Sample records for achieve permanent closure

  1. 40 CFR 280.71 - Permanent closure and changes-in-service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.71 Permanent closure and changes... sludges. All tanks taken out of service permanently must also be either removed from the ground or filled with an inert solid material. (c) Continued use of an UST system to store a non-regulated substance is...

  2. 40 CFR 280.71 - Permanent closure and changes-in-service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.71 Permanent closure and changes... sludges. All tanks taken out of service permanently must also be either removed from the ground or filled with an inert solid material. (c) Continued use of an UST system to store a non-regulated substance is...

  3. 40 CFR 280.71 - Permanent closure and changes-in-service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.71 Permanent closure and changes... sludges. All tanks taken out of service permanently must also be either removed from the ground or filled with an inert solid material. (c) Continued use of an UST system to store a non-regulated substance is...

  4. 40 CFR 280.71 - Permanent closure and changes-in-service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.71 Permanent closure and changes... sludges. All tanks taken out of service permanently must also be either removed from the ground or filled with an inert solid material. (c) Continued use of an UST system to store a non-regulated substance is...

  5. 10 CFR 63.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... to compliance with § 63.113. (2) A description of the program for post-permanent closure monitoring... that have been designed, fabricated, and emplaced to be as permanent as is practicable; (ii) Placement..., pertinent to compliance with § 63.113. (5) The results of tests, experiments, and any other analyses...

  6. 10 CFR 63.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to compliance with § 63.113. (2) A description of the program for post-permanent closure monitoring... that have been designed, fabricated, and emplaced to be as permanent as is practicable; (ii) Placement..., pertinent to compliance with § 63.113. (5) The results of tests, experiments, and any other analyses...

  7. Permanent Closure of MFC Biodiesel Underground Storage Tank 99ANL00013

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kerry L. Nisson

    2012-10-01

    This closure package documents the site assessment and permanent closure of the Materials and Fuels Complex biodiesel underground storage tank 99ANL00013 in accordance with the regulatory requirements established in 40 CFR 280.71, “Technical Standards and Corrective Action Requirements for Owners and Operators of Underground Storage Tanks: Out-of-Service UST Systems and Closure.”

  8. 10 CFR 60.112 - Overall system performance objective for the geologic repository after permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... repository after permanent closure. 60.112 Section 60.112 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES Technical Criteria Performance Objectives § 60.112 Overall system performance objective for the geologic repository after permanent closure...

  9. 10 CFR 60.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... description of the program for post-permanent closure monitoring of the geologic repository. (2) A detailed... postclosure controlled area and geologic repository operations area by monuments that have been designed... tests, experiments, and any other analyses relating to backfill of excavated areas, shaft sealing, waste...

  10. 10 CFR 60.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... description of the program for post-permanent closure monitoring of the geologic repository. (2) A detailed... postclosure controlled area and geologic repository operations area by monuments that have been designed... tests, experiments, and any other analyses relating to backfill of excavated areas, shaft sealing, waste...

  11. 10 CFR 60.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... description of the program for post-permanent closure monitoring of the geologic repository. (2) A detailed... postclosure controlled area and geologic repository operations area by monuments that have been designed... tests, experiments, and any other analyses relating to backfill of excavated areas, shaft sealing, waste...

  12. 10 CFR 60.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... description of the program for post-permanent closure monitoring of the geologic repository. (2) A detailed... postclosure controlled area and geologic repository operations area by monuments that have been designed... tests, experiments, and any other analyses relating to backfill of excavated areas, shaft sealing, waste...

  13. 10 CFR 60.51 - License amendment for permanent closure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... description of the program for post-permanent closure monitoring of the geologic repository. (2) A detailed... postclosure controlled area and geologic repository operations area by monuments that have been designed... tests, experiments, and any other analyses relating to backfill of excavated areas, shaft sealing, waste...

  14. 77 FR 55895 - Permanent Closure of Cincinnati Blue Ash Airport

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Permanent Closure of Cincinnati Blue... Cincinnati Blue Ash Airport (ISZ). SUMMARY: The Federal Aviation Administration (FAA) received written notice... closing Cincinnati Blue Ash Airport (ISZ), Cincinnati, Ohio; the notice was in excess of 30 days before...

  15. 40 CFR 280.71 - Permanent closure and changes-in-service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Permanent closure and changes-in-service. 280.71 Section 280.71 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID... for Occupational Safety and Health “Criteria for a Recommended Standard * * * Working in Confined...

  16. 10 CFR 63.113 - Performance objectives for the geologic repository after permanent closure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Performance objectives for the geologic repository after permanent closure. 63.113 Section 63.113 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH... and an engineered barrier system. (b) The engineered barrier system must be designed so that, working...

  17. 10 CFR 63.113 - Performance objectives for the geologic repository after permanent closure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Performance objectives for the geologic repository after permanent closure. 63.113 Section 63.113 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH... and an engineered barrier system. (b) The engineered barrier system must be designed so that, working...

  18. 10 CFR 63.113 - Performance objectives for the geologic repository after permanent closure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Performance objectives for the geologic repository after permanent closure. 63.113 Section 63.113 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH... and an engineered barrier system. (b) The engineered barrier system must be designed so that, working...

  19. 10 CFR 63.113 - Performance objectives for the geologic repository after permanent closure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Performance objectives for the geologic repository after permanent closure. 63.113 Section 63.113 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH... and an engineered barrier system. (b) The engineered barrier system must be designed so that, working...

  20. 10 CFR 60.111 - Performance of the geologic repository operations area through permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Performance of the geologic repository operations area... OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES Technical Criteria Performance Objectives § 60.111 Performance of the geologic repository operations area through permanent closure. (a...

  1. 10 CFR 63.111 - Performance objectives for the geologic repository operations area through permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Performance objectives for the geologic repository... (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN A GEOLOGIC REPOSITORY AT YUCCA MOUNTAIN, NEVADA... repository operations area through permanent closure. (a) Protection against radiation exposures and releases...

  2. Effect of Permanent Right Internal Mammary Artery Closure on Coronary Collateral Function and Myocardial Ischemia.

    PubMed

    Stoller, Michael; Seiler, Christian

    2017-06-01

    The objective of this study is to test the effect of permanent right internal mammary artery device closure on coronary collateral function and myocardial ischemia. This was a prospective, open-label clinical trial in 50 patients with coronary artery disease. The primary study end point was coronary collateral flow index as obtained during a 1-minute proximal right coronary artery (RCA) and left coronary artery balloon occlusion at baseline before and at follow-up examination 6 weeks after distal right internal mammary artery device closure. Collateral flow index is the ratio between simultaneously recorded mean coronary occlusive pressure divided by mean aortic pressure, both subtracted by central venous pressure. Secondary study end points were fractional flow reserve during vessel patency, the quantitative intracoronary ECG ST-segment elevation, and angina pectoris during the same 1-minute coronary occlusion. Collateral flow index in the untreated RCA and left coronary artery changed from 0.071±0.082 at baseline to 0.132±0.117 ( P <0.0001) at follow-up examination and from 0.106±0.092 to 0.081±0.079 ( P =0.29), respectively. RCA fractional flow reserve increased significantly ( P =0.0029) from baseline to follow-up examination, despite deferral of coronary intervention in all patients. There was a decrease in intracoronary ECG ST-elevation during RCA occlusion from baseline to follow-up examination ( P =0.0015); it did not change in the left coronary artery. Angina pectoris during RCA occlusion tended to occur in fewer patients at follow-up versus baseline examination ( P =0.06). Permanent right internal mammary artery device closure seems to augment extracardiac ipsilateral coronary supply to the effect of reducing ischemia in the dependent myocardial region. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02475408. © 2017 The Authors.

  3. Achieving Effective Risk Management Reduction Throughout Decommissioning at the Columbus Closure Project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Anderson, K.D.

    2006-07-01

    Nuclear facility decontamination, dismantlement, and demolition activities provide a myriad of challenges along the path to reaching a safe, effective, and compliant decommissioning. Among the challenges faced during decommissioning, is the constant management and technical effort to eliminate, mitigate, or minimize the potential of risks of radiation exposures and other hazards to the worker, the surrounding community, and the environment. Management strategies to eliminate, mitigate, or minimize risks include incorporating strong safety and As Low As Reasonably Achievable (ALARA) principles into an integrated work planning process. Technical and operational strategies may include utilizing predictive risk analysis tools to establish contaminationmore » limits for demolition and using remote handling equipment to reduce occupational and radiation exposures to workers. ECC and E2 Closure Services, LLC (Closure Services) have effectively utilized these management and technical tools to eliminate, mitigate, and reduce radiation exposures under contract to the U.S. Department of Energy (DOE) for the decontamination and decommissioning Columbus Closure Project (CCP). In particular, Closure Services achieved significant dose reduction during the dismantling, decontamination, and demolition activities for Building JN-1. Management strategies during the interior dismantlement, decontamination, and demolition of the facility demanded an integrated work planning processes that involved project disciplines. Integrated planning processes identified multiple opportunities to incorporate the use of remote handling equipment during the interior dismantling and demolition activities within areas of high radiation. Technical strategies employed predictive risk analysis tools to set upper bounding contamination limits, allowed for the radiological demolition of the building without exceeding administrative dose limits to the worker, general public, and the environment. Adhering

  4. 32 CFR 989.25 - Base closure and realignment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Base closure and realignment. 989.25 Section 989... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure...

  5. 32 CFR 989.25 - Base closure and realignment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Base closure and realignment. 989.25 Section 989... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure...

  6. Achieving Closure for Bioregenerative Life Support Systems: Engineering and Ecological Challenges, Research Opportunities

    NASA Astrophysics Data System (ADS)

    Dempster, William; Allen, John P.

    Closed systems are desirable for a number of purposes: space life support systems where precious life-supporting resources need to be kept inside; biospheric systems; where global ecological pro-cesses can be studied in great detail and testbeds where research topics requiring isolation from the outside (e.g. genetically modified organisms; radioisotopes) can be studied in isolation from the outside environment and where their ecological interactions and fluxes can be studied. But to achieve and maintain closure raises both engineering and ecological challenges. Engineering challenges include methods of achieving closure for structures of different materials, and devel-oping methods of allowing energy (for heating and cooling) and information transfer through the materially closed structure. Methods of calculating degree of closure include measuring degradation rates of inert trace gases introduced into the system. An allied problem is devel-oping means of locating where leaks are located so that they may be repaired and degree of closure maintained. Once closure is achieved, methods of dealing with the pressure differen-tials between inside and outside are needed: from inflatable structures which might adjust to the pressure difference to variable volume chambers attached to the life systems component. These issues are illustrated through the engineering employed at Biosphere 2, the Biosphere 2 Test Module and the Laboratory Biosphere and a discussion of methods used by other closed ecological system facility engineers. Ecological challenges include being able to handle faster cycling rates and accentuated daily and seasonal fluxes of critical life elements such as carbon dioxide, oxygen, water, macro-and mico-nutrients. The problems of achieving sustainability in closed systems for life support include how to handle atmospheric dynamics including trace gases, producing a complete human diet and recycling nutrients and maintaining soil fertility, healthy air and

  7. 32 CFR 989.25 - Base closure and realignment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure... frequently contain provisions limiting the extent of environmental analysis required for actions taken under...

  8. 32 CFR 989.25 - Base closure and realignment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure... frequently contain provisions limiting the extent of environmental analysis required for actions taken under...

  9. Assessing systemic barriers to permanency achievement for children in out-of-home care: development of the child permanency barriers scale.

    PubMed

    Murphy, April L; Van Zyl, Riaan; Collins-Camargo, Crystal; Sullivan, Dana

    2012-01-01

    State and local child welfare agencies are engaged in multiple efforts to enact systems change to improve outcomes, particularly in regard to achievement of child permanency. The Child and Family Services Review process, conducted by the Administration Children and Families, requires states to implement program improvement plans designed to improve outcomes for which they are not meeting national standards. However, a tool has not been demonstrated as useful in assessing the barriers to achievement of permanency across the out-of-home service continuum, from recruitment of families to placement stability. This article reports on the development and refinement of such a tool in one Midwestern state. The Child Permanency Barriers Scale has four factors: kinship, placement and matching, adequate services and resources, and communication and collaboration. Implications for use in state-specific and multisystem assessment and system reform are discussed.

  10. A closure test for time-specific capture-recapture data

    USGS Publications Warehouse

    Stanley, T.R.; Burnham, K.P.

    1999-01-01

    The assumption of demographic closure in the analysis of capture-recapture data under closed-population models is of fundamental importance. Yet, little progress has been made in the development of omnibus tests of the closure assumption. We present a closure test for time-specific data that, in principle, tests the null hypothesis of closed-population model M(t) against the open-population Jolly-Seber model as a specific alternative. This test is chi-square, and can be decomposed into informative components that can be interpreted to determine the nature of closure violations. The test is most sensitive to permanent emigration and least sensitive to temporary emigration, and is of intermediate sensitivity to permanent or temporary immigration. This test is a versatile tool for testing the assumption of demographic closure in the analysis of capture-recapture data.

  11. Need for closure and heuristic information processing: the moderating role of the ability to achieve the need for closure.

    PubMed

    Kossowska, Małgorzata; Bar-Tal, Yoram

    2013-11-01

    In contrast to the ample research that shows a positive relationship between the need for closure (NFC) and heuristic information processing, this research examines the hypothesis that this relationship is moderated by the ability to achieve closure (AAC), that is, the ability to use information-processing strategies consistent with the level of NFC. Three different operationalizations of heuristic information processing were used: recall of information consistent with the impression (Study 1); pre-decisional information search (Study 2); and stereotypic impression formation (Study 3). The results of the studies showed that there were positive relationships between NFC and heuristic information processing when participants assessed themselves as being able to use cognitive strategies consistent with their level of NFC (high AAC). For individuals with low AAC, the relationships were negative. Our data show that motivation-cognition interactions influence the information-processing style. © 2012 The British Psychological Society.

  12. CRP - VD Tube & Closure -  Unit Non-Reclosable Packaging Rigid

    EPA Pesticide Factsheets

    This is a unit-dose non-reclosable rigid package. The package consists of a tube and a closure that is permanently attached to the tube neck. The package is opened by pushing down on the closure and simultaneously turning it counterclockwise.

  13. Permanent right-to-left shunt is the key factor in managing patent foramen ovale.

    PubMed

    Rigatelli, Gianluca; Dell'Avvocata, Fabio; Cardaioli, Paolo; Giordan, Massimo; Braggion, Gabriele; Aggio, Silvio; Chinaglia, Mauro; Mandapaka, Sangeeta; Kuruvilla, John; Chen, Jack P; Nanjundappa, Aravinda

    2011-11-15

    We sought to prospectively evaluate risk of stroke and impact of transcatheter patent foramen ovale (PFO) closure in patients with permanent right-to left shunt compared with those with Valsalva maneuver-induced right-to-left shunt. Pathophysiology and properly management of PFO still remain far from being fully clarified: in particular, the contribution of permanent right-to-left shunt remains unknown. Between March 2006 and October 2010, we enrolled 180 (mean age 44 ± 10.9 years, 98 women) of 320 consecutive patients referred to our center for transcatheter PFO closure, who had spontaneous permanent right-to-left shunt on transcranial Doppler and transthoracic/transesophageal echocardiography. All patients fulfilled the standard current indications for transcatheter closure and underwent preoperative transesophageal echocardiography and brain magnetic resonance imaging, with subsequent intracardiac echocardiographic-guided transcatheter PFO closure. We compared the clinical echocardiographic characteristics of these patients (Permanent Group) with the rest of 140 patients with right-to-left shunt only during Valsalva maneuver (Valsalva Group). Compared with the Valsalva Group patients, patients of the Permanent Group had increased frequency of multiple ischemic brain lesions on magnetic resonance imaging, previous recurrent stroke, previous peripheral arteries embolism, migraine with aura, and-more frequently-atrial septal aneurysm and prominent Eustachian valve. The presence of permanent shunt confers the highest risk of recurrent stroke (odds ratio: 5.9, 95% confidence interval: 2.0 to 12, p < 0.001). No differences were recorded between the 2 groups with regard to recurrence of ischemic events after the closure procedure. Despite its small-sample nature, our study suggests that patients with permanent right-to-left shunt have potentially a higher risk of paradoxical embolism compared with those without. Copyright © 2011 American College of Cardiology

  14. Rationale and design of a randomised clinical trial comparing vascular closure device and manual compression to achieve haemostasis after diagnostic coronary angiography: the Instrumental Sealing of ARterial puncture site - CLOSURE device versus manual compression (ISAR-CLOSURE) trial.

    PubMed

    Xhepa, Erion; Byrne, Robert A; Schulz, Stefanie; Helde, Sandra; Gewalt, Senta; Cassese, Salvatore; Linhardt, Maryam; Ibrahim, Tareq; Mehilli, Julinda; Hoppe, Katharina; Grupp, Katharina; Kufner, Sebastian; Böttiger, Corinna; Hoppmann, Petra; Burgdorf, Christof; Fusaro, Massimiliano; Ott, Ilka; Schneider, Simon; Hengstenberg, Christian; Schunkert, Heribert; Laugwitz, Karl-Ludwig; Kastrati, Adnan

    2014-06-01

    Vascular closure devices (VCD) have been introduced into clinical practice with the aim of increasing the procedural efficiency and clinical safety of coronary angiography. However, clinical studies comparing VCD and manual compression have yielded mixed results, and large randomised clinical trials comparing the two strategies are missing. Moreover, comparative efficacy studies between different VCD in routine clinical use are lacking. The Instrumental Sealing of ARterial puncture site - CLOSURE device versus manual compression (ISAR-CLOSURE) trial is a prospective, randomised clinical trial designed to compare the outcomes associated with the use of VCD or manual compression to achieve femoral haemostasis. The test hypothesis is that femoral haemostasis after coronary angiography achieved using VCD is not inferior to manual compression in terms of access-site-related vascular complications. Patients undergoing coronary angiography via the common femoral artery will be randomised in a 1:1:1 fashion to receive FemoSeal VCD, EXOSEAL VCD or manual compression. The primary endpoint is the incidence of the composite of arterial access-related complications (haematoma ≥5 cm, pseudoaneurysm, arteriovenous fistula, access-site-related bleeding, acute ipsilateral leg ischaemia, the need for vascular surgical/interventional treatment or documented local infection) at 30 days after randomisation. According to power calculations based on non-inferiority hypothesis testing, enrolment of 4,500 patients is planned. The trial is registered at www.clinicaltrials.gov (study identifier: NCT01389375). The safety of VCD as compared to manual compression in patients undergoing transfemoral coronary angiography remains an issue of clinical equipoise. The aim of the ISAR-CLOSURE trial is to assess whether femoral haemostasis achieved through the use of VCD is non-inferior to manual compression in terms of access-site-related vascular complications.

  15. Achieving and documenting closure in plant growth facilities

    NASA Technical Reports Server (NTRS)

    Knott, W. M.; Sager, John C.; Wheeler, Ray

    1992-01-01

    As NASA proceeds with its effort to develop a Controlled Ecological Life Support System (CELSS) that will provide life support to crews during long duration space missions, it must address the question of facility and system closure. The concept of closure as it pertains to CELSS and engineering specifications, construction problems and monitoring procedures used in the development and operation of a closed plant growth facility for the CELSS program are described. A plant growth facility is one of several modules required for a CELSS. A prototype of this module at Kennedy Space Center is the large (7m tall x 3.5m diameter) Biomass Production Chamber (BPC), the central facility of the CELSS Breadboard Project. The BPC is atmospherically sealed to a leak rate of approximately 5 percent of its total volume per 24 hours. This paper will discuss the requirements for atmospheric closure in the facility, present CO2 and trace gas data from initial tests of the BPC with and without plants, and describe how the chamber was sealed atmospherically. Implications that research conducted in this type of facility will have for the CELSS program are discussed.

  16. Achieving a Successful Closure of an Anterior Tympanic Membrane Perforation: Evidence-Based Systematic Review.

    PubMed

    Visvanathan, Vikranth; Vallamkondu, Vamsidhar; Bhimrao, Sanjiv K

    2018-06-01

    Objectives Surgical repair of a tympanic membrane perforation is a common otologic procedure. However, achieving a successful closure can be challenging, especially if the anterior margin of the tympanic membrane is involved. The aim of this study was to systematically review the literature on evidence published in closure of anterior tympanic membrane perforations. Data Sources The following data sources were searched: Cochrane Central Register of Controlled Trials (1997 to August, 3 2017), MEDLINE (February 1948 to August 3, 2017), and Embase (1975 to August 3, 2017). Data Extraction Two authors independently reviewed titles and abstracts. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. For the purpose of this study, the inclusion criteria were as follows; (1) studies reporting surgical technique for closure of anterior tympanic membrane perforations, (2) primary cases only, (3) articles published in the English language, (4) minimum 6-month follow-up, and (5) recorded pre- and postoperative audiometry. The exclusion criteria were non-English language articles, revision surgery, and no audiometric outcomes. Results On initial search, a total of 181 articles were identified (PubMed, n = 136; Cochrane, n = 28; Embase, n = 17). Based on the criteria, 136 articles were excluded. Full text of 45 articles was reviewed, and a further 24 articles were excluded. A total of 21 articles fulfilled the criteria for study inclusion. Conclusions All published evidence is level 4. High-quality controlled studies are required to determine the most effective method for closure of anterior tympanic membrane perforation.

  17. Space Station evolution study oxygen loop closure

    NASA Technical Reports Server (NTRS)

    Wood, M. G.; Delong, D.

    1993-01-01

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

  18. Failure of mesenteric defect closure after Roux-en-Y gastric bypass.

    PubMed

    Hope, William W; Sing, Ronald F; Chen, Albert Y; Lincourt, Amy E; Gersin, Keith S; Kuwada, Timothy S; Heniford, B Todd

    2010-01-01

    Bowel obstructions following Roux-en-Y gastric bypass (RYGB) are a significant issue often caused by internal herniation. Controversy continues as to whether mesenteric defect closure is necessary to decrease the incidence of internal hernias after RYGB. Our purpose was to evaluate the effectiveness of closing the mesenteric defect at the jejunojejunostomy in patients who underwent RYGB by examining this potential space at reoperation for any reason. We retrospectively reviewed medical records of patients undergoing surgery after RYGB from August 1999 to October 2008 to determine the status of the mesentery at the jejunojejunostomy. Eighteen patients underwent surgery 2 to 19 months after open (n=8) or laparoscopic (n=10) RYGB. All patients had documented suture closure of their jejunojejunostomy at the time of RYGB. Permanent (n=12) or absorbable (n=6) sutures were used for closures. Patients lost 23.6 kg to 62.1 kg before a reoperation was required for a ventral hernia (n=8), cholecystectomy (n=4), abdominal pain (n=4), or small bowel obstruction (n=2). Fifteen of the 18 patients had open mesenteric defects at the jejunojejunostomy despite previous closure; none were the cause for reoperation. Routine suture closure of mesenteric defects after RYGB may not be an effective permanent closure likely due to the extensive fat loss and weight loss within the mesentery.

  19. Apical closure of mature molar roots with the use of calcium hydroxide.

    PubMed

    Rotstein, I; Friedman, S; Katz, J

    1990-11-01

    Calcium hydroxide may induce apical root closure in affected mature teeth as well as in immature teeth. Once an apical hard tissue barrier is formed, a permanent root canal filling can be safely condensed. Two cases are described in which calcium hydroxide induced apical root closure in mature molar teeth where the apical constriction was lost because of chronic inflammatory process.

  20. [Magnetic closure for ileostomy (author's transl)].

    PubMed

    Loygue, J; Salmon, R; Bloch, P

    1980-09-20

    The Maclet magnetic stoma seal already used by the authors for colostomies was applied to the closure of permanent terminal ileostomies. A reservoir is constructed upstreams of the closure with the last loop of ileum, so that the faeces accumulate and can be evacuated by intermittence. Patients empty the reservoir by removing the cap which blocks the intestinal lumen and introducing a probe into it. The technique was used on 2 patients who had undergone total proctocolectomy for familial polyposis of the colon. One patient has now been followed up for 3 years and the other for 6 months. The perfect continence obtained by this method favourably compares with Kock's continent ileostomy.

  1. Interferometric Imaging Directly with Closure Phases and Closure Amplitudes

    NASA Astrophysics Data System (ADS)

    Chael, Andrew A.; Johnson, Michael D.; Bouman, Katherine L.; Blackburn, Lindy L.; Akiyama, Kazunori; Narayan, Ramesh

    2018-04-01

    Interferometric imaging now achieves angular resolutions as fine as ∼10 μas, probing scales that are inaccessible to single telescopes. Traditional synthesis imaging methods require calibrated visibilities; however, interferometric calibration is challenging, especially at high frequencies. Nevertheless, most studies present only a single image of their data after a process of “self-calibration,” an iterative procedure where the initial image and calibration assumptions can significantly influence the final image. We present a method for efficient interferometric imaging directly using only closure amplitudes and closure phases, which are immune to station-based calibration errors. Closure-only imaging provides results that are as noncommittal as possible and allows for reconstructing an image independently from separate amplitude and phase self-calibration. While closure-only imaging eliminates some image information (e.g., the total image flux density and the image centroid), this information can be recovered through a small number of additional constraints. We demonstrate that closure-only imaging can produce high-fidelity results, even for sparse arrays such as the Event Horizon Telescope, and that the resulting images are independent of the level of systematic amplitude error. We apply closure imaging to VLBA and ALMA data and show that it is capable of matching or exceeding the performance of traditional self-calibration and CLEAN for these data sets.

  2. Self-testing security sensor for monitoring closure of vault doors and the like

    DOEpatents

    Cawthorne, Duane C.

    1997-05-27

    A self-testing device is provided for a monitoring system for monitoring whether a closure member such as a door or window is closed. The monitoring system includes a switch unit mounted on the frame of the closure member being monitored and including magnetically biased switches connected in one or more electrical monitoring circuits, and a door magnet unit mounted on the closure member being monitored. The door magnet includes one or more permanent magnets that produce a magnetic field which, when the closure member is closed, cause said switches to assume a first state. When the closure member is opened, the switches switch to a second, alarm state. The self-testing device is electrically controllable from a remote location and produces a canceling or diverting magnetic field which simulates the effect of movement of the closure member from the closed position thereof without any actual movement of the member.

  3. Nickel titanium springs versus stainless steel springs: A randomized clinical trial of two methods of space closure.

    PubMed

    Norman, Noraina Hafizan; Worthington, Helen; Chadwick, Stephen Mark

    2016-09-01

    To compare the clinical performance of nickel titanium (NiTi) versus stainless steel (SS) springs during orthodontic space closure. Two-centre parallel group randomized clinical trial. Orthodontic Department University of Manchester Dental Hospital and Orthodontic Department Countess of Chester Hospital, United Kingdom. Forty orthodontic patients requiring fixed appliance treatment were enrolled, each being randomly allocated into either NiTi (n = 19) or SS groups (n = 21). Study models were constructed at the start of the space closure phase (T0) and following the completion of space closure (T1). The rate of space closure achieved for each patient was calculated by taking an average measurement from the tip of the canine to the mesiobuccal groove on the first permanent molar of each quadrant. The study was terminated early due to time constraints. Only 30 patients completed, 15 in each study group. There was no statistically significant difference between the amounts of space closed (mean difference 0.17 mm (95%CI -0.99 to 1.34; P = 0.76)). The mean rate of space closure for NiTi coil springs was 0.58 mm/4 weeks (SD 0.24) and 0.85 mm/4 weeks (SD 0.36) for the stainless steel springs. There was a statistically significant difference between the two groups (P = 0.024), in favour of the stainless steel springs, when the mean values per patient were compared. Our study shows that stainless steel springs are clinically effective; these springs produce as much space closure as their more expensive rivals, the NiTi springs.

  4. Consequences of early extraction of compromised first permanent molar: a systematic review.

    PubMed

    Saber, Afnan M; Altoukhi, Doua H; Horaib, Mariam F; El-Housseiny, Azza A; Alamoudi, Najlaa M; Sabbagh, Heba J

    2018-04-05

    The aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. Meta-analysis was conducted when applicable. Our research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Scopus, and Science Direct. Study selection was performed independently by three reviewers. Articles published from 1960 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare space closure between upper and lower arches. Eleven studies fulfilled the inclusion criteria. The consequences were decrease in post extraction space, accelerated development and eruption of second permanents molars (SPMs) and third molars, a decrease in caries and/or fillings on the proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane. There were several consequences of early extraction of FPMs, which were related to skeletal and dental development. Our systematic review suggests that comprehensive evaluation of the compromised FPMs should be performed before planning an extraction. The ideal time for FPM extraction is when the SPM is at the early bifurcation stage in order to achieve complete closure of the extraction space by the SPM. Benefits should be weighed over the risks to decrease the risk of unfavorable outcomes as much as possible. However, due to the limited evidence on the outcomes and variables that influence them, high-quality prospective studies are needed.

  5. Self-testing security sensor for monitoring closure of vault doors and the like

    DOEpatents

    Cawthorne, D.C.

