Furthermore, endoscopic revision of bilateral stenting after occlusion can be challenging. This study was performed to evaluate the long-term efficacy of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents in high-grade malignant HBS and planned endoscopic bilateral revision. A total of 84 patients with inoperable high-grade malignant HBS were enrolled from three academic tertiary referral centers. Two cross-wired metal stents were inserted using a bilateral stent-in-stent placement method. Bilateral endoscopic revision was also performed during follow-up using either identical metal stents or plastic stents. The main outcome measurements were technical and functional success, complications, stent patency, and endoscopic revision efficacy. The technical and clinical success rates of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents were 95.2% (80/84) and 92.9% (78/84), respectively. Median patency (range) and survival were 238 days (10-429) and 256 days (10-1130), respectively. Obstruction of primary bilateral stents occurred in 30.8% (24/78) of patients with functionally successful stent placement. The technical and clinical success rates of planned bilateral endoscopic revision for occluded stents were 83.3% (20/24) and 79.2% (19/24), respectively. For revision, bilateral metallic stents were placed in 11 patients (55.0%); the remaining patients received plastic stents. Palliative endoscopic bilateral stent-in-stent placement of cross-wired metallic stents was effective in patients with inoperable HBS. Revision endoscopic bilateral stenting may be feasible and successful in cases where the primary deployed metal stents are occluded. © Georg Thieme Verlag KG Stuttgart · New York.

Resource utilization in surgery after the revision of surgical fee schedule in Japan.

Science.gov (United States)

Nakata, Yoshinori; Yoshimura, Tatsuya; Watanabe, Yuichi; Otake, Hiroshi; Oiso, Giichiro; Sawa, Tomohiro

2015-01-01

The purpose of this paper is to examine whether the current surgical reimbursement system in Japan reflects resource utilization after the revision of fee schedule in 2014. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30, 2014. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated surgeons' efficiency scores using data envelopment analysis. The efficiency scores of each surgical specialty were significantly different (p=0.000). This result demonstrates that the Japanese surgical reimbursement scales still fail to reflect resource utilization despite the revision of surgical fee schedule.

[Imperial Oil's Cold Lake oil sands operations

International Nuclear Information System (INIS)

Dingle, H. B.

1999-01-01

Imperial Oil Limited's Cold Lake oil sands resources, production and operations in Alberta are discussed. Cold Lake is the company's largest single asset and its largest source of crude oil production. In 1998, Cold Lake accounted for just under half of Imperial's total liquid production, averaging more than 135,000 barrels of bitumen a day. Despite the very difficult operating conditions experienced by the oil sands industry in 1998, Imperial Oil's Cold Lake operations generated a positive cash flow and earnings. Just as important, the near and long-term potential of Cold Lake property continues to be strong, even with the tough market conditions today and the foreseeable future. Proved reserves at the end of 1997 were 1.3 billions barrels, equal to about 24 years of current production, but even more important is Imperial's resource base in the Athabasca region, which represents 150 years of production at current rates. Although production forecasts for the near future are are revised downward because of production shut-in due to low prices, the company is confident of its long-term prospects mainly because of existing infrastructure, superior reservoir quality, 30 years worth of operating improvements and established bitumen-blend markets. Details of the company's future Cold Lake development plans are discussed. The need to continue technology development, which has been at the core of the industry's growth in the past and will continue to be the key to the future, are emphasized

Validity of administrative database code algorithms to identify vascular access placement, surgical revisions, and secondary patency.

Science.gov (United States)

Al-Jaishi, Ahmed A; Moist, Louise M; Oliver, Matthew J; Nash, Danielle M; Fleet, Jamie L; Garg, Amit X; Lok, Charmaine E

2018-03-01

We assessed the validity of physician billing codes and hospital admission using International Classification of Diseases 10th revision codes to identify vascular access placement, secondary patency, and surgical revisions in administrative data. We included adults (≥18 years) with a vascular access placed between 1 April 2004 and 31 March 2013 at the University Health Network, Toronto. Our reference standard was a prospective vascular access database (VASPRO) that contains information on vascular access type and dates of placement, dates for failure, and any revisions. We used VASPRO to assess the validity of different administrative coding algorithms by calculating the sensitivity, specificity, and positive predictive values of vascular access events. The sensitivity (95% confidence interval) of the best performing algorithm to identify arteriovenous access placement was 86% (83%, 89%) and specificity was 92% (89%, 93%). The corresponding numbers to identify catheter insertion were 84% (82%, 86%) and 84% (80%, 87%), respectively. The sensitivity of the best performing coding algorithm to identify arteriovenous access surgical revisions was 81% (67%, 90%) and specificity was 89% (87%, 90%). The algorithm capturing arteriovenous access placement and catheter insertion had a positive predictive value greater than 90% and arteriovenous access surgical revisions had a positive predictive value of 20%. The duration of arteriovenous access secondary patency was on average 578 (553, 603) days in VASPRO and 555 (530, 580) days in administrative databases. Administrative data algorithms have fair to good operating characteristics to identify vascular access placement and arteriovenous access secondary patency. Low positive predictive values for surgical revisions algorithm suggest that administrative data should only be used to rule out the occurrence of an event.

