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Sample records for total hospital solid

  1. Total quality management in the hospital setting.

    Science.gov (United States)

    Ernst, D F

    1994-01-01

    With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

  2. Assessing total and volatile solids in municipal solid waste samples.

    Science.gov (United States)

    Peces, M; Astals, S; Mata-Alvarez, J

    2014-01-01

    Municipal solid waste is broadly generated in everyday activities and its treatment is a global challenge. Total solids (TS) and volatile solids (VS) are typical control parameters measured in biological treatments. In this study, the TS and VS were determined using the standard methods, as well as introducing some variants: (i) the drying temperature for the TS assays was 105°C, 70°C and 50°C and (ii) the VS were determined using different heating ramps from room tempature to 550°C. TS could be determined at either 105°C or 70°C, but oven residence time was tripled at 70°C, increasing from 48 to 144 h. The VS could be determined by smouldering the sample (where the sample is burnt without a flame), which avoids the release of fumes and odours in the laboratory. However, smouldering can generate undesired pyrolysis products as a consequence of carbonization, which leads to VS being underestimated. Carbonization can be avoided using slow heating ramps to prevent the oxygen limitation. Furthermore, crushing the sample cores decreased the time to reach constant weight and decreased the potential to underestimate VS.

  3. Developing a master plan for hospital solid waste management: A case study

    International Nuclear Information System (INIS)

    Karamouz, Mohammad; Zahraie, Banafsheh; Kerachian, Reza; Jaafarzadeh, Nemat; Mahjouri, Najmeh

    2007-01-01

    Disposal of about 1750 tons of solid wastes per day is the result of a rapid population growth in the province of Khuzestan in the south west of Iran. Most of these wastes, especially hospital solid wastes which have contributed to the pollution of the environment in the study area, are not properly managed considering environmental standards and regulations. In this paper, the framework of a master plan for managing hospital solid wastes is proposed considering different criteria which are usually used for evaluating the pollution of hospital solid waste loads. The effectiveness of the management schemes is also evaluated. In order to rank the hospitals and determine the share of each hospital in the total hospital solid waste pollution load, a multiple criteria decision making technique, namely analytical hierarchy process (AHP), is used. A set of projects are proposed for solid waste pollution control and reduction in the proposed framework. It is partially applied for hospital solid waste management in the province of Khuzestan, Iran. The results have shown that the hospitals located near the capital city of the province, Ahvaz, produce more than 43% of the total hospital solid waste pollution load of the province. The results have also shown the importance of improving management techniques rather than building new facilities. The proposed methodology is used to formulate a master plan for hospital solid waste management

  4. Organics and Suspended Solids Removal from Hospital

    Directory of Open Access Journals (Sweden)

    Fakhri Y. Hmood

    2013-05-01

    Full Text Available The Sequencing Batch Reactor (SBR method is used for treating samples of waste water taken from hospitals in Mosul. Many run periods are used (6-24 hours for             6 months. It is found that the organics and suspended solids removal increase with increasing the period of run, it is in the range ( 96-82 % and ( 100-95 % respectively, while the pH values are nearly neutral (7.05 to 7.5.     BOD5 and SS concentrations of the effluent are within the limits of Iraqi standards,  40:30 mg/l respectively. Hence, SBR method could be used for treating hospitals, small factories and some  residential sectors waste waters.  

  5. Salinity: Electrical conductivity and total dissolved solids

    Science.gov (United States)

    The measurement of soil salinity is a quantification of the total salts present in the liquid portion of the soil. Soil salinity is important in agriculture because salinity reduces crop yields by reducing the osmotic potential making it more difficult for the plant to extract water, by causing spe...

  6. Management, treatment and final disposal of solid hazardous hospital wastes

    International Nuclear Information System (INIS)

    Sebiani Serrano, T.

    2000-01-01

    Medical Waste is characterized by its high risk to human health and the environment. The main risk is biological, due to the large amount of biologically contaminated materials present in such waste. However, this does not mean that the chemical and radioactive wastes are less harmful just because they represent a smaller part of the total waste. Hazardous wastes from hospitals can be divided in 3 main categories: Solid Hazardous Hospital Wastes (S.H.H.W.), Liquid Hazardous Hospital Wastes (L.H.H.W.) and Gaseous Hazardous Hospital Wastes (G.H.H.W.) Most gaseous and liquid hazardous wastes are discharged to the environment without treatment. Since this inappropriate disposal practice, however, is not visible to society, there is no societal reaction to such problem. On the contrary, hazardous solid wastes (S.H.H.W.) are visible to society and create worries in the population. As a result, social and political pressures arise, asking for solutions to the disposal problems of such wastes. In response to such pressures and legislation approved by Costa Rica on waste handling and disposal, the Caja Costarricense de Seguro Social developed a plan for the handling, treatment, and disposal of hazardous solid wastes at the hospitals and clinics of its system. The objective of the program is to reduce the risk to society of such wastes. In this thesis a cost-effectiveness analysis was conducted to determine the minimum cost at which it is possible to reach a maximum level of reduction in hazardous wastes, transferring to the environment the least possible volume of solid hazardous wastes, and therefore, reducing risk to a minimum. It was found that at the National Children's Hospital the internal handling of hazard solid wastes is conducted with a high level of effectiveness. However, once out of the hospital area, the handling is not effective, because hazardous and common wastes are all mixed together creating a larger amount of S.H.H.W. and reducing the final efficiency

  7. TOTAL HIP REPLACEMENTS AT KIKUYU HOSPITAL, KENYA

    African Journals Online (AJOL)

    equipments, few trained personnel and the high cost of implants. It is mainly in the ..... function more affected than the sensory a day after. There was a foot drop. .... 60: Issue 2, 217-. 220. 13. NIH Consensus Development Panel on Total Hip.

  8. Inter-relationship between major ions, total dissolved solids and ...

    African Journals Online (AJOL)

    Sulphate and magnesium concentrations were highest in station 7 while other parameters (potassium, chloride, calcium, alkalinity, conductivity and total dissolved solids (T. D. S.)) were highest in station 6. The ponds belong to class 1 of the African waters since they all have electrical conductance of less than 600 s cm-1.

  9. A solid-phase-radioimmunoassay for total serum thyroxine

    International Nuclear Information System (INIS)

    Moedder, G.; Sokolowski, G.

    1978-01-01

    A new solid phase radioimmunoassay for total serum thyroxine was evaluated over a longer time under clinical routine conditions and compared with an established test system. The results show up that the T 4 values are precise, reliable and reproducible, the is incomplicate to handle and well suitable for semiautomatic pipetting systems. (orig.) 891 MG [de

  10. Calculations of Total and Differential Solid Angles for a Proton Recoil Solid State Detector

    Energy Technology Data Exchange (ETDEWEB)

    Konijn, J; Lauber, A; Tollander, B

    1963-08-15

    The solid angles have been computed for a proton recoil counter consisting of a circular hydrogenous foil viewed by an isotropic neutron point source at different distances from the target foil. Tables are given for the total subtended solid angle as well as the differential energy distribution function of the proton recoil spectrum. The influence of finite foil thickness has also been studied.

  11. development of improved solid hospital waste management ...

    African Journals Online (AJOL)

    A pre-intervention situation analysis was conducted to assess Hospital Waste Management (HWM) practices, solutions were proffered for the observed inadequacies and advocacy was made to Hospital administration for which a number of interventional measures were instituted. A post interventional survey was conducted ...

  12. Measurement of total dissolved solids using electrical conductivity

    International Nuclear Information System (INIS)

    Ray, Vinod K.; Jat, J.R.; Reddy, G.B.; Balaji Rao, Y.; Phani Babu, C.; Kalyanakrishnan, G.

    2017-01-01

    Total dissolved solids (TDS) is an important parameter for the disposal of effluents generated during processing of different raw materials like Magnesium Di-uranate (MDU), Heat Treated Uranium Peroxide (HTUP), Sodium Di-uranate (SDU) in Uranium Extraction plant and Washed and Dried Frit (WDF) in Zirconium Extraction Plant. The present paper describes the use of electrical conductivity for determination of TDS. As electrical conductivity is matrix dependent property, matrix matched standards were prepared for determination of TDS in ammonium nitrate solution (AN) and mixture of ammonium nitrate and ammonium sulphate (AN/AS) and results were found to be in good agreement when compared with evaporation method. (author)

  13. Primary total hip replacement versus hip resurfacing - hospital considerations.

    Science.gov (United States)

    Ward, William G; Carter, Christina J; Barone, Marisa; Jinnah, Riyaz

    2011-01-01

    Multiple factors regarding surgical procedures and patient selection affect hospital staffing needs as well as hospital revenues. In order to better understand the potential impact on hospitals that hip arthroplasty device selection (standard total hip arthroplasty vs. resurfacing) creates, a review of all primary hip arthroplasties performed at one institution was designed to identify factors that impacted hospital staffing needs and revenue generation. All primary hip arthroplasties undertaken over three fiscal years (2008 to 2010) were reviewed, utilizing only hospital business office data and medical records data that had been previously extracted prior for billing purposes. Analysis confirmed differing demographics for two hip arthroplasty populations, with the resurfacing patients (compared to the conventional total hip arthroplasty population) consisting of younger patients (mean age, 50 vs. 61 years), who were more often male (75% vs. 45%), were more likely to have osteoarthritis as their primary diagnosis (83 vs. 67%) and were more often covered by managed care or commercial insurance (83 vs. 34%). They also had shorter hospital stays (mean length of stay, 2.3 vs. 4.1 days) and consequently provided a more favorable financial revenue stream to the hospital on a per patient basis. Several trends appeared during the study periods. There was a steady increase in all procedures in all groups except for the resurfacings, which decreased 26% in males and 53% in females between 2009 and 2010. Differences were observed in the demographics of patients presenting for resurfacing, compared to those presenting for conventional total hip arthroplasty. In addition to the revenue stream considerations, institutions undertaking a resurfacing program must commit the resources and planning in order to rehabilitate these patients more expeditiously than is usually required with conventional hip arthroplasty patients.

  14. SEM Model Medical Solid Waste Hospital Management In Medan City

    Science.gov (United States)

    Simarmata, Verawaty; Pandia, Setiaty; Mawengkang, Herman

    2018-01-01

    In daily activities, hospitals, as one of the important health care unit, generate both medical solid waste and non-medical solid waste. The occurrence of medical solid waste could be from the results of treatment activities, such as, in the treatment room for a hospital inpatient, general clinic, a dental clinic, a mother and child clinic, laboratories and pharmacies. Most of the medical solid waste contains infectious and hazardous materials. Therefore it should be managed properly, otherwise it could be a source of new infectious for the community around the hospital as well as for health workers themselves. Efforts surveillance of various environmental factors need to be applied in accordance with the principles of sanitation focuses on environmental cleanliness. One of the efforts that need to be done in improving the quality of the environment is to undertake waste management activities, because with proper waste management is the most important in order to achieve an optimal degree of human health. Health development in Indonesian aims to achieve a future in which the Indonesian people live in a healthy environment, its people behave clean and healthy, able to reach quality health services, fair and equitable, so as to have optimal health status, health development paradigm anchored to the healthy. The healthy condition of the individual and society can be influenced by the environment. Poor environmental quality is a cause of various health problems. Efforts surveillance of various environmental factors need to be applied in accordance with the principles of sanitation focuses on environmental cleanliness. This paper proposes a model for managing the medical solid waste in hospitals in Medan city, in order to create healthy environment around hospitals.

  15. JUICE EXTRACTION FOR TOTAL SOLUBLE SOLIDS CONTENT DETERMINATION IN MELON

    Directory of Open Access Journals (Sweden)

    Paulo Sérgio Lima e Silva

    2006-01-01

    Full Text Available The total soluble solids content (TSSC shows high positive correlation with sugars content, and therefore is generally accepted as an important quality trait of fruits. In melon, this evaluation is usually done by grinding a slice of the fruit's pulp in a household food processor, straining the ground material and then proceeding the TSSC determination in the resulting juice. This evaluation is labor-intensive and takes a long time to complete. An alternative process was delineated for obtaining the juice: the pulp of the fruit slice would be transversally cut one or more times, and longitudinally pressed by hand to obtain the juice. The objective of this work was to compare processes for obtaining juice to evaluate TSSC in melons. Fifty, 15, and 15 fruits of the Galia, Yellow, and Cantaloupe type melons were evaluated, respectively. Each fruit was considered as a block, and was longitudinally split into six fractions with similar sizes, which corresponded to the plots. The following treatments were evaluated: fraction without cuts, fractions with one, three, five, or seven transversal cuts, and the fraction treated by the conventional process. It was concluded that the procedure by which the melon slices of Galia, Yellow and Cantaloupe types are pressed for obtaining the juice to evaluate TSSC can overestimate this content. This would probably be due to the fact that the most internal section of the mesocarp presents greater TSSC than the portions closer to the epicarp.

  16. Distribution of Total Suspended Solids Concentration in a River

    Directory of Open Access Journals (Sweden)

    Ahmad Hanif Asyhar

    2012-08-01

    Full Text Available Disposal of either industrial or nonindustrial wastewater into a river has a potential to cause riverpollution. Because each load of wastewater discharged into a river contains physical, chemical, and biological parametersthat determine water quality, so that it can affect the dissolved oxygen concentration in a river. Therefore the conductedresearch was aimed to determine the pattern of pollutant dispersion in Surabaya River within the section that is closed tothe Karang Pilang Monitoring Station - Surabaya. Parameter used in this research was Total Suspended Solids (TSS. Themethod used was the finite volume method with Quadratic Upwind Interpolation Convective Kinematics (QUICK schemeby means of developing models of dispersion water pollutants in a river. The governing equation was controlled by the lawsof mass conservation, momentum conservation, and pollution transport equation. Further, these equations were solvedusing numerical calculation and followed by numerical simulation. From the numerical simulation results, it can beconcluded that the magnitude of pollutant dispersion is determined by the initial discharged TSS concentrations into theriver, however the longitudinal direction is more dominantly influenced than in lateral directions.

  17. Solid waste management in the hospitality industry: a review.

    Science.gov (United States)

    Pirani, Sanaa I; Arafat, Hassan A

    2014-12-15

    Solid waste management is a key aspect of the environmental management of establishments belonging to the hospitality sector. In this study, we reviewed literature in this area, examining the current status of waste management for the hospitality sector, in general, with a focus on food waste management in particular. We specifically examined the for-profit subdivision of the hospitality sector, comprising primarily of hotels and restaurants. An account is given of the causes of the different types of waste encountered in this sector and what strategies may be used to reduce them. These strategies are further highlighted in terms of initiatives and practices which are already being implemented around the world to facilitate sustainable waste management. We also recommended a general waste management procedure to be followed by properties of the hospitality sector and described how waste mapping, an innovative yet simple strategy, can significantly reduce the waste generation of a hotel. Generally, we found that not many scholarly publications are available in this area of research. More studies need to be carried out on the implementation of sustainable waste management for the hospitality industry in different parts of the world and the challenges and opportunities involved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Hospital Value-Based Purchasing (HVBP) – Total Performance Score

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their Clinical Process of Care domain scores, Patient Experience of Care dimension scores, and...

  19. Determination of Total Solids and Ash in Algal Biomass: Laboratory Analytical Procedure (LAP)

    Energy Technology Data Exchange (ETDEWEB)

    Van Wychen, Stefanie; Laurens, Lieve M. L.

    2016-01-13

    This procedure describes the methods used to determine the amount of moisture or total solids present in a freeze-dried algal biomass sample, as well as the ash content. A traditional convection oven drying procedure is covered for total solids content, and a dry oxidation method at 575 deg. C is covered for ash content.

  20. Assessment of conservation easements, total phosphorus, and total suspended solids in West Fork Beaver Creek, Minnesota, 1999-2012

    Science.gov (United States)

    Christensen, Victoria G.; Kieta, Kristen A.

    2014-01-01

    This study examined conservation easements and their effectiveness at reducing phosphorus and solids transport to streams. The U.S. Geological Survey cooperated with the Minnesota Board of Water and Soil Resources and worked collaboratively with the Hawk Creek Watershed Project to examine the West Fork Beaver Creek Basin in Renville County, which has the largest number of Reinvest In Minnesota land retirement contracts in the State (as of 2013). Among all conservation easement programs, a total of 24,218 acres of agricultural land were retired throughout Renville County, and 2,718 acres were retired in the West Fork Beaver Creek Basin from 1987 through 2012. Total land retirement increased steadily from 1987 until 2000. In 2000, land retirement increased sharply because of the Minnesota River Conservation Reserve Enhancement Program, then leveled off when the program ended in 2002. Streamflow data were collected during 1999 through 2011, and total phosphorus and total suspended solids data were collected during 1999 through 2012. During this period, the highest peak streamflow of 1,320 cubic feet per second was in March 2010. Total phosphorus and total suspended solids are constituents that tend to increase with increases in streamflow. Annual flow-weighted mean total-phosphorus concentrations ranged from 0.140 to 0.759 milligrams per liter, and annual flow-weighted mean total suspended solids concentrations ranged from 21.3 to 217 milligrams per liter. Annual flow-weighted mean total phosphorus and total suspended solids concentrations decreased steadily during the first 4 years of water-quality sample collection. A downward trend in flow-weighted mean total-phosphorus concentrations was significant from 1999 through 2008; however, flow-weighted total-phosphorus concentrations increased substantially in 2009, and the total phosphorus trend was no longer significant. The high annual flow-weighted mean concentrations for total phosphorus and total suspended solids

  1. Concentration and flux of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids for monitored tributaries of Lake Champlain, 1990-2012

    Science.gov (United States)

    Medalie, Laura

    2014-01-01

    Annual and daily concentrations and fluxes of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids were estimated for 18 monitored tributaries to Lake Champlain by using the Weighted Regressions on Time, Discharge, and Seasons regression model. Estimates were made for 21 or 23 years, depending on data availability, for the purpose of providing timely and accessible summary reports as stipulated in the 2010 update to the Lake Champlain “Opportunities for Action” management plan. Estimates of concentration and flux were provided for each tributary based on (1) observed daily discharges and (2) a flow-normalizing procedure, which removed the random fluctuations of climate-related variability. The flux bias statistic, an indicator of the ability of the Weighted Regressions on Time, Discharge, and Season regression models to provide accurate representations of flux, showed acceptable bias (less than ±10 percent) for 68 out of 72 models for total and dissolved phosphorus, total nitrogen, and chloride. Six out of 18 models for total suspended solids had moderate bias (between 10 and 30 percent), an expected result given the frequently nonlinear relation between total suspended solids and discharge. One model for total suspended solids with a very high bias was influenced by a single extreme value; however, removal of that value, although reducing the bias substantially, had little effect on annual fluxes.

  2. Hospital solid waste management practices in Limpopo Province, South Africa: A case study of two hospitals

    International Nuclear Information System (INIS)

    Nemathaga, Felicia; Maringa, Sally; Chimuka, Luke

    2008-01-01

    The shortcomings in the management practices of hospital solid waste in Limpopo Province of South Africa were studied by looking at two hospitals as case studies. Apart from field surveys, the generated hospital waste was weighed to compute the generation rates and was followed through various management practices to the final disposal. The findings revealed a major policy implementation gap between the national government and the hospitals. While modern practices such as landfill and incineration are used, their daily operations were not carried according to minimum standards. Incinerator ash is openly dumped and wastes are burned on landfills instead of being covered with soil. The incinerators used are also not environmentally friendly as they use old technology. The findings further revealed that there is no proper separation of wastes according to their classification as demanded by the national government. The mean percentage composition of the waste was found in the following decreasing order: general waste (60.74%) > medical waste (30.32%) > sharps (8.94%). The mean generation rates were found to be 0.60 kg per patient per day

  3. Turbidity and total suspended solid concentration dynamics in streamflow from California oak woodland watersheds

    Science.gov (United States)

    David J. Lewis; Kenneth W. Tate; Randy A. Dahlgren; Jacob Newell

    2002-01-01

    Resource agencies, private landowners, and citizen monitoring programs utilize turbidity (water clarity) measurements as a water quality indicator for total suspended solids (TSS – mass of solids per unit volume) and other constituents in streams and rivers. The dynamics and relationships between turbidity and TSS are functions of watershed-specific factors and...

  4. Total hip replacements at Kikuyu Hospital, Kenya | Kingori | East ...

    African Journals Online (AJOL)

    Background: Total joint arthroplasty is a highly effective procedure that is frequently performed in elderly patients. This is not so in the third world and is not frequently performed. Total hip replacement (THR) relieves the pain and functional disability experienced by patients with moderate to severe arthritis of the hip, ...

  5. An inexpensive optical sensor system for monitoring total suspended solids in water

    International Nuclear Information System (INIS)

    Sami Gumaan Daraigan; Mohd Zubir Matjafri; Khiruddin Abdullah; Azlan Abdul Aziz; Abdul Aziz Tajuddin; Mohd Firdaus Othman

    2005-01-01

    The objectives of this work are to design and develop an optical transsmissometer sensor for measuring total suspended solids TSS concentrations in water samples. The proposed optical sensor has the advantages of being relatively inexpensive, and easy to make and operate. An optical algorithm has been developed and used for the measurement of total suspended solids concentrations. The developed optical sensor components include light emitting diodes LEDs that are used for measuring transmitted light. The concentrations of total suspended solids TSS are determined from transmitted light through the water samples. The transmitted light is measured in terms of the output voltage of the photodetector of the sensor system. The readings are measured using a digital multimeter. The results indicate that the level of the photocurrent is linearly proportional to the total suspended solids concentration. The proposed algorithm produces a high correlation coefficient and low root mean square error. (Author)

  6. Hospital-onset Clostridium difficile infection among solid organ transplant recipients.

    Science.gov (United States)

    Donnelly, J P; Wang, H E; Locke, J E; Mannon, R B; Safford, M M; Baddley, J W

    2015-11-01

    Clostridium difficile infection (CDI) is a considerable health issue in the United States and represents the most common healthcare-associated infection. Solid organ transplant recipients are at increased risk of CDI, which can affect both graft and patient survival. However, little is known about the impact of CDI on health services utilization posttransplantation. We examined hospital-onset CDI from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. Infection was five times more common among transplant recipients than among general medicine inpatients (209 vs 40 per 10 000 discharges), and factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications. Institutional risk-standardized CDI varied more than 3-fold across high-volume hospitals (infection ratio 0.54-1.82, median 1.04, interquartile range 0.78-1.28). CDI was associated with increased 30-day readmission, transplant organ complications, cytomegalovirus infection, inpatient costs, and lengths of stay. Total observed inpatient days and direct costs for those with CDI were substantially higher than risk-standardized expected values (40 094 vs 22 843 days, costs $198 728 368 vs $154 020 528). Further efforts to detect, prevent, and manage CDI among solid organ transplant recipients are warranted. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  7. Total-dielectric-function approach to electron and phonon response in solids

    International Nuclear Information System (INIS)

    Penn, D.R.; Lewis, S.P.; Cohen, M.L.

    1995-01-01

    The interaction between two test charges, the response of a solid to an external field, and the normal modes of the solid can be determined from a total dielectric function that includes both electronic and lattice polarizabilities as well as local-field effects. In this paper we examine the relationship between superconductivity and the stability of a solid and derive sum rules for the electronic part of the dielectric function. It is also shown that there are negative eigenvalues of the total static dielectric function, implying the possibility of an attractive interaction between test charges. An attractive interaction is required for superconductivity

  8. Solid fat content as a substitute for total polar compound analysis in edible oils

    Science.gov (United States)

    The solid fat contents (SFC) of heated edible oil samples were measured and found to correlate positively with total polar compounds (TPC) and inversely with triglyceride concentration. Traditional methods for determination of total polar compounds require a laboratory setting and are time intensiv...

  9. The relationship of hospital charges and volume to surgical site infection after total hip replacement.

    Science.gov (United States)

    Boas, Rebecca; Ensor, Kelsey; Qian, Edward; Hutzler, Lorraine; Slover, James; Bosco, Joseph

    2015-05-01

    The purpose of this study was to analyze the effect of hospital volume and charges on the rate of surgical site infections for total hip replacements (THRs) in New York State (NYS). In NYS, higher volume hospitals have higher charges after THR. The study team analyzed 93,620 hip replacements performed in NYS between 2008 and 2011. Hospital charges increased significantly from $43,713 in 2008 to $50,652 in 2011 (P<.01). Compared with lower volume hospitals, patients who underwent THR at the highest volume hospitals had significantly lower surgical site infection rates (P=.003) and higher total hospital charges (P<.0001). The study team found that in the highest volume hospitals, preventing one surgical site infection was associated with $1.6 million dollars in increased charges. © 2014 by the American College of Medical Quality.

  10. Total Quality Management Implementation and Guest Satisfaction in Hospitality

    Directory of Open Access Journals (Sweden)

    Miroslav Knežević

    2017-02-01

    Full Text Available Total quality management (TQM has become a modern system of constant improvement of the quality of all company activities. The purpose of this study is to measure the expectations and satisfaction of the guests concerning the attribute quality of the hotel product. Furthermore obtained results were compared in such a way as to analyse particularly the reviews of hotels which have implemented TQM and have the ISO 9001 certificates with reviews from hotels which have not implemented TQM and do not have the ISO 9001 certificates. The conducted analysis included 55 hotels in Serbia belonging to the 4- and 5-star categories, i.e. 1308 guests who have stayed in them. The results show that between the observed groups of guests there are fewer differences in expectations than in perception, and that generally speaking guests who have stayed in the hotels that have implemented TQM are more satisfied. The biggest difference concerning the guest satisfaction with the quality of service in the observed hotels is noticeable in relation to the employees and the value-for-money.

  11. Hospital-Based Acute Care After Total Hip and Knee Arthroplasty: Implications for Quality Measurement.

    Science.gov (United States)

    Trimba, Roman; Laughlin, Richard T; Krishnamurthy, Anil; Ross, Joseph S; Fox, Justin P

    2016-03-01

    Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Dynamic effect of total solid content, low substrate/inoculum ratio and particle size on solid-state anaerobic digestion.

    Science.gov (United States)

    Motte, J-C; Escudié, R; Bernet, N; Delgenes, J-P; Steyer, J-P; Dumas, C

    2013-09-01

    Among all the process parameters of solid-state anaerobic digestion (SS-AD), total solid content (TS), inoculation (S/X ratio) and size of the organic solid particles can be optimized to improve methane yield and process stability. To evaluate the effects of each parameter and their interactions on methane production, a three level Box-Behnken experimental design was implemented in SS-AD batch tests degrading wheat straw by adjusting: TS content from 15% to 25%, S/X ratio (in volatile solids) between 28 and 47 and particle size with a mean diameter ranging from 0.1 to 1.4mm. A dynamic analysis of the methane production indicates that the S/X ratio has only an effect during the start-up phase of the SS-AD. During the growing phase, TS content becomes the main parameter governing the methane production and its strong interaction with the particle size suggests the important role of water compartmentation on SS-AD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Management of hospitals solid waste in Khartoum State.

    Science.gov (United States)

    Saad, Suhair A Gayoum

    2013-10-01

    This research had been conducted during year 2012 to review existing data on hospital waste management for some of Khartoum town hospitals and to try to produce appropriate proposals acceptable for waste management and final treatment methods. The overall status of hospital waste management in Khartoum has been assessed through direct visits and designated questionnaires. Eight main hospitals were covered in the study with an overall bed capacity of 2,978. The current waste management practice observed at all studied hospitals was that most of waste, office, general, food, construction debris, and hazardous chemical materials were all mixed together as they are generated, collected, and finally disposed of. Only a small portion of waste in some hospitals (part of potentially infectious, body parts, and sharps) are collected separately and treated in a central incinerator. The estimated value of per bed generation rate in the studied hospitals was found to be 0.87 kg/day, which lies within the range for the low-income countries. In all studied hospitals, it was found that workers were working under very poor unsafe conditions with very low salaries ($35 to $45 per month on average). About 90 % were completely illiterate or had very low education levels. At the national level, no laws considering hospital waste, or even hazardous waste, were found; only some federal general environmental regulations and some procedures from town and city localities for controlling general municipal waste exist. At the hospital level, no policies or rules were found, except in the radiotherapy center, where they manage radioactive wastes under the laws of the Sudanese Atomic Agency. Urgent actions are needed for the remediation and prevention of hazards associated with this type of waste.

  14. Decree 135/999 establishing legal norms for the management of solid waste in hospitals

    International Nuclear Information System (INIS)

    1999-01-01

    Presently ordinance regulation norms settle down on the hospital solid residuals. A definition of solid residuals, contaminated, common, the transport, treatment,installation and integral handling of the same ones is presented in normative happiness. For finish a classification of a residuals in: infectious, piercing or sharp and special as well as duties and sanctions [es

  15. Controlling costs without compromising quality: paying hospitals for total knee replacement.

    Science.gov (United States)

    Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

    2010-10-01

    Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

  16. Development of a field test method for total suspended solids analysis.

    Science.gov (United States)

    2013-11-01

    Total suspended solids (TSS) are all particles in water that will not pass through a glass fiber filter with a pore size less : than 2 m, including sediments, algae, nutrients, and metals. TSS is an important water quality parameter because of its ...

  17. COMMUNITY SCALE STREAM TAXA SENSITIVITIES TO DIFFERENT COMPOSITIONS OF EXCESS TOTAL DISSOLVED SOLIDS

    Science.gov (United States)

    Model stream chronic dosing studies (42 d) were conducted with three total dissolved solids (TDS) recipes. The recipes differed in composition of major ions. Community scale emergence was compared with single-species responses conducted simultaneously using the whole effluent tox...

  18. Evolution of hospital industrial engineering: from scientific management to total quality management.

    Science.gov (United States)

    Sahney, V K

    1993-01-01

    Industrial engineering applications in the hospital industry first began in 1910. This paper traces the evolution of hospital industrial engineering in five distinct phases. For each of the major phases, this paper presents the contributions made by industrial engineers. Many of the techniques advocated by industrial engineers are now being taught to hospital employees as hospitals introduce total quality management (TQM) within the health-care industry. TQM introduction has meant a new role for industrial engineers, as that of a teacher, coach, and a facilitator. This new role holds much promise for the improvement of quality and productivity in health care.

  19. Effects of thermal processing by nanofluids on vitamin C, total phenolics and total soluble solids of tomato juice.

    Science.gov (United States)

    Jafari, S M; Jabari, S S; Dehnad, D; Shahidi, S A

    2017-03-01

    In this research, our main idea was to apply thermal processing by nanofluids instead of conventional pasteurization processes, to shorten duration of thermal procedure and improve nutritional contents of fruit juices. Three different variables of temperature (70, 80 and 90 °C), nanofluid concentration (0, 2 and 4%) and time (30, 60 and 90 s) were selected for thermal processing of tomato juices by a shell and tube heat exchanger. The results demonstrated that 4% nanofluid concentration, at 30 °C for 30 s could result in 66% vitamin C retention of fresh juice while it was about 56% for the minimum nanofluid concentration and maximum temperature and time. Higher nanoparticle concentrations made tomato juices that require lowered thermal durations, because of better heat transfer to the product, and total phenolic compounds dwindle less severely; In fact, after 30 s thermal processing at 70 °C with 0 and 4% nanoparticles, total phenolic compounds were maintained by 71.9 and 73.6%, respectively. The range of total soluble solids for processed tomato juices was 5.4-5.6, meaning that nanofluid thermal processing could preserve the natural condition of tomato juices successfully. Based on the indices considered, a nanofluid thermal processing with 4% nanoparticle concentration at the temperature of 70 °C for 30 s will result in the best nutritional contents of final tomato juices.

  20. Cost-identification analysis of total laryngectomy: an itemized approach to hospital costs.

    Science.gov (United States)

    Dedhia, Raj C; Smith, Kenneth J; Weissfeld, Joel L; Saul, Melissa I; Lee, Steve C; Myers, Eugene N; Johnson, Jonas T

    2011-02-01

    To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Case series with chart review. Large tertiary care teaching hospital system. Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Mean total hospital costs were $29,563 (range, $10,915 to $120,345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6-43), and median Charlson comorbidity index score was 8 (2-16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46,831 vs $24,601, P cost differences with stratification based on previous radiation therapy ($27,598 vs $29,915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29,483 vs $29,609 without readmission, P = .97). This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

  1. Effect of increasing total solids contents on anaerobic digestion of food waste under mesophilic conditions: performance and microbial characteristics analysis.

    Directory of Open Access Journals (Sweden)

    Jing Yi

    Full Text Available The total solids content of feedstocks affects the performances of anaerobic digestion and the change of total solids content will lead the change of microbial morphology in systems. In order to increase the efficiency of anaerobic digestion, it is necessary to understand the role of the total solids content on the behavior of the microbial communities involved in anaerobic digestion of organic matter from wet to dry technology. The performances of mesophilic anaerobic digestion of food waste with different total solids contents from 5% to 20% were compared and the microbial communities in reactors were investigated using 454 pyrosequencing technology. Three stable anaerobic digestion processes were achieved for food waste biodegradation and methane generation. Better performances mainly including volatile solids reduction and methane yield were obtained in the reactors with higher total solids content. Pyrosequencing results revealed significant shifts in bacterial community with increasing total solids contents. The proportion of phylum Chloroflexi decreased obviously with increasing total solids contents while other functional bacteria showed increasing trend. Methanosarcina absolutely dominated in archaeal communities in three reactors and the relative abundance of this group showed increasing trend with increasing total solids contents. These results revealed the effects of the total solids content on the performance parameters and the behavior of the microbial communities involved in the anaerobic digestion of food waste from wet to dry technologies.

  2. Effect of Increasing Total Solids Contents on Anaerobic Digestion of Food Waste under Mesophilic Conditions: Performance and Microbial Characteristics Analysis

    Science.gov (United States)

    Jin, Jingwei; Dai, Xiaohu

    2014-01-01

    The total solids content of feedstocks affects the performances of anaerobic digestion and the change of total solids content will lead the change of microbial morphology in systems. In order to increase the efficiency of anaerobic digestion, it is necessary to understand the role of the total solids content on the behavior of the microbial communities involved in anaerobic digestion of organic matter from wet to dry technology. The performances of mesophilic anaerobic digestion of food waste with different total solids contents from 5% to 20% were compared and the microbial communities in reactors were investigated using 454 pyrosequencing technology. Three stable anaerobic digestion processes were achieved for food waste biodegradation and methane generation. Better performances mainly including volatile solids reduction and methane yield were obtained in the reactors with higher total solids content. Pyrosequencing results revealed significant shifts in bacterial community with increasing total solids contents. The proportion of phylum Chloroflexi decreased obviously with increasing total solids contents while other functional bacteria showed increasing trend. Methanosarcina absolutely dominated in archaeal communities in three reactors and the relative abundance of this group showed increasing trend with increasing total solids contents. These results revealed the effects of the total solids content on the performance parameters and the behavior of the microbial communities involved in the anaerobic digestion of food waste from wet to dry technologies. PMID:25051352

  3. Effect of increasing total solids contents on anaerobic digestion of food waste under mesophilic conditions: performance and microbial characteristics analysis.

    Science.gov (United States)

    Yi, Jing; Dong, Bin; Jin, Jingwei; Dai, Xiaohu

    2014-01-01

    The total solids content of feedstocks affects the performances of anaerobic digestion and the change of total solids content will lead the change of microbial morphology in systems. In order to increase the efficiency of anaerobic digestion, it is necessary to understand the role of the total solids content on the behavior of the microbial communities involved in anaerobic digestion of organic matter from wet to dry technology. The performances of mesophilic anaerobic digestion of food waste with different total solids contents from 5% to 20% were compared and the microbial communities in reactors were investigated using 454 pyrosequencing technology. Three stable anaerobic digestion processes were achieved for food waste biodegradation and methane generation. Better performances mainly including volatile solids reduction and methane yield were obtained in the reactors with higher total solids content. Pyrosequencing results revealed significant shifts in bacterial community with increasing total solids contents. The proportion of phylum Chloroflexi decreased obviously with increasing total solids contents while other functional bacteria showed increasing trend. Methanosarcina absolutely dominated in archaeal communities in three reactors and the relative abundance of this group showed increasing trend with increasing total solids contents. These results revealed the effects of the total solids content on the performance parameters and the behavior of the microbial communities involved in the anaerobic digestion of food waste from wet to dry technologies.

  4. SEBARAN TOTAL SUSPENDED SOLID (TSS PADA PROFIL VERTIKAL DI PERAIRAN SELAT MADURA KABUPATEN BANGKALAN

    Directory of Open Access Journals (Sweden)

    Aries Dwi Siswanto

    2015-04-01

    Full Text Available Sebaran sedimen tersuspensi (Total Suspended Solid (TSS dapat dipelajari secara horizontal maupun vertikal. Akumulasi sedimen tersuspensi (TSS secara horizontal sangat dipengaruhi oleh arus permukaan maupun gelombang yang dibangkitkan oleh angin. Keterdapatan TSS ini diduga berpengaruh terhadap sebarannya pada profil vertical. Kedua kondisi sebaran sedimen tersuspensi (TSS berpengaruh terhadap optimalisasi penetrasi cahaya matahari di perairan. Sedimen tersuspensi (TSS menjadi salah satu factor fisika yang penting sebagai indicator kondisi perairan. Penelitian ini bertujuan untuk mengetahui sebaran Total Suspended Solid (TSS di perairan Kabupaten Bangkalan. Materi utama yang digunakan dalam penelitian ini adalah contoh air dan data parameter lingkungan (pasang surut dan kecerahan yang diambil pada 7 stasiun pada bulan Agustus-September 2013 di Perairan Selat Madura, Kabupaten Bangkalan. Metode gravimetric (SNI-06-6989.3-2004 digunakan untuk analisa Total Suspended Solid (TSS. Data parameter lingkungan dianalisa secara deskriptif. Analisa TSS menunjukkan nilai yang berbeda pada beberapa stasiun penelitian untuk setiap minggunya. Konsentrasi TSS terendah sebesar 35 mg/L (Stasiun 3, profil permukaan, minggu pertama dan tertinggi sebesar 620 mg/L (Stasiun 4, profil dasar, minggu pertama. Secara umum, konsentrasi TSS secara vertikal (dari permukaan-dasar cenderung semakin besar, diduga dipengaruhi oleh jenis substrat dan parameter arus yang berpeluang untuk menimbulkan pengadukan di profil dasar. Kondisi lingkungan (kecerahan dan arus menunjukkan bahwa daerah dengan konsentrasi TSS yang tinggi cenderung memilki nilai kecerahan yang rendah dengan kecepatan arus yang lebih besar.Kata Kunci: kecerahan, pola arus, Total Suspended Solid (TSS DISTRIBUTION OF TOTAL SUSPENDED SOLID (TSS IN THE VERTICAL PROFILE IN THE MADURA STRAIT WATERS BANGKALAN DISTRICTABSTRACTDistribution of suspended sediment (Total Suspended Solid (TSS can be studied through

  5. On the disposal of solid radioactive wastes at hospitals

    International Nuclear Information System (INIS)

    Rogge, B.; Lewe, P.

    1987-01-01

    The disposal of radioactive materials in hospitals represents a considerable problem from the point of view of economics and organisation as well as from the point of view of radiological safety. On the one-hand, groups of people (nursing personal and clean-up crews) are involved in the handling of contaminated materials who can be instructed in special handling procedures only to a limited degree with the result that simple and clear procedures must be developed; on the other hand, such simply structured routes of disposal result in enormous volumes of radioactive waste, which represent a considerable cost factor. At the Offenbach City Hospital a concept has been created which takes these problems into account. It consists of nuclide-specific collection in groups, reduction of volume by breaking up of materials, interim storage, and government approved disposal as special hospital waste materials. (orig.) [de

  6. Effect of Increasing Total Solids Contents on Anaerobic Digestion of Food Waste under Mesophilic Conditions: Performance and Microbial Characteristics Analysis

    OpenAIRE

    Yi, Jing; Dong, Bin; Jin, Jingwei; Dai, Xiaohu

    2014-01-01

    The total solids content of feedstocks affects the performances of anaerobic digestion and the change of total solids content will lead the change of microbial morphology in systems. In order to increase the efficiency of anaerobic digestion, it is necessary to understand the role of the total solids content on the behavior of the microbial communities involved in anaerobic digestion of organic matter from wet to dry technology. The performances of mesophilic anaerobic digestion of food waste...

  7. Partial and total electronic stopping cross sections of atoms and solids for protons

    International Nuclear Information System (INIS)

    Kaneko, Toshiaki.

    1990-12-01

    Based on a wave packet theory (Phys. Rev. A40, 2188(1989); Phys. Stat. Sol. (B)156,49(1989)), partial and total electronic cross sections of target elements in atomic and solid phases with atomic number Z ranging from 2 (He) to 92 (U) are tabulated shell by shell for protons with velocity v from 0.2V 0 to 2OV 0 (V 0 =2.18 x 10 8 cm/s). (author)

  8. Is total lymphocyte count related to nutritional markers in hospitalized older adults?

    Directory of Open Access Journals (Sweden)

    Vânia Aparecida LEANDRO-MERHI

    Full Text Available ABSTRACT BACKGROUND Older patients are commonly malnourished during hospital stay, and a high prevalence of malnutrition is found in hospitalized patients aged more than 65 years. OBJECTIVE To investigate whether total lymphocyte count is related to other nutritional markers in hospitalized older adults. METHODS Hospitalized older adults (N=131 were recruited for a cross-sectional study. Their nutritional status was assessed by the Nutritional Risk Screening (NRS, anthropometry, and total lymphocyte count. The statistical analyses included the chi-square test, Fisher's exact test, and Mann-Whitney test. Spearman's linear correlation coefficient determined whether total lymphocyte count was correlated with the nutritional markers. Multiple linear regression determined the parameters associated with lymphocyte count. The significance level was set at 5%. RESULTS According to the NRS, 41.2% of the patients were at nutritional risk, and 36% had mild or moderate depletion according to total lymphocyte count. Total lymphocyte count was weakly correlated with mid-upper arm circumference (r=0.20507; triceps skinfold thickness (r=0.29036, and length of hospital stay (r= -0.21518. Total lymphocyte count in different NRS categories differed significantly: older adults who were not at nutritional risk had higher mean and median total lymphocyte count ( P =0.0245. Multiple regression analysis showed that higher lymphocyte counts were associated with higher triceps skinfold thicknesses and no nutritional risk according to the NRS. CONCLUSION Total lymphocyte count was correlated with mid-upper arm circumference, triceps skinfold thickness, and nutritional risk according to the NRS. In multiple regression the combined factors that remained associated with lymphocyte count were NRS and triceps skinfold thickness. Therefore, total lymphocyte count may be considered a nutritional marker. Other studies should confirm these findings.

  9. LISREL Model Medical Solid Infectious Waste Hazardous Hospital Management In Medan City

    Science.gov (United States)

    Simarmata, Verawaty; Siahaan, Ungkap; Pandia, Setiaty; Mawengkang, Herman

    2018-01-01

    Hazardous and toxic waste resulting from activities at most hospitals contain various elements of medical solid waste ranging from heavy metals that have the nature of accumulative toxic which are harmful to human health. Medical waste in the form of gas, liquid or solid generally include the category or the nature of the hazard and toxicity waste. The operational in activities of the hospital aims to improve the health and well-being, but it also produces waste as an environmental pollutant waters, soil and gas. From the description of the background of the above in mind that the management of solid waste pollution control medical hospital, is one of the fundamental problems in the city of Medan and application supervision is the main business licensing and control alternatives in accordance with applicable regulations.

  10. Application of life cycle assessment for hospital solid waste management: A case study.

    Science.gov (United States)

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-10-01

    This study was meant to determine environmental aspects of hospital waste management scenarios using a life cycle analysis approach. The survey for this study was conducted at the largest hospital in a major city of Pakistan. The hospital was thoroughly analyzed from November 2014 to January 2015 to quantify its wastes by category. The functional unit of the study was selected as 1 tonne of disposable solid hospital waste. System boundaries included transportation of hospital solid waste and its treatment and disposal by landfilling, incineration, composting, and material recycling methods. These methods were evaluated based on their greenhouse gas emissions. Landfilling and incineration turned out to be the worst final disposal alternatives, whereas composting and material recovery displayed savings in emissions. An integrated system (composting, incineration, and material recycling) was found as the best solution among the evaluated scenarios. This study can be used by policymakers for the formulation of an integrated hospital waste management plan. This study deals with environmental aspects of hospital waste management scenarios. It is an increasing area of concern in many developing and resource-constrained countries of the world. The life cycle analysis (LCA) approach is a useful tool for estimation of greenhouse gas emissions from different waste management activities. There is a shortage of information in existing literature regarding LCA of hospital wastes. To the best knowledge of the authors this work is the first attempt at quantifying the environmental footprint of hospital waste in Pakistan.

  11. Trends in hospital labor and total factor productivity, 1981-86

    Science.gov (United States)

    Cromwell, Jerry; Pope, Gregory C.

    1989-01-01

    The per-case payment rates of Medicare's prospective payment system are annually updated. As one element of the update factor, Congress required consideration of changes in hospital productivity. In this article, calculations of annual changes in labor and total factor productivity during 1981-86 of hospitals eligible for prospective payment are presented using several output and input variants. Generally, productivity has declined since 1980, although the rates of decline have slowed since prospective payment implementation. According to the series of analyses most relevant for policy, significant hospital productivity gains occurred during 1983-86. This may justify a lower update factor. PMID:10313278

  12. Three-tiered integration of PACS and HIS toward next generation total hospital information system.

    Science.gov (United States)

    Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

    1998-01-01

    The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

  13. Lessons learned from the total evacuation of a hospital after the 2016 Kumamoto Earthquake.

    Science.gov (United States)

    Yanagawa, Youichi; Kondo, Hisayoshi; Okawa, Takashi; Ochi, Fumio

    The 2016 Kumamoto Earthquakes were a series of earthquakes that included a foreshock earthquake (magnitude 6.2) on April 14 and a main shock (magnitude 7.0) on April 16, 2016. A number of hospitals in Kumamoto were severely damaged by the two major earthquakes and required total evacuation. The authors retrospectively analyzed the activity data of the Disaster Medical Assistance Teams using the Emergency Medical Information System records to investigate the cases in which the total evacuation of a hospital was attempted following the 2016 Kumamoto Earthquake. Total evacuation was attempted at 17 hospitals. The evacuation of one of these hospitals was canceled. Most of the hospital buildings were more than 20 years old. The danger of collapse was the most frequent reason for evacuation. Various transportation methods were employed, some of which involved the Japan Ground Self-Defense Force; no preventable deaths occurred during transportation. The hospitals must now be renovated to improve their earthquake resistance. The coordinated and combined use of military and civilian resources is beneficial and can significantly reduce human suffering in large-scale disasters.

  14. Machine Learning methods in fitting first-principles total energies for substitutionally disordered solid

    Science.gov (United States)

    Gao, Qin; Yao, Sanxi; Widom, Michael

    2015-03-01

    Density functional theory (DFT) provides an accurate and first-principles description of solid structures and total energies. However, it is highly time-consuming to calculate structures with hundreds of atoms in the unit cell and almost not possible to calculate thousands of atoms. We apply and adapt machine learning algorithms, including compressive sensing, support vector regression and artificial neural networks to fit the DFT total energies of substitutionally disordered boron carbide. The nonparametric kernel method is also included in our models. Our fitted total energy model reproduces the DFT energies with prediction error of around 1 meV/atom. The assumptions of these machine learning models and applications of the fitted total energies will also be discussed. Financial support from McWilliams Fellowship and the ONR-MURI under the Grant No. N00014-11-1-0678 is gratefully acknowledged.

  15. Hubungan Antara Konsumsi Serat Kasar dan Lemak Kasar dengan Kadar Total Solid dan Lemak Susu Kambing Peranakan Ettawa

    Directory of Open Access Journals (Sweden)

    Aisyah Nurhajah

    2016-04-01

    Full Text Available ABSTRAK. Penelitian ini bertujuan mengetahui hubungan antara konsumsi serat kasar dan lemak kasar dengan total solid dan lemak susu kambing Peranakan Ettawa. Penelitian ini menggunakan metode survei dan purposive sampling. Sampel yang digunakan pada penelitian ini adalah 35 ekor kambing Peranakan Ettawa dengan kriteria bulan laktasi 4-5, periode laktasi 2-3 dan frekuensi pemerahan 2 kali. Analisis data dilakukan menggunakan analisis regresi linier sederhana dan non linier kuadratik dan korelasi. Variabel bebas (variabel X pada penelitian ini adalah konsumsi serat kasar dan lemak kasar, sedangkan variabel terikat (variabel Y pada penelitian ini adalah total solid dan lemak susu. Hasil penelitian menunjukkan bahwa terdapat hubungan linier positif yang lemah antara konsumsi serat kasar dengan total solid dan lemak susu (r = 0,185 dan r = 0,160. Hubungan antara konsumsi lemak kasar dengan total solid dan lemak susu pada penelitian ini menunjukkan adanya hubungan kuadratik yang lemah (r = 0,316 dan r = 0,320. Kesimpulan dari penelitian ini adalah terdapat hubungan yang lemah antara konsumsi serat kasar dan lemak kasar dengan total solid dan lemak susu. Semakin tinggi konsumsi serat kasar akan meningkatkan kandungan total solid dan lemak susu, tetapi konsumsi lemak kasar yang semakin tinggi tidak selalu meningkatkan kandungan total solid dan lemak susu.    (Correlations between crude fiber and crude fat intake with total solid and milk fat contents in ettawa crossbreed goat  ABSTRACT. This study was aimed to determine the correlations between crude fiber and crude fat intake with total solid and milk fat contents. Samples used in this study were 35 Ettawa Crossbreed goats with lactation month of 4-5, lactation period of 2-3 and twice daily milking. Simple linear regression and non linear quadratic regression analysis were used in this study with crude fiber and crude fat intake as independent variables (X, meanwhile total solid and milk fat as

  16. Karakteristik Total Padatan Tersuspensi (Total Suspended Solid Dan Kekeruhan (Turbidity Secara Vertikal Di Perairan Teluk Benoa, Bali

    Directory of Open Access Journals (Sweden)

    I Gede Hendrawan

    2016-06-01

    Full Text Available Benoa bay is one of estuary that located in the Southern part of Bali Island, and as a strategic tourism destination. The increased of the human activity has an important role to give an ecological pressure for the seawater ecosystem in the Benoa bay. Total suspended solid (TSS and turbidity is one of the important indicators that could be determining the quality of the seawater. As the estuary, Benoa bay received fresh water from the river discharge that also potentially carries any material to the bay. In addition, port activity is also has an important role in contributing a various material to the Benoa bay. From this research, we found that the TSS concentration and the turbidity are higher in the surface water and also in the bottom layer. TSS concentration and the turbidity also varied from the bay mouth trough the line of vessel onto the inner of bay. TSS concentration and turbidity in the bay mouth has a smaller concentration rather than in the inner part of bay. TSS concentration and turbidity in the inner of bay could be caused by the port activity. In addition, seawater circulation is also has an importan factor to contributing the TSS concentration and the turbidity. Sea current would be erroted the seabottom and with the different shape of the topography could be increased the TSS and turbidity.

  17. Characterization of suspended solids and total phosphorus loadings from small watersheds in Wisconsin

    Science.gov (United States)

    Danz, Mari E.; Corsi, Steven R.; Graczyk, David J.; Bannerman, Roger T.

    2010-01-01

    Knowledge of the daily, monthly, and yearly distribution of contaminant loadings and streamflow can be critical for the successful implementation and evaluation of water-quality management practices. Loading data for solids (suspended sediment and total suspended solids) and total phosphorus and streamflow data for 23 watersheds were summarized for four ecoregions of Wisconsin: the Driftless Area Ecoregion, the Northern Lakes and Forests Ecoregion, the North Central Hardwoods Ecoregion, and the Southeastern Wisconsin Till Plains Ecoregion. The Northern Lakes and Forests and the North Central Hardwoods Ecoregions were combined into one region for analysis due to a lack of sufficient data in each region. Urban watersheds, all located in the Southeastern Wisconsin Till Plains, were analyzed separately from rural watersheds as the Rural Southeastern Wisconsin Till Plains region and the Urban Southeastern Wisconsin Till Plains region. Results provide information on the distribution of loadings and streamflow between base flow and stormflow, the timing of loadings and streamflow throughout the year, and information regarding the number of days in which the majority of the annual loading is transported. The average contribution to annual solids loading from stormflow periods for the Driftless Area Ecoregion was 84 percent, the Northern Lakes and Forests/North Central Hardwoods region was 71 percent, the Rural Southeastern Wisconsin Till Plains region was 70 percent, and the Urban Southeastern Wisconsin Till Plains region was 90 percent. The average contributions to annual total phosphorus loading from stormflow periods were 72, 49, 61, and 76 percent for each of the respective regions. The average contributions to annual streamflow from stormflow periods are 20, 23, 31, and 50 percent for each of the respective regions. In all regions, the most substantial loading contributions for solids were in the late winter (February through March), spring (April through May), and

  18. Temporal and spatial variations in total suspended and dissolved solids in the upper part of Manoa stream, Hawaii

    NARCIS (Netherlands)

    Augustijn, Dionysius C.M.; Fares, Ali; Tran, Dai Ngia

    2011-01-01

    Hawaiian watersheds are small, steep, and receive high intensity rainfall events of non-uniform distribution. These geographic and weather patterns result in flashy streams of strongly variable water quality even within various stream segments. Total suspended solids (TSS) and total dissolved solids

  19. Total body irradiation and marrow transplantation for acute leukaemia. The Royal Marsden Hospital experience

    Energy Technology Data Exchange (ETDEWEB)

    Barrett, A; Barrett, A J; Powles, R L [Institute of Cancer Research, Sutton (UK). Surrey Branch; Royal Marsden Hospital, London (UK))

    1979-06-01

    The experience with total body irradiation at the Royal Marsden Hospital is described for an elective program of transplantation in patients with acute myeloid leukaemia (AML) in first remission. Dose rate appears to be a critical factor in the reduction of radiation-associated damage and careful monitoring of the actual dose distribution and dose received is mandatory.