    1997-05-27

    A self-testing device is provided for a monitoring system for monitoring whether a closure member such as a door or window is closed. The monitoring system includes a switch unit mounted on the frame of the closure member being monitored and including magnetically biased switches connected in one or more electrical monitoring circuits, and a door magnet unit mounted on the closure member being monitored. The door magnet includes one or more permanent magnets that produce a magnetic field which, when the closure member is closed, cause said switches to assume a first state. When the closure member is opened, the switches switch to a second, alarm state. The self-testing device is electrically controllable from a remote location and produces a canceling or diverting magnetic field which simulates the effect of movement of the closure member from the closed position thereof without any actual movement of the member. 5 figs.

  6. Stigma Sensitivity and the Duration of Temporary Closure Are Affected by Pollinator Identity in Mazus miquelii (Phrymaceae), a Species with Bilobed Stigma

    PubMed Central

    Jin, Xiao-Fang; Ye, Zhong-Ming; Amboka, Grace M.; Wang, Qing-Feng; Yang, Chun-Feng

    2017-01-01

    A sensitive bilobed stigma is thought to assure reproduction, avoid selfing and promote outcrossing. In addition, it may also play a role in pollinator selection since only pollinators with the appropriate body size can trigger this mechanism. However, no experimental study has investigated how the sensitive stigma responds to different pollinators and its potential effects on pollination. Mazus miquelii (Phrymaceae), a plant with a bilobed stigma was studied to investigate the relationship between stigma behaviors and its multiple insect pollinators. The reaction time of stigma closure after touched, duration of temporary closure, and factors determining permanent closure of the stigma were studied when flowers were exposed to different visitors and conducted with hand pollination. Manual stimulation was also used to detect the potential differences in stigmas when touched with different degrees of external forces. Results indicated that, compared to pollinators with a small body size, larger pollinators transferred more pollen grains to the stigma, causing a rapid stigma response and resulting in a higher percentage of permanent closures. Duration of temporary closure was negatively correlated with the speed of stigma closure; a stigma that closed more rapidly reopened more slowly. Manual stimulation showed that reaction time of stigma closure was likely a response to external mechanical forces. Hand pollination treatments revealed that the permanent closure of a stigma was determined by the size of stigmatic pollen load. For large pollinators, the speedy reaction of the stigma might help to reduce pollen loss, enhance pollen germination and avoid obstructing pollen export. Stigmas showed low sensitivity when touched by inferior pollinators, which may have increased the possibility of pollen deposition by subsequent visits. Therefore, the stigma behavior in M. miquelii is likely a mechanism of pollinator selection to maximize pollination success. PMID:28539934

  7. Stigma Sensitivity and the Duration of Temporary Closure Are Affected by Pollinator Identity in Mazus miquelii (Phrymaceae), a Species with Bilobed Stigma.

    PubMed

    Jin, Xiao-Fang; Ye, Zhong-Ming; Amboka, Grace M; Wang, Qing-Feng; Yang, Chun-Feng

    2017-01-01

    A sensitive bilobed stigma is thought to assure reproduction, avoid selfing and promote outcrossing. In addition, it may also play a role in pollinator selection since only pollinators with the appropriate body size can trigger this mechanism. However, no experimental study has investigated how the sensitive stigma responds to different pollinators and its potential effects on pollination. Mazus miquelii (Phrymaceae), a plant with a bilobed stigma was studied to investigate the relationship between stigma behaviors and its multiple insect pollinators. The reaction time of stigma closure after touched, duration of temporary closure, and factors determining permanent closure of the stigma were studied when flowers were exposed to different visitors and conducted with hand pollination. Manual stimulation was also used to detect the potential differences in stigmas when touched with different degrees of external forces. Results indicated that, compared to pollinators with a small body size, larger pollinators transferred more pollen grains to the stigma, causing a rapid stigma response and resulting in a higher percentage of permanent closures. Duration of temporary closure was negatively correlated with the speed of stigma closure; a stigma that closed more rapidly reopened more slowly. Manual stimulation showed that reaction time of stigma closure was likely a response to external mechanical forces. Hand pollination treatments revealed that the permanent closure of a stigma was determined by the size of stigmatic pollen load. For large pollinators, the speedy reaction of the stigma might help to reduce pollen loss, enhance pollen germination and avoid obstructing pollen export. Stigmas showed low sensitivity when touched by inferior pollinators, which may have increased the possibility of pollen deposition by subsequent visits. Therefore, the stigma behavior in M. miquelii is likely a mechanism of pollinator selection to maximize pollination success.

  8. Patent foramen ovale closure using a bioabsorbable closure device: safety and efficacy at 6-month follow-up.

    PubMed

    Van den Branden, Ben J; Post, Martijn C; Plokker, Herbert W; ten Berg, Jurriën M; Suttorp, Maarten J

    2010-09-01

    The aim of this study was to assess the mid-term safety and efficacy of percutaneous patent foramen ovale (PFO) closure using a bioabsorbable device (BioSTAR, NMT Medical, Boston, Massachusetts). Closure of PFO in patients with cryptogenic stroke has proven to be safe and effective using different types of permanent devices. All consecutive patients who underwent percutaneous PFO closure with the bioabsorbable closure device between November 2007 and January 2009 were included. Residual shunt was assessed using contrast transthoracic echocardiography. Sixty-two patients (55% women, mean age 47.7 ± 11.8 years) underwent PFO closure. The in-hospital complications were a surgical device retrieval in 2 patients (3.2%), device reposition in 1 (1.6%), and a minimal groin hematoma in 6 patients (9.7%). The short-term complications at 1-month follow-up (n = 60) were a transient ischemic attack in the presence of a residual shunt in 1 patient and new supraventricular tachycardia in 7 patients (11.3%). At 6-month follow-up (n = 60), 1 patient without residual shunt developed a transient ischemic attack and 1 developed atrial fibrillation. A mild or moderate residual shunt was noted in 51.7%, 33.9%, and 23.7% after 1-day, 1-month, and 6-month follow-up, respectively. A large shunt was present in 8.3%, 3.4%, and 0% after 1-day, 1-month, and 6-month follow-up. Closure of PFO using the bioabsorbable device is associated with a low complication rate and a low recurrence rate of embolic events. However, a relatively high percentage of mild or moderate residual shunting is still present at 6-month follow-up. Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2017-06-01

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

  10. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry.

    PubMed

    Saaby, Marie-Louise

    2014-02-01

    Stress urinary incontinence (SUI) occurs when the bladder pressure exceeds the urethral pressure in connection with physical effort or exertion or when sneezing or coughing and depends both on the strength of the urethral closure function and the abdominal pressure to which it is subjected. The urethral closure function in continent women and the dysfunction causing SUI are not known in details. The currently accepted view is based on the concept of a sphincteric unit and a support system. Our incomplete knowledge relates to the complexity of the closure apparatus and to inadequate assessment methods which so far have not provided robust urodynamic diagnostic tools, severity measures, or parameters to assess outcome after intervention. Urethral Pressure Reflectometry (UPR) is a novel method that measures the urethral pressure and cross-sectional area (by use of sound waves) simultaneously. The technique involves insertion of only a small, light and flexible polyurethane bag in the urethra and therefore avoids the common artifacts encountered with conventional methods. The UPR parameters can be obtained at a specific site of the urethra, e.g. the high pressure zone, and during various circumstances, i.e. resting and squeezing. During the study period, we advanced the UPR technique to enable faster measurement (within 7 seconds by the continuous technique) which allowed assessment during increased intra-abdominal pressure induced by physical straining. We investigated the urethral closure function in continent and SUI women during resting and straining by the "fast" UPR technique. Thereby new promising urethral parameters were provided that allowed characterization of the closure function based on the permanent closure forces (primarily generated by the sphincteric unit, measured by the Po-rest) and the adjunctive closure forces (primarily generated by the support system, measured by the abdominal to urethral pressure impact ratio (APIR)). The new parameters enabled

  11. Orthodontic Replacement of Lost Permanent Molar with Neighbor Molar: A Six-Year Follow-Up

    PubMed Central

    Shintcovsk, Ricardo Lima; Knop, Luegya Amorim Henriques; Sampaio, Luana Paz

    2017-01-01

    Extraction is very frequent indication in orthodontic planning, especially when there are crowding, biprotrusion, and aesthetically unpleasant profiles. Next to extraction comes space closure, which represents a challenge for orthodontists because of extended treatment time, discomfort created for the patient, tissue tolerance, and stability concerns. When it comes to what mechanics to choose for space closure, loops present two major advantages in relation to sliding mechanics: absence of abrasion and possibility to reach pure dental translation. A case is presented where an adult female patient with early loss of the first lower permanent molars, minor lower crowding, and tooth biprotrusion was treated with upper first bicuspids extraction along with upper and lower space closure done with T-loops to promote best space closure control in order to correct the malocclusion and enhance facial aesthetics. PMID:29318054

  12. Teaching Object Permanence: An Action Research Study

    ERIC Educational Resources Information Center

    Bruce, Susan M.; Vargas, Claudia

    2013-01-01

    "Object permanence," also known as "object concept" in the field of visual impairment, is one of the most important early developmental milestones. The achievement of object permanence is associated with the onset of representational thought and language. Object permanence is important to orientation, including the recognition of landmarks.…

  13. 40 CFR 265.310 - Closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Closure and post-closure care. 265.310... DISPOSAL FACILITIES Landfills § 265.310 Closure and post-closure care. (a) At final closure of the landfill... subsoils present. (b) After final closure, the owner or operator must comply with all post-closure...

  14. 40 CFR 265.310 - Closure and post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure and post-closure care. 265.310... DISPOSAL FACILITIES Landfills § 265.310 Closure and post-closure care. (a) At final closure of the landfill... subsoils present. (b) After final closure, the owner or operator must comply with all post-closure...

  15. 40 CFR 265.310 - Closure and post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Closure and post-closure care. 265.310... DISPOSAL FACILITIES Landfills § 265.310 Closure and post-closure care. (a) At final closure of the landfill... subsoils present. (b) After final closure, the owner or operator must comply with all post-closure...

  16. 40 CFR 264.228 - Closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

  17. 40 CFR 264.228 - Closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

  18. 40 CFR 264.228 - Closure and post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

  19. 40 CFR 264.228 - Closure and post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

  20. 40 CFR 264.228 - Closure and post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

  1. 40 CFR 265.228 - Closure and post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure and post-closure care. 265.228... DISPOSAL FACILITIES Surface Impoundments § 265.228 Closure and post-closure care. (a) At closure, the owner... impoundment and provide post-closure care for a landfill under subpart G and § 265.310, including the...

  2. 40 CFR 265.228 - Closure and post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Closure and post-closure care. 265.228... DISPOSAL FACILITIES Surface Impoundments § 265.228 Closure and post-closure care. (a) At closure, the owner... impoundment and provide post-closure care for a landfill under subpart G and § 265.310, including the...

  3. Technical advances for abdominal wall closure after intestinal and multivisceral transplantation.

    PubMed

    Gerlach, Undine A; Pascher, Andreas

    2012-06-01

    Abdominal wall closure after intestinal transplantation (ITX) or multivisceral transplantation (MVTX) is challenging because of the loss of abdominal domain and wall elasticity as a result of previous operations and donor-to-recipient weight and height mismatch. We report on abdominal wall closure management in 30 ITX and MVTX recipients. In 60% of patients (n = 18), a primary abdominal closure (PAC) was achieved, in 40% (n = 12) a staged closure (SAC) was necessary. Patients with PAC had undergone less pretransplant operations and required less posttransplant relaparotomies. They were mainly ITX recipients or more abdominal domain because of a longer intestinal remnant. A literature review revealed different strategies to overcome a failed primary closure. They focus on graft reduction or an enlargement of the abdominal domain. The latter includes temporary coverage with prosthetic materials for SAC. Definite abdominal closure is achieved by skin only closure, or by using acellular dermal matrix, rotational flaps, rectus muscle fascia or abdominal wall grafts. Abdominal wall reconstruction after ITX/MVTX is commonly demanded and can be conducted by different strategies. The technique should be easy to use in a timely manner and should prevent abdominal infections, intestinal fistulation, incisional hernias, and wound dehiscence.

  4. Influence of glottal closure configuration on vocal efficacy in young normal-speaking women.

    PubMed

    Schneider, Berit; Bigenzahn, Wolfgang

    2003-12-01

    Posterior closure insufficiency of the glottis is often mentioned in connection with permanent voice disorders. Recently published studies have revealed that an incomplete closure of the glottis can be found also in normal-speaking voices, especially in women. However, the effect of glottal closure configuration on vocal efficacy is not sufficiently clarified. The purpose of this study was to determine the effect of glottal closure configuration on singing and speaking voice characteristics. Overall, 520 young female normal-speaking subjects were examined by videostroboscopy for different phonation conditions in the combination of soft, loud, low, and/or high phonation and by voice range profile measurements. According to the videostroboscopic analysis, the subjects were subdivided into four groups: complete closure of the vocal folds already in soft phonation (group 1), closure of the vocal fold with increasing intensity (group 2), persistent closure insufficiencies despite increasing intensity (group 3), and hourglass-shaped closure in subjects with vocal nodules (group 4). Subjects in which the glottal closure could not be evaluated sufficiently were subclassified into group 5 (missing values). Selected criteria of the singing and speaking voice were evaluated and statistically processed according to the mentioned subclassification. Group 1 reached significantly the highest sound pressure levels (SPLmax) for the singing voice as well as for the shouting voice. Group 3 showed a limited capacity to increase the intensity of the singing and speaking voice. The results gathered in this study objectify the relationship of insufficient glottal closure and reduced vocal capabilities. As long as no conclusive data on long-term consequences of insufficient glottal closure are available, a prophylactic improvement of the laryngeal situation especially in female professional voice users by voice therapy should be recommended.

  5. Variable Permanent Magnet Quadrupole

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mihara, T.; Iwashita, Y.; /Kyoto U.

    A permanent magnet quadrupole (PMQ) is one of the candidates for the final focus lens in a linear collider. An over 120 T/m strong variable permanent magnet quadrupole is achieved by the introduction of saturated iron and a 'double ring structure'. A fabricated PMQ achieved 24 T integrated gradient with 20 mm bore diameter, 100 mm magnet diameter and 20 cm pole length. The strength of the PMQ is adjustable in 1.4 T steps, due to its 'double ring structure': the PMQ is split into two nested rings; the outer ring is sliced along the beam line into four partsmore » and is rotated to change the strength. This paper describes the variable PMQ from fabrication to recent adjustments.« less

  6. 10 CFR 63.113 - Performance objectives for the geologic repository after permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Performance objectives for the geologic repository after...-LEVEL RADIOACTIVE WASTES IN A GEOLOGIC REPOSITORY AT YUCCA MOUNTAIN, NEVADA Technical Criteria Postclosure Performance Objectives § 63.113 Performance objectives for the geologic repository after permanent...

  7. Use of the densiometer to estimate density of forest canopy on permanent sample plots.

    Treesearch

    Gerald S. Strickler

    1959-01-01

    An instrument known as the spherical densiometer has been found adaptable to permanent-plot estimates of relative canopy closure or density in forest and range ecological studies. The device is more compact and simpler to use than previous ocular-type instruments. Because the instrument has a curved reflecting surface which results in observations from lateral as well...

  8. Urethral pressure reflectometry during intra-abdominal pressure increase-an improved technique to characterize the urethral closure function in continent and stress urinary incontinent women.

    PubMed

    Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar

    2013-11-01

    to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women. Twenty-five urodynamically proven SUI women and eight continent volunteer women were assessed by ICIQ-SF, pad-weighing test, incontinence diary, and UPR. UPR was conducted during resting and increased intra-abdominal pressure (P(Abd)) by straining. Related values of P(Abd) and urethral opening pressure (P(o)) were plotted into an abdomino-urethral pressuregram. Linear regression of the values was conducted, and the slope of the line ("APIR") and the intercept with the y-axis found. By the equation of the line, Po was calculated for various values of P(Abd), for example, 50 cm H2O (P(o-Abd 50)). The resting P(o) (P(o-rest)) and APIR, respectively, significantly differed in SUI and continent women but could not separate the two groups. The urethral closure equation (UCE) based on P(o-rest) and APIR provided a more detailed characterization of a woman's closure function based on the permanent closure forces (primarily generated by the urethral sphincteric unit) and the adjunctive closure forces (primarily generated by the support system). P(o-Abd 50) and UCE, respectively, which express the combined permanent and adjunctive closure forces and estimate the efficiency of the closure function, separated SUI and continent women and were highly significantly negatively correlated with ICIQ-SF, pad test, and the number of incontinence episodes. New parameters for characterization of the urethral closure function and possible dysfunctions and its efficiency were provided. P(o-Abd 50) and UCE may be used as diagnostic tests and severity measures. © 2013 Wiley Periodicals, Inc.

  9. A novel, simple method for achieving hemostasis of fingertip dermal avulsion injuries.

    PubMed

    Lin, Brian Wai

    2015-06-01

    Distal fingertip pad dermal avulsion injuries can be challenging for emergency physicians. A common occurrence with these injuries is difficult-to-control bleeding. The nature of these wounds is such that conventional primary closure to achieve hemostasis is not feasible. Often, direct pressure, even for prolonged periods, will not adequately control the bleeding. Currently recommended techniques are inadequate to control bleeding, and commercially available hemostatic products may be more costly and not widely available. To present a simple method to achieve permanent hemostasis of these injuries using a tourniquet and tissue adhesive glue. A tourniquet is placed around the proximal digit, and the digit is exsanguinated and elevated to achieve short-term hemostasis. Several layers of commercially available tissue adhesive glue are applied sequentially over the avulsed region of the digit and allowed to dry. The tourniquet is then removed. A clean, bloodless dressing is created over the avulsed fingertip. This technique provides a rapid, simple, and likely safe means to control bleeding from a fingertip dermal avulsion injury. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Endoscopic full-thickness resection and defect closure in the colon.

    PubMed

    von Renteln, Daniel; Schmidt, Arthur; Vassiliou, Melina C; Rudolph, Hans-Ulrich; Caca, Karel

    2010-06-01

    Endoscopic full-thickness resection (eFTR) is a minimally invasive method for en bloc resection of GI lesions. The aim of this pilot study was to evaluate the feasibility of a grasp-and-snare technique for eFTR combined with an over-the-scope clip (OTSC) for defect closure. Nonsurvival animal study. Animal laboratory. Fourteen female domestic pigs. The eFTR was performed in porcine colons using a novel tissue anchor in combination with a standard monofilament snare and 14 mm OTSC. In the first group (n = 20), closure of the colonic defects with OTSC was attempted after the resection. In the second group (n = 8), an endoloop was used to secure the resection base before eFTR was performed. In the first group (n = 20), eFTR specimens ranged from 2.4 to 5.5 cm in diameter. Successful closure was achieved in 9 out of 20 cases. Mean burst pressure for OTSC closure was 29.2 mm Hg (range, 2-90; SD, 29.92). Injury to adjacent organs occurred in 3 cases. Lumen obstruction due to the OTSC closure occurred in 3 cases. In the second group (n = 8), the diameter of specimens ranged from 1.2 to 2.2 cm. Complete closure was achieved in all cases, with a mean burst pressure of 76.6 mm Hg (range, 35-120; SD, 31). Lumen obstruction due to the endoloop closure occurred in one case. No other complications or injuries were observed in the second group. Nonsurvival setting. Colonic eFTR using the grasp-and-snare technique is feasible in an animal model. Ligation of the resection base with an endoloop before eFTR seems to reduce complication rates and improve closure success and leak test results despite yielding smaller specimens. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  11. VR closure rates for two vocational models.

    PubMed

    Fraser, Virginia V; Jones, Amanda M; Frounfelker, Rochelle; Harding, Brian; Hardin, Teresa; Bond, Gary R

    2008-01-01

    The Individual Placement and Support (IPS) model of supported employment is an evidence-based practice for individuals with psychiatric disabilities. To be financially viable, IPS programs require funding from the state-federal vocational rehabilitation (VR) system. However, some observers have questioned the compatibility of IPS and the VR system. Using a randomized controlled trial comparing IPS to a well-established vocational program called the Diversified Placement Approach (DPA), we examined rates of VR sponsorship and successful VR closures. We also describe the establishment of an active collaboration between a psychiatric rehabilitation agency and the state VR system to facilitate rapid VR sponsorship for IPS clients. Both IPS and DPA achieved a 44% rate of VR Status 26 closure when considering all clients entering the study. IPS and DPA averaged similar amount of time to achieve VR sponsorship. Time from vocational program entry to Status 26 was 51 days longer on average for IPS. Even though several IPS principles seem to run counter to VR practices, such as zero exclusion and rapid job search, we found IPS closure rates comparable to those for DPA, a vocational model that screens for readiness, provides prevocational preparation, and extensively uses agency-run businesses.

  12. 40 CFR 264.258 - Closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Waste Piles § 264.258 Closure and post-closure care. (a) At closure, the owner or operator must remove... that apply to landfills (§ 264.310). (c)(1) The owner or operator of a waste pile that does not comply...(c) or § 264.251(b), must: (i) Include in the closure plan for the pile under § 264.112 both a plan...

  13. Patent ductus arteriosus with persistent pulmonary artery hypertension after transcatheter closure.

    PubMed

    Feng, Jianqi; Kong, Xiangqing; Sheng, Yanhui; Yang, Rong

    2016-01-01

    To observe the change in pulmonary artery systolic pressure (PASP) of patients with persistent pulmonary arterial hypertension (PAH) after patent ductus arteriosus (PDA) occlusion. After occlusion of PDA in patients with PAH, some patients still tend to suffer from persistent PAH. A chest X-ray, an electrocardiogram, and an echocardiogram were performed on nine patients at 24 hours, 1 and 6 months, and 1 year serially. There was a significant fall ( P <0.05) in mean PASP after occlusion (to 59.3±12.7 mmHg). However, the aortic pressure and systemic arterial oxygen saturation changed slightly ( P >0.05). During the follow up, there was a further fall in the PASP in five patients (No 1, 5, 6, 7, and 8). Four patients (No 2, 3, 4, and 8) showed the evidence of worsening PAH and were treated with sildenafil. Patient 2 died from acute right heart failure after a period of 11 months from the time of transcatheter closure, triggered by pulmonary infection. Some patients with borderline hemodynamic data with PDA and PAH can deteriorate or keep sustained PAH after PDA closure. The treatment of permanent closure to these patients must be cautious.

  14. 76 FR 54788 - Notice of Permanent Closure of Public Lands in Clackamas and Multnomah Counties, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ..., State, and local government permittees and contractors conducting authorized activities; members of.... The BLM will post closure signs at main entry points to this area and take steps to install physical barriers at the BRWMU boundary. The affected lands will be represented as closed to public entry in maps...

  15. 78 FR 33067 - Fisheries of the United States; NOAA Fisheries Policy for Modifying Fisheries Closures in the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-03

    ... regarding those closures to the public during a public health emergency or oil spill characterized by... regulations to address a public health emergency or oil spill. Section 305(c)(3) states: (3) Any emergency... on a permanent basis; (C) that responds to a public health emergency or an oil spill may remain in...

  16. Use of cartilage grafts for closure of cleft palate fistulae.

    PubMed

    Jeffery, S L; Boorman, J G; Dive, D C

    2000-10-01

    We describe the results of using a free cartilage graft in the closure of cleft palate fistulae in 14 patients with a mean follow-up of 8.6 months. Complete closure of the fistula was achieved in 11 patients (79%), with partial closure in the remaining three patients. This technique is simple, causes relatively little discomfort, involves little tissue dissection and can be performed as a day-case procedure. The success rate is comparable with or better than other methods, and we consider it the treatment of choice for small cleft palate fistulae. Copyright 2000 The British Association of Plastic Surgeons.

  17. Numerical Modeling of ROM Panel Closures at WIPP

    NASA Astrophysics Data System (ADS)

    Herrick, C. G.

    2016-12-01

    The Waste Isolation Pilot Plant (WIPP) in New Mexico is a U.S. DOE geologic repository for permanent disposal of defense-related transuranic (TRU) waste. Waste is emplaced in panels excavated in a bedded salt formation (Salado Fm.) at 655 m bgs. In 2014 the U.S. EPA approved the new Run-of-Mine Panel Closure System (ROMPCS) for WIPP. The closure system consists of 100 feet of run-of-mine (ROM) salt sandwiched between two barriers. Nuclear Waste Partnership LLC (the M&O contractor for WIPP) initiated construction of the ROMPCS. The design calls for three horizontal ROM salt layers at different compaction levels ranging from 70-85% intact salt density. Due to panel drift size constraints and equipment availability the design was modified. Three prototype panel closures were constructed: two having two layers of compacted ROM salt (one closure had 1% water added) and a third consisting of simply ROM salt with no layering or added water. Sampling of the prototype ROMPCS layers was conducted to determine the following ROM salt parameters: thickness, moisture content, emplaced density, and grain-size distribution. Previous modeling efforts were performed without knowledge of these ROM salt parameters. This modeling effort incorporates them. The program-accepted multimechanism deformation model is used to model intact salt room creep closure. An advanced crushed salt model is used to model the ROM salt. Comparison of the two models' results with the prototypes' behavior is given. Our goal is to develop a realistic, reliable model that can be used for ROM salt applications at WIPP. Sandia National Laboratories is a multi-program laboratory operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U. S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000. This research is funded by WIPP programs administered by the Office of Environmental Management (EM) of the U.S Department of Energy SAND

  18. Catheter Closure Through a Venous Approach of Patent Ductus Arteriosus in Small Pediatric Patients Using Combined Angiographic and Echocardiographic Guidance.

    PubMed

    Thanopoulos, Basil Vasilios D; Ninios, Vlassis; Dardas, Petros; Giannopoulos, Andreas; Deleanou, Dan; Iancovici, Silvia

    2016-11-15

    The standard technique of catheter closure of patent ductus arteriosus (PDA) may be associated with arterial complications particularly in small pediatric patients. The aim of this study was to evaluate whether catheter closure of PDA in small children using an exclusive venous approach is a safe and effective alternative to closure with the standard technique. One hundred-twelve patients, aged 2 to 24 months, were randomly assigned in a 1:1 ratio to catheter closure of PDA using the standard technique (group 1) and an exclusive venous approach (group 2), respectively. In group 2, the procedure was guided using hand injections of contrast media through the delivery sheath and 2-dimensional and color Doppler echocardiography. Group 1: the PDA diameter ranged from 2 to 5.5 mm and the device diameter ranged from 4 to 8 mm. The PDA occluders were permanently implanted in all patients. Five losses of the arterial pulses that were restored with intravenous infusion of heparin and recombinant tissue plasminogen activator (rtPA), and 4 groin hematomas were the main complications of the procedure. Group 2: the mean PDA diameter ranged from 2.5 to 6 mm and the device diameter ranged from 3 to 8 mm. The PDA occluders were permanently implanted in all but 2 patients. There were no complications. Complete echocardiographic closure of PDA at 1-month follow-up was observed in all 110 patients. Exclusive transvenous PDA occlusion is an effective and safe technique that prevents the arterial complications of the standard approach in small children. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 40 CFR 264.280 - Closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

  20. 40 CFR 264.280 - Closure and post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

  1. 40 CFR 264.280 - Closure and post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

  2. 40 CFR 264.280 - Closure and post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

  3. Novel application of polyelectrolyte multilayers as nanoscopic closures with hermetic sealing.

    PubMed

    Marcott, Stephanie A; Ada, Sena; Gibson, Phillip; Camesano, Terri A; Nagarajan, R

    2012-03-01

    Closure systems for personnel protection applications, such as protective clothing or respirator face seals, should provide effective permeation barrier to toxic gases. Currently available mechanical closure systems based on the hook and loop types (example, Velcro) do not provide adequate barrier to gas permeation. To achieve hermetic sealing, we propose a nonmechanical, nanoscopic molecular closure system based on complementary polyelectrolyte multilayers, one with a polycation outermost layer and the other with a polyanion outermost layer. The closure surfaces were prepared by depositing polyelectrolyte multilayers under a variety of deposition conditions, on conformable polymer substrates (thin films of polyethylene teraphthalate, PET or polyimide, PI). The hermetic sealing property of the closures was evaluated by measuring the air flow resistance using the dynamic moisture permeation cell (DMPC) at different humidity conditions. The DMPC measurements show that the polyelectrolyte multilayer closures provide significantly large resistance to air flow, approximately 20-800 times larger than that possible with conventional hook and loop type closure systems, at all humidity levels (from 5 to 95% relative humidity). Hence, from the point of view of providing a hermetic seal against toxic gas permeation, the polyelectrolyte multilayer closures are viable candidates for further engineering development. However, the adhesive strength of the multilayer closures measured by atomic force microscopy suggests that the magnitude of adhesion is much smaller than what is possible with mechanical closures. Therefore, we envisage the development of a composite closure system combining the mechanical closure to provide strong adhesion and the multilayer closure to provide hermetic sealing. © 2012 American Chemical Society

  4. Predictors of successful closure of patent ductus arteriosus with indomethacin.

    PubMed

    Ahamed, M F; Verma, P; Lee, S; Vega, M; Wang, D; Kim, M; Fuloria, M

    2015-09-01

    To determine whether platelet counts can predict the likelihood of successful closure of patent ductus arteriosus (PDA) with indomethacin. This was a retrospective cohort study of infants <32 weeks' gestational age (GA) and birth weight <1500 g with PDA. Clinical characteristics between infants who achieved ductal closure with indomethacin and those who failed were compared. Multivariable logistic regression was used to identify predictors of successful ductal closure. In infants with hemodynamically significant PDA, older GA (odds ratio=1.54; 95% confidence interval: 1.12 to 2.13), male gender (odds ratio=3.02; 95% confidence interval: 1.08 to 8.49) and higher platelet count (odds ratio=1.5; 95% confidence interval: 1.04 to 2.17) prior to indomethacin treatment were associated with successful ductal closure with indomethacin. Older GA, male gender and higher platelet count at time of treatment of hemodynamically significant PDA are predictors of successful ductal closure with indomethacin.