Test-Retest Reliability of the Parent Behavior Importance Questionnaire-Revised and the Parent Behavior Frequency Questionnaire-Revised

Science.gov (United States)

Mowder, Barbara A.; Shamah, Renee

2011-01-01

This study evaluated the test-retest reliability of two parenting measures: the Parent Behavior Importance Questionnaire-Revised (PBIQ-R) and Parent Behavior Frequency Questionnaire-Revised (PBFQ-R). These self-report parenting behavior assessment measures may be utilized as pre- and post-parent education program measures, with parents as well as…

Convergence rates and finite-dimensional approximations for nonlinear ill-posed problems involving monotone operators in Banach spaces

International Nuclear Information System (INIS)

Nguyen Buong.

1992-11-01

The purpose of this paper is to investigate convergence rates for an operator version of Tikhonov regularization constructed by dual mapping for nonlinear ill-posed problems involving monotone operators in real reflective Banach spaces. The obtained results are considered in combination with finite-dimensional approximations for the space. An example is considered for illustration. (author). 15 refs

Non-infected penile prosthesis cultures during revision surgery; comparison between antibiotic coated and non - coated devices

Directory of Open Access Journals (Sweden)

Seyfettin Ciftci

Full Text Available ABSTRACT Introduction: Aim of this study is to investigate bacterial growth on non-infected devices and compare antibiotic-coated and non-coated implants. Materials and methods: The charts of 71 patients who underwent revision surgeries for penile prosthesis between 1995 and 2013 were reviewed. Of those, 31 devices were antibiotic-coated prostheses, while 40 of the implants were non-coated. Swab cultures were routinely obtained from corporal, pump or reservoir site during the operation. If a bacterial biofilm was determined on the prosthesis, it was also cultured. Results: A total of 5 different organisms were cultured from 18 patients. Of them, 4 devices were antibiotic-coated and the other 14 were non-coated devices. Staphylococcus epidermidis was the most common organism, while Staphylococcus hominis, beta hemolitic streptococcus, Escherichia coli and Proteus mirabilis were also cultured. All patients who had positive cultures were treated with appropriate antibiotics for four weeks postoperatively. Median follow-up time was 41 months, ranging between 8 and 82 months. One prosthesis (non-coated became clinically infected in the follow-up period with a totally different organism. Culture positivity rates of antibiotic-coated and non-coated devices were 13% and 35% respectively and the result was significant (p=0.00254. Conclusions: Positive bacterial cultures are present on non-infected penile prostheses at revision surgeries in some of the patients. Antibiotic coated prostheses have much less positive cultures than non-coated devices.

Short-term survival of the trabecular metal cup is similar to that of standard cups used in acetabular revision surgery.

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Mohaddes, Maziar; Rolfson, Ola; Kärrholm, Johan

2015-02-01

The use of trabecular metal (TM) cups in revision surgery has increased worldwide during the last decade. Since the introduction of the TM cup in Sweden in 2006, this design has gradually replaced other uncemented designs used in Sweden. According to data from the Swedish Hip Arthroplasty Register (SHAR) in 2012, one-third of all uncemented first-time cup revisions were performed using a TM cup. We compared the risk of reoperation and re-revision for TM cups and the 2 other most frequently used cup designs in acetabular revisions reported to the SHAR. The hypothesis was that the performance of TM cups is as good as that of established designs in the short term. The study population consisted of 2,384 patients who underwent 2,460 revisions during the period 2006 through 2012. The most commonly used cup designs were the press-fit porous-coated cup (n = 870), the trabecular metal cup (n = 805), and the cemented all-polyethylene cup (n = 785). 54% of the patients were female, and the median age at index revision was 72 (19-95) years. Reoperation was defined as a second surgical intervention, and re-revision-meaning exchange or removal of the cup-was used as endpoint. The mean follow-up time was 3.3 (0-7) years. There were 215 reoperations, 132 of which were re-revisions. The unadjusted and adjusted risk of reoperation or re-revision was not significantly different for the TM cup and the other 2 cup designs. Our data support continued use of TM cups in acetabular revisions. Further follow-up is necessary to determine whether trabecular metal cups can reduce the re-revision rate in the long term, compared to the less costly porous press-fit and cemented designs.

Uroflowmetric changes, success rate and complications following Tension-free Vaginal Tape Obturator (TVT-O) operation in obese females.

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Fouad, Reham; El-Faissal, Yahia M; Hashem, Ahmed T; Gad Allah, Sherine H

2017-07-01

The goal of this study was to evaluate the outcome of Tension-free Vaginal Tape Obturator (TVT-O) operation in the treatment of urodynamic stress incontinence (USI) in obese females, with respect to uroflowmetric changes, success rate and postoperative complications. This prospective observational study included 26 patients with USI at the Obstetrics & Gynecology department-Cairo University hospital during the year 2015. The participants had body mass index (BMI)≥30. Patients underwent TVT-O operation. Follow up of the patients was performed by cough test and uroflowmetry after one week, one month, three months and six months. Postoperative complications such as groin pain, sense of incomplete emptying, need to strain to complete micturition and urinary tract infection were recorded. Comparisons between groups were done using Chi square, Phi-Cramer test for categorical variables. The mean age for the subjects was 43.58±9.01years. The mean BMI was 33.4±2.1. The success rate of TVT-O operation was 21 out of 26 patients (≈81%). Normal maximum flow rate was in 88% of patients at week one and was normal in 100% of patients at months three and six (p=0.101 & 0.101). Postoperative groin pain was the main complaint during the first week after operation and decreased significantly from week one to the 1st month postoperative (84.62% & 65.38%, P=0.041). TVT-O operation showed a high success rate in treatment of USI in obese patients without affecting the voiding function of the bladder as proven by the uroflowmetry. The main postoperative complaint was the groin pain which significantly improved after one month. Copyright © 2017 Elsevier B.V. All rights reserved.