  20. Bulk metal concentrations versus total suspended solids in rivers: Time-invariant & catchment-specific relationships.

    Science.gov (United States)

    Nasrabadi, Touraj; Ruegner, Hermann; Schwientek, Marc; Bennett, Jeremy; Fazel Valipour, Shahin; Grathwohl, Peter

    2018-01-01

    Suspended particles in rivers can act as carriers of potentially bioavailable metal species and are thus an emerging area of interest in river system monitoring. The delineation of bulk metals concentrations in river water into dissolved and particulate components is also important for risk assessment. Linear relationships between bulk metal concentrations in water (CW,tot) and total suspended solids (TSS) in water can be used to easily evaluate dissolved (CW, intercept) and particle-bound metal fluxes (CSUS, slope) in streams (CW,tot = CW + CSUS TSS). In this study, we apply this principle to catchments in Iran (Haraz) and Germany (Ammer, Goldersbach, and Steinlach) that show differences in geology, geochemistry, land use and hydrological characteristics. For each catchment, particle-bound and dissolved concentrations for a suite of metals in water were calculated based on linear regressions of total suspended solids and total metal concentrations. Results were replicable across sampling campaigns in different years and seasons (between 2013 and 2016) and could be reproduced in a laboratory sedimentation experiment. CSUS values generally showed little variability in different catchments and agree well with soil background values for some metals (e.g. lead and nickel) while other metals (e.g. copper) indicate anthropogenic influences. CW was elevated in the Haraz (Iran) catchment, indicating higher bioavailability and potential human and ecological health concerns (where higher values of CSUS/CW are considered as a risk indicator).

  1. Alternatives of Treatment and Final Disposition of the Solid Hospital residuals

    International Nuclear Information System (INIS)

    Meza Monge, K.

    1998-01-01

    The current handling, treatment and final disposition of the hospital solid waste in Costa Rica are considered inadequate or at least insufficient. This situation represents a serious danger for the population's health and the environment, because they are exposed to infectious agents, toxic substances and even radioactive products that are generated among the residuals of the centers of health. This work, alternatives propose for the treatment and adequate final disposition of the solid waste produced in the hospitals of the country. They take into consideration the characteristics that present these residuals, the advantages and disadvantages of each one of the existent techniques and the technical and economic possibilities of the country. For this purpose, in first instance, a revision about the properties, the quality and the quantity of the solid waste produced by the national hospital centers was carried out. Also, a diagnostic of the current situation of the treatment and final disposition of these residuals in some of the most important hospitals of the country, as well as of the possibilities of physical space with that they count on was carried out. Then, the existent different treatment techniques and final disposition for the solid waste that comes from the centers of health are described, as well as their advantages and disadvantages and a comparative analysis of the same ones is carried out. The objective is completed, since alternatives of treatment and final disposition that are considered appropriate for this type of residuals are planned. Nevertheless, in the future, more detailed investigations and studies of feasibility, with the purpose of developing handling programs and elimination of the solid waste for each one of the hospital centers in Costa Rica should be carried out. (Author) [es

  2. Municipal solid waste management for total resource recycling: a case study on Haulien County in Taiwan.

    Science.gov (United States)

    Chang, Yu-Min; Liu, Chien-Chung; Dai, Wen-Chien; Hu, Allen; Tseng, Chao-Heng; Chou, Chieh-Mei

    2013-01-01

    This work presents the enforcement performance of recent Haulien County, Taiwan municipal solid waste (MSW) recycling management programs. These programs include: Mandatory Refuse Sorting and Recycling, Diverse Bulk Waste Reuse, Pay-as-you-Discharge, Total Food Waste Recycling, Restricted Use on Plastic Shopping Bags & Plastic Tableware, Recycling Fund Management, and Ash Reuse. These programs provide incentives to reduce the MSW quantity growth rate. It was found that the recycled material fraction of MSW generated in 2001 was from 6.8%, but was 32.4% in 2010 and will increase stably by 2-5% yearly in the near future. Survey data for the last few years show that only 2.68% (based on total MSW generated) of food waste was collected in 2001. However, food waste was up to 9.7% in 2010 after the Total Food Waste Recycling program was implemented. The reutilization rate of bottom ash was 20% in 2005 and up to 65% in 2010 owing to Ash Reuse Program enforcement. A quantified index, the Total Recycle Index, was proposed to evaluate MSW management program performance. The demonstrated county will move toward a zero waste society in 2015 if the Total Recycle Index approaches 1.00. Exact management with available programs can lead to slow-growing waste volume and recovery of all MSW.

  3. Implementation of a multi-variable regression analysis in the assessment of the generation rate and composition of hospital solid waste for the design of a sustainable management system in developing countries.

    Science.gov (United States)

    Al-Khatib, Issam A; Abu Fkhidah, Ismail; Khatib, Jumana I; Kontogianni, Stamatia

    2016-03-01

    Forecasting of hospital solid waste generation is a critical challenge for future planning. The composition and generation rate of hospital solid waste in hospital units was the field where the proposed methodology of the present article was applied in order to validate the results and secure the outcomes of the management plan in national hospitals. A set of three multiple-variable regression models has been derived for estimating the daily total hospital waste, general hospital waste, and total hazardous waste as a function of number of inpatients, number of total patients, and number of beds. The application of several key indicators and validation procedures indicates the high significance and reliability of the developed models in predicting the hospital solid waste of any hospital. Methodology data were drawn from existent scientific literature. Also, useful raw data were retrieved from international organisations and the investigated hospitals' personnel. The primal generation outcomes are compared with other local hospitals and also with hospitals from other countries. The main outcome, which is the developed model results, are presented and analysed thoroughly. The goal is this model to act as leverage in the discussions among governmental authorities on the implementation of a national plan for safe hospital waste management in Palestine. © The Author(s) 2016.

  4. Association of Hospital Costs With Complications Following Total Gastrectomy for Gastric Adenocarcinoma.

    Science.gov (United States)

    Selby, Luke V; Gennarelli, Renee L; Schnorr, Geoffrey C; Solomon, Stephen B; Schattner, Mark A; Elkin, Elena B; Bach, Peter B; Strong, Vivian E

    2017-10-01

    Postoperative complications are associated with increased hospital costs following major surgery, but the mechanism by which they increase cost and the categories of care that drive this increase are poorly described. To describe the association of postoperative complications with hospital costs following total gastrectomy for gastric adenocarcinoma. This retrospective analysis of a prospectively collected gastric cancer surgery database at a single National Cancer Institute-designated comprehensive cancer center included all patients undergoing curative-intent total gastrectomy for gastric adenocarcinoma between January 2009 and December 2012 and was conducted in 2015 and 2016. Ninety-day normalized postoperative costs. Hospital accounting system costs were normalized to reflect Medicare reimbursement levels using the ratio of hospital costs to Medicare reimbursement and categorized into major cost categories. Differences between costs in Medicare proportional dollars (MP $) can be interpreted as the amount that would be reimbursed to an average hospital by Medicare if it paid differentially based on types and extent of postoperative complications. In total, 120 patients underwent curative-intent total gastrectomy for stage I through III gastric adenocarcinoma between 2009 and 2012. Of these, 79 patients (65.8%) were men, and the median (interquartile range) age was 64 (52-70) years. The 51 patients (42.5%) who underwent an uncomplicated total gastrectomy had a mean (SD) normalized cost of MP $12 330 (MP $2500), predominantly owing to the cost of surgical care (mean [SD] cost, MP $6830 [MP $1600]). The 34 patients (28.3%) who had a major complication had a mean (SD) normalized cost of MP $37 700 (MP $28 090). Surgical care was more expensive in these patients (mean [SD] cost, MP $8970 [MP $2750]) but was a smaller contributor to total cost (24%) owing to increased costs from room and board (mean [SD] cost, MP $11 940 [MP $8820]), consultations (mean [SD

  5. Utilization of Total Joint Arthroplasty in Physician-Owned Specialty Hospitals vs Acute Care Facilities.

    Science.gov (United States)

    Chen, Antonia F; Pflug, Emily; O'Brien, Daniel; Maltenfort, Mitchell G; Parvizi, Javad

    2017-07-01

    The recent emergence of physician-owned specialty hospitals has sparked controversy about overutilization. Thus, the purpose of this study was to compare utilization patterns of total joint arthroplasty (TJA) between physician-specialty hospitals (PSHs) and acute care hospitals (ACHs). A retrospective study was conducted from January 2010 to August 2014 comparing primary TJA patients between a PSH and an ACH; 103 PSH patients were matched to 103 ACH patients by age, gender, BMI, and ASA classification with similar case distribution between facilities. All surgeons in the study operated at both hospitals and were shareholders of the PSH. Information on nonoperative treatments, and timing to the initial appointment, consent, and surgery were analyzed using univariate analysis. Nonoperative treatments before surgery were similar between hospitals (P = 1.00). The time from the initial appointment to consent was longer for PSH (P = .0001). However, the time from consent to the date of surgery (P = .04) and the timing from symptoms to initial appointment (P = .006) was shorter for PSH. The time from initial appointment to the day of surgery was similar between groups (P = .20). Patients were more likely to be consented for surgery on their first clinic visit when undergoing surgery at ACH (87 of 103, 84.4%) compared to PSH (61 of 103; 59.2%; P total knee arthroplasty (P = .001) and total hip arthroplasty patients (P = .001) at PSH. Facility ownership in PSH resulted in similar conservative treatment before TJA. The time to surgical consent after the initial appointment was longer PSH, whereas the time from consent to the date of surgery was shorter at the PSH. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Development and evaluation of a magnetic solid-phase radioimmunoassay for total human thyroxine (T4)

    International Nuclear Information System (INIS)

    Abbas, S. H.; Hassan, A. M. E.; Abdalla, O. M.; Zahran, A. B.; Shabbo, N. M.; Ali, N. I.; Gubara, A.

    2009-02-01

    In this study a simple and rapid magnetic solid-phase radioimmunoassay (RIA) for human thyroxine (T4) was developed using locally raised sheep thyroxine antibody and radioiodinated thyroxine (T4) tracer by chloramine-T method. The assay involves two hours incubation at ambient temperature rang (30 to 35 o C ) associated with the antibody covalently linked by the easily performed carbonyldiimidazole (CDI) method to magnetic particles obtained from SIPAC. 0.1% triton with sodium azide used as a wash buffer. L-Thyroxine Na-salt peta hydrate from sigma was used for the preparation of standards and quality control sera. The coupled magnetic anti-T4 solid phase titrated in order to find out the suitable antibody concentration (titre) to be used in the assay. Optimizations followed by validation procedures were done. When correlated with kits imported from NETRIA and AMERSHAM, results were found to be highly comparable r=0.965 and p<0.05. Shelf life was also studied, so that the local prepared T4 RIA magnetic reagents can be used for the measurement of total human thyroxine with a very low cost compared to imported kits. (Author)

  7. Total expenditures per patient in hospital-owned and physician-owned physician organizations in California.

    Science.gov (United States)

    Robinson, James C; Miller, Kelly

    Hospitals are rapidly acquiring medical groups and physician practices. This consolidation may foster cooperation and thereby reduce expenditures, but also may lead to higher expenditures through greater use of hospital-based ambulatory services and through greater hospital pricing leverage against health insurers. To determine whether total expenditures per patient were higher in physician organizations (integrated medical groups and independent practice associations) owned by local hospitals or multihospital systems compared with groups owned by participating physicians. Data were obtained on total expenditures for the care provided to 4.5 million patients treated by integrated medical groups and independent practice associations in California between 2009 and 2012. The patients were covered by commercial health maintenance organization (HMO) insurance and the data did not include patients covered by commercial preferred provider organization (PPO) insurance, Medicare, or Medicaid. Total expenditures per patient annually, measured in terms of what insurers paid to the physician organizations for professional services, to hospitals for inpatient and outpatient procedures, to clinical laboratories for diagnostic tests, and to pharmaceutical manufacturers for drugs and biologics. Annual expenditures per patient were compared after adjusting for patient illness burden, geographic input costs, and organizational characteristics. Of the 158 organizations, 118 physician organizations (75%) were physician-owned and provided care for 3,065,551 patients, 19 organizations (12%) were owned by local hospitals and provided care for 728,608 patients, and 21 organizations (13%) were owned by multihospital systems and provided care for 693,254 patients. In 2012, physician-owned physician organizations had mean expenditures of $3066 per patient (95% CI, $2892 to $3240), hospital-owned physician organizations had mean expenditures of $4312 per patient (95% CI, $3768 to $4857), and

  8. Recent Developments in Solid-Phase Extraction for Near and Attenuated Total Reflection Infrared Spectroscopic Analysis

    Directory of Open Access Journals (Sweden)

    Christian W. Huck

    2016-05-01

    Full Text Available A review with more than 100 references on the principles and recent developments in the solid-phase extraction (SPE prior and for in situ near and attenuated total reflection (ATR infrared spectroscopic analysis is presented. New materials, chromatographic modalities, experimental setups and configurations are described. Their advantages for fast sample preparation for distinct classes of compounds containing different functional groups in order to enhance selectivity and sensitivity are discussed and compared. This is the first review highlighting both the fundamentals of SPE, near and ATR spectroscopy with a view to real sample applicability and routine analysis. Most of real sample analyses examples are found in environmental research, followed by food- and bioanalysis. In this contribution a comprehensive overview of the most potent SPE-NIR and SPE-ATR approaches is summarized and provided.

  9. Forecasting models for flow and total dissolved solids in Karoun river-Iran

    Science.gov (United States)

    Salmani, Mohammad Hassan; Salmani Jajaei, Efat

    2016-04-01

    Water quality is one of the most important factors contributing to a healthy life. From the water quality management point of view, TDS (total dissolved solids) is the most important factor and many water developing plans have been implemented in recognition of this factor. However, these plans have not been perfect and very successful in overcoming the poor water quality problem, so there are a good volume of related studies in the literature. We study TDS and the water flow of the Karoun river in southwest Iran. We collected the necessary time series data from the Harmaleh station located in the river. We present two Univariate Seasonal Autoregressive Integrated Movement Average (ARIMA) models to forecast TDS and water flow in this river. Then, we build up a Transfer Function (TF) model to formulate the TDS as a function of water flow volume. A performance comparison between the Seasonal ARIMA and the TF models are presented.

  10. Design and Implementation of Remotely Monitoring System for Total Dissolved Solid in Baghdad Drinking Water Networks

    Directory of Open Access Journals (Sweden)

    Hussein Abdul-Ridha Mohammed

    2018-01-01

    Full Text Available he pollution of drinking water is a dangerous problem for the whole world, it can threaten the health of people and as people in developed society attaches more importance to environmental protection, it is of great research significance to intelligently and remotely monitoring the environment. Therefore in this paper, a remote water monitoring system for Baghdad drinking water system is suggested. The proposed system consists of data sensing and monitoring nodes at different locations in Baghdad to sensing and analyzes the data. These nodes are periodically measured Total Dissolved Solids (TDS. In case of measured value above TDS threshold which is 500 ppm, then an automated warning message will be sent to authorize persons in the maintenance center via Global Position System to take the correct action. This suggested structure has several advantages over traditional monitoring systems in terms of price, portability, reliability, applicability and takes a sample from a water tap in easy and real-time approach.

  11. Real-space formulation of the electrostatic potential and total energy of solids

    International Nuclear Information System (INIS)

    Pask, J E; Sterne, P A

    2004-01-01

    We develop expressions for the electrostatic potential and total energy of crystalline solids which are amenable to direct evaluation in real space. Unlike conventional reciprocal space formulations, no Fourier transforms or reciprocal lattice summations are required, and the formulation is well suited for large-scale, parallel computations. The need for reciprocal space expressions is eliminated by replacing long-range potentials by equivalent localized charge distributions and incorporating long-range interactions into boundary conditions on the unit cell. In so doing, a simplification of the conventional reciprocal space formalism is obtained. The equivalence of the real- and reciprocal space formalisms is demonstrated by direct comparison in self-consistent density-functional calculations

  12. Stochastic modeling of total suspended solids (TSS) in urban areas during rain events.

    Science.gov (United States)

    Rossi, Luca; Krejci, Vladimir; Rauch, Wolfgang; Kreikenbaum, Simon; Fankhauser, Rolf; Gujer, Willi

    2005-10-01

    The load of total suspended solids (TSS) is one of the most important parameters for evaluating wet-weather pollution in urban sanitation systems. In fact, pollutants such as heavy metals, polycyclic aromatic hydrocarbons (PAHs), phosphorous and organic compounds are adsorbed onto these particles so that a high TSS load indicates the potential impact on the receiving waters. In this paper, a stochastic model is proposed to estimate the TSS load and its dynamics during rain events. Information on the various simulated processes was extracted from different studies of TSS in urban areas. The model thus predicts the probability of TSS loads arising from combined sewer overflows (CSOs) in combined sewer systems as well as from stormwater in separate sewer systems in addition to the amount of TSS retained in treatment devices in both sewer systems. The results of this TSS model illustrate the potential of the stochastic modeling approach for assessing environmental problems.

  13. Improved estimates of filtered total mercury loadings and total mercury concentrations of solids from potential sources to Sinclair Inlet, Kitsap County, Washington

    Science.gov (United States)

    Paulson, Anthony J.; Conn, Kathleen E.; DeWild, John F.

    2013-01-01

    Previous investigations examined sources and sinks of mercury to Sinclair Inlet based on historic and new data. This included an evaluation of mercury concentrations from various sources and mercury loadings from industrial discharges and groundwater flowing from the Bremerton naval complex to Sinclair Inlet. This report provides new data from four potential sources of mercury to Sinclair Inlet: (1) filtered and particulate total mercury concentrations of creek water during the wet season, (2) filtered and particulate total mercury releases from the Navy steam plant following changes in the water softening process and discharge operations, (3) release of mercury from soils to groundwater in two landfill areas at the Bremerton naval complex, and (4) total mercury concentrations of solids in dry dock sumps that were not affected by bias from sequential sampling. The previous estimate of the loading of filtered total mercury from Sinclair Inlet creeks was based solely on dry season samples. Concentrations of filtered total mercury in creek samples collected during wet weather were significantly higher than dry weather concentrations, which increased the estimated loading of filtered total mercury from creek basins from 27.1 to 78.1 grams per year. Changes in the concentrations and loading of filtered and particulate total mercury in the effluent of the steam plant were investigated after the water softening process was changed from ion-exchange to reverse osmosis and the discharge of stack blow-down wash began to be diverted to the municipal water-treatment plant. These changes reduced the concentrations of filtered and particulate total mercury from the steam plant of the Bremerton naval complex, which resulted in reduced loadings of filtered total mercury from 5.9 to 0.15 grams per year. Previous investigations identified three fill areas on the Bremerton naval complex, of which the western fill area is thought to be the largest source of mercury on the base

  14. KUALITAS LIMBAH PADAT MEDIS RUMAH SAKIT (Quality of Solid Medical Waste in Hospital

    Directory of Open Access Journals (Sweden)

    Riris Nainggolan

    2012-11-01

    Full Text Available Hospital is one of critical and important part of health care chain due to improvement of it. Hospital can cause nosocomial case for example cellulitis at Dr. Sutomo Hospital in Surabaya because the environment of it not fulfil the health requirements. Several studies reported that hospital environmental health not yet fulfil all the health requirements needed. Only 56.5% used incenerator with unperfect result in temperature which is only reached 200°C. The need of waste management recently have taken attention to improve its quality. Important factors such as volume and waste characteristics are major concern. According to measurement result held in Latin America showed that the hospital garbage and waste production every day per bed about 3.6 Kgs while in England approximately 3.3 Kgs. This research aimed to have characteristic information and the medical waste management of several hospital in Jakarta and Medan. The collection of data conducted through research and book reference, interview and laboratory test for 9 (nine parameters. Characteristic and solid medical waste volume in this research are 2.5-53 Kgs of infectious waste. 0.8-60 Kgs of solid material, 0.8-3 Kgs of unused human anatomy, 0.5-3.3 Kgs of chemical side products, 2-6.6 Kgs of plastic waste. Number of patients with one day care per year about 1228 people while for several days care about 4928 people. From the test results showed that Cu, Se, Zn and Cr value over the quality standard requirements based on Government Acts no 18, 1999.Keywords: Medical waste, Waste Quality, Hospital

  15. Blood Transfusion During Total Ankle Arthroplasty Is Associated With Increased In-Hospital Complications and Costs.

    Science.gov (United States)

    Ewing, Michael A; Huntley, Samuel R; Baker, Dustin K; Smith, Kenneth S; Hudson, Parke W; McGwin, Gerald; Ponce, Brent A; Johnson, Michael D

    2018-04-01

    Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA. Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1.1%) receiving a blood transfusion. Univariate analysis assessed patient and hospital factors associated with blood transfusion following TAA. Patients requiring blood transfusion were more likely to be female, African American, Medicare recipients, and treated in nonteaching hospitals. Average length of stay for patients following transfusion was 3.0 days longer, while average inpatient cost was increased by approximately 50%. Patients who received blood transfusion were significantly more likely to suffer from congestive heart failure, peripheral vascular disease, hypothyroidism, coagulation disorder, or anemia. Acute renal failure was significantly more common among patients receiving blood transfusion ( P < .001). Blood transfusions following TAA are infrequent and are associated with multiple medical comorbidities, increased complications, longer hospital stays, and increased overall cost. Level III: Retrospective, comparative study.

  16. Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital.

    Science.gov (United States)

    Yokoe, Deborah S; Avery, Taliser R; Platt, Richard; Huang, Susan S

    2013-11-01

    Public reporting of surgical site infections (SSIs) by hospitals is largely limited to infections detected during surgical hospitalizations or readmissions to the same facility. SSI rates may be underestimated if patients with SSIs are readmitted to other hospitals. We assessed the impact of readmissions to other facilities on hospitals' SSI rates following primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). This was a retrospective cohort study of all patients who underwent primary THA or TKA at California hospitals between 1 January 2006 and 31 December 2009. SSIs were identified using ICD-9-CM diagnosis codes predictive of SSI assigned at any California hospital within 365 days of surgery using a statewide repository of hospital data that allowed tracking of patients between facilities. We used statewide data to estimate the fraction of each hospital's THA and TKA SSIs identified at the operative hospital versus other hospitals. A total of 91 121 THA and 121 640 TKA procedures were identified. Based on diagnosis codes, SSIs developed following 2214 (2.3%) THAs and 2465 (2.0%) TKAs. Seventeen percent of SSIs would have been missed by operative hospital surveillance alone. The proportion of hospitals' SSIs detected at nonoperative hospitals ranged from 0% to 100%. Including SSIs detected at nonoperative hospitals resulted in better relative ranking for 61% of THA hospitals and 61% of TKA hospitals. Limiting SSI surveillance to the operative hospital caused varying degrees of SSI underestimation and substantially impacted hospitals' relative rankings, suggesting that alternative methods for comprehensive postdischarge surveillance are needed for accurate benchmarking.

  17. Loads of nitrate, phosphorus, and total suspended solids from Indiana watersheds

    Science.gov (United States)

    Bunch, Aubrey R.

    2016-01-01

    Transport of excess nutrients and total suspended solids (TSS) such as sediment by freshwater systems has led to degradation of aquatic ecosystems around the world. Nutrient and TSS loads from Midwestern states to the Mississippi River are a major contributor to the Gulf of Mexico Hypoxic Zone, an area of very low dissolved oxygen concentration in the Gulf of Mexico. To better understand Indiana’s contribution of nutrients and TSS to the Mississippi River, annual loads of nitrate plus nitrite as nitrogen, total phosphorus, and TSS were calculated for nine selected watersheds in Indiana using the load estimation model, S-LOADEST. Discrete water-quality samples collected monthly by the Indiana Department of Environmental Management’s Fixed Stations Monitoring Program from 2000–2010 and concurrent discharge data from the U. S. Geological Survey streamflow gages were used to create load models. Annual nutrient and TSS loads varied across Indiana by watershed and hydrologic condition. Understanding the loads from large river sites in Indiana is important for assessing contributions of nutrients and TSS to the Mississippi River Basin and in determining the effectiveness of best management practices in the state. Additionally, evaluation of loads from smaller upstream watersheds is important to characterize improvements at the local level and to identify priorities for reduction.

  18. Solid-Liquid Extraction Kinetics of Total Phenolic Compounds (TPC from Red Dates

    Directory of Open Access Journals (Sweden)

    Bee Lin Chua

    2018-01-01

    Full Text Available Red dates are one of the most famous herbal plants in making traditional Chinese medicine. They contain large amount of bioactive compounds. The objectives of this research were to optimise the crude extract yield and total phenolic compounds (TPC yield from red dates using response surface methodology (RSM and model the extraction kinetics of TPC yield from red dates. Date fruits were dried in an oven under temperatures 50°C, 60°C, 70°C and 80°C until a constant weight was obtained. The optimum drying temperature was 60°C as it gave the highest crude extract yield and TPC yield. Besides that, single factor experiments were used to determine the optimum range of four extraction parameters which were: liquid-solid ratio (10-30 ml/g; ultrasonic power (70-90%; extraction temperature (50-70°C; and extraction time (40-60min. The optimum range of the four parameters were further optimised using the Box-Behken Design (BBD of RSM. The extraction conditions that gave the highest crude extract yield and TPC yield were chosen. The optimum value for liquid-solid ratio, ultrasonic power, extraction temperature and extraction time were 30ml/g, 70%, 60°C and 60 min respectively. The two equations generated from RSM were reliable and can be used to predict the crude extract yield and TPC yield. The higher the extraction temperature, liquid-solid ratio, and extraction time and lower ultrasonic power, the higher the crude extract and TPC yield. Finally, the results of TPC yield versus time based on the optimum extraction parameters from RSM optimisation were fitted into three extraction kinetic models (Peleg’s model, Page’s model and Ponomaryov’s model. It was found that the most suitable kinetic model to represent the extraction process of TPC from red dates was Page’s model due to its coefficient of determination (R2 was the closest to unity, 0.9663 while its root mean square error (RMSE was the closest to zero, 0.001534.

  19. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Remedios López-Liria

    2015-01-01

    Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

  20. Type 2 diabetes and in-hospital complications after revision of total hip and knee arthroplasty.

    Directory of Open Access Journals (Sweden)

    Ana López-de-Andrés

    Full Text Available To assess the effect of type 2 diabetes (T2DM on hospital outcomes such as in hospital postoperative complications (IHPC, length of hospital stay (LOHS and in-hospital mortality (IHM after the revision of total hip arthroplasty (RHA and total knee arthroplasty (RKA and to identify factors associated with IHPC among T2DM patients undergoing these procedures.We performed a retrospective study using the Spanish National Hospital Discharge Database, 2005-2014. We included patients who were ≥40 years old that had undergone RHA and RKA. For each T2DM patient, we selected a year-, gender-, age- and Charlson Comorbidity Index-matched non-diabetic patient.We identified 44,055 and 39,938 patients who underwent RHA (12.72% with T2DM and RKA (15.01% with T2DM. We matched 4,700 and 5,394 couples with RHA and RKA, respectively. Any IHPC was more frequent among patients with T2DM than among non-T2DM patients (19% vs. 15.64% in the RHA cohort and 12.94% vs. 11.09% in the RKA cohort, respectively. For patients who underwent RHA, postoperative infection (4.51% vs. 2.94%, p<0.001, acute post-hemorrhagic anemia (9.53% vs. 7.70%, p<0.001, mean LOHS and IHM were significantly higher in patients with T2DM. Among RKA patients, the incidence of acute posthemorrhagic anemia (7.21% vs. 5.62%; p = 0.001 and urinary tract infection (1.13% vs. 0.72%; p = 0.029 was significantly higher in patients with diabetes. Older age, obesity, infection due to internal joint prosthesis, myocardial infarction, congestive heart failure, mild liver disease and renal disease and emergency room admission were significantly associated with a higher risk of IHPC in T2DM patients. IHPC decreased over time only in T2DM patients who underwent RHA (OR 0.94, 95%CI 0.89-0.98.Patients with T2DM who underwent RHA and RKA procedures had more IHPC after controlling for the effects of possible confounders. LOHS and IHM were also higher among RHA patients with diabetes. Older age, comorbidity, obesity

  1. Removal of total suspended solid by natural coagulant derived from cassava peel waste

    Science.gov (United States)

    Mohd-Asharuddin, S.; Othman, N.; Mohd-Zin, N. S.; Tajarudin, H. A.

    2018-04-01

    The present study was aimed to investigate the performance of starch derived from cassava peel waste as primary coagulant and coagulant aid. Comparable study was also conducted using commercially used aluminium sulfate (alum) as primary coagulant. A series of Jar tests were performed using raw water from Sembrong Barat water treatment plant. It was observed that coagulation test using cassava peel starch (CPS) alone had unappreciable removing ability. However, it was found that combination of alum-CPS successfully achieve up to 90.48% of total suspended solid (TSS) removal under optimized working conditions (pH 9, 7.5mg/L : 100 mg/L of alum : CPS dosage, rapid mixing of 200 rpm for 1 minute; 100 rpm for 2 minutes, slow mixing of 25 rpm for 30 minutes and 30 minutes settling time). This remarks the reduction in alum dosage up to 50% compared to coagulation test using alum alone. Therefore this finding suggesting that CPS can be considered as potential source of sustainable and effective coagulant aid for water treatment especially in developing countries.

  2. Correlation between conductivity and total dissolved solid in various type of water: A review

    Science.gov (United States)

    Rusydi, Anna F.

    2018-02-01

    Conductivity (EC) and total dissolved solids (TDS) are water quality parameters, which are used to describe salinity level. These two parameters are correlated and usually expressed by a simple equation: TDS = k EC (in 25 °C). The process of obtaining TDS from water sample is more complex than that of EC. Meanwhile, TDS analysis is very important because it can illustrate groundwater quality, particularly in understanding the effect of seawater intrusion better than EC analysis. These conditions make research in revealing TDS/EC ratios interesting to do. By finding the ratio value, TDS concentration can be measured easily from EC value. However, the ratio cannot be defined easily. Previous research results have found that the correlation between TDS and EC are not always linear. The ratio is not only strongly influenced by salinity contents, but also by materials contents. Furthermore, the analysis of TDS concentration from EC value can be used to give an overview of water quality. For more precision, TDS concentrations need to be analyzed using the gravimetric method in the laboratory.

  3. Enhancing anaerobic digestion of waste activated sludge by pretreatment: effect of volatile to total solids.

    Science.gov (United States)

    Wang, Xiao; Duan, Xu; Chen, Jianguang; Fang, Kuo; Feng, Leiyu; Yan, Yuanyuan; Zhou, Qi

    2016-01-01

    In this study the effect of volatile to total solids (VS/TS) on anaerobic digestion of waste activated sludge (WAS) pretreated by alkaline, thermal and thermal-alkaline strategies was studied. Experimental results showed that the production of methane from sludge was increased with VS/TS. When anaerobic digesters were fed with sludge pretreated by the thermal-alkaline method, the average methane yield was improved from 2.8 L/d at VS/TS 0.35 to 4.7 L/d at VS/TS 0.56. Also, the efficiency of VS reduction during sludge anaerobic digestion varied between 18.9% and 45.6%, and increased gradually with VS/TS. Mechanism investigation of VS/TS on WAS anaerobic digestion suggested that the general activities of anaerobic microorganisms, activities of key enzymes related to sludge hydrolysis, acidification and methanogenesis, and the ratio of Archaea to Bacteria were all increased with VS/TS, showing good agreement with methane production.

  4. Turbidity and Total Suspended Solids on the Lower Cache River Watershed, AR.

    Science.gov (United States)

    Rosado-Berrios, Carlos A; Bouldin, Jennifer L

    2016-06-01

    The Cache River Watershed (CRW) in Arkansas is part of one of the largest remaining bottomland hardwood forests in the US. Although wetlands are known to improve water quality, the Cache River is listed as impaired due to sedimentation and turbidity. This study measured turbidity and total suspended solids (TSS) in seven sites of the lower CRW; six sites were located on the Bayou DeView tributary of the Cache River. Turbidity and TSS levels ranged from 1.21 to 896 NTU, and 0.17 to 386.33 mg/L respectively and had an increasing trend over the 3-year study. However, a decreasing trend from upstream to downstream in the Bayou DeView tributary was noted. Sediment loading calculated from high precipitation events and mean TSS values indicate that contributions from the Cache River main channel was approximately 6.6 times greater than contributions from Bayou DeView. Land use surrounding this river channel affects water quality as wetlands provide a filter for sediments in the Bayou DeView channel.

  5. Solid State Sensor for Simultaneous Measurement of Total Alkalinity and pH of Seawater.

    Science.gov (United States)

    Briggs, Ellen M; Sandoval, Sergio; Erten, Ahmet; Takeshita, Yuichiro; Kummel, Andrew C; Martz, Todd R

    2017-09-22

    A novel design is demonstrated for a solid state, reagent-less sensor capable of rapid and simultaneous measurement of pH and Total Alkalinity (A T ) using ion sensitive field effect transistor (ISFET) technology to provide a simplified means of characterization of the aqueous carbon dioxide system through measurement of two "master variables": pH and A T . ISFET-based pH sensors that achieve 0.001 precision are widely used in various oceanographic applications. A modified ISFET is demonstrated to perform a nanoliter-scale acid-base titration of A T in under 40 s. This method of measuring A T , a Coulometric Diffusion Titration, involves electrolytic generation of titrant, H + , through the electrolysis of water on the surface of the chip via a microfabricated electrode eliminating the requirement of external reagents. Characterization has been performed in seawater as well as titrating individual components (i.e., OH - , HCO 3 - , CO 3 2- , B(OH) 4 - , PO 4 3- ) of seawater A T . The seawater measurements are consistent with the design in reaching the benchmark goal of 0.5% precision in A T over the range of seawater A T of ∼2200-2500 μmol kg -1 which demonstrates great potential for autonomous sensing.

  6. Characteristic of total suspended particulate (TSP) containing Pb and Zn at solid waste landfill

    Science.gov (United States)

    Budihardjo, M. A.; Noveandra, K.; Samadikun, B. P.

    2018-05-01

    Activities conducted at municipal solid waste landfills (MSWLs) potentially cause air pollution. Heavy vehicles in MSWLs release various pollutants that can have negative impacts for humans. One noticeable pollutant at MSWLs is airborne total suspended particulate (TSP) which may contain heavy metals such as Pb and Zn and can cause disease when inhaled by humans. In this study, TSP from a landfill in Semarang, Indonesia was collected and characterized to quantify the concentration of Pb and Zn. Meteorological factors (i.e. temperature, humidity and wind velocity) and landfill activities were considered as factors affecting pollutant concentrations. TSP was sampled using dust samplers while the concentrations of heavy metals in TSP were analyzed using an Atomic Absorption Spectrophotometer (AAS). Pb concentration ranged from 0.84 to 1.78 µg/m3 while Zn concentration was from 7.87 to 8.76 µg/m3. The levels of Pb were below the threshold specified by the Indonesian Government. Meanwhile, the threshold for Zn has not yet been determined.

  7. Impact of Inpatient Versus Outpatient Total Joint Arthroplasty on 30-Day Hospital Readmission Rates and Unplanned Episodes of Care.

    Science.gov (United States)

    Springer, Bryan D; Odum, Susan M; Vegari, David N; Mokris, Jeffrey G; Beaver, Walter B

    2017-01-01

    This article describes a study comparing 30-day readmission rates between patients undergoing outpatient versus inpatient total hip (THA) and knee (TKA) arthroplasty. A retrospective review of 137 patients undergoing outpatient total joint arthroplasty (TJA) and 106 patients undergoing inpatient (minimum 2-day hospital stay) TJA was conducted. Unplanned hospital readmissions and unplanned episodes of care were recorded. All patients completed a telephone survey. Seven inpatients and 16 outpatients required hospital readmission or an unplanned episode of care following hospital discharge. Readmission rates were higher for TKA than THA. The authors found no statistical differences in 30-day readmission or unplanned care episodes. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Calibration of a turbidity meter for making estimates of total suspended solids concentrations and beam attenuation coefficients in field experiments

    Science.gov (United States)

    Usry, J. W.; Whitlock, C. H.

    1981-01-01

    Management of water resources such as a reservoir requires using analytical models which describe such parameters as the suspended sediment field. To select or develop an appropriate model requires making many measurements to describe the distribution of this parameter in the water column. One potential method for making those measurements expeditiously is to measure light transmission or turbidity and relate that parameter to total suspended solids concentrations. An instrument which may be used for this purpose was calibrated by generating curves of transmission measurements plotted against measured values of total suspended solids concentrations and beam attenuation coefficients. Results of these experiments indicate that field measurements made with this instrument using curves generated in this study should correlate with total suspended solids concentrations and beam attenuation coefficients in the water column within 20 percent.

  9. Solid Waste Management Available Information Materials. Total Listing 1966-1976.

    Science.gov (United States)

    Larsen, Julie L.

    This publication is a compiled and indexed bibliography of solid waste management documents produced in the last ten years. This U.S. Environmental Protection Agency (EPA) publication is compiled from the Office of Solid Waste Management Programs (OSWMP) publications and the National Technical Information Service (NTIS) reports. Included are…

  10. A total quality management approach to healthcare waste management in Namazi Hospital, Iran.

    Science.gov (United States)

    Askarian, Mehrdad; Heidarpoor, Peigham; Assadian, Ojan

    2010-11-01

    Healthcare waste comprises all wastes generated at healthcare facilities, medical research centers and laboratories. Although 75-90% of these wastes are classified as household waste posing no potential risk, 10-25% are deemed to be hazardous, representing a potential threat to healthcare workers, patients, the environment and even the general population, if not disposed of appropriately. If hazardous and non-hazardous waste is mixed and not segregated prior to disposal, costs will increase substantially. Medical waste management is a worldwide issue. In Iran, the majority of problems are associated with an exponential growth in the healthcare sector together with low- or non-compliance with guidelines and recommendations. The aim of this study was to reduce the amounts of infectious waste by clear definition and segregation of waste at the production site in Namazi Hospital in Shiraz, Iran. Namazi Hospital was selected as a study site with an aim to achieving a significant decrease in infectious waste and implementing a total quality management (TQM) method. Infectious and non-infectious waste was weighed at 29 admission wards over a 1-month period. Before the introduction of the new guidelines and the new waste management concept, weight of total waste was 6.67 kg per occupied bed per day (kg/occupied bed/day), of which 73% was infectious and 27% non-infectious waste. After intervention, total waste was reduced to 5.92 kg/occupied bed/day, of which infectious waste represented 61% and non-infectious waste 30%. The implementation of a new waste management concept achieved a 26% reduction in infectious waste. A structured waste management concept together with clear definitions and staff training will result in waste reduction, consequently leading to decreased expenditure in healthcare settings. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Ganoderma lucidum total triterpenes attenuate DLA induced ascites and EAC induced solid tumours in Swiss albino mice.

    Science.gov (United States)

    Smina, T P; Mathew, J; Janardhanan, K K

    2016-04-30

    G. lucidum total triterpenes were assessed for its apoptosis-inducing and anti-tumour activities. The ability of the total triterpenes to induce apoptosis was evaluated in Dalton's lymphoma ascites (DLA) and Ehrlich's ascites carcinoma (EAC) cell lines. Total triterpenes were found to be highly cytotoxic to DLA and EAC cell lines with IC50 values 5 ± 0.32 and 7.9 ± 0.2 µg/ml respectively. Total triterpenes induced apoptosis in both cell lines which is evident from the DNA fragmentation assay. Anti-tumour activity was accessed using DLA induced solid and EAC induced ascites tumour models in Swiss albino mice. Administration of 10, 50 and 100 mg/kg b. wt. total triterpenes showed 11.86, 27.27 and 40.57% increase in life span of animals in ascites tumour model. Treatment with 10, 50 and 100 mg/kg b. wt. total triterpenes exhibited 76.86, 85.01 and 91.03% inhibition in tumour volume and 67.96, 72.38 and 77.90% inhibition in tumour weight respectively in the solid tumour model. The study reveals the significant dose-dependent anti-tumour activity of total triterpenes in both models. Total triterpenes were more active against the solid tumour than the ascites tumour. The anti-oxidant potential and ability to induce cell-specific apoptosis could be contributing to its anti-tumour activities.

  12. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  13. Total quality management in a 300-bed community hospital: the quality improvement process translated to health care.

    Science.gov (United States)

    Hughes, J M

    1992-09-01

    Winter Park Memorial Hospital (Winter Park, Florida) began implementation of a well-strategized plan for total quality management (TQM) in 1987. Having no guidelines for applying TQM to health care but using the industrial quality management techniques of Philip Crosby Associates, Inc, the hospital made the transition and saved thousands of dollars in the process. This article describes the transition, especially the integral part played by the Medical Staff Quality Council in changing the hospital's culture.

  14. Biomedical solid waste management in an Indian hospital: a case study

    International Nuclear Information System (INIS)

    Patil, Gayathri V.; Pokhrel, Kamala

    2005-01-01

    The objectives of this study were: (i) to assess the waste handling and treatment system of hospital bio-medical solid waste and its mandatory compliance with Regulatory Notifications for Bio-medical Waste (Management and Handling) Rules, 1998, under the Environment (Protection Act 1986), Ministry of Environment and Forestry, Govt. of India, at the chosen KLE Society's J. N. Hospital and Medical Research Center, Belgaum, India and (ii) to quantitatively estimate the amount of non-infectious and infectious waste generated in different wards/sections. During the study, it was observed that: (i) the personnel working under the occupier (who has control over the institution to take all steps to ensure biomedical waste is handled without any adverse effects to human health and the environment) were trained to take adequate precautionary measures in handling these bio-hazardous waste materials, (ii) the process of segregation, collection, transport, storage and final disposal of infectious waste was done in compliance with the Standard Procedures, (iii) the final disposal was by incineration in accordance to EPA Rules 1998 (iv) the non-infectious waste was collected separately in different containers and treated as general waste, and (v) on an average about 520 kg of non-infectious and 101 kg of infectious waste is generated per day (about 2.31 kg per day per bed, gross weight comprising both infectious and non-infectious waste). This hospital also extends its facility to the neighboring clinics and hospitals by treating their produced waste for incineration

  15. Stability investigation of total parenteral nutrition admixture prepared in a hospital pharmacy

    Directory of Open Access Journals (Sweden)

    Mirković Dušica

    2008-01-01

    Full Text Available Background/Aim. In the cases when nutrition of patients can not be orally nor enterally performed, parenteral nutrition is a method of the therapy that provides more successful and rapid recovery. In that way, hospitalization can be significantly shorter, healing costs reduced and mortality minimized. Total parenteral nutrition (TPN admixtures are the most complex systems which contain amino acids, carbohydrates, lipid emulsion, macroelectrolytes (Na+, K+, Ca2+, Mg2+, Cl-, SO42-, PO43-, oligoelements, hydro- and liposoluble vitamines, heparin, insulin and water. Concerning the mentioned complexity, special attention should be payed to physicochemical and microbiological stability of a mixture, because of interactions among components, that can be very hard to analyze. The aim of this study was to investigate the problem of stability of TPN admixtures prepared in a hospital pharmacy. Methods. Admixture TPN was aseptically prepared in laminar air - flow environment on the basis of the specified order in supplementing components and additives to basic solutions. Solutions were kept in sterile multicompartment ethylene-vinyl-acetate bags. After preparation and slow homogenization, TPN admixtures were submitted to physicochemical and microbiological stability analyses in various period of time. The assessment of physical stability of TPN admixture was done on the basis of visual inspection, determination of pH value and measuring of particle size. The investigation of sterility and pyrogenic test were performed according to Ph. Yug. V regulations. Results. Physico-chemical and microbiological analyses were applied and no significant changes in visual sense, pH value and droplet size stability of the TPN admixture were observed during the period of 60 hours. The lipid droplets were smaller in size than 5 μm, that is the most common pharmacopoeia requirement. Conclusion. The results of our study confirmed that a TPN admixture prepared in a hospital

  16. Clinical nutrition and foodservice personnel in teaching hospitals have different perceptions of total quality management performance.

    Science.gov (United States)

    Chong, Y; Unklesbay, N; Dowdy, R

    2000-09-01

    To investigate the perceived total quality management (TQM) performance of their department by clinical nutrition managers and dietitians, and foodservice managers and supervisors, in hospital food and nutrition service departments. Using a 2-part questionnaire containing items about 3 constructs of TQM performance and demographic characteristics, participants rated their perceptions of TQM performance. Employees in 7 Council of Teaching Hospitals. Of the 128 possible respondents, 73 (57%) completed the study. Correlation analysis to identify relationships between demographic characteristics and TQM performance. Analysis of variance to investigate statistical differences among hospitals and between subject groups and types of employment positions. Three TQM constructs--organization, information, and quality management--were evaluated. The clinical nutrition manager and dietitian group had mean ratings between 3.1 and 4.7 (5-point Likert scale); the foodservice manager and supervisor group had mean ratings from 2.7 to 4.0. Education level was significantly correlated (r = 0.44) to performance of employee training in the clinical nutrition group. The number of employees directly supervised was negatively correlated (r = -0.21) to the performance of employee training in the foodservice group. As the dynamic roles of dietitians change, many dietitians will occupy management positions in organizations such as restaurants, health food stores, food processing/distribution companies, and schools. This study demonstrates how a TQM survey instrument could be applied to clinical nutrition and foodservice settings. Dietitians will need to assess TQM in their workplace facilities, especially because of the direct links of TQM to productivity and client satisfaction.

  17. Selected Aspects of a Total Quality Management in an Army Hospital (Ausgewachlte Aspekte eines Total Quality Management in einem Bundeswehrkrankenhaus)

    National Research Council Canada - National Science Library

    Brjaun, Guenther

    2000-01-01

    Total Quality Management is a long-term, integrated concept that covers all aspects and all levels of responsibility, an essential part of which is the continual improvement of how the business is run...

  18. Bench-Scale and Pilot-Scale Treatment Technologies for the Removal of Total Dissolved Solids from Coal Mine Water: A Review

    Science.gov (United States)

    Coal mine water (CMW) is typically treated to remove suspended solids, acidity, and soluble metals, but high concentrations of total dissolved solids (TDS) have been reported to impact the environment at several CMW discharge points. Consequently, various states have establishe...

  19. Total versus subtotal Laparoscopic Hysterectomy: A comparative study in Arash Hospital

    Directory of Open Access Journals (Sweden)

    Samiei H

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Over the past 50 years, subtotal or supracervical hysterectomy has come to be viewed as a suboptimal procedure reserved for those rare instances in which when concern over blood loss or anatomic distortion dictates limiting the extent of dissection, the aim of this study was to compare total and subtotal laparoscopic hysterectomy. "n"nMethods: The patients who were candidates for hysterectomy with benign disease, with no contraindication for laparoscopic surgery entered the study in Arash Hospital, from March 2007 to April 2009. By simple randomization 45 patients (25 for TLH and 20 for SLH were selected. Demographic Details and intra and post operative complications, were recorded by the staff and were compared between two groups."n"nResults: The average time for TLH operations look significantly longer than SLH operation (148.6±29.7 minutes; 128.5±25.64 minutes, p=0.03. Although, the hemoglobin (gr/dl drop in TLH was significantly higher than SLH (1.54 Versus 0.9, p<0.05 Blood transfusion were common in SLH (1 case Versus 3 Cases. The total length of hospital stay, was significantly shorter after SLH than TLH (3.6±1.47 day and 2.85±0.59, p=0.04. The drug requirements to

  20. Effect of total solids content on methane and volatile fatty acid production in anaerobic digestion of food waste.

    Science.gov (United States)

    Liotta, Flavia; d'Antonio, Giuseppe; Esposito, Giovanni; Fabbricino, Massimiliano; van Hullebusch, Eric D; Lens, Piet N L; Pirozzi, Francesco; Pontoni, Ludovico

    2014-10-01

    This work investigates the role of the moisture content on anaerobic digestion of food waste, as representative of rapidly biodegradable substrates, analysing the role of volatile fatty acid production on process kinetics. A range of total solids from 4.5% to 19.2% is considered in order to compare methane yields and kinetics of reactors operated under wet to dry conditions. The experimental results show a reduction of the specific final methane yield of 4.3% and 40.8% in semi-dry and dry conditions compared with wet conditions. A decreasing trend of the specific initial methane production rate is observed when increasing the total solids concentration. Because of lack of water, volatile fatty acids accumulation occurs during the first step of the process at semi-dry and dry conditions, which is considered to be responsible for the reduction of process kinetic rates. The total volatile fatty acids concentration and speciation are proposed as indicators of process development at different total solids content. © The Author(s) 2014.

  1. AbioCor totally implantable artificial heart. How will it impact hospitals?

    Science.gov (United States)

    2002-09-01

    Although heart transplantation remains the most effective treatment for severe heart failure, there are far fewer donor hearts available than there are patients who could benefit from them. One approach to addressing this shortfall is the total artificial heart, or TAH. To date, however, no TAH design has been able to achieve one of the ultimate goals of heart replacement: to allow a patient to live a reasonably normal life without being connected to external machinery. A new design, the AbioCor TAH developed by Abiomed Inc., may make this goal achievable. Thanks to a power system that transfers energy through the skin without the aid of wires, the AbioCor--currently undergoing clinical trials in the United States--allows the patient to be completely mobile. The lack of transcutaneous wires also eliminates the primary source of the infections that have plagued TAH patients in the past. Though it is not without drawbacks, the AbioCor could represent a crucial advance in TAH technology. In this Technology Overview, we describe the operation of the AbioCor and discuss its likely impact on hospitals if it is approved for marketing in the United States. We also discuss a related cardiac-support technology: ventricular assist devices (VADs), which may also be used for permanent cardiac support someday.

  2. Evaluation of Productivity of Zymotis Solid-State Bioreactor Based on Total Reactor Volume

    Directory of Open Access Journals (Sweden)

    Oscar F. von Meien

    2002-01-01

    Full Text Available In this work a method of analyzing the performance of solid-state fermentation bioreactors is described. The method is used to investigate the optimal value for the spacing between the cooling plates of the Zymotis bioreactor, using simulated fermentation data supplied by a mathematical model. The Zymotis bioreactor has good potential for those solid-state fermentation processes in which the substrate bed must remain static. The current work addresses two design parameters introduced by the presence of the internal heat transfer plates: the width of the heat transfer plate, which is governed by the amount of heat to be removed and the pressure drop of the cooling water, and the spacing between these heat transfer plates. In order to analyze the performance of the bioreactor a productivity term is introduced that takes into account the volume occupied within the bioreactor by the heat transfer plates. As part of this analysis, it is shown that, for logistic growth kinetics, the time at which the biomass reaches 90 % of its maximum possible value is a good estimate of the optimum harvesting time for maximizing productivity. Application of the productivity analysis to the simulated fermentation results suggests that, with typical fast growing fungi ( = 0.324 h–1, the optimal spacing between heat transfer plates is of the order of 6 cm. The general applicability of this approach to evaluate the productivity of solid-state bioreactors is demonstrated.

  3. Determination of the concentration of total suspends solids (TSS) and heavy metals in basin rio Morote, Nicoya, Guanacaste

    International Nuclear Information System (INIS)

    Sanchez Murillo, Ricardo; Leon, Sandra; Saravia, Ana Yuri; Mena Sanchez, Carlos de

    2009-01-01

    The total concentration of suspends solids and heavy metals were determined of the Basin of rio Morote. The study spanned six sampling campaigns between April 2003 and May 2005. Sampling points were selected to correspond to places from the high basin to the mouth of the rio Morote in the Golfo de Nicoya. Suspends total solids concentration (TSS) on average exceeds 200 mg/L during the rainy season at the mouth. Enrichment of metals as: Cu, Ni, Cd and Fe was found in riverbed sediments; but not in Pb. The concentration of Zn has been near the limit value (200 mg/kg) in the dry season, value which has been established for the Environmental Protection Agency of United States (EPA). (author) [es

  4. Determination of total mercury for marine environmental monitoring studies by solid sampling continuum source high resolution atomic absorption spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Mandjukov, Petko; Orani, Anna Maria; Han, Eunmi; Vassileva, Emilia, E-mail: e.vasileva-veleva@iaea.org

    2015-01-01

    The most critical step in almost all commonly used analytical procedures for Hg determination is the sample preparation due to its extreme volatility. One of the possible solutions of this problem is the application of methods for direct analysis of solid samples. The possibilities for solid sampling high resolution continuum source atomic absorption spectrometry (HR CS AAS) determination of total mercury in various marine environmental samples e.g. sediments and biota are object of the present study. The instrumental parameters were optimized in order to obtain reproducible and interference free analytical signal. A calibration technique based on the use of solid standard certified reference materials similar to the nature of the analyzed sample was developed and applied to various CRMs and real samples. This technique allows simple and reliable evaluation of the uncertainty of the result and the metrological characteristics of the method. A validation approach in line with the requirements of ISO 17025 standard and Eurachem guidelines was followed. With this in mind, selectivity, working range (0.06 to 25 ng for biota and 0.025 to 4 ng for sediment samples, expressed as total Hg) linearity (confirmed by Student's t-test), bias (1.6–4.3%), repeatability (4–9%), reproducibility (9–11%), and absolute limit of detection (0.025 ng for sediment, 0.096 ng for marine biota) were systematically assessed using solid CRMs. The relative expanded uncertainty was estimated at 15% for sediment sample and 8.5% for marine biota sample (k = 2). Demonstration of traceability of measurement results is also presented. The potential of the proposed analytical procedure, based on solid sampling HR CS AAS technique was demonstrated by direct analysis of sea sediments form the Caribbean region and various CRMs. Overall, the use of solid sampling HR CS AAS permits obtaining significant advantages for the determination of this complex analyte in marine samples, such as

  5. Comparison of 3 Types of Readmission Rates for Measuring Hospital and Surgeon Performance After Primary Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Bottle, Alex; Loeffler, Mark D; Aylin, Paul; Ali, Adam M

    2018-02-26

    All-cause 30-day hospital readmission is in widespread use for monitoring and incentivizing hospital performance for patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, little is known on the extent to which all-cause readmission is influenced by hospital or surgeon performance and whether alternative measures may be more valid. This is an observational study using multilevel modeling on English administrative data to determine the interhospital and intersurgeon variation for 3 readmission metrics: all-cause, surgical, and return-to-theater. Power calculations estimated the likelihood of identifying whether the readmission rate for a surgeon or hospital differed from the national average by a factor of 1.25, 1.5, 2, or 3 times, for both average and high-volume providers. 259,980 THAs and 311,033 TKAs were analyzed. Variations by both surgeons and hospitals were smaller for the all-cause measure than for the surgical or return-to-theater metrics, although statistical power to detect differences was higher. Statistical power to detect surgeon-level rates of 1.25 or 1.5 times the average was consistently low. However, at the hospital level, the surgical readmission measure showed more variation by hospital while maintaining excellent power to detect differences in rates between hospitals performing the average number of THA or TKA cases per year in England. In practice, more outliers than expected from purely random variation were found for all-cause and surgical readmissions, especially at hospital level. The 30-day surgical readmission rate should be considered as an adjunctive measure to 30-day all-cause readmission rate when assessing hospital performance. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Airborne concentrations of metals and total dust during solid catalyst loading and unloading operations at a petroleum refinery.