  5. 40 CFR 265.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... post-closure care. (a) At closure of a magazine or unit which stored hazardous waste under this subpart... estimates for closure, and financial responsibility for magazines or units must meet all of the requirements... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

  6. Evaluation of the Momentum Closure Schemes in MPAS-Ocean

    NASA Astrophysics Data System (ADS)

    Zhao, Shimei; Liu, Yudi; Liu, Wei

    2018-04-01

    closure. The dissipative scale in the Leith closure depends on the parameter L, and the dissipative intensity depends on the parameter D. 5) Although optimal results may not be achieved by using the optimal parameters obtained from the 2D barotropic model in the 3D baroclinic simulation, the total energies are dissipative in all three closures. Dissipation is the strongest in the biharmonic viscosity closure, followed by that in the Leith closure, and that in the Laplacian viscosity closure is the weakest. Mesoscale eddies develop the fastest in the biharmonic viscosity closure after the baroclinic adjustment process finishes, and the kinetic energy reaches its maximum, which is attributed to the smallest dissipation of enstrophy in the biharmonic viscosity closure. Mesoscale eddies develop the slowest, and the kinetic energy peak value is the smallest in the Laplacian viscosity closure. Results in the Leith closure are between that in the biharmonic viscosity closure and the Laplacian viscosity closure.

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

    PubMed

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

    2014-03-01

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

  8. Boundary Closures for Fourth-order Energy Stable Weighted Essentially Non-Oscillatory Finite Difference Schemes

    NASA Technical Reports Server (NTRS)

    Fisher, Travis C.; Carpenter, Mark H.; Yamaleev, Nail K.; Frankel, Steven H.

    2009-01-01

    A general strategy exists for constructing Energy Stable Weighted Essentially Non Oscillatory (ESWENO) finite difference schemes up to eighth-order on periodic domains. These ESWENO schemes satisfy an energy norm stability proof for both continuous and discontinuous solutions of systems of linear hyperbolic equations. Herein, boundary closures are developed for the fourth-order ESWENO scheme that maintain wherever possible the WENO stencil biasing properties, while satisfying the summation-by-parts (SBP) operator convention, thereby ensuring stability in an L2 norm. Second-order, and third-order boundary closures are developed that achieve stability in diagonal and block norms, respectively. The global accuracy for the second-order closures is three, and for the third-order closures is four. A novel set of non-uniform flux interpolation points is necessary near the boundaries to simultaneously achieve 1) accuracy, 2) the SBP convention, and 3) WENO stencil biasing mechanics.

  9. Open abdomen treatment for septic patients with gastrointestinal fistula: from fistula control to definitive closure.

    PubMed

    Ren, Jianan; Yuan, Yujie; Zhao, Yunzhao; Gu, Guosheng; Wang, Gefei; Chen, Jun; Fan, Chaogang; Wang, Xinbo; Li, Jieshou

    2014-04-01

    The use of open abdomen in the management of gastrointestinal fistula complicated with severe intra-abdominal infection is uncommon. This study was designed to evaluate outcomes of our staged approach for the infected open abdomen. Patients who had gastrointestinal fistula and underwent open abdomen treatment were retrospectively reviewed. Various materials such as polypropylene mesh and a modified sandwich package were used to achieve temporary abdominal closure followed by skin grafting when the granulation bed matured. A delayed definitive operation was performed for final abdominal closure without implant of prosthetic mesh. Between 1999 and 2009, 56 (68.3%) of 82 patients survived through this treatment. Among them, 42 patients achieved final abdominal closure. Spontaneous fistula closure occurred in 16 patients with secondary fistula recorded in six patients. Besides, wound complications occurred in 13 patients with two cases for pulmonary infection. Within a 12-month follow-up period after definitive closure, no additional fistula was recorded excluding planned ventral hernia repair. Open abdomen treatment was effective for gastrointestinal fistula complicated by severe intra-abdominal infection. A delayed and deliberate operative strategy aiming at fistula excision and fascial closure, with simultaneous abdominal wall reconstruction, was required for the infected open abdomen.

  10. Autonomic Closure for Turbulent Flows Using Approximate Bayesian Computation

    NASA Astrophysics Data System (ADS)

    Doronina, Olga; Christopher, Jason; Hamlington, Peter; Dahm, Werner

    2017-11-01

    Autonomic closure is a new technique for achieving fully adaptive and physically accurate closure of coarse-grained turbulent flow governing equations, such as those solved in large eddy simulations (LES). Although autonomic closure has been shown in recent a priori tests to more accurately represent unclosed terms than do dynamic versions of traditional LES models, the computational cost of the approach makes it challenging to implement for simulations of practical turbulent flows at realistically high Reynolds numbers. The optimization step used in the approach introduces large matrices that must be inverted and is highly memory intensive. In order to reduce memory requirements, here we propose to use approximate Bayesian computation (ABC) in place of the optimization step, thereby yielding a computationally-efficient implementation of autonomic closure that trades memory-intensive for processor-intensive computations. The latter challenge can be overcome as co-processors such as general purpose graphical processing units become increasingly available on current generation petascale and exascale supercomputers. In this work, we outline the formulation of ABC-enabled autonomic closure and present initial results demonstrating the accuracy and computational cost of the approach.

  11. Closure of colostomy.

    PubMed Central

    Beck, P H; Conklin, H B

    1975-01-01

    We analyzed the records of 77 cases of loop colostomy closure in Vietnam War Casualties. All records were complete from the date of injury to discharge following colostomy closure. Simple of the loop colostomy was performed in 44 patients and resection of the stoma and reanastomosis of bowel segments was performed in 33 patients. Average operating time for simple closure of the loop was 70 minutes compared to 115 minutes for resection and anastomosis. Nasogastric suction was used less frequently and for a shorter time with simple loop closure. The total postoperative complication rate was 9% with simple loop closure as compared to 24% for resection and anastomosis. Simple closure of the loop described in this report is technically easier and as safe as resection of the stoma and reanastomosis. Images Fig. 1. PMID:1094967

  12. Clinically apparent long-term electric disturbances in the acute and very long-term of patent foramen ovale device-based closure.

    PubMed

    Rigatelli, Gianluca; Zuin, Marco; Pedon, Luigi; Zecchel, Roberto; Dell'Avvocata, Fabio; Carrozza, Antonio; Zennaro, Marco; Pastore, Gianni; Zanon, Francesco

    2017-03-01

    Incidence of electrical disturbances in patients submitted to transcatheter patent foramen ovale (PFO) closure has not been fully clarified in a large population. The aim of the study is to assess the incidence of atrial fibrillation, supraventricular tachi-arrhythmias, and atrio-ventricular block in the acute and very long-term follow-up. We reviewed the medical and instrumental data of 1000 consecutive patients (mean age 47.3±17.1years) prospectively enrolled in two centers over a 13-year period (February 1999 to February 2012) for right-to-left (R-to-L) shunt ICE-aided catheter-based closure using different devices. Successful transcatheter PFO closure was achieved in 99.8% of the patients. Implanted devices were: Amplatzer PFO Occluder in 463 patients (46.3%), Amplatzer ASD Cribriform Occluder in 420 patients (42.0%), Premere Occlusion System in 95 patients (9.5%), and Biostar Occluder in 22 patients (2.2%). Postprocedural electrical complications occurred in 5.9% of patients. The only independent predictors of electrophysiological complications were female gender (OR 2.3, 0.5-5.1 [95% CI], p<0.001) and device disk >30mm (OR 5.0, 1.2-7.2 [95% CI], p<0.001). On a mean follow-up of 12 .3±0.6years (minimum 4- maximum 17years), electrical complications occurred in 1.4% of patients including one only case of complete AVB and 5 cases of permanent AF. The only independent predictors were female gender (OR 2.3, 0.5-5.1 [95% CI], p<0.001) and device disk >30mm (OR 5.0, 1.2-7.2 [95% CI], p<0.001). Device-based closure of PFO using different devices, appeared very safe from an electrophysiological point of view with low incidence of electrical disturbances even in the very long-term follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Development of object permanence in food-storing magpies (Pica pica).

    PubMed

    Pollok, B; Prior, H; Güntürkün, O

    2000-06-01

    The development of object permanence was investigated in black-billed magpies (Pica pica), a food-storing passerine bird. The authors tested the hypothesis that food-storing development should be correlated with object-permanence development and that specific stages of object permanence should be achieved before magpies become independent. As predicted, Piagetian Stages 4 and 5 were reached before independence was achieved, and the ability to represent a fully hidden object (Piagetian Stage 4) emerged by the age when magpies begin to retrieve food. Contrary to psittacine birds and humans, but as in dogs and cats, no "A-not-B error" occurred. Although magpies also mastered 5 of 6 invisible displacement tasks, evidence of Piagetian Stage 6 competence was ambiguous.

  14. 10 CFR 63.161 - Emergency plan for the geologic repository operations area through permanent closure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Emergency plan for the geologic repository operations area... OF HIGH-LEVEL RADIOACTIVE WASTES IN A GEOLOGIC REPOSITORY AT YUCCA MOUNTAIN, NEVADA Emergency Planning Criteria § 63.161 Emergency plan for the geologic repository operations area through permanent...

  15. Composite three-layer closure of oral antral communication with 10 months follow-up-a case study.

    PubMed

    Weinstock, Robert J; Nikoyan, Levon; Dym, Harry

    2014-02-01

    We propose a 3-layer composite closure technique for an oral antral communication (OAC) while avoiding secondary donor site morbidity. A patient had developed a 1-cm OAC after extraction of right maxillary first molar. The patient subsequently developed acute maxillary sinusitis. The patient was taken to the operating room, and a Caldwell-Luc procedure was performed. The bony window from the Caldwell-Luc was "press fit" over the bony OAC defect. Soft tissue closure was then achieved with a buccal fat pad flap and a buccal mucosal advancement flap. The patient was examined on postoperative day 5 and 1, 2, 3, 6, and 10 months postoperatively. The acute sinusitis had resolved. The soft tissue closure was successful. The bone graft remained intact, prevented sinus pneumatization, and restored continuity to the floor of the maxillary sinus. The presented technique for 3-layer closure of OACs allows for the stability of a double-layer closure of OAC with the added benefit of bone grafting from single operative site, achieving stable oral antral closure, bone grafting, and the avoidance of secondary donor site morbidity. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making.

    PubMed

    Otto, Ashley S; Clarkson, Joshua J; Kardes, Frank R

    2016-07-01

    We all too often have to make decisions-from the mundane (e.g., what to eat for breakfast) to the complex (e.g., what to buy a loved one)-and yet there exists a multitude of strategies that allows us to make a decision. This work focuses on a subset of decision strategies that allows individuals to make decisions by bypassing the decision-making process-a phenomenon we term decision sidestepping. Critical to the present manuscript, however, we contend that decision sidestepping stems from the motivation to achieve closure. We link this proposition back to the fundamental nature of closure and how those seeking closure are highly bothered by decision making. As such, we argue that the motivation to achieve closure prompts a reliance on sidestepping strategies (e.g., default bias, choice delegation, status quo bias, inaction inertia, option fixation) to reduce the bothersome nature of decision making. In support of this framework, five experiments demonstrate that (a) those seeking closure are more likely to engage in decision sidestepping, (b) the effect of closure on sidestepping stems from the bothersome nature of decision making, and (c) the reliance on sidestepping results in downstream consequences for subsequent choice. Taken together, these findings offer unique insight into the cognitive motivations stimulating a reliance on decision sidestepping and thus a novel framework by which to understand how individuals make decisions while bypassing the decision-making process. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Assessment of a simple, novel endoluminal method for gastrotomy closure in NOTES.

    PubMed

    Lee, Sang Soo; Oelschlager, Brant K; Wright, Andrew S; Soares, Renato V; Sinan, Huseyin; Montenovo, Martin I; Hwang, Joo Ha

    2011-10-01

    A reliable method for gastrotomy closure in NOTES will be essential for NOTES to become viable clinically. However, methods using existing and widely available endoscopic accessories have been ineffective. The objective of this study was to evaluate the feasibility and safety of a new simple method for gastric closure (retracted clip-assisted loop closure) that uses existing endoscopic accessories with minor modifications. The retracted clip-assisted loop closure technique involves deploying 3-4 Resolution(®) clips (modified by attaching a 90-cm length of suture to the end of each clip) along the margin of the gastrotomy with one jaw on the serosal surface and the other jaw on the mucosal surface. The suture strings are threaded through an endoloop. Traction is then applied to the strings causing the gastric wall to tent. The endoloop is secured below the tip of the clips, completing a full-thickness gastrotomy closure. The main outcome measures were feasibility, efficacy, and safety of the new retracted clip-assisted loop closure technique for NOTES gastrotomy closure. An air-tight seal was achieved in 100% (n = 9) of stomachs. The mean leak pressure was 116.3 (±19.4) mmHg. The retracted clip-assisted loop closure technique can be used to perform NOTES gastrotomy closure by using existing endoscopic accessories with minor modifications.

  18. Direct Percutaneous Left Ventricular Access and Port Closure

    PubMed Central

    Barbash, Israel M.; Saikus, Christina E.; Faranesh, Anthony Z.; Ratnayaka, Kanishka; Kocaturk, Ozgur; Chen, Marcus Y.; Bell, Jamie A.; Virmani, Renu; Schenke, William H.; Hansen, Michael S.; Slack, Michael C.; Lederman, Robert J.

    2012-01-01

    Objectives This study sought to evaluate feasibility of nonsurgical transthoracic catheter-based left ventricular (LV) access and closure. Background Implanting large devices, such as mitral or aortic valve prostheses, into the heart requires surgical exposure and repair. Reliable percutaneous direct transthoracic LV access and closure would allow new nonsurgical therapeutic procedures. Methods Percutaneous direct LV access was performed in 19 swine using real-time magnetic resonance imaging (MRI) and an “active” MRI needle antenna to deliver an 18-F introducer sheath. The LV access ports were closed percutaneously using a commercial ventricular septal defect occluder and an “active” MRI delivery cable for enhanced visibility. We used “permissive pericardial tamponade” (temporary fluid instillation to separate the 2 pericardial layers) to avoid pericardial entrapment by the epicardial disk. Techniques were developed in 8 animals, and 11 more were followed up to 3 months by MRI and histopathology. Results Imaging guidance allowed 18-F sheath access and closure with appropriate positioning of the occluder inside the transmyocardial tunnel. Of the survival cohort, immediate hemostasis was achieved in 8 of 11 patients. Failure modes included pericardial entrapment by the epicardial occluder disk (n = 2) and a true-apex entry site that prevented hemostatic apposition of the endocardial disk (n = 1). Reactive pericardial effusion (192 ± 118 ml) accumulated 5 ± 1 days after the procedure, requiring 1-time drainage. At 3 months, LV function was preserved, and the device was endothelialized. Conclusions Direct percutaneous LV access and closure is feasible using real-time MRI. A commercial occluder achieved hemostasis without evident deleterious effects on the LV. Having established the concept, further clinical development of this approach appears realistic. PMID:22192372

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

    PubMed

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

    2013-10-15

    The aim of this study was to evaluate the ability of percutaneous patent foramen ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated right-to-left shunt (RTLS) is associated with hypoxemia, the ability of percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was disproportionate to underlying lung disease were included for evaluation. All patients exhibited PFO-mediated RTLS as determined by agitated saline echocardiography. Procedural success was defined as implantation of a device without major complications and mild or no residual shunt at 6 months. Clinical success was defined as a composite of an improvement in New York Heart Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and clinical success was achieved in 68 of 97 (70%). The presence of any moderate or severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p <0.024), NYHA class at referral (OR = 2.9; p <0.0087), and 10-year increase in age (OR = 1.8; p <0.0017) increased likelihood of clinical success. In contrast, a pulmonary comorbidity (OR = 0.18; p <0.005) and male gender (OR = 0.30; p <0.017) decreased the likelihood of success. In conclusion, based on the largest single-center experience of patients referred for PFO closure for systemic hypoxemia, PFO closure was a mechanically effective procedure with an associated improvement in echocardiographic evidence of RTLS, NYHA functional class, and oxygen requirement. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Permanency and the Foster Care System.

    PubMed

    Lockwood, Katie K; Friedman, Susan; Christian, Cindy W

    2015-10-01

    Each year over 20,000 youth age out of the child welfare system without reaching a permanent placement in a family. Certain children, such as those spending extended time in foster care, with a diagnosed disability, or adolescents, are at the highest risk for aging out. As young adults, this population is at and increased risk of incarceration; food, housing, and income insecurity; unemployment; educational deficits; receipt of public assistance; and mental health disorders. We reviewed the literature on foster care legislation, permanency, outcomes, and interventions. The outcomes of children who age out of the child welfare system are poor. Interventions to increase permanency include training programs for youth and foster parents, age extension for foster care and insurance coverage, an adoption tax credit, and specialized services and programs that support youth preparing for their transition to adulthood. Future ideas include expanding mentoring, educational support, mental health services, and post-permanency services to foster stability in foster care placements and encourage permanency planning. Children in the child welfare system are at a high risk for physical, mental, and emotional health problems that can lead to placement instability and create barriers to achieving permanency. Failure to reach the permanency of a family leads to poor outcomes, which have negative effects on the individual and society. Supporting youth in foster care throughout transitions may mediate the negative outcomes that have historically followed placement in out-of-home care. Copyright © 2015 Mosby, Inc. All rights reserved.

  1. [Effect of revascularization treatment of immature permanent teeth with endodontic infection].

    PubMed

    Huang, Yibin; Chen, Ke; Zhang, Ying; Xiong, Huacui; Liu, Caiqi

    2013-05-01

    To observe the effect of revascularization for treatment of immature teeth with endodontic infection mediated by calcium hydroxide. Seventeen pediatric patients with endodontic infections of the permanent teeth were treated with routine root canal and pulp cavity irrigation and disinfection followed by application of calcium hydroxide paste to the root canal orifice to induce revascularization. Another 17 patients received conventional apexification procedures to serve as the control group. The patients were followed up to observe the therapeutic effect of the treatments. In the revascularization treatment group, 4 cases showed healed periapical lesions 6 to 18 months after the surgery with thickened root canal walls and closure of the apical foramen; in 10 cases, the periapical lesions healed 12 to 18 months postoperatively with lengthened root, thickened root canal wall, and narrowed apical foramen. One patient reported pain and swelling at 2 months, and 2 patients showed the formation of gum fistula and ceased development of the roots at 7 and 8 months. In the control group, the periapical lesions healed in 1 cases at 12 months postoperatively with apical foramen closure; in 11 cases, hard tissues formed in the root apex without obviously lengthened roots 6 to 8 months after the surgery; in 5 cases, no apical barrier formed even 12 to 18 months after the surgery. The overall effective rates were similar between the two groups (P>0.05). Revascularization by calcium hydroxide sealing can promote root development of immature permanent teeth with pulpitis or periradicular periodontitis.

  2. 40 CFR 264.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

  3. 40 CFR 264.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

  4. 40 CFR 264.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

  5. 40 CFR 264.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

  6. Ratio-driven resuscitation predicts early fascial closure in the combat wounded.

    PubMed

    Glaser, Jacob; Vasquez, Matthew; Cardarelli, Cassandra; Dunne, James; Elster, Eric; Hathaway, Emily; Bograd, Benjamin; Safford, Shawn; Rodriguez, Carlos

    2015-10-01

    Operation Iraqi Freedom and Operation Enduring Freedom have seen the highest rates of combat casualties since Vietnam. These casualties often require massive transfusion (MT) and immediate surgical attention to control hemorrhage. Clinical practice guidelines dictate ratio-driven resuscitation (RDR) for patients requiring MT. With the transition from crystalloid to blood product resuscitation, we have seen fewer open abdomens in combat casualties. We sought to determine the effect RDR has on achieving early definitive abdominal fascial closure in combat casualties undergoing exploratory laparotomy. Records of 1,977 combat casualties admitted to a single US military hospital from April 2003 to December 2011 were reviewed. Patients receiving an MT and laparotomy in theater constituted the study cohort. The cohort was divided into RDR, defined as a ratio of 0.8-U to 1.2-U packed red blood cells to 1-U fresh frozen plasma, and No-RDR groups. Age, injury patterns, mechanism of injury, injury severity, blood products, number of laparotomies, and days to fascial closure were collected. Assessed outcomes were number of days (early ≤ 2 days) and number of laparotomies to achieve fascial closure. The mean age of the study cohort (n = 172) was 24.0 years, and mean Injury Severity Score (ISS) was 24.8. Improvised explosive device blast was the most common mechanism of injury (74.4%). The cohort was divided into RDR patients (n = 73) and no RDR (n = 99). There was no difference in mean age, mean ISS, or rate of nontherapeutic exploratory laparotomies between the groups. RDR patients had a significantly lower abdominal injury rate (34.2% vs. 72.7%, p < 0.01), had fewer laparotomies (2.7 vs. 4.3, p = 0.003), and achieved primary fascial closure faster (2.4 days vs. 7.2 days, p = 0.004). On multivariate analysis, RDR (2.74; 95% confidence interval, 1.44-5.2) was an independent predictor for early fascial closure. Adherence to RDR guidelines resulted in significantly decreased

  7. Quick actuating closure

    NASA Technical Reports Server (NTRS)

    White, III, Dorsey E. (Inventor); Updike, deceased, Benjamin T. (Inventor); Allred, Johnny W. (Inventor)

    1989-01-01

    A quick actuating closure for a pressure vessel 80 in which a wedge ring 30 with a conical outer surface 31 is moved forward to force shear blocks 40, with conical inner surfaces 41, radially outward to lock an end closure plug 70 within an opening 81 in the pressure vessel 80. A seal ring 60 and a preload ramp 50 sit between the shear blocks 40 and the end closure plug 70 to provide a backup sealing capability. Conical surfaces 44 and 55 of the preload ramp 50 and the shear blocks 40 interact to force the seal ring 60 into shoulders 73 and 85 in the end closure plug 70 and opening 81 to form a tight seal. The end closure plug 70 is unlocked by moving the wedge ring 30 rearward, which causes T-bars 32 of the wedge ring 30 riding within T -slots 42 of the shear blocks 40 to force them radially inward. The end closure plug 70 is then removed, allowing access to the interior of the pressure vessel 80.

  8. Gestalt concept of closure: a construct without closure.

    PubMed

    Wasserstein, Jeanette

    2002-12-01

    This comment reviews the original Gestalt literature which introduced the concept of 'closure'. It is argued that the meaning of 'closure' was confounded in the source literature and, thus, the term connotes more than it denotes. Research based on different measures of this ambiguous construct inevitably may not always converge.

  9. Incorporating Conservation Zone Effectiveness for Protecting Biodiversity in Marine Planning

    PubMed Central

    Makino, Azusa; Klein, Carissa J.; Beger, Maria; Jupiter, Stacy D.; Possingham, Hugh P.

    2013-01-01

    Establishing different types of conservation zones is becoming commonplace. However, spatial prioritization methods that can accommodate multiple zones are poorly understood in theory and application. It is typically assumed that management regulations across zones have differential levels of effectiveness (“zone effectiveness”) for biodiversity protection, but the influence of zone effectiveness on achieving conservation targets has not yet been explored. Here, we consider the zone effectiveness of three zones: permanent closure, partial protection, and open, for planning for the protection of five different marine habitats in the Vatu-i-Ra Seascape, Fiji. We explore the impact of differential zone effectiveness on the location and costs of conservation priorities. We assume that permanent closure zones are fully effective at protecting all habitats, open zones do not contribute towards the conservation targets and partial protection zones lie between these two extremes. We use four different estimates for zone effectiveness and three different estimates for zone cost of the partial protection zone. To enhance the practical utility of the approach, we also explore how much of each traditional fishing ground can remain open for fishing while still achieving conservation targets. Our results show that all of the high priority areas for permanent closure zones would not be a high priority when the zone effectiveness of the partial protection zone is equal to that of permanent closure zones. When differential zone effectiveness and costs are considered, the resulting marine protected area network consequently increases in size, with more area allocated to permanent closure zones to meet conservation targets. By distributing the loss of fishing opportunity equitably among local communities, we find that 84–88% of each traditional fishing ground can be left open while still meeting conservation targets. Finally, we summarize the steps for developing marine zoning

  10. Port closure techniques.

    PubMed

    Shaher, Z

    2007-08-01

    Laparoscopic trocars do create wounds. This article aims to review and list different techniques used for closure of the fascia incision at trocar sites. A literature search was performed for articles dealing with closure techniques. The author searched this subject in English on Medline by combining the words "trocar" and "hernia," as well as "Deschamps" and "Reverdin." All articles reporting techniques with their references were reviewed. The articles described many techniques in addition to classical closure using curved needles, including Grice needle, Maciol needles, Endoclose device, Carter-Thomason device, Tahoe ligature device, Endo-Judge device, eXit puncture closure device, Lowsley retractor, spinal cord needles, dual hemostat, suture carrier, Riverdin and Deschamps needles, and Gore-Tex closure device. Three main groups of techniques were found with favor of extracorporeal manipulations under direct visualization. Old methods are sufficient and cost-effective.

  11. The use of a silicon sheet for gradual wound closure after fasciotomy.

    PubMed

    Walker, Tobias; Gruler, Miriam; Ziemer, Gerhard; Bail, Dorothee H L

    2012-06-01

    We present a silicon sheet for temporary wound covering and gradual wound closure after open fasciotomy. Fasciotomy was performed in a total of 70 limbs with compartment syndrome (CS). The main etiology of CS was predominantly vascular. All patients were treated with a silicon sheet to cover the soft tissue defect and gradually reapproximate the skin margins. In 53% of the patients, a delayed final wound closure was achieved after a mean of 11.9 days. This method allows final closure of fasciotomy wounds without scar contractures, marginal necrosis, infection, or significant pain. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  12. Student Achievement: Improving Our Focus.

    ERIC Educational Resources Information Center

    Hawkins, Amber

    An efficient way to help students achieve academically is to maximize the consistent attendance of permanent teachers in the classroom. Students nationwide are spending increased amounts of time with instructors other than their permanent teachers. A large contributor to the problem of teacher absenteeism is mandatory leave for professional…

  13. Achieving effective hearing aid fitting within one month after identification of childhood permanent hearing impairment.

    PubMed

    Bastanza, G; Gallus, R; De Carlini, M; Picciotti, P M; Muzzi, E; Ciciriello, E; Orzan, E; Conti, G

    2016-02-01

    Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  14. 40 CFR 264.197 - Closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Section 264.197 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES... as hazardous waste, unless § 261.3(d) of this chapter applies. The closure plan, closure activities...

  15. Micromagnetics of rare-earth efficient permanent magnets

    NASA Astrophysics Data System (ADS)

    Fischbacher, Johann; Kovacs, Alexander; Gusenbauer, Markus; Oezelt, Harald; Exl, Lukas; Bance, Simon; Schrefl, Thomas

    2018-05-01

    The development of permanent magnets containing less or no rare-earth elements is linked to profound knowledge of the coercivity mechanism. Prerequisites for a promising permanent magnet material are a high spontaneous magnetization and a sufficiently high magnetic anisotropy. In addition to the intrinsic magnetic properties the microstructure of the magnet plays a significant role in establishing coercivity. The influence of the microstructure on coercivity, remanence, and energy density product can be understood by using micromagnetic simulations. With advances in computer hardware and numerical methods, hysteresis curves of magnets can be computed quickly so that the simulations can readily provide guidance for the development of permanent magnets. The potential of rare-earth reduced and rare-earth free permanent magnets is investigated using micromagnetic simulations. The results show excellent hard magnetic properties can be achieved in grain boundary engineered NdFeB, rare-earth magnets with a ThMn12 structure, Co-based nano-wires, and L10-FeNi provided that the magnet’s microstructure is optimized.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ketusky, Edward; Blanton, Paul; Bobbitt, John H.

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

  17. 40 CFR 264.280 - Closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure and post-closure care. 264.280 Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES... § 264.278, except that soil-pore liquid monitoring may be terminated 90 days after the last application...

  18. Development of Infrared Phase Closure Capability in the Infrared-Optical Telescope Array (IOTA)

    NASA Technical Reports Server (NTRS)

    Traub, Wesley A.

    2002-01-01

    We completed all major fabrication and testing for the third telescope and phase-closure operation at the Infrared-Optical Telescope Array (IOTA) during this period. In particular we successfully tested the phase-closure operation, using a laboratory light source illuminating the full delay-line optical paths, and using an integrated-optic beam combiner coupled to our Picnic-detector camera. This demonstration is an important and near-final milestone achievement. As of this writing, however, several tasks yet remain, owing to development snags and weather, so the final proof of success, phase-closure observation of a star, is now expected to occur in early 2002, soon after this report has been submitted.

  19. Stump closure of a thick pancreas using stapler closure increases pancreatic fistula after distal pancreatectomy.

    PubMed

    Kawai, Manabu; Tani, Masaji; Okada, Ken-ichi; Hirono, Seiko; Miyazawa, Motoki; Shimizu, Astusi; Kitahata, Yuji; Yamaue, Hiroki

    2013-09-01

    The appropriate surgical stump closure after distal pancreatectomy (DP) is still controversial. This study investigated the benefits and risks of stapler closure during DP. The risk factors of pancreatic fistulas were investigated in 122 DPs among 3 types of stump closure: hand-sewn suture (n = 32), bipolar scissors (n = 45), and stapler closure (n = 45). There was no significant difference in the incidence of pancreatic fistula between the 3 types of stump closure (hand-sewn suture [44%] vs bipolar scissors [37.7%] vs stapler closure [35.5%]). By using receiver operating characteristics curves, 12 mm was the best cutoff value of the thickness of the pancreas for pancreatic fistulas after DP using stapler closure. Three factors (ie, male sex, body mass index >25 kg/m(2), and stapler closure) were independent risk factors of pancreatic fistulas after DP with a pancreas thicker than 12 mm. A pancreas thicker than 12 mm significantly increased the incidence of pancreatic fistulas after DP using stapler closure. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. 75 FR 45661 - Notice of Permanent Closure on Public Lands in Ada County, ID

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ...On April 12, 2010, Higby Cave and all public lands within 1,000 feet of the entrance were permanently closed to vehicle access and public use at all times, due to changes in the cave's structural integrity and related potential hazards. The cave entrance has been gated and access limited to BLM-permitted and administrative activities. Exempt from this order are BLM employees, authorized permittees, and other Federal, State and County employees while on official business of their respective agencies, including associated vehicle use for administrative and emergency purposes.

  1. A simple technique of laparoscopic port closure allowing wound extension.

    PubMed

    Christey, G R; Poole, G

    2002-04-01

    Reliable and safe access to the abdominal cavity and efficient removal of the resected gallbladder are essential to laparoscopic cholecystectomy. The unpredictable size of the cholecystectomy specimen can sometimes lead to frustration at the time of removal. A simple technique has been developed that allows for tissue extraction and easy fascial closure regardless of the size of the specimen. This is achieved by using a four bite "U-shaped" purse string at the time of Hasson insertion, with cephalad advancement of the proximal two bites. This allows for variable wound extension and secure closure, without the need for additional sutures.

  2. Primary closure versus delayed closure for non bite traumatic wounds within 24 hours post injury.

    PubMed

    Eliya-Masamba, Martha C; Banda, Grace W

    2013-10-22

    Acute traumatic wounds are one of the common reasons why people present to the emergency department. Primary closure has traditionally been reserved for traumatic wounds presenting within six hours of injury and considered 'clean' by the attending surgeon, with the rest undergoing delayed primary closure as a means of controlling wound infection. Primary closure has the potential benefit of rapid wound healing but poses the potential threat of increased wound infection. There is currently no evidence to guide clinical decision-making on the best timing for closure of traumatic wounds. To determine the effect on time to healing of primary closure versus delayed closure for non bite traumatic wounds presenting within 24 hours post injury. To explore the adverse effects of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours post injury. In May 2013, for this first update we searched the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. There were no restrictions with respect to language, date of publication or study setting. Randomised controlled trials comparing primary closure with delayed closure of non bite traumatic wounds. Two review authors independently evaluated the results of the searches against the inclusion criteria. No studies met the inclusion criteria for this review. Since no studies met the inclusion criteria, neither a meta-analysis nor a narrative description of studies was possible. There is currently no systematic evidence to guide clinical decision-making regarding the timing for closure of traumatic wounds. There is a need for robust research to investigate the effect of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours of injury.

  3. Higher order turbulence closure models

    NASA Technical Reports Server (NTRS)

    Amano, Ryoichi S.; Chai, John C.; Chen, Jau-Der

    1988-01-01

    Theoretical models are developed and numerical studies conducted on various types of flows including both elliptic and parabolic. The purpose of this study is to find better higher order closure models for the computations of complex flows. This report summarizes three new achievements: (1) completion of the Reynolds-stress closure by developing a new pressure-strain correlation; (2) development of a parabolic code to compute jets and wakes; and, (3) application to a flow through a 180 deg turnaround duct by adopting a boundary fitted coordinate system. In the above mentioned models near-wall models are developed for pressure-strain correlation and third-moment, and incorporated into the transport equations. This addition improved the results considerably and is recommended for future computations. A new parabolic code to solve shear flows without coordinate tranformations is developed and incorporated in this study. This code uses the structure of the finite volume method to solve the governing equations implicitly. The code was validated with the experimental results available in the literature.

  4. Postretention stability after orthodontic closure of maxillary interincisor diastemas

    PubMed Central

    de MORAIS, Juliana Fernandes; de FREITAS, Marcos Roberto; de FREITAS, Karina Maria Salvatore; JANSON, Guilherme; CASTELLO BRANCO, Nuria

    2014-01-01

    Anterior spaces may interfere with smile attractiveness and compromise dentofacial harmony. They are among the most frequent reasons why patients seek orthodontic treatment. However, midline diastema is commonly cited as a malocclusion with high relapse incidence by orthodontists. Objectives This study aimed to evaluate the stability of maxillary interincisor diastemas closure and the association of their relapse and interincisor width, overjet, overbite and root parallelism. Material and Methods Sample comprised 30 patients with at least a pretreatment midline diastema of 0.5 mm or greater after eruption of the maxillary permanent canines. Dental casts and panoramic radiographs were taken at pretreatment, posttreatment and postretention. Results Before treatment, midline diastema width was 1.52 mm (SD=0.88) and right and left lateral diastema widths were 0.55 mm (SD=0.56) and 0.57 mm (SD=0.53), respectively. According to repeated measures analysis of variance, only midline diastema demonstrated significant relapse. In the overall sample the average relapse of midline diastema was 0.49 mm (SD=0.66), whilst the unstable patients showed a mean space reopening of 0.78 mm (SD=0.66). Diastema closure in the area between central and lateral incisors showed great stability. Multivariate correlation tests showed that only initial diastema width (β=0.60) and relapse of overjet (β=0.39) presented association with relapse of midline diastema. Conclusions Midline diastema relapse was statistically significant and occurred in 60% of the sample, while lateral diastemas closure remained stable after treatment. Only initial diastema width and overjet relapse showed association with relapse of midline diastema. There was no association between relapse of interincisor diastema and root parallelism. PMID:24918661

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

    PubMed

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

    2016-09-01

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

  6. New permanent magnets

    NASA Astrophysics Data System (ADS)

    Müller, K.-H.; Krabbes, G.; Fink, J.; Gruß, S.; Kirchner, A.; Fuchs, G.; Schultz, L.

    2001-05-01

    Permanent magnets play an important role and are widely spread in daily-life applications. Due to their very low costs, large availability of the row materials and their high chemical stability, hard ferrites are still dominant in the permanent magnet market although their relatively poor magnetic properties are a distinct disadvantage. Today's high-performance magnets are mostly made from Nd 2Fe 14B. The aim of research is to combine the large spontaneous magnetization of 3d metals with strong anisotropy fields known from rare-earth transition-metal compounds and, at the same time, to maintain a high value of the Curie temperature. However, the number of iron-rich rare-earth intermetallics is very limited and, consequently, not much success can be noted in this field for the last 10 years. One alternative concept is to use magnetic fields trapped in type II superconductors where much higher fields can be achieved compared to conventional rare-earth magnets. Very recently, we obtained a trapped field as high as 14.4 T in a melt-textured YBCO bulk sample of a few centimeters in diameter. This is the highest value ever achieved in a bulk superconductor. The trapped field of a superconductor is not governed by the Laplace equation and, therefore, levitation works without any additional (active) stabilization. The disadvantage of these magnets is their low working temperature (of liquid nitrogen and below).

  7. Revascularization for a necrotic immature permanent lateral incisor: a case report and literature review.

    PubMed

    Kottoor, Jojo; Velmurugan, Natanasabapathy

    2013-07-01

    Revascularization is a valuable treatment in immature necrotic teeth that allows the continuation of root development. This article describes the successful revascularization treatment of an immature maxillary lateral incisor that was initially diagnosed with apical periodontitis. The tooth was asymptomatic and functional clinically and radiographically during the follow-up period of 5 years. The follow-up showed evidence of progressive thickening of the dentinal walls, development of root length and apical closure. The article also discusses the currently available literature regarding revascularization of immature permanent teeth. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.

  8. Impact of Vial Capping on Residual Seal Force and Container Closure Integrity.

    PubMed

    Mathaes, Roman; Mahler, Hanns-Christian; Roggo, Yves; Ovadia, Robert; Lam, Philippe; Stauch, Oliver; Vogt, Martin; Roehl, Holger; Huwyler, Joerg; Mohl, Silke; Streubel, Alexander

    2016-01-01

    The vial capping process is a critical unit operation during drug product manufacturing, as it could possibly generate cosmetic defects or even affect container closure integrity. Yet there is significant variability in capping equipment and processes, and their relation to potential defects or container closure integrity has not been thoroughly studied. In this study we applied several methods-residual seal force tester, a self-developed system of a piezo force sensor measurement, and computed tomography-to characterize different container closure system combinations that had been sealed using different capping process parameter settings. Additionally, container closure integrity of these samples was measured using helium leakage (physical container closure integrity) and compared to characterization data. The different capping equipment settings lead to residual seal force values from 7 to 115 N. High residual seal force values were achieved with high capping pre-compression force and a short distance between the capping plate and plunge. The choice of container closure system influenced the obtained residual seal force values. The residual seal force tester and piezoelectric measurements showed similar trends. All vials passed physical container closure integrity testing, and no stopper rupture was seen with any of the settings applied, suggesting that container closure integrity was warranted for the studied container closure system with the chosen capping setting ranges. The vial capping process is a critical unit operation during drug product manufacturing, as it could possibly generate cosmetic defects or even affect container closure integrity. Yet there is significant variability in capping equipment and processes, and their relation to potential defects or container closure integrity has not been thoroughly studied. In this study we applied several methods-residual seal force tester, a self-developed system of a piezo force sensor measurement, and

  9. School Closures in New York City: Did Students Do Better after Their High Schools Were Closed?

    ERIC Educational Resources Information Center

    Kemple, James J.

    2016-01-01

    Much has been written about the controversy surrounding performance-based school closures, but there has been no rigorous assessment of their impact on student achievement. Does the closure process harm students who are enrolled in a school while it is being phased out? Are future students better-off because a low-performing option has been…

  10. Traction-compression-closure for exomphalos major.

    PubMed

    Morabito, Antonino; Owen, Anthony; Bianchi, Adrian

    2006-11-01

    We present our experience with traction-compression-closure (TCC) for exomphalos major (EM) to achieve a safe and embryologically correct midline supraumbilical aesthetic closure with preservation of the umbilicus. Nineteen neonates with EM were paralyzed and ventilated. The abdominal domain was increased by upward cord traction to assist liver-bowel reduction by gravity and sac ligation, followed by circumferential elastic body binder compression. The supraumbilical abdominal wall anomaly cicatrized spontaneously or was closed surgically as a midline scar, with preservation of the umbilicus. Over 7 years (1998-2004), 19 patients with EM were treated by TCC, 18 of whom survived. The patients' median gestational age was 36 weeks (range, 24-40 weeks); their median birth weight was 2312 g (range, 890-3000 g). The median time to reduction was 4 days (range, 3-5 days), whereas that to full enteral feeds was 6 days (range, 4-6 days). Mechanical ventilation for 7 days (range, 6-8 days) was not associated with any morbidity, and the time to home discharge was 11 days (range, 8-12 days). Five patients did not require any surgery. There was no episode of sac rupture or infection. Abdominal expansion by vertical cord traction followed by compression reduction (TCC) under muscle relaxation and ventilation is time well spent toward a safe and aesthetic midline abdominal wall closure without tension for EM.

  11. The TopClosure® 3S System, for skin stretching and a secure wound closure.

    PubMed

    Topaz, Moris; Carmel, Narin-Nard; Silberman, Adi; Li, Ming Sen; Li, Yong Zhong

    2012-07-01

    The principle of stretching wound margins for primary wound closure is commonly practiced and used for various skin defects, leading at times to excessive tension and complications during wound closure. Different surgical techniques, skin stretching devices and tissue expanders have been utilized to address this issue. Previously designed skin stretching devices resulted in considerable morbidity. They were invasive by nature and associated with relatively high localized tissue pressure, frequently leading to necrosis, damage and tearing of skin at the wound margins. To assess the clinical effectiveness and performance and, to determine the safety of TopClosure® for gradual, controlled, temporary, noninvasive and invasive applications for skin stretching and secure wound closing, the TopClosure® device was applied to 20 patients for preoperative skin lesion removal and to secure closure of a variety of wound sizes. TopClosure® was reinforced with adhesives, staples and/or surgical sutures, depending on the circumstances of the wound and the surgeon's judgment. TopClosure® was used prior to, during and/or after surgery to reduce tension across wound edges. No significant complications or adverse events were associated with its use. TopClosure® was effectively used for preoperative skin expansion in preparation for dermal resection (e.g., congenital nevi). It aided closure of large wounds involving significant loss of skin and soft tissue by mobilizing skin and subcutaneous tissue, thus avoiding the need for skin grafts or flaps. Following surgery, it was used to secure closure of wounds under tension, thus improving wound aesthetics. A sample case study will be presented. We designed TopClosure®, an innovative device, to modify the currently practiced concept of wound closure by applying minimal stress to the skin, away from damaged wound edges, with flexible force vectors and versatile methods of attachment to the skin, in a noninvasive or invasive manner.

  12. 40 CFR 264.146 - Use of a mechanism for financial assurance of both closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... assurance of both closure and post-closure care. 264.146 Section 264.146 Protection of Environment... mechanism for financial assurance of both closure and post-closure care. An owner or operator may satisfy the requirements for financial assurance for both closure and post-closure care for one or more...

  13. Identification of Selected Child-Resistant Closures (Continuous Thread, Lug-Bayonet, and Snap Closures).

    ERIC Educational Resources Information Center

    Gross, Rosalind L.; White, Harry E.

    This publication describes a selected group of child-resistant closures used in packaging five categories of medicine and household products. The material in the document was collected to train survey personnel to identify closures for a planned household study of the effectiveness of child-resistant packaging. The 39 closures described are of…

  14. Permanent bending and alignment of ZnO nanowires.

    PubMed

    Borschel, Christian; Spindler, Susann; Lerose, Damiana; Bochmann, Arne; Christiansen, Silke H; Nietzsche, Sandor; Oertel, Michael; Ronning, Carsten

    2011-05-06

    Ion beams can be used to permanently bend and re-align nanowires after growth. We have irradiated ZnO nanowires with energetic ions, achieving bending and alignment in different directions. Not only the bending of single nanowires is studied in detail, but also the simultaneous alignment of large ensembles of ZnO nanowires. Computer simulations reveal how the bending is initiated by ion beam induced damage. Detailed structural characterization identifies dislocations to relax stresses and make the bending and alignment permanent, even surviving annealing procedures.

  15. 40 CFR 265.146 - Use of a mechanism for financial assurance of both closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... assurance of both closure and post-closure care. 265.146 Section 265.146 Protection of Environment... Use of a mechanism for financial assurance of both closure and post-closure care. An owner or operator may satisfy the requirements for financial assurance for both closure and post-closure care for one or...

  16. Continued root maturation despite persistent apical periodontitis of immature permanent teeth after failed regenerative endodontic therapy.

    PubMed

    Lin, Louis M; Kim, Sahng G; Martin, Gabriela; Kahler, Bill

    2018-01-16

    Three immature permanent teeth with pulp necrosis and apical periodontitis were treated with regenerative endodontic therapy (RET), which included root canal disinfection with sodium hypochlorite irrigation, intra-canal medication with calcium hydroxide paste, 17% EDTA rinse, induction of periapical bleeding into the canal, collagen matrix and MTA coronal seal, and composite resin restoration of access cavities. After different periods of follow-up, it was observed that continued root maturation, especially apical closure occurred despite persistent apical periodontitis of immature permanent teeth after failed RET. This finding is of interest as the secondary goal of further root maturation occurred despite failure of the primary goal of elimination of clinical symptom/sign and periapical inflammation. The possible biological mechanisms that could allow for further root maturation to occur in spite of persistent root canal infection of immature permanent teeth are discussed. Based on these observations, the biology of wound healing of immature permanent teeth after injury is not fully understood and should be further investigated. This case report demonstrates that whilst further root maturation is considered a successful outcome for teeth treated with RET, the primary objective must be the resolution of the signs and symptoms of apical periodontitis. © 2018 Australian Society of Endodontology Inc.

  17. "When the going gets tough, the tough get going": Motivation towards closure and effort investment in the performance of cognitive tasks.

    PubMed

    Sankaran, Sindhuja; Szumowska, Ewa; Kossowska, Małgorzata

    2017-01-01

    Previous studies have demonstrated that the need for closure (NFC), which refers to an individual's aversion toward uncertainty and the desire to quickly reduce it, leads to reluctance to invest effort in judgments and decision making. However, we argue that NFC may lead to either an increase or a decrease in effort depending on the availability of easy vs. difficult means to achieve closure and perceived importance of the task goal. We found that when closure could be achieved via both less and more demanding means, NFC was associated with decreased effort unless the task was perceived as important (Study 1). However, when attaining closure was possible via demanding means only, NFC was associated with increased effort, regardless of the task importance (Study 2). Moreover, NFC was related to choosing a more instrumental strategy for the goal of closure, even if this strategy required effort (Study 3). The results are discussed in the light of cognitive energetics theory.

  18. Severe valgus deformity of the knee with permanent patellar dislocation associated with melorheostosis: a case report and review of the literature.

    PubMed

    Kitta, Yuki; Niki, Yasuo; Udagawa, Kazuhiko; Enomoto, Hiroyuki; Toyama, Yoshiaki; Suda, Yasunori

    2014-03-01

    We present a case of an 8-year-old boy diagnosed with melorheostosis who was suffering from severe genu valgum, permanent dislocation of the patella, knee flexion contracture and leg length shortening. Soft tissue contracture of the limb and subsequent joint deformities were reported to represent clinical manifestations of pediatric melorheostosis. As the epiphyseal plate had not closed, patellar reduction was achieved by soft tissue surgical stabilization, including lateral retinacular release, medial retinaculum plication, and transfer of the lateral half of the patellar tendon. At 4 years postoperatively, as a result of improved limb alignment and knee flexion contracture, the leg length shortening has improved, and the patient does not limp and participates in sports activities. Surgical intervention should be performed as early as possible, because genu valgum and external rotation of the tibia may deteriorate with age, rendering the patellar dislocation irreversible in patients with melorheostosis before epiphyseal closure. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Material balance and diet in bioregenerative life support systems: connection with coefficient of closure.

    PubMed

    Manukovsky, N S; Kovalev, V S; Somova, L A; Gurevich, Yu L; Sadovsky, M G

    2005-01-01

    Bioregenerative life support systems (BLSS) with different coefficients of closure are considered. The 66.2% coefficient of closure achieved in "BIOS-3" facility experiments has been taken as a base value. The increase in coefficient of closure up to 72.6-93.0% is planned due to use of soil-like substrate (SLS) and concentrating of urine. Food values were estimated both in a base variant ("BIOS-3"), and with increases in the coefficient of closure. It is shown that food requirements will be more fully satisfied by internal crop production with an increase in the coefficient of closure of the BLSS. Changes of massflow rates on an 'input-output' and inside BLSS are considered. Equations of synthesis and degradation of organic substances in BLSS were examined using a stoichiometric model. The paper shows that at incomplete closure of BLSS containing SLS there is a problem of nitrogen balancing. To compensate for the removal of nitrogen from the system in urine and feces, it is necessary to introduce food and a nitrogen-containing additive. c2005 COSPAR. Published by Elsevier Ltd. All rights reserved.

  20. Topology optimization for design of segmented permanent magnet arrays with ferromagnetic materials

    NASA Astrophysics Data System (ADS)

    Lee, Jaewook; Yoon, Minho; Nomura, Tsuyoshi; Dede, Ercan M.

    2018-03-01

    This paper presents multi-material topology optimization for the co-design of permanent magnet segments and iron material. Specifically, a co-design methodology is proposed to find an optimal border of permanent magnet segments, a pattern of magnetization directions, and an iron shape. A material interpolation scheme is proposed for material property representation among air, permanent magnet, and iron materials. In this scheme, the permanent magnet strength and permeability are controlled by density design variables, and permanent magnet magnetization directions are controlled by angle design variables. In addition, a scheme to penalize intermediate magnetization direction is proposed to achieve segmented permanent magnet arrays with discrete magnetization directions. In this scheme, permanent magnet strength is controlled depending on magnetization direction, and consequently the final permanent magnet design converges into permanent magnet segments having target discrete directions. To validate the effectiveness of the proposed approach, three design examples are provided. The examples include the design of a dipole Halbach cylinder, magnetic system with arbitrarily-shaped cavity, and multi-objective problem resembling a magnetic refrigeration device.

  1. Biosphere 2: a prototype project for a permanent and evolving life system for Mars base.

    PubMed

    Nelson, M; Allen, J P; Dempster, W F

    1992-01-01

    As part of the ground-based preparation for creating long-term life systems needed for space habitation and settlement, Space Biospheres Ventures (SBV) is undertaking the Biosphere 2 project near Oracle, Arizona. Biosphere 2, currently under construction, is scheduled to commence its operations in 1991 with a two-year closure period with a crew of eight people. Biosphere 2 is a facility which will be essentialy materially-closed to exchange with the outside environment. It is open to information and energy flow. Biosphere 2 is designed to achieve a complex life-support system by the integration of seven areas or "biomes"--rainforest, savannah, desert, marsh, ocean, intensive agriculture and human habitat. Unique bioregenerative technologies, such as soil bed reactors for air purification, aquatic waste processing systems, real-time analytic systems and complex computer monitoring and control systems are being developed for the Biosphere 2 project. Its operation should afford valuable insight into the functioning of complex life systems necessary for long-term habitation in space. It will serve as an experimental ground-based prototype and testbed for the stable, permanent life systems needed for human exploration of Mars.

  2. Structure of highly asymmetric hard-sphere mixtures: an efficient closure of the Ornstein-Zernike equations.

    PubMed

    Amokrane, S; Ayadim, A; Malherbe, J G

    2005-11-01

    A simple modification of the reference hypernetted chain (RHNC) closure of the multicomponent Ornstein-Zernike equations with bridge functions taken from Rosenfeld's hard-sphere bridge functional is proposed. Its main effect is to remedy the major limitation of the RHNC closure in the case of highly asymmetric mixtures--the wide domain of packing fractions in which it has no solution. The modified closure is also much faster, while being of similar complexity. This is achieved with a limited loss of accuracy, mainly for the contact value of the big sphere correlation functions. Comparison with simulation shows that inside the RHNC no-solution domain, it provides a good description of the structure, while being clearly superior to all the other closures used so far to study highly asymmetric mixtures. The generic nature of this closure and its good accuracy combined with a reduced no-solution domain open up the possibility to study the phase diagram of complex fluids beyond the hard-sphere model.

  3. Percutaneous closure of patent foramen ovale in patients with presumed paradoxical embolism: periprocedural results and midterm risk of recurrent neurologic events.

    PubMed

    Balbi, Manrico; Casalino, Laura; Gnecco, Giovanni; Bezante, Gian Paolo; Pongiglione, Giacomo; Marasini, Maurizio; Del Sette, Massimo; Barsotti, Antonio

    2008-08-01

    To report our data on selected patients with previous paradoxical embolism who underwent transcatheter patent foramen ovale (PFO) closure. Between July 2001 and July 2007, percutaneous PFO closure was performed on 128 patients (65 women, mean age: 46 +/- 12.8 years). Patent foramen ovale closure was recommended for secondary prevention in patients with previous transient ischemic attacks (52.5%), stroke (46%), or peripheral embolism (1.5%). Implantation was successful in all patients, and at the end of intervention, complete PFO closure was achieved in 70.3% of them. There were no "major" complications (ie, deaths, device embolization or thrombosis, need for cardiac surgery). The overall incidence of complications (mostly hemorrhagic) was 7%. The mean follow-up period was 32 months. Complete closure had been achieved in 78.4% and in 82.5% of patients at the third month of transesophageal echocardiography examination and at the sixth month of transcranial Doppler examination, respectively. There were no recurrent thromboembolic events during the follow-up period. Percutaneous closure of PFO is a feasible procedure, but it is not a risk-free technique. However, in correctly selected patients (ie, large PFO and those at risk for neurologic relapse), nearly complete PFO closure seems to provide protection from future neurologic ischaemic events at midterm follow-up.

  4. Investigation of Anisotropic Bonded Magnets in Permanent Magnet Machine Applications

    NASA Astrophysics Data System (ADS)

    Khazdozian, H. A.; McCall, S. K.; Kramer, M. J.; Paranthaman, M. P.; Nlebedim, I. C.

    Rare earth elements (REE) provide the high energy product necessary for permanent magnets, such as sintered Nd2Fe14B, in many applications like wind energy generators. However, REEs are considered critical materials due to risk in their supply. To reduce the use of critical materials in permanent magnet machines, the performance of anisotropic bonded NdFeB magnets, aligned under varying magnetic field strength, was simulated using 3D finite element analysis in a 3MW direct-drive permanent magnet generator (DDPMG), with sintered N42 magnets used as a baseline for comparison. For direct substitution of the anisotropic bonded magnets, approximately 85% of the efficiency of the baseline model was achieved, irrespective of the alignment field. The torque and power generation of the DDPMG was not found to vary significantly with increase in the alignment field. Finally, design changes were studied to allow for the achievement of rated torque and power with the use of anisotropic bonded magnets, demonstrating the potential for reduction of critical materials in permanent magnets for renewable energy applications. This work was supported by the Critical Materials Institute, an Energy Innovation Hub funded by the U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy, Advanced Manufacturing Office.

  5. Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure.

    PubMed

    Cheng, Li-Fu; Lee, Jiunn-Tat; Hsu, Honda; Wu, Meng-Si

    2017-03-01

    Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. This retrospective study was conducted to evaluate our clinical experiences with 22 large wounds, which involved performing primary closures under a considerable amount of tension by using elastic rubber bands in a skin-stretching technique after a wide undermining procedure. Assessment of the results entailed complete wound healing and related complications. All 22 wounds in our study showed fair to good results except for one. The mean success rate was approximately 95.45%. The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful.

  6. Simple skin-stretching device in assisted tension-free wound closure

    PubMed Central

    Cheng, Li-Fu; Lee, Jiunn-Tat; Hsu, Honda; Wu, Meng-Si

    2017-01-01

    Background Numerous conventional wound reconstruction methods such as wound undermining with direct suture, skin graft, and flap surgery can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. Materials and Methods This retrospective study was conducted to evaluate our clinical experiences with 22 large wounds, which involved performing primary closures under a considerable amount of tension by using elastic rubber bands in a skin-stretching technique following a wide undermining procedure. Assessment of the results entailed complete wound healing and related complications. Results All 22 wounds in our study showed fair to good results except for one. The mean success rate was approximately 95.45%. Conclusion The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful. PMID:28195891

  7. Object permanence development in infants with motor handicaps.

    PubMed

    Fetters, L

    1981-03-01

    This study was an investigation of the effects of a motor handicap on the development of object permanence in the young child. Motor abilities were evaluated for 12 infants aged 13 to 29 months. Based on this evaluation, the children were described as manipulators or nonmanipulators in reference to their upper extremity skills. Their stage of object permanence was assessed using traditional and nontraditional assessments. Heart rate and visual tracking were recorded during the nontraditional assessment. Heart rate did not significantly relate to visual fixation or search response. There was, however, a significant difference (p less than .02) between stage achievement with traditional testing and age-appropriate levels. There was no significant difference between the nontraditional assessment and the age-appropriate levels. In addition, there was no significant difference in the development of object permanence between infants described as manipulators and those described as nonmanipulators. The last two findings suggest that infants with motor handicaps may develop object permanence at the expected ages, according to a nontraditional assessment.