    Science.gov (United States)

    Lewis, Ryan C; Gaffney, Shannon H; Le, Matthew H; Unice, Ken M; Paustenbach, Dennis J

    2012-09-01

    Workers handle catalysts extensively at petroleum refineries throughout the world each year; however, little information is available regarding the airborne concentrations and plausible exposures during this type of work. In this paper, we evaluated the airborne concentrations of 15 metals and total dust generated during solid catalyst loading and unloading operations at one of the largest petroleum refineries in the world using historical industrial hygiene samples collected between 1989 and 2006. The total dust and metals, which included aluminum, cadmium, chromium, cobalt, copper, iron, lead, manganese, molybdenum, nickel, platinum, silicon, silver, vanadium, and zinc, were evaluated in relation to the handling of four different types of solid catalysts associated with three major types of catalytic processes. Consideration was given to the known components of the solid catalysts and any metals that were likely deposited onto them during use. A total of 180 analytical results were included in this analysis, representing 13 personal and 54 area samples. Of the long-term personal samples, airborne concentrations of metals ranged from refinery and perhaps other modern refineries during the timeframe examined. Copyright © 2011 Elsevier GmbH. All rights reserved.

  7. Effect Of Adding Sago Flour In Yoghurt Based On Viscosity, Overrun, Melting Rate And Total Solid Of Yoghurt Ice Cream

    Directory of Open Access Journals (Sweden)

    Ika Ayu Wijayanti

    2017-03-01

    Full Text Available The purpose of this research was to find out the best concentration of adding sago flour in yoghurt based on viscosity, overrun, melting rate and total solid of yoghurt ice cream. The experiment was designed by Completely Randomized Design (CRD using four treatments were 0 %, 2 %, 4 %, 6 % from volume of fresh milk and four replication. The data were analyzed by using Analysis of Variance (ANOVA and continued by Duncan’s Multiple Range Test (DMRT. Result of this research showed that concentration of adding sago flour in yoghurt gave highly significant difference effect (P<0.01 on viscosity, overrun, melting rate and total solid of yoghurt ice cream. It can be concluded that the adding of sago flour 2% in yoghurt gave the best result with the viscosity was 1750.75 cP, overrun was 25.14%, melting rate was 39.13 minutes/50 g, total solid was 36.20% and gave the best quality of yoghurt ice cream.

  8. Factors Influencing the Total Inpatient Pharmacy Cost at a Tertiary Hospital in Malaysia: A Retrospective Study

    Science.gov (United States)

    Ali Jadoo, Saad Ahmed

    2018-01-01

    The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III (B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC (B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC. PMID:29436248

  9. Effect of aflatoxin ingestion on total body water (T OH3 - space), total body solids A KD on some physiological and reproductive characteristics of male albino rats

    International Nuclear Information System (INIS)

    Nowar, M.S.; Eldarawany, A.A.; Habeeb, A.A.

    1992-01-01

    This investigation aimed to study the effects of aflatoxins B 1 +G 1 mixture mainly on total body water (TBW) and on total body solids (TBS) of male albino rats. Some blood components and some reproductive characteristic were also taken into consideration. Two groups, each of 8 male rats were fed the same ration. Rats of one group had been individually ingested daily with a dose of 22 μg B 1 plus 22 μg G 1 for 15 successive weeks. The obtained results showed that aflatoxin administration caused: 1- A decrease in final body weight (FBW), TBW (P<0.01) and TBS (P<0.05). 2- A decrease in serum total proteins (P<0.01), albumin (P<0.05), globulin (P<0.05), glucose (P<0.05) and increase in serum cholesterol, GOT and GPT (P<0.05) activities. 3- A decrease in each of the number of effective matings of males and delivery percentages of females mated with treated males.1 tab

  10. Neer Award 2016: Outpatient total shoulder arthroplasty in an ambulatory surgery center is a safe alternative to inpatient total shoulder arthroplasty in a hospital: a matched cohort study.

    Science.gov (United States)

    Brolin, Tyler J; Mulligan, Ryan P; Azar, Frederick M; Throckmorton, Thomas W

    2017-02-01

    Recent emphasis on safe and efficient delivery of high-quality health care has increased interest in outpatient total joint arthroplasty. The purpose of this study was to evaluate the safety of outpatient total shoulder arthroplasty (TSA) by comparing episode-of-care complications in matched cohorts of patients with anatomic TSA as an outpatient or inpatient procedure. Thirty patients with outpatient TSA at a freestanding ambulatory surgery center (ASC) were compared with an age- and comorbidities-matched cohort of 30 patients with traditional inpatient TSA to evaluate 90-day episode-of-care complications, including hospital admissions or readmissions and reoperations. Two-tailed t-tests were used to evaluate differences, and differences of P surgery and disrupted his subscapularis repair. Three minor complications in the hospital cohort were mild asymptomatic anterior subluxation, blood transfusion, and superficial venous thrombosis. The complication rates (13% vs. 10%) were not significantly different. Outpatient TSA is a safe alternative to hospital admission in appropriately selected patients. Further investigation is warranted to evaluate the longer term outcomes and cost-effectiveness of outpatient TSA. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  11. Diagnose and Redesign of the handling and treatment processes of the solid waste in the Hospital Mexico

    International Nuclear Information System (INIS)

    Campos Arrieta, G.; Navarro Blanco, D

    1999-01-01

    In the Hospital Mexico a program for the handling of the solid waste was implemented. The program consists on placing recipients, in all the corridors, for each type of waste (recyclable, toxic, dangerous, kitchens). However, this measure doesn't eliminate the risk that the waste represents for the community and the environment. The handling of the solid waste includes the selection or classification, the gathering, the transportation, and the temporary storage. While the treatment consists on the application of procedures that reduce the polluting properties of the waste. The planning of the topic is: To diagnose and to redesign of the handling processes and internal treatment of the hospital solid waste (HSW) in the Hospital Mexico. The contribution of the Industrial Engineering is given in the thematic of redesign of processes; the complementary areas are engineering of the human factor, environmental impact and normalization. The current problem that undergoes the Hospital was defined as follows: The Hospital Mexico cannot assure that the handling and current treatment of the solid waste diminish the risk that they represent to the health of the hospital community and the deterioration of the environment. This problem contains the independent variables such as the handling and current treatment of the solid waste, and the dependent variables such as the risk to the health of the community and deterioration of the environment. Based on the problem, the following hypothesis is established: The current conditions of handling and the lack of internal treatment of the solid waste in the Hospital Mexico, causes that the waste is a risk for the health of the hospital community and the deterioration of the environment. The project was structured in three denominated stages: Diagnose, Design and Validation, which respond to different general and specific objectives. In the stage of diagnose, to determine that the waste generated in the centers of health contain

  12. Resuspended contaminated sediments cause sublethal stress to oysters: A biomarker differentiates total suspended solids and contaminant effects.

    Science.gov (United States)

    Edge, Katelyn J; Dafforn, Katherine A; Simpson, Stuart L; Ringwood, Amy H; Johnston, Emma L

    2015-06-01

    Resuspended contaminated sediments represent an important route of contaminant exposure for aquatic organisms. During resuspension events, filter-feeding organisms are exposed to contaminants, in both the dissolved form (at the gills) and the particulate form (in the digestive system). In addition, these organisms must manage the physical stress associated with an increase in total suspended solids (TSS). To date, few studies have experimentally compared the contributions to biological stress of contaminated and clean suspended solids. The authors mixed field-collected sediments (cellular biomarkers (lysosomal membrane stability, lipid peroxidation, and glutathione) were measured to evaluate sublethal toxicity. Lysosomal membrane stability was the most sensitive biomarker for distinguishing effects from resuspended contaminated sediments, as increasing amounts of contaminated TSS increased lysosomal membrane destabilization. The authors' results illustrate the importance of considering contaminant exposures from resuspended sediments when assessing the toxicity of contaminants to aquatic organisms. © 2015 SETAC.

  13. Effect of total solids content on biohydrogen production and lactic acid accumulation during dark fermentation of organic waste biomass.

    Science.gov (United States)

    Ghimire, Anish; Trably, Eric; Frunzo, Luigi; Pirozzi, Francesco; Lens, Piet N L; Esposito, Giovanni; Cazier, Elisabeth A; Escudié, Renaud

    2018-01-01

    Production of biohydrogen and related metabolic by-products was investigated in Solid State Dark Fermentation (SSDF) of food waste (FW) and wheat straw (WS). The effect of the total solids (TS) content and H 2 partial pressure (pp H2 ), two of the main operating factors of SSDF, were investigated. Batch tests with FW at 10, 15, 20, 25 and 30% TS showed considerable effects of the TS on metabolites distribution. H 2 production was strongly inhibited for TS contents higher than 15% with a concomitant accumulation of lactic acid and a decrease in substrate conversion. Varying the pp H2 had no significant effect on the conversion products and overall degradation of FW and WS, suggesting that pp H2 was not the main limiting factor in SSDF. This study showed that the conversion of complex substrates by SSDF depends on the substrate type and is limited by the TS content. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Total cross sections for slow-electron (1--20 eV) scattering in solid H2O

    International Nuclear Information System (INIS)

    Michaud, M.; Sanche, L.

    1987-01-01

    An analytical method is proposed to determine absolute total cross sections per scatterer and related mean free paths for low-energy electron scattering in disordered molecular solid films. The procedure is based on a two-stream multiple-scattering model of the thickness dependence of the film reflectivity for elastic electrons. The expected analytical behavior and accuracy are tested on a model sample whose scattering properties are generated by a Monte Carlo simulation from initially known parameters. The effects of multiple scattering inside the film and at its interfaces are taken into account and discussed. The thickness dependence of the elastic electron reflectivity of H 2 O film condensed at 14 K is reported between 1 and 20 eV incident energy with a spectrometer resolution of 10 MeV. The proposed method is applied to extract from these measurements the energy dependence of the total effective and total inelastic cross sections for electron scattering in amorphous ice

  15. Determination of total mercury for marine environmental monitoring studies by solid sampling continuum source high resolution atomic absorption spectrometry

    Science.gov (United States)

    Mandjukov, Petko; Orani, Anna Maria; Han, Eunmi; Vassileva, Emilia

    2015-01-01

    The most critical step in almost all commonly used analytical procedures for Hg determination is the sample preparation due to its extreme volatility. One of the possible solutions of this problem is the application of methods for direct analysis of solid samples. The possibilities for solid sampling high resolution continuum source atomic absorption spectrometry (HR CS AAS) determination of total mercury in various marine environmental samples e.g. sediments and biota are object of the present study. The instrumental parameters were optimized in order to obtain reproducible and interference free analytical signal. A calibration technique based on the use of solid standard certified reference materials similar to the nature of the analyzed sample was developed and applied to various CRMs and real samples. This technique allows simple and reliable evaluation of the uncertainty of the result and the metrological characteristics of the method. A validation approach in line with the requirements of ISO 17025 standard and Eurachem guidelines was followed. With this in mind, selectivity, working range (0.06 to 25 ng for biota and 0.025 to 4 ng for sediment samples, expressed as total Hg) linearity (confirmed by Student's t-test), bias (1.6-4.3%), repeatability (4-9%), reproducibility (9-11%), and absolute limit of detection (0.025 ng for sediment, 0.096 ng for marine biota) were systematically assessed using solid CRMs. The relative expanded uncertainty was estimated at 15% for sediment sample and 8.5% for marine biota sample (k = 2). Demonstration of traceability of measurement results is also presented. The potential of the proposed analytical procedure, based on solid sampling HR CS AAS technique was demonstrated by direct analysis of sea sediments form the Caribbean region and various CRMs. Overall, the use of solid sampling HR CS AAS permits obtaining significant advantages for the determination of this complex analyte in marine samples, such as straightforward

  16. Accuracy of different sensors for the estimation of pollutant concentrations (total suspended solids, total and dissolved chemical oxygen demand) in wastewater and stormwater.

    Science.gov (United States)

    Lepot, Mathieu; Aubin, Jean-Baptiste; Bertrand-Krajewski, Jean-Luc

    2013-01-01

    Many field investigations have used continuous sensors (turbidimeters and/or ultraviolet (UV)-visible spectrophotometers) to estimate with a short time step pollutant concentrations in sewer systems. Few, if any, publications compare the performance of various sensors for the same set of samples. Different surrogate sensors (turbidity sensors, UV-visible spectrophotometer, pH meter, conductivity meter and microwave sensor) were tested to link concentrations of total suspended solids (TSS), total and dissolved chemical oxygen demand (COD), and sensors' outputs. In the combined sewer at the inlet of a wastewater treatment plant, 94 samples were collected during dry weather, 44 samples were collected during wet weather, and 165 samples were collected under both dry and wet weather conditions. From these samples, triplicate standard laboratory analyses were performed and corresponding sensors outputs were recorded. Two outlier detection methods were developed, based, respectively, on the Mahalanobis and Euclidean distances. Several hundred regression models were tested, and the best ones (according to the root mean square error criterion) are presented in order of decreasing performance. No sensor appears as the best one for all three investigated pollutants.

  17. [Improvement approaches in the hospital setting: From total quality management to Lean].

    Science.gov (United States)

    Curatolo, N; Lamouri, S; Huet, J-C; Rieutord, A

    2015-07-01

    Hospitals have to deal strong with economic constraints and increasing requirements in terms of quality and safety of care. To address these constraints, one solution could be the adoption of approaches from the industry sector. Following the decree of April 6, 2011 on the quality management of the medication use process, some of these approaches, such as risk management, are now part of the everyday work of healthcare professionals. However, other approaches, such as business process improvement, are still poorly developed in the hospital setting. In this general review, we discuss the main approaches of business process improvements that have been used in hospitals by focusing specifically on one of the newest and most currently used: Lean. Copyright © 2014. Published by Elsevier Masson SAS.

  18. Total direct cost, length of hospital stay, institutional discharges and their determinants from rehabilitation settings in stroke patients.

    Science.gov (United States)

    Saxena, S K; Ng, T P; Yong, D; Fong, N P; Gerald, K

    2006-11-01

    Length of hospital stay (LOHS) is the largest determinant of direct cost for stroke care. Institutional discharges (acute care and nursing homes) from rehabilitation settings add to the direct cost. It is important to identify potentially preventable medical and non-medical reasons determining LOHS and institutional discharges to reduce the direct cost of stroke care. The aim of the study was to ascertain the total direct cost, LOHS, frequency of institutional discharges and their determinants from rehabilitation settings. Observational study was conducted on 200 stroke patients in two rehabilitation settings. The patients were examined for various socio-demographic, neurological and clinical variables upon admission to the rehabilitation hospitals. Information on total direct cost and medical complications during hospitalization were also recorded. The outcome variables measured were total direct cost, LOHS and discharges to institutions (acute care and nursing home facility) and their determinants. The mean and median LOHS in our study were 34 days (SD = 18) and 32 days respectively. LOHS and the cost of hospital stay were significantly correlated. The significant variables associated with LOHS on multiple linear regression analysis were: (i) severe functional impairment/functional dependence Barthel Index institutional discharges (22 to acute care and 17 to nursing homes). On multivariate analysis the significant predictors of discharges to institutions from rehabilitation hospitals were medical complications (OR = 4.37; 95% CI 1.01-12.53) and severe functional impairment/functional dependence. (OR = 5.90, 95% CI 2.32-14.98). Length of hospital stay and discharges to institutions from rehabilitation settings are significantly determined by medical complications. Importance of adhering to clinical pathway/protocol for stroke care is further discussed.

  19. Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts.

    Science.gov (United States)

    Altawalbeh, Shoroq M; Saul, Melissa I; Seybert, Amy L; Thorpe, Joshua M; Kane-Gill, Sandra L

    2018-04-01

    To assess costs of intensive care unit (ICU) related pharmacotherapy relative to hospital drug expenditures, and to identify potential targets for cost-effectiveness investigations. We offer the unique advantage of comparing ICU drug costs with previously published data a decade earlier to describe changes over time. Financial transactions for all ICU patients during fiscal years (FY) 2009-2012 were retrieved from the hospital's data repository. ICU drug costs were evaluated for each FY. ICU departments' charges were also retrieved and calculated as percentages of total ICU charges. Albumin, prismasate (dialysate), voriconazole, factor VII and alteplase denoted the highest percentages of ICU drug costs. ICU drug costs contributed to an average of 31% (SD 1.0%) of the hospital's total drug costs. ICU drug costs per patient day increased by 5.8% yearly versus 7.8% yearly for non-ICU drugs. This rate was higher for ICU drugs costs at 12% a decade previous. Pharmacy charges contributed to 17.7% of the total ICU charges. Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Evaluation of low-level solid radioactive waste generated by a large hospital and disposed of with ordinary refuse

    International Nuclear Information System (INIS)

    Conte, L.; Pedroli, G.; Monciardini, M.; Bianchi, L.; Novario, R.; Beretta, A.

    1996-01-01

    In the Lombardy region some hospitals have recently been reported to the local authorities because of the presence of radioactivity in hospital refuse sent to the municipal tips for incineration. On various occasions the refuse collectors coming from the hospitals had to return with their refuse as traces of radioactivity were detected at the entrance to the tips equipped with monitoring systems. Hospitals administering radioactive substances for diagnostic or therapeutic purposes produce radioactive waste mainly in solid and liquid form. This waste is principally present in patient excreta and in contaminated materials. Radioactive waste present in patient excreta is normally disposed of through the sewage system provided that the concentration limits and annual activity stipulated by law are respected. The contaminated materials coming from the departments that carry out radioisotopic investigations and therapy with unsealed sources can be collected separately and sent to a tip after a period of storage to permit radioactive decay. However, part of the radioactive waste escapes all checks and inevitably mixes with normal refuse or with special hospital refuse that is not considered radioactive. This occurs in the case of: 1. excreta from patients who are not hospitalised after a radioisotopic investigation and materials contaminated by the excreta; 2. excreta from hospitalised patients which are eliminated outside the nuclear medicine and radiotherapy departments; 3. contaminated materials produced with unsealed sources in hospital departments other than those of nuclear medicine and radiotherapy; The waste indicated in point 1 is probably the main problem in ecological terms as the patients who are not hospitalised eliminate radioactive excreta into domestic sewage systems and can also contaminate materials that are disposed of with normal household refuse. In this case any solution to the problem would seriously affect diagnostic activities carried out in the

  1. Total yield and escape depth of electrons from heavy ion solid interactions

    International Nuclear Information System (INIS)

    Frischkorn, H.J.; Burkhard, M.; Groenveld, K.O.; Hofmann, D.; Koschar, P.; Latz, R.; Schader, J.

    1983-01-01

    At high projectile energies ( aboutMeV/U) several mechanisms for electron production are discussed as e.g. direct ionization collisions, recoil particle cascades, collective electron emission. Results are presented of total electron yield (#betta#) measurements over a wide projectile energy E /SUB p/ range (40 keV/U< E /SUB p/ /M <12 MeV/U) and a wide projectile Z /SUB p/ range (1<2 /SUB p-/ <92) of both monoionic and molecular projectiles and of different target thicknesses. From the target thickness dependence of #betta# the mean free path lambda of electrons in carbon can be calculated. The data are discussed in the frame of current theories. Significant deviations from calculated values and predicted dependencies are found, in particular for projectile velocities v /SUB p/ close to the Fermi velocity v /SUB F/ of target electrons and for molecular projectile ions

  2. Effect of initial total solids concentration on volatile fatty acid production from food waste during anaerobic acidification.

    Science.gov (United States)

    Wang, Quan; Jiang, Jianguo; Zhang, Yujing; Li, Kaimin

    2015-01-01

    The effect of initial total solids (TS) concentration on volatile fatty acid (VFAs) production from food waste under mesophilic conditions (35 °C) was determined. VFAs concentration and composition, biogas production, soluble chemical oxygen demand concentration, TS and volatile solids (VS) reduction, and ammonia nitrogen [Formula: see text] release were investigated. The VFAs concentrations were 26.10, 39.68, 59.58, and 62.64 g COD/L at TS contents of 40, 70, 100, and 130 g/L, respectively. While the VFAs' yields ranged from 0.467 to 0.799 g COD/g VSfed, decreased as initial TS increased. The percentage of propionate was not affected by TS concentration, accounting for 30.19-34.86% of the total VFAs, while a higher percentage of butyrate and lower percentage of acetate was achieved at a higher TS concentration. Biogas included mainly hydrogen and carbon dioxide and the maximum hydrogen yield of 148.9 ml/g VSfed was obtained at 130 g TS/L. [Formula: see text] concentration, TS and VS reductions increased as initial TS increased. Considering the above variables, we conclude that initial TS of 100 g/L shall be the most appropriate to VFAs production.

  3. Ranking hospitals for outcomes in total hip replacement - administrative data with or without additional patient surveys? - Part 1: Administrative data

    Directory of Open Access Journals (Sweden)

    Dörning, Hans

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part I of the publication, we present the results of the approach based on administrative data. Methods: We used administrative data from the AOK-Lower Saxony of the years 2000, 2001 and 2002. The study population comprised all beneficiaries, who received total hip replacement in the years 2000 or 2001. Performance indicators used where “critical incident (Mortality or revision” and “number of revisions” within the first year. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries in each of the two years. Multivariate modelling (logistic and poisson regression was used to estimate the performance indicators by case-mix variables (age, sex, co-diagnoses and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or SMR respectively with respect to a pre-selected reference hospital. The resulting rankings were compared with each other, with regard to temporal stability, and the impact of case-mix variables.Results: About 4500 beneficiaries received total hip replacement in each year (n2000: 4482; n2001: 4579. The ranking included 65 hospitals. Comparing the years 2000 and 2001, the temporal stability of the rankings based on a single performance indicator was low (Spearman rang correlation coefficients 0.158 and 0.191. The agreement of rankings based on different performance indicators in the

  4. Fast track in total hip and knee arthroplasty--experiences from Hvidovre University Hospital, Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte

    2006-01-01

    This study investigated whether unselected patients operated on with total hip arthroplasty (THA) or total knee arthroplasty (TKA) could accomplish a self-developed accelerated track, ANORAK-HH, with a planned length of stay (LOS) of maximum 5 days and patient satisfaction at all parts of the tra...

  5. Reducing the length of hospital stay after total knee arthroplasty: influence of femoral and sciatic nerve block.

    Science.gov (United States)

    Carvalho Júnior, Lúcio Honório de; Temponi, Eduardo Frois; Paganini, Vinícius Oliveira; Costa, Lincoln Paiva; Soares, Luiz Fernando Machado; Gonçalves, Matheus Braga Jacques

    2015-01-01

    the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block. the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not. During the years 2009 and 2010, isolated spinal anesthesia was the method used in the procedure. From 2011 on, femoral and sciatic nerve blocking was introduced. between the years 2009 and 2012, the average length of stay ranged from 74 hours in 2009 to 75.2 hours in 2010. The average length of stay in 2011 was 56.52 hours and 53.72 hours in 2012, all in the group of patients who did not remain in the ICU postoperatively. In the same period, among those in the group that needed ICU admission, the average length of stay was 138.7 hours in 2009, 90.25 hours in 2010, 79.8 hours in 2011, and 52.91 hours in 2012. During 2009 and 2010, the rate of re-hospitalization was 0%, while in 2011 and 2012, were 3.44% and 1%, respectively. according to this study, the use of femoral and sciatic nerve blocking after total knee arthroplasty allowed significant reduction in hospital stay.

  6. Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-11-01

    The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs. The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA. The year-to-year risk of 90-day readmission was reduced by 2% and 4% (P total joint arthroplasty volume. The top 5 factors associated with the cost of 90-day TKA readmissions were (in rank order) the length of stay, hospital's teaching status, discharge disposition, patient's gender, and age. Although readmission rates declined slightly, the results of this study do not support the hypothesis that readmission costs have decreased since the introduction of health care reform legislation. Instead, we found that clinical and hospital factors were among the most important cost drivers. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Evaluation of Total Daily Dose and Glycemic Control for Patients on U-500 Insulin Admitted to the Hospital

    Science.gov (United States)

    2016-05-20

    regular insulin has significantly increased in recent years. These patients are severely insulin resistant requiring high doses of insulin to achieve...on U-500 Insulin Admitted to the Hospital presented at SURF Conference, San Antonio, TX 20 May 201 6 with MDWI 41-108, and has been assigned local...59th CSPG/SGVU) C.201 4 . I 52d PROTOCOL TITLE Evaluation of Total Dai ly Dose and Glycemic Control for Patients on U-500 Insulin Admitted to the

  8. The influence of total solids content and initial pH on batch biohydrogen production by solid substrate fermentation of agroindustrial wastes.

    Science.gov (United States)

    Robledo-Narváez, Paula N; Muñoz-Páez, Karla M; Poggi-Varaldo, Hector M; Ríos-Leal, Elvira; Calva-Calva, Graciano; Ortega-Clemente, L Alfredo; Rinderknecht-Seijas, Noemí; Estrada-Vázquez, Carlos; Ponce-Noyola, M Teresa; Salazar-Montoya, J Alfredo

    2013-10-15

    Hydrogen is a valuable clean energy source, and its production by biological processes is attractive and environmentally sound and friendly. In México 5 million tons/yr of agroindustrial wastes are generated; these residues are rich in fermentable organic matter that can be used for hydrogen production. On the other hand, batch, intermittently vented, solid substrate fermentation of organic waste has attracted interest in the last 10 years. Thus the objective of our work was to determine the effect of initial total solids content and initial pH on H2 production in batch fermentation of a substrate that consisted of a mixture of sugarcane bagasse, pineapple peelings, and waste activated sludge. The experiment was a response surface based on 2(2) factorial with central and axial points with initial TS (15-35%) and initial pH (6.5-7.5) as factors. Fermentation was carried out at 35 °C, with intermittent venting of minireactors and periodic flushing with inert N2 gas. Up to 5 cycles of H2 production were observed; the best treatment in our work showed cumulative H2 productions (ca. 3 mmol H2/gds) with 18% and 6.65 initial TS and pH, respectively. There was a significant effect of TS on production of hydrogen, the latter decreased with initial TS increase from 18% onwards. Cumulative H2 productions achieved in this work were higher than those reported for organic fraction of municipal solid waste (OFMSW) and mixtures of OFMSW and fruit peels waste from fruit juice industry, using the same process. Specific energetic potential due to H2 in our work was attractive and fell in the high side of the range of reported results in the open literature. Batch dark fermentation of agrowastes as practiced in our work could be useful for future biorefineries that generate biohydrogen as a first step and could influence the management of this type of agricultural wastes in México and other countries and regions as well. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Epidemiology and Outcomes of Bloodstream Infections in Patients With Solid Tumors in a Central American Population at Mexico Hospital, San Jose, Costa Rica

    Directory of Open Access Journals (Sweden)

    Jorge Calvo-Lon

    2017-12-01

    Full Text Available Purpose: Bloodstream infections (BSIs are an important cause of mortality in patients with solid tumors. We conducted a retrospective study to evaluate the epidemiologic profile and mortality of patients with solid tumors who have BSIs and were admitted to Mexico Hospital. This is the first study in Costa Rica and Central America describing the current epidemiologic situation. Methods: We analyzed the infectious disease database for BSIs in patients with solid tumors admitted to Mexico Hospital from January 2012 to December 2014. Epidemiology and mortality were obtained according to microorganism, antibiotic sensitivity, tumor type, and presence of central venous catheter (CVC. Descriptive statistics were used. Results: A total of 164 BSIs were recorded, the median age was 58 years, 103 patients (63% were males, and 128 cases of infection (78% were the result of gram-negative bacilli (GNB. Klebsiella pneumoniae (21%, Escherichia coli (21%, and Pseudomonas aeruginosa (15% were the most common microorganisms isolated. Gram-positive cocci (GPC were found in 36 patients, with the most frequent microorganisms being Staphylococcus aureus (10% and Staphyloccocus epidermidis (6%. With respect to tumor type, BSIs were more frequent in the GI tract (57% followed by head and neck (9% and genitourinary tract (8%. Regarding antibiotic susceptibility, only 17% (GNB expressed extended-spectrum beta-lactamase and 12% (GPC had methicillin resistance. Patients with CVCs (n = 59 were colonized mainly by GNB (78%. Overall the mortality rate at 30 days was about 30%. Conclusion: GNB are the most frequent cause of BSIs in solid tumors and in patients with CVCs. GI cancers had more BSIs than other sites. Mortality and antibiotic sensitivity remained stable and acceptable during this observational period in this Latin American population.

  10. Simultaneous Effects of Total Solids Content, Milk Base, Heat Treatment Temperature and Sample Temperature on the Rheological Properties of Plain Stirred Yogurt

    Directory of Open Access Journals (Sweden)

    Attilio Converti

    2006-01-01

    Full Text Available Response surface methodology was used to establish a relationship between total solids content, milk base, heat treatment temperature, and sample temperature, and consistency index, flow behaviour index, and apparent viscosity of plain stirred yogurts. Statistical treatments resulted in developments of mathematical models. All samples presented shear thinning fluid behaviour. The increase of the content of total solids (9.3–22.7 % and milk base heat treatment temperature (81.6–98.4 °C resulted in a significant increase in consistency index and a decrease in flow behaviour index. Increase in the sample temperature (1.6–18.4 °C caused a decrease in consistency index and increase in flow behaviour index. Apparent viscosity was directly related to the content of total solids. Rheological properties of yogurt were highly dependent on the content of total solids in milk.

  11. Using total suspended solids (TSS) and turbidity as proxies for evaluation of metal transport in river water

    International Nuclear Information System (INIS)

    Nasrabadi, T.; Ruegner, H.; Sirdari, Z.Z.; Schwientek, M.; Grathwohl, P.

    2016-01-01

    The present study was carried out in Haraz basin (Iran) that is located in south of the Caspian Sea. The goal of this study was to establish correlations amongst total suspended solids concentration (TSS) and turbidity with total pollutant concentrations to evaluate the dissolved and particle-bound concentrations of major toxic metals. It also aimed to validate TSS and/or turbidity measurements as proxies to monitor pollutant fluxes. Eight metals, namely nickel, lead, cadmium, copper, zinc, cobalt, arsenic and strontium were analyzed for dissolved and total concentrations in water at ten locations within the catchment. TSS and turbidity were also measured. Sampling campaigns were designed to cover both the rainy (December) and the dry (May) season within the basin. The robust relationship between TSS (202–1212 mg/l) and turbidity (63–501 NTUs) in both seasons warranted their interchangeable potential as proxies within the observed ranges. Total element concentrations were plotted in separate attempts versus TSS and turbidity for all locations and both events. Very good linear correlations were attained where the slopes represent the metals concentration on suspended solids and the intercept the dissolved concentration in water. The results achieved by these linear regressions were in very good agreement with independently measured values for dissolved concentration and concentrations on river bed sediments taken at the same locations. This demonstrates that turbidity and/or TSS measurements may be used for monitoring of metal loads if once calibrated against total concentration of metals. The results also revealed that in the lower Haraz catchment metal concentrations on suspended and river bed sediment were homogeneously distributed along the investigated river stretch. This is assumed to be due to intensive gravel and sand mining activities in the upper and middle part of the catchment. - Highlights: • Turbidity is evaluated as a feasible proxy to predict

  12. Cardboard proportions and total solids contents as driving factors in dry co-fermentation of food waste.

    Science.gov (United States)

    Capson-Tojo, Gabriel; Trably, Eric; Rouez, Maxime; Crest, Marion; Bernet, Nicolas; Steyer, Jean-Philippe; Delgenès, Jean-Philippe; Escudié, Renaud

    2018-01-01

    This study evaluated the influence of the co-substrate proportions (0-60% of cardboard in dry basis) and the initial total solid contents (20-40%) on the batch fermentation performance. Maximum hydrogen yields were obtained when mono-fermenting food waste at high solids contents (89mlH 2 ·gVS -1 ). The hydrogen yields were lower when increasing the proportions of cardboard. The lower hydrogen yields at higher proportions of cardboard were translated into higher yields of caproic acid (up to 70.1gCOD·kgCOD bio -1 ), produced by consumption of acetic acid and hydrogen. The highest substrate conversions were achieved at low proportions of cardboard, indicating a stabilization effect due to higher buffering capacities in co-fermentation. Clostridiales were predominant in all operational conditions. This study opens up new possibilities for using the cardboard proportions for controlling the production of high added-value products in dry co-fermentation of food waste. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Label-free potentiometric biosensor based on solid-contact for determination of total phenols in honey and propolis.

    Science.gov (United States)

    Draghi, Patrícia Ferrante; Fernandes, Julio Cesar Bastos

    2017-03-01

    We developed a label-free potentiometric biosensor using tyrosinase extracted from Musa acuminata and immobilized by covalent bond on a surface of a solid-contact transducer. The transducer was manufactured containing two layers. The first layer contained a blend of poly(vinyl) chloride carboxylated (PVC-COOH), graphite and potassium permanganate. On this layer, we deposited a second layer containing just a mixture of poly(vinyl chloride) carboxylated and graphite. On the last layer of the transducer, we immobilized the tyrosinase enzyme by reaction with N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride. The solid-contact potentiometric biosensor presented at low detection limit of 7.3×10 -7 M and a linear range to catechol concentration between 9.3×10 -7 M and 8.3×10 -2 M. This biosensor was applied to determine the amount of total phenols in different samples of honey and propolis. The results agreed with the Folin-Ciocalteu method. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain

    DEFF Research Database (Denmark)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B

    2018-01-01

    AIMS: This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. METHODS: A total of 76,438 adults answered questions regarding their total sitting time and physical...... activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment...... disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk...

  15. Fast track in total hip and knee arthroplasty--experiences from Hvidovre University Hospital, Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte

    2006-01-01

    This study investigated whether unselected patients operated on with total hip arthroplasty (THA) or total knee arthroplasty (TKA) could accomplish a self-developed accelerated track, ANORAK-HH, with a planned length of stay (LOS) of maximum 5 days and patient satisfaction at all parts of the track...... and a planned LOS of maximum 5 days. 22 patient characteristics and 11 satisfaction parameters were registered as well as readmissions within 3 months. 95% of patients had a LOS of maximum 5 days with a mean of 3.9 days. Median and mean values of satisfaction for the entire track were 10 and 9.4 out of 10...

  16. Total picture archiving communication system for medical use at medium-sized hospitals

    International Nuclear Information System (INIS)

    Kabata, Shun; Goto, Kazuhiko; Yamada, Kazumi; Okaniwa, Hiroshi.

    1991-01-01

    An increasingly widespread use of diagnostic imaging systems has seen a concomitant rise in the number of medical images. Picture archiving and communication system (PACS) allows filmless storage by digitizing images to record and store into the optical disk, and allows the rapid data retrieval and transmission. It is anticipated that PACS may be a promising approach to the medical routine practice. In January 1991, Hitachi PACS was introduced in Tokyo Hitachi Hospital. In this paper, the experience with PACS in the clinical setting is presented. The process of improvement in PACS is given in terms of the following: the flow of images, image deletion in the image workstation, and the number of sequential images to be observed. (N.K.)

  17. Association of Total Fluid Intake and Output with Duration of Hospital Stay in Patients with Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Andree H. Koop

    2018-01-01

    Full Text Available Background/Aims. The aim of this study was to evaluate the association of fluid balance with outcomes in patients hospitalized with acute pancreatitis (AP. Methods. This was a retrospective study of patients hospitalized between May 2008 and June 2016 with AP and a clinical order for strict recording of intake and output. Data collected included various types of fluid intake and output at 24 and 48 hours after admission. The primary outcome was length of stay (LOS. Analysis was performed using single-variable and multivariable negative binomial regression models. Results. Of 1256 patients hospitalized for AP during the study period, only 71 patients (5.6% had a clinical order for strict recording of intake and output. Increased urine output was associated with a decreased LOS at 24 and 48 hours in univariable analysis. An increasingly positive fluid balance (total intake minus urine output at 24 hours was associated with a longer LOS in multivariable analysis. Conclusions. Few patients hospitalized for AP had a documented order for strict monitoring of fluid intake and output, despite the importance of monitoring fluid balance in these patients. Our study suggests an association between urine output and fluid balance with LOS in AP.

  18. Methodology to quantify the role of the factors controlling the variation of rivers' total dissolved solids in Jiu Catchment (Romania)

    Science.gov (United States)

    Adina Morosanu, Gabriela; Zaharia, Liliana; Ioana-Toroimac, Gabriela; Belleudy, Philippe

    2017-04-01

    The total dissolved solids (TDS) is a river water quality parameter reflecting its concentration in solute ions. It is sensitive to many physical and anthropogenic features of the watershed. In this context, the objective of this work is to analyze the spatial variation of the TDS and to identify the role of the main controlling factors (e.g. geology, soils, land use) in Jiu River and some of its main tributaries, by using a methodology based on GIS and multivariate analysis. The Jiu watershed (10,000 kmp) is located in south-western Romania and it has a high diversity of physical and anthropogenic features influencing the water flow and its quality. The study is based on TDS measurements performed in August, 2016, during low flow conditions in the Jiu River and its tributaries. To measure in situ the TDS (ppm), an EC/TDS/Temperature Hand-held Tester was used in the 12 measuring points on Jiu River and in another 7 points on some of its tributaries. Across the hydrographic basin, the recorded TDS values ranged from 31 ppm to 607 ppm, while in the case of Jiu River, the TDS varied between 38 ppm at Lonea station (upper Jiu River) and 314 ppm at Išalniča (in the lower course). For each catchment corresponding to the sampling points, the influence of some contiguous features was defined on the basis of the lithology (marls, limestones, erodible bedrocks) and soils (clay textures), as well as the land cover/use influencing the solubility and solid content. This assessment was carried out in GIS through a set of spatial statistics analysis by calculating the percentages of the catchment coverage area for each determinant. In order to identify the contributions of different catchment features on the TDS variability, principal components analysis (PCA) was then applied. The results revealed the major role of the marls and clayey soils in the increase of TDS (on the Amaradia and Gilort rivers and some sections in the middle course of the Jiu River). In contrast

  19. Reducing the length of hospital stay after total knee arthroplasty: influence of femoral and sciatic nerve block

    Directory of Open Access Journals (Sweden)

    Lúcio Honório de Carvalho Júnior

    2015-02-01

    Full Text Available Objective: the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block. Materials and methods: the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not. During the years 2009 and 2010, isolated spinal anesthesia was the method used in the procedure. From 2011 on, femoral and sciatic nerve blocking was introduced. Results: between the years 2009 and 2012, the average length of stay ranged from 74 hours in 2009 to 75.2 hours in 2010. The average length of stay in 2011 was 56.52 hours and 53.72 hours in 2012, all in the group of patients who did not remain in the ICU postoperatively. In the same period, among those in the group that needed ICU admission, the average length of stay was 138.7 hours in 2009, 90.25 hours in 2010, 79.8 hours in 2011, and 52.91 hours in 2012. During 2009 and 2010, the rate of re-hospitalization was 0%, while in 2011 and 2012, were 3.44% and 1%, respectively. Conclusion: according to this study, the use of femoral and sciatic nerve blocking after total knee arthroplasty allowed significant reduction in hospital stay.

  20. Time-driven activity based costing of total knee replacement surgery at a London teaching hospital.

    Science.gov (United States)

    Chen, Alvin; Sabharwal, Sanjeeve; Akhtar, Kashif; Makaram, Navnit; Gupte, Chinmay M

    2015-12-01

    The aim of this study was to conduct a time-driven activity based costing (TDABC) analysis of the clinical pathway for total knee replacement (TKR) and to determine where the major cost drivers lay. The in-patient pathway was prospectively mapped utilising a TDABC model, following 20 TKRs. The mean age for these patients was 73.4 years. All patients were ASA grade I or II and their mean BMI was 30.4. The 14 varus knees had a mean deformity of 5.32° and the six valgus knee had a mean deformity of 10.83°. Timings were prospectively collected as each patient was followed through the TKR pathway. Pre-operative costs including pre-assessment and joint school were £ 163. Total staff costs for admission and the operating theatre were £ 658. Consumables cost for the operating theatre were £ 1862. The average length of stay was 5.25 days at a total cost of £ 910. Trust overheads contributed £ 1651. The overall institutional cost of a 'noncomplex' TKR in patients without substantial medical co-morbidities was estimated to be £ 5422, representing a profit of £ 1065 based on a best practice tariff of £ 6487. The major cost drivers in the TKR pathway were determined to be theatre consumables, corporate overheads, overall ward cost and operating theatre staffing costs. Appropriate discounting of implant costs, reduction in length of stay by adopting an enhanced recovery programme and control of corporate overheads through the use of elective orthopaedic treatment centres are proposed approaches for reducing the overall cost of treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Infecções hospitalares em 46 pacientes submetidos a artroplastia total do quadril Hospital infections in 46 patients submitted to total hip replacement

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Lei Munhoz Lima

    2001-03-01

    Full Text Available Foram estudados 46 pacientes submetidos a artroplastia total do quadril em um Instituto de Ortopedia de São Paulo, Brasil, no período de 1993 a 1995, com o objetivo de obter a real frequência das infecções hospitalares da ferida operatória superficial e profunda que ocorrem nessa cirurgia. O estudo baseou-se no acompanhamento pré-operatório, trans-operatório e pós-operatório com seguimento mínimo de três meses de todos os pacientes, no sentido de caracterizar os agentes etiológicos das infecções e os fatores de risco que contribuem para o seu desenvolvimento. Foi observada uma freqüência total de 15.1% de infecções hospitalares, sendo 6.5% de infecção superficial da ferida operatória, 6.5% de infecção profunda e 2.1% de infecção do trato urinário. Os agentes etiológicos encontrados foram Pseudomonas aeruginosa (2 casos, Staphylococcus coagulase negativo (2 casos, Morganella morgani (1 caso e associação de Acinetobacter calcoaceticus (2 casos. O fator de risco com significância estatística observado nesta casuística foi o tempo cirúrgico aumentado. Concluiu-se que a frequência de infecção da ferida cirúrgica superficial e profunda nas artroplastias totais de quadril foi maior, nesta casuística, do que a relatada na literatura internacional, com elevada participação de bacilos Gram-negativos como agentes etiológicos e tendo como principal fator de risco o tempo cirúrgico aumentado.We studied 46 patients submitted to total hip replacement at an Orthopaedics Institute in the city of São Paulo, Brazil, from 1993 to 1995, in order to determine the real frequency of hospital infections of the superficial and deep surgical wounds occurring in this operation. The study consisted of preoperative, transoperative and postoperative monitoring and a minimum follow-up period of three months for all patients in order to characterise the etiologic agents of the infections and risk factors contributing to the

  2. Increase of content and bioactivity of total phenolic compounds from spent coffee grounds through solid state fermentation by Bacillus clausii.

    Science.gov (United States)

    Rochín-Medina, Jesús J; Ramírez, Karina; Rangel-Peraza, Jesús G; Bustos-Terrones, Yaneth A

    2018-03-01

    Spent coffee grounds are waste material generated during coffee beverage preparation. This by-product disposal causes a negative environmental impact, in addition to the loss of a rich source of nutrients and bioactive compounds. A rotating central composition design was used to determine the optimal conditions for the bioactivity of phenolic compounds obtained after the solid state fermentation of spent coffee grounds by Bacillus clausii . To achieve this, temperature and fermentation time were varied according to the experimental design and the total phenolic and flavonoid content, antioxidant activity and antimicrobial activity were determined. Surface response methodology showed that optimum bioprocessing conditions were a temperature of 37 °C and a fermentation time of 39 h. Under these conditions, total phenolic and flavonoid contents increased by 36 and 13%, respectively, in fermented extracts as compared to non-fermented. In addition, the antioxidant activity was increased by 15% and higher antimicrobial activity was observed against Gram positive and negative bacteria. These data demonstrated that bioprocessing optimization of spent coffee grounds using the surface response methodology was an important tool to improve phenolic extraction, which could be used as an antioxidant and antimicrobial agents incorporated into different types of food products.

  3. Response surface modeling for optimization heterocatalytic Fenton oxidation of persistence organic pollution in high total dissolved solid containing wastewater.

    Science.gov (United States)

    Sekaran, G; Karthikeyan, S; Boopathy, R; Maharaja, P; Gupta, V K; Anandan, C

    2014-01-01

    The rice-husk-based mesoporous activated carbon (MAC) used in this study was precarbonized and activated using phosphoric acid. N2 adsorption/desorption isotherm, X-ray powder diffraction, electron spin resonance, X-ray photoelectron spectroscopy and scanning electron microscopy, transmission electron microscopy, (29)Si-NMR spectroscopy, and diffuse reflectance spectroscopy were used to characterize the MAC. The tannery wastewater carrying high total dissolved solids (TDS) discharged from leather industry lacks biodegradability despite the presence of dissolved protein. This paper demonstrates the application of free electron-rich MAC as heterogeneous catalyst along with Fenton reagent for the oxidation of persistence organic compounds in high TDS wastewater. The heterogeneous Fenton oxidation of the pretreated wastewater at optimum pH (3.5), H2O2 (4 mmol/L), FeSO4[Symbol: see text]7H2O (0.2 mmol/L), and time (4 h) removed chemical oxygen demand, biochemical oxygen demand, total organic carbon and dissolved protein by 86, 91, 83, and 90%, respectively.

  4. Study on the collection and disposal of hospital solid wastes in Karaj City (Iran)

    International Nuclear Information System (INIS)

    Farzadkia, M.; Sabily, M.; Ghanbary, S.

    2009-01-01

    Hospitals and other health care institutions generate waste day in and day out which may be a potential health hazard to the health care workers, the general public and, the flora and fauna of that area. Safe and effective management of hospital waste is not only a legal necessity but also a social responsibility. Many of hospitals in Iran neither have a satisfactory waste disposal system nor a waste management and disposal policy. (Author)

  5. Total hip arthroplasty in Jesenice General hospital 1985–2006 – what has been done and look forward

    Directory of Open Access Journals (Sweden)

    Tomaž Silvester

    2007-11-01

    Full Text Available Background: Total arthroplasty is one of the most interesting and fast developing fields in orthopaedic surgery. Practically every joint in the human body is involved, total hip arthroplasties (THA being most frequent and with the longest history. Information on long-term results and survival of different types of prosthesis is invaluable for both patients and surgeons.Patients and methods: Between 1985 and 2006 there were 1563 THAs performed in Jesenice General Hospital. Average age at the time of operation was 67 years, almost two thirds of patients were women. The reason for operation was in 72 % idiopathic arthrosis and in 14 % sequaele of dysplasia.Results: There were 1370 primary procedures and 193 revisions (12.6 %. Aseptic loosening of the implant was the most frequent reason for revision (74 % and infection was observed in 1.5 %. In the first ten years of this research hybrid type of prosthesis was most frequently used, but nowadays, non-cemented prosthesis is used in majority of cases.Conclusions: Total hip arthroplasty is well established procedure at the Jesenice General Hospital. It considerably improves quality of life of the patient, for both, short- and long term, results are very good. New minimal invasive surgical techniques make postoperative rehabilitation faster and easier. The Register of prosthesis enables us to regularly analyze the results and provides treatment outcome information concerning the choice of prosthesis and the optimal surgical technique. Jesenice General Hospital is well recognized as one of the centers for arthroplasties in our country.

  6. Which Clinical and Patient Factors Influence the National Economic Burden of Hospital Readmissions After Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-12-01

    The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. We classified the reasons for readmissions as either procedure- or medical-related. Cost-to-charge ratios supplied with the Nationwide Readmissions Database were used to compute the individual per-patient cost of 90-day readmissions as a continuous variable in separate general linear models for THA and TKA. Payer, patient, clinical, and hospital factors were treated as covariates. We estimated the national burden of readmissions by payer and by the reason for readmission. The national rates of 30- and 90-day readmissions after THA were 4% (95% confidence interval [CI], 4.2%-4.5%) and 8% (95% CI, 7.5%-8.1%), respectively. The national rates of 30- and 90-day readmissions after primary TKA were 4% (95% CI, 3.8%-4.0%) and 7% (95% CI, 6.8%-7.2%), respectively. The five most important variables responsible for the cost of 90-day THA readmissions (in rank order, based

  7. A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

    Science.gov (United States)

    van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

    2016-10-01

    Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  8. Registry of Hospital das Clínicas of the University of São Paulo Medical School: first official solid organ and tissue transplantation report - 2008

    Directory of Open Access Journals (Sweden)

    Estela Azeka

    2009-02-01

    Full Text Available OBJECTIVE: The aim of this study was to report a single center experience of organ and tissue transplantation INTRODUCTION: This is the first report of organ and tissue transplantation at the Hospital das Clínicas of the University of Sao Paulo Medical School. METHODS: We collected data from each type of organ transplantation from 2002 to 2007. The data collected were patient characteristics and actuarial survival Kaplan-Meier curves at 30 days, one year, and five years RESULTS: There were a total of 3,321 transplants at our institution and the 5-year survival curve ranged from 53% to 88%. CONCLUSION: This report shows that solid organ and tissue transplants are feasible within the institution and allow us to expect that the quality of transplantation will improve in the future.

  9. Effect of culture levels, ultrafiltered retentate addition, total solid levels and heat treatments on quality improvement of buffalo milk plain set yoghurt.

    Science.gov (United States)

    Yadav, Vijesh; Gupta, Vijay Kumar; Meena, Ganga Sahay

    2018-05-01

    Studied the effect of culture (2, 2.5 and 3%), ultrafiltered (UF) retentate addition (0, 11, 18%), total milk solids (13, 13.50, 14%) and heat treatments (80 and 85 °C/30 min) on the change in pH and titratable acidity (TA), sensory scores and rheological parameters of yoghurt. With 3% culture levels, the required TA (0.90% LA) was achieved in minimum 6 h incubation. With an increase in UF retentate addition, there was observed a highly significant decrease in overall acceptability, body and texture and colour and appearance scores, but there was highly significant increase in rheological parameters of yoghurt samples. Yoghurt made from even 13.75% total solids containing nil UF retentate was observed to be sufficiently firm by the sensory panel. Most of the sensory attributes of yoghurt made with 13.50% total solids were significantly better than yoghurt prepared with either 13 or 14% total solids. Standardised milk heated to 85 °C/30 min resulted in significantly better overall acceptability in yoghurt. Overall acceptability of optimised yoghurt was significantly better than a branded market sample. UF retentate addition adversely affected yoghurt quality, whereas optimization of culture levels, totals milk solids and others process parameters noticeably improved the quality of plain set yoghurt with a shelf life of 15 days at 4 °C.

  10. Effect of fermentation time of mixture of solid and liquid wastes from tapioca industry to percentage reduction of TSS (Total Suspended Solids)

    Science.gov (United States)

    Pandia, S.; Tanata, S.; Rachel, M.; Octiva, C.; Sialagan, N.

    2018-02-01

    The waste from tapioca industry is as an organic waste that contains many important compounds such as carbohydrate, protein, and glucose. This research as aimed to know the effect of fermentation time from solid waste combined with waste-water from the tapioca industry to percentage reduction of TSS. The study was started by mixing the solid and liquid wastes from tapioca industry at a ratio of 70:30, 60:40, 50:50, 40:60, and 30:70 (w/w) with a starter from solid waste of cattle in a batch anaerobic digester. The percentage reduction of TSS was 72.2289 at a ratio by weight of the composition of solid and liquid wastes from tapioca industry was 70:30 after 30 days of fermentation time.

  11. Evaluation of total soluble solids content (TSSC and endogenous pH in antimicrobials of pediatric use

    Directory of Open Access Journals (Sweden)

    Alessandro Leite Cavalcanti

    2013-01-01

    Full Text Available Background: The use of liquid pharmaceutical preparations is a daily occurrence for some children. Evidences show a significant relation between the intake of oral sucrose based medicines and an increase incidence in dental caries. Aim: This in vitro experimental study evaluated the Total Soluble Solids Content (TSSC by means of Brix scale refractometry and the endogenous pH of antimicrobials of pediatric use presented as oral suspensions. Materials and Methods: Nine medications (6 chemotherapics and 3 antibiotics were evaluated by random experiment with 3 repetitions for each sample. The analysis of TSSC readings were performed by Brix refractometry using the Abbé refractometer, and the pH values were determined by potentiometry. Results: The mean TSS contents ranged from 11.73 (Keflaxina to 63.83 (Azitromed. The minimum and maximum mean pH values were 4.12 (Keflaxina and 10.97 (Zitroneo, respectively. Conclusions: The chemotherapic antimicrobials evaluated in this study presented the highest TSSC means, while the antibiotics showed pHs below the values considered as critical, which may contribute to the development of caries lesions in case of inadequate administration of these medications to children.