  8. A Self-Contained Mapping Closure Approximation for Scalar Mixing

    NASA Technical Reports Server (NTRS)

    He, Guo-Wei; Zhang, Zi-Fan

    2003-01-01

    Scalar turbulence exhibits interplays of coherent structures and random fluctuations over a broad range of spatial and temporal scales. This feature necessitates a probabilistic description of the scalar dynamics, which can be achieved comprehensively by using probability density functions (PDFs). Therefore, the challenge is to obtain the scalar PDFs (Lundgren 1967; Dopazo 1979). Generally, the evolution of a scalar is governed by three dynamical processes: advection, diffusion and reaction. In a PDF approach (Pope 1985), the advection and reaction can be treated exactly but the effect of molecular diffusion has to be modeled. It has been shown (Pope 1985) that the effect of molecular diffusion can be expressed as conditional dissipation rates or conditional diffusions. The currently used models for the conditional dissipation rates and conditional diffusions (Pope 1991) have resisted deduction from the fundamental equations and are unable to yield satisfactory results for the basic test cases of decaying scalars in isotropic turbulence, although they have achieved some success in a variety of individual cases. The recently developed mapping closure approach (Pope 1991; Chen, Chen & Kraichnan 1989; Kraichnan 1990; Klimenko & Pope 2003) provides a deductive method for conditional dissipation rates and conditional di usions, and the models obtained can successfully describe the shape relaxation of the scalar PDF from an initial double delta distribution to a Gaussian one. However, the mapping closure approach is not able to provide the rate at which the scalar evolves. The evolution rate has to be modeled. Therefore, the mapping closure approach is not closed. In this letter, we will address this problem.

  9. [Object permanence in children with neurological and psychomotor disorders].

    PubMed

    Pisaturo, C; Frassoni, S; Borreani, A; Battaglia, F; Meruzzi, B

    1995-06-01

    The aim of this research was to investigate whether the development of object permanence is an available sign of the cognitive development in infants with psychomotor handicaps. Subjects consisted of 5 males, ranging in age from 12 to 33 months, with handicaps as a result of perinatal brain injury. Four were preterm infants. All of the children received psychomotor treatment. Their stage of object permanence was assessed using traditional (B-L) and non traditional test (U-H). (The children's performances on the U-H scales have an "Intrinsic validity"). Four children achieved the first stages of the development of object permanence. The acquisition of object permanence was delayed in comparison with the age-appropriated time, but it may be considered adequate in comparison with the "developmental age" (B-L). One children with severe mental and motor disorders solved no task, the findings suggest that the children with psychomotor handicaps may gain the concept of object permanence and that psychomotor treatment may assist them in the development of the concept. This performance is not age-dependent. So the acquisition of the concept of object permanence may be considered an accurate and sensitive tool for the follow-up of the sensorimotor development in the handicapped children.

  10. Initial experience with the Cardiva Boomerang vascular closure device in diagnostic catheterization.

    PubMed

    Doyle, Brendan J; Godfrey, Michael J; Lennon, Ryan J; Ryan, James L; Bresnahan, John F; Rihal, Charanjit S; Ting, Henry H

    2007-02-01

    The authors studied the safety and efficacy of the Cardiva Boomerang vascular closure device in patients undergoing diagnostic cardiac catheterization. Conventional vascular closure devices (sutures, collagen plugs, or metal clips) have been associated with catastrophic complications including arterial occlusion and foreign body infections; furthermore, they cannot be utilized in patients with peripheral vascular disease or vascular access site in a vessel other than the common femoral artery. The Cardiva Boomerang device facilitates vascular hemostasis without leaving any foreign body behind at the access site, can be used in peripheral vascular disease, and can be used in vessels other than the common femoral artery A total of 96 patients undergoing transfemoral diagnostic cardiac catheterization were included in this study, including 25 (26%) patients with contraindications to conventional closure devices. Femoral angiography was performed prior to deployment of the Cardiva Boomerang closure device. Patients were ambulated at 1 hr after hemostasis was achieved. The device was successfully deployed and hemostasis achieved with the device alone in 95 (99%) patients. The device failed to deploy in 1 (1%) patient and required conversion to standard manual compression. Minor complications were observed in 5 (5%) patients. No patients experienced major complications including femoral hematoma > 4 cm, red blood cell transfusion, retroperitoneal bleed, arteriovenous fistula, pseudoaneurysm, infection, arterial occlusion, or vascular surgery. The Cardiva Boomerang device is safe and effective in patients undergoing diagnostic cardiac catheterization using the transfemoral approach, facilitating early ambulation with low rates of vascular complications. (c) 2006 Wiley-Liss, Inc.

  11. Observations on early and delayed colostomy closure.

    PubMed

    Tade, A O; Salami, B A; Ayoade, B A

    2011-06-01

    Traditional treatment of a variety of colorectal pathologies had included a diverting colostomy that was closed eight or more weeks later during a readmission. The aim of this retrospective study was to determine the outcomes of early colostomy closure and delayed colostomy closure in patients with temporary colostomies following traumatic and non-traumatic colorectal pathologies. In this study early colostomy closure was the closure of a colostomy within three weeks of its construction, while delayed colostomy closure referred to closure after 3 weeks. Complete records of the 37 adult patients who had temporary colostomy constructed and closed between Jan. 1997 December 2003 for various colorectal pathologies were studied. Fourteen patients had early colostomy closure while 23 had delayed closure. In the early colostomy closure group there were 10 men and 4 women. The mean age of the patients was 28yr with a range of 18-65yr. Colostomies were closed 9-18 days after initial colostomy construction. There was no mortality. Morbidity rate 28.6% (4 out of 14). There were two faecal fistulas (14.3%). Twenty-three patients had delayed colostomy closure 8 weeks to 18 months after initial colostomy construction. These were patients unfit for early surgery after initial colostomy construction because of carcinoma, significant weight loss, or sepsis. There was no mortality. Morbidity rate was 26.1%. There were 3 faecal fistulas (13.2%). Outcomes following early colostomy closure and delayed closure were comparable. Patients fit for surgery should have early closure whilst patients who may have compromised health should have delayed closure.

  12. RCRA, superfund and EPCRA hotline training module. Introduction to: Closure/post-closure (40 cfr parts 264/265, subpart g) updated July 1996

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1996-07-01

    The module explains the difference between closure and post-closure. It lists the types of facilities that are subject to closure/post-closures and defines the difference between partial and final closure. It specifies who submits a closure plan and when a closure plan must be submitted, lists the steps in the process, and states the time frame for submittal. It identifies when and how a closure must be amended. It explains the time frame for notification of closure and the deadlines for beginning and completing closure. It specifies which facilities need contingent post-closure plans and lists and the elements of post-closure andmore » cites the requirements. It specifies the conditions and timing for amending a post-closure plan and states who must certify closure/post-closure.« less

  13. Photodynamic therapy with PhotoPoint photosensitiser MV6401, indium chloride methyl pyropheophorbide, achieves selective closure of rat corneal neovascularisation and rabbit choriocapillaris.

    PubMed

    Ciulla, T A; Criswell, M H; Snyder, W J; Small, W

    2005-01-01

    The new photosensitiser PhotoPoint MV6401, indium chloride methyl pyropheophorbide, was assessed as a possible ocular photodynamic therapy agent in a rat model of experimentally induced corneal neovascularisation and in choriocapillaris closure in the rabbit. Optimal drug and light activation parameters were determined. MV6401 (Miravant Pharmaceuticals, Inc, Santa Barbara, CA, USA) was activated at 664 nm using a DD3-0665 (Miravant Systems Inc) 0.5 W diode laser. Corneal neovascularisation in rats was induced using an N-heptanol technique. The evaluated drug dosages, light dosages, and post-injection activation times ranged from 0.01-0.1 micromol/kg, 5-25 J/cm(2), and 10-60 minutes, respectively. The efficacy of MV6401 on normal choriocapillaris and choroidal vessels was evaluated in rabbits with indirect ophthalmoscopy, fundus photography, fluorescein angiography, and histology. In rabbits, the evaluated drug dosages, light dosages, and post-injection activation times ranged from 0.025-0.25 micromol/kg, 3.3-20 J/cm(2), and 10 minutes, respectively. In the rat corneal neovascularisation model, an optimal intravenous drug dosage of 0.075 micromol/kg was activated by a 20 J/cm(2) light dose at 10 minutes after drug administration, the results of which demonstrated early evidence of efficacy in ocular neovascularisation. In rabbits, closure of the normal choriocapillaris was selectively achieved at a drug dosage of 0.15 micromol/kg using light doses from 3.3 to 20 J/cm(2). PhotoPoint MV6401 is a potent photosensitiser that demonstrates both efficacy and selectivity in experimental ocular models.

  14. Cloud condensation nuclei closure study on summer arctic aerosol

    NASA Astrophysics Data System (ADS)

    Martin, M.; Chang, R. Y.-W.; Sierau, B.; Sjogren, S.; Swietlicki, E.; Abbatt, J. P. D.; Leck, C.; Lohmann, U.

    2011-11-01

    We present an aerosol - cloud condensation nuclei (CCN) closure study on summer high Arctic aerosol based on measurements that were carried out in 2008 during the Arctic Summer Cloud Ocean Study (ASCOS) on board the Swedish ice breaker Oden. The data presented here were collected during a three-week time period in the pack ice (>85° N) when the icebreaker Oden was moored to an ice floe and drifted passively during the most biological active period into autumn freeze up conditions. CCN number concentrations were obtained using two CCN counters measuring at different supersaturations. The directly measured CCN number concentration was then compared with a CCN number concentration calculated using both bulk aerosol mass composition data from an aerosol mass spectrometer (AMS) and aerosol number size distributions obtained from a differential mobility particle sizer, assuming κ-Köhler theory, surface tension of water and an internally mixed aerosol. The last assumption was supported by measurements made with a hygroscopic tandem differential mobility analyzer (HTDMA) for particles >70 nm. For the two highest measured supersaturations, 0.73 and 0.41%, closure could not be achieved with the investigated settings concerning hygroscopicity and density. The calculated CCN number concentration was always higher than the measured one for those two supersaturations. This might be caused by a relative larger insoluble organic mass fraction of the smaller particles that activate at these supersaturations, which are thus less good CCN than the larger particles. On average, 36% of the mass measured with the AMS was organic mass. At 0.20, 0.15 and 0.10% supersaturation, closure could be achieved with different combinations of hygroscopic parameters and densities within the uncertainty range of the fit. The best agreement of the calculated CCN number concentration with the observed one was achieved when the organic fraction of the aerosol was treated as nearly water insoluble

  15. Device-less patent foramen ovale closure by radiofrequency thermal energy.

    PubMed

    Walpoth, Nazan B; Habermacher, Kathrin; Moarof, Igal; Watson, Sandy; Wahl, Andreas; Windecker, Stephan; Schönenberger, Christa; Meier, Bernhard

    2008-02-23

    The goal of this study was to assess the feasibility, safety and success of a system which uses radiofrequency energy (RFE) rather than a device for percutaneous closure of patent foramen ovale (PFO). Sixteen patients (10 men, 6 women, mean age 50 years) were included in the study. All of them had a proven PFO with documented right-to-left shunt (RLS) after Valsalva manoeuvre (VM) during transoesophageal echocardiography (TEE). The patients had an average PFO diameter of 6 +/- 2 mm at TEE and an average of 23 +/- 4 microembolic signals (MES) in power M-mode transcranial Doppler sonography (pm-TCD), measured over the middle cerebral artery. An atrial septal aneurysm (ASA) was present in 7 patients (44%). Balloon measurement, performed in all patients, revealed a stretched PFO diameter of 8 +/- 3 mm. In 2 patients (stretched diameter 11 and 14 mm respectively, both with ASA >10 mm), radiofrequency was not applied (PFO too large) and the PFO was closed with an Amplatzer PFO occluder instead. A 6-month follow-up TEE was performed in all patients. There were no serious adverse events during the procedure or at follow-up (12 months average). TEE 6 months after the first RFE procedure showed complete closure of the PFO in 50% of the patients (7/14). Closure appeared to be influenced by PFO diameter, complete closure being achieved in 89% (7/8) with a balloon-stretched diameter < or =7 mm but in none of the patients >7 mm. Only one of the complete closure patients had an ASA. Of the remainder, 4 (29%) had an ASA. Although the PFO was not completely closed in this group, some reduction in the diameter of the PFO and in MES was documented by TEE and pm-TCD with VM. Five of the 7 residual shunt patients received an Amplatzer PFO occluder. Except for one patient with a minimal residual shunt, all showed complete closure of PFO at 6-month follow-up TEE and pm-TCD with VM. The other two refused a closure device. The results confirm that radiofrequency closure of the PFO is safe

  16. Full closure strategic analysis.

    DOT National Transportation Integrated Search

    2014-07-01

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

  17. Crack closure, a literature study

    NASA Astrophysics Data System (ADS)

    Holmgren, M.

    1993-08-01

    In this report crack closure is treated. The state of the art is reviewed. Different empirical formulas for determining the crack closure are compared with each other, and their benefits are discussed. Experimental techniques for determining the crack closure stress are discussed, and some results from fatigue tests are also reported. Experimental data from the literature are reported.

  18. 40 CFR 146.71 - Closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Waste Injection Wells § 146.71 Closure. (a) Closure Plan. The owner or operator of a Class I hazardous waste injection well shall prepare, maintain, and comply with a plan for closure of the well that meets... of material to be used in plugging; (iv) The method of placement of the plugs; (v) Any proposed test...

  19. Predicting permanent and transient protein-protein interfaces.

    PubMed

    La, David; Kong, Misun; Hoffman, William; Choi, Youn Im; Kihara, Daisuke

    2013-05-01

    Protein-protein interactions (PPIs) are involved in diverse functions in a cell. To optimize functional roles of interactions, proteins interact with a spectrum of binding affinities. Interactions are conventionally classified into permanent and transient, where the former denotes tight binding between proteins that result in strong complexes, whereas the latter compose of relatively weak interactions that can dissociate after binding to regulate functional activity at specific time point. Knowing the type of interactions has significant implications for understanding the nature and function of PPIs. In this study, we constructed amino acid substitution models that capture mutation patterns at permanent and transient type of protein interfaces, which were found to be different with statistical significance. Using the substitution models, we developed a novel computational method that predicts permanent and transient protein binding interfaces (PBIs) in protein surfaces. Without knowledge of the interacting partner, the method uses a single query protein structure and a multiple sequence alignment of the sequence family. Using a large dataset of permanent and transient proteins, we show that our method, BindML+, performs very well in protein interface classification. A very high area under the curve (AUC) value of 0.957 was observed when predicted protein binding sites were classified. Remarkably, near prefect accuracy was achieved with an AUC of 0.991 when actual binding sites were classified. The developed method will be also useful for protein design of permanent and transient PBIs. Copyright © 2013 Wiley Periodicals, Inc.

  20. Linearly exact parallel closures for slab geometry

    NASA Astrophysics Data System (ADS)

    Ji, Jeong-Young; Held, Eric D.; Jhang, Hogun

    2013-08-01

    Parallel closures are obtained by solving a linearized kinetic equation with a model collision operator using the Fourier transform method. The closures expressed in wave number space are exact for time-dependent linear problems to within the limits of the model collision operator. In the adiabatic, collisionless limit, an inverse Fourier transform is performed to obtain integral (nonlocal) parallel closures in real space; parallel heat flow and viscosity closures for density, temperature, and flow velocity equations replace Braginskii's parallel closure relations, and parallel flow velocity and heat flow closures for density and temperature equations replace Spitzer's parallel transport relations. It is verified that the closures reproduce the exact linear response function of Hammett and Perkins [Phys. Rev. Lett. 64, 3019 (1990)] for Landau damping given a temperature gradient. In contrast to their approximate closures where the vanishing viscosity coefficient numerically gives an exact response, our closures relate the heat flow and nonvanishing viscosity to temperature and flow velocity (gradients).

  1. Direct bonding in diastema closure--high drama, immediate resolution.

    PubMed

    Blitz, N

    1996-07-01

    Aesthetic rehabilitation in complex diastema closure cases is guided by the principles of proportion. The width to length ratio of the centrals must be pleasing. Achievement of this proper balance dictates treatment. It determines the following: 1) the amount of distal proximal reduction; 2) the decision to completely veneer the incisors vs. just adding to the interproximal; 3) the number of teeth to be treated; 4) the placement and location of naturally occurring prominences and concavities to create the illusion of a narrower tooth. The proper accommodation of these four topics will permit the maintenance or restoration of acceptable dimensions in the centrals. If they are made to appear harmonious then the principle of "golden proportion" (1.6:1:0.6) can be achieved among the centrals, laterals and cuspids. Direct bonding in diastema closure cases allow the dentist and the patient complete control in the formation of that smile. This treatment modality is challenging and ultimately rewarding for the patient and the dentist. At times it enables us to restore form and function and to make our patients whole again not just figuratively but literally.

  2. 27 CFR 26.136 - Affixing closures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

  3. 27 CFR 26.136 - Affixing closures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... OF THE TREASURY ALCOHOL LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

  4. 27 CFR 26.136 - Affixing closures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

  5. 27 CFR 26.136 - Affixing closures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... OF THE TREASURY ALCOHOL LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

  6. 27 CFR 26.136 - Affixing closures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

  7. System for closure of a physical anomaly

    DOEpatents

    Bearinger, Jane P; Maitland, Duncan J; Schumann, Daniel L; Wilson, Thomas S

    2014-11-11

    Systems for closure of a physical anomaly. Closure is accomplished by a closure body with an exterior surface. The exterior surface contacts the opening of the anomaly and closes the anomaly. The closure body has a primary shape for closing the anomaly and a secondary shape for being positioned in the physical anomaly. The closure body preferably comprises a shape memory polymer.

  8. Scalp Wound Closure with K wires: An alternative easier method to scalp wound closure.

    PubMed

    Ramesh, S; Ajik, S

    2012-12-01

    Scalp defects and lacerations present a reconstructive challenge to plastic surgeons. Many methods have been described from the use of skin grafting to rotation flaps. Here we present a method of closure of a contaminated scalp wound with the use of Kirschner wires. In our case, closure of scalp laceration was made possible with the use of 1.4 Kirschner wires and cable tie/ zip tie fasteners. The duration to closure of wound was 10 days. In reconstructing the scalp defect, this method was found to adhere to principles of scalp reconstruction. There were no post operative complications found from the procedure. On initial application on the edge of the wound, tension applied caused the K wires to cut through the wound edge. On replacement of K wires 1cm away from wound edge the procedure was not plagued by any further complication. In conclusion we find scalp closure with Kirschner wires are a simple and effective method for scalp wound closure.

  9. Automated Road Closure Gate

    DOT National Transportation Integrated Search

    2000-05-01

    This report presents the procedures involved in the research, design, construction, and testing of an Automated Road Closure Gate. The current road closure gates used in South Dakota are often unsafe and difficult to operate. This report will assist ...

  10. ROCKET PORT CLOSURE

    DOEpatents

    Mattingly, J.T.

    1963-02-12

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

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios

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

  12. Significant skin-tightening by closure of fractional ablative laser holes.

    PubMed

    Russe, Elisabeth; Purschke, Martin; Limpiangkanan, Wikunda; Farinelli, William A; Wang, Ying; Doukas, Apostolos G; Sakamoto, Fernanda H; Wechselberger, Gottfried; Anderson, Richard Rox

    2018-01-01

    Ablative fractional laser treatment uses thousands of very small laser beam wounds to damage a fraction of the skin, which stimulates tissue remodeling. Each open micro-wound heals without scarring, but the amount of skin tightening achieved is limited. This animal study was performed to test the hypothesis that immediate temporary closure of fractional laser wounds could increase skin tightening after fractional ablative laser treatment. Four adult swine were used for the study; 98 square test sites (3 × 3 cm) were tattooed on the abdomen and flanks of each pig. An ablative fractional Erbium:YAG laser (Sciton Profile, Sciton Inc, Palo Alto, CA) was used to treat the test areas. A laser micro-spot fluence of 375 J/cm 2 was delivered in 150-250 microseconds pulses, resulting in an array of ablation channels extending 1.5 mm deep into the skin, with a spot size of 250 µm, with 10% treatment density. Immediately following laser exposure the resulting holes were closed using a stretched elastic adhesive dressing, which, when applied, recoiled and compressed the diameter of the ablation holes. The compressive dressings were removed after 7 days. This procedure was compared to removing the same amount of skin (10%) mechanically by specially designed 19 gauge coring needles, as well as to the same laser and coring methods without compression closure. Area and shape of test sites were measured by digital photography before and 28 days after treatment. Data analysis included compensation for animal growth, as measured by increase in the area of the untreated control sites. All treated and control sites healed within a week, without scarring evident at 28 days. Laser treatment combined with compressive wound closure caused significant shrinkage at 28 days compared with untreated control sites. The treated skin area was reduced by 11.5% (P = 0.0001). Needle coring with wound closure produced similar, significant shrinkage (8%, P < 0.0021), whereas laser

  13. Angle closure in younger patients.

    PubMed Central

    Chang, Brian M; Liebmann, Jeffrey M; Ritch, Robert

    2002-01-01

    PURPOSE: Angle-closure glaucoma is rare in children and young adults. Only scattered cases associated with specific clinical entities have been reported. We evaluated the findings in patients in our database aged 40 or younger with angle closure. METHODS: Our database was searched for patients with angle closure who were 40 years old or younger. Data recorded included age at initial consultation; age at the time of diagnosis; gender; results of slit-lamp examination, gonioscopy, and ultrasound biomicroscopy (from 1993 onward); clinical diagnosis; and therapy. Patients with previous incisional surgery were excluded, as were patients with anterior chamber proliferative mechanisms leading to angle closure. RESULTS: Sixty-seven patients (49 females, 18 males) met entry criteria. Mean age (+/- SD) at the time of consultation was 34.4 +/- 9.4 years (range, 3-68 years). Diagnoses included plateau iris syndrome (35 patients), iridociliary cysts (8 patients), retinopathy of prematurity (7 patients), uveitis (5 patients), isolated nanophthalmos (3 patients), relative pupillary block (2 patients), Weill-Marchesani syndrome (3 patients), and 1 patient each with Marfan syndrome, miotic-induced angle closure, persistent hyperplastic primary vitreous, and idiopathic lens subluxation. CONCLUSION: The etiology of angle closure in young persons is different from that in the older population and is typically associated with structural or developmental ocular anomalies rather than relative pupillary block. Following laser iridotomy, these eyes should be monitored for recurrent angle closure and the need for additional laser or incisional surgical intervention. PMID:12545694

  14. Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives.

    PubMed

    Zempsky, William T; Zehrer, Cindy L; Lyle, Christopher T; Hedbloom, Edwin C

    2005-09-01

    Our objective was to review and assess the treatment of low-tension wounds and evaluate the cost-effectiveness of wound closure methods. We used a health economic model to estimate cost/closure of adhesive wound closure strips, tissue adhesives and sutures. The model incorporated cost-driving variables: application time, costs and the likelihood and costs of dehiscence and infection. The model was populated with variable estimates derived from the literature. Cost estimates and cosmetic results were compared. Parameter values were estimated using national healthcare and labour statistics. Sensitivity analyses were used to verify the results. Our analysis suggests that adhesive wound closure strips had the lowest average cost per laceration ($7.54), the lowest cost per infected laceration ($53.40) and the lowest cost per laceration with dehiscence ($25.40). The costs for sutures were $24.11, $69.91 and $41.91, respectively; the costs for tissue adhesives were $28.77, $74.68 and $46.68, respectively. The cosmetic outcome for all three treatments was equivalent. We conclude adhesive wound closure strips were both a cost-saving and a cost-effective alternative to sutures and tissue adhesives in the closure of low-tension lacerations.

  15. Occupancy estimation and the closure assumption

    USGS Publications Warehouse

    Rota, Christopher T.; Fletcher, Robert J.; Dorazio, Robert M.; Betts, Matthew G.

    2009-01-01

    1. Recent advances in occupancy estimation that adjust for imperfect detection have provided substantial improvements over traditional approaches and are receiving considerable use in applied ecology. To estimate and adjust for detectability, occupancy modelling requires multiple surveys at a site and requires the assumption of 'closure' between surveys, i.e. no changes in occupancy between surveys. Violations of this assumption could bias parameter estimates; however, little work has assessed model sensitivity to violations of this assumption or how commonly such violations occur in nature. 2. We apply a modelling procedure that can test for closure to two avian point-count data sets in Montana and New Hampshire, USA, that exemplify time-scales at which closure is often assumed. These data sets illustrate different sampling designs that allow testing for closure but are currently rarely employed in field investigations. Using a simulation study, we then evaluate the sensitivity of parameter estimates to changes in site occupancy and evaluate a power analysis developed for sampling designs that is aimed at limiting the likelihood of closure. 3. Application of our approach to point-count data indicates that habitats may frequently be open to changes in site occupancy at time-scales typical of many occupancy investigations, with 71% and 100% of species investigated in Montana and New Hampshire respectively, showing violation of closure across time periods of 3 weeks and 8 days respectively. 4. Simulations suggest that models assuming closure are sensitive to changes in occupancy. Power analyses further suggest that the modelling procedure we apply can effectively test for closure. 5. Synthesis and applications. Our demonstration that sites may be open to changes in site occupancy over time-scales typical of many occupancy investigations, combined with the sensitivity of models to violations of the closure assumption, highlights the importance of properly addressing

  16. Closedure - Mine Closure Technologies Resource

    NASA Astrophysics Data System (ADS)

    Kauppila, Päivi; Kauppila, Tommi; Pasanen, Antti; Backnäs, Soile; Liisa Räisänen, Marja; Turunen, Kaisa; Karlsson, Teemu; Solismaa, Lauri; Hentinen, Kimmo

    2015-04-01

    Closure of mining operations is an essential part of the development of eco-efficient mining and the Green Mining concept in Finland to reduce the environmental footprint of mining. Closedure is a 2-year joint research project between Geological Survey of Finland and Technical Research Centre of Finland that aims at developing accessible tools and resources for planning, executing and monitoring mine closure. The main outcome of the Closedure project is an updatable wiki technology-based internet platform (http://mineclosure.gtk.fi) in which comprehensive guidance on the mine closure is provided and main methods and technologies related to mine closure are evaluated. Closedure also provides new data on the key issues of mine closure, such as performance of passive water treatment in Finland, applicability of test methods for evaluating cover structures for mining wastes, prediction of water effluents from mine wastes, and isotopic and geophysical methods to recognize contaminant transport paths in crystalline bedrock.

  17. Photodynamic therapy with PhotoPoint photosensitiser MV6401, indium chloride methyl pyropheophorbide, achieves selective closure of rat corneal neovascularisation and rabbit choriocapillaris

    PubMed Central

    Ciulla, T A; Criswell, M H; Snyder, W J; Small, W

    2005-01-01

    Aim: The new photosensitiser PhotoPoint MV6401, indium chloride methyl pyropheophorbide, was assessed as a possible ocular photodynamic therapy agent in a rat model of experimentally induced corneal neovascularisation and in choriocapillaris closure in the rabbit. Optimal drug and light activation parameters were determined. Methods: MV6401 (Miravant Pharmaceuticals, Inc, Santa Barbara, CA, USA) was activated at 664 nm using a DD3-0665 (Miravant Systems Inc) 0.5 W diode laser. Corneal neovascularisation in rats was induced using an N-heptanol technique. The evaluated drug dosages, light dosages, and post-injection activation times ranged from 0.01–0.1 μmol/kg, 5–25 J/cm2, and 10–60 minutes, respectively. The efficacy of MV6401 on normal choriocapillaris and choroidal vessels was evaluated in rabbits with indirect ophthalmoscopy, fundus photography, fluorescein angiography, and histology. In rabbits, the evaluated drug dosages, light dosages, and post-injection activation times ranged from 0.025–0.25 μmol/kg, 3.3–20 J/cm2, and 10 minutes, respectively. Results: In the rat corneal neovascularisation model, an optimal intravenous drug dosage of 0.075 μmol/kg was activated by a 20 J/cm2 light dose at 10 minutes after drug administration, the results of which demonstrated early evidence of efficacy in ocular neovascularisation. In rabbits, closure of the normal choriocapillaris was selectively achieved at a drug dosage of 0.15 μmol/kg using light doses from 3.3 to 20 J/cm2. Conclusion: PhotoPoint MV6401 is a potent photosensitiser that demonstrates both efficacy and selectivity in experimental ocular models. PMID:15615758

  18. Quantum-inspired algorithm for estimating the permanent of positive semidefinite matrices

    NASA Astrophysics Data System (ADS)

    Chakhmakhchyan, L.; Cerf, N. J.; Garcia-Patron, R.

    2017-08-01

    We construct a quantum-inspired classical algorithm for computing the permanent of Hermitian positive semidefinite matrices by exploiting a connection between these mathematical structures and the boson sampling model. Specifically, the permanent of a Hermitian positive semidefinite matrix can be expressed in terms of the expected value of a random variable, which stands for a specific photon-counting probability when measuring a linear-optically evolved random multimode coherent state. Our algorithm then approximates the matrix permanent from the corresponding sample mean and is shown to run in polynomial time for various sets of Hermitian positive semidefinite matrices, achieving a precision that improves over known techniques. This work illustrates how quantum optics may benefit algorithm development.

  19. 100-D Ponds closure plan. Revision 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Petersen, S.W.

    1997-09-01

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

  20. 40 CFR 265.404 - Closure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

  1. 40 CFR 265.404 - Closure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

  2. 40 CFR 265.404 - Closure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

  3. 40 CFR 265.404 - Closure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

  4. 40 CFR 265.404 - Closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

  5. On the feasibility of the computational modelling of the endoluminal vacuum-assisted closure of an oesophageal anastomotic leakage

    PubMed Central

    Bellomo, Facundo J.; Rosales, Iván; del Castillo, Luis F.; Sánchez, Ricardo; Turon, Pau

    2018-01-01

    Endoluminal vacuum-assisted closure (E-VAC) is a promising therapy to treat anastomotic leakages of the oesophagus and bowel which are associated with high morbidity and mortality rates. An open-pore polyurethane foam is introduced into the leakage cavity and connected to a device that applies a suction pressure to accelerate the closure of the defect. Computational analysis of this healing process can advance our understanding of the biomechanical mechanisms at play. To this aim, we use a dual-stage finite-element analysis in which (i) the structural problem addresses the cavity reduction caused by the suction and (ii) a new constitutive formulation models tissue healing via permanent deformations coupled to a stiffness increase. The numerical implementation in an in-house code is described and a qualitative example illustrates the basic characteristics of the model. The computational model successfully reproduces the generic closure of an anastomotic leakage cavity, supporting the hypothesis that suction pressure promotes healing by means of the aforementioned mechanisms. However, the current framework needs to be enriched with empirical data to help advance device designs and treatment guidelines. Nonetheless, this conceptual study confirms that computational analysis can reproduce E-VAC of anastomotic leakages and establishes the bases for better understanding the mechanobiology of anastomotic defect healing. PMID:29515846

  6. Closing Schools to Improve Student Achievement: What the Research and Researchers Say. Research Summary

    ERIC Educational Resources Information Center

    American Federation of Teachers (NJ), 2012

    2012-01-01

    School districts close schools for many appropriate reasons. School closure has now evolved into a school improvement strategy. Sometimes the strategy is to close the lowest-performing schools rather than low-enrollment schools and move the students into higher-achieving neighborhood schools. School closure also has become a common strategy to…

  7. Closure of skin incisions in rabbits by laser soldering: I: Wound healing pattern.

    PubMed

    Simhon, David; Brosh, Tamar; Halpern, Marisa; Ravid, Avi; Vasilyev, Tamar; Kariv, Naam; Katzir, Abraham; Nevo, Zvi

    2004-01-01

    Temperature-controlled tissue laser soldering is an innovative sutureless technique awaiting only solid experimental data to become the gold-standard surgical procedure for incision closure. The goals of the current study were: (1) to define the optimal laser soldering conditions, (2) to explore the immediate skin reparative healing events after sealing the wound, and (3) to determine the long-term trajectory of skin wound healing. Skin incisions were generated over rabbit dorsa and were closed using different wound-closure interventions, in three groups: (a) closure, using a temperature-controlled infrared fiberoptic CO2 laser system, employing 47% bovine serum albumin as a solder; (b) wound closure by cyanoacrylate glues; and (c) wound closure by sutures. The reparative outcomes were evaluated macroscopically and microscopically, employing semi-quantitative grading indices. Laser soldering of incisions at T = 65 degrees C emerged as the optimal method achieving immediate wound sealing. This in turn induced accelerated reparative events characterized by a reduced inflammatory reaction, followed by minimal scarring and leading to a fine quality healing. Temperature-controlled laser soldering offers an accelerated wound reparative process with numerous advantages over the conventional methods. Further investigations may reveal additional benefits in the spectrum of advantages that this innovative surgical technology has to offer. This can introduce new scientific insight that will pave the way for clinical use.

  8. DETERMINATION OF OPTIMAL TOXICANT LOADING FOR BIOLOGICAL CLOSURE OF A HAZARDOUS WASTE SITE

    EPA Science Inventory

    Information on Phase I and Phase Il of a multitask effort to achieve biological closure of an abandoned hazardous waste site. aste materials, in the form of buried sludges and lagoon wastes, were examined. ptimal loading levels were evaluated on the basis of biodegradative potent...

  9. Closure of oroantral communications using biodegradable polyurethane foam: a feasibility study.

    PubMed

    Visscher, Susan H; van Minnen, Baucke; Bos, Rudolf R M

    2010-02-01

    The aim of this study was to assess the feasibility of biodegradable polyurethane (PU) foam for closure of oroantral communications (OACs). Ten consecutive patients with OACs (existing <24 hours) were treated with PU foam. Standardized evaluations were performed at 2 weeks and 8 weeks after closure of the OAC. In 5 patients, the OACs were closed successfully without complications. Three patients developed sinusitis, which was conservatively managed with antibiotics in 2 cases. In 1 case the sinus was reopened for irrigation, after which a buccal flap procedure was performed. In 2 patients the OAC recurred and was surgically closed with a buccal flap after thorough irrigation. In this feasibility study, closure was achieved in 7 of the 10 patients without further surgical intervention. Complications of the procedure using PU foam may be related to the fit of the foam in the socket and the size of the perforation. In general, closure of OACs with biodegradable polyurethane foam is feasible and has the potential to spare a large number of patients with OACs a surgical procedure. Furthermore, in case the treatment with PU foam fails to close the OAC, the attending physician can always fall back on the standard surgical procedure. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Detecting the limits of bronchial closure methods in an animal model.

    PubMed

    Tezel, C; Urek, S; Keles, M; Kiral, H; Koşar, A; Dudu, C; Arman, B

    2006-04-01

    Bronchopleural fistula is a serious complication of major lung resections that may lead to mortality. An experimental animal model was designed to find out the safest bronchial closure method by comparing leakage rates under pressure. The tracheobronchial trees of 50 freshly dead sheep were prepared for either manual closure or closure with a stapler. After left pneumonectomy, the specimens were divided into five groups (n = 10); 3/0 Premilene suture was used with two "u" sutures + interrupted sutures in Group I; in Group II, 3/0 Premilene sutures with continuous horizontal mattress + over-over continuous sutures were used. In Group III and IV the same techniques were used with 3/0 Vicryl. A stapler was used in Group V. Specimens were intubated with an endotracheal tube, connected to a sphygmomanometer, and subsequently positioned under water. The pressure level at which we detected air bubbles indicated the limits of the technique. The median leakage pressure resistance was significantly lower in Group III (135 mm Hg) ( P = 0.001). The best results were achieved by using the continuous horizontal mattress + over-over continuous suture technique. No statistical significance difference was found between the stapler group, Groups I, II, and IV in terms of median leakage pressures. This trial suggests that manual suture closure using an appropriate technique and monofilament materials is as safe as the stapler.

  11. Pressure-tight closure for thermoelements

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1937-06-14

    The thermoelements were arranged in a pressure-tight housing for measuring temperatures on the inside of high-pressure hydrogenation equipment. Should the housing ever leak due to failure of the material or the grinding action of the high sand content of the coal paste, the stall was liable to be set on fire. If, in an installation protected in this manner, an element housing should leak, the pressure tight closure at one end of the housing prevented an escape of the gas and product and the stall could continue to run without danger. The final form of this closure was discussed inmore » detail in this report. In the development of this closure, particular value was attached to a compact construction. In the sealing for a 30-mm high pressure tube, four steel and four constantan wires were insulated and arranged pressure-tight. Each of the three fillers had a different purpose. The hard-rubber insert took the surface pressure, the rubber stopper provided a seal and the cast gypsum provided protection against heat should hot gas or product reach the closure in case of a leaky housing. Two drawings were given showing the thermoelement-closure, and the final form of the closure. The report discussed methods of evacuating from the thermohousings any accumulations of condensed water, which could damage insulation, or hydrogen, which continually diffused in small amounts during operation and which could attack the iron elements of the thermocouples. The pressure-tight closures for thermoelements had been successful at preventing fires due to leakage for more than nine months of operation. 2 sketches.« less

  12. 50 CFR 648.161 - Closures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Bluefish Fishery § 648.161 Closures. (a) EEZ closure. NMFS shall close the EEZ to fishing for bluefish by... dealer permit holders that no commercial quota is available for landing bluefish in that state. ...

  13. Percutaneous Patent Ductus Arteriosus (PDA) Closure in Very Preterm Infants: Feasibility and Complications.

    PubMed

    Backes, Carl H; Cheatham, Sharon L; Deyo, Grace M; Leopold, Scott; Ball, Molly K; Smith, Charles V; Garg, Vidu; Holzer, Ralf J; Cheatham, John P; Berman, Darren P

    2016-02-12

    Percutaneous closure of patent ductus arteriosus (PDA) in term neonates is established, but data regarding outcomes in infants born very preterm (<32 weeks of gestation) are minimal, and no published criteria exist establishing a minimal weight of 4 kg as a suitable cutoff. We sought to analyze outcomes of percutaneous PDA occlusion in infants born very preterm and referred for PDA closure at weights <4 kg. Retrospective analysis (January 2005-January 2014) was done at a single pediatric center. Procedural successes and adverse events were recorded. Markers of respiratory status (need for mechanical ventilation) were determined, with comparisons made before and after catheterization. A total of 52 very preterm infants with a median procedural weight of 2.9 kg (range 1.2-3.9 kg) underwent attempted PDA closure. Twenty-five percent (13/52) of infants were <2.5 kg. Successful device placement was achieved in 46/52 (88%) of infants. An adverse event occurred in 33% of cases, with an acute arterial injury the most common complication. We observed no association between weight at time of procedure and the risk of an adverse event. No deaths were attributable to the PDA closure. Compared to precatheterization trends, percutaneous PDA closure resulted in improved respiratory status, including less exposure to mechanical ventilation (mixed effects logistic model, P<0.01). Among infants born very preterm, percutaneous PDA closure at weights <4 kg is generally safe and may improve respiratory health, but risk of arterial injury is noteworthy. Randomized clinical trials are needed to assess clinically relevant differences in outcomes following percutaneous PDA closure versus alternative (surgical ligation) management strategies. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  14. Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure.

    PubMed

    Roushdy, Alaa; Abd El Razek, Yasmeen; Mamdouh Tawfik, Ahmed

    2018-01-01

    To determine anatomic and hemodynamic echocardiographic predictors for patent ductus arteriosus (PDA) device vs coil closure. Seventy-six patients who were referred for elective transcatheter PDA closure were enrolled in the study. All patients underwent full echocardiogram including measurement of the PDA pulmonary end diameter, color flow width and extent, peak and end-diastolic Doppler gradients across the duct, diastolic flow reversal, left atrial dimensions and volume, left ventricular sphericity index, and volumes. The study group was subdivided into 2 subgroups based on the mode of PDA closure whether by coil (n = 42) or device (n = 34). Using univariate analysis there was a highly significant difference between the 2 groups as regard the pulmonary end diameter measured in both the suprasternal and parasternal short-axis views as well as the color flow width and color flow extent (P < .0001). The device closure group had statistically significant higher end-systolic and end-diastolic volumes indexed, left atrial volume, and diastolic flow reversal. Receiver operating characteristic curve analysis showed a pulmonary end diameter cutoff point from the suprasternal view > 2.5 mm and from parasternal short-axis view > 2.61 mm to have the highest balanced sensitivity and specificity to predict the likelihood for device closure (AUC 0.971 and 0.979 respectively). The pulmonary end diameter measured from the suprasternal view was the most independent predictor of device closure. The selection between PDA coil or device closure can be done on the basis of multiple anatomic and hemodynamic echocardiographic variables. © 2017 Wiley Periodicals, Inc.

  15. Mitigation of infectious disease at school: targeted class closure vs school closure.

    PubMed

    Gemmetto, Valerio; Barrat, Alain; Cattuto, Ciro

    2014-12-31

    School environments are thought to play an important role in the community spread of infectious diseases such as influenza because of the high mixing rates of school children. The closure of schools has therefore been proposed as an efficient mitigation strategy. Such measures come however with high associated social and economic costs, making alternative, less disruptive interventions highly desirable. The recent availability of high-resolution contact network data from school environments provides an opportunity to design models of micro-interventions and compare the outcomes of alternative mitigation measures. We model mitigation measures that involve the targeted closure of school classes or grades based on readily available information such as the number of symptomatic infectious children in a class. We focus on the specific case of a primary school for which we have high-resolution data on the close-range interactions of children and teachers. We simulate the spread of an influenza-like illness in this population by using an SEIR model with asymptomatics, and compare the outcomes of different mitigation strategies. We find that targeted class closure affords strong mitigation effects: closing a class for a fixed period of time--equal to the sum of the average infectious and latent durations--whenever two infectious individuals are detected in that class decreases the attack rate by almost 70% and significantly decreases the probability of a severe outbreak. The closure of all classes of the same grade mitigates the spread almost as much as closing the whole school. Our model of targeted class closure strategies based on readily available information on symptomatic subjects and on limited information on mixing patterns, such as the grade structure of the school, shows that these strategies might be almost as effective as whole-school closure, at a much lower cost. This may inform public health policies for the management and mitigation of influenza

  16. RCT of a Mentoring and Skills Group Program: Placement and Permanency Outcomes for Foster Youth

    PubMed Central

    Culhane, Sara E.; Garrido, Edward; Knudtson, Michael D.

    2012-01-01

    OBJECTIVE: To examine the impact of a mentoring and skills group intervention for preadolescent children in foster care on placement stability and permanence at 1-year postintervention. METHODS: A randomized controlled trial was conducted with 9- to 11-year-old children who were maltreated and placed in foster care (n = 54 control; n = 56 intervention). State child welfare records provided information on number of placement changes, placement in residential treatment, and case closure (ie, permanency). Rates of adoption and reunification were also examined. Analysis was by intention to treat. RESULTS: After controlling for baseline functioning and preintervention placement history, intervention youth were 71% less likely to be placed in residential treatment (odds ratio [OR] = 0.29, 95% confidence interval [CI] 0.09–0.98). There were no significant treatment differences in predicting placement changes or permanency for the total sample. Among a subsample of children living in nonrelative foster care at baseline, intervention youth had 44% fewer placement changes (incidence ratio = 0.56, 95% CI 0.34–0.93), were 82% less likely to be placed in a residential treatment center (OR = 0.18, 95% CI 0.03–0.96), and were 5 times more likely to have attained permanency at 1 year postintervention (OR = 5.14, 95% CI 1.55–17.07). More intervention youth had reunified 1-year postintervention [χ2(1, N = 78) = 3.99; P < .05], and the pattern of findings suggested that intervention youth had higher rates of adoption. A significant interaction [χ2(1, N = 110) = 5.43; P = .02] demonstrated that the intervention attenuated the impact of baseline behavior problems on placement changes. CONCLUSIONS: The findings suggest that participation in a 9-month mentoring and skills group intervention leads to greater placement stability and permanence, especially for children in nonrelative foster care. PMID:22689870

  17. Laceration of the Common Femoral Artery Following Deployment of the StarClose{sup TM} Vascular Closure System

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gonsalves, Michael, E-mail: drmag1975@gmail.com; Walkden, Miles, E-mail: rwalkden@nhs.net; Belli, Anna Maria, E-mail: Anna.Belli@stgeorges.nhs.u

    2008-07-15

    StarClose is a novel arterial closure device which achieves hemostasis, following arteriotomy, via a nitinol clip deployed on the outer arterial wall. Since its introduction to the market, several studies have shown StarClose to be both safe and effective, with few major complications encountered. We report a case of common femoral artery laceration following deployment of the StarClose vascular closure system. We conclude that the injury occurred secondary to intravascular misplacement of the nitinol clip.

  18. Anatomical approach to permanent His bundle pacing: Optimizing His bundle capture.

    PubMed

    Vijayaraman, Pugazhendhi; Dandamudi, Gopi

    2016-01-01

    Permanent His bundle pacing is a physiological alternative to right ventricular pacing. In this article we describe our approach to His bundle pacing in patients with AV nodal and intra-Hisian conduction disease. It is essential for the implanters to understand the anatomic variations of the His bundle course and its effect on the type of His bundle pacing achieved. We describe several case examples to illustrate our anatomical approach to permanent His bundle pacing in this article. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. School closure as an influenza mitigation strategy: how variations in legal authority and plan criteria can alter the impact.

    PubMed

    Potter, Margaret A; Brown, Shawn T; Cooley, Phillip C; Sweeney, Patricia M; Hershey, Tina B; Gleason, Sherrianne M; Lee, Bruce Y; Keane, Christopher R; Grefenstette, John; Burke, Donald S

    2012-11-14

    States' pandemic influenza plans and school closure statutes are intended to guide state and local officials, but most faced a great deal of uncertainty during the 2009 influenza H1N1 epidemic. Questions remained about whether, when, and for how long to close schools and about which agencies and officials had legal authority over school closures. This study began with analysis of states' school-closure statutes and pandemic influenza plans to identify the variations among them. An agent-based model of one state was used to represent as constants a population's demographics, commuting patterns, work and school attendance, and community mixing patterns while repeated simulations explored the effects of variations in school closure authority, duration, closure thresholds, and reopening criteria. The results show no basis on which to justify statewide rather than school-specific or community-specific authority for school closures. Nor do these simulations offer evidence to require school closures promptly at the earliest stage of an epidemic. More important are criteria based on monitoring of local case incidence and on authority to sustain closure periods sufficiently to achieve epidemic mitigation. This agent-based simulation suggests several ways to improve statutes and influenza plans. First, school closure should remain available to state and local authorities as an influenza mitigation strategy. Second, influenza plans need not necessarily specify the threshold for school closures but should clearly define provisions for early and ongoing local monitoring. Finally, school closure authority may be exercised at the statewide or local level, so long as decisions are informed by monitoring incidence in local communities and schools.

  20. Ethnic differences in primary angle-closure glaucoma.

    PubMed

    Yip, Jennifer L Y; Foster, Paul J

    2006-04-01

    Observational studies from different countries have shown that populations of East Asian origin have a higher frequency of primary angle-closure glaucoma compared with those of European or African descent. As half of all cases of glaucoma reside in Asia, and with primary angle-closure glaucoma carrying a higher rate of visual morbidity, primary angle-closure glaucoma poses an important public health problem; however, the inconsistent use of techniques and definitions to detect and diagnose primary angle-closure glaucoma has resulted in difficulties in interpreting the accuracy and comparability of such data. Therefore it is important to review these studies in the light of a consistent classification system. There are increasing reports that support previous findings on the incidence and prevalence of primary angle-closure glaucoma in different ethnic groups. There have also been further investigations into the mechanism and natural history of primary angle-closure glaucoma in Asian populations. International investigations into primary angle-closure glaucoma have demonstrated reproducible evidence that ethnic variations do exist. Cross-sectional studies in this area have also suggested that differences in anterior chamber depth, together with its association with peripheral anterior synechiae, may be part of the underlying mechanism behind these differences. The ideas generated need to be further explored with longitudinal data of changes in anterior chamber depth and peripheral anterior synechiae in different populations. The detailed mechanisms behind the development of angle-closure and primary angle-closure glaucoma should also be investigated.

  1. ASD Closure in Structural Heart Disease.

    PubMed

    Wiktor, Dominik M; Carroll, John D

    2018-04-17

    While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up. With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published. While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.

  2. The Development of Object Permanence in Children with Intellectual Disability, Physical Disability, Autism, and Blindness

    ERIC Educational Resources Information Center

    Bruce, Susan; Muhammad, Zayyad

    2009-01-01

    This article presents a review of the literature on object permanence with an emphasis on research on children with severe disabilities. Object permanence is the realisation that objects continue to exist in time and place even when they are no longer visible. This understanding is achieved across Stages IV-VI of Piaget's Sensorimotor Period.…

  3. Rational design of the exchange-spring permanent magnet.

    PubMed

    Jiang, J S; Bader, S D

    2014-02-12

    The development of the optimal exchange-spring permanent magnet balances exchange hardening, magnetization enhancement, and the feasibility of scalable fabrication. These requirements can be met with a rational design of the microstructural characteristics. The magnetization processes in several model exchange-spring structures with different geometries have been analyzed with both micromagnetic simulations and nucleation theory. The multilayer geometry and the soft-cylinders-in-hard-matrix geometry have the highest achievable figure of merit (BH)max, while the soft-spheres-in-hard-matrix geometry has the lowest upper limit for (BH)max. The cylindrical geometry permits the soft phase to be larger and does not require strict size control. Exchange-spring permanent magnets based on the cylindrical geometry may be amenable to scaled-up fabrication.

  4. Patent ductus arteriosus closure using an Amplatzer™ ventricular septal defect closure device

    PubMed Central

    Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

    2013-01-01

    The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs. PMID:24294051

  5. [Periprocedural and late complications after percutaneous closure of patent foramen ovale: a single centre experience].

    PubMed

    Węglarz, Przemysław; Konarska Kuszewska, Ewa; Spisak Borowska, Katarzyna; Machowski, Jerzy; Drzewiecka-Gerber, Agnieszka; Kuszewski, Piotr; Jackson, Christopher L; Opala, Grzegorz; Trusz Gluza, Maria

    2012-01-01

    Patent foramen ovale (PFO) is a potential risk factor for ischaemic stroke in young individuals. An interventional method of secondary stroke prevention in PFO patients is its percutaneous closure. To assess safety and effectiveness (i.e. lack of residual shunt) of percutaneous PFO closure in patients with history of cryptogenic cerebrovascular event. 149 patients (56 men/93 women), aged 39 ± 12 years, underwent percutaneous PFO closure. The implantation was performed under local anaesthesia, guided by trans-oesophageal echocardiography (TEE) and fluoroscopy. Follow-up trans-thoracic echocardiography (TTE) was performed at 1 month and follow-up TEE at 6-months. In cases of residual shunt, additional TEE was performed after ensuing 6 months. Effective PFO closure (no residual shunt) was achieved in 91.3% patients at 6 months and 95.3% patients at 12 months. In 2 patients transient atrial fibrillation was observed during the procedure. In 2 patients, a puncture site haematoma developed and in 1 patient superficial thrombophlebitis was noted. In 1 patient a small pericardial effusion was observed, which resolved at day 3 post-procedurally, after administration of non-steroidal anti-inflammatory drugs. Percutaneous PFO closure seems to be a safe procedure when performed in a centre with adequate expertise with regard to these procedures.

  6. Endoscopic repair of an injured internal carotid artery utilizing femoral endovascular closure devices.

    PubMed

    Van Rompaey, Jason; Bowers, Greg; Radhakrishnan, Jay; Panizza, Benedict; Solares, C Arturo

    2014-06-01

    Injury to the internal carotid artery is a feared complication of endoscopic endonasal surgery of the skull base. Such an event, although rare, is associated with high morbidity and mortality. Even if bleeding is controlled, permanent neurological defects frequently persist. Many techniques have been developed to manage internal carotid artery rupture with varying degrees of success. The purpose of this study was to explore endoscopic management of arterial damage with endovascular closure devices used for a femoral arteriotomy. The ability to remotely suture a damaged artery permits the possible adaptation of this technology in managing endoscopic arterial complications. Technical note. After the creation of an endoscopic endonasal corridor in a cadaveric specimen, an arteriotomy was created at the cavernous portion of the internal carotid artery. The Angio-Seal, StarClose, and MynxGrip vascular closure devices were utilized under endoscopic guidance to repair the arteriotomy. Angiography was then done on a cadaver sutured with the StarClose. Both the Angio-Seal and StarClose were deployed quickly and appeared to provide sufficient closure of the arteriotomy. The Angio-Seal required the use of a guidewire and was longer to deploy when compared with the StarClose. The StarClose deployment was quick and facile. The MynxGrip also deployed without difficulty. The Angio-Seal and StarClose systems were both successfully deployed utilizing an endoscopic endonasal approach. The MynxGrip was the easiest to deploy and has the greatest potential to be of benefit in this application. Further studies with hemodynamic models are required to properly assess the appropriateness in this setting. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  7. A clinical investigation of force delivery systems for orthodontic space closure.

    PubMed

    Nightingale, C; Jones, S P

    2003-09-01

    To investigate the force retention, and rates of space closure achieved by elastomeric chain and nickel titanium coil springs. Randomized clinical trial. Eastman Dental Hospital, London and Queen Mary's University Hospital, Roehampton, 1998-2000. Twenty-two orthodontic patients, wearing the pre-adjusted edgewise appliance undergoing space closure in opposing quadrants, using sliding mechanics on 0.019 x 0.025-inch posted stainless steel archwires. Medium-spaced elastomeric chain [Durachain, OrthoCare (UK) Ltd., Bradford, UK] and 9-mm nickel titanium coil springs [OrthoCare (UK) Ltd.] were placed in opposing quadrants for 15 patients. Elastomeric chain only was used in a further seven patients. The initial forces on placement and residual forces at the subsequent visit were measured with a dial push-pull gauge [Orthocare (UK) Ltd]. Study models of eight patients were taken before and after space closure, from which measurements were made to establish mean space closure. The forces were measured in grammes and space closure in millimetres. Fifty-nine per cent (31/53) of the elastomeric sample maintained at least 50 per cent of the initial force over a time period of 1-15 weeks. No sample lost all its force, and the mean loss was 47 per cent (range: 0-76 per cent). Nickel titanium coil springs lost force rapidly over 6 weeks, following that force levels plateaued. Forty-six per cent (12/26) maintained at least 50 per cent of their initial force over a time period of 1-22 weeks, and mean force loss was 48 per cent (range: 12-68 per cent). The rate of mean weekly space closure for elastomeric chain was 0.21 mm and for nickel titanium coil springs 0.26 mm. There was no relationship between the initial force applied and rate of space closure. None of the sample failed during the study period giving a 100 per cent response rate. In clinical use, the force retention of elastomeric chain was better than previously concluded. High initial forces resulted in high force decay

  8. The Question of Decalage Between Object Permanence and Person Permanence

    ERIC Educational Resources Information Center

    And Others; Jackson, Elaine

    1978-01-01

    Presents a study of decalage between object permanence and person permanence. Decalage was influenced by environmental as well as stimulus factors with infants tested between 6- and 81/4-months/of-age. (BD)

  9. Essure Permanent Birth Control

    MedlinePlus

    ... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  10. Umbilical hernia following gastroschisis closure: a common event?

    PubMed

    Tullie, L G C; Bough, G M; Shalaby, A; Kiely, E M; Curry, J I; Pierro, A; De Coppi, P; Cross, K M K

    2016-08-01

    To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007-2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. Fifty-three patients were identified, gestation 36 weeks (31-38), birth weight 2.39 kg (1-3.52) and 23 (43 %) were male. Fourteen patients (26 %) underwent sutureless closure: 12 primary, 2 staged; and 39 (74 %) sutured closure: 19 primary, 20 staged. Sutured closure was interrupted sutures in 24 patients, 11 pursestring and 4 not specified. Fifty patients were followed-up over 53 months (10-101) and 22 (44 %) developed umbilical hernias. There was a significantly greater hernia incidence following sutureless closure (p = 0.0002). In sutured closure, pursestring technique had the highest hernia rate (64 %). Seven patients underwent operative hernia closure; three secondary to another procedure. Seven patients had their hernias resolve. One patient was lost to follow-up and seven remain under observation with no reported complications. There is a significant umbilical hernia incidence following sutureless and pursestring sutured gastroschisis closure. This has not led to complications and the majority have not undergone repair.

  11. On a neutral particle with permanent magnetic dipole moment in a magnetic medium

    NASA Astrophysics Data System (ADS)

    Bakke, K.; Salvador, C.

    2018-03-01

    We investigate quantum effects that stem from the interaction of a permanent magnetic dipole moment of a neutral particle with an electric field in a magnetic medium. We consider a long non-conductor cylinder that possesses a uniform distribution of electric charges and a non-uniform magnetization. We discuss the possibility of achieving this non-uniform magnetization from the experimental point of view. Besides, due to this non-uniform magnetization, the permanent magnetic dipole moment of the neutral particle also interacts with a non-uniform magnetic field. This interaction gives rise to a linear scalar potential. Then, we show that bound states solutions to the Schrödinger-Pauli equation can be achieved.

  12. Preliminary experience with a new device for delayed sternal closure strategy in cardiac surgery.

    PubMed

    Santini, Francesco; Onorati, Francesco; Telesca, Mariassunta; Faggian, Giuseppe; Mazzucco, Alessandro

    2012-06-01

    Open chest management with delayed sternal closure (DSC) is a valuable strategy in the management of patients with postcardiotomy hemodynamic instability or severe coagulopathy. The conventional extemporized material available for off-label sternal stenting however may limit its efficacy. We evaluated outcomes of patients with refractory severe postcardiotomy cardiogenic shock (SPCCS) treated with DSC using a novel temporary sternal spreader (NTSS) which allows myocardial recovery by progressive controlled approximation of the sternal edges. Seven patients (4 male, mean age 66.5 ± 5 years) with refractory SPCCS showing acute hemodynamic instability at sternal closure, were implanted with the NTSS, consisting of stainless-steel branches linked to 2 diverging plates of polyether-ether ketone, whose progressive opening/closing mechanism can be controlled from outside the chest with a rotating steel wire. The sternal wound was closed by an elastic membrane to achieve a sterile field. Swan-Ganz monitoring was employed, and clinical outcomes evaluated. The device was successfully implanted in all patients without device-related complications or failures. Progressive approximation of sternal edges, titrated on cardiac index values, was successfully completed allowing subsequent uneventful sternal closure in all. Mean time from SPCCS to sternal closure was 70 ± 21 hours. No patient developed infective complications or late hemodynamic instability after device removal and sternal closure. One patient (14%) died of multiorgan failure on postoperative day 9. Despite the limited number of patients enrolled, the NTSS proved safe and effective in allowing complete myocardial recovery after SPCCS, avoiding hemodynamic instability related to abrupt sternal closure, with no occurrence of infective complications.