  12. Evaluation of stream water quality data generated from MODIS images in modeling total suspended solid emission to a freshwater lake.

    Science.gov (United States)

    Ayana, Essayas K; Worqlul, Abeyou W; Steenhuis, Tammo S

    2015-08-01

    Modeling of suspended sediment emission into freshwater lakes is challenging due to data gaps in developing countries. Existing models simulate sediment concentration at a gauging station upstream and none of these studies had modeled total suspended solids (TSS) emissions by inflowing rivers to freshwater lakes as there are no TSS measurements at the river mouth in the upper Blue Nile basin. In this study a 10year TSS time series data generated from remotely sensed MODIS/Terra images using established empirical relationship is applied to calibrate and validate a hydrology model for Lake Tana in Upper Blue Nile Basin. The result showed that at a monthly time scale TSS at the river mouth can be replicated with Nash-Sutcliffe efficiency (NS) of 0.34 for calibration and 0.21 for validation periods. Percent bias (PBIAS) and ratio of the root-mean-square error to the standard deviation of measured data (RSR) are all within range. Given the inaccessibility and costliness to measure TSS at river mouths to a lake the results found here are considered useful for suspended sediment budget studies in water bodies of the basin. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Hyperspectral Imaging Coupled with Random Frog and Calibration Models for Assessment of Total Soluble Solids in Mulberries

    Directory of Open Access Journals (Sweden)

    Yan-Ru Zhao

    2015-01-01

    Full Text Available Chemometrics methods coupled with hyperspectral imaging technology in visible and near infrared (Vis/NIR region (380–1030 nm were introduced to assess total soluble solids (TSS in mulberries. Hyperspectral images of 310 mulberries were acquired by hyperspectral reflectance imaging system (512 bands and their corresponding TSS contents were measured by a Brix meter. Random frog (RF method was used to select important wavelengths from the full wavelengths. TSS values in mulberry fruits were predicted by partial least squares regression (PLSR and least-square support vector machine (LS-SVM models based on full wavelengths and the selected important wavelengths. The optimal PLSR model with 23 important wavelengths was employed to visualise the spatial distribution of TSS in tested samples, and TSS concentrations in mulberries were revealed through the TSS spatial distribution. The results declared that hyperspectral imaging is promising for determining the spatial distribution of TSS content in mulberry fruits, which provides a reference for detecting the internal quality of fruits.

  14. Classification and Processing Optimization of Barley Milk Production Using NIR Spectroscopy, Particle Size, and Total Dissolved Solids Analysis

    Directory of Open Access Journals (Sweden)

    Jasenka Gajdoš Kljusurić

    2015-01-01

    Full Text Available Barley is a grain whose consumption has a significant nutritional benefit for human health as a very good source of dietary fibre, minerals, vitamins, and phenolic and phytic acids. Nowadays, it is more and more often used in the production of plant milk, which is used to replace cow milk in the diet by an increasing number of consumers. The aim of the study was to classify barley milk and determine the optimal processing conditions in barley milk production based on NIR spectra, particle size, and total dissolved solids analysis. Standard recipe for barley milk was used without added additives. Barley grain was ground and mixed in a blender for 15, 30, 45, and 60 seconds. The samples were filtered and particle size of the grains was determined by laser diffraction particle sizing. The plant milk was also analysed using near infrared spectroscopy (NIRS, in the range from 904 to 1699 nm. Furthermore, conductivity of each sample was determined and microphotographs were taken in order to identify the structure of fat globules and particles in the barley milk. NIR spectra, particle size distribution, and conductivity results all point to 45 seconds as the optimal blending time, since further blending results in the saturation of the samples.

  15. EPA Method 3135.2I: Cyanide, Total and Amenable in Aqueous and Solid Samples Automated Colorimetric With Manual Digestion

    Science.gov (United States)

    This method describes procedures for preparation and analysis of solid, water and wipe samples for detection and measurement of cyanide amendable to chlorination using acid digestion and spectrophotometry.

  16. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  17. National trends and in hospital outcomes for total hip arthroplasty in avascular necrosis in the United States.

    Science.gov (United States)

    Mayers, William; Schwartz, Brian; Schwartz, Aaron; Moretti, Vincent; Goldstein, Wayne; Shah, Ritesh

    2016-09-01

    While a majority of total hip arthroplasty (THA) is performed for osteoarthritis (OA), a significant portion is performed in the setting of avascular necrosis (AVN). The purpose of this study is to evaluate recent trends, patient demographics, and in hospital outcomes for primary THA in the setting of AVN in the United States. The National Hospital Discharge Survey database was searched for patients admitted to US hospitals after a primary THA for the years 2001-2010. Patients were then separated into two groups by ICD-9 diagnosis codes for OA and AVN. The rates of THA for AVN (r = 0.65) and THA for OA (r = 0.82) both demonstrated a positive correlation with time. The mean patient age of the AVN group was significantly lower (56.9 vs 65.9 years, p < 0.01). Men accounted for 51.9 % of the AVN group and 43.0 % of the OA group (p < 0.01). The AVN group had a significantly higher percentage of African Americans (11.2 % vs 5.4 %, p < 0.01) when compared to the OA group. The AVN group had a higher rate of myocardial infarction (0.3 % vs 0.07 %, p = 0.0163) and a higher average number of medical co-morbidities (5.16 vs 4.77, p < 0.01). Patients undergoing THA for AVN were more likely to be younger, male, African American, have more medical co-morbidities, and more likely to have a myocardial infarction than those with OA. While the number of primary THAs performed for AVN in the United States has increased over the past ten years, the rate of primary THA for OA increased at a much more rapid rate.

  18. Measurement of total hemoglobin reduces red cell transfusion in hospitalized patients undergoing cardiac surgery: a retrospective database analysis.

    Science.gov (United States)

    Craver, Christopher; Belk, Kathy W; Myers, Gerard J

    2018-01-01

    Historically, perioperative hemoglobin monitoring has relied on calculated saturation, using blood gas devices that measure plasma hematocrit (Hct). Co-oximetry, which measures total hemoglobin (tHb), yields a more comprehensive assessment of hemodilution. The purpose of this study was to examine the association of tHb measurement by co-oximetry and Hct, using conductivity with red blood cell (RBC) transfusion, length of stay (LOS) and inpatient costs in patients having major cardiac surgery. A retrospective study was conducted on patients who underwent coronary artery bypass graft (CABG) and/or valve replacement (VR) procedures from January 2014 to June 2016, using MedAssets discharge data. The patient population was sub-divided by the measurement modality (tHb and Hct), using detailed billing records and Current Procedural Terminology coding. Cost was calculated using hospital-specific cost-to-charge ratios. Multivariable logistic regression was performed to identify significant drivers of RBC transfusion and resource utilization. The study population included 18,169 cardiovascular surgery patients. Hct-monitored patients accounted for 66% of the population and were more likely to have dual CABG and VR procedures (10.4% vs 8.9%, p=0.0069). After controlling for patient and hospital characteristics, as well as patient comorbidities, Hct-monitored patients had significantly higher RBC transfusion risk (OR=1.26, CI 1.15-1.38, pcosts (IRR=1.15, pcost (IRR=1.22, pcost compared to Hct monitoring.

  19. Annual and seasonal variation of turbidity, total dissolved solids, nitrate and nitrite in the Parsabad water treatment plant, Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Zare

    2013-01-01

    Full Text Available Aims: This study investigated the annual and seasonal variation of turbidity; total dissolved solid (TDS, nitrate and nitrite in Parsabad water treatment plant (WTP, Iran. Materials and Methods: The water samples were obtained from the inlet and outlet of Parsabad WTP from February 2002 to June 2009. The samples′ turbidity, TDS, nitrate, nitrite, pH, and temperature were measured according to standard methods once a month and the average of these parameters were calculated for each season of year. Results: The maximum concentration of inlet turbidity, TDS, nitrate and nitrite were 691, 700.5, 25, and 0.17 mg/l, respectively. These parameters for outlet samples in the study period were 3.0, 696.7, 18, and 0.06 mg/l, respectively. While these concentrations in outlet zone were lower than World Health Organization (WHO or United States Environmental Protection Agency (US-EPA water quality guidelines, WTP could not reduce the TDS, nitrate, nitrite and pH value and these parameters were not different in the inlet and outlet samples. However, the WTP reduced the turbidity significantly with an efficiency of up to 85%. Conclusion: This study showed that a common WTP with rapid sand filtration can treat a maximum river turbidity of 700 NTU in several years. As no differences were observed between inlet and outlet TDS, nitrate, nitrite and pH in the studied WTP. It can be concluded that compensatory schemes should be predicted for modification of these parameters when they exceed the standards in the emergency situations.

  20. Flow-injection determination of total organic fluorine with off-line defluorination reaction on a solid sorbent bed.

    Science.gov (United States)

    Musijowski, Jacek; Trojanowicz, Marek; Szostek, Bogdan; da Costa Lima, José Luis Fontes; Lapa, Rui; Yamashita, Hiroki; Takayanagi, Toshio; Motomizu, Shoji

    2007-09-26

    Considering recent reports on widespread occurrence and concerns about perfluoroalkyl substances (PFAS) in environmental and biological systems, analysis of these compounds have gained much attention in recent years. Majority of analyte-specific methods are based on a LC/MS/MS or a GC/MS detection, however many environmental or biological studies would benefit from a total organic fluorine (TOF) determination. Presented work was aimed at developing a method for TOF determination. TOF is determined as an amount of inorganic fluoride obtained after defluorination reaction conducted off-line using sodium biphenyl reagent directly on the sorbent without elution of retained analytes. Recovered fluoride was analyzed using flow-injection system with either fluorimetric or potentiometric detection. The TOF method was tested using perfluorocarboxylic acids (PFCA), including perfluorooctanoic acid (PFOA), as model compounds. Considering low concentrations of PFAS in natural samples, solid-phase extraction as a preconcentration procedure was evaluated. Several carbon-based sorbents were tested, namely multi-wall carbon nanotubes, carbon nanofibres and activated carbon. Good sorption of all analytes was achieved and defluorination reaction was possible to carry out directly on a sorbent bed. Recoveries obtained for PFCAs, adsorbed on an activated carbon sorbent, and measured as TOF, were 99.5+/-1.7, 110+/-9.4, 95+/-26, 120+/-32, 110+/-12 for C4, C6, C8, C10 and C12-PFCA, respectively. Two flow systems that would enable the defluorination reaction and fluoride determination in a single system were designed and tested.

  1. An audit of pregnancy outcomes in solid organ transplant recipients at a metropolitan hospital.

    Science.gov (United States)

    Fang, Yunjing E; Nayyar, Roshini; Diplock, Hayley

    2018-04-22

    Pregnancies in patients with solid organ transplants have higher rates of complications and caesarean sections (CS). To perform an audit of the pregnancy outcomes in transplant recipients, to determine the rate of CS in our cohort, the appropriate skin incision for CS in these patients and to formulate recommendations for preoperative planning. This is a retrospective cohort study. All patients who had a solid organ transplant were identified from the obstetrics database. The operation records of the transplant recipients who delivered by CS were reviewed and the de-identified data were evaluated for pregnancy outcomes. This cohort consisted of 22 women: six had simultaneous pancreas and kidney (SPK) transplants and 16 had kidney transplants. Over a ten-year period, four women had two pregnancies and one had a twin pregnancy, thus 27 babies were born. The rate of CS was 58% (n = 15) and the surgical approach in 13 of these patients was by Pfannenstiel incision. One patient had an elective midline incision at the first CS, which was repeated in the next pregnancy. Two CS were complicated by bladder injury, both occurring in SPK recipients. Patients with solid organ transplants have a higher rate of CS and SPK patients may be at a higher risk of bladder injuries during CS. Our data suggest that Pfannenstiel skin incision is still suitable for these patients. We recommend reviewing the operative details of the transplant operation and a pelvic magnetic resonance imaging for pre-operative planning. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. Hyperspectral sensing for turbid water quality monitoring in freshwater rivers: Empirical relationship between reflectance and turbidity and total solids.

    Science.gov (United States)

    Wu, Jiunn-Lin; Ho, Chung-Ru; Huang, Chia-Ching; Srivastav, Arun Lal; Tzeng, Jing-Hua; Lin, Yao-Tung

    2014-11-28

    Total suspended solid (TSS) is an important water quality parameter. This study was conducted to test the feasibility of the band combination of hyperspectral sensing for inland turbid water monitoring in Taiwan. The field spectral reflectance in the Wu river basin of Taiwan was measured with a spectroradiometer; the water samples were collected from the different sites of the Wu river basin and some water quality parameters were analyzed on the sites (in situ) as well as brought to the laboratory for further analysis. To obtain the data set for this study, 160 in situ sample observations were carried out during campaigns from August to December, 2005. The water quality results were correlated with the reflectivity to determine the spectral characteristics and their relationship with turbidity and TSS. Furthermore, multiple-regression (MR) and artificial neural network (ANN) were used to model the transformation function between TSS concentration and turbidity levels of stream water, and the radiance measured by the spectroradiometer. The value of the turbidity and TSS correlation coefficient was 0.766, which implies that turbidity is significantly related to TSS in the Wu river basin. The results indicated that TSS and turbidity are positively correlated in a significant way across the entire spectrum, when TSS concentration and turbidity levels were under 800 mg·L(-1) and 600 NTU, respectively. Optimal wavelengths for the measurements of TSS and turbidity are found in the 700 and 900 nm range, respectively. Based on the results, better accuracy was obtained only when the ranges of turbidity and TSS concentration were less than 800 mg·L(-1) and less than 600 NTU, respectively and used rather than using whole dataset (R(2) = 0.93 versus 0.88 for turbidity and R(2) = 0.83 versus 0.58 for TSS). On the other hand, the ANN approach can improve the TSS retrieval using MR. The accuracy of TSS estimation applying ANN (R(2) = 0.66) was better than with the MR approach (R

  3. Hyperspectral Sensing for Turbid Water Quality Monitoring in Freshwater Rivers: Empirical Relationship between Reflectance and Turbidity and Total Solids

    Directory of Open Access Journals (Sweden)

    Jiunn-Lin Wu

    2014-11-01

    Full Text Available Total suspended solid (TSS is an important water quality parameter. This study was conducted to test the feasibility of the band combination of hyperspectral sensing for inland turbid water monitoring in Taiwan. The field spectral reflectance in the Wu river basin of Taiwan was measured with a spectroradiometer; the water samples were collected from the different sites of the Wu river basin and some water quality parameters were analyzed on the sites (in situ as well as brought to the laboratory for further analysis. To obtain the data set for this study, 160 in situ sample observations were carried out during campaigns from August to December, 2005. The water quality results were correlated with the reflectivity to determine the spectral characteristics and their relationship with turbidity and TSS. Furthermore, multiple-regression (MR and artificial neural network (ANN were used to model the transformation function between TSS concentration and turbidity levels of stream water, and the radiance measured by the spectroradiometer. The value of the turbidity and TSS correlation coefficient was 0.766, which implies that turbidity is significantly related to TSS in the Wu river basin. The results indicated that TSS and turbidity are positively correlated in a significant way across the entire spectrum, when TSS concentration and turbidity levels were under 800 mg·L−1 and 600 NTU, respectively. Optimal wavelengths for the measurements of TSS and turbidity are found in the 700 and 900 nm range, respectively. Based on the results, better accuracy was obtained only when the ranges of turbidity and TSS concentration were less than 800 mg·L−1 and less than 600 NTU, respectively and used rather than using whole dataset (R2 = 0.93 versus 0.88 for turbidity and R2 = 0.83 versus 0.58 for TSS. On the other hand, the ANN approach can improve the TSS retrieval using MR. The accuracy of TSS estimation applying ANN (R2 = 0.66 was better than with the MR

  4. Association Between Provider Volume and Comorbidity on Hospital Utilization and Outcomes of Total Hip Arthroplasty Among National Health Insurance Enrollees

    Directory of Open Access Journals (Sweden)

    Chung-Shih Huang

    2011-06-01

    Conclusions: This study revealed that the volume of THAs performed by individual surgeons was a more important determinant of hospital utilization than hospital volume. Perioperative adverse events were associated with patients' age and comorbidity.

  5. Quality of Recovery, Postdischarge Hospital Utilization, and 2-Year Functional Outcomes After an Outpatient Total Knee Arthroplasty Program.

    Science.gov (United States)

    Gauthier-Kwan, Olivier Y; Dobransky, Johanna S; Dervin, Geoffrey F

    2018-02-05

    Outpatient total knee arthroplasty (TKA) has been made possible with advances in perioperative care and standardized clinical inpatient pathways. While many studies report on benefits of outpatient programs, none explore patient-reported outcome measures. As such, our goals were to compare the short-term quality of recovery; highlight postdischarge hospital resources utilization; and report on 2-year functional outcomes scores. This was a prospective comparative cohort study of 43 inpatients (43 TKAs) and 43 outpatients (43 TKAs) operated on by a single surgeon between September 28, 2010 and May 5, 2015. All patients were given a diary to complete at 1, 3, 7, 14, and 28 days postoperatively; we collected 90-day complications, readmissions, and emergency department visits; Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index scores were completed preoperatively and 2 years postoperatively. SPSS (IBM, version 22.0) was used for all statistical analyses. Quality of recovery (QoR-9) was similar in the outpatient TKA group compared with the inpatient group. No statistically significant differences were observed for Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index subscores (P > .05). There was 1 readmission in both outpatient and inpatient groups. Six inpatients and 8 outpatients returned to the emergency department for any reason within 90 days, with no statistical significance observed between the 2 groups (P = .771). Outpatient TKA in selected patients produced similar short-term and 2-year patient-reported outcome measures and a comparable 90-day postdischarge hospital resource utilization when compared to an inpatient cohort, supporting further investigation into outpatient TKA. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Solid waste management in local hospitals of the north of Valle del Cauca, Colombia

    Directory of Open Access Journals (Sweden)

    Patricia Torres L

    2010-04-01

    Full Text Available Health-care institutions must offer adequate conditions for both employers and users in order to maintain, improve or recover their health status; inadequate health-care solid waste (h s w management is an obstacle to achieve this goal. Objective:to estimate the quantity and composition of h s w in ten healthcare public institutions located in ten municipalities in northern Valle del Cauca region (Colombia. Methodology: quantity and composition of h s w was estimated through two 24 hours sampling rounds. Results: the proportion of hazardous healthcare solid waste (h h s w was usually equal to or higher than 25% and it also surpassed the mean average values reported by organizations like World Health Organization; bio-sanitary waste was the category with major proportion in the h h s w fraction. Discussion: the values obtained in order to determine indicators as kg/bed-day and kg/patient-day were in a lower or equal range of those values reported by different institutional or scientific sources. Considering the health-care services offered in the evaluated institutions, the kg/patient-day indicator is considered more representative than the kg/bed-day.

  7. Challenges in assessing hospital-level stroke mortality as a quality measure: comparison of ischemic, intracerebral hemorrhage, and total stroke mortality rates.

    Science.gov (United States)

    Xian, Ying; Holloway, Robert G; Pan, Wenqin; Peterson, Eric D

    2012-06-01

    Public reporting efforts currently profile hospitals based on overall stroke mortality rates, yet the "mix" of hemorrhagic and ischemic stroke cases may impact this rate. Using the 2005 to 2006 New York state data, we examined the degree to which hospital stroke mortality rankings varied regarding ischemic versus hemorrhagic versus total stroke. Observed/expected ratio was calculated using the Agency for Healthcare Research and Quality Inpatient Quality Indicator software. The observed/expected ratio and outlier status based on stroke types across hospitals were examined using Pearson correlation coefficients (r) and weighted κ. Overall 30-day stroke mortality rates were 15.2% and varied from 11.3% for ischemic stroke and 37.3% for intracerebral hemorrhage. Hospital risk-adjusted ischemic stroke observed/expected ratio was weakly correlated with its own intracerebral hemorrhage observed/expected ratio (r=0.38). When examining hospital performance group (mortality better, worse, or no different than average), disagreement was observed in 35 of 81 hospitals (κ=0.23). Total stroke mortality observed/expected ratio and rankings were correlated with intracerebral hemorrhage (r=0.61 and κ=0.36) and ischemic stroke (r=0.94 and κ=0.71), but many hospitals still switched classification depending on mortality metrics. However, hospitals treating a higher percent of hemorrhagic stroke did not have a statistically significant higher total stroke mortality rate relative to those treating fewer hemorrhagic strokes. Hospital stroke mortality ratings varied considerably depending on whether ischemic, hemorrhagic, or total stroke mortality rates were used. Public reporting of stroke mortality measures should consider providing risk-adjusted outcome on separate stroke types.

  8. Baseline toxicity of a chlorobenzene mixture and total body residues measured and estimated with solid-phase microextraction

    NARCIS (Netherlands)

    Leslie, H.A.; Hermens, J.L.; Kraak, M.H.S.

    2004-01-01

    Body residues of compounds with a narcotic mode of action that exceed critical levels result in baseline toxicity in organisms. Previous studies have shown that internal concentrations in organisms also can be estimated by way of passive sampling. In this experiment, solid-phase microextraction

  9. Divergent solid-phase synthesis of natural product-inspired bipartite cyclodepsipeptides : total synthesis of seragamide A

    NARCIS (Netherlands)

    Arndt, H.-D.; Rizzo, S.; Nöcker, Chr.; Wackchaure, V.N.; Milroy, L.G.; Bieker, V.; Calderon, A.; Tran, T.T.N.; Brand, S.; Dehmelt, L.; Waldmann, H.

    2015-01-01

    Macrocyclic natural products (NPs) and analogues thereof often show high affinity, selectivity, and metabolic stability, and methods for the synthesis of NP-like macrocycle collections are of major current interest. We report an efficient solid-phase/cyclorelease method for the synthesis of a

  10. [Quality of Outcome after Primary Total Hip Replacement at a Maximum Care Hospital in Relation to Preoperative Influencing Factors].

    Science.gov (United States)

    Osmanski-Zenk, K; Steinig, N S; Glass, Ä; Mittelmeier, W; Bader, R

    2015-12-01

    As the need for joint replacements will continue to rise, the outcome of primary total hip replacement (THR) must be improved and stabilised at a high level. In this study, we investigated whether pre-operative risk factors, such as gender, age and body weight at the time of the surgery or a restricted physical status (ASA-Status > 2 or Kellgren and Lawrence grade > 2) have a negative influence on the post-operative results or on patient satisfaction. Retrospective data collection and a prospective interview were performed with 486 patients who underwent primary total hip replacement between January 2007 and December 2010 in our hospital. The patients' satisfaction and quality of life were surveyed with the WOMAC-Score, SF-36 and EuroQol-5. Differences between more than two independent spot tests were tested with the non-parametric Kruskal-Wallis test. Differences between two independent spot tests were tested with the non-parametric Mann-Whitney U test. The frequencies were reported and odds ratios calculated. The confidence interval was set at 95 %. The level of significance was p total score of the SF-36 was 66.9 points. The patients declared an average EuroQol Index of 0.81. Our data show that the patients' gender did not influence the duration of surgery or the scores. However, female patients tended to exhibit more postoperative complications. However, increased patient age at the time of surgery was associated with an increased OR for duration of surgery, length of stay and risk of complications. Patients who had a normal body weight at time of the surgery showed better peri- and post-operative results. We showed that the preoperative estimated Kellgren and Lawrence grade had a significant influence on the duration of surgery. The ASA classification influenced the duration of surgery as well the length of stay and the rate of complications. The quality of results after primary THR depends on preoperative factors. Existing comorbidities have a

  11. Reconsidering the Affordable Care Act's Restrictions on Physician-Owned Hospitals: Analysis of CMS Data on Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Courtney, P Maxwell; Darrith, Brian; Bohl, Daniel D; Frisch, Nicholas B; Della Valle, Craig J

    2017-11-15

    Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA). With use of the U.S. Centers for Medicare & Medicaid Services (CMS) Inpatient Charge Data, we identified 45 physician-owned and 2,657 non-physician-owned hospitals that performed ≥11 primary TKA and THA procedures in 2014. Cost data, patient-satisfaction scores, and risk-adjusted complication and 30-day readmission scores for knee and hip arthroplasty patients were obtained from the multiyear CMS Hospital Compare database. Physician-owned hospitals received lower mean Medicare payments than did non-physician-owned hospitals for THA and TKA procedures ($11,106 compared with $12,699; p = 0.002). While the 30-day readmission score did not differ significantly between the 2 types of hospitals (4.48 compared with 4.62 for physician-owned and non-physician-owned, respectively; p = 0.104), physician-owned hospitals had a lower risk-adjusted complication score (2.83 compared with 3.04; p = 0.015). Physician-owned hospitals outperformed non-physician-owned hospitals in all patient-satisfaction categories, including mean linear scores for recommending the hospital (93.9 compared with 87.9; p CMS payment methodology. Our findings suggest that physician-owned hospitals are associated with lower mean Medicare costs, fewer complications, and higher patient satisfaction following THA and TKA than non-physician-owned hospitals. Policymakers should consider these data when debating the current moratorium on physician-owned hospital expansion. Therapeutic Level III. See

  12. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  13. Total integrated dose testing of solid-state scientific CD4011, CD4013, and CD4060 devices by irradiation with CO-60 gamma rays

    Science.gov (United States)

    Dantas, A. R. V.; Gauthier, M. K.; Coss, J. R.

    1985-01-01

    The total integrated dose response of three CMOS devices manufactured by Solid State Scientific has been measured using CO-60 gamma rays. Key parameter measurements were made and compared for each device type. The data show that the CD4011, CD4013, and CD4060 produced by this manufacturers should not be used in any environments where radiation levels might exceed 1,000 rad(Si).

  14. Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2015-08-01

    Full Text Available Introduction. Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission.Materials and Methods. All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge.Results. The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9% and had a DRG weight of 1.22 (0.68. 219 patients (13% were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58% patients and a low TLC was found in 1,152 (68% patients. Low albumin and low TLC was found in 709 (42% of patients. Kaplan–Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001 predictor of hospital readmission. Low serum albumin (p < 0.001 and TLC (p = 0.018 show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI [2.30–4.63] and higher DRG weight (Hazard Ratio 1.19, 95% CI [1.03–1.38] to be significant

  15. Concentration, flux, and trend estimates with uncertainty for nutrients, chloride, and total suspended solids in tributaries of Lake Champlain, 1990–2014

    Science.gov (United States)

    Medalie, Laura

    2016-12-20

    The U.S. Geological Survey, in cooperation with the New England Interstate Water Pollution Control Commission and the Vermont Department of Environmental Conservation, estimated daily and 9-month concentrations and fluxes of total and dissolved phosphorus, total nitrogen, chloride, and total suspended solids from 1990 (or first available date) through 2014 for 18 tributaries of Lake Champlain. Estimates of concentration and flux, provided separately in Medalie (2016), were made by using the Weighted Regressions on Time, Discharge, and Season (WRTDS) regression model and update previously published WRTDS model results with recent data. Assessment of progress towards meeting phosphorus-reduction goals outlined in the Lake Champlain management plan relies on annual estimates of phosphorus flux. The percent change in annual concentration and flux is provided for two time periods. The R package EGRETci was used to estimate the uncertainty of the trend estimate. Differences in model specification and function between this study and previous studies that used WRTDS to estimate concentration and flux using data from Lake Champlain tributaries are described. Winter data were too sparse and nonrepresentative to use for estimates of concentration and flux but were sufficient for estimating the percentage of total annual flux over the period of record. Median winter-to-annual fractions ranged between 21 percent for total suspended solids and 27 percent for dissolved phosphorus. The winter contribution was largest for all constituents from the Mettawee River and smallest from the Ausable River. For the full record (1991 through 2014 for total and dissolved phosphorus and chloride and 1993 through 2014 for nitrogen and total suspended solids), 6 tributaries had decreasing trends in concentrations of total phosphorus, and 12 had increasing trends; concentrations of dissolved phosphorus decreased in 6 and increased in 8 tributaries; fluxes of total phosphorus decreased in 5 and

  16. Role of alkaline-tolerant fungal cellulases in release of total antioxidants from agro-wastes under solid state fermentation

    Digital Repository Service at National Institute of Oceanography (India)

    Ravindran, C.; Varatharajan, G. R.; Karthikeyan, A.

    -wastes and total antioxidant property. The increased antioxidant activity on free radical scavenging was also observed with the increase in pH. Thus, the present study makes it possible to produce nutraceutical ingredients cost-effectively from agricultural wastes....

  17. The percentage of nosocomial-related out of total hospitalizations for rotavirus gastroenteritis and its association with hand hygiene compliance.

    Science.gov (United States)

    Waisbourd-Zinman, Orith; Ben-Ziony, Shiri; Solter, Ester; Chodick, Gabriel; Ashkenazi, Shai; Livni, Gilat

    2011-03-01

    Because the absolute numbers of both community-acquired and nosocomial rotavirus gastroenteritis (RVGE) vary, we studied the percentage of hospitalizations for RVGE that were transmitted nosocomially as an indicator of in-hospital acquisition of the infection. In a 4-year prospective study, the percentage of nosocomial RVGE declined steadily, from 20.3% in 2003 to 12.7% in 2006 (P = .001). Concomitantly, the rate of compliance with hand hygiene increased from 33.7% to 49% (P = .012), with a significant (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Determination of solid surface composition by the X-ray fluorescence method under total external reflection with angular scanning

    International Nuclear Information System (INIS)

    Krasnolutskij, V.P.

    2000-01-01

    Possibilities of determination of composition of surface layers by X-ray fluorescence analysis under total reflection of incident radiation with angular scanning of a target are investigated. For the case of the GaAs target it is shown that the sensibility of this method is sufficient for a control of element composition in layer of thickness 1 nm. A simple method for solution of inverse task of analysis of a two component medium is considered [ru

  19. Open focused microwave-assisted sample preparation for rapid total and mercury species determination in environmental solid samples

    OpenAIRE

    Tseng, C. M.; Garraud, H.; Amouroux, D.; Donard, O. F. X.; de Diego, A.

    1998-01-01

    This paper describes rapid, simple microwave-assisted leaching/ digestion procedures for total and mercury species determination in sediment samples and biomaterials. An open focused microwave system allowed the sample preparation time to be dramatically reduced to only 24 min when a power of 40-80 W was applied. Quantitative leaching of methylmercury from sediments by HNO3 solution and complete dissolution of biomaterials by an alkaline solution, such as 25% TMAH solution, were obtained. Met...

  20. Predictors for total hospital and cardiology cost claims among patients with atrial fibrillation initiating dabigatran or acenocoumarol in the Netherlands

    NARCIS (Netherlands)

    Jacobs, M S; van Leent, M W J; Tieleman, R G; Jansman, F G A; Cao, Q; Postma, M J; van Hulst, M

    2017-01-01

    Aims: The prevalence of atrial fibrillation (AF) has increased over the past years due to aging of the population, and healthcare costs associated with AF reflect a significant financial burden. The aim of this study was to explore predictors for the real-world AF-related in-hospital costs in

  1. An evaluation of the total quality management implementation strategy for the advanced solid rocket motor project at NASA's Marshall Space Flight Center. M.S. Thesis - Tennessee Univ.

    Science.gov (United States)

    Schramm, Harry F.; Sullivan, Kenneth W.

    1991-01-01

    An evaluation of the NASA's Marshall Space Flight Center (MSFC) strategy to implement Total Quality Management (TQM) in the Advanced Solid Rocket Motor (ASRM) Project is presented. The evaluation of the implementation strategy reflected the Civil Service personnel perspective at the project level. The external and internal environments at MSFC were analyzed for their effects on the ASRM TQM strategy. Organizational forms, cultures, management systems, problem solving techniques, and training were assessed for their influence on the implementation strategy. The influence of ASRM's effort was assessed relative to its impact on mature projects as well as future projects at MSFC.

  2. Ranking hospitals for outcomes in total hip replacement - administrative data with or without patient surveys? - Part 2: Patient survey and administrative data

    Directory of Open Access Journals (Sweden)

    Schäfer, Thomas

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part II of the publication, we present the results of the approach based on administrative and patient-derived data. Methods: We used administrative data from a large health insurance (AOK-Lower Saxony of the year 2002 and from a patient survey. The study population comprised mainly beneficiaries, who received primary total hip replacement in the year 2002, were mailed a survey 6 month post-operatively and participated in the survey. Performance indicators used where “Revision”, “Complications” and “Change of functional impairment”. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries. Multivariate modelling (logistic regression and generalized linear models was used to estimate the performance indicators by case-mix variables (a.o. age, sex, co-morbidity, medical history and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or Standardized Difference (SDR with respect to a pre-selected reference hospital. The resulting rankings were compared with each other and with regard to the impact of case-mix variables. Results: 4089 beneficiaries received primary total hip replacement in 2002. 3293 patients participated in the survey (80.5%. The ranking included 60 hospitals. The agreement of rankings based on different performance indicators in the same year was low to high (a correlation

  3. Effect of modulation of the particle size distributions in the direct solid analysis by total-reflection X-ray fluorescence

    Science.gov (United States)

    Fernández-Ruiz, Ramón; Friedrich K., E. Josue; Redrejo, M. J.

    2018-02-01

    The main goal of this work was to investigate, in a systematic way, the influence of the controlled modulation of the particle size distribution of a representative solid sample with respect to the more relevant analytical parameters of the Direct Solid Analysis (DSA) by Total-reflection X-Ray Fluorescence (TXRF) quantitative method. In particular, accuracy, uncertainty, linearity and detection limits were correlated with the main parameters of their size distributions for the following elements; Al, Si, P, S, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Rb, Sr, Ba and Pb. In all cases strong correlations were finded. The main conclusion of this work can be resumed as follows; the modulation of particles shape to lower average sizes next to a minimization of the width of particle size distributions, produce a strong increment of accuracy, minimization of uncertainties and limit of detections for DSA-TXRF methodology. These achievements allow the future use of the DSA-TXRF analytical methodology for development of ISO norms and standardized protocols for the direct analysis of solids by mean of TXRF.

  4. Estimating solid waste generation by hospitality industry during major festivals: A quantification model based on multiple regression.

    Science.gov (United States)

    Abdulredha, Muhammad; Al Khaddar, Rafid; Jordan, David; Kot, Patryk; Abdulridha, Ali; Hashim, Khalid

    2018-04-26

    Major-religious festivals hosted in the city of Kerbala, Iraq, annually generate large quantities of Municipal Solid Waste (MSW) which negatively impacts the environment and human health when poorly managed. The hospitality sector, specifically hotels, is one of the major sources of MSW generated during these festivals. Because it is essential to establish a proper waste management system for such festivals, accurate information regarding MSW generation is required. This study therefore investigated the rate of production of MSW from hotels in Kerbala during major festivals. A field questionnaire survey was conducted with 150 hotels during the Arba'een festival, one of the largest festivals in the world, attended by about 18 million participants, to identify how much MSW is produced and what features of hotels impact on this. Hotel managers responded to questions regarding features of the hotel such as size (Hs), expenditure (Hex), area (Ha) and number of staff (Hst). An on-site audit was also carried out with all participating hotels to estimate the mass of MSW generated from these hotels. The results indicate that MSW produced by hotels varies widely. In general, it was found that each hotel guest produces an estimated 0.89 kg of MSW per day. However, this figure varies according to the hotels' rating. Average rates of MSW production from one and four star hotels were 0.83 and 1.22 kg per guest per day, respectively. Statistically, it was found that the relationship between MSW production and hotel features can be modelled with an R 2 of 0.799, where the influence of hotel feature on MSW production followed the order Hs > Hex > Hst. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. The impact of total quality service (TQS) on healthcare and patient satisfaction: an empirical study of Turkish private and public hospitals.

    Science.gov (United States)

    Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu

    2014-01-01

    This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Hospital Discharge Information After Elective Total hip or knee Joint Replacement Surgery: A clinical Audit of preferences among general practitioners

    Directory of Open Access Journals (Sweden)

    Andrew M Briggs

    2012-05-01

    Full Text Available AbstractThe demand for elective joint replacement (EJR surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale. Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate. All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%. GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff

  7. A novel solid phase extraction procedure on Amberlite XAD-1180 for speciation of Cr(III), Cr(VI) and total chromium in environmental and pharmaceutical samples

    International Nuclear Information System (INIS)

    Narin, Ibrahim; Kars, Ayse; Soylak, Mustafa

    2008-01-01

    Due to the toxicity of chromium, species depend on their chemical properties and bioavailabilities, speciation of chromium is very important in environmental samples. A speciation procedure for chromium(III), chromium(VI) and total chromium in environmental samples is presented in this work, prior to flame atomic absorption spectrometric determination of chromium. The procedure is based on the adsorption of Cr(III)-diphenylcarbazone complex on Amberlite XAD-1180 resin. After oxidation of Cr(III), the developed solid phase extraction system was applied to determinate the total chromium. Cr(III) was calculated as the difference between the total Cr content and the Cr(VI) content. The analytical conditions for the quantitative recoveries of Cr(VI) on Amberlite XAD-1180 resin were investigated. The effects of some alkaline, earth alkaline, metal ions and also some anions were also examined. Preconcentration factor was found to be 75. The detection limits (LOD) based on three times sigma of the blank (N: 21) for Cr(VI) and total chromium were 7.7 and 8.6 μg/L, respectively. Satisfactory results for the analysis of total chromium in the stream sediment (GBW7310) certified reference material for the validation of the presented method was obtained. The procedure was applied to food, water and pharmaceutical samples successfully

  8. Remote sensing and water quality indicators in the Korean West coast: Spatio-temporal structures of MODIS-derived chlorophyll-a and total suspended solids.

    Science.gov (United States)

    Kim, Hae-Cheol; Son, Seunghyun; Kim, Yong Hoon; Khim, Jong Seong; Nam, Jungho; Chang, Won Keun; Lee, Jung-Ho; Lee, Chang-Hee; Ryu, Jongseong

    2017-08-15

    The Yellow Sea is a shallow marginal sea with a large tidal range. In this study, ten areas located along the western coast of the Korean Peninsula are investigated with respect to remotely sensed water quality indicators derived from NASA MODIS aboard of the satellite Aqua. We found that there was a strong seasonal trend with spatial heterogeneity. In specific, a strong six-month phase-lag was found between chlorophyll-a and total suspended solid owing to their inversed seasonality, which could be explained by different dynamics and environmental settings. Chlorophyll-a concentration seemed to be dominantly influenced by temperature, while total suspended solid was largely governed by local tidal forcing and bottom topography. This study demonstrated the potential and applicability of satellite products in coastal management, and highlighted find that remote-sensing would be a promising tool in resolving orthogonality of large spatio-temporal scale variabilities when combining with proper time series analyses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Particle size distribution and total solids suspension in samples monitoring of capturing water for optimization of water injection filtration system; Monitoramento da quantidade de particulas e do total de solidos em suspensao em amostras de agua de captacao

    Energy Technology Data Exchange (ETDEWEB)

    Ramalhao, Adriano Gorga; Seno, Carlos Eduardo; Ribeiro, Alice [3M do Brasil, Sumare, SP (Brazil)

    2008-07-01

    There is a wide variation in the amount of particulate material in sea water by a great number of reasons. The most well-known contaminant is the organic material derived from seaweed or fish spawning causing seasonally sensitive variations in the water quality treated and injected for enhance oil recovery. This paper presents the results of one year the water monitoring form water sampled at 30 meters deep in the Roncador field, which is located 125 km from the coast with a depth of 1290 meters. It was observed the water seasonal variation with peaks in summer and winter. The monitoring was done through particle counting and distribution analysis and total solids in suspension. It was noted that even in peak with largest amount of particles and greater quantity of solid in suspension the particles had remained concentrated in the range bellow 25 {mu}m. For that reason the life of final filter elements may vary and pre-filters are many times ineffective and sometimes even bypassed due to frequent clogging and not to do the protecting job of the final filter. (author)

  10. CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Asan Medical Center, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Park, Chang Min; Song, Yong Sub; Kim, Hyungjin; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Seoul National University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Park, Young Sik [Seoul National University Hospital, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of)

    2017-12-15

    To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. (orig.)

  11. CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

    International Nuclear Information System (INIS)

    Lee, Sang Min; Park, Chang Min; Song, Yong Sub; Kim, Hyungjin; Goo, Jin Mo; Kim, Young Tae; Park, Young Sik

    2017-01-01

    To retrospectively evaluate the feasibility of CT assessment-based direct surgical resection of part-solid nodules (PSNs) with solid components > 5 mm without preoperative percutaneous transthoracic needle biopsies (PTNBs). From January 2009-December 2014, 85 PSNs with solid components > 5 mm on CT were included. Preoperative PTNBs were performed for 41 PSNs (biopsy group) and CT assessment-based direct resections were performed for 44 PSNs (direct surgery group). Diagnostic accuracy and complication rates of the groups were compared. Pathological results of 83 PSNs excluding two indeterminate nodules included 76 adenocarcinomas (91.6%), two adenocarcinomas in situ (2.4%) and five benign lesions (6.0%). In the biopsy group, the overall sensitivity, specificity and accuracy for the diagnosis of adenocarcinoma were 78.9% (30/38), 100% (1/1) and 79.5% (31/39), respectively. Pneumothorax and haemoptysis occurred in 11 procedures (26.8%). In the direct surgery group, the respective values for the diagnosis of adenocarcinoma were 100% (38/38), 0% (0/6) and 86.4% (38/44), respectively. Seven pneumothoraces (15.9%); no haemoptysis occurred during localization procedures. There were no significant differences in diagnostic accuracy (P = 0.559) between the two groups. CT assessment-based direct resection can be reasonable for PSNs with solid part > 5 mm. (orig.)

  12. PENDUGAAN UMUR SIMPAN JAGUNG MANIS BERDASARKAN KANDUNGAN TOTAL PADATAN TERLARUT DENGAN MODEL ARRHENIUS (Shelf Life Estimation of Sweet Corn Based on Its Total Soluble Solid by Using Arrhenius Model

    Directory of Open Access Journals (Sweden)

    Rita Khatir

    2015-09-01

    Full Text Available Sweet corn has short shelf life at room temperature storage in the tropical countries (28-33°C. The quality deterioration of sweet corn can be determined by the decrease of its sugar content. The study aimed to estimate the shelf life of sweet corn based on the reduction of its total soluble solid (TSS by using Arrhenius model. The samples were prepared from fresh harvested corn stored for 10 days at 3 different temperatures of 5, 15 and 28 °C. Total soluble solid (TSS were analyzed every day by using abbe refractrometer. Organoleptic analysis was used by using hedonic scales from 1 to 7. The analysis was conducted until respondents had graded the samples at score 5 (dislike slightly, 6 (dislike and approaches can be used to calculate the shelf life of sweet corn. The acceleration factor for the TSS degradation at null approach, it was estimated that if the sweet corn were stored at temperature of 30, 25, 20, 15, 10 and 5°C, the shelf temperatures, the shelf life of sweet corn would be 3.7, 4.5, 5.6, 6.8, 8.4, and 10.3 days. In conclusion, the shelf life predictions of sweet corn were valid well with the experimental results. Keywords: Sweet corn, shelf life, total soluble solid   ABSTRAK Umur simpan jagung manis relatif singkat apalagi kalau disimpan pada suhu ruang di negara-negara tropis (28-32°C. Kerusakan jagung manis dapat diindikasikan dengan penurunan kandungan gulanya. Penelitian ini bertujuan untuk menduga umur simpan jagung manis berdasarkan reaksi penurunan kandungan total padatan terlarutnya (TPT dengan pendekatan model Arrhenius. Jagung manis segar yang baru siap panen segera disimpan selama 10 hari pada 3 kombinasi suhu yaitu 5, 15 dan 28°C. Setiap hari dilakukan analisis kandungan TPT dengan . Uji organoleptik dilakukan dengan skala hedonik 1-7. Proses pengamatan dihentikan apabila responden telah memberikan nilai 5 (agak tidak suka, 6 (tidak suka dan 7 (sangat tidak suka. Pendekatan model Arrhenius dilakukan dengan dua

  13. Ten-Year Trends and Independent Risk Factors for Unplanned Readmission Following Elective Total Joint Arthroplasty at a Large Urban Academic Hospital.

    Science.gov (United States)

    Varacallo, Matthew A; Herzog, Leah; Toossi, Nader; Johanson, Norman A

    2017-06-01

    Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013. In total, 1165 primary total hip (511) and knee (654) arthroplasty procedures were identified, and the 30-day and 90-day unplanned readmission rates were 4.6% and 7.3%, respectively. A multivariate regression model controlled for a variety of potential clinical and surgical confounders. Increasing body mass index levels, an American Society of Anesthesiologists score of ≥3, and discharge to an inpatient rehab facility each independently correlated with risk of both 30-day and 90-day unplanned readmission to our institution. Additionally, use of general anesthesia during the procedure independently correlated with risk of readmission at 30 days only, while congestive heart failure independently correlated with risk of 90-day unplanned readmission. Readmissions related directly to the surgical site accounted for 47% of the cases, and collectively totaled more than any single medical or clinical complication leading to unplanned readmission within the 90-day period. Increasing body mass index values, general anesthesia, an American Society of Anesthesiologists score of ≥3, and discharge to an inpatient rehab facility each were independent risk factors for early unplanned readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Study of Attitude staff in the Field of Total Quality Management by using Fuzzy Logic, Case Study in Teaching Hospitals in Yazd

    Directory of Open Access Journals (Sweden)

    M ArabBanadaki

    2016-03-01

    Full Text Available Introduction: In Total Quality Management, Quality is not only an admirable phenomenon but also is a customer inalienable right and will be created through the involvement and participation of all employees, managers and customers of an organization. This study was designed to evaluate staff attitudes in teaching hospitals of Yazd in the field of Total Quality Management by using fuzzy logic. Methods: This was a descriptive, analytical, cross – sectional study. Research population, were all staff in teaching hospitals of Yazd that among them 235 people were randomly Stratified, selected and studied. Data for this study were collected through a questionnaire. Since the theory of fuzzy is more suitable approach for measuring linguistic variables, so this paper determines the attitude of staff in the field of Quality Management by the use of fuzzy logic. Results: Results showed that the dimensions of the “Identification and training of staff," "empowerment and teamwork of Employees" and "support and leadership of the top management organization" respectively ranked first, second and third importance In terms of staff. Conclusion: Criteria of identification and training of staff and teamwork and support and leadership of the top management organization are Important in motivating Total Quality Management. So in total quality management improve programs, these aspects should be prioritized according to the degree of importance and effort to improve the quality of service.

  15. Trend overtime of total haemoglobin, iron metabolism and trace minerals in veal calves fed high amounts of two different solid feeds

    Directory of Open Access Journals (Sweden)

    Anna-Lisa Stefani

    2010-01-01

    Full Text Available Fifty Polish Friesian veal calves were administrated high amounts of two different solid feeds (maize grain and a mix diet containing 10% of straw and 8% of soy in addition to the traditional milk replacer diet. Compared to the mix diet, maize grain had a lower content of iron, copper and zinc and a minor fibre level. Effects of the two diets on calves’ blood haemoglobin, iron, iron metabolism parameters, copper and zinc concentrations were studied. Haemoglobin concentration resulted higher at the end of the fattening for calves fed the mix diet, as expected. Values remained, however, within ranges that allowed acceptable carcass paleness. Haematic iron, unsaturated iron binding capacity (UIBC and total iron binding capacity (TIBC levels were not significantly different between the two solid feeds. Lower copper and zinc blood concentrations resulted for calves fed the mix diet were likely due to the feed fibre interfering with the bioavailability of the two minerals, according to what happens for iron.

  16. Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Tom Schaal

    Full Text Available The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction.A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model.The bivariate analysis showed a strong association between satisfaction and sex (male or female, the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met.The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

  17. Home Discharge and Out-of-Hospital Follow-Up of Total Artificial Heart Patients Supported by a Portable Driver System

    Science.gov (United States)

    2014-01-01

    To enhance ambulation and facilitate hospital discharge of total artificial heart (TAH)–supported patients, we adapted a mobile ventricular assistance device (VAD) driver (Excor) for TAH use and report on the performance of Excor-driven TAH patients discharged home. Ten patients stabilized on a TAH, driven by the CSS (“Circulatory Support System”), were progressively switched over to the Excor in hospital over 14 days as a pilot, with daily hemodynamics and laboratory parameters measured. Twenty-two stable TAH patients were subsequently placed on the Excor, trained, and discharged home. Clinical and hemodynamic parameters were followed. All pilot study patients were clinically stable on the Excor, with no decrease in TAH output noted (6.3 + 0.3 L/min [day 1] vs. 5.8 + 0.2 L/min [day 14], p = 0.174), with a trend suggesting improvement of both hepatic and renal function. Twenty-two TAH patients were subsequently successfully discharged home on the portable driver and were supported out of hospital for up to 598 days (range, 2–598; mean = 179 ± 140 days), remaining ambulatory, New York Heart Association (NYHA) class I or II, and free of readmission for 88.5% of the time of support. TAH patients may be effectively and safely supported by a mobile drive system. As such, the utility of the TAH may be extended to support patients beyond the hospital, at home, with overall ambulatory freedom. PMID:24577369

  18. Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

    Science.gov (United States)

    Schaal, Tom; Schoenfelder, Tonio; Klewer, Joerg; Kugler, Joachim

    2017-01-01

    The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

  19. Total gaseous mercury and volatile organic compounds measurements at five municipal solid waste disposal sites surrounding the Mexico City Metropolitan Area

    Science.gov (United States)

    de la Rosa, D. A.; Velasco, A.; Rosas, A.; Volke-Sepúlveda, T.

    The daily municipal solid waste (MSW) generation in the Mexico City Metropolitan Area (MCMA) is the highest nationwide (˜26000 ton day -1); this amount is discarded in sanitary landfills and controlled dumps. Information about the type and concentration of potential pollutants contained in landfill gas (LFG) from these MSW disposal sites is limited. This study intends to generate information about the composition of LFG from five MSW disposal sites with different operational characteristics and stages, in order to identify their contribution as potential pollutant sources of total gaseous mercury (TGM) and volatile organic compounds (VOCs). Important methane (CH 4) contents (>55%) in LFG were registered at three of the five sites, while two sites were found in semi-aerobic conditions (CH 4clay cover. High values of the TGM air/LFG ratio were also related to external TGM sources of influence, as a landfill in operation stage located at a highly industrialized area.

  20. Optimization of total vaporization solid-phase microextraction (TV-SPME) for the determination of lipid profiles of Phormia regina, a forensically important blow fly species.

    Science.gov (United States)

    Kranz, William; Carroll, Clinton; Dixon, Darren; Picard, Christine; Goodpaster, John

    2017-11-01

    A new method has been developed for the determination of fatty acids, sterols, and other lipids which naturally occur within pupae of the blow fly Phormia regina. The method relies upon liquid extraction in non-polar solvent, followed by derivatization using N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA) w/ 1% trimethylchlorsilane (TMCS) carried out inside the sample vial. The analysis is facilitated by total vaporization solid-phase microextraction (TV-SPME), with gas chromatography-mass spectrometry (GC-MS) serving as the instrumentation for analysis. The TV-SPME delivery technique is approximately a factor of five more sensitive than traditional liquid injection, which may alleviate the need for rotary evaporation, reconstitution, collection of high performance liquid chromatography fractions, and many of the other pre-concentration steps that are commonplace in the current literature. Furthermore, the ability to derivatize the liquid extract in a single easy step while increasing sensitivity represents an improvement over current derivatization methods. The most common lipids identified in fly pupae were various saturated and unsaturated fatty acids ranging from lauric acid (12:0) to arachinoic acid (20:4), as well as cholesterol. The concentrations of myristic acid (14:0), palmitelaidic acid (16:2), and palmitoleic acid (16:1) were the most reliable indicators of the age of the pupae. Graphical abstract Blow fly pupae were extracted prior to emerging as adults. The extracts were analyzed via total vaporization solid-phase microextraction (TV-SPME), revealing a complex mixture of lipids that could be associated with the age of the insect. This information may assist in determining a post-mortum interval (PMI) in a death investigation.

  1. Significance analysis of the leachate level in a solid waste landfill in a coastal zone using total water balance and slope stability alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Ja-Kong; Do, Nam-Young [Korea Advanced Institute of Science & Technology, Taejon (Korea, Republic of)

    1996-12-31

    The K site near Seoul began landfilling in 1992. The landfilled wastes include municipal solid waste (66.4%), construction residues (20.4%), water and wastewater sludges (trace levels), and hazardous waste (trace levels). The water content of the municipal solid waste is very high (47.3%); as a result, the leachate level (average E.L.) of the landfill, the design value of which is 7.0 m, was measured at 10.3 m in January 1995 and is increasing. The increase of leachate level in the landfill site causes a problem with slope stability. The leachate level at each disposal stage divided by the intermediate cover layer was calculated with the HELP (Hydrologic Evaluation of Landfill Performance) model and calibrated with the data measured from February 1993 to June 1995. Also, the hydraulic conductivities of the waste layer and the intermediate cover layer in each stage were calibrated continuously with HELP model analysis. To verify these results, the total water balance in the landfill site was calculated using the infiltration rate calculated from HELP modeling. The leachate level was E.L. 10.0 m, which was close to the measured leachate level. To estimate the change of the leachate level in the future, the total water balances with different leachate discharge rates of 3,000, 3,500, and 5,000 m{sup 3}/day were analyzed. When the leachate discharge rate was 5,000 ton/day and the initial water content was decreased below 25%, the average leachate level was 10.8 m. This result satisfies the safety factor requirements (=1.3) for landfill slope stability. 4 refs., 8 figs., 1 tab.

  2. Optimization of methane production in anaerobic co-digestion of poultry litter and wheat straw at different percentages of total solid and volatile solid using a developed response surface model.