  13. Multi-Material Closure Model for High-Order Finite Element Lagrangian Hydrodynamics

    DOE PAGES

    Dobrev, V. A.; Kolev, T. V.; Rieben, R. N.; ...

    2016-04-27

    We present a new closure model for single fluid, multi-material Lagrangian hydrodynamics and its application to high-order finite element discretizations of these equations [1]. The model is general with respect to the number of materials, dimension and space and time discretizations. Knowledge about exact material interfaces is not required. Material indicator functions are evolved by a closure computation at each quadrature point of mixed cells, which can be viewed as a high-order variational generalization of the method of Tipton [2]. This computation is defined by the notion of partial non-instantaneous pressure equilibration, while the full pressure equilibration is achieved bymore » both the closure model and the hydrodynamic motion. Exchange of internal energy between materials is derived through entropy considerations, that is, every material produces positive entropy, and the total entropy production is maximized in compression and minimized in expansion. Results are presented for standard one-dimensional two-material problems, followed by two-dimensional and three-dimensional multi-material high-velocity impact arbitrary Lagrangian–Eulerian calculations. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.« less

  14. Multi-Material Closure Model for High-Order Finite Element Lagrangian Hydrodynamics

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dobrev, V. A.; Kolev, T. V.; Rieben, R. N.

    We present a new closure model for single fluid, multi-material Lagrangian hydrodynamics and its application to high-order finite element discretizations of these equations [1]. The model is general with respect to the number of materials, dimension and space and time discretizations. Knowledge about exact material interfaces is not required. Material indicator functions are evolved by a closure computation at each quadrature point of mixed cells, which can be viewed as a high-order variational generalization of the method of Tipton [2]. This computation is defined by the notion of partial non-instantaneous pressure equilibration, while the full pressure equilibration is achieved bymore » both the closure model and the hydrodynamic motion. Exchange of internal energy between materials is derived through entropy considerations, that is, every material produces positive entropy, and the total entropy production is maximized in compression and minimized in expansion. Results are presented for standard one-dimensional two-material problems, followed by two-dimensional and three-dimensional multi-material high-velocity impact arbitrary Lagrangian–Eulerian calculations. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.« less

  15. Duct closure

    DOEpatents

    Vowell, Kennison L.

    1987-01-01

    A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

  16. Three point-advancement closure for skin defects.

    PubMed

    Tamir, G; Birkby, C S; Berg, D

    1999-10-01

    Circular skin defects are common following Mohs' surgery. Traditional closure (primary, flap, or graft) may involve extensive surgery. Multidirectional advancement closures such as the purse-string closure have been advocated as another useful tool in such cases. To describe a variation on purse-string closure that, in certain cases, is an excellent alternative to other reconstructions, and will provide good cosmetic and functional outcome. A three-point anchoring suture is placed after undermining to advance the surrounding tissue toward the centre, creating a "Mercedes Benz" or tripod closure following removal of "dog-ears." Circular wounds in designated areas can be more easily closed, creating well-tolerated, favourable scars. Large wounds may be closed with the advantage of avoidance of larger flaps, of decreased wound healing compared to second intention, and of minimizing removal of healthy tissue. An initial trial of closure with this method does not limit subsequent use of other repairs should it be less than satisfactory.

  17. Short-term safety and efficacy of left atrial appendage closure with the WATCHMAN device in patients with small left atrial appendage ostia.

    PubMed

    Venkataraman, Ganesh; Strickberger, S Adam; Doshi, Shephal; Ellis, Christopher R; Lakkireddy, Dhanunjaya; Whalen, S Patrick; Cuoco, Frank

    2018-01-01

    Left atrial appendage (LAA) closure with the WATCHMAN device, according to FDA labelling, is recommended in patients with a maximal LAA ostial width between 17 and 31 mm. The safety and efficacy of LAA closure in patients with a maximal LAA ostial width < 17 mm has not been evaluated. The goal of this study was to determine the acute and short-term safety and efficacy of LAA closure with the WATCHMAN device in patients with a maximal LAA ostial width < 17 mm. Thirty-two consecutive patients with a maximal LAA ostial width < 17 mm as determined by a screening transesophageal echocardiogram (TEE) underwent LAA closure with the WATCHMAN device between March 2015 and November 2016 at five medical centers, and were included in this study. Mean age, body mass index (BMI), and CHA 2 DS 2 -VASC score were 70.8 ± 8.6 years, 29.3 ± 6.5 kg/m 2 , and 3.9 ±1.2, respectively. At the screening TEE, mean maximal LAA ostial width and depth were 15.6 ± 0.6 mm (range 14-16) and 23.2 ± 4.5 mm (range 13-31), respectively. Successful LAA closure with the WATCHMAN device was achieved in 31 of 32 patients (97%), with no major complications. TEE performed 45 days after LAA closure demonstrated no peridevice leak > 5 mm and no device related thrombi. Warfarin was discontinued in all 31 patients 45 days after LAA closure. LAA closure with the WATCHMAN device can be successfully and safely achieved in patients with a maximal LAA ostial width < 17 mm. © 2017 Wiley Periodicals, Inc.

  18. Use of a fibrin adhesive for conjunctival closure in trabeculectomy.

    PubMed

    Martinez-de-la-Casa, José M; Rayward, Omar; Saenz-Frances, Federico; Mendez, Carmen; Bueso, Enrique Santos; Garcia-Feijoo, Julián

    2013-08-01

    To assess the safety and efficacy of a fibrin tissue adhesive (Tissucol Duo(®) ) used to close the conjunctiva in trabeculectomy. A nonrandomized prospective study including 57 patients with chronic simple glaucoma who underwent trabeculectomy surgery. All the trabeculectomies were conducted by the same surgeon using the same surgical technique with the exception that conjunctival closure was achieved by either running Nylon 10/0 suture (n = 29) or using the fibrin glue (n = 28). Preoperative and postoperative data were obtained on intraocular pressure (IOP), number of hypotensive medications used, self-reported discomfort and complications arising during and after surgery. No differences were detected between the two patient groups regarding the intraocular pressure reduction achieved during follow-up. In the first 2 weeks of follow-up, reported discomfort assessed using a visual analogue scale was significantly lower in the Tissucol Duo(®) group. Two patients in the Tissucol Duo(®) group suffered conjunctival dehiscence and suturing was required at 24 hours postsurgery. Remaining complications were similar in the two groups. The use of Tissucol Duo(®) seems to be a safe and efficient option for conjunctival closure in trabeculectomy that simplifies the surgical procedure and reduces patient discomfort in the immediate postoperative period. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  19. Anterior Segment Imaging for Angle Closure.

    PubMed

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

    2018-04-01

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

  20. A chiral-based magnetic memory device without a permanent magnet

    PubMed Central

    Dor, Oren Ben; Yochelis, Shira; Mathew, Shinto P.; Naaman, Ron; Paltiel, Yossi

    2013-01-01

    Several technologies are currently in use for computer memory devices. However, there is a need for a universal memory device that has high density, high speed and low power requirements. To this end, various types of magnetic-based technologies with a permanent magnet have been proposed. Recent charge-transfer studies indicate that chiral molecules act as an efficient spin filter. Here we utilize this effect to achieve a proof of concept for a new type of chiral-based magnetic-based Si-compatible universal memory device without a permanent magnet. More specifically, we use spin-selective charge transfer through a self-assembled monolayer of polyalanine to magnetize a Ni layer. This magnitude of magnetization corresponds to applying an external magnetic field of 0.4 T to the Ni layer. The readout is achieved using low currents. The presented technology has the potential to overcome the limitations of other magnetic-based memory technologies to allow fabricating inexpensive, high-density universal memory-on-chip devices. PMID:23922081

  1. A chiral-based magnetic memory device without a permanent magnet.

    PubMed

    Ben Dor, Oren; Yochelis, Shira; Mathew, Shinto P; Naaman, Ron; Paltiel, Yossi

    2013-01-01

    Several technologies are currently in use for computer memory devices. However, there is a need for a universal memory device that has high density, high speed and low power requirements. To this end, various types of magnetic-based technologies with a permanent magnet have been proposed. Recent charge-transfer studies indicate that chiral molecules act as an efficient spin filter. Here we utilize this effect to achieve a proof of concept for a new type of chiral-based magnetic-based Si-compatible universal memory device without a permanent magnet. More specifically, we use spin-selective charge transfer through a self-assembled monolayer of polyalanine to magnetize a Ni layer. This magnitude of magnetization corresponds to applying an external magnetic field of 0.4 T to the Ni layer. The readout is achieved using low currents. The presented technology has the potential to overcome the limitations of other magnetic-based memory technologies to allow fabricating inexpensive, high-density universal memory-on-chip devices.

  2. Analytic closures for M1 neutrino transport

    DOE PAGES

    Murchikova, E. M.; Abdikamalov, E.; Urbatsch, T.

    2017-04-25

    Carefully accounting for neutrino transport is an essential component of many astrophysical studies. Solving the full transport equation is too expensive for most realistic applications, especially those involving multiple spatial dimensions. For such cases, resorting to approximations is often the only viable option for obtaining solutions. One such approximation, which recently became popular, is the M1 method. It utilizes the system of the lowest two moments of the transport equation and closes the system with an ad hoc closure relation. The accuracy of the M1 solution depends on the quality of the closure. Several closures have been proposed in themore » literature and have been used in various studies. We carry out an extensive study of these closures by comparing the results of M1 calculations with precise Monte Carlo calculations of the radiation field around spherically symmetric protoneutron star models. We find that no closure performs consistently better or worse than others in all cases. The level of accuracy that a given closure yields depends on the matter configuration, neutrino type and neutrino energy. As a result, given this limitation, the maximum entropy closure by Minerbo on average yields relatively accurate results in the broadest set of cases considered in this work.« less

  3. Factors associated with increasing nursing home closures.

    PubMed

    Castle, Nicholas G; Engberg, John; Lave, Judith; Fisher, Andrew

    2009-06-01

    We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures. The names of the closed facilities and dates of closure from state regulators in all 50 states were obtained. This information was linked to the Online Survey, Certification, and Reporting data, which contains information on internal, organizational, and market factors for almost all nursing homes in the United States. One thousand seven hundred and eighty-nine facilities closed over this time period (1999-2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. Nursing homes with higher rates of deficiency citations, hospital-based facilities, chain members, small bed size, and facilities located in markets with high levels of competition were more likely to close. High Medicaid occupancy rates were associated with a high likelihood of closure, especially for facilities with low Medicaid reimbursement rates. As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures.

  4. 31 CFR 413.1 - Closure of streets.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

  5. 31 CFR 413.1 - Closure of streets.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

  6. 31 CFR 413.1 - Closure of streets.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

  7. 31 CFR 413.1 - Closure of streets.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

  8. 31 CFR 413.1 - Closure of streets.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

  9. 77 FR 75186 - Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-19

    ... Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT AGENCY: Bureau of... Lake Mountains in Utah County, Utah, to recreational target shooting to protect public safety. This... shooting closure within the described area will remain in effect no longer than two years from December 19...

  10. The Flatstent versus the conventional umbrella devices in the percutaneous closure of patent foramen ovale.

    PubMed

    Aral, Mert; Mullen, Michael

    2015-05-01

    Patent foramen ovale (PFO) has been associated with paradoxical embolism leading to stroke/transient ischemic attack, migraine, and neurological decompression sickness. In search for the optimal device that would achieve effective clinical closure with minimal complications, a better device selection based on PFO anatomy and improvements in device design is needed. The Flatstent is a new device designed to treat the highly prevalent long-tunnel PFOs from within, minimizing the amount of material left behind in an attempt to reduce device-related complications. The objective is to compare the safety and efficacy of the novel Flatstent versus the conventional umbrella devices in the transcatheter closure of PFO in a nonrandomized, retrospective, single-center study. Between March 2010 and March 2013, 88 patients underwent PFO closure at The Heart Hospital, London with either the novel Flatstent or one of the four conventionally used umbrella devices (GORE Helex Septal Occluder, Occlutech Figulla Flex, Biostar Septal Occluder, and Amplatzer PFO Occluder) depending on their PFO anatomy. Patients were then evaluated with contrast transthoracic echocardiography (TTE) and/or transoesophageal echocardiography (TOE) at 6 weeks and 1 year after the procedure. The residual shunt and complication rates between the Flatstent and umbrella devices were compared. The Flatstent was used in 27 patients (30.7%), whereas 61 patients (69.3%) received one of the four umbrella devices. Primary efficacy point of clinical closure defined as grade 0 or grade 1; residual shunt was achieved in 81.3% in the Flatstent cohort and 80.3% in the umbrella device group at 6 weeks follow-up. At 1 year, the clinical closure rates reached 92.6 and 91.8%. There were two device embolizations, one in each cohort during the immediate postoperative period (<24 hrs), with successful retrieval. One patient in the umbrella device group developed transient atrial fibrillation, which was controlled medically

  11. Design improvement of permanent magnet flux switching motor with dual rotor structure

    NASA Astrophysics Data System (ADS)

    Soomro, H. A.; Sulaiman, E.; Kumar, R.; Rahim, N. S.

    2017-08-01

    This paper presents design enhancement to reduce permanent magnet (PM) volume for 7S-6P-7S dual rotor permanent magnet flux-switching machines (DRPMFSM) for electric vehicle application. In recent years, Permanent magnet flux switching (PMFS) motor and a new member of brushless permanent magnet machine are prominently used for the electric vehicle. Though, more volume of Rare-Earth Permanent Magnet (REPM) is used to increase the cost and weight of these motors. Thus, to overcome the issue, new configuration of 7S-6P- 7S dual rotor permanent magnet flux-switching machine (DRPMFSM) has been proposed and investigated in this paper. Initially proposed 7S-6P-7S DRPMFSM has been optimized using “deterministic optimization” to reduce the volume of PM and to attain optimum performances. In addition, the performances of initial and optimized DRPMFSM have been compared such that back-emf, cogging torque, average torque, torque and power vs speed performances, losses and efficiency have been analysed by 2D-finite element analysis (FEA) using the JMAG- Designer software ver. 14.1. Consequently, the final design 7S-6P-7S DRPMFSM has achieved the efficiency of 83.91% at reduced PM volume than initial design to confirm the better efficient motor for HEVs applications.

  12. APPARATUS AND METHOD FOR WELDING END CLOSURE TO CONTAINER

    DOEpatents

    Frantz, C.E.; Correy, T.B.

    1959-08-01

    A semi-automatic apparatus is described for welding a closure to the open end of a can containing a nuclear fuel slug. An arc is struck at the center of the closure and is shifted to a region near its periphery. Then the assembly of closure, can, and fuel slug is rotated so that the peripheral region of the closure is preheated. Next the arc is shifted to the periphery itself of the closure, and the assembly is rotated so that the closure is welded to the can.

  13. A permanent-magnet rotor for a high-temperature superconducting bearing

    NASA Astrophysics Data System (ADS)

    Mulcahy, T. M.; Hull, J. R.; Uherka, K. L.; Abboud, R. G.; Wise, J. H.; Carnegie, D. W.

    1995-06-01

    Design, fabrication, and performance, of a 1/3-m dia., 10-kg flywheel rotor with only one bearing is discussed. To achieve low-loss energy storage, the rotor's segmented-ring permanent-magnet (PM) is optimized for levitation and circumferential homogeneity. The magnet's carbon composite bands enable practical energy storage.

  14. Contemporary outcomes of percutaneous closure of patent ductus arteriosus in adolescents and adults.

    PubMed

    P, Sudhakar; Jose, John; George, Oommen K

    Catheter based treatment has gained wide acceptance for management of patent ductus arteriosus (PDA) ever since its introduction. Percutaneous closure in adults can be challenging because of anatomical factors including large sizes, associated pulmonary arterial hypertension (PAH) and co-morbidities. This study aimed to provide comprehensive contemporary data on the safety and efficacy of percutaneous device closure of PDA in adult and adolescent population at a large referral center. This single-center retrospective analysis included 70 patients (33 adolescents and 37 adults) who underwent successful percutaneous device closure of PDA between January 2011 and February 2017.Baseline patient demographics, clinical characteristics, procedural and device related variables, and immediate outcomes during hospital stay were recorded. Patients were followed up for residual shunt and complications. Of 70 PDA device closure cases, 71.4% were females; the mean age was 23 years (range:10-58years). Devices used were 4-Cook's detachable coils, 64-occluders (ADO-I and II, Lifetech, Cardi-O-Fix), 1-vascular plug and 1-ventricular septal occluder device. Device success was achieved in all including those with very large PDAs. At 24-h post-procedure, the success rate of transcatheter intervention was 95.7%. At 6-months follow up, complete closure was observed in all (mean follow up duration-531days). In patients with severe PAH, significant immediate and sustained reduction of the mean pulmonary pressure was observed(77mmHg to 33mmHg;P=0.014). No procedure-related complications including death, device embolization and stenosis of aorta or pulmonary artery occurred. In contemporary practice, percutaneous device closure is an effective and safe treatment option for adolescent and adult PDA patients. Copyright © 2017. Published by Elsevier B.V.

  15. Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

    PubMed

    Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

    2015-12-01

    To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at

  16. Rubber closures for freeze-dried products.

    PubMed

    Hopkins, G H

    1976-10-01

    Once a biological product has been developed to perform its required medical or pharmaceutical function, it is essential that a container-closure system by chosen which will preserve the efficacy of the product up to the point of administration. The general requirements applicable to proper closure function will be reviewed and the suitability of natural and synthetic elastomers to perform these functions will be discussed. The specialized application of elastomeric materials as closures for freeze-dried products presents additional requirements which are superimposed upon those previously discussed. The first of these unique considerations relates to the proper physical design which will permit the outgassing of water vapor during the sublimation step in the lyophilizing chamber. During this outgassing the design must also permit the closure to remain affixed in the neck while only partially inserted. Since these preparations are lyophilized because they are unstable in aqueous solutions, the elastomer used must constitute an effective barrier to the transmission of moisture vapor through the closure. The MVT and gas transmission properties of elastomers will be discussed. Special consideration will be given to the extremely low temperatures used in the sublimation, stoppering, and storage before use of lyophilized products. The phenomenon of glass transition points with different elastomers will be explained as its relation to satisfactory performance of the closure function at low temperatures.

  17. Autologus Platelet Rich Fibrin aided Revascularization of an immature, non-vital permanent tooth with apical periodontitis: A case report.

    PubMed

    Jadhav, Ganesh Ranganath; Shah, Dipali; Raghvendra, Srinidhi Surya

    2015-01-01

    Caries or trauma induced non-vital immature permanent tooth with blunderbuss, thin root which are very common among childrens are corrected using regenerative endodontic (revascularization) procedures. In the presented case, a 16-year-old boy reported with chief complaint of pain in maxillary left central incisor (Tooth #21). Tooth #21 showed grade III mobility, draining labial sinus, and short blunderbuss root with diffuse periapical radiolucency. Patient was explained the treatment plan and written informed consent was taken. Platelet rich fibrin (PRF) was prepared according to standard protocol. Autologous PRF was carried to the apical portion of the root canal after inducing revascularization. Access opening was double sealed with MTA and resin modified glass ionomer cement (RMGI). Baseline, 12 month and 18 month follow-up intraoral radiographs were taken. Clinically case was asymptomatic with complete resolution of intraoral sinus. Periapical healing, apical closure, root lengthening and dentinal wall thickening were uneventful. Thus PRF supplementation hastens the predictability and rate of revascularization in non-vital immature permanent teeth.

  18. Transcatheter Closure of Patent Ductus Arteriosus in Children with the Occlutech Duct Occluder.

    PubMed

    Bilici, Meki; Demir, Fikri; Akın, Alper; Türe, Mehmet; Balık, Hasan; Kuyumcu, Mahir

    2017-12-01

    The aim of this study was to evaluate the feasibility, efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with the Occlutech duct occluder (ODO) in children. We reviewed the clinical records of 71 patients who underwent percutaneous closure of PDA with an ODO between September 2014 and August 2016. The Occlutech duct occluder was applied to 71 patients during the study period (September 2014-August 2016), and the results were analyzed in this study. Forty-two of the patients were female and 29 male. The median age was 20.5 months (range, 6-194 months) and median weight was 16 kg (range, 6-68 kg). The PDA was classified as type A in 54 patients (76.1%), type E in 14 (19.7%), type C in 2 (2.8%) and type B in 1 (1.4%) based on the Krichenko classification. A standard ODO device was used for the transcatheter closure procedure in 66 patients and the long-shank ODO device in 5. In the echocardiographic measurement of PDA, the median smallest diameter was 2.7 mm (range, 1.5-7.0 mm), and in the angiographic measurement, the median smallest diameter was 2.5 mm (range, 1.5-6.5 mm). All 71 patients underwent successful PDA closure with the ODO. Angiography following the procedure showed complete closure in 47 patients (66.2%), mild residual shunt in 13 patients (18.3%) and a trivial shunt in 11 patients (15.5%). Color flow Doppler echocardiogpaphy at 24 h post-implantation showed that complete closure was achieved in 65 patients (91.5%), and 6 patients (8.5%) had mild residual shunt. All patients (100%) had complete closure at 30 days of follow-up. The results of this study showed that the Occlutech PDA occluder device is safe and effective in the closure of PDA. As the pulmonary artery side of the device is wider than the aortic side, protrusion toward the aortic side and embolization are prevented, but there is residual shunt in the early period, although this residual shunt disappeared after a few months.

  19. Silicone absorption of elastomeric closures--an accelerated study.

    PubMed

    Degrazio, F L; Hlobik, T; Vaughan, S

    1998-01-01

    There is a trend in the parenteral industry to move from the use of elastomeric closures which are washed, siliconized, dried and sterilized in-house at the pharmaceutical manufacturers' site to pre-prepared closures purchased from the closure supplier. This preparation can consist of washing to reduce particle-load and bioburden, siliconization, placement in ready-to-sterilize bags and may eventually extend to sterilization by steam autoclave or gamma irradiation. Since silicone oil lubrication is critical to the processability/machinability of closures, research was designed to investigate this phenomenon in closures prepared using the Westar RS (Ready-to-Sterilize) process. This paper presents the data gathered in a study of the characteristic of silicone absorption into elastomeric closures under accelerated conditions. Variables such as silicone viscosity, rubber formulation, effect of sterilization and others are considered.

  20. Patent ductus arteriosus closure using an Amplatzer(™) ventricular septal defect closure device.

    PubMed

    Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

    2013-01-01

    The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs.

  1. Rotatable Small Permanent Magnet Array for Ultra-Low Field Nuclear Magnetic Resonance Instrumentation: A Concept Study.

    PubMed

    Vogel, Michael W; Giorni, Andrea; Vegh, Viktor; Pellicer-Guridi, Ruben; Reutens, David C

    2016-01-01

    We studied the feasibility of generating the variable magnetic fields required for ultra-low field nuclear magnetic resonance relaxometry with dynamically adjustable permanent magnets. Our motivation was to substitute traditional electromagnets by distributed permanent magnets, increasing system portability. The finite element method (COMSOL®) was employed for the numerical study of a small permanent magnet array to calculate achievable magnetic field strength, homogeneity, switching time and magnetic forces. A manually operated prototype was simulated and constructed to validate the numerical approach and to verify the generated magnetic field. A concentric small permanent magnet array can be used to generate strong sample pre-polarisation and variable measurement fields for ultra-low field relaxometry via simple prescribed magnet rotations. Using the array, it is possible to achieve a pre-polarisation field strength above 100 mT and variable measurement fields ranging from 20-50 μT with 200 ppm absolute field homogeneity within a field-of-view of 5 x 5 x 5 cubic centimetres. A dynamic small permanent magnet array can generate multiple highly homogeneous magnetic fields required in ultra-low field nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) instruments. This design can significantly reduce the volume and energy requirements of traditional systems based on electromagnets, improving portability considerably.

  2. Randomized clinical trial of intestinal ostomy takedown comparing pursestring wound closure vs conventional closure to eliminate the risk of wound infection.

    PubMed

    Camacho-Mauries, Daniel; Rodriguez-Díaz, José Luis; Salgado-Nesme, Noel; González, Quintín H; Vergara-Fernández, Omar

    2013-02-01

    The use of temporary stomas has been demonstrated to reduce septic complications, especially in high-risk anastomosis; therefore, it is necessary to reduce the number of complications secondary to ostomy takedowns, namely wound infection, anastomotic leaks, and intestinal obstruction. To compare the rates of superficial wound infection and patient satisfaction after pursestring closure of ostomy wound vs conventional linear closure. Patients undergoing colostomy or ileostomy closure between January 2010 and February 2011 were randomly assigned to linear closure (n = 30) or pursestring closure (n = 31) of their ostomy wound. Wound infection within 30 days of surgery was defined as the presence of purulent discharge, pain, erythema, warmth, or positive culture for bacteria. Patient satisfaction, healing time, difficulty managing the wound, and limitation of activities were analyzed with the Likert questionnaire. The infection rate for the control group was 36.6% (n = 11) vs 0% in the pursestring closure group (p < 0.0001). Healing time was 5.9 weeks in the linear closure group and 3.8 weeks in the pursestring group (p = 0.0002). Seventy percent of the patients with pursestring closure were very satisfied in comparison with 20% in the other group (p = 0.0001). This study was limited by the heterogeneity in the type of stoma in both groups. The pursestring method resulted in the absence of infection after ostomy wound closure (shorter healing time and improved patient satisfaction).

  3. 50 CFR 622.43 - Closures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... following closure restrictions apply (See § 622.49 for closure provisions when an ACL is reached or... quota specified in § 622.42, or the ACL specified in 622.49, being reached and subsequent data indicate that the quota or ACL was not reached, the Assistant Administrator may file a notification to that...

  4. Novel dural closure technique using polyglactin acid sheet prevents cerebrospinal fluid leakage after spinal surgery.

    PubMed

    Sugawara, Taku; Itoh, Yasunobu; Hirano, Yoshitaka; Higashiyama, Naoki; Shimada, Yoichi; Kinouchi, Hiroyuki; Mizoi, Kazuo

    2005-10-01

    Extradural or subcutaneous cerebrospinal fluid (CSF) leakage is a common complication after spinal surgery and is associated with the risks of poor wound healing, meningitis, and pseudomeningocele. Numerous methods to prevent postoperative CSF leakage are available, but pressure-tight dural closure remains difficult, especially with synthetic surgical membranes. The efficacy of a novel dural closure technique was assessed by detecting extradural or subcutaneous CSF leakage on magnetic resonance imaging. The novel dural closure technique using absorbable polyglactin acid sheet and fibrin glue and the conventional procedure using only fibrin glue were evaluated retrospectively by identifying extradural or subcutaneous CSF leakage on magnetic resonance imaging scans in the acute (2-7 d) and chronic (3-6 mo) postoperative stages after spinal intradural surgery in 53 patients. The incidence of extradural and subcutaneous CSF leakage was significantly lower (P < 0.05) in the acute (20%) and chronic (0%) stages using polyglactin acid sheet and fibrin glue in 15 patients compared with that in the acute (81%) and chronic (24%) stages using only fibrin glue in 38 patients. One patient in the fibrin glue-only group required repair surgery for cutaneous CSF leakage. The combination of polyglactin acid sheet and fibrin glue can achieve water-tight closure after spinal intradural surgery and can minimize the risk of intractable postoperative CSF leakage. This simple, economical technique is recommended for dural closure after spinal intradural surgery.

  5. Comparison of two neonatal indomethacin protocols: efficacy and outcome for patent ductus arteriosus closure.

    PubMed

    Rosito, G; Sum, K; Chorne, N

    2010-10-01

    Indomethacin, a non-selective inhibitor of prostaglandin synthesis, is the gold standard treatment for patent ductus arteriosus (PDA). Indomethacin has been shown to permanently close the ductus and when given prophylactically, it reduces the incidence of PDA (1, 2). This study compares PDA closure and surgical ligation rates between patients using two different indomethacin administration protocols. This is a retrospective comparison analysis of 72 neonates, who received one of two indomethacin administration protocols. Our previous protocol suggested an initial dose of 0·2 mg/kg followed by two 0·1 mg/kg, with doses infused over 4 h and a 24-h dosing interval. A new potentially more useful protocol using the same mg/kg dose regimen but with doses infused over 30 min and a 12-h dosing interval, was evaluated. Each neonate was allowed three courses of treatment before surgical ligation was performed for persistent PDA. There were no statistically significant differences between the two protocol groups when comparing percentages of neonates with gestational age≤28 weeks, birth weight≤1000 g, male gender or receiving indomethacin for the indication of PDA prophylaxis vs. treatment. There was a trend towards a higher PDA closure rate and subsequently a lower PDA ligation rate in the new protocol when compared with the previous protocol. In this small population of premature neonates, there was a trend, but no significant difference, towards increasing PDA closure and lower surgical ligation rates in neonates given indomethacin with more frequent dosing and shorter infusion time. A well-powered randomized controlled trial is now needed. Copyright © 2010 The Authors. JCPT © 2010 Blackwell Publishing Ltd.