    Science.gov (United States)

    Shen, Jiacheng; Zhu, Jun

    2016-01-01

    Poultry litter (PL) can be good feedstock for biogas production using anaerobic digestion. In this study, methane production from batch co-digestion of PL and wheat straw (WS) was investigated for two factors, i.e., total solid (2%, 5%, and 10%) and volatile solid (0, 25, and 50% of WS), constituting a 3 × 3 experimental design. The results showed that the maximum specific methane volume [197 mL (g VS)(‑1)] was achieved at 50% VS from WS at 5% TS level. It was estimated that the inhibitory threshold of free ammonia was about 289 mg L(--1), beyond which reduction of methanogenic activity by at least 54% was observed. The specific methane volume and COD removal can be expressed using two response surface models (R(2) = 0.9570 and 0.9704, respectively). Analysis of variance of the experimental results indicated that the C/N ratio was the most significant factor influencing the specific methane volume and COD removal in the co-digestion of these two materials.

  3. Evaluation of apoptosis and micronucleation induced by reactor neutron beams with two different cadmium ratios in total and quiescent cell populations within solid tumors

    International Nuclear Information System (INIS)

    Masunaga, Shin-ichiro; Ono, Koji; Sakurai, Yoshinori; Takagaki, Masao; Kobayashi, Tooru; Kinashi, Yuko; Suzuki, Minoru

    2001-01-01

    Purpose: Response of quiescent (Q) and total tumor cells in solid tumors to reactor neutron beam irradiation with two different cadmium (Cd) ratios was examined in terms of micronucleus (MN) frequency and apoptosis frequency, using four different tumor cell lines. Methods and Materials: C57BL mice bearing EL4 tumors, C3H/He mice bearing SCC VII or FM3A tumors, and Balb/c mice bearing EMT6/KU tumors received 5-bromo-2'-deoxyuridine (BrdU) continuously for 5 days via implanted mini-osmotic pumps to label all proliferating (P) cells. Thirty min after i.p. injection of sodium borocaptate- 10 B (BSH), or 3 h after oral administration of p-boronophenylalanine- 10 B (BPA), the tumors were irradiated with neutron beams. The tumors without 10 B-compound administration were irradiated with neutron beams or γ-rays. This neutron beam irradiation was performed using neutrons with two different Cd ratios. The tumors were then excised, minced, and trypsinized. The tumor cell suspensions thus obtained were incubated with cytochalasin-B (a cytokinesis blocker), and the MN frequency in cells without BrdU labeling (=Q cells) was determined using immunofluorescence staining for BrdU. Meanwhile, for apoptosis assay, 6 h after irradiation, tumor cell suspensions obtained in the same manner were fixed, and the apoptosis frequency in Q cells was also determined with immunofluorescence staining for BrdU. The MN and apoptosis frequencies in total (P+Q) tumor cells were determined from the tumors that were not pretreated with BrdU. Results: Without 10 B-compounds, the sensitivity difference between total and Q cells was reduced by neutron beam irradiation. Under our particular neutron beam irradiation condition, relative biological effectiveness (RBE) of neutrons was larger in Q cells than in total cells, and the RBE values were larger for low Cd-ratio than high Cd-ratio neutrons. With 10 B-compounds, both frequencies were increased for each cell population, especially for total cells. BPA

  4. Physical aspects of total-body irradiation at the Middlesex Hospital (UCL group of hospitals), London 1988 - 1993: II. In vivo planning and dosimetry

    Science.gov (United States)

    Planskoy, B.; Tapper, P. D.; Bedford, A. M.; Davis, F. M.

    1996-11-01

    Part II of this paper gives the results of applying the TBI methods described in part I, to in vivo patient planning and dosimetry. Patients are planned on nine CT based body slices, five of which pass through the lungs. Planned doses are verified with ten silicon diodes applied bi-laterally to five body sites, at each treatment. LiF TLDs are applied to seven other body sites at the first treatment only. For 84 patients and at least 1016 measurements per body site with the diodes, the mean measured total doses agreed with planned doses within at most 2% except at lung levels, where the mean measured dose was 3% too low. Standard deviations of the measurements about the mean were between 2.4 and 3.1%. For the LiF TLDs, the mean measured doses for all seven body sites were within of planned doses. A separate assessment of measured entrance and transmitted doses showed that the former agreed well with planned doses, but that the latter tended to be low, especially over the lungs, and that they had a wider dispersion. Possible reasons for this are discussed. These results show measurement uncertainties similar to those for non-TBI treatments of Nilsson et al, Leunens et al and Essers et al. An analysis of the treatment plans showed a mean dose inhomogeneity in the body (75 patients, nine slices) of (1 s.d.) and in the lungs (40 patients, five slices) of (1 s.d.). The conclusions are that, overall, the methods are reasonably satisfactory but that, with an extra effort, even closer agreement between measured and planned doses and a further limited reduction in the body dose inhomogeneity could be obtained. However, if it were thought desirable to make a substantial reduction in the dose inhomogeneity in the body and lungs, this could only be achieved with the available equipment by changing from lateral to anterior - posterior irradiation and any potential advantages of this change would have to be balanced against a likely deterioration in patient comfort and an

  5. Total anomalous pulmonary venous connection in a 9-year-old girl at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

    Directory of Open Access Journals (Sweden)

    Usman Muhammad Sani

    2016-01-01

    Full Text Available Total anomalous pulmonary venous connection (TAPVC is a rare cyanotic congenital heart disease in which all the four pulmonary veins drain into the right atrium instead of the left. Without surgical intervention, 80% of the patients die before the age of 1 year. We report a 9-year-old girl with unrepaired supracardiac TAPVC complicated by severe pulmonary artery hypertension. The patient was managed conservatively including the use of pulmonary antihypertensive (sildenafil, with significant improvement. She is currently on follow-up at our pediatric cardiology clinic. TAPVC requires surgical intervention in early infancy to prevent the onset of pulmonary hypertension, which may contraindicate surgery. High index of suspicion and improved diagnostic skill will enhance early diagnosis and enable timely intervention.

  6. Influences of chia flour and the concentration of total solids on the characteristics of ‘dulce de leche’ from goat milk

    Directory of Open Access Journals (Sweden)

    Marcia Alves CHAVES

    2018-03-01

    Full Text Available Abstract A factorial categorical design totalling six treatments was applied to investigate the influence of the substitution of corn starch with whole and partially defatted chia flour under the technical characteristics (centesimal composition, instrumental analyses, and sensory evaluation and nutritional disorders (composition of fatty acids and index of the nutritional quality of the lipid fraction of ‘dulce de leche’ concentrated to 72 and 78 °B. The treatments with chia flour concentrated to 72 °B showed higher moisture content and lower compression force, and when the concentration range increased to 78 °B, the levels of total lipids amounted up to 1.40 times when compared to treatment with corn starch. The polyunsaturated fatty acids, particularly omega-3 and omega-6 levels, were higher in treatments with chia flour on both tracks of concentration, allowing a reduction in the atherogenic index and thrombogenic index effects and the n-6/n-3 ratio. The treatments of ‘dulce de leche’ with a lower concentration of soluble solids obtained greater acceptance and consumer purchase intention. The application of whole chia flour in small proportions and in the concentration of 72 °B was the most appropriate under the studied conditions, showing improvement in the nutritional quality and with good technical aspects of candy made with goat milk.

  7. Single-objective vs. multi-objective autocalibration in modelling total suspended solids and phosphorus in a small agricultural watershed with SWAT.

    Science.gov (United States)

    Rasolomanana, Santatriniaina Denise; Lessard, Paul; Vanrolleghem, Peter A

    2012-01-01

    To obtain greater precision in modelling small agricultural watersheds, a shorter simulation time step is beneficial. A daily time step better represents the dynamics of pollutants in the river and provides more realistic simulation results. However, with a daily evaluation performance, good fits are rarely obtained. With the Shuffled Complex Evolution (SCE) method embedded in the Soil and Water Assessment Tool (SWAT), two calibration approaches are available, single-objective or multi-objective optimization. The goal of the present study is to evaluate which approach can improve the daily performance with SWAT, in modelling flow (Q), total suspended solids (TSS) and total phosphorus (TP). The influence of weights assigned to the different variables included in the objective function has also been tested. The results showed that: (i) the model performance depends not only on the choice of calibration approach, but essentially on the influential parameters; (ii) the multi-objective calibration estimating at once all parameters related to all measured variables is the best approach to model Q, TSS and TP; (iii) changing weights does not improve model performance; and (iv) with a single-objective optimization, an excellent water quality modelling performance may hide a loss of performance of predicting flows and unbalanced internal model components.

  8. A sensitive method for determining total vanadium in water samples using colorimetric-solid-phase extraction-fiber optic reflectance spectroscopy

    International Nuclear Information System (INIS)

    Filik, Hayati; Yanaz, Zeynep

    2009-01-01

    A selective colorimetric-solid-phase extraction (C-SPE) method for the determination of total vanadium in water samples was developed. This method introduced a new variation of C-SPE. The colour reaction is based on the reaction of vanadium(V) ternary complex formed with 1-(2-Pyridylazo)-2-naphtol (PAN) in the presence hydrogen peroxide (H 2 O 2 ). In this technique, the target analytes in samples are extracted onto solid matrix loaded with a colorimetric reagent and then quantified directly on the adsorbent surface by using a miniature fiber optic reflectance spectrometer. The measurements were carried out at a wavelength of 589.4 nm since it yielded the largest divergence different in reflectance spectra before and after reaction with the vanadium. The overall time required for the C-SPE procedure was ∼20 min. The amount of concentrated V is then determined in a few seconds by using miniature reflectance spectrometer. At the optimal conditions, a calibration curve was constructed, revealing a linear range of 0.05-0.52 mg L -1 and a detection limit as low as 0.01 mg L -1 while the RSD lower than 2.8%. In order to verify the accuracy of the method, a certified reference water samples (TMDA) were analysed and the results obtained were in good agreement with the certified values. The proposed method was applied to the determination of vanadium in tap water, seawater samples with a recovery for the spiked samples in the range of 98-102%.

  9. Patient-Specific CT-Based Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty: A Prospective Randomized Controlled Study on Clinical Outcomes and In-Hospital Data

    Directory of Open Access Journals (Sweden)

    Andrzej Kotela

    2015-01-01

    Full Text Available Total knee arthroplasty (TKA is a frequently performed procedure in orthopaedic surgery. Recently, patient-specific instrumentation was introduced to facilitate correct positioning of implants. The aim of this study was to compare the early clinical results of TKA performed with patient-specific CT-based instrumentation and conventional technique. A prospective, randomized controlled trial on 112 patients was performed between January 2011 and December 2011. A group of 112 patients who met the inclusion and exclusion criteria were enrolled in this study and randomly assigned to an experimental or control group. The experimental group comprised 52 patients who received the Signature CT-based implant positioning system, and the control group consisted of 60 patients with conventional instrumentation. Clinical outcomes were evaluated with the KSS scale, WOMAC scale, and VAS scales to assess knee pain severity and patient satisfaction with the surgery. Specified in-hospital data were recorded. Patients were followed up for 12 months. At one year after surgery, there were no statistically significant differences between groups with respect to clinical outcomes and in-hospital data, including operative time, blood loss, hospital length of stay, intraoperative observations, and postoperative complications. Further high-quality investigations of various patient-specific systems and longer follow-up may be helpful in assessing their utility for TKA.

  10. Economic analysis of two-stage septic revision after total hip arthroplasty: What are the relevant costs for the hospital's orthopedic department?

    Science.gov (United States)

    Kasch, R; Assmann, G; Merk, S; Barz, T; Melloh, M; Hofer, A; Merk, H; Flessa, S

    2016-03-01

    The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown. It is widely assumed that septic THA procedures can only be performed at a loss for the department. Therefore, the purpose of this study was to investigate whether this assumption is true by performing a detailed analysis of the costs and revenues for two-stage septic THA revision. Patients who underwent revision THA for septic loosening in two sessions from January 2009 through March 2012 were included in this retrospective, consecutive cost study from the orthopedic department's point of view. We analyzed variable and case-fixed costs for septic revision THA with special regard to implantation and explantation stay. By using marginal costing approach we neglected hospital-fixed costs. Outcome measures include reimbursement and daily contribution margins. The average direct costs (reimbursement) incurred for septic two-stage revision THA was €10,828 (€24,201). The difference in cost and contribution margins per day was significant (p cost for septic revision THA performed in two sessions. Disregarding hospital-fixed costs the included variable and case fixed-costs were covered by revenues. This study provides cost data, which will be guidance for health care decision makers.

  11. Alternatives of Treatment and Final Disposition of the Solid Hospital residuals; Alternativas de Tratamiento y Disposicion Final de los Residuos Solidos Hospitalarios

    Energy Technology Data Exchange (ETDEWEB)

    Meza Monge, K

    1998-07-01

    The current handling, treatment and final disposition of the hospital solid waste in Costa Rica are considered inadequate or at least insufficient. This situation represents a serious danger for the population's health and the environment, because they are exposed to infectious agents, toxic substances and even radioactive products that are generated among the residuals of the centers of health. This work, alternatives propose for the treatment and adequate final disposition of the solid waste produced in the hospitals of the country. They take into consideration the characteristics that present these residuals, the advantages and disadvantages of each one of the existent techniques and the technical and economic possibilities of the country. For this purpose, in first instance, a revision about the properties, the quality and the quantity of the solid waste produced by the national hospital centers was carried out. Also, a diagnostic of the current situation of the treatment and final disposition of these residuals in some of the most important hospitals of the country, as well as of the possibilities of physical space with that they count on was carried out. Then, the existent different treatment techniques and final disposition for the solid waste that comes from the centers of health are described, as well as their advantages and disadvantages and a comparative analysis of the same ones is carried out. The objective is completed, since alternatives of treatment and final disposition that are considered appropriate for this type of residuals are planned. Nevertheless, in the future, more detailed investigations and studies of feasibility, with the purpose of developing handling programs and elimination of the solid waste for each one of the hospital centers in Costa Rica should be carried out. (Author) [Spanish] El actual manejo, tratamiento y disposicion final de los desechos solidos hospitalarios en Costa Rica se considera inadecuado o cuando menos

  12. Total phenolic contents, antioxidant activities, and lipid fractions from berry pomaces obtained by solid-state fermentation of two Sambucus species with Aspergillus niger.

    Science.gov (United States)

    Dulf, Francisc Vasile; Vodnar, Dan Cristian; Dulf, Eva-Henrietta; Toşa, Monica Ioana

    2015-04-08

    The aim of this study was to investigate the effect of solid-state fermentation (SSF) by Aspergillus niger on phenolic contents and antioxidant activity in Sambucus nigra L. and Sambucus ebulus L. berry pomaces. The effect of fermentation time on the total fats and major lipid classes (neutral and polar) was also investigated. During the SSF, the extractable phenolics increased with 18.82% for S. ebulus L. and 11.11% for S. nigra L. The levels of antioxidant activity of methanolic extracts were also significantly enhanced. The HPLC-MS analysis indicated that the cyanidin 3-sambubioside-5-glucoside is the major phenolic compound in both fermented Sambucus fruit residues. In the early stages of fungal growth, the extracted oils (with TAGs as major lipid fraction) increased with 12% for S. nigra L. and 10.50% for S. ebulus L. The GC-MS analysis showed that the SSF resulted in a slight increase of the linoleic and oleic acids level.

  13. Effect of total solid content and pretreatment on the production of lactic acid from mixed culture dark fermentation of food waste.

    Science.gov (United States)

    Yousuf, Ahasa; Bastidas-Oyanedel, Juan-Rodrigo; Schmidt, Jens Ejbye

    2018-04-28

    Food waste landfilling causes environmental degradation, and this work assesses a sustainable food valorization technique. In this study, food waste is converted into lactic acid in a batch assembly by dark fermentation without pH control and without the addition of external inoculum at 37 °C. The effect of total solid (TS), enzymatic and aeration pretreatment was investigated on liquid products concentration and product yield. The maximum possible TS content was 34% of enzymatic pretreated waste, and showed the highest lactic acid concentration of 52 g/L, with a lactic acid selectivity of 0.6 g lactic /g totalacids . The results indicated that aeration pretreatment does not significantly improve product concentration or yield. Non-pretreated waste in a 29% TS system showed a lactic acid concentration of 31 g/L. The results showed that enzymatic pretreated waste at TS of 34% results in the highest production of lactic acid. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Development of solid lipid nanoparticles containing total flavonoid extract from Dracocephalum moldavica L. and their therapeutic effect against myocardial ischemia-reperfusion injury in rats.

    Science.gov (United States)

    Tan, Mei-E; He, Cheng-Hui; Jiang, Wen; Zeng, Cheng; Yu, Ning; Huang, Wei; Gao, Zhong-Gao; Xing, Jian-Guo

    2017-01-01

    Total flavonoid extract from Dracocephalum moldavica L. (TFDM) contains effective components of D. moldavica L. that have myocardial protective function. However, the cardioprotection function of TFDM is undesirable due to its poor solubility. In order to improve the solubility and efficacy of TFDM, we developed TFDM-loaded solid lipid nanoparticles (TFDM-SLNs) and optimized the formulation of TFDM-SLNs using central composite design and response surface methodology. The physicochemical properties of TFDM-SLNs were characterized, and the pharmacodynamics was investigated using the myocardial ischemia-reperfusion injury model in rats. The nanoparticles of optimal formulation for TFDM-SLNs were spherical in shape with the average particle size of 104.83 nm and had a uniform size distribution with the polydispersity index value of 0.201. TFDM-SLNs also had a negative zeta potential of -28.7 mV to ensure the stability of the TFDM-SLNs emulsion system. The results of pharmacodynamics demonstrated that both TFDM and TFDM-SLN groups afforded myocardial protection, and the protective effect of TFDM-SLNs was significantly superior to that of TFDM alone, based on the infarct area, histopathological examination, cardiac enzyme levels and inflammatory factors in serum. Due to the optimal quality and the better myocardial protective effect, TFDM-SLNs are expected to become a safe and effective nanocarrier for the oral delivery of TFDM.

  15. Surfactant-enhanced spectrofluorimetric determination of total aflatoxins from wheat samples after magnetic solid-phase extraction using modified Fe3O4 nanoparticles

    Science.gov (United States)

    Manafi, Mohammad Hanif; Allahyari, Mehdi; Pourghazi, Kamyar; Amoli-Diva, Mitra; Taherimaslak, Zohreh

    2015-07-01

    The extraction and preconcentration of total aflatoxins (including aflatoxin B1, B2, G1, and G2) using magnetic nanoparticles based solid phase extraction (MSPE) followed by surfactant-enhanced spectrofluorimetric detection was proposed. Ethylene glycol bis-mercaptoacetate modified silica coated Fe3O4 nanoparticles as an efficient antibody-free adsorbent was successfully applied to extract aflatoxins from wheat samples. High surface area and strong magnetization properties of magnetic nanoparticles were utilized to achieve high enrichment factor (97), and satisfactory recoveries (92-105%) using only 100 mg of the adsorbent. Furthermore, the fast separation time (less than 10 min) avoids many time-consuming cartridge loading or column-passing procedures accompany with the conventional SPE. In determination step, signal enhancement was performed by formation of Triton X-100 micelles around the analytes in 15% (v/v) acetonitrile-water which dramatically increase the sensitivity of the method. Main factors affecting the extraction efficiency and signal enhancement of the analytes including pH of sample solution, desorption conditions, extraction time, sample volume, adsorbent amount, surfactant concentration and volume and time of micelle formation were evaluated and optimized. Under the optimum conditions, wide linear range of 0.1-50 ng mL-1 with low detection limit of 0.03 ng mL-1 were obtained. The developed method was successfully applied to the extraction and preconcentration of aflatoxins in three commercially available wheat samples and the results were compared with the official AOAC method.

  16. Remote Sensing and Water Quality Indicators in the West Flood Canal Semarang City: Spatio-temporal Structures of Lansat-8 Derived Chlorophyll-a and Total Suspended Solids

    Science.gov (United States)

    Subiyanto, Sawitri

    2017-12-01

    One of the waters that has been contaminated by industrial waste and domestic waste is the waters of West Flood Canal in Semarang City which is the estuary of the river system, which passes through the Western City of Semarang which is dense with residential and industrial. So, it is necessary to have information about the assessment of water quality in the estuary of the West Flood Canal. Remote sensing technology can analyze the results of recording the spectral characteristics of water with water quality parameters. One of the parameters for assessing water quality is Chlorophyll-a and Total Suspended Solid, can be estimated through remote sensing technology using multispectral Lansat-8 Satellite images data from April, June, and August, 2017 and there are three selected algorithms. Based on the results of TSS and Chlorophyll-A processing, the TSS shows values greater than or equal to 100 which can be said that West Flood Canal is damaged (hypertrophic). While the chlorophyll-a shows a value less than 100 indicating Eutrophic status (threatened). This is caused by the number of suspended materials in the water surface and also because of the disturbance of water vegetation in the form of weeds that destroy the function of the actual West Canal Flood.

  17. Development of solid lipid nanoparticles containing total flavonoid extract from Dracocephalum moldavica L. and their therapeutic effect against myocardial ischemia–reperfusion injury in rats

    Directory of Open Access Journals (Sweden)

    Tan ME

    2017-04-01

    Full Text Available Mei-e Tan,1–3,* Cheng-hui He,3,* Wen Jiang,4 Cheng Zeng,2–4 Ning Yu,3 Wei Huang,2 Zhong-gao Gao,2 Jian-guo Xing3 1Key Laboratory of Xinjiang Endemic Phytomedicine Resources of Ministry of Education, School of Pharmacy, Shihezi University, Shihezi, 2State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Department of Pharmaceutics, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 3Xinjiang Key Laboratory of Uighur Medicines, Xinjiang Institute of Materia Medica, 4Xinjiang Medical University, Urumqi, People’s Republic of China *These authors contributed equally to this work Abstract: Total flavonoid extract from Dracocephalum moldavica L. (TFDM contains effective components of D. moldavica L. that have myocardial protective function. However, the cardioprotection function of TFDM is undesirable due to its poor solubility. In order to improve the solubility and efficacy of TFDM, we developed TFDM-loaded solid lipid nanoparticles (TFDM-SLNs and optimized the formulation of TFDM-SLNs using central composite design and response surface methodology. The physicochemical properties of TFDM-SLNs were characterized, and the pharmacodynamics was investigated using the myocardial ischemia–reperfusion injury model in rats. The nanoparticles of optimal formulation for TFDM-SLNs were spherical in shape with the average particle size of 104.83 nm and had a uniform size distribution with the polydispersity index value of 0.201. TFDM-SLNs also had a negative zeta potential of -28.7 mV to ensure the stability of the TFDM-SLNs emulsion system. The results of pharmacodynamics demonstrated that both TFDM and TFDM-SLN groups afforded myocardial protection, and the protective effect of TFDM-SLNs was significantly superior to that of TFDM alone, based on the infarct area, histopathological examination, cardiac enzyme levels and inflammatory factors in serum. Due to the optimal

  18. Predictors for total medical costs for acute hemorrhagic stroke patients transferred to the rehabilitation ward at a regional hospital in Taiwan.

    Science.gov (United States)

    Chen, Chien-Min; Ke, Yen-Liang

    2016-02-01

    One-third of the acute stroke patients in Taiwan receive rehabilitation. It is imperative for clinicians who care for acute stroke patients undergoing inpatient rehabilitation to identify which medical factors could be the predictors of the total medical costs. The aim of this study was to identify the most important predictors of the total medical costs for first-time hemorrhagic stroke patients transferred to inpatient rehabilitation using a retrospective design. All data were retrospectively collected from July 2002 to June 2012 from a regional hospital in Taiwan. A stepwise multivariate linear regression analysis was used to identify the most important predictors for the total medical costs. The medical records of 237 patients (137 males and 100 females) were reviewed. The mean total medical cost per patient was United States dollar (USD) 5939.5 ± 3578.5.The following were the significant predictors for the total medical costs: impaired consciousness [coefficient (B), 1075.7; 95% confidence interval (CI) = 138.5-2012.9], dysphagia [coefficient (B), 1025.8; 95% CI = 193.9-1857.8], number of surgeries [coefficient (B), 796.4; 95% CI = 316.0-1276.7], pneumonia in the neurosurgery ward [coefficient (B), 2330.1; 95% CI = 1339.5-3320.7], symptomatic urinary tract infection (UTI) in the rehabilitation ward [coefficient (B), 1138.7; 95% CI = 221.6-2055.7], and rehabilitation ward stay [coefficient (B), 64.9; 95% CI = 31.2-98.7] (R(2) = 0.387). Our findings could help clinicians to understand that cost reduction may be achieved by minimizing complications (pneumonia and UTI) in these patients.

  19. Determination of As(III) and total inorganic As in water samples using an on-line solid phase extraction and flow injection hydride generation atomic absorption spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Sigrist, Mirna, E-mail: msigrist@fiq.unl.edu.ar [Laboratorio Central, Facultad de Ingenieria Quimica, Universidad Nacional del Litoral, Santiago del Estero 2654-Piso 6, (3000) Santa Fe (Argentina); Albertengo, Antonela; Beldomenico, Horacio [Laboratorio Central, Facultad de Ingenieria Quimica, Universidad Nacional del Litoral, Santiago del Estero 2654-Piso 6, (3000) Santa Fe (Argentina); Tudino, Mabel [Laboratorio de Analisis de Trazas, Departamento de Quimica Inorganica, Analitica y Quimica Fisica/INQUIMAE, Facultad de Ciencias Exactas y Naturales, Pabellon II, Ciudad Universitaria (1428), Buenos Aires (Argentina)

    2011-04-15

    A simple and robust on-line sequential injection system based on solid phase extraction (SPE) coupled to a flow injection hydride generation atomic absorption spectrometer (FI-HGAAS) with a heated quartz tube atomizer (QTA) was developed and optimized for the determination of As(III) in groundwater without any kind of sample pretreatment. The method was based on the selective retention of inorganic As(V) that was carried out by passing the filtered original sample through a cartridge containing a chloride-form strong anion exchanger. Thus the most toxic form, inorganic As(III), was determined fast and directly by AsH{sub 3} generation using 3.5 mol L{sup -1} HCl as carrier solution and 0.35% (m/v) NaBH{sub 4} in 0.025% NaOH as the reductant. Since the uptake of As(V) should be interfered by several anions of natural occurrence in waters, the effect of Cl{sup -}, SO{sub 4}{sup 2-}, NO{sub 3}{sup -}, HPO{sub 4}{sup 2-}, HCO{sub 3}{sup -} on retention was evaluated and discussed. The total soluble inorganic arsenic concentration was determined on aliquots of filtered samples acidified with concentrated HCl and pre-reduced with 5% KI-5% C{sub 6}H{sub 8}O{sub 6} solution. The concentration of As(V) was calculated by difference between the total soluble inorganic arsenic and As(III) concentrations. Detection limits (LODs) of 0.5 {mu}g L{sup -1} and 0.6 {mu}g L{sup -1} for As(III) and inorganic total As, respectively, were obtained for a 500 {mu}L sample volume. The obtained limits of detection allowed testing the water quality according to the national and international regulations. The analytical recovery for water samples spiked with As(III) ranged between 98% and 106%. The sampling throughput for As(III) determination was 60 samples h{sup -1}. The device for groundwater sampling was especially designed for the authors. Metallic components were avoided and the contact between the sample and the atmospheric oxygen was carried to a minimum. On-field arsenic species

  20. Determination of As(III) and total inorganic As in water samples using an on-line solid phase extraction and flow injection hydride generation atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Sigrist, Mirna; Albertengo, Antonela; Beldomenico, Horacio; Tudino, Mabel

    2011-01-01

    A simple and robust on-line sequential injection system based on solid phase extraction (SPE) coupled to a flow injection hydride generation atomic absorption spectrometer (FI-HGAAS) with a heated quartz tube atomizer (QTA) was developed and optimized for the determination of As(III) in groundwater without any kind of sample pretreatment. The method was based on the selective retention of inorganic As(V) that was carried out by passing the filtered original sample through a cartridge containing a chloride-form strong anion exchanger. Thus the most toxic form, inorganic As(III), was determined fast and directly by AsH 3 generation using 3.5 mol L -1 HCl as carrier solution and 0.35% (m/v) NaBH 4 in 0.025% NaOH as the reductant. Since the uptake of As(V) should be interfered by several anions of natural occurrence in waters, the effect of Cl - , SO 4 2- , NO 3 - , HPO 4 2- , HCO 3 - on retention was evaluated and discussed. The total soluble inorganic arsenic concentration was determined on aliquots of filtered samples acidified with concentrated HCl and pre-reduced with 5% KI-5% C 6 H 8 O 6 solution. The concentration of As(V) was calculated by difference between the total soluble inorganic arsenic and As(III) concentrations. Detection limits (LODs) of 0.5 μg L -1 and 0.6 μg L -1 for As(III) and inorganic total As, respectively, were obtained for a 500 μL sample volume. The obtained limits of detection allowed testing the water quality according to the national and international regulations. The analytical recovery for water samples spiked with As(III) ranged between 98% and 106%. The sampling throughput for As(III) determination was 60 samples h -1 . The device for groundwater sampling was especially designed for the authors. Metallic components were avoided and the contact between the sample and the atmospheric oxygen was carried to a minimum. On-field arsenic species separation was performed through the employ of a serial connection of membrane filters and

  1. Solid waste

    International Nuclear Information System (INIS)

    1995-01-01

    The article drawn up within the framework of 'the assessment of the state of the environment in Lebanon' provides an overview of solid waste management, and assesses future wastes volume and waste disposal issues.In particular it addresses the following concerns: - Long term projections of solid waste arisings (i.e. domestic, industrial, such commercial wastes, vehicle types, construction waste, waste oils, hazardous toxic wastes and finally hospital and clinical wastes) are described. - Appropriate disposal routes, and strategies for reducing volumes for final disposal - Balance between municipal and industrial solid waste generation and disposal/treatment and - environmental impacts (aesthetics, human health, natural environment )of existing dumps, and the potential impact of government plans for construction of solid waste facilities). Possible policies for institutional reform within the waste management sector are proposed. Tables provides estimations of generation rates and distribution of wastes in different regions of Lebanon. Laws related to solid waste management are summarized

  2. Profundization of acetabular cup uncemented in total substitution of hip in-patient with acetabular dysplasia - Experience university hospital - Clinica San Rafael

    International Nuclear Information System (INIS)

    Dimian Mayorga, Omar David; Sandoval Daza, Alejandro; Vargas Turriago, Marcela; Perez Torres, Javier

    2005-01-01

    14 patients with acetabular dysplasia were treated at Hospital Universitario Clinica San Rafael with total hip arthroplasty with uncemented cup internization. According to Crowe classification, one was type 1, eight were type 2 and five were type 3. The average follow up was twenty-four months. The Harris hip score was used for the clinical evaluation with a pre operative average of 35 points and 37 points post operative. The average cup internization was four millimeters, with an average cup protrutio of 47% and an average of cup coverage of 81%. The average internization of the femoral head's center was 26mm. screws for cup fixation were used in 3 patients. We did not have complications nor implant revision at the time of follow up

  3. Bundled payment initiatives for Medicare and non-Medicare total joint arthroplasty patients at a community hospital: bundles in the real world.

    Science.gov (United States)

    Doran, James P; Zabinski, Stephen J

    2015-03-01

    In the setting of current United States healthcare reform, bundled payment initiatives and episode of care payment models for total joint arthroplasty (TJA) have become increasingly common. The following is a review of our results and experience in a community hospital with bundled payment initiatives for both non-Medicare and Medicare TJA patients since 2011. We have successfully decreased the cost of the TJA episode of care in comparison to our historical averages prior to 2011. This cost-reduction has primarily been achieved through decreased length of inpatient stay, increased discharge to home rather than to skilled nursing or inpatient rehabilitation facilities, reduction in implant cost, improvement in readmission rate and migration of cases to lower cost sites of service. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Suspended-sediment concentrations, loads, total suspended solids, turbidity, and particle-size fractions for selected rivers in Minnesota, 2007 through 2011

    Science.gov (United States)

    Ellison, Christopher A.; Savage, Brett E.; Johnson, Gregory D.

    2014-01-01

    Sediment-laden rivers and streams pose substantial environmental and economic challenges. Excessive sediment transport in rivers causes problems for flood control, soil conservation, irrigation, aquatic health, and navigation, and transports harmful contaminants like organic chemicals and eutrophication-causing nutrients. In Minnesota, more than 5,800 miles of streams are identified as impaired by the Minnesota Pollution Control Agency (MPCA) due to elevated levels of suspended sediment. The U.S. Geological Survey, in cooperation with the MPCA, established a sediment monitoring network in 2007 and began systematic sampling of suspended-sediment concentrations (SSC), total suspended solids (TSS), and turbidity in rivers across Minnesota to improve the understanding of fluvial sediment transport relations. Suspended-sediment samples collected from 14 sites from 2007 through 2011 indicated that the Zumbro River at Kellogg in the driftless region of southeast Minnesota had the highest mean SSC of 226 milligrams per liter (mg/L) followed by the Minnesota River at Mankato with a mean SSC of 193 mg/L. During the 2011 spring runoff, the single highest SSC of 1,250 mg/L was measured at the Zumbro River. The lowest mean SSC of 21 mg/L was measured at Rice Creek in the northern Minneapolis- St. Paul metropolitan area. Total suspended solids (TSS) have been used as a measure of fluvial sediment by the MPCA since the early 1970s; however, TSS concentrations have been determined to underrepresent the amount of suspended sediment. Because of this, the MPCA was interested in quantifying the differences between SSC and TSS in different parts of the State. Comparisons between concurrently sampled SSC and TSS indicated significant differences at every site, with SSC on average two times larger than TSS concentrations. The largest percent difference between SSC and TSS was measured at the South Branch Buffalo River at Sabin, and the smallest difference was observed at the Des Moines

  5. Quantification of Lycopene, β-Carotene, and Total Soluble Solids in Intact Red-Flesh Watermelon (Citrullus lanatus) Using On-Line Near-Infrared Spectroscopy.

    Science.gov (United States)

    Tamburini, Elena; Costa, Stefania; Rugiero, Irene; Pedrini, Paola; Marchetti, Maria Gabriella

    2017-04-11

    A great interest has recently been focused on lycopene and β-carotene, because of their antioxidant action in the organism. Red-flesh watermelon is one of the main sources of lycopene as the most abundant carotenoid. The use of near-infrared spectroscopy (NIRS) in post-harvesting has permitted us to rapidly quantify lycopene, β-carotene, and total soluble solids (TSS) on single intact fruits. Watermelons, harvested in 2013-2015, were submitted to near-infrared (NIR) radiation while being transported along a conveyor belt system, stationary and in movement, and at different positions on the belt. Eight hundred spectra from 100 samples were collected as calibration set in the 900-1700 nm interval. Calibration models were performed using partial least squares (PLS) regression on pre-treated spectra (derivatives and SNV) in the ranges 2.65-151.75 mg/kg (lycopene), 0.19-9.39 mg/kg (β-carotene), and 5.3%-13.7% (TSS). External validation was carried out with 35 new samples and on 35 spectra. The PLS models for intact watermelon could predict lycopene with R² = 0.877 and SECV = 15.68 mg/kg, β-carotene with R² = 0.822 and SECV = 0.81 mg/kg, and TSS with R² = 0.836 and SECV = 0.8%. External validation has confirmed predictive ability with R² = 0.805 and RMSEP = 16.19 mg/kg for lycopene, R2 = 0.737 and RMSEP = 0.96 mg/kg for β-carotene, and R² = 0.707 and RMSEP = 1.4% for TSS. The results allow for the market valorization of fruits.

  6. Impact of pH and Total Soluble Solids on Enzyme Inactivation Kinetics during High Pressure Processing of Mango (Mangifera indica) Pulp.

    Science.gov (United States)

    Kaushik, Neelima; Nadella, Tejaswi; Rao, P Srinivasa

    2015-11-01

    This study was undertaken with an aim to enhance the enzyme inactivation during high pressure processing (HPP) with pH and total soluble solids (TSS) as additional hurdles. Impact of mango pulp pH (3.5, 4.0, 4.5) and TSS (15, 20, 25 °Brix) variations on the inactivation of pectin methylesterase (PME), polyphenol oxidase (PPO), and peroxidase (POD) enzymes were studied during HPP at 400 to 600 MPa pressure (P), 40 to 70 °C temperature (T), and 6- to 20-min pressure-hold time (t). The enzyme inactivation (%) was modeled using second order polynomial equations with a good fit that revealed that all the enzymes were significantly affected by HPP. Response surface and contour models predicted the kinetic behavior of mango pulp enzymes adequately as indicated by the small error between predicted and experimental data. The predicted kinetics indicated that for a fixed P and T, higher pulse pressure effect and increased isobaric inactivation rates were possible at lower levels of pH and TSS. In contrast, at a fixed pH or TSS level, an increase in P or T led to enhanced inactivation rates, irrespective of the type of enzyme. PPO and POD were found to have similar barosensitivity, whereas PME was found to be most resistant to HPP. Furthermore, simultaneous variation in pH and TSS levels of mango pulp resulted in higher enzyme inactivation at lower pH and TSS during HPP, where the effect of pH was found to be predominant than TSS within the experimental domain. Exploration of additional hurdles such as pH, TSS, and temperature for enzyme inactivation during high pressure processing of fruits is useful from industrial point of view, as these parameters play key role in preservation process design. © 2015 Institute of Food Technologists®

  7. [Ability of Staphylococcus cohnii strains to adhere to epithelial cells and solid surfaces in the hospital environment].

    Science.gov (United States)

    Waldon, Edyta; Szewczyk, Eligia M

    2002-01-01

    Presented study describes abilities of staphylococci to adhere to exfoliated cheek and uroepithelial epithelium cells and to various surfaces such as plastics, glass and steel. The subject of the study were strains of Staphylococcus cohnii ssp. cohnii and Staphylococcus cohnii ssp. urealyticus isolated from Intensive Care Unit of Pediatric Hospital. Staphylococcus cohnii ssp.cohnii adhered in great number to epithelial cells. However, the adhesion differed by individual strains. We did not find relationship between slime production and adherence to epithelial cell. Most of investigated strains adhered closely to surfaces--especially of plastics and glass. This phenomenon was stronger in the presence of culture medium and phosphate buffer.

  8. Solid waste management

    OpenAIRE

    Srebrenkoska, Vineta; Golomeova, Saska; Zhezhova, Silvana

    2013-01-01

    Waste is unwanted or useless materials from households, industry, agriculture, hospitals. Waste materials in solid state are classified as solid waste. Increasing of the amount of solid waste and the pressure what it has on the environment, impose the need to introduce sustainable solid waste management. Advanced sustainable solid waste management involves several activities at a higher level of final disposal of the waste management hierarchy. Minimal use of material and energy resources ...

  9. Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study.

    Science.gov (United States)

    Abdullah, Hairil Rizal; Sim, Yilin Eileen; Hao, Ying; Lin, Geng Yu; Liew, Geoffrey Haw Chieh; Lamoureux, Ecosse L; Tan, Mann Hong

    2017-06-08

    Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, preoperative haemoglobin (Hb) level, LOS and 30-day readmission data were collected. Anaemia was classified according to WHO definition. Prolonged LOS was defined as more than 6 days, which corresponds to >75th centile LOS of the data. We analysed 2394 patients. The prevalence of anaemia was 23.7%. 403 patients (16.8%) had mild anaemia and 164 patients (6.8%) had moderate to severe anaemia. Overall mean LOS was 5.4±4.8 days. Based on multivariate logistic regression, preoperative anaemia significantly increased LOS (mild anaemia, adjusted OR (aOR) 1.71, p70 years were associated with prolonged LOS. Our 30-day related readmission rate was 1.7% (42) cases. Anaemia is common among patients undergoing elective TKA in Singapore and is independently associated with prolonged LOS and increased perioperative blood transfusion. We suggest measures to correct anaemia prior to surgery, including the use of non-gender-based Hb cut-off for establishing diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. SUB-PPB QUANTITATION AND CONFIRMATION OF PERCHLORATE IN DRINKING WATERS CONTAINING HIGH TOTAL DISSOLVED SOLIDS USING ION CHROMATOGRAPHY WITH MASS SPECTROMETRIC DETECTION

    Science.gov (United States)

    Perchlorate (ClO4 -) is a drinking water contaminant originating from the dissolution of the salts of ammonium, potassium, magnesium, or sodium in water. It is used primarily as an oxidant in solid propellant for rockets, missiles, pyrotechnics, as a component in air bag infla...

  11. Quality differences between private for-profit, private non-profit and public hospitals in Norway: a retrospective national register-based study of acute readmission rates following total hip and knee arthroplasties.

    Science.gov (United States)

    Holom, Geir Hiller; Hagen, Terje P

    2017-08-18

    To compare the quality of care-using unplanned acute hospital readmissions as a quality measure-among patients treated at private for-profit hospitals (PFPs), private non-profit hospitals (PNPs) and public hospitals (PUBs) in Norway. A retrospective comparative study using the Norwegian Patient Register. Readmissions were evaluated by logistic regressions both using adjustment for various patient-level and other covariates, and a two-stage model using distance as an instrumental variable. The Norwegian healthcare system. All publicly financed patients having primary total hip (37 897 patients) or primary total knee arthroplasty (25 802 patients) at one of the three hospital types from 2009 to 2014. 30-day unplanned acute hospital readmission rate. We found highest readmission rates among PUBs and lowest among PFPs, for both procedures. However, the patients were on average more than 2 years younger at PFPs. PFPs also treated the least severe patients, while PUBs treated the most severe. Using adjustment for various patient-level and other covariates, compared to PUBs, both PFPs and PNPs had lower odds of readmission following both procedures. However, using the instrumental variable method, the only significant difference found was a lower odds of readmission at PNPs among hip patients when compared with PUBs. No patients in our data set were readmitted to PFPs, those originally treated at PFPs were readmitted to either PNPs or PUBs, and PUBs received most of the readmitted patients across hospital types. Quality differences between hospital types were small; however, PNPs had significantly lower readmission rates compared with PUBs among patients having total hip arthroplasty. PUBs received the larger part of the readmitted patients across hospital types and thus play an essential role in the care of more complex patients and for readmissions, regardless of any quality differences. © Article author(s) (or their employer(s) unless otherwise stated in the

  12. The spatial and temporal variation of total suspended solid concentration in Pearl River Estuary during 1987-2015 based on remote sensing.

    Science.gov (United States)

    Wang, Chongyang; Li, Weijiao; Chen, Shuisen; Li, Dan; Wang, Danni; Liu, Jia

    2018-03-15

    The movement and migration of total suspended solid (TSS) are the essential component of global material cycling and change. Based on the TSS concentrations retrieved from 112 scenes of Landsat remote sensing imageries during 1987-2015, the spatial and temporal variations of TSS concentration in high flow season and low flow seasons of six sub-regions (west shoal, west channel, middle shoal, east channel, east shoal and Pearl River Estuary Chinese White Dolphin National Nature Reserve and its adjacent waters (NNR)) of Pearl River Estuary (PRE) were analyzed and compared by statistical simulation. It was found that TSS concentrations in east and west shoals were about 23mg/L and 64mg/L higher than that of the middle shoal, respectively. There was a significant decreasing trend of TSS concentration from the northwest (223.7mg/L) to southeast (51.4mg/L) of study area, with an average reduction of 5.86mg/Lperkm, which mainly attributes to unique interaction of runoff and tide in PRE. In high flow season, there existed a significant and definite annual cycle period (5-8years) of TSS concentration change primarily responding to the periodic variation of precipitation. There were five full-fledged period changes of TSS detected in west shoal and west channel (the years of changes in 1988, 1994, 1998, 2003, 2010, 2015), while there were the last four cycle periods found in middle shoal, east channel, east shoal and NNR only. TSS concentrations in shoals and channels of PRE showed a significant decreased trend mainly due to the dam construction at the same time, with an average annual TSS concentration decrease of 5.7-10.1mg/L in high flow season from 1988 to 2015. There was no significant change trend of TSS concentration in NNR before 2003, but the TSS concentration decreased significantly after the establishment of the NNR since June 2003, with an average annual decrease of 9.7mg/L from 2004 to 2015. It was deduced that man-made protection measures had a great influence

  13. Evaluation of heavy metals in solid waste disposal sites in Campinas city, Brazil, using synchrotron radiation total reflection X-ray fluorescence

    International Nuclear Information System (INIS)

    Faria, Bruna F.; Moreira, Silvana

    2011-01-01

    The problem of solid waste in most countries is on the rise as a result of rapid population growth, urbanization, industrial development and changes in consumption habits. Amongst the various forms of waste disposals, landfills are today the most viable for the Brazilian reality; both technically and economically. Constructive characteristics allow minimizing the effects of the two main sources of pollution from solid waste: landfill gas and slurry. However, minimizing is not synonymous with eliminating, consequently the landfill alone cannot resolve all the problems concerning solid waste disposal. The main goal of this work is to evaluate the content of trace elements in samples of groundwater, surface water and slurry arising from local solid waste disposals in the city of Campinas SP Brazil. Samples of surface and groundwater, slurry; were collected in the Delta, Santa Barbara and Pirelli landfills. At Delta and Santa Barbara values above the maximum permitted level established by CETESB for Cr, Ni and Pb in samples of groundwater were observed, while at Pirelli, P b concentrations were above the permitted. At Delta values above levels permitted by legislation CONAMA 357 were still observed in surface water samples for Cr and Cu; whereas in slurry samples, values above the levels permitted were observed for: Cr, Ni, Cu, Zn and Pb. Slurry samples were prepared in accordance with two extraction methodologies, EPA 3050B and EPA 200.8. Concentrations of Cr, Ni, Cu and Pb obtained were higher than the limit established by CONAMA 357 for most samples collected at different periods (dry and rainy) and also for the two extraction methodologies employed. (author)

  14. Evaluation of Heavy Metals in Solid Waste Disposal Sites in Campinas City, Brazil Using Synchrotron Radiation Total Reflection X-Ray Fluorescence

    International Nuclear Information System (INIS)

    Faria, Bruna Fernanda de; Moreira, Silvana

    2011-01-01

    The problem of solid waste in most countries is on the rise as a result of rapid population growth, urbanization, industrial development and changes in consumption habits. Amongst the various forms of waste disposals, landfills are today the most viable for the Brazilian reality, both technically and economically. Proper landfill construction practices allow minimizing the effects of the two main sources of pollution from solid waste: landfill gas and slurry. However, minimizing is not synonymous with eliminating; consequently, the landfill alone cannot resolve all the problems with solid waste disposal. The main goal of this work is to evaluate the content of trace elements in samples of groundwater, surface water and slurry arising from local solid waste disposals in the city of Campinas, SP, Brazil. Samples were collected at the Delta, Santa Barbara and Pirelli landfills. At the Delta and Santa Barbara sites, values above the maximum permitted level established by CETESB for Cr, Mn, Fe, Ni and Pb were observed in samples of groundwater, while at the Pirelli site, elements with concentrations above the permitted levels were Mn, Fe, Ba and Pb. At Delta, values above levels permitted by the CONAMA 357 legislation were still observed in surface water samples for Cr, Mn, Fe and Cu, whereas in slurry samples, values above the permitted levels were observed for Cr, Mn, Fe, Ni, Cu, Zn and Pb. Slurry samples were prepared in accordance with two extraction methodologies, EPA 3050B and EPA 200.8. Concentrations of Cr, Ni, Cu and Pb were higher than the limit established by CONAMA 357 for most samples collected at different periods (dry and rainy) and also for the two extraction methodologies employed.

  15. Evaluation of Heavy Metals in Solid Waste Disposal Sites in Campinas City, Brazil Using Synchrotron Radiation Total Reflection X-Ray Fluorescence

    Science.gov (United States)

    de Faria, Bruna Fernanda; Moreira, Silvana

    2011-12-01

    The problem of solid waste in most countries is on the rise as a result of rapid population growth, urbanization, industrial development and changes in consumption habits. Amongst the various forms of waste disposals, landfills are today the most viable for the Brazilian reality, both technically and economically. Proper landfill construction practices allow minimizing the effects of the two main sources of pollution from solid waste: landfill gas and slurry. However, minimizing is not synonymous with eliminating; consequently, the landfill alone cannot resolve all the problems with solid waste disposal. The main goal of this work is to evaluate the content of trace elements in samples of groundwater, surface water and slurry arising from local solid waste disposals in the city of Campinas, SP, Brazil. Samples were collected at the Delta, Santa Barbara and Pirelli landfills. At the Delta and Santa Barbara sites, values above the maximum permitted level established by CETESB for Cr, Mn, Fe, Ni and Pb were observed in samples of groundwater, while at the Pirelli site, elements with concentrations above the permitted levels were Mn, Fe, Ba and Pb. At Delta, values above levels permitted by the CONAMA 357 legislation were still observed in surface water samples for Cr, Mn, Fe and Cu, whereas in slurry samples, values above the permitted levels were observed for Cr, Mn, Fe, Ni, Cu, Zn and Pb. Slurry samples were prepared in accordance with two extraction methodologies, EPA 3050B and EPA 200.8. Concentrations of Cr, Ni, Cu and Pb were higher than the limit established by CONAMA 357 for most samples collected at different periods (dry and rainy) and also for the two extraction methodologies employed.

  16. Optimization of the quantitative direct solid total-reflection X-ray fluorescence analysis of glass microspheres functionalized with Zr organometallic compounds

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Ruiz, Ramon, E-mail: ramon.fernandez@uam.e [Servicio Interdepartamental de Investigacion, Facultad de Ciencias, Universidad Autonoma de Madrid, Cantoblanco, E-28049, Madrid (Spain); Andres, Roman; Jesus, Ernesto de [Departamento de Quimica Inorganica, Universidad de Alcala, Campus Universitario, 28871, Alcala de Henares, Madrid (Spain); Terreros, Pilar [Instituto de Catalisis y Petroleo-Quimica, CSIC, Cantoblanco, 28049, Madrid (Spain)

    2010-06-15

    Quantitative determination of Zr in the system constituted by quartz microspheres functionalized with two kinds of organometallic compounds has been studied due to the importance of the correct quantization of the Zr from a catalytic point of view. Two parallel approximations were done, i.e. acid leaching and direct solid quantization. To validate the acid leaching TXRF measures, ICP-MS analysis were carried out. The results obtained by means of the optimization of the quantitative direct solid procedure show that, with a previous particle size distribution modification, TXRF obtain the same analytical results as ICP-MS and TXRF by acid leaching way but without previous chemical acid manipulation. This fact implies an important improvement for the analysis time, reagents costs and analysis facility and it proves again the versatility of TXRF to solve analytical problems in an easy, quick and accurate way. Additionally and for the direct solid TXRF measurements, a deeper study was done to evaluate the intrinsic analytical parameters of the Zr TXRF analysis of this material. So, the influence of the particle size distributions (modified by means of a high power ultrasound probe) with respect to uncertainty and detection limits for Zr were developed. The main analytical conclusion was the strong correlation between the average particle sizes and the TXRF analytical parameters of Zr measurements, i.e. concentration, accuracy, uncertainty and detection limits.

  17. Attenuated Total Reflection Fourier Transform Infrared (ATR FT-IR) Spectroscopy as an Analytical Method to Investigate the Secondary Structure of a Model Protein Embedded in Solid Lipid Matrices.

    Science.gov (United States)

    Zeeshan, Farrukh; Tabbassum, Misbah; Jorgensen, Lene; Medlicott, Natalie J

    2018-02-01

    Protein drugs may encounter conformational perturbations during the formulation processing of lipid-based solid dosage forms. In aqueous protein solutions, attenuated total reflection Fourier transform infrared (ATR FT-IR) spectroscopy can investigate these conformational changes following the subtraction of spectral interference of solvent with protein amide I bands. However, in solid dosage forms, the possible spectral contribution of lipid carriers to protein amide I band may be an obstacle to determine conformational alterations. The objective of this study was to develop an ATR FT-IR spectroscopic method for the analysis of protein secondary structure embedded in solid lipid matrices. Bovine serum albumin (BSA) was chosen as a model protein, while Precirol AT05 (glycerol palmitostearate, melting point 58 ℃) was employed as the model lipid matrix. Bovine serum albumin was incorporated into lipid using physical mixing, melting and mixing, or wet granulation mixing methods. Attenuated total reflection FT-IR spectroscopy and size exclusion chromatography (SEC) were performed for the analysis of BSA secondary structure and its dissolution in aqueous media, respectively. The results showed significant interference of Precirol ATO5 with BSA amide I band which was subtracted up to 90% w/w lipid content to analyze BSA secondary structure. In addition, ATR FT-IR spectroscopy also detected thermally denatured BSA solid alone and in the presence of lipid matrix indicating its suitability for the detection of denatured protein solids in lipid matrices. Despite being in the solid state, conformational changes occurred to BSA upon incorporation into solid lipid matrices. However, the extent of these conformational alterations was found to be dependent on the mixing method employed as indicated by area overlap calculations. For instance, the melting and mixing method imparted negligible effect on BSA secondary structure, whereas the wet granulation mixing method promoted

  18. Solid-Phase Synthesis of Difficult Purine-Rich PNAs through Selective Hmb Incorporation: Application to the Total Synthesis of Cell Penetrating Peptide-PNAs

    Directory of Open Access Journals (Sweden)

    Julien Tailhades

    2017-10-01

    Full Text Available Antisense oligonucleotide (ASO-based drug development is gaining significant momentum following the recent FDA approval of Eteplirsen (an ASO based on phosphorodiamidate morpholino and Spinraza (2′-O-methoxyethyl-phosphorothioate in late 2016. Their attractiveness is mainly due to the backbone modifications which have improved the in vivo characteristics of oligonucleotide drugs. Another class of ASO, based on peptide nucleic acid (PNA chemistry, is also gaining popularity as a platform for development of gene-specific therapy for various disorders. However, the chemical synthesis of long PNAs, which are more target-specific, remains an ongoing challenge. Most of the reported methodology for the solid-phase synthesis of PNA suffer from poor coupling efficiency which limits production to short PNA sequences of less than 15 residues. Here, we have studied the effect of backbone modifications with Hmb (2-hydroxy-4-methoxybenzyl and Dmb (2,4-dimethoxybenzyl to ameliorate difficult couplings and reduce “on-resin” aggregation. We firstly synthesized a library of PNA dimers incorporating either Hmb or Dmb and identified that Hmb is superior to Dmb in terms of its ease of removal. Subsequently, we used Hmb backbone modification to synthesize a 22-mer purine-rich PNA, targeting dystrophin RNA splicing, which could not be synthesized by standard coupling methodology. Hmb backbone modification allowed this difficult PNA to be synthesized as well as to be continued to include a cell-penetrating peptide on the same solid support. This approach provides a novel and straightforward strategy for facile solid-phase synthesis of difficult purine-rich PNA sequences.

  19. Solid-phase synthesis of difficult purine-rich PNAs through selective Hmb incorporation: Application to the total synthesis of cell penetrating peptide-PNAs

    Science.gov (United States)

    Tailhades, Julien; Takizawa, Hotake; Gait, Michael J.; Wellings, Don A.; Wade, John D.; Aoki, Yoshitsugu; Shabanpoor, Fazel

    2017-10-01

    Antisense oligonucleotide (ASO)-based drug development is gaining significant momentum following the recent FDA approval of Eteplirsen (an ASO based on phosphorodiamidate morpholino) and Spinraza (2’-O-methoxyethyl-phosphorothioate) in late 2016. Their attractiveness is mainly due to the backbone modifications which have improved the in vivo characteristics of oligonucleotide drugs. Another class of ASO, based on peptide nucleic acid (PNA) chemistry, is also gaining popularity as a platform for development of gene-specific therapy for various disorders. However, the chemical synthesis of long PNAs, which are more target-specific, remains an ongoing challenge. Most of the reported methodology for the solid-phase synthesis of PNA suffer from poor coupling efficiency which limits production to short PNA sequences of less than 15 residues. Here we have studied the effect of backbone modifications with Hmb (2-hydroxy-4-methoxybenzyl) and Dmb (2,4-dimethoxybenzyl) to ameliorate difficult couplings and reduce “on-resin” aggregation. We firstly synthesized a library of PNA dimers incorporating either Hmb or Dmb and identified that Hmb is superior to Dmb in terms of its ease of removal. Subsequently, we used Hmb backbone modification to synthesize a 22-mer purine-rich PNA, targeting dystrophin RNA splicing, which could not be synthesized by standard coupling methodology. Hmb backbone modification allowed this difficult PNA to be synthesized as well as to be continued to include a cell-penetrating peptide on the same solid support. This approach provides a novel and straightforward strategy for facile solid-phase synthesis of difficult purine-rich PNA sequences.

  20. Preparation and quantification of the total phenolic products in Citrus fruit using solid-phase extraction coupled with high-performance liquid chromatography with diode array and UV detection.

    Science.gov (United States)

    Zeng, Honglian; Liu, Zhenli; Zhao, Siyu; Shu, Yisong; Song, Zhiqian; Wang, Chun; Dong, Yunzhuo; Ning, Zhangchi; He, Dan; Wang, Menglei; Lu, Cheng; Liu, Yuanyan; Lu, Aiping

    2016-10-01

    Citrus fruit is an important health-promoting food that is rich in dietary phenolic metabolites. Traditional Chinese medicines, such as Zhishi and Zhiqiao, come from young and immature fruits of Citrus cultivars. The preparation of diversified bioactive phenolic products and establishment of the corresponding quality control methodology are challenging and necessary. In the current study, four types of solid-phase extraction sorbents for the enrichment and clean-up of the phenolic matrix were evaluated. A solid-phase extraction column coated with Strata-X was finally used in the procedure. Twenty phenolic compounds were selected to evaluate the extraction performances of the sorbents using high-performance liquid chromatography analysis. Under the optimized conditions, good linearities were obtained with R 2 more than 0.9996 for all analytes with LODs of 0.04-1.012 μg/g. Intra- and interday relative standard deviation values were less than 3%, and the recovery was equal to or higher than 90.02%. Compared to non-solid-phase extraction process, the content of total phenolic products was elevated 35.55-68.48% with solid-phase extraction. Finally, the developed and validated method was successfully applied to the discrimination of Zhishi samples from different species as well as Zhishi and Zhiqiao samples in different development stages. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Análise da produção e taxa de geração de resíduos sólidos de serviços de saúde do Hospital Universitário Regional de Maringá = Production analysis and generation rate of solid health-care waste at Maringá Regional University Hospital

    Directory of Open Access Journals (Sweden)

    Lucila Akiko Nagashima

    2007-07-01

    Full Text Available Os resíduos sólidos de serviços de saúde (RSSS representam reduzida parcela do total dos resíduos sólidos urbanos gerados diariamente por uma cidade. Considerando a própria origem, parte desses resíduos apresenta riscos e dificuldades especiais em seu manejo, devido especialmente ao caráter infeccioso de alguns componentes. Estasconstatações associadas à necessidade de conhecer a situação dos RSSS do Hospital Universitário Regional de Maringá motivaram a elaboração do estudo. A pesquisa buscou identificar as diferentes fontes geradoras, caracterizar qualitativa e quantitativamente osresíduos gerados determinando a taxa de geração diária. A caracterização foi efetuada mediante a pesagem dos resíduos, acompanhamento das atividades internas do hospital, quanto aos procedimentos de coleta, armazenamento interno e externo e transporte de seus resíduos sólidos. Constatou-se que do total de resíduos gerados, cerca de 53% são considerados contaminados, percentual creditado como não-satisfatório para uma parcela significante de bibliografia consultada.Solid health-care waste (SHCW represents only a small fraction of the total urban solid waste generated daily in a city. Taking its origin into consideration, part of this waste presents risks and special difficulties in handling, especially due to the infectious aspects of some components. The elaboration of study was motivated by these findings, associated with the need to find out the conditions of the SHCW from the Maringá Regional University Hospital. The research attempted to identify the different generating sources, quantifying and qualifying the generated waste, and determining the daily generated rate. The characterization was done by weighing the waste, observing internal hospital activities regarding collection procedures, internal and external storage and transportation of the waste. It was verified that from the total generated waste, around 53% is considered

  2. Quantitative analysis of unconjugated and total bisphenol A in human urine using solid-phase extraction and UPLC-MS/MS: method implementation, method qualification and troubleshooting.

    Science.gov (United States)

    Buscher, Brigitte; van de Lagemaat, Dick; Gries, Wolfgang; Beyer, Dieter; Markham, Dan A; Budinsky, Robert A; Dimond, Stephen S; Nath, Rajesh V; Snyder, Stephanie A; Hentges, Steven G

    2015-11-15

    The aim of the presented investigation was to document challenges encountered during implementation and qualification of a method for bisphenol A (BPA) analysis and to develop and discuss precautions taken to avoid and to monitor contamination with BPA during sample handling and analysis. Previously developed and published HPLC-MS/MS methods for the determination of unconjugated BPA (Markham et al. Journal of Analytical Toxicology, 34 (2010) 293-303) [17] and total BPA (Markham et al. Journal of Analytical Toxicology, 38 (2014) 194-203) [20] in human urine were combined and transferred into another laboratory. The initial method for unconjugated BPA was developed and evaluated in two independent laboratories simultaneously. The second method for total BPA was developed and evaluated in one of these laboratories to conserve resources. Accurate analysis of BPA at sub-ppb levels is a challenging task as BPA is a widely used material and is ubiquitous in the environment at trace concentrations. Propensity for contamination of biological samples with BPA is reported in the literature during sample collection, storage, and/or analysis. Contamination by trace levels of BPA is so pervasive that even with extraordinary care, it is difficult to completely exclude the introduction of BPA into biological samples and, consequently, contamination might have an impact on BPA biomonitoring data. The applied UPLC-MS/MS method was calibrated from 0.05 to 25ng/ml. The limit of quantification was 0.1ng/ml for unconjugated BPA and 0.2ng/ml for total BPA, respectively, in human urine. Finally, the method was applied to urine samples derived from 20 volunteers. Overall, BPA can be analyzed in human urine with acceptable recovery and repeatability if sufficient measures are taken to avoid contamination throughout the procedure from sample collection until UPLC-MS/MS analysis. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Size distribution and total number concentration of ultrafine and accumulation mode particles and hospital admissions in children and the elderly in Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Wåhlin, Peter; Raaschou-Nielsen, O

    2008-01-01

    (15 May 2001 to 31 December 2004) and hospital admissions due to cardiovascular (CVD) and respiratory disease (RD) in the elderly (age >or=65 years), and due to asthma in children (age 5-18 years). We examined these associations in the presence of PM(10), PM(2.5) (particulate matter ... that particle volume/mass from long-range transported air pollution is relevant for CVD and RD admissions in the elderly, and possibly particle numbers from traffic sources for paediatric asthma....

  4. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  5. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain: The Danish Health Examination Survey cohort 2007-2008.

    Science.gov (United States)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B; Aadahl, Mette; Meyrowitsch, Dan W; Tolstrup, Janne S

    2018-02-01

    This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.

  6. A randomized trial of a standard dose of Edmonston-Zagreb measles vaccine given at 4.5 months of age: effect on total hospital admissions.

    Science.gov (United States)

    Martins, Cesario L; Benn, Christine S; Andersen, Andreas; Balé, Carlito; Schaltz-Buchholzer, Frederik; Do, Vu An; Rodrigues, Amabelia; Aaby, Peter; Ravn, Henrik; Whittle, Hilton; Garly, May-Lill

    2014-06-01

    Observational studies and trials from low-income countries indicate that measles vaccine has beneficial nonspecific effects, protecting against non-measles-related mortality. It is not known whether measles vaccine protects against hospital admissions. Between 2003 and 2007, 6417 children who had received the third dose of diphtheria, tetanus, and pertussis vaccine were randomly assigned to receive measles vaccine at 4.5 months or no measles vaccine; all children were offered measles vaccine at 9 months of age. Using hospital admission data from the national pediatric ward in Bissau, Guinea-Bissau, we compared admission rates between enrollment and the 9-month vaccination in Cox models, providing admission hazard rate ratios (HRRs) for measles vaccine versus no measles vaccine. All analyses were conducted stratified by sex and reception of neonatal vitamin A supplementation (NVAS). Before enrollment the 2 groups had similar admission rates. Following enrollment, the measles vaccine group had an admission HRR of 0.70 (95% confidence interval [CI], .52-.95), with a ratio of 0.53 (95% CI, .32-.86) for girls and 0.86 (95% CI, .58-1.26) for boys. For children who had not received NVAS, the admission HRR was 0.53 (95% CI, .34-.84), with an effect of 0.30 (95% CI, .13-.70) for girls and 0.73 (95% CI, .42-1.28) for boys (P = .08, interaction test). The reduction in admissions was separately significant for measles infection (admission HRR, 0 [95% CI, 0-.24]) and respiratory infections (admission HRR, 0.37 [95% CI, .16-.89]). Early measles vaccine may have major benefits for infant morbidity patterns and healthcare costs. Clinical trials registration NCT00168558.

  7. The difference between actual and prescribed weight bearing of total hip patients with a trochanteric osteotomy: long-term vertical force measurements inside and outside the hospital

    NARCIS (Netherlands)

    H.L.P. Hurkmans (Henri); J.B.J. Bussmann (Hans); R.W. Selles (Ruud); E. Benda (Eric); H.J. Stam (Henk); J.A.N. Verhaar (Jan)

    2007-01-01

    textabstractOBJECTIVE: To determine whether patients load the operated leg at a prescribed weight-bearing target load during postoperative recovery. DESIGN: A descriptive prospective study. SETTING: Orthopedic clinic and patients' homes. PARTICIPANTS: Fifty patients who had undergone total hip

  8. Decree 135/999 establishing legal norms for the management of solid waste in hospitals; Decreto 135/999 establecense normas reglamentarias de la gestion de los residuos solidos hospitalarios

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-27

    Presently ordinance regulation norms settle down on the hospital solid residuals. A definition of solid residuals, contaminated, common, the transport, treatment,installation and integral handling of the same ones is presented in normative happiness. For finish a classification of a residuals in: infectious, piercing or sharp and special as well as duties and sanctions. [Spanish] En el presente decreto se establecen normas reglamentarias sobre los residuos solidos hospitalarios.Una definicion de los residuos solidos hospitalarios,contaminados,comunes, el transporte,tratamiento,instalacion de tratamiento,disposicion final y manejo integral de los mismos es presentada en dicha normativa.Por ultimo se establece una clasificacion de residuos solidos : infecciosos, punzantes o cortantes y especiales asi como tambien obligaciones y sanciones por incumplimiento.

  9. DETERMINACIONES DE FLUJO DEL SUERO COSTEÑO CON DIFERENTES CONCENTRACIONES DE SÓLIDOS TOTALES DETERMINAÇÃO DE FLUJO DO SORO COSTENHO CON DIFERENTES CONCENTRAÇOES DO SOLIDOS TOTAIS SUERO COSTEÑO FLOW DETERMINATIONS WITH DIFFERENT CONCENTRATIONS OF TOTAL SOLIDS

    Directory of Open Access Journals (Sweden)

    DIOFANOR ACEVEDO

    2012-12-01

    Full Text Available El objetivo de este estudio fue determinar los efectos del incremento de los sólidos totales con lactosuero parcialmente desmineralizado en las determinaciones de flujo del Suero costeño. Los resultados muestran que el flujo fue de naturaleza no-newtoniana, las curvas se ajustaron mejor al modelo de Herschel-Bulkley, previamente evaluado por la ecuación de Casson. El aumento de los sólidos totales disminuye el índice de flujo (n, aumenta el umbral de fluencia (?0 y el coeficiente de consistencia (K, presentando un adelgazamiento por corte o cizalladuraO objetivo deste estudo foi determinar os efeitos do aumento de sólidos totais com soro parcialmente desmineralizado na determinação do fluxo de soro costenho. Os resultados mostram que o fluxo era de curvas não-newtoniano montado um modelo de Herschel-Bulkley, previamente avaliada pela equação de Casson. O aumento do teor de sólidos diminui a taxa de fluxo (n aumenta a tensão de escoamento (?0 e o coeficiente de consistência (K, indicando uma tesoura de desbaste ou de corte.The main objective in this study was to determine the effects of increment in total solids concentration with partially dematerialized whey for the flow determinations in Suero Costeño. The results shown that the increase in total solids concentration affects the rheological properties, like consistency coefficient (K and an increment of the values of yield stress (?0, while the flow index (n values slightly decreased, showing a leverage in shear-thinning behavior

  10. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  11. Serum albumin levels in burn people are associated to the total body surface burned and the length of hospital stay but not to the initiation of the oral/enteral nutrition.

    Science.gov (United States)

    Pérez-Guisado, Joaquín; de Haro-Padilla, Jesús M; Rioja, Luis F; Derosier, Leo C; de la Torre, Jorge I

    2013-01-01

    Serum albumin levels have been used to evaluate the severity of the burns and the nutrition protein status in burn people, specifically in the response of the burn patient to the nutrition. Although it hasn't been proven if all these associations are fully funded. The aim of this retrospective study was to determine the relationship of serum albumin levels at 3-7 days after the burn injury, with the total body surface area burned (TBSA), the length of hospital stay (LHS) and the initiation of the oral/enteral nutrition (IOEN). It was carried out with the health records of patients that accomplished the inclusion criteria and were admitted to the burn units at the University Hospital of Reina Sofia (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA) over a 10 years period, between January 2000 and December 2009. We studied the statistical association of serum albumin levels with the TBSA, LHS and IOEN by ANOVA one way test. The confidence interval chosen for statistical differences was 95%. Duncan's test was used to determine the number of statistically significantly groups. Were expressed as mean±standard deviation. We found serum albumin levels association with TBSA and LHS, with greater to lesser serum albumin levels found associated to lesser to greater TBSA and LHS. We didn't find statistical association with IOEN. We conclude that serum albumin levels aren't a nutritional marker in burn people although they could be used as a simple clinical tool to identify the severity of the burn wounds represented by the total body surface area burned and the lenght of hospital stay.

  12. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  13. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  14. Clinical evaluation of bone marrow transplantation using total body irradiation and induction chemotherapy. Treatment results during twelve years at our hospital and some problems on the therapy

    International Nuclear Information System (INIS)

    Kawamura, Toshiki; Koga, Sukehiko; Kikukawa, Kaoru; Okamoto, Masataka; Miyazaki, Hitoshi; Kojima, Hiroshi; Esaki, Kohji

    2000-01-01

    We performed sixty patients with hematological malignancies the total body irradiation prior to bone marrow transplantation (TBI-BMT) from 1988 to 2000. We delivered our each patient hyperfractionated TBI consisting of 2 fractions of 3 Gy per day for 2 consecutive days following induction chemotherapy. It proved that TBI-BMT was a valuable treatment method for hematological malignancies which have poor prognosis. About the cumulative survival rate, patients of first remission were better outcome than patients beyond second remission. However, the therapy remained some problems which were the prophylaxis of GVHD for HLA-matched unrelated recipients. And we have to consider a new maintenance procedure to prevent relapse from transplanted donor cell. (author)

  15. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  16. Effects of solid-state fermentation with two filamentous fungi on the total phenolic contents, flavonoids, antioxidant activities and lipid fractions of plum fruit (Prunus domestica L.) by-products.

    Science.gov (United States)

    Dulf, Francisc Vasile; Vodnar, Dan Cristian; Socaciu, Carmen

    2016-10-15

    Evolutions of phenolic contents and antioxidant activities during solid-state fermentation (SSF) of plum pomaces (from the juice industry) and brandy distillery wastes with Aspergillus niger and Rhizopus oligosporus were investigated. The effect of fermentation time on the oil content and major lipid classes in the plum kernels was also studied. Results showed that total phenolic (TP) amounts increased by over 30% for SSF with Rhizopus oligosporus and by >21% for SSF with A. niger. The total flavonoid contents presented similar tendencies to those of the TPs. The free radical scavenging activities of methanolic extracts were also significantly enhanced. The HPLC-MS analysis showed that quercetin-3-glucoside was the major phenolic compound in both fermented plum by-products. The results also demonstrated that SSF not only helped to achieve higher lipid recovery from plum kernels, but also resulted in oils with better quality attributes (high sterol ester and n-3 PUFA-rich polar lipid contents). Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Complications in total and partial hip and knee replacement in the San Jose Universitary Hospital Popayan

    Directory of Open Access Journals (Sweden)

    Alejandro Sandoval-Daza

    2010-03-01

    Full Text Available Introduction: Total hip and knee replacements are surgical procedures commonly used in cases of degenerative articular problems, intrarticular fractures and less common in tumor conditions. Despite its great success complications can arise. Objective: Describe complications in total knee and hip replacements. Methods: A descriptive study, cases serie was done in Hospital Universitario San José in Popayán Colombia, analyzing the period between January 2004 and January 2009, Seventy six patients were included: 53 total hips replacements, 12 cases of partial hip replacements and 11 total knee replacements. Patient's age was in the range between 27 and 97. Results: The main complications founded were: respiratory insufficiency, inability to place the prosthesis, prosthesis dislocation, anemic syndrome, acetabular protrusion, infection, iatrogenic Gushing's syndrome, discrepancy of length limb, residual pain, inability to walk, nosocomial pneumonia, renal failure and periprosthetic fracture. An average of 4, 6% mortality index, 10, 8% hip prosthesis dislocation, 9, 2% infections, all these indices over the different literature reports.

  18. Trends in concentrations of nitrate and total dissolved solids in public supply wells of the Bunker Hill, Lytle, Rialto, and Colton groundwater subbasins, San Bernardino County, California: Influence of legacy land use

    Science.gov (United States)

    Kent, Robert; Landon, Matthew K.

    2013-01-01

    Concentrations and temporal changes in concentrations of nitrate and total dissolved solids (TDS) in groundwater of the Bunker Hill, Lytle, Rialto, and Colton groundwater subbasins of the Upper Santa Ana Valley Groundwater Basin were evaluated to identify trends and factors that may be affecting trends. One hundred, thirty-one public-supply wells were selected for analysis based on the availability of data spanning at least 11 years between the late 1980s and the 2000s. Forty-one of the 131 wells (31%) had a significant (p relations of nitrate trends to depth, lateral position, and VOCs imply that increasing nitrate concentrations are associated with nitrate loading from historical agricultural land use and that more recent urban land use is generally associated with lower nitrate concentrations and greater VOC occurrence. Increasing TDS trends were associated with relatively greater current nitrate concentrations and relatively greater amounts of urban land. Decreasing TDS trends were associated with relatively greater amounts of natural land use. Trends in TDS concentrations were not related to depth, lateral position, or VOC occurrence, reflecting more complex factors affecting TDS than nitrate in the study area.

  19. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  20. Survey of commercially available chocolate- and cocoa-containing products in the United States. 2. Comparison of flavan-3-ol content with nonfat cocoa solids, total polyphenols, and percent cacao.

    Science.gov (United States)

    Miller, Kenneth B; Hurst, W Jeffrey; Flannigan, Nancy; Ou, Boxin; Lee, C Y; Smith, Nancy; Stuart, David A

    2009-10-14

    A survey of a broad range of chocolate- and cocoa-containing products marketed in the United States was conducted to provide a more detailed analysis of flavan-3-ol monomers, oligomers, and polymers, which can be grouped into a class of compounds called procyanidins. Samples consisted of the three or four top-selling products within the following six categories: natural cocoa powder, unsweetened baking chocolate, dark chocolate, semisweet baking chips, milk chocolate, and chocolate syrup. Composite samples were characterized for percent fat (% fat), percent nonfat cocoa solids (% NFCS), antioxidant level by ORAC, total polyphenols, epicatechin, catechin, total monomers, and flavan-3-ol oligomers and polymers (procyanidins). On a gram weight basis epicatechin and catechin content of the products follow in decreasing order: cocoa powder > baking chocolate > dark chocolate = baking chips > milk chocolate > chocolate syrup. Analysis of the monomer and oligomer profiles within product categories shows there are two types of profiles: (1) products that have high monomers with decreasing levels of oligomers and (2) products in which the level of dimers is equal to or greater than the monomers. Results show a strong correlation (R(2) = 0.834) of epicatechin to the level of % NFCS and also very good correlations for N = 2-5 oligomers to % NFCS. A weaker correlation was observed for catechin to % NFCS (R(2) = 0.680). Other analyses show a similar high degree of correlation with epicatechin and N = 2-5 oligomers to total polyphenols, with catechin being less well correlated to total polyphenols. A lesser but still good correlation exists between the calculated percent cacao (calcd % cacao) content, a proxy for percent cacao, and these same flavanol measures, with catechin again showing a lesser degree of correlation to calcd % cacao. Principal component analysis (PCA) shows that the products group discretely into five classes: (1) cocoa powder, (2) baking chocolate, (3) dark

  1. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  2. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

  3. The influence of the solid waste disposal areas in Campinas city, Sao Paulo state (Brazil) on water quality: determination of metals using synchrotron radiation total reflection X-ray fluorescence

    International Nuclear Information System (INIS)

    Oliveira, Bruna F.F.; Moreira, Silvana; Canteras, Felippe Benavente

    2013-01-01

    Among the many forms of waste disposal, landfills today are best suited to Brazilian conditions, this because their construction allows minimizing the negative effects of landfill gas and slurry produced. However, the confinement of pollutants from landfills is linked to its construction and operation and when the construction and/or is wrong they can endanger air, groundwater and surface waters qualities. Thus, the main objective of this study was to analyze the concentration of heavy metals in samples of groundwater, surface water and slurry coming from solid waste disposal locations in the city of Campinas, SP - Delta, Santa Barbara and Pirelli Landfills. The samples were analyzed at the Brazilian Synchrotron Light Laboratory using Synchrotron Radiation Total Reflection X-Ray Fluorescence technique (SR-TXRF). In Pirelli Landfill, the highest concentrations were observed in one of the wells located to downstream of the Landfill (in relation to the groundwater flux) - the monitoring well PM04, exceeding the intervention value defined by CETESB. For Santa Barbara landfill in one upstream monitoring well the concentrations of Ni, Mn, Pb and Cr, surpassed the maximum permissive values. The manganese in Landfill Delta showed to be higher in wells located downstream and 50% of the wells analyzed exceeded the maximum permissive value for groundwater samples. In the case of surface waters located in the vicinity of landfill sites, the metals that surpassed the maximum permissive values according the legislation in most of the points analyzed were Mn, Cu and Pb. For slurry samples collected in Delta Landfill, the average concentrations for Mn, Ni, Cu and Pb not exceeded the maximum permissive values during the period studied. Moreover for Santa Barbara the average concentration of Mn, Cu and Zn surpassed the permissive limits, as was observed for Mn in the Pirelli Landfill. (author)

  4. Trends in concentrations of nitrate and total dissolved solids in public supply wells of the Bunker Hill, Lytle, Rialto, and Colton groundwater subbasins, San Bernardino County, California: influence of legacy land use.

    Science.gov (United States)

    Kent, Robert; Landon, Matthew K

    2013-05-01

    Concentrations and temporal changes in concentrations of nitrate and total dissolved solids (TDS) in groundwater of the Bunker Hill, Lytle, Rialto, and Colton groundwater subbasins of the Upper Santa Ana Valley Groundwater Basin were evaluated to identify trends and factors that may be affecting trends. One hundred, thirty-one public-supply wells were selected for analysis based on the availability of data spanning at least 11 years between the late 1980s and the 2000s. Forty-one of the 131 wells (31%) had a significant (p<0.10) increase in nitrate and 14 wells (11%) had a significant decrease in nitrate. For TDS, 46 wells (35%) had a significant increase and 8 wells (6%) had a significant decrease. Slopes for the observed significant trends ranged from -0.44 to 0.91 mg/L/yr for nitrate (as N) and -8 to 13 mg/L/yr for TDS. Increasing nitrate trends were associated with greater well depth, higher percentage of agricultural land use, and being closer to the distal end of the flow system. Decreasing nitrate trends were associated with the occurrence of volatile organic compounds (VOCs); VOC occurrence decreases with increasing depth. The relations of nitrate trends to depth, lateral position, and VOCs imply that increasing nitrate concentrations are associated with nitrate loading from historical agricultural land use and that more recent urban land use is generally associated with lower nitrate concentrations and greater VOC occurrence. Increasing TDS trends were associated with relatively greater current nitrate concentrations and relatively greater amounts of urban land. Decreasing TDS trends were associated with relatively greater amounts of natural land use. Trends in TDS concentrations were not related to depth, lateral position, or VOC occurrence, reflecting more complex factors affecting TDS than nitrate in the study area. Published by Elsevier B.V.

  5. Review of Oceanographic and Geochemical Data Collected in Massachusetts Bay during a Large Discharge of Total Suspended Solids from Boston's Sewage-Treatment System and Ocean Outfall in August 2002

    Science.gov (United States)

    Bothner, Michael H.; Butman, Bradford; Casso, Michael A.

    2010-01-01

    During the period August 14-23, 2002, the discharge of total suspended solids (TSS) from the Massachusetts Water Resources Authority sewage-treatment plant ranged from 32 to 132 milligrams per liter, causing the monthly average discharge to exceed the limit specified in the National Pollution Discharge Elimination System permit. Time-series monitoring data collected by the U.S. Geological Survey in western Massachusetts Bay were examined to evaluate changes in environmental conditions during and after this exceedance event. The rate of sediment trapping and the concentrations of near-bottom suspended sediment measured near the outfall in western Massachusetts Bay increased during this period. Because similar increases in sediment-trapping rate were observed in the summers of 2003 and 2004, however, the increase in 2002 cannot be definitively attributed to the increased TSS discharge. Concentrations of copper and silver in trapped sediment collected 10 and 20 days following the 2002 TSS event were elevated compared to those in pre-event samples. Maximum concentrations were less than 50 percent of toxicity guidelines. Photographs of surficial bottom sediments obtained before and after the TSS event do not show sediment accumulation on the sea floor. Concentrations of silver, Clostridium perfringens, and clay in surficial bottom sediments sampled 10 weeks after the discharge event at a depositional site 3 kilometers west of the outfall were unchanged from those in samples obtained before the event. Simulation of the TSS event by using a coupled hydrodynamic-wave-sediment-transport model could enhance understanding of these observations and of the effects of the exceedance on the local marine environment.

  6. Removal of endocrine disruptors and non-steroidal anti-inflammatory drugs through wastewater chlorination: the effect of pH, total suspended solids and humic acids and identification of degradation by-products.

    Science.gov (United States)

    Noutsopoulos, Constantinos; Koumaki, Elena; Mamais, Daniel; Nika, Maria-Christina; Bletsou, Anna A; Thomaidis, Nikolaos S

    2015-01-01

    Endocrine disrupting chemicals (EDCs) and non-steroidal anti-inflammatory drugs (NSAIDs) are two groups of emerging pollutants the significance of which rests on their persistent detection in the aquatic environment and their possible adverse effects. Wastewater treatment plants are one of the major ways for transporting such chemicals in the aquatic environment. Chlorination is usually the last stage of treatment before wastewater being disposed to the aquatic environment. This work focuses on the evaluation of the effect of chlorine dose and specific wastewater characteristics (pH, total suspended solids and humic acids) on the removal of target EDCs and NSAIDs through chlorination. Another objective of this study is the identification of chlorination by-products of specific EDCs and NSAIDs and their dependence on contact time. Based on the results it is concluded that the effect of chlorine dose and humic acids concentration on the degradation of target compounds during chlorination is minimal. On the contrary, pH is a critical parameter which highly affects process performance. Moreover, it is concluded that not only the free available chlorine species, but also the properties of EDCs and NSAIDs under different pH conditions can affect chlorination process performance. The effect of TSS on the degradation of the target compounds during chlorination is more profound for chemicals with high Kow values and therefore higher affinity to partition to the particulate phase (i.e. nonylphenols, triclosan). Several degradation by-products were identified through chlorination of nonylphenol, bisphenol A and diclofenac. The dependence of these by-products on chlorination contact time is also demonstrated. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Study of the effect of the energy spectrum and of the total flux on the damage produced by neutrons in solids; Contribution a l'etude de l'influence du spectre et du flux integre sur les dommages crees par les neutrons dans les solides

    Energy Technology Data Exchange (ETDEWEB)

    Dulieu, P C [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1967-01-01

    In the first part are studied the general relationships between the physical effects produced by neutrons in solids, and the total flux and neutron energy spectrum; some examples are given. The second part, describes the application to a silicon damage detector whose principle is to use the damage produced in a PIN Junction for measuring the neutron flux (intermediate and fast) received by the detector. Chapter I is devoted to the experimental determination of the energy given to the atoms by a primary in the silicon. The results and conclusions drawn from this determination make it possible to consider, in chapter II, the calculation of the detectors response characteristics.Chapter III deals with the measurement of the detectors response function and it is noted that good agreement is obtained between the calculation and experimental results. The whole of the second part constitutes a test of the methods presented in the first part. (author) [French] Dans la premiere partie, nous etudions les relations generales qui lient les effets physiques engendres par les neutrons dans les solides au flux integre et au spectre des neutrons et nous donnons des exemples d'utilisation. La deuxieme partie est une application au detecteur de dommages en silicium, dont le principe est d'utiliser les dommages crees dans une jonction PIN pour mesurer les flux de neutrons (intermediaires et rapides) recus par le detecteur. Le chapitre I est consacre a la determination experimentale de l'energie cedee aux atomes par un primaire dans le silicium. Les resultats et les conclusions que l'on peut tirer de cette determination permettent d'aborder, au chapitre II, le calcul de la fonction de reponse du detecteur. Le chapitre III porte sur la mesure de la fonction de reponse du detecteur et on constate qu'il y a un bon accord entre le calcul et l'experience. L'ensemble de la deuxieme partie constitue un test des methodes exposees dans la premiere partie. (auteur)

  8. Os reflexos da gestão pela qualidade total em instituições hospitalares brasileiras Los reflejos de la gerencia para la calidad total en institutos hospitalares brasilenos The reflexes of the management for the total quality in brazilians hospitals institutes

    Directory of Open Access Journals (Sweden)

    Alexandre Pazetto Balsanelli

    2005-12-01

    Full Text Available OBJETIVO: O objetivo do presente estudo consistiu em apresentar os resultados alcançados pelos hospitais e serviços de enfermagem na adoção dessa filosofia gerencial. MÉTODOS: Utilizou-se a revisão da literatura como procedimento metodológico. RESULTADOS: A análise das experiências descritas permitiu concluir que a G. Q. T. propiciou um ganho com relação aos recursos humanos garantindo a satisfação do cliente interno no seu ambiente de trabalho. O paciente teve suas necessidades supridas, houve reconhecimento da sociedade e também ocorreram melhorias nos indicadores de estatística hospitalar. CONSIDERAÇÕES FINAIS: A agregação de valores baseados na consciência do conhecimento de sistemas, em estudos de cenários e na aprendizagem contínua tornou-se o elemento diferenciador destas organizações.OBJETIVO: El objetivo del actual estudio consistió en levantar los resultados para los hospitales y los trabajos del cuidado en la adopción gerencial de la filosofía. MÉTODO: La revisión de la literatura había sido utilizada como procedimiento de la metodología. RESULTADOS: El análisis de las experiencias descritas permitió para concluir que el G. Q. T. propitiated un beneficio en relación a las características humanas que garantizaban la satisfacción del cliente interno en su ambiente del trabajo. El paciente hizo sus necesidades proveer, había reconocimiento de la sociedad y había también mejora en los indicadores de la estadística de hospital. CONSIDERACIONES FINALES: La agregación de valores con base en la conciencia de los sistemas, en estudios de escenarios y el aprendizaje continuo se tornó el elemento diferenciador de estas organizaciones.OBJECTIVE: The present study objective consisted in raising the results for the hospitals and jobs of nursing in the managemental philosophy adoption. METHODS: The literature review had been used as methodology procedure. RESULTS: The analysis of the described experiences

  9. One Hundred Twenty-One Resected Solid Pseudopapillary Tumors of the Pancreas: An 8-Year Single-Institution Experience at Zhongshan Hospital, Shanghai, China.

    Science.gov (United States)

    Xu, Yadong; Zhao, Guochao; Pu, Ning; Nuerxiati, Abulimiti; Ji, Yuan; Zhang, Lei; Rong, Yefei; Lou, Wenhui; Wang, Dansong; Kuang, Tiantao; Xu, Xuefeng; Wu, Wenchuan

    2017-09-01

    The aims of this study were to introduce our experience with treating patients with pancreatic solid pseudopapillary tumors (SPTs) and to investigate the clinical risk factors for recurrence of SPTs because no consensus has been established to date. One hundred twenty-one patients underwent surgical resection from January 2008 to December 2015 in our institution. Clinical data were collected from the standardized reports. Of the 121 patients, 93 (76.9%) were women, 28 (23.1%) were men, and the mean age at diagnosis was 33.7 years (range, 11-68 years). Sixty patients were subjected to short-term complications, and 8 patients experienced long-term complications, some of whom may require surgery. The tumor located in the distal pancreas (P = 0.02), and a Ki-67 index value > 1.5 (P = 0.01) indicated malignancy according to the World Health Organization 2000 classification. One hundred three patients responded to follow-up, and 3 cases (2.9%) were subject to liver metastases. Recurrence was more frequently observed in tumors classified as high-grade malignancies according to the World Health Organization 2010 classification (P = 0.013), synchronous metastases (P < 0.001), peripancreatic fat infiltration (P = 0.018), and lymphovascular invasion (P < 0.001). Evaluating the risk of the recurrence of SPTs still requires systematic and multicenter trials in the future, even some pathological features showed statistical differences.

  10. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  11. Discussions on the business strategy against total reimbursement control of medical insurance for large public hospitals%医保总额控制下大型公立医院经营策略探讨

    Institute of Scientific and Technical Information of China (English)

    余臻峥; 陈敏芳

    2015-01-01

    为解决医疗费用过快上涨、医保对供方行为约束不足、基金运行风险加剧等问题,人力资源和社会保障部等要求在统筹地区开展以总额控制为主的医保支付方式改革.总额控制对城市大型公立医院的经营管理产生了较大的影响.按照总额控制政策,提出3个层面的转型策略.在发展战略方面,转变增长方式,发挥医联体作用,增强辐射能力;在业务管理方面,确保医疗质量和安全,落实临床路径,优化服务流程;在行政管理方面,强化成本控制,加强信息化建设,转变管理职能.%To address such challenges as the rapid rise in health care costs,insufficient constraints on supply-side behavior by medical insurance,and rising risk exposure of the insurance foundation,the Ministry of Human Resources and Social Security has proposed a payment mode reform featuring total reimbursement control.Such a total control policy will affect significantly the business operation of urban public hospitals.To adapt to the impacts so incurred,a three-level transformation strategy is recommended as follows.A development strategy calling for a new growth model,greater role of hospital-health alliances for greater service coverage; a business management strategy to ensure quality of care and safety,clinical pathways in place and optimize service processes; an administrative strategy to enhance cost control,strengthen information technology,and transform the management functions.

  12. Study of the effect of the energy spectrum and of the total flux on the damage produced by neutrons in solids; Contribution a l'etude de l'influence du spectre et du flux integre sur les dommages crees par les neutrons dans les solides

    Energy Technology Data Exchange (ETDEWEB)

    Dulieu, P.C. [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1967-01-01

    In the first part are studied the general relationships between the physical effects produced by neutrons in solids, and the total flux and neutron energy spectrum; some examples are given. The second part, describes the application to a silicon damage detector whose principle is to use the damage produced in a PIN Junction for measuring the neutron flux (intermediate and fast) received by the detector. Chapter I is devoted to the experimental determination of the energy given to the atoms by a primary in the silicon. The results and conclusions drawn from this determination make it possible to consider, in chapter II, the calculation of the detectors response characteristics.Chapter III deals with the measurement of the detectors response function and it is noted that good agreement is obtained between the calculation and experimental results. The whole of the second part constitutes a test of the methods presented in the first part. (author) [French] Dans la premiere partie, nous etudions les relations generales qui lient les effets physiques engendres par les neutrons dans les solides au flux integre et au spectre des neutrons et nous donnons des exemples d'utilisation. La deuxieme partie est une application au detecteur de dommages en silicium, dont le principe est d'utiliser les dommages crees dans une jonction PIN pour mesurer les flux de neutrons (intermediaires et rapides) recus par le detecteur. Le chapitre I est consacre a la determination experimentale de l'energie cedee aux atomes par un primaire dans le silicium. Les resultats et les conclusions que l'on peut tirer de cette determination permettent d'aborder, au chapitre II, le calcul de la fonction de reponse du detecteur. Le chapitre III porte sur la mesure de la fonction de reponse du detecteur et on constate qu'il y a un bon accord entre le calcul et l'experience. L'ensemble de la deuxieme partie constitue un test des methodes exposees dans la premiere partie

  13. A Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds

    Science.gov (United States)

    1984-08-01

    their role in the hospital. The book Megatrends points out that there are six States which set the pace for national trends. One of these is California...care hospitals but two. Again, one must recall what the book Megatrends says about California and national trends. Another key according to this study...Catholic Hospitals," Ethics Committees Newsletter, Vol 1, No. 2, November 1983, p. 2. 7. R. Veatch, Death, PyiLn and the Biological Revolution, New Haven

  14. Hospitals look to hospitality service firms to meet TQM goals.

    Science.gov (United States)

    Hard, R

    1992-05-20

    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

  15. The Effect of 5S-Continuous Quality Improvement-Total Quality Management Approach on Staff Motivation, Patients' Waiting Time and Patient Satisfaction with Services at Hospitals in Uganda.

    Science.gov (United States)

    Take, Naoki; Byakika, Sarah; Tasei, Hiroshi; Yoshikawa, Toru

    2015-03-31

    This study aimed at analyzing the effect of 5S practice on staff motivation, patients' waiting time and patient satisfaction with health services at hospitals in Uganda. Double-difference estimates were measured for 13 Regional Referral Hospitals and eight General Hospitals implementing 5S practice separately. The study for Regional Referral Hospitals revealed 5S practice had the effect on staff motivation in terms of commitment to work in the current hospital and waiting time in the dispensary in 10 hospitals implementing 5S, but significant difference was not identified on patient satisfaction. The study for General Hospitals indicated the effect of 5S practice on patient satisfaction as well as waiting time, but staff motivation in two hospitals did not improve. 5S practice enables the hospitals to improve the quality of services in terms of staff motivation, waiting time and patient satisfaction and it takes as least four years in Uganda. The fourth year since the commencement of 5S can be a threshold to move forward to the next step, Continuous Quality Improvement.

  16. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  17. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  18. Nanocrystalline solids

    International Nuclear Information System (INIS)

    Gleiter, H.

    1991-01-01

    Nanocrystalline solids are polycrystals, the crystal size of which is a few (typically 1 to 10) nanometres so that 50% or more of the solid consists of incoherent interfaces between crystals of different orientations. Solids consisting primarily of internal interfaces represent a separate class of atomic structures because the atomic arrangement formed in the core of an interface is known to be an arrangement of minimum energy in the potential field of the two adjacent crystal lattices with different crystallographic orientations on either side of the boundary core. These boundary conditions result in atomic structures in the interfacial cores which cannot be formed elsewhere (e.g. in glasses or perfect crystals). Nanocrystalline solids are of interest for the following four reasons: (1) Nanocrystalline solids exhibit an atomic structure which differs from that of the two known solid states: the crystalline (with long-range order) and the glassy (with short-range order). (2) The properties of nanocrystalline solids differ (in some cases by several orders of magnitude) from those of glasses and/or crystals with the same chemical composition, which suggests that they may be utilized technologically in the future. (3) Nanocrystalline solids seem to permit the alloying of conventionally immiscible components. (4) If small (1 to 10 nm diameter) solid droplets with a glassy structure are consolidated (instead of small crystals), a new type of glass, called nanoglass, is obtained. Such glasses seem to differ structurally from conventional glasses. (orig.)

  19. Solid Matter

    CERN Document Server

    Angelo, Joseph A

    2011-01-01

    Supported by a generous quantity of full-color illustrations and interesting sidebars, Solid Matter introduces the basic characteristics and properties of solid matter. It briefly describes the cosmic connection of the elements, leading readers through several key events in human pre-history that resulted in more advanced uses of matter in the solid state. Chapters include:. -Solid Matter: An Initial Perspective. -Physical Behavior of Matter. -The Gravity of Matter. -Fundamentals of Materials Science. -Rocks and Minerals. -Metals. -Building Materials. -Carbon Earth's Most Versatile Element. -S

  20. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  1. development of improved solid hospital waste management

    African Journals Online (AJOL)

    user

    2016-07-03

    Jul 3, 2016 ... procurement of waste segregation practices, double chambered incinerator while evaluation of medical and health .... Government area of Kwara state in the north central ... with an international organization were conducted.

  2. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  3. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  4. Fraud in Hospitals

    OpenAIRE

    Musau, Steve; Vian, Taryn

    2008-01-01

    Hospitals are vulnerable to corruption. In the U.S., health care fraud has been stimated to cost $60 billion per year, or 3% of total health care expenditures - much of it in the hospital sector. Hospitals account for 50% or more of health care pending in many countries. Fraud and corruption in hospitals negatively affect access and quality, as public servants make off with resources which could have been used to reduce out-of-pocket expenditures for patients, or improve needed services. This...

  5. Hospital waste management in nonteaching hospitals of Lucknow City, India

    Directory of Open Access Journals (Sweden)

    Manish Kumar Manar

    2014-01-01

    Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

  6. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  7. Solid electrolytes

    Science.gov (United States)

    Abraham, Kuzhikalail M.; Alamgir, Mohamed

    1993-06-15

    This invention pertains to Li ion (Li.sup.+) conductive solid polymer electrolytes composed of solvates of Li salts immobilized (encapsulated) in a solid organic polymer matrix. In particular, this invention relates to solid polymer electrolytes derived by immobilizing complexes (solvates) formed between a Li salt such as LiAsF.sub.6, LiCF.sub.3 SO.sub.3 or LiClO.sub.4 and a mixture of aprotic organic solvents having high dielectric constants such as ethylene carbonate (EC) (dielectric constant=89.6) and propylene carbonate (PC) (dielectric constant=64.4) in a polymer matrix such as polyacrylonitrile, poly(tetraethylene glycol diacrylate), or poly(vinyl pyrrolidinone).

  8. Electronic remote blood issue: a combination of remote blood issue with a system for end-to-end electronic control of transfusion to provide a "total solution" for a safe and timely hospital blood transfusion service.

    Science.gov (United States)

    Staves, Julie; Davies, Amanda; Kay, Jonathan; Pearson, Oliver; Johnson, Tony; Murphy, Michael F

    2008-03-01

    The rapid provision of red cell (RBC) units to patients needing blood urgently is an issue of major importance in transfusion medicine. The development of electronic issue (sometimes termed "electronic crossmatch") has facilitated rapid provision of RBC units by avoidance of the serologic crossmatch in eligible patients. A further development is the issue of blood under electronic control at blood refrigerator remote from the blood bank. This study evaluated a system for electronic remote blood issue (ERBI) developed as an enhancement of a system for end-to-end electronic control of hospital transfusion. Practice was evaluated before and after its introduction in cardiac surgery. Before the implementation of ERBI, the median time to deliver urgently required RBC units to the patient was 24 minutes. After its implementation, RBC units were obtained from the nearby blood refrigerator in a median time of 59 seconds (range, 30 sec to 2 min). The study also found that unused requests were reduced significantly from 42 to 20 percent, the number of RBC units issued reduced by 52 percent, the number of issued units that were transfused increased from 40 to 62 percent, and there was a significant reduction in the workload of both blood bank and clinical staff. This study evaluated a combination of remote blood issue with an end-to-end electronically controlled hospital transfusion process, ERBI. ERBI reduced the time to make blood available for surgical patients and improved the efficiency of hospital transfusion.

  9. Characterization of Hospital Residuals

    International Nuclear Information System (INIS)

    Blanco Meza, A.; Bonilla Jimenez, S.

    1997-01-01

    The main objective of this investigation is the characterization of the solid residuals. A description of the handling of the liquid and gassy waste generated in hospitals is also given, identifying the source where they originate. To achieve the proposed objective the work was divided in three stages: The first one was the planning and the coordination with each hospital center, in this way, to determine the schedule of gathering of the waste can be possible. In the second stage a fieldwork was made; it consisted in gathering the quantitative and qualitative information of the general state of the handling of residuals. In the third and last stage, the information previously obtained was organized to express the results as the production rate per day by bed, generation of solid residuals for sampled services, type of solid residuals and density of the same ones. With the obtained results, approaches are settled down to either determine design parameters for final disposition whether for incineration, trituration, sanitary filler or recycling of some materials, and storage politics of the solid residuals that allow to determine the gathering frequency. The study concludes that it is necessary to improve the conditions of the residuals handling in some aspects, to provide the cleaning personnel of the equipment for gathering disposition and of security, minimum to carry out this work efficiently, and to maintain a control of all the dangerous waste, like sharp or polluted materials. In this way, an appreciable reduction is guaranteed in the impact on the atmosphere. (Author) [es

  10. Bacteria contamination of touch surfaces in Polish hospital wards

    Directory of Open Access Journals (Sweden)

    Anna Różańska

    2017-08-01

    Full Text Available Background: The objective of the study has been to evaluate the pathogenic bacteria contamination of touch surfaces in hospital wards. Material and Methods: Samples were taken from frequently touched surfaces in the hospital environment in 13 units of various types. Culturing was carried out on solid blood agar and in growth broth (tryptic soy broth – TSB. Species identification was performed using the analytical profile index (API biochemical testing and confirmed with matrix assisted laser desorption ionization time-flight mass spectrometry (MALDI-TOF-MS system. Results: The total of 161 samples were taken for the study. Fifty-two of them, after 24 h of culture on a solid medium, demonstrated bacterial growth and further 60 samples had growth after prior multiplication in TSB. Overall, 69.6% of samples exhibited growth of 19 bacterial species. Pathogenic species – representing indicator organisms of efficiency of hospital cleaning – was demonstrated by 21.4% of samples. Among them Acinetobacter spp., Enterocococci spp. and Staphylococcus aureus were identified. Coagulase-negative staphylococci (CNS were predominant. The proportion of various groups of bacteria significantly varied in respective hospitals, and in various types of wards. Disturbing observation is a large proportion of resistance of isolated CNS strains as a potential reservoir of resistance genes. Conclusions: The results show that touch surfaces in hospital units are contaminated by both potentially pathogenic and pathogenic bacterial species. In connection with the reported, also in Poland, frequent omission or incorrect execution of hand hygiene by hospital staff, and probably patients, touch surfaces still constitute important reservoir of pathogenic bacteria. Improving hand hygiene compliance of health-care workers with recommendations is necessary for increasing biological safety of hospital environment. Med Pr 2017;68(3:459–467

  11. Total filmless digital radiology service

    International Nuclear Information System (INIS)

    Mun, S.K.; Goeringer, F.; Benson, H.; Horii, S.C.

    1989-01-01

    The completion of a comprehensive picture archiving and communication system (PACS) at Georgetown University Hospital has allowed us to identify a number of technical, administrative, personnel, and operational issues that will affect a total digital radiology service. With a hospital-wide digital imaging network system, computer simulation of communications and storage options, and economic modeling, we have developed a feasibility study and implementation strategy for the smooth transition to a nearly filmless radiology service over the next several years. This paper describes the technical and operational requirements for various database operations, workstations (used in diagnosis, review, and education), and communications. Site and installation planning, personnel training, and transition operations are discussed

  12. High-performance liquid chromatography - Ultraviolet method for the determination of total specific migration of nine ultraviolet absorbers in food simulants based on 1,1,3,3-Tetramethylguanidine and organic phase anion exchange solid phase extraction to remove glyceride.

    Science.gov (United States)

    Wang, Jianling; Xiao, Xiaofeng; Chen, Tong; Liu, Tingfei; Tao, Huaming; He, Jun

    2016-06-17

    The glyceride in oil food simulant usually causes serious interferences to target analytes and leads to failure of the normal function of the RP-HPLC column. In this work, a convenient HPLC-UV method for the determination of the total specific migration of nine ultraviolet (UV) absorbers in food simulants was developed based on 1,1,3,3-tetramethylguanidine (TMG) and organic phase anion exchange (OPAE) SPE to efficiently remove glyceride in olive oil simulant. In contrast to the normal ion exchange carried out in an aqueous solution or aqueous phase environment, the OPAE SPE was performed in the organic phase environments, and the time-consuming and challenging extraction of the nine UV absorbers from vegetable oil with aqueous solution could be readily omitted. The method was proved to have good linearity (r≥0.99992), precision (intra-day RSD≤3.3%), and accuracy(91.0%≤recoveries≤107%); furthermore, the lower limit of quantifications (0.05-0.2mg/kg) in five types of food simulants(10% ethanol, 3% acetic acid, 20% ethanol, 50% ethanol and olive oil) was observed. The method was found to be well suited for quantitative determination of the total specific migration of the nine UV absorbers both in aqueous and vegetable oil simulant according to Commission Regulation (EU) No. 10/2011. Migration levels of the nine UV absorbers were determined in 31 plastic samples, and UV-24, UV-531, HHBP and UV-326 were frequently detected, especially in olive oil simulant for UV-326 in PE samples. In addition, the OPAE SPE procedure was also been applied to efficiently enrich or purify seven antioxidants in olive oil simulant. Results indicate that this procedure will have more extensive applications in the enriching or purification of the extremely weak acidic compounds with phenol hydroxyl group that are relatively stable in TMG n-hexane solution and that can be barely extracted from vegetable oil. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Handling of Solid Residues

    International Nuclear Information System (INIS)

    Medina Bermudez, Clara Ines

    1999-01-01

    The topic of solid residues is specifically of great interest and concern for the authorities, institutions and community that identify in them a true threat against the human health and the atmosphere in the related with the aesthetic deterioration of the urban centers and of the natural landscape; in the proliferation of vectorial transmitters of illnesses and the effect on the biodiversity. Inside the wide spectrum of topics that they keep relationship with the environmental protection, the inadequate handling of solid residues and residues dangerous squatter an important line in the definition of political and practical environmentally sustainable. The industrial development and the population's growth have originated a continuous increase in the production of solid residues; of equal it forms, their composition day after day is more heterogeneous. The base for the good handling includes the appropriate intervention of the different stages of an integral administration of residues, which include the separation in the source, the gathering, the handling, the use, treatment, final disposition and the institutional organization of the administration. The topic of the dangerous residues generates more expectation. These residues understand from those of pathogen type that are generated in the establishments of health that of hospital attention, until those of combustible, inflammable type, explosive, radio-active, volatile, corrosive, reagent or toxic, associated to numerous industrial processes, common in our countries in development

  14. Ground-fire effects on the composition of dissolved and total organic matter in forest floor and soil solutions from Scots pine forests in Germany: new insights from solid state 13C NMR analysis

    Science.gov (United States)

    Näthe, Kerstin; Michalzik, Beate; Levia, Delphis; Steffens, Markus

    2016-04-01

    Fires represent an ecosystem disturbance and are recognized to seriously pertubate the nutrient budgets of forested ecosystems. While the effects of fires on chemical, biological, and physical soil properties have been intensively studied, especially in Mediterranean areas and North America, few investigations examined the effects of fire-induced alterations in the water-bound fluxes and the chemical composition of dissolved and particulate organic carbon and nitrogen (DOC, POC, DN, PN). The exclusion of the particulate organic matter fraction (0.45 μm Independent from fire manipulation, the composition of TOM was generally less aromatic (aromaticity index [%] according to Hatcher et al., 1981) with values between 18 (FF) - 25% (B horizon) than the DOM fraction with 23 (FF) - 27% (B horizon). For DOM in FF solution, fire manipulation caused an increase in aromaticity from 23 to 27% compared to the control, due to an increase of the aryl-C and a decrease of the O-alkyl-C and alkyl-C signal. Fire effects were leveled out in the mineral soil. For TOM, fire effects became notable only in the A horizon, exhibiting a decrease in aromaticity from 22 to 18% compared to the control, due to increased O-alkyl-C and diminished aryl-C proportions. Compared to the control, fire only caused minor DOC release rates (events did not significantly enhance the proportion of POC and PN in the total C and N amounts exhibiting values between 10 and 20%. To fully understand the quality and amount of translocated organic C and N compounds within soils under both ambient as well as fire environments, dissolved and particulate size fractions need to be considered.

  15. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  16. Blood Management Strategies to Reduce Transfusions After Elective Lower-Extremity Joint Arthroplasty Surgeries: One Tertiary Care Hospital's Early Experience With an Alternative Payment Model-a Total Joint "Bundle".

    Science.gov (United States)

    Kansagra, Ankit; Andrzejewski, Chester; Krushell, Robert; Lehman, Andrew; Greenbaum, Jordan; Visintainer, Paul; McGirr, Joan; Mahoney, Kathleen; Cloutier, Darlene; Ehresman, Alice; Stefan, Mihaela S

    Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post. Fractional logistic regression was used to describe differences between various intervention periods. During the study period, 2511 patients underwent TJA. Compared with the preintervention period, there was 81.8% decrease in total units of RBCT during the postintervention period. Using activity-based costing (~$1000/unit), the annualized saving in RBC expenditure was $480 000. A multidisciplinary approach can be successful and sustainable in reducing RBCT and its associated costs for patients undergoing TJA.

  17. Efeito do teor de sólidos e da concentração de sacarose na acidificação, firmeza e viabilidade de bactérias do iogurte e probióticas em leite fermentado Effect of total solids and sucrose contents on acidity, firmness and viability of yogurt and probiotic bacteria in fermented milk

    Directory of Open Access Journals (Sweden)

    Maricê N. Oliveira

    2003-12-01

    Full Text Available Doze lotes de leites fermentados foram preparados a 42ºC nos quais as variáveis estudadas foram o teor de sólidos totais (12 e 15%, o teor de sacarose (0% e 8% e o tipo de co-cultura (Streptococcus thermophilus e Lactobacillus delbrueckii subsp. bulgaricus ; Streptococcus thermophilus e Lactobacillus acidophilus ; Streptococcus thermophilus e Lactobacillus rhamnosus. Parâmetros cinéticos para a diminuição do pH até 4,5 foram calculados. Determinações físico-químicas e microbiológicas foram realizadas após um e sete dias de armazenamento dos produtos a 4ºC. Com o aumento do teor de sólidos totais e adição de sacarose, a atividade de água do leite diminuiu e o tempo para atingir pH 4,5 variou conforme a co-cultura empregada. Os leites fermentados por S. thermophilus e L. acidphilus (STLA apresentaram pós-acidificação mais acentuada. Aqueles fermentados por S. thermophilus e L. rhamnosus (STLR foram mais estáveis. Os leites contendo maiores teores de sólidos totais foram aqueles com maior acidez total independente da co-cultura usada. Com o aumento do teor de sacarose e de sólidos solúveis houve um aumento da firmeza usando-se as co-culturas STLR e STLA. Após sete dias, o número de bactérias do iogurte e as probióticas não variou significativamente. Em todos os lotes, o número de bactérias probióticas ficou acima do sugerido pela literatura.Twelve batches of fermented milk were prepared at 42ºC where the studied variables were total solids content (12 and 15%, sucrose concentration (0 and 8%, and co-culture type (Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus ; Streptococcus thermophilus and Lactobacillus acidophilus ; Streptococcus thermophilus and Lactobacillus rhamnosus. Kinetic parameters to decrease pH until 4.5 were calculated. Physico-chemical and microbiological determinations were carried out on products after 1 and 7 days of storage at 4ºC. The increase in total solids and

  18. MBR technology: a promising approach for the (pre-)treatment of hospital wastewater.

    Science.gov (United States)

    Beier, S; Cramer, C; Mauer, C; Köster, S; Schröder, H Fr; Pinnekamp, J

    2012-01-01

    Membrane bioreactor (MBR) technology is a very reliable and extensively tested solution for biological wastewater treatment. Nowadays, separate treatment of highly polluted wastewater streams especially from hospitals and other health care facilities is currently under investigation worldwide. In this context, the MBR technology will play a decisive role because an effluent widely cleaned up from solids and nutrients is absolutely mandatory for a subsequent further elimination of organic trace pollutants. Taking hospital wastewater as an example, the aim of this study was to investigate to what extent MBR technology is an adequate 'pre-treatment' solution for further elimination of trace pollutants. Therefore, we investigated - within a 2-year period - the performance of a full-scale hospital wastewater treatment plant (WWTP) equipped with a MBR by referring to conventional chemical and microbiological standard parameters. Furthermore, we measured the energy consumption and tested different operating conditions. According to our findings the MBR treatment of the hospital wastewater was highly efficient in terms of the removal of solids and nutrients. Finally, we did not observe any major adverse effects on the operation and performance of the MBR system which potentially could derive from the composition of the hospital wastewater. In total, the present study proved that MBR technology is a very efficient and reliable treatment approach for the treatment of highly polluted wastewater from hospitals and can be recommended as a suitable pre-treatment solution for further trace pollutant removal.

  19. Surgical waste audit of 5 total knee arthroplasties.

    Science.gov (United States)

    Stall, Nathan M; Kagoma, Yoan M; Bondy, Jennifer N; Naudie, Douglas

    2013-04-01

    Operating rooms (ORs) are estimated to generate up to one-third of hospital waste. At the London Health Sciences Centre, prosthetics and implants represent 17% of the institution's ecological footprint. To investigate waste production associated with total knee arthroplasties (TKAs), we performed a surgical waste audit to gauge the environmental impact of this procedure and generate strategies to improve waste management. We conducted a waste audit of 5 primary TKAs performed by a single surgeon in February 2010. Waste was categorized into 6 streams: regular solid waste, recyclable plastics, biohazard waste, laundered linens, sharps and blue sterile wrap. Volume and weight of each stream was quantified. We used Canadian Joint Replacement Registry data (2008-2009) to estimate annual weight and volume totals of waste from all TKAs performed in Canada. The average surgical waste (excluding laundered linens) per TKA was 13.3 kg, of which 8.6 kg (64.5%) was normal solid waste, 2.5 kg (19.2%) was biohazard waste, 1.6 kg (12.1%) was blue sterile wrap, 0.3 kg (2.2%) was recyclables and 0.3 kg (2.2%) was sharps. Plastic wrappers, disposable surgical linens and personal protective equipment contributed considerably to total waste. We estimated that landfill waste from all 47 429 TKAs performed in Canada in 2008-2009 was 407 889 kg by weight and 15 272 m3 by volume. Total knee arthroplasties produce substantial amounts of surgical waste. Environmentally friendly surgical products and waste management strategies may allow ORs to reduce the negative impacts of waste production without compromising patient care. Level IV, case series.

  20. CMS penalizes 758 hospitals for safety incidents

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-12-01

    Full Text Available No abstract available. Article truncated after 150 words. The Centers for Medicare and Medicaid Services (CMS is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those were also fined last year, as reported by Kaiser Health News (1. Among the hospitals being financially punished are some well-known institutions, including Yale New Haven Hospital, Medstar Washington Hospital Center in DC, Grady Memorial Hospital, Northwestern Memorial Hospital in Chicago, Indiana University Health, Brigham and Womens Hospital, Tufts Medical Center, University of North Carolina Hospital, the Cleveland Clinic, Hospital of the University of Pennsylvania, Parkland Health and Hospital, and the University of Virginia Medical Center (Complete List of Hospitals Penalized 2016. In the Southwest the list includes Banner University Medical Center in Tucson, Ronald Reagan UCLA Medical Center, Stanford Health Care, Denver Health Medical Center and the University of New Mexico Medical Center (for list of Southwest hospitals see Appendix 1. In total, CMS ...

  1. Environmental pollution from solid wastes

    International Nuclear Information System (INIS)

    Jervis, R.E.; Krishnan, S.S.; Accetone, P.; Arifin, N.; Ko, M.M.C.; Nhan, C.; Nguyen, L.; Vela, L.; Yee, T.

    1992-01-01

    Research completed under the CRP during the past two years has encompassed several related aspects of environmental problems associated with solid wastes: assessment of major sources of toxic elements in a variety of solid waste forms, their leachability by simulated groundwater or rain/acid rain and the determination of the contribution of hospital incinerator to atmospheric releases. The summary of the findings of these investigations are given in this report. Unexpected high levels of cadmium have been found in many solid wastes. Leaching tests indicate that, in some cases, over 70% of this can be leached out into the nearby waterways. Combustibility tests indicated that 35 to 45% of it is emitted to the atmosphere during burning. This explains the increased levels of cadmium in air particulates sampled downwind from waste incinerators. Plastic items in municipal and hospital wastes were particularly elevated in Cd, Cl, Cr, Ba and Zn. Up to 1300 μg/g of Cd was found in some domestic items. By inference, Pb also is found in some common plastics but the current studies did not permit Pb determination in solid wastes, but only in aerosols. (author). 8 tabs

  2. Solid residues

    International Nuclear Information System (INIS)

    Mulder, E.; Duin, P.J. van; Grootenboer, G.J.

    1995-01-01

    A summary is presented of the many investigations that have been done on solid residues of atmospheric fluid bed combustion (AFBC). These residues are bed ash, cyclone ash and bag filter ash. Physical and chemical properties are discussed and then the various uses of residues (in fillers, bricks, gravel, and for recovery of aluminium) are summarised. Toxicological properties of fly ash and stack ash are discussed as are risks of pneumoconiosis for workers handling fly ash, and contamination of water by ashes. On the basis of present information it is concluded that risks to public health from exposure to emissions of coal fly ash from AFBC appear small or negligible as are health risk to workers in the coal fly ash processing industry. 35 refs., 5 figs., 12 tabs

  3. MODIFIED TECHNIQUE OF TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Predrag Spirić

    2010-12-01

    Full Text Available Surgical technique of total laryngectomy is well presented in many surgical textbooks. Essentially, it has remained the same since Gluck an Soerensen in 1922 described all its details. Generally, it stresses the U shape skin incision with releasing laryngeal structures and removing larynx from up to down. Further, pharyngeal reconstruction is performed with different kinds of sutures in two or more layers and is finished with skin suture and suction drainage. One of worst complications following this surgery is pharyngocutaneous fistula (PF. Modifications proposed in this this article suggests vertical skin incision with larynx removal from below upwards. In pharyngeal reconstruction we used the running locked suture in submucosal plan with „tobacco sac“ at the end on the tongue base instead of traditional T shaped suture. Suction drains were not used.The aim of study was to present the modified surgical technique of total laryingectomy and its impact on hospital stay duration and pharyngocutanous fistula formation. In this randomized study we analyzed 49 patients operated with modified surgical technique compared to 49 patient operated with traditional surgical technique of total laryngectomy. The modified technique of total laryngectomy was presented. Using modified technique we managed to decrease the PF percentage from previous 20,41% to acceptable 8,16% (p=0,0334. Also, the average hospital stay was shortened from 14,96 to 10,63 days (t =-2.9850; p=0.0358.The modified technique of total laryngectomy is safe, short and efficient surgical intervention which decreases the number of pharyngocutaneos fistulas and shortens the hospital stay.

  4. an approach to estimate total dissolved solids in groundwater using

    African Journals Online (AJOL)

    resistivities of the aquifer delineated were subsequently used to estimate TDS in groundwater which was correlated with those ... the concentrations of these chemical constituents in the ..... TDS determined by water analysis varied between 17.

  5. Effects of electrolyte total dissolved solids (TDS) on performance ...

    African Journals Online (AJOL)

    use

    2011-10-24

    Oct 24, 2011 ... microbial desalination cells; rRNA, ribosomal ribonucleic acid;. NCBI, national center for biotechnology information. microbial fuel cells (MFC) technology provides a new way to saline wastewater treatment. MFCs are bio-electro- chemical reactors which are different from traditional anaerobic biological ...

  6. Acoustic chemometric prediction of total solids in bioslurry

    DEFF Research Database (Denmark)

    Ihunegbo, Felicia; Madsen, Michael; Esbensen, Kim

    2012-01-01

    .86%) in the range of 5.8–10.8% w/w dry matter. Based on these excellent prediction performance measures, it is concluded that acoustic chemometrics has come of age as a full grown PAT approach for on-line monitoring of dry matter (TS) in complex bioslurry, with a promising application potential in other biomass...

  7. STUDY ON WASTEWATER TREATMENT SYSTEMS IN HOSPITALS OF IRAN

    Directory of Open Access Journals (Sweden)

    M. Majlesi Nasr, A. R. Yazdanbakhsh

    2008-07-01

    Full Text Available Nowadays, water resources shortage is one of the most important issues for environmental engineers and managers as well as its conservation due to population growth and ever-increasing water demands. Besides, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components. In this paper, physical and chemical specifications of produced wastewater in hospitals of Iran were investigated experiments. Results were compared with the effluent parameters of wastewater standards of Iranian Department of the Environment. 70 governmental hospitals from different provinces of Iran were selected by purposive (non-random sampling method. For data analysis, SPSS and EXCEL softwares were applied. The findings of the study showed that 52% of the surveyed hospitals were not equipped and 48% were equipped with wastewater treatment systems. The mean of Biochemical Oxygen Demand, Chemical Oxygen Demand and Total Suspended Solids of the effluent of wastewater treatment systems were reported as 113, 188 and 99 mg/L respectively. Comparison of the indicators between effluents of wastewater treatment systems and the standards of Departments of the Environment, showed the inefficiency in these systems and it was concluded that despite the recent improvements in hospital wastewater treatment systems, they should be upgraded based on the remarks in this paper.

  8. Determinação de mercúrio total em amostras de água, sedimento e sólidos em suspensão de corpos aquáticos por espectrofotometria de absorção atômica com gerador de vapor a frio Determination of total mercury in water, sediments and solids in suspension in aquatic systems by cold vapor atomic absorption spectrometry

    Directory of Open Access Journals (Sweden)

    José L. F. Vieira

    1996-06-01

    Full Text Available O emprego de mercúrio metálico nos processos de extração do ouro libera toneladas de mercúrio ao meio ambiente, provocando um aumento considerável nas concentrações presentes. Com a finalidade de prevenir a exposição humana a concentrações excessivas, o que poderá resultar em graves episódios de intoxicação mercurial, bem como avaliar a possibilidade de sedimentos tornarem-se fontes potenciais de contaminação para os seres vivos, é de fundamental importância a monitorização do mercúrio em diversos compartimentos ambientais. Efetuou-se a padronização de uma metodologia analítica para determinação de mercúrio total em amostras de água, sólidos em suspensão e sedimentos de corpos aquáticos para monitorização ambiental do xenobiótico. Posteriormente, foram analisadas amostras oriundas de regiões garimpeiras, com vistas a avaliar o desempenho do método em amostras reais e efetuar levantamento preliminar sobre a contaminação mercurial na área de estudo.The use of metallic mercury in the extraction and concentration of gold causes the discarding of tons of this metal in the environment, leading to a considerable increase in the natural levels of the same and the contamination of the surrounding areas. Thus it is extremely important to monitor the presence of this metal in various sectors of the environment with a view aiming to previnting human exposure to excessive concentrations which can result in serious episodes of mercury poisoning. It is also important to estimate the possibility of river sediments becoming potential sources of contamination of human beings. The determination of total mercury was undertaken by using cold vapor atomic absorption spectrometry. River waters, as well as sediments and suspended solids were used as samples for the standardization of the analytical procedure. Later on, this method was tested on samples originating in gold mining areas for the purpose of assessing its validity.

  9. Disposable products in the hospital waste stream.

    OpenAIRE

    Gilden, D. J.; Scissors, K. N.; Reuler, J. B.

    1992-01-01

    Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were so...

  10. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  11. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  12. Use of the total motile sperm count to predict total fertilization failure in in vitro fertilization

    NARCIS (Netherlands)

    Repping, Sjoerd; van Weert, Janne-Meije; Mol, Ben W. J.; de Vries, Jan W. A.; van der Veen, Fulco

    2002-01-01

    Objective: To evaluate the capacity of baseline characteristics and total motile sperm count (TMC) to predict total fertilization failure (TIFF) in patients undergoing IVF. Design: Retrospective cohort study. Setting: University hospital. Patient(s): Eight hundred ninety-two couples with a total of

  13. Prevalencia, impacto en la productividad y costos totales de las principales enfermedades en los trabajadores de un hospital al sur del Perú en el año 2003.: Prevalence and economy impact

    Directory of Open Access Journals (Sweden)

    Fermín RUIZ GUTIÉRREZ

    2006-01-01

    Full Text Available Objetivos: Determinar la prevalencia, indicadores productivos y costos de las principales enfermedades en el personal hospitalario. Materiales y métodos: Se entrevistó a los trabajadores mediante un cuestionario de auto evaluación validado. Resultados: Se determinó que las enfermedades más frecuentes en el personal fueron: enfermedades respiratorias en 27%, cefalea o migraña y enfermedades vertebrales 15%, dolor abdominal y rinitis alérgica 12%, depresión / ansiedad y enfermedad diarreica aguda (EDA 9% y, asma y enfermedad coronaria en 1%. El absentismo representó el 29% del tiempo total perdido por enfermedad y fueron los trastornos músculo-esqueléticos, cefalea o migraña y enfermedad cardiaca, las enfermedades que más provocaron absentismo en la población con 34,78; 23,34 y 16,63 días respectivamente. El presentismo representó el 71% del tiempo perdido por enfermedad y fueron los trastornos vertebrales con 120,55 días, depresión o ansiedad 53,24 días, cefalea o migraña 52,35, enfermedades respiratorias 44,35 días, rinitis alérgica 25,2 días, dolor abdominal 19,5 días, EDA 15,21 días y enfermedad cardiaca 1,85 días, las que provocaron mas presentismo. Con respectos a los costos, los directos fueron de 9 552,94 dólares, los indirectos fue de 24 596,00 dólares, considerándose que el costo del presentismo fue de 17 561,70 dólares y del absentismo de 7 034,30 dólares. Conclusiones: Las enfermedades con mas prevalencia fueron enfermedades respiratorias, migraña y trastornos vertebrales y las que mas causan pérdida de productividad son las enfermedades de la columna vertebral, cefalea o migraña y ansiedad o depresión, causando cuantiosas pérdidas a la institución, además el presentismo fue 3 veces mas que el absentismo y los costos indirectos fueron 2,5 veces mas que los directos.(Rev Med Hered 2006;17:28-34.

  14. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  15. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  16. A Multifactorial Analysis of Reconstruction Methods Applied After Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Oktay Büyükaşık

    2010-12-01

    Full Text Available Aim: The aim of this study was to evaluate the reconstruction methods applied after total gastrectomy in terms of postoperative symptomology and nutrition. Methods: This retrospective study was conducted on 31 patients who underwent total gastrectomy due to gastric cancer in 2. Clinic of General Surgery, SSK Ankara Training Hospital. 6 different reconstruction methods were used and analyzed in terms of age, sex and postoperative complications. One from esophagus and two biopsy specimens from jejunum were taken through upper gastrointestinal endoscopy from all cases, and late period morphological and microbiological changes were examined. Postoperative weight change, dumping symptoms, reflux esophagitis, solid/liquid dysphagia, early satiety, postprandial pain, diarrhea and anorexia were assessed. Results: Of 31 patients,18 were males and 13 females; the youngest one was 33 years old, while the oldest- 69 years old. It was found that reconstruction without pouch was performed in 22 cases and with pouch in 9 cases. Early satiety, postprandial pain, dumping symptoms, diarrhea and anemia were found most commonly in cases with reconstruction without pouch. The rate of bacterial colonization of the jejunal mucosa was identical in both groups. Reflux esophagitis was most commonly seen in omega esophagojejunostomy (EJ, while the least-in Roux-en-Y, Tooley and Tanner 19 EJ. Conclusion: Reconstruction with pouch performed after total gastrectomy is still a preferable method. (The Medical Bulletin of Haseki 2010; 48:126-31

  17. Analyzing Solutions High in Total Dissolved Solids for Rare Earth Elements (REEs) Using Cation Exchange and Online Pre-Concentration with the seaFAST2 Unit; NETL-TRS-7-2017; NETL Technical Report Series; U.S. Department of Energy, National Energy Technology Laboratory: Albany, OR, 2017; p 32

    Energy Technology Data Exchange (ETDEWEB)

    Yang, J. [National Energy Technology Lab. (NETL), Albany, OR (United States); Oregon State Univ., Corvallis, OR (United States). College of Earth, Ocean, and Atmospheric Science; Torres, M. [Oregon State Univ., Corvallis, OR (United States). College of Earth, Ocean, and Atmospheric Science; Verba, C. [National Energy Technology Lab. (NETL), Albany, OR (United States); Oregon State Univ., Corvallis, OR (United States); Hakala, A. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

    2017-08-01

    The accurate quantification of the rare earth element (REE) dissolved concentrations in natural waters are often inhibited by their low abundances in relation to other dissolved constituents such as alkali, alkaline earth elements, and dissolved solids. The high abundance of these constituents can suppress the overall analytical signal as well as create isobaric interferences on the REEs during analysis. Waters associated with natural gas operations on black shale plays are characterized by high salinities and high total dissolved solids (TDS) contents >150,000 mg/L. Methods used to isolate and quantify dissolved REEs in seawater were adapted in order to develop the capability of analyzing REEs in waters that are high in TDS. First, a synthetic fluid based on geochemical modelling of natural brine formation fluids was created within the Marcellus black shale with a TDS loading of 153,000 mg/L. To this solution, 1,000 ng/mL of REE standards was added based on preliminary analyses of experimental fluids reacted at high pressure and temperature with Marcellus black shale. These synthetic fluids were then run at three different dilution levels of 10, 100, and 1,000–fold dilutions through cation exchange columns using AG50-X8 exchange resin from Eichrom Industries. The eluent from the cation columns were then sent through a seaFAST2 unit directly connected to an inductively coupled plasma mass spectrometer (ICP-MS) to analyze the REEs. Percent recoveries of the REEs ranged from 80–110% and fell within error for the external reference standard used and no signal suppression or isobaric interferences on the REEs were observed. These results demonstrate that a combined use of cation exchange columns and seaFAST2 instrumentation are effective in accurately quantifying the dissolved REEs in fluids that are >150,000 mg/L in TDS and have Ba:Eu ratios in excess of 380,000.

  18. Statics of deformable solids

    CERN Document Server

    Bisplinghoff, Raymond L; Pian, Theodore HH

    2014-01-01

    Profusely illustrated exposition of fundamentals of solid mechanics and principles of mechanics, statics, and simple statically indeterminate systems. Covers strain and stress in three-dimensional solids, elementary elasticity, energy principles in solid continuum, and more. 1965 edition.

  19. A Survey of Municipal Solid Waste Generation in 22 Regions of Tehran With Solid Waste Reduction Approach

    Directory of Open Access Journals (Sweden)

    MA Abduli

    2015-07-01

    Methods: The study was a descriptive cross-sectional one conducted from 2010 to 2014. Relevant officials of the waste recovery in 22 regions of Tehran were approached in order to collect data about municipal solid waste generation through interviewing, filling out questionnaires, conducting field visits from Aradkooh Disposal and Processing Complex and collecting information on disposal and destiny of wastes. Then the data were compiled and analyzed. Results: Total solid waste generation in Tehran from 2010 to 2014 amounted to respectively 3389662, 3399344, 3449338 and 3245157 Metric Tons, categorized into three groups of municipal, companies and townships and hospital wastes. Most of the generated waste produced in Tehran was that of households and commercial (known as municipal waste from 22 Regions of Tehran. Based on the surveys conducted, per capita solid waste generation of 11 regions of Tehran ranged from 550 to 1000 grams and in other 11 ones from 1000 to 1521 grams per capita per day. The lowest and highest waste generation rate belonged respectively to region 13 with 556 grams and region 12 with 1521 grams per capita per day in 2011. Conclusion: Comparing per capita generation of municipal solid waste in different municipal regions in Tehran with maximum acceptable capacity of waste generation indicates the deviation of waste generation of all Tehran regions from the standard acceptable amount. Therefore, not only is it necessary to plan and take strategic measures to reduce Tehran waste generation but also these programs and measures should be specific to each region considering its specifications and solid waste quality and quantity.

  20. The Impact of Hospital Size on CMS Hospital Profiling.

    Science.gov (United States)

    Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J

    2016-04-01

    The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

  1. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  2. Theoretical solid state physics

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    Research activities at ORNL in theoretical solid state physics are described. Topics covered include: surface studies; particle-solid interactions; electronic and magnetic properties; and lattice dynamics

  3. Nota científica: Avaliação sensorial de geleia de marmelo 'Japonês' em diferentes concentrações de sólidos solúveis totais Scientific note: Sensory evaluation of japanese quince jam with different concentrations of total soluble solids

    Directory of Open Access Journals (Sweden)

    Gustavo das Graças Pereira

    2011-09-01

    Full Text Available As plantas do marmeleiro 'Japonês' (Chaenomeles sinensis Koehne vem sendo amplamente pesquisadas nos últimos anos em função da alta produtividade, da resistência à entomosporiose e da capacidade de servir como porta-enxerto para as demais cultivares. Visando propiciar o aproveitamento dessa cultivar para o consumo humano, o presente trabalho objetivou desenvolver e avaliar a aceitação da geleia de marmelo 'Japonês' em diferentes concentrações de sólidos solúveis totais. Os frutos utilizados no experimento foram colhidos na Fazenda Experimental da EPAMIG, localizada no município de Maria da Fé-MG. Para a obtenção das geleias, os frutos foram processados até se obter um produto final com as concentrações de 66, 68 e 70 °Brix de sólidos solúveis totais. O teste de aceitação foi realizado por um grupo de 50 julgadores não treinados que avaliaram aparência, consistência, aroma, sabor, aspecto global e intenção de compra dos diferentes tratamentos. Os resultados obtidos revelaram que as geleias de marmelo 'Japonês' apresentaram uma boa aceitação para todos os atributos avaliados, sendo que, de uma forma geral, as amostras com 68 e 70 °Brix obtiveram maior aceitabilidade e intenção de compra pelos julgadores.In recent years, Japanese quince (Chaenomeles sinensis Koehne plants have been widely studied due to their high productivity, resistance to entomosporium and ability to serve as rootstock for other cultivars. In order to facilitate the use of this cultivar for human consumption, the present study aimed to develop and evaluate the acceptance of a Japanese quince jam with different concentrations of total soluble solids. The fruits used in the experiment were harvested at the Experimental Farm of EPAMIG, located in the city of Maria da Fé, MG, Brazil. To obtain the jams, the fruits were processed to obtain a final product with concentrations of 66, 68 and 70 °Brix with respect to the total soluble solids

  4. ???????????? SolidWorks/SolidWorks Flow Simulation/SolidWorks Simulation ??? ?????????? ???????? ?? ????????????? ???

    OpenAIRE

    ????????????, ?. ?.; ????????, ?. ?.; ?????, ?. ?.

    2012-01-01

    ? ?????? ???????? ??????? ??????? ???????? ?? ???????????? ??????????? ????????? SolidWorks/SolidWorks Flow Simulation (COSMOSFloWorks)/SolidWorks Simulation ??? ?????????? ???????? ?? ????????????? ???. ??? ???????? ????????? ???????? ?????????? ?? ?????? ???????? ??????? ? ????????????? ?????? ? ????????????? ????????????? ?????????? ???????????? SolidWorks Flow Simulation (COSMOSFloWorks). ??? ???????????? ??????????? ????????????? ?????? ?? ????????? ??????????? ??????? ?? ??????????? ...

  5. Total perinatally related losses at Tygerberg Hospital – a ...

    African Journals Online (AJOL)

    Objective. To determine the leading causes of perinatal deaths and to evaluate any changes, with the inclusion of placental histology. Method. At perinatal mortality meetings, primary and final causes of death were assigned for the period 1 July 2006 - 30 June 2007. All singleton babies born to women residing in the ...

  6. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  7. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  8. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  9. Total body water and total body potassium in anorexia nervosa

    International Nuclear Information System (INIS)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-01-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation

  10. Assessment of health care waste management in sajjadieh hospital in Torbat Jam and addressing the improving procedures

    Directory of Open Access Journals (Sweden)

    Seyed Ali Sajjadi

    2018-01-01

    Full Text Available Aims: Health-care waste is one of the most crucial issues in solid waste management due to its adverse effects on human health and the environment. The aim of this study was to investigate the present situation of health-care waste management in Sajadieh Hospital in Torbat-e Jam to find the major challenges and offer the best practice regarding this issue. Materials and Methods: This cross-sectional study was conducted in Sajadieh hospital in Torbat-e Jam in 2017. The total amount of waste produced in hospital was measured for 3 months. Waste management pattern was carried out based on a checklist obtained from the Ministry of Health (MOH of Iran. Excel software was employed for data analysis. Results: In total, the mean amount of wastes generated in studied hospital was 658.9 kg/day, including domestic waste (397.6 kg/day and hazardous waste (261.4 kg/day. The highest amount of hazardous wastes was generated in operating room with 32.9 kg/day. Quantity analysis of total waste showed that food wastes (25% comprise the highest fraction. Based on MOH checklist, the status of the waste management practices was determined as fair. Conclusions: The results of this study showed that despite the segregation of hospital wastes, the amount of hazardous wastes were higher than recommended guidelines. Therefore, more attention of the authorities and the correction of hospital waste management are required.

  11. Solid waste management in Khartoum industrial area

    International Nuclear Information System (INIS)

    Elsidig, N. O. A.

    2004-05-01

    This study was conducted in Khartoum industrial area (KIA). The study discusses solid waste generation issues in KIA as well as solid waste collection, storage, transport and final disposal methods. A focus on environmental impact resulting from the accumulation of solid waste was presented by reviewing solid waste management in developed as well as developing countries starting from generation to final disposal. Environmental health legislation in Sudan was investigated. The study covers all the (eight) industrial sub-sectors presented in KIA. The main objective of the study is to assess the situation of solid waste in KIA. To fulfill the objectives of the study the researcher deemed it necessary to explore problems related to solid waste generation and solid waste arrangement with special emphasis on final disposal methods. Practically, 31 (thirty-one) factories representing the different industrial sub-sectors in KIA were studied. This represents 25% of the total number of factories located in KIA. Data were obtained by, questionnaires, interviews and observations mainly directed to concerned officials, solid waste workers, pickers and brokers. Obtained data were stored, coded, tabulated and analyzed using the computer systems (excel and SPSS programmes). The obtained results should clear deficiency in the management of solid waste which led to great environmental deterioration in KIA and neighboring residential areas. The environment in studied area is continuously polluted due to high pollution loads and unproved solid waste management. In order to maintain health environment operating factories have to pretreated their solid waste according to the recognized standards and waste minimization techniques such as recycling and re use should be widely applied, moreover, running crash programme for environmental sanitation in Khartoum state should be expanded and improved to include special characteristics of solid waste from industries. Finally, increase awareness

  12. Management of hospital radioactive wastes

    International Nuclear Information System (INIS)

    Mantrana, D.

    1986-01-01

    The general structure of a regulatory scheme for the management of hospital radioactive wastes is presented. The responsabilities of an institution in the radioactive waste management, and storage conditions are defined. The radioactive wastes are classified in physical terms, and the criteria for evaluating the activity of solid wastes are described. The container characteristics and, the types of treatments given to the wastes are specified. (M.C.K.) [pt

  13. STUDY OF PAEDIATRIC SOLID TUMOURS FOR A PERIOD OF 5 YEARS

    Directory of Open Access Journals (Sweden)

    Basumitra Das

    2017-12-01

    Full Text Available BACKGROUND Paediatric Solid Neoplasms (PSN are a global problem. There is significant variation of incidence of paediatric solid neoplasms in various regions of the world. Benign tumours are more common than cancer. In an effort to better understand the prevalence of paediatric solid tumours in our region, a retrospective review of the tumours diagnosed histopathologically was carried out. MATERIALS AND METHODS This is a retrospective study undertaken in a tertiary care hospital for a period of five years. All the benign and malignant paediatric solid tumours of children below 14 years from January 2012 to December 2016 were retrieved and analysed according to age, sex and histopathological diagnosis. Leukaemias were excluded from our study. All tumours were diagnosed on conventional haematoxylin and eosin-stained sections. RESULTS A total of 109 cases of solid paediatric tumours were received during this period. Of these, maximum of 30 tumours were of soft tissue tumours followed by Central Nervous System (CNS and bone tumours with 24 and 23 cases, respectively. 7 cases of blastomas were also observed. CONCLUSION This study showed benign and malignant tumours to be of near-equal prevalence. Soft tissue tumours were the most common. Ratio of benign tumours to malignant were almost equal below 4 years. Malignant tumours were higher in 5-9 years group.

  14. Solid lubricants and surfaces

    CERN Document Server

    Braithwaite, E R

    1964-01-01

    Solid Lubricants and Surfaces deals with the theory and use of solid lubricants, particularly in colloidal form. Portions of this book are devoted to graphite and molybdenum disulfides, which are widely used solid lubricants in colloidal form. An extensive literature on the laboratory examination of hundreds of solids as potential lubricants is also provided in this text. Other topics discussed include the metals and solid lubricants; techniques for examining surfaces; other solid lubricants; metal shaping; and industrial uses of solid-lubricant dispersions. This publication is beneficial to e

  15. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  16. Solid and liquid radioactive wastes

    International Nuclear Information System (INIS)

    Cluchet, J.; Desroches, J.

    1977-01-01

    The problems raised by the solid and liquid radioactive wastes from the CEA nuclear centres are briefly exposed. The processing methods developed at the Saclay centre are described together with the methods for the wastes from nuclear power plants and reprocessing plants. The different storage techniques used at the La Hague centre are presented. The production of radioactive wastes by laboratories, hospitals and private industry is studied for the sealed sources and the various radioactive substances used in these plants. The cost of the radioactive wastes is analysed: processing, transport, long term storage [fr

  17. Solid biomass barometer

    International Nuclear Information System (INIS)

    Anon.

    2011-01-01

    The primary energy production from solid biomass in the European Union reached 79.3 Mtoe in 2010 which implies a growth rate of 8% between 2009 and 2010. The trend, which was driven deeper by Europe's particularly cold winter of 2009-2010, demonstrates that the economic down-turn failed to weaken the member states' efforts to structure the solid biomass sector. Heat consumption rose sharply: the volume of heat sold by heating networks increased by 18% and reached 6.7 Mtoe and if we consider the total heat consumption (it means with and without recovery via heating networks) the figure is 66 Mtoe in 2010, which amounts to 10.1% growth. The growth of electricity production continued through 2010 (8.3% up on 2009) and rose to 67 TWh but at a slower pace than in 2009 (when it rose by 11.3% on 2008). The situation of the main producer countries: Sweden, Finland, Germany and France is reviewed. It appears that cogeneration unit manufacturers and biomass power plant constructors are the main beneficiaries of the current biomass energy sector boom. There is a trend to replace coal-fired plants that are either obsolete or near their end of life with biomass or multi-fuel plants. These opportunities will enable the industry to develop and further exploit new technologies such as gasification, pyrolysis and torrefaction which will enable biomass to be turned into bio-coal. (A.C.)

  18. Hospital waste management in El-Beheira Governorate, Egypt.

    Science.gov (United States)

    Abd El-Salam, Magda Magdy

    2010-01-01

    This study investigated the hospital waste management practices used by eight randomly selected hospitals located in Damanhour City of El-Beheira Governorate and determined the total daily generation rate of their wastes. Physico-chemical characteristics of hospital wastes were determined according to standard methods. A survey was conducted using a questionnaire to collect information about the practices related to waste segregation, collection procedures, the type of temporary storage containers, on-site transport and central storage area, treatment of wastes, off-site transport, and final disposal options. This study indicated that the quantity of medical waste generated by these hospitals was 1.249tons/day. Almost two-thirds was waste similar to domestic waste. The remainder (38.9%) was considered to be hazardous waste. The survey results showed that segregation of all wastes was not conducted according to consistent rules and standards where some quantity of medical waste was disposed of with domestic wastes. The most frequently used treatment method for solid medical waste was incineration which is not accepted at the current time due to the risks associated with it. Only one of the hospitals was equipped with an incinerator which is devoid of any air pollution control system. Autoclaving was also used in only one of the selected hospitals. As for the liquid medical waste, the survey results indicated that nearly all of the surveyed hospitals were discharging it in the municipal sewerage system without any treatment. It was concluded that the inadequacies in the current hospital waste management practices in Damanhour City were mainly related to ineffective segregation at the source, inappropriate collection methods, unsafe storage of waste, insufficient financial and human resources for proper management, and poor control of waste disposal. The other issues that need to be considered are a lack of appropriate protective equipment and lack of training and

  19. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  20. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  1. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  2. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  3. SWINE MANURE SOLIDS SEPARATION AND THERMOCHEMICAL CONVERSION TO HEAVY OIL

    Directory of Open Access Journals (Sweden)

    Shuangning Xiu

    2009-05-01

    Full Text Available Separation of solids from liquid swine manure and subsequent thermo-chemical conversion (TCC of the solids fraction into oil is one way of reducing the waste strength and odor emission. Such processing also provides a potential means of producing renewable energy from animal wastes. Gravity settling and mechanical separation techniques, by means of a centrifuge and belt press, were used to remove the solids from liquid swine manure. The solid fractions from the above separation processes were used as the feedstock for the TCC process for oil production. Experiments were conducted in a batch reactor with a steady temperature 305 oC, and the corresponding pressure was 10.34 Mpa. Gravity settling was demonstrated to be capable of increasing the total solids content of manure from 1% to 9%. Both of the mechanical separation systems were able to produce solids with dry matter around 18% for manure, with 1% to 2% initial total solids. A significant amount of volatile solid (75.7% was also obtained from the liquid fraction using the belt press process. The oil yields of shallow pit manure solids and deep pit manure solids with belt press separation were 28.72% and 29.8% of the total volatile solids, respectively. There was no visible oil product obtained from the deep pit manure solids with centrifuge separation. It is believed that it is the volatile solid content and the other components in the manure chemical composition which mainly deter-mine the oil production.

  4. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

    Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

    2012-01-01

    To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

  5. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  6. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  7. Minimizing variance in Care of Pediatric Blunt Solid Organ Injury through Utilization of a hemodynamic-driven protocol: a multi-institution study.

    Science.gov (United States)

    Cunningham, Aaron J; Lofberg, Katrine M; Krishnaswami, Sanjay; Butler, Marilyn W; Azarow, Kenneth S; Hamilton, Nicholas A; Fialkowski, Elizabeth A; Bilyeu, Pamela; Ohm, Erika; Burns, Erin C; Hendrickson, Margo; Krishnan, Preetha; Gingalewski, Cynthia; Jafri, Mubeen A

    2017-12-01

    An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation. A total of 106 patients were treated (control=55, protocol=51). Demographics were similar among groups, and compliance was 78%. Hospital stay (4.6 vs. 3.5days, p=0.04), ICU stay (1.9 vs. 1.0days, p=0.02), and total phlebotomy (7.7 vs. 5.3 draws, p=0.007) were significantly less in the protocol group. A decrease in direct hospital costs was also observed ($11,965 vs. $8795, p=0.09). Complication rates (1.8% vs. 3.9%, p=0.86, no deaths) were similar. An expedited, hemodynamic-driven, pediatric solid organ injury protocol is achievable across hospital systems and surgeons. Through implementation we maintained quality while impacting length of stay, ICU utilization, phlebotomy, and cost. Future protocols should work to further limit resource utilization. Retrospective cohort study. Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. All-Round Marketing Increases Hospital Popularity.

    Science.gov (United States)

    Ziqi, Tao

    2015-06-01

    Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

  9. Hospital infections waste and its proper disposal

    International Nuclear Information System (INIS)

    Bhatti, A.Q.; Memon, A.A.; Mahar, R.B.

    2002-01-01

    Hazardous hospital waste is a unique in several ways. There are a large variety of wastes but volume is a small relative to industrial wastes. Hospital infections solid waste is getting to be serious problem day by day. This waste contribute to the overall pollution in the city; much of it is also hazardous, thus putting at risk the health of those who come into contact with it. This paper addresses the various aspects of incineration, recycling and landfill process with detailed illustration. Hospital waste management in rural hospitals of Pakistan with particular reference to Gambat Hospital is discussed in this paper, including study of existing waste management system, estimation of waste production per day from different sources of Hospital and suitable waste management system is recommended. (author)

  10. Solid state physics

    CERN Document Server

    Burns, Gerald

    2013-01-01

    Solid State Physics, International Edition covers the fundamentals and the advanced concepts of solid state physics. The book is comprised of 18 chapters that tackle a specific aspect of solid state physics. Chapters 1 to 3 discuss the symmetry aspects of crystalline solids, while Chapter 4 covers the application of X-rays in solid state science. Chapter 5 deals with the anisotropic character of crystals. Chapters 6 to 8 talk about the five common types of bonding in solids, while Chapters 9 and 10 cover the free electron theory and band theory. Chapters 11 and 12 discuss the effects of moveme

  11. Theoretical solid state physics

    CERN Document Server

    Haug, Albert

    2013-01-01

    Theoretical Solid State Physics, Volume 1 focuses on the study of solid state physics. The volume first takes a look at the basic concepts and structures of solid state physics, including potential energies of solids, concept and classification of solids, and crystal structure. The book then explains single-electron approximation wherein the methods for calculating energy bands; electron in the field of crystal atoms; laws of motion of the electrons in solids; and electron statistics are discussed. The text describes general forms of solutions and relationships, including collective electron i

  12. Geographical differences in the relationship between total dissolved ...

    African Journals Online (AJOL)

    on the Department of Water Affairs water quality database. ... Keywords: conversion factors, electrical conductivity, field instruments, rivers, total dissolved solids, water quality ... of a number of TDS:EC ratios in samples where both measure-.

  13. Costs of hospital malnutrition.

    Science.gov (United States)

    Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H

    2017-10-01

    Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

  14. Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece

    International Nuclear Information System (INIS)

    Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

    2012-01-01

    solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective unit production rates were: (1) for reagents 1.7 (2.4) g/patient/d and 0.3 (0.4) g/examination/d, (2) for solvents 248 (127) g/patient/d and 192 (101) g/examination/d, (3) for dyes and tracers 4.7 (1.4) g/patient/d and 2.5 (0.9) g/examination/d and (4) for solid waste 54 (28) g/patient/d and 42 (22) g/examination/d.

  15. Solid phase radioimmunoassays

    International Nuclear Information System (INIS)

    Wide, L.

    1977-01-01

    Solid phase coupled antibodies were introduced to facilitate the separation of bound and free labelled ligand in the competitive inhibition radioimmunoassay. Originally, the solid matrix used was in the form of small particles and since then a number of different matrices have been used such as very fine powder particles, gels, paper and plastic discs, magnetic particles and the inside surface of plastic tubes. The coupling of antibodies may be that of a covalent chemical binding, a strong physical adsorbtion, or an immunological binding to a solid phase coupled antigen. New principles of radioimmunoassay such as the solid phase sandwich techniques and the immunoradiometric assay were developped from the use of solid phase coupled antigens and antibodies. The solid phase sandwich techniques are reagent excess methods with a very wide applicability. Several of the different variants of solid phase techniques are suitable for automation. Advantages and disadvantages of solid phase radioimmunoassays when compared with those using soluble reagents are discussed. (orig.) [de

  16. Laser cooling of solids

    Energy Technology Data Exchange (ETDEWEB)

    Epstein, Richard I [Los Alamos National Laboratory; Sheik-bahae, Mansoor [UNM

    2008-01-01

    We present an overview of solid-state optical refrigeration also known as laser cooling in solids by fluorescence upconversion. The idea of cooling a solid-state optical material by simply shining a laser beam onto it may sound counter intuitive but is rapidly becoming a promising technology for future cryocooler. We chart the evolution of this science in rare-earth doped solids and semiconductors.

  17. 78 FR 50495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-08-19

    ... Connective Tissue) a. Reverse Shoulder Procedures b. Total Ankle Replacement Procedures 6. MDC 15 (Newborns... specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric... Issues. James Poyer, (410) 786-2261, PPS-Exempt Cancer Hospital Quality Reporting Issues. Allison Lee...

  18. Medicare's Hospital Readmissions Reduction Program in Surgery May Disproportionately Affect Minority-serving Hospitals.

    Science.gov (United States)

    Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B

    2015-06-01

    To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.

  19. Solid State Division

    International Nuclear Information System (INIS)

    Green, P.H.; Watson, D.M.

    1989-08-01

    This report contains brief discussions on work done in the Solid State Division of Oak Ridge National Laboratory. The topics covered are: Theoretical Solid State Physics; Neutron scattering; Physical properties of materials; The synthesis and characterization of materials; Ion beam and laser processing; and Structure of solids and surfaces

  20. Solid State Division

    Energy Technology Data Exchange (ETDEWEB)

    Green, P.H.; Watson, D.M. (eds.)

    1989-08-01

    This report contains brief discussions on work done in the Solid State Division of Oak Ridge National Laboratory. The topics covered are: Theoretical Solid State Physics; Neutron scattering; Physical properties of materials; The synthesis and characterization of materials; Ion beam and laser processing; and Structure of solids and surfaces. (LSP)

  1. Solid state radiation dosimetry

    International Nuclear Information System (INIS)

    Moran, P.R.

    1976-01-01

    Important recent developments provide accurate, sensitive, and reliable radiation measurements by using solid state radiation dosimetry methods. A review of the basic phenomena, devices, practical limitations, and categories of solid state methods is presented. The primary focus is upon the general physics underlying radiation measurements with solid state devices

  2. [Leadership in the hospital].

    Science.gov (United States)

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.

  3. Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

    Science.gov (United States)

    Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

    2018-03-01

    The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

  4. Combustibility of tetraphenylborate solids

    International Nuclear Information System (INIS)

    Walker, D.D.

    1989-01-01

    Liquid slurries expected under normal in-tank processing (ITP) operations are not ignitible because of their high water content. However, deposits of dry solids from the slurries are combustible and produce dense, black smoke when burned. The dry solids burn similarly to Styrofoam and more easily than sawdust. It is the opinion of fire hazard experts that a benzene vapor deflagration could ignite the dry solids. A tetraphenylborate solids fire will rapidly plug the waste tank HEPA ventilation filters due to the nature of the smoke produced. To prevent ignition and combustion of these solids, the waste tanks have been equipped with a nitrogen inerting system

  5. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  6. History of Solid Rockets

    Science.gov (United States)

    Green, Rebecca

    2017-01-01

    Solid rockets are of interest to the space program because they are commonly used as boosters that provide the additional thrust needed for the space launch vehicle to escape the gravitational pull of the Earth. Larger, more advanced solid rockets allow for space launch vehicles with larger payload capacities, enabling mankind to reach new depths of space. This presentation will discuss, in detail, the history of solid rockets. The history begins with the invention and origin of the solid rocket, and then goes into the early uses and design of the solid rocket. The evolution of solid rockets is depicted by a description of how solid rockets changed and improved and how they were used throughout the 16th, 17th, 18th, and 19th centuries. Modern uses of the solid rocket include the Solid Rocket Boosters (SRBs) on the Space Shuttle and the solid rockets used on current space launch vehicles. The functions and design of the SRB and the advancements in solid rocket technology since the use of the SRB are discussed as well. Common failure modes and design difficulties are discussed as well.

  7. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  8. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  9. Solid Base Catalysis

    CERN Document Server

    Ono, Yoshio

    2011-01-01

    The importance of solid base catalysts has come to be recognized for their environmentally benign qualities, and much significant progress has been made over the past two decades in catalytic materials and solid base-catalyzed reactions. The book is focused on the solid base. Because of the advantages over liquid bases, the use of solid base catalysts in organic synthesis is expanding. Solid bases are easier to dispose than liquid bases, separation and recovery of products, catalysts and solvents are less difficult, and they are non-corrosive. Furthermore, base-catalyzed reactions can be performed without using solvents and even in the gas phase, opening up more possibilities for discovering novel reaction systems. Using numerous examples, the present volume describes the remarkable role solid base catalysis can play, given the ever increasing worldwide importance of "green" chemistry. The reader will obtain an overall view of solid base catalysis and gain insight into the versatility of the reactions to whic...

  10. PAEDIATRIC POSTERIOR FOSSA TUMORS: A CLIN ICO - PATHOLOGICAL STUDY I N A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Raja Sekhar Kennedy

    2015-09-01

    Full Text Available INTRODUCTION: Tumors of the Central Nervous S ystem , are the second commonest childhood tumors and are the most common solid paediatric tumors comprising 40% - 50% of all tumors . 1 2 Posterior fossa brain tumors are one of the most devastating forms of human illnesses wh ich are more common in children. AIMS AND OBJECTIVES : To study the incidence, clinicopathological features and management of paediatric posterior fossa tumors. MATERIALS AND METHOD S : This is a prospective study done in the Department of Neurosurgery, Ranga raya Medical College, Government General Hospital, Kakinada from 2012 to 2015. It is a Tertiary Care Hospital. A total of 25 paediatric patients ranging from infants to 15 years were included in the study. DISCUSSION AND CONCL USION: Posterior fossa tumors are the commonest solid brain tumors of children with a rate of 2.4 per lakh of children at risk per year. The predominant symptoms are headache and vomiting followed by cerebellar symptoms (gait disturbances. Posterior fossa tumors are predominantly seen in children with peak incidence in first decade. Commonest presenting symptoms are due to raised intracranial pressure with headache and vomiting followed by cerebellar symptoms. Meticulous microsurgical techniques are to be followed in removing these tum ors. The incidence of recurrence is very less after gross total excision. Prognosis is good in patients with total excision

  11. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  12. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  13. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  14. Anxiety, depression in patients receiving chemotherapy for solid tumors

    International Nuclear Information System (INIS)

    Mansoor, S.; Jehangir, S.

    2015-01-01

    To determine the frequency of anxiety and depression in patients undergoing chemotherapy for solid tumors using Hospital Anxiety Depression Scale (HADS). Study Design: Cross sectional descriptive study. Place and Duration of Study: Out-patient department of Armed Forces Institute of Mental Health, Rawalpindi from June 2011 to December 2011. Methodology: Consecutive non probability sampling technique was used to select patients of age (25-70 years), male or female, who had received atleast 03 cycles of chemotherapy for solid tumors. Those with history of prior psychiatric illness, current use of psychotropic medication or psychoactive substance use, and any major bereavement in past one year were excluded from the study. After taking informed consent, relevant socio- demographic data was collected and HADS was administered. HADS-A cut off score of 7 was taken as significant anxiety while a HADS-D cut off score of 7 was taken as significant depression. Results: The total number of participants was 209. The mean age of patients was 42.9 years, with 55.5% males and 44.5% females. Overall 33/209 (15.8%) patients had anxiety while 56/209 (26.8%) were found to have depression. There was a higher frequency of anxiety and depression in younger patients (less than age 40 years), females, patients who were single or divorced, and patients receiving chemotherapy for pancreatic carcinoma. Conclusion: Patients undergoing chemotherapy suffer from considerable levels of anxiety and depression, thus highlighting the need for specialized interventions. (author)

  15. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  16. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  17. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  18. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  19. VALIDACIÓN DE TRES SUPLEMENTOS ALIMENTICIOS ELABORADOS A PARTIR DE SUBPRODUCTOS AGROINDUSTRIALES DE POSCOSECHA EN FUNCIÓN DEL INCREMENTO EN SÓLIDOS TOTALES DE LA LECHE VALIDAÇÃO DE TRÊS SUPLEMENTOS ALIMENTARES FEITOS A PARTIR DA PÓS-COLHEITA DE SUBPRODUTOS AGROINDUSTIAIS EM FUNÇÃO DO AUMENTO DE SÓLIDOS TOTAIS DO LEITE VALIDATION OF THREE FOOD SUPPLEMENTS MADE FROM POST-HARVEST AGRO-INDUSTRIAL IN TERMS OF INCREASED MILK TOTAL SOLID

    Directory of Open Access Journals (Sweden)

    PAULA ANDREA HENAO C

    2011-12-01

    dietéticos que foram desenvolvidos a partir de produtos pós-colheita, gerados durante o processamento de polpas e néctares de frutos, não mostraram patógenos e quantificação de aflatoxinas, além de teor de fibras, proteínas e representante suplementação de gordura na alimentação animal. Posteriormente validada em suplementos lácteos, com o objetivo de identificar aqueles que expressaram um melhor desempenho em sólidos totais. Estes suplementos foram avaliadas pelo teste estatístico, procurando determinar se a sua utilização, aumenta o teor de sólidos totais do leite, em comparação com um alimento tradicional. Os resultados mostraram que, em particular o uso de suplementos B gera um aumento significativo de sólidos totais no leite.This is a project to accompany a processing plant that takes advantage of post-harvest products in the region, in the production of a food supplement for cattle. The process involved the evaluation of three supplements on their chemical composition for substance and microbiological analysis to determine its safety. Finally, the validation of these three leading dietary supplements to determine if your intake increased the percentage of total solids of milk from the lot of animals that consumed it. Dietary supplements that were developed from post-harvest products, generated during the processing of pulps and nectars, showed no pathogens, and quantification of aflatoxins, moreover showed in addition to fiber content, protein and fat supplementation representative for animal feed. Subsequently validated in dairy supplements, with the aim of identifying those who expressed a better performance in total solids. These supplements were tested by statistical testing, seeking to determine whether the use of the same, increase the total solids of milk, compared with a traditional food. The results showed that in particular the use of supplemental B generates significant increases in total solids in milk.

  20. Total pollution effect of urban surface runoff.

    Science.gov (United States)

    Luo, Hongbing; Luo, Lin; Huang, Gu; Liu, Ping; Li, Jingxian; Hu, Sheng; Wang, Fuxiang; Xu, Rui; Huang, Xiaoxue

    2009-01-01

    For pollution research with regard to urban surface runoff, most sampling strategies to date have focused on differences in land usage. With single land-use sampling, total surface runoff pollution effect cannot be evaluated unless every land usage spot is monitored. Through a new sampling strategy known as mixed stormwater sampling for a street community at discharge outlet adjacent to river, this study assessed the total urban surface runoff pollution effect caused by a variety of land uses and the pollutants washed off from the rain pipe system in the Futian River watershed in Shenzhen City of China. The water quality monitoring indices were COD (chemical oxygen demand), TSS (total suspend solid), TP (total phosphorus), TN (total nitrogen) and BOD (biochemical oxygen demand). The sums of total pollution loads discharged into the river for the four indices of COD, TSS, TN, and TP over all seven rainfall events were very different. The mathematical model for simulating total pollution loads was established from discharge outlet mixed stormwater sampling of total pollution loads on the basis of four parameters: rainfall intensity, total land area, impervious land area, and pervious land area. In order to treat surface runoff pollution, the values of MFF30 (mass first flush ratio) and FF30 (first 30% of runoff volume) can be considered as split-flow control criteria to obtain more effective and economical design of structural BMPs (best management practices) facilities.

  1. A Decomposition of Hospital Profitability

    Directory of Open Access Journals (Sweden)

    Jason Turner

    2015-06-01

    Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of

  2. A Decomposition of Hospital Profitability

    Science.gov (United States)

    Broom, Kevin; Elliott, Michael; Lee, Jen-Fu

    2015-01-01

    Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover), and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552). The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS) against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of NFP and IO

  3. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  4. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  5. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  6. Solid state video cameras

    CERN Document Server

    Cristol, Y

    2013-01-01

    Solid State Video Cameras reviews the state of the art in the field of solid-state television cameras as compiled from patent literature. Organized into 10 chapters, the book begins with the basic array types of solid-state imagers and appropriate read-out circuits and methods. Documents relating to improvement of picture quality, such as spurious signal suppression, uniformity correction, or resolution enhancement, are also cited. The last part considerssolid-state color cameras.

  7. Environmental management in public hospitals: Environmental management in Colombia

    OpenAIRE

    Juan Pablo Rodríguez-Miranda; César Augusto García-Ubaque; María Camila García-Vaca

    2016-01-01

    Introduction: Activities in hospitals have environmental impacts which may pose risks to human and environmental health if they are not managed correctly. For this reason, it is necessary to implement an environmental management plan in hospitals that not only focuses on solid waste management but includes all aspects associated with health within institutions. Objective: To review environmental management aspects related to public hospitals in order to identify environmental management a...

  8. Nanoscale hydrodynamics near solids

    Science.gov (United States)

    Camargo, Diego; de la Torre, J. A.; Duque-Zumajo, D.; Español, Pep; Delgado-Buscalioni, Rafael; Chejne, Farid

    2018-02-01

    Density Functional Theory (DFT) is a successful and well-established theory for the study of the structure of simple and complex fluids at equilibrium. The theory has been generalized to dynamical situations when the underlying dynamics is diffusive as in, for example, colloidal systems. However, there is no such a clear foundation for Dynamic DFT (DDFT) for the case of simple fluids in contact with solid walls. In this work, we derive DDFT for simple fluids by including not only the mass density field but also the momentum density field of the fluid. The standard projection operator method based on the Kawasaki-Gunton operator is used for deriving the equations for the average value of these fields. The solid is described as featureless under the assumption that all the internal degrees of freedom of the solid relax much faster than those of the fluid (solid elasticity is irrelevant). The fluid moves according to a set of non-local hydrodynamic equations that include explicitly the forces due to the solid. These forces are of two types, reversible forces emerging from the free energy density functional, and accounting for impenetrability of the solid, and irreversible forces that involve the velocity of both the fluid and the solid. These forces are localized in the vicinity of the solid surface. The resulting hydrodynamic equations should allow one to study dynamical regimes of simple fluids in contact with solid objects in isothermal situations.

  9. Utilisation of solid waste

    Energy Technology Data Exchange (ETDEWEB)

    Balu, K

    1978-07-01

    The prime solution to the present energy crisis is the recovery of latent energy from waste materials, for solid waste contains recoverable energy and it merely needs to be released. The paper is concerned with classification of solid waste, energy content of waste, methods of solid waste disposal, and chemical processing of solid waste. Waste disposal must be performed in situ with energy recovery. Scarcity of available land, pollution problem, and unrecovered latent energy restrict the use of the land-filling method. Pyrolysis is an effective method for the energy recovery and disposal problems. Chemical processing is suitable for the separated cellulosic fraction of the waste material.

  10. Multivalent ion conducting solids

    Energy Technology Data Exchange (ETDEWEB)

    Imanaka, N. [Osaka Univ., Suita, Osaka (Japan). Dept. of Applied Chemistry

    2008-07-01

    Solid electrolytes possess important characteristics for industrial applications. Only a single ionic species can macroscopically migrate in these solids. This paper described a the new NASICON (M-Zr-Nb-P-O) type system, exhibiting an exceptionally high level of trivalent M3+ ion conductivity on polycrystalline solids. The partial substitution of the smaller higher valent Nb5+ ion for Zr4+ stabilized the NASICON phase and realized the M3+ ion conduction in the NASICON structure. It was concluded that the conductivities of the series are comparable to those of the practically applied solid electrolytes of oxide anion conductors of YSZ and CSZ. 3 refs., 2 figs.

  11. Management of solid waste

    Science.gov (United States)

    Thompson, W. T.; Stinton, L. H.

    1980-04-01

    Compliance with the latest regulatory requirements addressing disposal of radioactive, hazardous, and sanitary solid waste criteria in the selection, design, and operation of solid waste management facilities. Due to the state of flux of these regulatory requirements from EPA and NRC, several waste management options were of solid waste. The current regulatory constraints and the design and operational requirements for construction of both storage and disposal facilities for use in management of DOE-ORO solid waste are highlighted. Capital operational costs are included for both disposal and storage options.

  12. Management of solid waste

    International Nuclear Information System (INIS)

    Thompson, W.T.; Stinton, L.H.

    1980-01-01

    Compliance with the latest regulatory requirements addressing disposal of radioactive, hazardous, and sanitary solid waste requires the application of numerous qualitative and quantitative criteria in the selection, design, and operation of solid waste management facilities. Due to the state of flux of these regulatory requirements from EPA and NRC several waste management options were identified as being applicable to the management of the various types of solid waste. This paper highlights the current regulatory constraints and the design and operational requirements for construction of both storage and disposal facilities for use in management of DOE-ORO solid waste. Capital and operational costs are included for both disposal and storage options

  13. Management of solid waste

    International Nuclear Information System (INIS)

    Thompson, W.T.; Stinton, L.H.

    1980-01-01

    Compliance with the latest regulatory requirements addressing disposal of radioactive, hazardous, and sanitary solid waste requires the application of numerous qualitative and quantitative criteria in the selection, design, and operation of solid waste management facilities. Due to the state of flux of these regulatory requirements from EPA and NRC, several waste management options were identified as being applicable to the management of the various types of solid waste. This paper highlights the current regulatory constraints and the design and operational requirements for construction of both storage and disposal facilities for use in management of DOE-ORO solid waste. Capital and operational costs are included for both disposal and storage options

  14. Understanding solid state physics

    CERN Document Server

    Holgate, Sharon Ann

    2009-01-01

    Where Sharon Ann Holgate has succeeded in this book is in packing it with examples of the application of solid state physics to technology. … All the basic elements of solid state physics are covered … . The range of materials is good, including as it does polymers and glasses as well as crystalline solids. In general, the style makes for easy reading. … Overall this book succeeds in showing the relevance of solid state physics to the modern world … .-Contemporary Physics, Vol. 52, No. 2, 2011I was indeed amused and inspired by the wonderful images throughout the book, carefully selected by th

  15. Management of solid wastes

    Energy Technology Data Exchange (ETDEWEB)

    Williams, D.J. [University of Queensland, St. Lucia, Qld. (Australia). Dept. of Civil Engineering

    1996-12-31

    This chapter introduces the range of solid waste materials produced in the mining and mineral processing industries, with particular reference to Australia. The waste materials are characterised and their important geotechnical engineering properties are discussed. Disposal management techniques for metalliferous, coal, heavy mineral sand, fly ash and bauxite solid wastes are described. Geo-technical techniques for the management of potential contaminants are presented. Minimisation and utilisation of solid wastes, and the economics of solid waste management, are discussed from the perspectives of policy, planning, costing and rehabilitation. 19 figs., 2 tabs.

  16. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  17. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  18. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  19. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  20. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  1. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  2. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  3. Solid wastes management in Lebanon

    International Nuclear Information System (INIS)

    Daniel, Simon E.

    1999-01-01

    The paper describes the problem of wastes in Lebanon and their management according to international (European and French) descriptions. It presents the situation in Lebanon including the policies taken by the ministry of environment towards the treatment of different types of wastes especially solid wastes. It is estimated that the production of wastes in Lebanon is 5854 tones per day and it is distributed as follows: Domestic wastes 3200 t/d; industrial wastes 1300 t/d; commercial wastes 1000 t/d; slaughter-houses 150 t/d; waste oils 100 t/d; hospital wastes 64 t/d; vehicle wheels 40 t/d. The annual production within regions is also presented in tables. Collection, transportation, recycling, composting and incineration of wastes are included

  4. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

  5. Performance of A Pilot-Scale Vermifilter for the Treatment of A Real Hospital Wastewater

    Directory of Open Access Journals (Sweden)

    Nahid Ghobadi

    2016-12-01

    Full Text Available In this study, the performance of a pilot-scale vermifilter (VF for the treatment of hospital wastewater using the earthworm species Eisenia fetida was evaluated. The earthworms’ gut acts as a bioreactor and can ingest the wastewater solid and liquid organic wastes and expel these as vermicompost. A pilot-scale vermifilter was installed and operated for 133 days in one of hospitals in Hamadan city; the designed system was fed with the influent passed through coarse and fine grillage and the sedimentation tank of the hospital’s sanitary collection system. In order to study the efficiency of the system, the variations of pH value, chemical oxygen demand (COD, biochemical oxygen demand (BOD5, and total suspended solids (TSS were measured. In addition, a conventional geofilter (GF without Earthworm was used as the experimental control. The vermifiltration caused a significant decrease in the levels of COD (75%, BOD5 (93%, and TSS (89% as well as neutralized pH in the wastewater. Also, these contents in the geofilter were observed to be 65%, 71%, and 71%, respectively. The vermifiltration technology can, therefore, be applied as an environmentally friendly method for hospital wastewater treatment.

  6. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  7. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  8. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  9. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  10. Travel and Hospitality | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 1 - 67 of 67 ... Search. Home · About IDRC · Accountability · Transparency ... IDRC also provides information on the total annual expenses for each of travel, hospitality and ... The information on this website is updated every three months.

  11. Mercury emissions from municipal solid waste combustors

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    This report examines emissions of mercury (Hg) from municipal solid waste (MSW) combustion in the United States (US). It is projected that total annual nationwide MSW combustor emissions of mercury could decrease from about 97 tonnes (1989 baseline uncontrolled emissions) to less than about 4 tonnes in the year 2000. This represents approximately a 95 percent reduction in the amount of mercury emitted from combusted MSW compared to the 1989 mercury emissions baseline. The likelihood that routinely achievable mercury emissions removal efficiencies of about 80 percent or more can be assured; it is estimated that MSW combustors in the US could prove to be a comparatively minor source of mercury emissions after about 1995. This forecast assumes that diligent measures to control mercury emissions, such as via use of supplemental control technologies (e.g., carbon adsorption), are generally employed at that time. However, no present consensus was found that such emissions control measures can be implemented industry-wide in the US within this time frame. Although the availability of technology is apparently not a limiting factor, practical implementation of necessary control technology may be limited by administrative constraints and other considerations (e.g., planning, budgeting, regulatory compliance requirements, etc.). These projections assume that: (a) about 80 percent mercury emissions reduction control efficiency is achieved with air pollution control equipment likely to be employed by that time; (b) most cylinder-shaped mercury-zinc (CSMZ) batteries used in hospital applications can be prevented from being disposed into the MSW stream or are replaced with alternative batteries that do not contain mercury; and (c) either the amount of mercury used in fluorescent lamps is decreased to an industry-wide average of about 27 milligrams of mercury per lamp or extensive diversion from the MSW stream of fluorescent lamps that contain mercury is accomplished.

  12. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  13. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  14. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  15. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  16. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  17. Help prevent hospital errors

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000618.htm Help prevent hospital errors To use the sharing features ... in the hospital. If You Are Having Surgery, Help Keep Yourself Safe Go to a hospital you ...

  18. Solid waste management - Pakistan's perspective

    International Nuclear Information System (INIS)

    Hussain, M.

    2003-01-01

    The discipline of 'Solid Waste Management' is as old as human civilization itself. The problem had been felt when the human beings commenced living together in the form of communities. The situation got worsened with ever-increasing population and growing industrialization. The developed nations have endeavored to tackle the issue of the industrial and municipal wastes according to the principles of engineering and environment. Most of the developing countries have not dealt with the 'Third Pollution' in the eco-friendly manner. Ironically Pakistan is facing this serious menace because of ever-expanding population (2.2% per annum) and ill management of the wastes and effluents being generated from multifarious activities. These pollutants are degrading the land, air and water resources at alarming rates. In Pakistan about 7,250 tonnes of solid waste is generated per day. Of this quantity only 60-70% is collected and the remaining quantity is allowed to burn indiscriminately or decay in situ. Unfortunately the industrial waste, animal dung and hospital waste are allowed to mix with the municipal waste, which adds to inefficiency of the existing 'Solid Waste Management System'. Scores of faecal, fly, rodent and mosquito born diseases are caused due to open dumping of the waste besides aesthetic impairment of the surroundings. None of the scientifically recognized methods of disposal is practiced. It is not based on administrative, financial, environmental and technical consideration. There is dire necessity of educating the masses to adopt clean habits and resort to generation of minimum waste. Further, nothing is waste as the so-called 'waste material' is the raw material after reuse and recycling for another process. (author)

  19. Universal decoherence in solids.

    Science.gov (United States)

    Chudnovsky, Eugene M

    2004-03-26

    Symmetry implications for the decoherence of quantum oscillations of a two-state system in a solid are studied. When the oscillation frequency is small compared to the Debye frequency, the universal lower bound on the decoherence due to the atomic environment is derived in terms of the macroscopic parameters of the solid, with no unknown interaction constants.

  20. Ceramic solid electrolytes

    Energy Technology Data Exchange (ETDEWEB)

    Goodenough, John B. [Center for Materials Science and Engineering, University of Texas at Austin, Austin, TX (United States)

    1997-02-15

    Strategies for the design of ceramic solid electrolytes are reviewed. Problems associated with stoichiometric and doped compounds are compared. In the illustration of design principles, emphasis is given to oxide-ion electrolytes for use in solid-oxide fuel cells, oxygen pumps, and oxygen sensors

  1. Methane potential of sterilized solid slaughterhouse wastes.

    Science.gov (United States)

    Pitk, Peep; Kaparaju, Prasad; Vilu, Raivo

    2012-07-01

    The aim of the current study was to determine chemical composition and methane potential of Category 2 and 3 solid slaughterhouse wastes rendering products (SSHWRP) viz. melt, decanter sludge, meat and bone meal (MBM), technical fat and flotation sludge from wastewater treatment. Chemical analyses showed that SSHWRP were high in protein and lipids with total solids (TS) content of 96-99%. Methane yields of the SSHWRP were between 390 and 978 m(3) CH(4)/t volatile solids (VS)(added). Based on batch experiments, anaerobic digestion of SSHWRP from the dry rendering process could recover 4.6 times more primary energy than the energy required for the rendering process. Estonia has technological capacity to sterilize all the produced Category 2 and 3 solid slaughterhouse wastes (SSHW) and if separated from Category 1 animal by-products (ABP), it could be further utilized as energy rich input material for anaerobic digestion. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. A system dynamics approach for hospital waste management in a city in a developing country: the case of Nablus, Palestine.

    Science.gov (United States)

    Al-Khatib, Issam A; Eleyan, Derar; Garfield, Joy

    2016-09-01

    Hospitals and health centers provide a variety of healthcare services and normally generate hazardous waste as well as general waste. General waste has a similar nature to that of municipal solid waste and therefore could be disposed of in municipal landfills. However, hazardous waste poses risks to public health, unless it is properly managed. The hospital waste management system encompasses many factors, i.e., number of beds, number of employees, level of service, population, birth rate, fertility rate, and not in my back yard (NIMBY) syndrome. Therefore, this management system requires a comprehensive analysis to determine the role of each factor and its influence on the whole system. In this research, a hospital waste management simulation model is presented based on the system dynamics technique to determine the interaction among these factors in the system using a software package, ithink. This model is used to estimate waste segregation as this is important in the hospital waste management system to minimize risk to public health. Real data has been obtained from a case study of the city of Nablus, Palestine to validate the model. The model exhibits wastes generated from three types of hospitals (private, charitable, and government) by considering the number of both inpatients and outpatients depending on the population of the city under study. The model also offers the facility to compare the total waste generated among these different types of hospitals and anticipate and predict the future generated waste both infectious and non-infectious and the treatment cost incurred.

  3. Applied mechanics of solids

    CERN Document Server

    Bower, Allan F

    2009-01-01

    Modern computer simulations make stress analysis easy. As they continue to replace classical mathematical methods of analysis, these software programs require users to have a solid understanding of the fundamental principles on which they are based. Develop Intuitive Ability to Identify and Avoid Physically Meaningless Predictions Applied Mechanics of Solids is a powerful tool for understanding how to take advantage of these revolutionary computer advances in the field of solid mechanics. Beginning with a description of the physical and mathematical laws that govern deformation in solids, the text presents modern constitutive equations, as well as analytical and computational methods of stress analysis and fracture mechanics. It also addresses the nonlinear theory of deformable rods, membranes, plates, and shells, and solutions to important boundary and initial value problems in solid mechanics. The author uses the step-by-step manner of a blackboard lecture to explain problem solving methods, often providing...

  4. The cost of hospitalization in Crohn's disease.

    Science.gov (United States)

    Cohen, R D; Larson, L R; Roth, J M; Becker, R V; Mummert, L L

    2000-02-01

    The aim of this study was to evaluate the demographics, resource use, and costs associated with hospitalization of Crohn's disease patients. All patients hospitalized at our institution from 7/1/96 to 6/30/97 with a primary diagnosis of "Crohn's Disease" were analyzed using a computerized database. Data are presented "per hospitalization." A total of 175 hospitalizations (147 patients) were identified. Mean patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was most commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medical. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 days). The average cost of hospitalization, excluding physician fees, was $12,528 (surgical, $14,409; medical, $10,020), whereas average charges were $35,378 (surgical, $46,354; medical, $20,744), including physician fees, which averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursements were $21,968 (surgical, $28,946; medical, $12,666) with average weighted reimbursement rates of 60.17% of hospital charges, 69.57% of physician fees. The distribution of costs across subcategories was: Surgery (39.6%), Pharmacy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endoscopy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with aminosalicylates; 27% included the administration of total parenteral nutrition, which accounted for 63% of the total pharmacy costs. Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.

  5. Estimación del agua corporal total y del peso seco usando impedancia bioeléctrica tetrapolar de multifrecuencia en pacientes en hemodiálisis. Universidad Nacional de Colombia, Unidad Renal Fundación Hospital San Carlos, Cruz Roja y Centro de Investigación

    Directory of Open Access Journals (Sweden)

    Doris Ramirez de Peña

    2015-01-01

    Full Text Available En la búsqueda de métodos confiables y sencillos para la medición de la composición corporal de los pacientes renales en hemodiálisis (HD y, particularmente, del agua total corporal (TBW, se ha utilizado la bioimpedancia tetrapolar de unifrecuencia (BIA-1 y, más recientemente, la bioimpedancia tetrapolar de multifrecuencia, (BIA-4 como métodos confiables a utilizar en pacientes renales. Es necesario conocer el agua total corporal y el peso seco lo más acertadamente posible, puesto que con ellos se determina el tratamiento dialítico, farmacológico y nutricional de los pacientes renales en hemodiálisis. Por esta razón, se realizó un estudio clínico controlado no aleatorizado en seis fases, desde el año 2001 al 2010, en el que participaron estudiantes de pregrado del Programa de Nutrición y Dietética de la Universidad Nacional de Colombia, profesores de la Facultad de Medicina de la misma Universidad y el equipo de nefrólogos y nutricionistas de las unidades renales de la Fundación Hospital San Carlos, de la Cruz Roja y del Centro de Investigación de Enfermedades Crónicas de Bogotá, con el fin de establecer la confiabilidad del método, determinar una ecuación para conocer el agua total corporal de pacientes renales en HD colombianos, determinar un punto de corte utilizando la resistencia de la BIA para monitorear la cantidad de agua aumentada  interdiálisis de los pacientes, la presencia de síntomas, y conocer la utilidad de la normovolemia en la obtención del peso seco. Se encontró -al igual que en otros estudios- que la BIA-4 multifrecuencia es un método que ofrece enormes posibilidades en el estudio del paciente renal, al ser sensible a los cambios de la composición corporal del individuo, además de ser un método sencillo, indoloro, no invasivo y de fácil ejecución que permite establecer el peso seco, el estado nutricional, el agua extra e intracelular, la masa magra, la masa grasa, etc. También se logr

  6. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  7. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  8. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  9. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  10. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  11. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  12. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  13. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  14. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  15. Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece.

    Science.gov (United States)

    Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

    2012-07-01

    The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and "other". Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective

  16. Solid Lithium Ion Conductors (SLIC) for Lithium Solid State Batteries

    Data.gov (United States)

    National Aeronautics and Space Administration — To identify the most lithium-ion conducting solid electrolytes for lithium solid state batteries from the emerging types of solid electrolytes, based on a...

  17. Evaluation of dry solid waste recycling from municipal solid waste: case of Mashhad city, Iran.

    Science.gov (United States)

    Farzadkia, Mahdi; Jorfi, Sahand; Akbari, Hamideh; Ghasemi, Mehdi

    2012-01-01

    The recycling for recovery and reuse of material and energy resources undoubtedly provides a substantial alternative supply of raw materials and reduces the dependence on virgin feedstock. The main objective of this study was to assess the potential of dry municipal solid waste recycling in Mashhad city, Iran. Several questionnaires were prepared and distributed among various branches of the municipality, related organizations and people. The total amount of solid waste generated in Mashhad in 2008 was 594, 800  tons with per capita solid waste generation rate of 0.609  kg  person(-1) day(-1). Environmental educational programmes via mass media and direct education of civilians were implemented to publicize the advantages and necessity of recycling. The amount of recycled dry solid waste was increased from 2.42% of total dry solid waste (2588.36  ton  year(-1)) in 1999 to 7.22% (10, 165  ton  year(-1)) in 2008. The most important fractions of recycled dry solid waste in Mashhad included paper and board (51.33%), stale bread (14.59%), glass (9.73%), ferrous metals (9.73%), plastic (9.73%), polyethylene terephthalate (2.62%) and non-ferrous metals (0.97%). It can be concluded that unfortunately the potential of dry solid waste recycling in Mashhad has not been considered properly and there is a great effort to be made in order to achieve the desired conditions of recycling.

  18. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  19. Potential of solid state fermentation for production of ergot alkaloids

    OpenAIRE

    Trejo Hernandez, M.R.; Raimbault, Maurice; Roussos, Sevastianos; Lonsane, B.K.

    1992-01-01

    Production of total ergot alkaloids by #Claviceps fusiformis$ in solid state fermentation was 3.9 times higher compared to that in submerged fermentation. Production was equal in the case of #Claviceps purpurea$ but the spectra of alkaloids were advantageous with the use of solid state fermentation. The data establish potential of solid state fermentation which was not explored earlier for production of ergot alkaloids. (Résumé d'auteur)

  20. Characterization of domestic graywater and graywater solids.

    Science.gov (United States)

    Sievers, Jan Christian; Londong, Jörg

    2018-03-01

    The knowledge of loads and concentrations is fundamental for the design of graywater treatment units, but the data on the characteristics of graywater and in particular graywater solids are weak. As general design values regarding graywater treatment facilities are not available for Germany, the objective of this article is to elaborate the characteristics of graywater and graywater solids. This paper describes the results of six sampling campaigns carried out on graywater systems in the German cities Berlin, Lübeck and Kiel. All graywater samples were collected proportional to the flow and the graywater solids were gathered separately. The collected data include graywater volumes and characteristics regarding the organic pollution (chemical oxygen demand (COD), 5-day biochemical oxygen demand (BOD 5 )) and nutrients (total nitrogen (TN), total phosphorus (TP)). The graywater volume fluctuated depending on the location. The specific average flow was 68 litre per inhabitant per day (L/inh.d). Inhabitant-specific loads of 49.3 gCOD t /inh·d, 28 gBOD 5 /inh.d, 1 gTN t /inh.d and 0.38 gTP t /inh.d (subscript 't' = total) were found. Information about the composition of graywater solids in terms of quantity and quality is seriously lacking. Therefore, graywater solids were examined with respect to organic matter (COD) and nutrients (TN, TP). The contribution of graywater solids with particle sizes over 200 microns in relation to the total inhabitant-specific load was approximately 3-8% depending on the parameter. The qualitative and quantitative characteristics of the investigated graywater fractions may serve as a base for the estimation of design values.

  1. Solid biomass barometer

    International Nuclear Information System (INIS)

    Anon.

    2007-01-01

    Primary energy production from solid biomass (wood, wood waste and other solid vegetal and animal materials) reached 62,4 million tons oil equivalent (Mtoe) in 2006, i-e 3,1 more than in 2005. The primary energy coming from the direct combustion of renewable origin solid urban waste in incineration unit scan also be added to this figure. In 2006 this represented a production of 5,3 Mtoe, i-e 0,1 Mtoe more than in 2005. (author)

  2. Applications in solid mechanics

    DEFF Research Database (Denmark)

    Ølgaard, Kristian Breum; Wells, Garth N.

    2012-01-01

    Problems in solid mechanics constitute perhaps the largest field of application of finite element methods. The vast majority of solid mechanics problems involve the standard momentum balance equation, posed in a Lagrangian setting, with different models distinguished by the choice of nonlinear...... or linearized kinematics, and the constitutive model for determining the stress. For some common models, the constitutive relationships are rather complex. This chapter addresses a number of canonical solid mechanics models in the context of automated modeling, and focuses on some pertinent issues that arise...

  3. The solid state maser

    CERN Document Server

    Orton, J W; Walling, J C; Ter Haar, D

    1970-01-01

    The Solid State Maser presents readings related to solid state maser amplifier from the first tentative theoretical proposals that appeared in the early 1950s to the successful realization of practical devices and their application to satellite communications and radio astronomy almost exactly 10 years later. The book discusses a historical account of the early developments (including that of the ammonia maser) of solid state maser; the properties of paramagnetic ions in crystals; the development of practical low noise amplifiers; and the characteristics of maser devices designed for communica

  4. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  5. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  6. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  7. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Radiation resistance of plastic solid

    International Nuclear Information System (INIS)

    Moriyama, Noboru; Dojiri, Shigeru; Wadachi, Yoshiki

    1985-01-01

    The radiation from nucleides contained in solidified wates have some effects on the degradation of the solidification materials. This report deals with effects of such radiation on the mechanical strength of waste-plastics composites and on the generation of gasses. It is shown that the mechanical strength of polyethylene and polyester solids will not decrease at a total absorbed dose of 10 6 rad, a dose which a low-level waste composite is expected to receive during an infinite period of time. Rather, it increases in the case of polyethylene. The amount of gas generated from degraded polyethylene is about three times as large as that from polyester, namely, about 6 l per 200 l drum can at 10 6 rad. Hydrogen accounts for about 80 % of the total gas generated from polyethylene. On the other hand, the gas from polyester solid mainly contains hydrogen, carbon dioxide, carbon monoxide and methane, with a composition greatly dependent on the type of the waste contained. It is concluded from these results that plastic materials can serve satisfactorily as for as the effects of radiation on their mechanical strength and gas generation are concerned. A more important problem still remaining to be solved is the effects of radiation on the leaching of radioactive nuclides. (Nogami, K.)

  9. Development of a master plan for industrial solid waste management

    International Nuclear Information System (INIS)

    Karamouz, M.; Zahraie, B.; Kerachian, R.; Mahjouri, N.; Moridi, A.

    2006-01-01

    Rapid industrial growth in the province of Khuzestan in the south west of Iran has resulted in disposal of about 1750 tons of solid waste per day. Most of these industrial solid wastes including hazardous wastes are disposed without considering environmental issues. This has contributed considerably to the pollution of the environment. This paper introduces a framework in which to develop a master plan for industrial solid waste management. There are usually different criteria for evaluating the existing solid waste pollution loads and how effective the management schemes are. A multiple criteria decision making technique, namely Analytical Hierarchy Process, is used for ranking the industrial units based on their share in solid waste related environmental pollution and determining the share of each unit in total solid waste pollution load. In this framework, a comprehensive set of direct, indirect, and supporting projects are proposed for solid waste pollution control. The proposed framework is applied for industrial solid waste management in the province of Khuzestan in Iran and a databank including GIS based maps of the study area is also developed. The results have shown that the industries located near the capital city of the province, Ahwaz, produce more than 32 percent of the total solid waste pollution load of the province. Application of the methodology also has shown that it can be effectively used for development of the master plan and management of industrial solid wastes

  10. Impact of bleeding-related complications and/or blood product transfusions on hospital costs in inpatient surgical patients

    Directory of Open Access Journals (Sweden)

    Reynolds Matthew W

    2011-05-01

    Full Text Available Abstract Background Inadequate surgical hemostasis may lead to transfusion and/or other bleeding-related complications. This study examines the incidence and costs of bleeding-related complications and/or blood product transfusions occurring as a consequence of surgery in various inpatient surgical cohorts. Methods A retrospective analysis was conducted using Premier's Perspective™ hospital database. Patients who had an inpatient procedure within a specialty of interest (cardiac, vascular, non-cardiac thoracic, solid organ, general, reproductive organ, knee/hip replacement, or spinal surgery during 2006-2007 were identified. For each specialty, the rate of bleeding-related complications (including bleeding event, intervention to control for bleeding, and blood product transfusions was examined, and hospital costs and length of stay (LOS were compared between surgeries with and without bleeding-related complications. Incremental costs and ratios of average total hospital costs for patients with bleeding-related complications vs. those without complications were estimated using ordinary least squares (OLS regression, adjusting for demographics, hospital characteristics, and other baseline characteristics. Models using generalized estimating equations (GEE were also used to measure the impact of bleeding-related complications on costs while accounting for the effects related to the clustering of patients receiving care from the same hospitals. Results A total of 103,829 cardiac, 216,199 vascular, 142,562 non-cardiac thoracic, 45,687 solid organ, 362,512 general, 384,132 reproductive organ, 246,815 knee/hip replacement, and 107,187 spinal surgeries were identified. Overall, the rate of bleeding-related complications was 29.9% and ranged from 7.5% to 47.4% for reproductive organ and cardiac, respectively. Overall, incremental LOS associated with bleeding-related complications or transfusions (unadjusted for covariates was 6.0 days and ranged from 1

  11. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  12. Hospital Library Administration.

    Science.gov (United States)

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  13. Determining Disturbing Factors of Sleep Quality among Hospitalized Elderly Patients in Kashan Hospitals, Iran 2009

    Directory of Open Access Journals (Sweden)

    M Kafaei

    2013-03-01

    Full Text Available Introduction: Sleep is an effective factor in the recovery processes. Many variables affect on the sleep quality of hospitalized elderly people. This study was conducted to determine the factors disturbing sleep quality among hospitalized older adult patients in Kashan hospitals. Methods: A cross-sectional study was carried out on a sample of 390 elderly hospitalized patients in Kashan hospitals. The study data was gathered via Pittsburgh Sleep Quality Index (PSQI Questionnaire. A global total score of 5 or greater indicated a “poor" quality of sleep. The data were analyzed using Chi square, t- test and binary logistic regression at multivariate model. Results: The total quality of sleep was poor in hospitalized elderly patients (7/2±4/8. Sex, marital status, level of education, type of ward, previous hospitalization experience, use of hypnotics at home and hospital, and previous sleep disorders were statistically associated with quality of sleep; however, there was not significant relationship between quality of sleep and age, length of hospitalization, and daytime napping. In the final regression model, marital status (OR=4.6, level of education (OR=1.9, length of hospitalization (OR=1.1, Previous hospitalization experience (OR=0.4, use of hypnotics in hospital (OR=0.27 and previous sleep disorder (OR=0.01 were the most important determinants of sleep quality. Conclusion: Quality of sleep was poor in hospitalized elderly due to a wide range of sleep disturbing factors. The most important factors involved marital status, level of education, previous hospitalization experience, previous sleep disorder and use of hypnotics in hospital.

  14. Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

    Science.gov (United States)

    Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

    2012-12-01

    Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  15. Sputtering of solid deuterium by He-ions

    DEFF Research Database (Denmark)

    Schou, Jørgen; Stenum, B.; Pedrys, R.

    2001-01-01

    Sputtering of solid deuterium by bombardment of 3He+ and 4He+ ions was studied. Some features are similar to hydrogen ion bombardment of solid deuterium, but for the He-ions a significant contribution of elastic processes to the total yield can be identified. The thin-film enhancement is more pro...... pronounced than that for hydrogen projectiles in the same energy range....

  16. Layered inorganic solids

    Czech Academy of Sciences Publication Activity Database

    Čejka, Jiří; Morris, R. E.; Nachtigall, P.; Roth, Wieslaw Jerzy

    2014-01-01

    Roč. 43, č. 27 (2014), s. 10274-10275 ISSN 1477-9226 Institutional support: RVO:61388955 Keywords : layered inorganic solids * physical chemistry * catalysis Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 4.197, year: 2014

  17. Sheared solid materials

    Indian Academy of Sciences (India)

    ingredient, solving the equations yields formation of dislocation dipoles or slips. In plastic ... We expect that m is a key order parameter for amorphous solids or glasses. .... It satisfies the mechanical equilibrium condition and can be calculated ...

  18. Solid Waste Management Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Solid waste management districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This dataset...

  19. Solids Accumulation Scouting Studies

    Energy Technology Data Exchange (ETDEWEB)

    Duignan, M. R.; Steeper, T. J.; Steimke, J. L.

    2012-09-26

    The objective of Solids Accumulation activities was to perform scaled testing to understand the behavior of remaining solids in a Double Shell Tank (DST), specifically AW-105, at Hanford during multiple fill, mix, and transfer operations. It is important to know if fissionable materials can concentrate when waste is transferred from staging tanks prior to feeding waste treatment plants. Specifically, there is a concern that large, dense particles containing plutonium could accumulate in poorly mixed regions of a blend tank heel for tanks that employ mixing jet pumps. At the request of the DOE Hanford Tank Operations Contractor, Washington River Protection Solutions, the Engineering Development Laboratory of the Savannah River National Laboratory performed a scouting study in a 1/22-scale model of a waste staging tank to investigate this concern and to develop measurement techniques that could be applied in a more extensive study at a larger scale. Simulated waste tank solids: Gibbsite, Zirconia, Sand, and Stainless Steel, with stainless steel particles representing the heavier particles, e.g., plutonium, and supernatant were charged to the test tank and rotating liquid jets were used to mix most of the solids while the simulant was pumped out. Subsequently, the volume and shape of the mounds of residual solids and the spatial concentration profiles for the surrogate for heavier particles were measured. Several techniques were developed and equipment designed to accomplish the measurements needed and they included: 1. Magnetic particle separator to remove simulant stainless steel solids. A device was designed and built to capture these solids, which represent the heavier solids during a waste transfer from a staging tank. 2. Photographic equipment to determine the volume of the solids mounds. The mounds were photographed as they were exposed at different tank waste levels to develop a composite of topographical areas. 3. Laser rangefinders to determine the volume of

  20. Direct cost comparison of totally endoscopic versus open ear surgery.

    Science.gov (United States)

    Patel, N; Mohammadi, A; Jufas, N

    2018-02-01

    Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting. A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy. Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

  1. Solid polymer electrolytes

    Science.gov (United States)

    Abraham, Kuzhikalail M.; Alamgir, Mohamed; Choe, Hyoun S.

    1995-01-01

    This invention relates to Li ion (Li.sup.+) conductive solid polymer electrolytes composed of poly(vinyl sulfone) and lithium salts, and their use in all-solid-state rechargeable lithium ion batteries. The lithium salts comprise low lattice energy lithium salts such as LiN(CF.sub.3 SO.sub.2).sub.2, LiAsF.sub.6, and LiClO.sub.4.

  2. Organic Molecular Solids

    CERN Document Server

    Schwoerer, Marcus

    2007-01-01

    This is the first comprehensive textbook on the physical aspects of organic solids. All phenomena which are necessary in order to understand modern technical applications are being dealt with in a way which makes the concepts of the topics accessible for students. The chapters - from the basics, production and characterization of organic solids and layers to organic semiconductors, superconductors and opto-electronical applications - have been arranged in a logical and well thought-out order.

  3. ELEMENTAL FORMS OF HOSPITALITY

    OpenAIRE

    Maximiliano Emanuel Korstanje

    2010-01-01

    Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...

  4. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  5. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  6. Laser cooling of solids

    CERN Document Server

    Petrushkin, S V

    2009-01-01

    Laser cooling is an important emerging technology in such areas as the cooling of semiconductors. The book examines and suggests solutions for a range of problems in the development of miniature solid-state laser refrigerators, self-cooling solid-state lasers and optical echo-processors. It begins by looking at the basic theory of laser cooling before considering such topics as self-cooling of active elements of solid-state lasers, laser cooling of solid-state information media of optical echo-processors, and problems of cooling solid-state quantum processors. Laser Cooling of Solids is an important contribution to the development of compact laser-powered cryogenic refrigerators, both for the academic community and those in the microelectronics and other industries. Provides a timely review of this promising field of research and discusses the fundamentals and theory of laser cooling Particular attention is given to the physics of cooling processes and the mathematical description of these processes Reviews p...

  7. [Total knee and hip prosthesis: variables associated with costs].

    Science.gov (United States)

    Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

    2013-01-01

    The elevated prevalence of osteoarthritis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in the clinical practice have generated considerable interest in comparing the associated costs before and after surgery. To determine the influence of a number of variables on the costs of total knee and hip arthroplasty surgery during the hospital stay and during the one-year post-discharge. A prospective multi-center study was performed in 15 hospitals from three Spanish regions. Relationships between the independent variables and the costs of hospital stay and postdischarge follow-up were analyzed by using multilevel models in which the "hospital" variable was used to group cases. Independent variables were: age, sex, body mass index, preoperative quality of life (SF-12, EQ-5 and Womac questionnaires), surgery (hip/knee), Charlson Index, general and local complications, number of beds and economic-institutional dependency of the hospital, the autonomous region to which it belongs, and the presence of a caregiver. The cost of hospital stay, excluding the cost of the prosthesis, was 4,734 Euros, and the post-discharge cost was 554 Euros. With regard to hospital stay costs, the variance among hospitals explained 44-46% of the total variance among the patients. With regard to the post-discharge costs, the variability among hospitals explained 7-9% of the variance among the patients. There is considerable potential for reducing the hospital stay costs of these patients, given that more than 44% of the observed variability was not determined by the clinical conditions of the patients but rather by the behavior of the hospitals.

  8. EARNINGS MANAGEMENT IN U.S. HOSPITALS.

    Science.gov (United States)

    Dong, Gang Nathan

    2016-01-01

    This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP). We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior. From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership. Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts. We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.

  9. Epidemiology of paediatric poisoning reporting to a tertiary hospital ...

    African Journals Online (AJOL)

    Methods. We conducted a retrospective study from January 2007 to January 2012 at the Komfo Anokye Teaching Hospital, a tertiary hospital in Ghana. Results. Poisoning is a significant health problem in the study area. A total of 253 children reported to the hospital with poisoning over the 61month period, with an average ...

  10. Graduate Education for Hospital Administration in the United States: Trends.

    Science.gov (United States)

    Chester, Theodore E.

    In 1968, 75% of the 5,466 graduates of hospital administration were in management positions in hospitals and related institutions, and about 1,000 to 1,500 held key government jobs. The US needs approximately 40,000 trained hospital administrators, but the total graduate output is about one-eighth of that amount. Of the 23 existing programs, 8 are…

  11. Technical efficiency of selected hospitals in Eastern Ethiopia.

    Science.gov (United States)

    Ali, Murad; Debela, Megersa; Bamud, Tewfik

    2017-12-01

    This study examines the relative technical efficiency of 12 hospitals in Eastern Ethiopia. Using six-year-round panel data for the period between 2007/08 and 2012/13, this study examines the technical efficiency, total factor productivity, and determinants of the technical inefficiency of hospitals. Data envelopment analysis (DEA) and DEA- based Malmquist productivity index used to estimate relative technical efficiency, scale efficiency, and total factor productivity index of hospitals. Tobit model used to examine the determinants of the technical inefficiency of hospitals. The DEA Variable Returns to Scale (VRS) estimate indicated that 6 (50%), 5 (42%), 3 (25%), 3 (25%), 4 (33%), and 3 (25%) of the hospitals were technically inefficient while 9 (75%), 9 (75%), 7 (58%), 7 (58%), 7 (58%) and 8 (67%) of hospitals were scale inefficient between 2007/08 and 2012/13, respectively. On average, Malmquist Total Factor Productivity (MTFP) of the hospitals decreased by 3.6% over the panel period. The Tobit model shows that teaching hospital is less efficiency than other hospitals. The Tobit regression model further shows that medical doctor to total staff ratio, the proportion of outpatient visit to inpatient days, and the proportion of inpatients treated per medical doctor were negatively related with technical inefficiency of hospitals. Hence, policy interventions that help utilize excess capacity of hospitals, increase doctor to other staff ratio, and standardize number of inpatients treated per doctor would contribute to the improvement of the technical efficiency of hospitals.

  12. Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias.

    Science.gov (United States)

    Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie

    2015-11-01

    Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  13. Medicare Payment Penalties and Safety Net Hospital Profitability: Minimal Impact on These Vulnerable Hospitals.

    Science.gov (United States)

    Bazzoli, Gloria J; Thompson, Michael P; Waters, Teresa M

    2018-02-08

    To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition. Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations. Bivariate and multivariate analysis of pooled cross-sectional data. Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins. Safety net hospitals appear to rely on nonpatient care revenues to offset higher penalties for the years studied. While reassuring, these funding streams are volatile and may not be able to compensate for cumulative losses over time. © Health Research and Educational Trust.

  14. The use of adaptive equipment following total knee replacement

    OpenAIRE

    McNaught, Jamie; Paul, Lorna

    2015-01-01

    Introduction: This study evaluates the need for adaptive equipment following total knee replacement. There are no recent studies to guide occupational therapists in the optimum time adaptive equipment is required following total knee replacement.\\ud \\ud Method: A non-experimental, concurrent mixed methods approach was used. The study population was patients attending for total knee replacement at a large general hospital. Outcome measures were the Oxford Knee Score, the United Kingdom Functio...

  15. Welfare standards in hospital mergers.

    Science.gov (United States)

    Katona, Katalin; Canoy, Marcel

    2013-08-01

    There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.

  16. Development of total medical material distribution management system.

    Science.gov (United States)

    Uto, Y; Kumamoto, I

    1994-07-01

    Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.

  17. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  18. Hospitality Healthscapes: The New Standard for Making Hospitals More Hospitable

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi

    2017-06-01

    Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?

  19. Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation.

    Science.gov (United States)

    Keong, Nicole; Ricketts, David; Alakeson, Nuki; Rust, Philippa

    2004-01-01

    OBJECTIVE: To assess the reliability of reporting protocols regarding pressure sores. METHODS: Retrospective data were collected regarding pressure sore rates following total hip arthroplasty operations carried out during 2001 at two orthopaedic units in an NHS hospital (Princess Royal Hospital) and in a local private hospital. RESULTS: Preliminary results presented in audit and interim reports indicated an alarmingly high pressure sore rate across the two sites (17/172 [9.9%] NHS, 23/71 [32.4%] private hospital). On analysis, the data collection system was revealed to be flawed. Grade 1 areas (erythema with no ulceration) were included, leading to a dramatic discrepancy between reported and confirmed pressure sores. Re-analysis showed the confirmed pressure sore rates to be much lower (2.3% NHS, 1.0% private hospital). CONCLUSIONS: This audit suggests that both poor data collection and education lead to inaccurate audit. This may lead to subsequent inappropriate management and inappropriate NHS star ratings. PMID:15140301

  20. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  1. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Zierhut, D.; Lohr, F.; Schraube, P.; Huber, P.; Haas, R.; Hunstein, W.; Wannenmacher, M.

    1997-01-01

    Purpose: Aim of this retrospective study was to evaluate cataract incidence in a homogeneous group of patients after total-body irradiation followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Method and Materials: Between 11/1982 and 6/1994 in total 260 patients received in our hospital total-body irradiation for treatment of haematological malignancy. In 1996-96 patients out of these 260 patients were still alive. 85 from these still living patients (52 men, 33 women) answered evaluable on a questionnaire and could be examined ophthalmologically. Median age of these patients was 38,5 years (15 - 59 years) at time of total-body irradiation. Radiotherapy was applied as hyperfractionated total-body irradiation with a median dose of 14,4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 hours, photons with a energy of 23 MeV were used, and the dose rate was 7 - 18 cGy/min. Results: Median follow-up is now 5,8 years (1,7 - 13 years). Cataract occurred in (28(85)) patients after a median time of 47 months (1 - 104 months). In 6 out of these 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to total-body irradiation was more often in the group of patients developing a cataract (14,3%) vs. 10,7% in the group of patients without cataract. Conclusion: Cataract is a common side effect of total-body irradiation. Cataract incidence found in our patients is comparable to results of other centres using a fractionated regimen for total-body irradiation. The hyperfractionated regimen used in our hospital does obviously not result in a even lower cataract incidence. In contrast to acute and late toxicity in other organ/organsystems, hyperfractionation of total-body irradiation does not further reduce toxicity for the eye-lens. Dose rate may have more influence on cataract incidence

  2. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  3. Waste is a resource: A study on the opportunities in a new solid waste management in Iringa municipality

    OpenAIRE

    Solberg, Eirin

    2012-01-01

    Master i produktdesign Municipal solid waste refers to waste in a solid form, produced in the daily day life of a society such as packaging, food scrapes, grass clippings, clothing, furniture, paper, electronics and so on. It is called municipal solid waste because it is in the responsibility of the local government and comes from our homes, schools, hospitals and businesses. It is produced 108 tons municipal solid waste in Iringa each day. Iringa district is located approximately 500...

  4. Applying a Network-Lens to Hospitality Business Research: A New Research Agenda

    OpenAIRE

    AUBKE, Florian

    2014-01-01

    Hospitality businesses are first and foremost places of social interaction. This paper argues for an inclusion of network methodology into the tool kit of hospitality researchers. This methodology focuses on the interaction of people rather than applying an actor-focused view, which currently seems dominant in hospitality research. Outside the field, a solid research basis has been formed, upon which hospitality researchers can build. The paper introduces the foundations ...

  5. Pediatric inpatient hospital resource use for congenital heart defects.

    Science.gov (United States)

    Simeone, Regina M; Oster, Matthew E; Cassell, Cynthia H; Armour, Brian S; Gray, Darryl T; Honein, Margaret A

    2014-12-01

    Congenital heart defects (CHDs) occur in approximately 8 per 1000 live births. Improvements in detection and treatment have increased survival. Few national estimates of the healthcare costs for infants, children and adolescents with CHDs are available. We estimated hospital costs for hospitalizations using pediatric (0-20 years) hospital discharge data from the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) for hospitalizations with CHD diagnoses. Estimates were up-weighted to be nationally representative. Mean costs were compared by demographic factors and presence of critical CHDs (CCHDs). Up-weighting of the KID generated an estimated 4,461,615 pediatric hospitalizations nationwide, excluding normal newborn births. The 163,980 (3.7%) pediatric hospitalizations with CHDs accounted for approximately $5.6 billion in hospital costs, representing 15.1% of costs for all pediatric hospitalizations in 2009. Approximately 17% of CHD hospitalizations had a CCHD, but it varied by age: approximately 14% of hospitalizations of infants, 30% of hospitalizations of patients aged 1 to 10 years, and 25% of hospitalizations of patients aged 11 to 20 years. Mean costs of CHD hospitalizations were higher in infancy ($36,601) than at older ages and were higher for hospitalizations with a CCHD diagnosis ($52,899). Hospitalizations with CCHDs accounted for 26.7% of all costs for CHD hospitalizations, with hypoplastic left heart syndrome, coarctation of the aorta, and tetralogy of Fallot having the highest total costs. Hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with CCHD diagnoses accounted for 27% of CHD hospital costs. © 2014 Wiley Periodicals, Inc.

  6. Solid biomass barometer

    International Nuclear Information System (INIS)

    Anon.

    2006-01-01

    The European (EU 25) wish to substitute solid biomass origin energy consumption (principally wood and wood waste, but also straw, crop harvest residues, vegetal and animal waste) for a part of that of fossil fuel origin (petrol, gas and coal) is beginning to pay off. 58,7 million tons oil equivalent (Mtoe) of solid biomass was produced in 2005, i.e. a 3.1 Mtoe increase with respect to 2004. Production of primary energy coming from direct combustion of renewable municipal solid waste in incineration plants should also be added on to this figure. The 0,2 Mtoe increase in this production with respect to 2004 brings valorization of this type of waste up to 5,3 Mtoe in 2005. (author)

  7. Solid electrolyte fuel cells

    Science.gov (United States)

    Isaacs, H. S.

    Progress in the development of functioning solid electrolyte fuel cells is summarized. The solid electrolyte cells perform at 1000 C, a temperature elevated enough to indicate high efficiencies are available, especially if the cell is combined with a steam generator/turbine system. The system is noted to be sulfur tolerant, so coal containing significant amounts of sulfur is expected to yield satisfactory performances with low parasitic losses for gasification and purification. Solid oxide systems are electrically reversible, and are usable in both fuel cell and electrolysis modes. Employing zirconium and yttrium in the electrolyte provides component stability with time, a feature not present with other fuel cells. The chemical reactions producing the cell current are reviewed, along with materials choices for the cathodes, anodes, and interconnections.

  8. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  9. The interstices of hospitality

    African Journals Online (AJOL)

    jane.b

    School of Hospitality and Tourism, Anhembi Morumbi University, São Paulo, Brazil ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of ..... in the virtual media, the ritual always begins with an invitation.

  10. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  11. Unplanned Hospital Visits - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...

  12. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte

    2017-01-01

    This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...

  13. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...

  14. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  15. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management (RHM) is a peer-reviewed journal ... to the quintessential managerial areas of Finance, Human Resources, Operations, ... competency and career development of hospitality management students · EMAIL ...

  16. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  17. Photochemistry on solid surfaces

    CERN Document Server

    Matsuura, T

    1989-01-01

    The latest developments in photochemistry on solid surfaces, i.e. photochemistry in heterogeneous systems, including liquid crystallines, are brought together for the first time in a single volume. Distinguished photochemists from various fields have contributed to the book which covers a number of important applications: molecular photo-devices for super-memory, photochemical vapor deposition to produce thin-layered electronic semiconducting materials, sensitive optical media, the control of photochemical reactions pathways, etc. Photochemistry on solid surfaces is now a major field and this

  18. Proton tunneling in solids

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, J.

    1998-10-01

    The tunneling rate of the proton and its isotopes between interstitial sites in solids is studied theoretically. The phonons and/or the electrons in the solid have two effects on the tunneling phenomenon. First, they suppress the transfer integral between two neighbouring states. Second, they give rise to a finite lifetime of the proton state. Usually the second effect is large and the tunneling probability per unit time (tunneling rate) can be defined. In some cases, however, a coherent tunneling is expected and actually observed. (author)

  19. Hybrid elastic solids

    KAUST Repository

    Lai, Yun

    2011-06-26

    Metamaterials can exhibit electromagnetic and elastic characteristics beyond those found in nature. In this work, we present a design of elastic metamaterial that exhibits multiple resonances in its building blocks. Band structure calculations show two negative dispersion bands, of which one supports only compressional waves and thereby blurs the distinction between a fluid and a solid over a finite frequency regime, whereas the other displays super anisotropy-in which compressional waves and shear waves can propagate only along different directions. Such unusual characteristics, well explained by the effective medium theory, have no comparable analogue in conventional solids and may lead to novel applications. © 2011 Macmillan Publishers Limited. All rights reserved.

  20. Hybrid elastic solids

    KAUST Repository

    Lai, Yun; Wu, Ying; Sheng, Ping; Zhang, Zhaoqing

    2011-01-01

    Metamaterials can exhibit electromagnetic and elastic characteristics beyond those found in nature. In this work, we present a design of elastic metamaterial that exhibits multiple resonances in its building blocks. Band structure calculations show two negative dispersion bands, of which one supports only compressional waves and thereby blurs the distinction between a fluid and a solid over a finite frequency regime, whereas the other displays super anisotropy-in which compressional waves and shear waves can propagate only along different directions. Such unusual characteristics, well explained by the effective medium theory, have no comparable analogue in conventional solids and may lead to novel applications. © 2011 Macmillan Publishers Limited. All rights reserved.