  6. Vacuum-assisted wound closure and mesh-mediated fascial traction for open abdomen therapy - a systematic review.

    PubMed

    Acosta, Stefan; Björck, Martin; Petersson, Ulf

    2017-01-01

    The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias. A high primary fascial closure rate can be achieved with the vacuum-assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-trauma patients, in need of prolonged open abdomen therapy.

  7. 40 CFR 265.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

  8. 40 CFR 265.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

  9. 40 CFR 265.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

  10. 40 CFR 265.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

  11. Permanent tensions in organization.

    PubMed

    Jansson, Noora

    2015-01-01

    The purpose of this paper is to investigate the relationship between permanent tensions and organizational change. This study used paradox theory and a case study. The case organization is a public university hospital in Finland involving several stakeholders. The analysis suggests that the relationship between permanent tensions and organizational change is a paradox that is part of organizational reality. As an organization learns to live with its permanent tensions, the renewal paradox settles into equilibrium. When tensions are provoked, the paradox is disturbed until it finds a new balance. This flexible nature of the paradox is the force that keeps the different stakeholders simultaneously empowered to maintain their unique missions and cohesive in order to benefit from the larger synergy. This research suggests that identification and evaluation of each permanent tension within an organization is important when executing organizational change. The fact that certain tensions are permanent and cannot be solved may have an influence on how planned change initiatives are executed. The results show that permanent tensions may be harnessed for the benefit of an organizational change. This research demonstrates originality by offering an alternative view of tensions, a view which emphasizes not only their permanent and plural nature but their importance for enabling the organization to change at its own, non-disruptive pace. The research also proposes a new concept, the "renewal paradox", to enhance understanding of the relationship between permanent tensions and organizational change.

  12. 40 CFR 61.226 - Reconsideration of rescission and reinstatement of this subpart.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Emission Standards for Radon Emissions From the Disposal of Uranium Mill Tailings § 61.226 Reconsideration... by EPA and NRC or the tailings closure plan (radon) (i.e., contained in the license) requirements establishing milestones for the purpose of emplacing a permanent radon barrier that will achieve compliance...

  13. 40 CFR 61.226 - Reconsideration of rescission and reinstatement of this subpart.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Emission Standards for Radon Emissions From the Disposal of Uranium Mill Tailings § 61.226 Reconsideration... by EPA and NRC or the tailings closure plan (radon) (i.e., contained in the license) requirements establishing milestones for the purpose of emplacing a permanent radon barrier that will achieve compliance...

  14. Some Recent Developments in Turbulence Closure Modeling

    NASA Astrophysics Data System (ADS)

    Durbin, Paul A.

    2018-01-01

    Turbulence closure models are central to a good deal of applied computational fluid dynamical analysis. Closure modeling endures as a productive area of research. This review covers recent developments in elliptic relaxation and elliptic blending models, unified rotation and curvature corrections, transition prediction, hybrid simulation, and data-driven methods. The focus is on closure models in which transport equations are solved for scalar variables, such as the turbulent kinetic energy, a timescale, or a measure of anisotropy. Algebraic constitutive representations are reviewed for their role in relating scalar closures to the Reynolds stress tensor. Seamless and nonzonal methods, which invoke a single closure model, are reviewed, especially detached eddy simulation (DES) and adaptive DES. Other topics surveyed include data-driven modeling and intermittency and laminar fluctuation models for transition prediction. The review concludes with an outlook.

  15. "Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making": Correction to Otto et al. (2016).

    PubMed

    2016-09-01

    Reports an error in "Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making" by Ashley S. Otto, Joshua J. Clarkson and Frank R. Kardes ( Journal of Personality and Social Psychology , 2016[Jul], Vol 111[1], 1-16). In the article, the main heading for Experiment 3 was missing due to a production error, and the first sentence of the first paragraph of Experiment 3 should begin as follows: Experiment 2 offered support for the hypothesis that those seeking closure engage in decision sidestepping to reduce the bothersome nature of decision making. (The following abstract of the original article appeared in record 2016-30159-001.) We all too often have to make decisions—from the mundane (e.g., what to eat for breakfast) to the complex (e.g., what to buy a loved one)—and yet there exists a multitude of strategies that allows us to make a decision. This work focuses on a subset of decision strategies that allows individuals to make decisions by bypassing the decision-making process—a phenomenon we term decision sidestepping. Critical to the present manuscript, however, we contend that decision sidestepping stems from the motivation to achieve closure. We link this proposition back to the fundamental nature of closure and how those seeking closure are highly bothered by decision making. As such, we argue that the motivation to achieve closure prompts a reliance on sidestepping strategies (e.g., default bias, choice delegation, status quo bias, inaction inertia, option fixation) to reduce the bothersome nature of decision making. In support of this framework, five experiments demonstrate that (a) those seeking closure are more likely to engage in decision sidestepping, (b) the effect of closure on sidestepping stems from the bothersome nature of decision making, and (c) the reliance on sidestepping results in downstream consequences for subsequent choice. Taken together, these findings offer unique insight into the cognitive

  16. Analysis of Mining-induced Valley Closure Movements

    NASA Astrophysics Data System (ADS)

    Zhang, C.; Mitra, R.; Oh, J.; Hebblewhite, B.

    2016-05-01

    Valley closure movements have been observed for decades in Australia and overseas when underground mining occurred beneath or in close proximity to valleys and other forms of irregular topographies. Valley closure is defined as the inward movements of the valley sides towards the valley centreline. Due to the complexity of the local geology and the interplay between several geological, topographical and mining factors, the underlying mechanisms that actually cause this behaviour are not completely understood. A comprehensive programme of numerical modelling investigations has been carried out to further evaluate and quantify the influence of a number of these mining and geological factors and their inter-relationships. The factors investigated in this paper include longwall positional factors, horizontal stress, panel width, depth of cover and geological structures around the valley. It is found that mining in a series passing beneath the valley dramatically increases valley closure, and mining parallel to valley induces much more closure than other mining orientations. The redistribution of horizontal stress and influence of mining activity have also been recognised as important factors promoting valley closure, and the effect of geological structure around the valley is found to be relatively small. This paper provides further insight into both the valley closure mechanisms and how these mechanisms should be considered in valley closure prediction models.

  17. Gyro-effect stabilizes unstable permanent maglev centrifugal pump.

    PubMed

    Qian, Kun-Xi

    2007-03-01

    According to Earnshaw's Theorem (1839), the passive maglev cannot achieve stable equilibrium and thus an extra coil is needed to make the rotor electrically levitated in a heart pump. The author had developed a permanent maglev centrifugal pump utilizing only passive magnetic bearings, to keep the advantages but to avoid the disadvantages of the electric maglev pumps. The equilibrium stability was achieved by use of so-called "gyro-effect": a rotating body with certain high speed can maintain its rotation stably. This pump consisted of a rotor (driven magnets and an impeller), and a stator with motor coil and pump housing. Two passive magnetic bearings between rotor and stator were devised to counteract the attractive force between the motor coil iron core and the rotor driven magnets. Bench testing with saline demonstrated a levitated rotor under preconditions of higher than 3,250 rpm rotation and more than 1 l/min pumping flow. Rotor levitation was demonstrated by 4 Hall sensors on the stator, with evidence of reduced maximal eccentric distance from 0.15 mm to 0.07 mm. The maximal rotor vibration amplitude was 0.06 mm in a gap of 0.15 mm between rotor and stator. It concluded that Gyro-effect can help passive maglev bearings to achieve stabilization of permanent maglev pump; and that high flow rate indicates good hydraulic property of the pump, which helps also the stability of passive maglev pump.

  18. Baseline factors affecting closure of venous leg ulcers.

    PubMed

    Marston, William A; Ennis, William J; Lantis, John C; Kirsner, Robert S; Galiano, Robert D; Vanscheidt, Wolfgang; Eming, Sabine A; Malka, Marcin; Cargill, D Innes; Dickerson, Jaime E; Slade, Herbert B

    2017-11-01

    wound duration at baseline (0.971 [0.955-0.987]). Factors associated with VLU lesions including location, area, and duration were important predictors of healing. Women were more likely than men to achieve wound closure. Factors including body mass index, the presence of diabetes mellitus, and higher concentrations of glycated hemoglobin were not significant independent predictors of wound closure in this analysis. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  19. Vascular Closure Devices in Interventional Radiology Practice

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk; Muller-Hulsbeck, Stefan, E-mail: muehue@diako.de; Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk

    2015-08-15

    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, whichmore » should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.« less

  20. Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic

    PubMed Central

    House, Thomas; Baguelin, Marc; Van Hoek, Albert Jan; White, Peter J.; Sadique, Zia; Eames, Ken; Read, Jonathan M.; Hens, Niel; Melegaro, Alessia; Edmunds, W. John; Keeling, Matt J.

    2011-01-01

    Despite the fact that the 2009 H1N1 pandemic influenza strain was less severe than had been feared, both seasonal epidemics of influenza-like-illness and future influenza pandemics have the potential to place a serious burden on health services. The closure of schools has been postulated as a means of reducing transmission between children and hence reducing the number of cases at the peak of an epidemic; this is supported by the marked reduction in cases during school holidays observed across the world during the 2009 pandemic. However, a national policy of long-duration school closures could have severe economic costs. Reactive short-duration closure of schools in regions where health services are close to capacity offers a potential compromise, but it is unclear over what spatial scale and time frame closures would need to be made to be effective. Here, using detailed geographical information for England, we assess how localized school closures could alleviate the burden on hospital intensive care units (ICUs) that are reaching capacity. We show that, for a range of epidemiologically plausible assumptions, considerable local coordination of school closures is needed to achieve a substantial reduction in the number of hospitals where capacity is exceeded at the peak of the epidemic. The heterogeneity in demand per hospital ICU bed means that even widespread school closures are unlikely to have an impact on whether demand will exceed capacity for many hospitals. These results support the UK decision not to use localized school closures as a control mechanism, but have far wider international public-health implications. The spatial heterogeneities in both population density and hospital capacity that give rise to our results exist in many developed countries, while our model assumptions are sufficiently general to cover a wide range of pathogens. This leads us to believe that when a pandemic has severe implications for ICU capacity, only widespread school closures

  1. A reliable and safe gastrotomy closure technique assessed in a porcine survival model pilot study: success of the Queen's closure.

    PubMed

    Hookey, L C; Bielawska, B; Samis, A; Jalink, D; Ellis, R; Khokhotva, V; Hurlbut, D; Mercer, D

    2009-06-01

    The evolution of NOTES to clinical implementation has been hampered by lack of a reliable, safe, and easy-to-implement technique for closure of the opening created in accessing the peritoneum. The Queen's closure uses a combination of endoscopic clips and loop devices to seal such defects in the stomach wall. This study aimed to assess the Queen's closure in a porcine survival model. Five 30-kg pigs underwent endoscopic transgastric surgery with exploration of the peritoneum. The endoscope was then withdrawn back into the stomach and the closure performed. The animals were recovered, monitored closely, and underwent endoscopy 1 week after surgery. They were then euthanized at 2 (n = 2) and 3 (n = 3) weeks after surgery with subsequent necropsy. The mean procedure time (from intubation of the esophagus to withdrawal of the endoscope) was 79 minutes (range 45-105 minutes) with a mean time of exploration of the peritoneum of 14 minutes (range 8-25 minutes). All animals recovered well with no apparent pain, distress, or signs of infection. Endoscopic examination 1 week after surgery revealed all the closures to be intact and only identifiable by a small ulcer. At necropsy, the gastrotomy site was identifiable only by minor serosal adhesions. Histological study demonstrated full-thickness closure with minimal inflammation. The Queen's closure is a reliable and safe technique that provides full-thickness gastrotomy closure without any observed complications. The technique has proven to be transferable knowledge that holds promise for clinical implementation.

  2. 40 CFR 264.118 - Post-closure plan; amendment of plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

  3. 40 CFR 264.118 - Post-closure plan; amendment of plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

  4. 40 CFR 264.118 - Post-closure plan; amendment of plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

  5. 40 CFR 264.118 - Post-closure plan; amendment of plan.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

  6. 40 CFR 264.118 - Post-closure plan; amendment of plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

  7. Uncertainty Quantification of Multi-Phase Closures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nadiga, Balasubramanya T.; Baglietto, Emilio

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

  8. Use of the"bogota bag"for closure of open abdominal wound after exploratory laparotomy - our experience at Mayo Hospital Lahore.

    PubMed

    Muhammad, Yar; Gondal, Khalid Masood; Khan, Umair Ahmed

    2016-08-01

    To assess the efficacy of Bogota bag for closure of open abdominal wounds after laparotomy where the primary closure cannot be achieved and other closure techniques are not available. The descriptive study was conducted at Mayo Hospital, Lahore, Pakistan, from September 2011 to February2015, and comprised patients who underwent laparotomy and peritoneal cavities and who could not be closed primarily because of various reasons like traumatic loss and oedematous gut. They were managed with Bogota bag for abdominal closure. SPSS 18 was used for statistical analysis. Of the 55 patients, 37(67.27%) were male and 18(32.73%) were female. There was traumatic loss in 34(61.8%), oedematous gut and omentum in 15(27.27%) and gangrenous abdominal wall in 6(10.9%) patients. Bogota bag was applied in all (100%) of them. In 19(34.55%) patients, delayed primary closure was possible, so the Bogota was used temporarily. In 36(65.45%) cases managed with Bogota bag, healing occurred by granulation tissue or skin grafting/flaps were applied and these patients developed hernia. Five (9.09%) patients developed small bowel fistula which was managed conservatively. No patient developed complication due to exposure or abdominal compartment. There were 7(12.8%) postoperative deaths due to the disease process and were unrelated to the closure technique. Bogota bag was an effective means of closure of open abdominal wound and prevented the complications due to open abdominal wounds or closure under tension.

  9. Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect.

    PubMed

    Liang, Fei; Hongxin, Li; Zhang, Hai-Zhou; Wenbin, Guo; Zou, Cheng-Wei; Farhaj, Zeeshan

    2017-04-17

    Device closure of a wide-spaced multi-hole PmVSD is difficult to succeed in percutaneous approach. This study is to evaluate the feasibility, safety and efficacy of perventricular device closure of wide-spaced multi-hole PmVSD using a double-device implanting technique. Sixteen patients with wide-spaced multi-hole PmVSD underwent perventricular closure with two devices through an inferior median sternotomy approach under transesophageal echocardiographic guidance. The largest hole and its adjacent small holes were occluded with an optimal-sized device. The far-away residual hole was occluded with the other device using a probe-assisted delivery system. All patients were followed up for a period of 1 to 4 years to determine the residual shunt, atrioventricular block and the adjacent valvular function. The number of the holes of the PmVSD was 2 to 4. The maximum distance between the holes was 5.0 to 10.0 mm (median, 6.4 mm). The diameter of the largest hole was 2.5 to 7.0 mm (median, 3.6 mm). The success rate of double-device closure was 100%. Immediate residual shunts were found in 6 patients (38%), and incomplete right bundle branch block at discharge occurred in 3 cases (19%). Both complications decreased to 6% at 1-year follow-up. Neither of them had a severe device-related complication. Perventricular closure of a wide-spaced multi-hole PmVSD using a double-device implanting technique is feasible, safe, and efficacious. In multi-hole PmVSDs with the distance between the holes of more than 5 mm, double-device implantation may achieve a complete occlusion.

  10. Permanent magnet assembly

    DOEpatents

    Chell, Jeremy; Zimm, Carl B.

    2006-12-12

    A permanent magnet assembly is disclosed that is adapted to provide a magnetic field across an arc-shaped gap. Such a permanent magnet assembly can be used, for example, to provide a time-varying magnetic field to an annular region for use in a magnetic refrigerator.

  11. 40 CFR 267.143 - Financial assurance for closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Financial assurance for closure. 267... PERMIT Financial Requirements § 267.143 Financial assurance for closure. The owner or operator must establish financial assurance for closure of each storage or treatment unit that he owns or operates. In...

  12. Rotatable Small Permanent Magnet Array for Ultra-Low Field Nuclear Magnetic Resonance Instrumentation: A Concept Study

    PubMed Central

    Vegh, Viktor; Reutens, David C.

    2016-01-01

    Object We studied the feasibility of generating the variable magnetic fields required for ultra-low field nuclear magnetic resonance relaxometry with dynamically adjustable permanent magnets. Our motivation was to substitute traditional electromagnets by distributed permanent magnets, increasing system portability. Materials and Methods The finite element method (COMSOL®) was employed for the numerical study of a small permanent magnet array to calculate achievable magnetic field strength, homogeneity, switching time and magnetic forces. A manually operated prototype was simulated and constructed to validate the numerical approach and to verify the generated magnetic field. Results A concentric small permanent magnet array can be used to generate strong sample pre-polarisation and variable measurement fields for ultra-low field relaxometry via simple prescribed magnet rotations. Using the array, it is possible to achieve a pre-polarisation field strength above 100 mT and variable measurement fields ranging from 20–50 μT with 200 ppm absolute field homogeneity within a field-of-view of 5 x 5 x 5 cubic centimetres. Conclusions A dynamic small permanent magnet array can generate multiple highly homogeneous magnetic fields required in ultra-low field nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) instruments. This design can significantly reduce the volume and energy requirements of traditional systems based on electromagnets, improving portability considerably. PMID:27271886

  13. Phase closure nulling: Theory and practice

    NASA Astrophysics Data System (ADS)

    Chelli, A.; Duvert, G.; Malbet, F.; Kern, P.

    2009-11-01

    We provide a complete theory of the phase closure of a binary system in which a small, feeble, and unresolved companion acts as a perturbing parameter on the spatial frequency spectrum of a dominant, bright, resolved source. We demonstrate that the influence of the companion can be measured with precision by measuring the phase closure of the system near the nulls of the primary visibility function. In these regions of phase closure nulling, frequency intervals always exist where the phase closure signature of the companion is larger than any systematic error and can thus be measured. We show that this technique allows retrieval of many astrophysically relevant properties of faint and close companions such as flux, position, and in favorable cases, spectrum. As a proof of concept, using the AMBER/VLTI instrument with 3 auxiliary telescopes of 1.8 m and only 15 minutes of on-sky integration, we detected the five magnitudes fainter companion of HD 59717 at only 3.5 stellar radii distance from the primary. This is one of the highest contrast detected by interferometry between a companion and its parent star. We conclude by a rapid study of the potentialities of phase closure nulling observations with current interferometers and explore the requirements for a new type of dedicated instrument.

  14. Endovascular closure of ascending aortic pseudoaneurysm with a type II Amplatzer vascular plug.

    PubMed

    De Boo, Diederick W; Mott, Nigel; Kavnoudias, Helen; Walton, Antony; Lyon, Stuart M

    2014-05-01

    A 71-year-old man initially presented with an asymptomatic, incidentally detected ascending aortic pseudoaneurysm 25 years following aortic root repair with mechanical aortic valve replacement. This pseudoaneurysm was previously treated with coil embolization but due to coil impaction it reopened 8 years later. Endovascular closure of the pseudoaneurysm was achieved with the off-label use of a type II Amplatzer vascular plug.

  15. The Effect of Rural Hospital Closures on Community Economic Health

    PubMed Central

    Holmes, George M; Slifkin, Rebecca T; Randolph, Randy K; Poley, Stephanie

    2006-01-01

    Objective To examine the effect of rural hospital closures on the local economy. Data Sources U.S. Census Bureau, OSCAR, Medicare Cost Reports, and surveys of individuals knowledgeable about local hospital closures. Study Design Economic data at the county level for 1990–2000 were combined with information on hospital closures. The study sample was restricted to rural counties experiencing a closure during the sample period. Longitudinal regression methods were used to estimate the effect of hospital closure on per-capita income, unemployment rate, and other community economic measures. Models included both leading and lagged closure terms allowing a preclosure economic downturn as well as time for the closure to be fully realized by the community. Data Collection Information on closures was collected by contacting every state hospital association, reconciling information gathered with that contained in the American Hospital Association file and OIG reports. Principal Findings Results indicate that the closure of the sole hospital in the community reduces per-capita income by $703 (p<0.05) or 4 percent (p<0.05) and increases the unemployment rate by 1.6 percentage points (p<0.01). Closures in communities with alternative sources of hospital care had no long-term economic impact, although income decreased for 2 years following the closure. Conclusions The local economic effects of a hospital closure should be considered when regulations that affect hospitals' financial well-being are designed or changed. PMID:16584460

  16. Permanent split capacitor single phase electric motor system

    DOEpatents

    Kirschbaum, Herbert S.

    1984-01-01

    A permanent split capacitor single phase electric motor achieves balanced operation at more than one operating point by adjusting the voltage supplied to the main and auxiliary windings and adjusting the capacitance in the auxiliary winding circuit. An intermediate voltage tap on an autotransformer supplies voltage to the main winding for low speed operation while a capacitive voltage divider is used to adjust the voltage supplied to the auxiliary winding for low speed operation.

  17. 50 CFR 635.28 - Fishery closures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Fishery closures. 635.28 Section 635.28 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE ATLANTIC HIGHLY MIGRATORY SPECIES Management Measures § 635.28 Fishery closures. (a...

  18. Sampling and monitoring for closure

    USGS Publications Warehouse

    McLemore, Virginia T.; Smith, Kathleen S.; Russell, Carol C.

    2007-01-01

    An important aspect of planning a new mine or mine expansion within the modern regulatory framework is to design for ultimate closure. Sampling and monitoring for closure is a form of environmental risk management. By implementing a sampling and monitoring program early in the life of the mining operation, major costs can be avoided or minimized. The costs for treating mine drainage in perpetuity are staggering, especially if they are unanticipated. The Metal Mining Sector of the Acid Drainage Technology Initiative (ADTI-MMS), a cooperative government-industry-academia organization, was established to address drainage-quality technologies of metal mining and metallurgical operations. ADTI-MMS recommends that sampling and monitoring programs consider the entire mine-life cycle and that data needed for closure of an operation be collected from exploration through postclosure.

  19. Closure versus non-closure of the peritoneum at caesarean section: short- and long-term outcomes

    PubMed Central

    Bamigboye, Anthony A; Hofmeyr, G Justus

    2014-01-01

    Background Caesarean section is a very common surgical procedure worldwide. Suturing the peritoneal layers at caesarean section may or may not confer benefit, hence the need to evaluate whether this step should be omitted or routinely performed. Objectives The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intraoperative and immediate- and long-term postoperative outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (1 November 2013). Selection criteria Randomised controlled trials comparing leaving the visceral or parietal peritoneum, or both, unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section. Data collection and analysis Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked it for accuracy. Main results A total of 29 trials were included in this review and 21 trials (17,276 women) provided data that could be included in an analysis. The quality of the trials was variable. 1. Non-closure of visceral and parietal peritoneum versus closure of both parietal layers Sixteen trials involving 15,480 women, were included and analysed, when both parietal peritoneum was left unclosed versus when both peritoneal surfaces were closed. Postoperative adhesion formation was assessed in only four trials with 282 women, and no difference was found between groups (risk ratio (RR) 0.99, 95% confidence interval (CI) 0.76 to 1.29). There was significant reduction in the operative time (mean difference (MD) -5.81 minutes, 95% CI -7.68 to -3.93). The duration of hospital stay in a total of 13 trials involving 14,906 women, was also reduced (MD -0.26, 95% CI -0.47 to -0.05) days. In a trial involving 112 women, reduced chronic pelvic pain was found in the peritoneal non-closure group. 2. Non-closure of

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

    PubMed

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

    2017-10-01

    Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent in literature concerning embryology. Inspired by Victor Hamburgers (1900-2001) statement that "our real teacher has been and still is the embryo, who is, incidentally, the only teacher who is always right", we decided to critically review both theories of neural tube closure. To verify the theories of closure, we studied serial histological sections of 10 mouse embryos between 8.5 and 9.5 days of gestation and 18 human embryos of the Carnegie collection between Carnegie stage 9 (19-21 days) and 13 (28-32 days). Neural tube closure was histologically defined by the neuroepithelial remodeling of the two adjoining neural fold tips in the midline. We did not observe multiple fusion sites in neither mouse nor human embryos. A meta-analysis of case reports on neural tube defects showed that defects can occur at any level of the neural axis. Our data indicate that the human neural tube fuses at a single site and, therefore, we propose to reinstate the single-site closure theory for neural tube closure. We showed that neural tube defects are not restricted to a specific location, thereby refuting the reasoning underlying the multi-site closure theory. Clin. Anat. 30:988-999, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. [Traumatic asphyxia with permanent visual loss. Case report].

    PubMed

    Kántor, Tibor; Grigorescu, Bianca; Popescu, Gabriel; Ferencz, Attila; Nagy, Örs; Jung, János; Gergely, István

    2017-06-01

    Traumatic asphyxia is a rare condition that occurs after compressive thoracoabdominal trauma, which is characterized by subconjunctival hemorrhage, cervicofacial cyanosis, edema and petechiae. Serious life-threatening thoracic and abdominal injuries may coexist. After conservatory treatment in most cases complete recovery is achieved, but in isolated cases permanent neurological lesions may occur. We present the case of the 39-year-old male patient who suffered a compressive thoracoabdominal trauma. The physical examination showed the characteristic "ecchymotic mask". After surgical treatment of the abdominal injuries and intensive therapy the patient was discharged with permanent vision loss. The high retrograde venous pressure in the head and neck may be associated with neuronal ischemia, which can lead to irreversible optic nerve atrophy. It is therefore important to carry out an early, routine and complete ophtalmologic examination, especially in the intubated and poorly cooperative patients. Orv Hetil. 2017; 158(22): 864-868.

  2. Cavity closure arrangement for high pressure vessels

    DOEpatents

    Amtmann, Hans H.

    1981-01-01

    A closure arrangement for a pressure vessel such as the pressure vessel of a high temperature gas-cooled reactor wherein a liner is disposed within a cavity penetration in the reactor vessel and defines an access opening therein. A closure is adapted for sealing relation with an annular mounting flange formed on the penetration liner and has a plurality of radially movable locking blocks thereon having outer serrations adapted for releasable interlocking engagement with serrations formed internally of the upper end of the penetration liner so as to effect high strength closure hold-down. In one embodiment, ramping surfaces are formed on the locking block serrations to bias the closure into sealed relation with the mounting flange when the locking blocks are actuated to locking positions.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-01-01

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

  5. Mass extraction container closure integrity physical testing method development for parenteral container closure systems.

    PubMed

    Yoon, Seung-Yil; Sagi, Hemi; Goldhammer, Craig; Li, Lei

    2012-01-01

    Container closure integrity (CCI) is a critical factor to ensure that product sterility is maintained over its entire shelf life. Assuring the CCI during container closure (C/C) system qualification, routine manufacturing and stability is important. FDA guidance also encourages industry to develop a CCI physical testing method in lieu of sterility testing in a stability program. A mass extraction system has been developed to check CCI for a variety of container closure systems such as vials, syringes, and cartridges. Various types of defects (e.g., glass micropipette, laser drill, wire) were created and used to demonstrate a detection limit. Leakage, detected as mass flow in this study, changes as a function of defect length and diameter. Therefore, the morphology of defects has been examined in detail with fluid theories. This study demonstrated that a mass extraction system was able to distinguish between intact samples and samples with 2 μm defects reliably when the defect was exposed to air, water, placebo, or drug product (3 mg/mL concentration) solution. Also, it has been verified that the method was robust, and capable of determining the acceptance limit using 3σ for syringes and 6σ for vials. Sterile products must maintain their sterility over their entire shelf life. Container closure systems such as those found in syringes and vials provide a seal between rubber and glass containers. This seal must be ensured to maintain product sterility. A mass extraction system has been developed to check container closure integrity for a variety of container closure systems such as vials, syringes, and cartridges. In order to demonstrate the method's capability, various types of defects (e.g., glass micropipette, laser drill, wire) were created in syringes and vials and were tested. This study demonstrated that a mass extraction system was able to distinguish between intact samples and samples with 2 μm defects reliably when the defect was exposed to air, water

  6. No evidence that manual closure of the bronchial stump has a lower failure rate than mechanical stapler closure following anatomical lung resection.

    PubMed

    Zakkar, Mustafa; Kanagasabay, Robin; Hunt, Ian

    2014-04-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether manual closure of the bronchial stump is safer with lower failure rates than mechanical closure using a stapling device following anatomical lung resection. One hundred and twenty-nine papers were identified using the search below. Eight papers presented the best evidence to answer the clinical question as they included sufficient number of patients to reach conclusions regarding the issues of interest for this review. Complications, complication rates and operation time were included in the assessment. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the papers are tabulated. When looking at manual vs mechanical staples, it was noted that stapler failure can occur in around 4% of cases. The rate of bronchopleural fistula (BPF) development varied more in patients who underwent manual closure (1.5-12.5%) than in patients who underwent mechanical closure (1-5.7%). Although most of the studies reviewed showed no statistical differences between manual and mechanical closure in terms of BPF development, one study, however, showed that manual closure was significantly associated with lower numbers of postoperative BPF, while another study showed that mechanical closure is significantly associated with lower incidence of BPF. When looking at the role of the learning curve and training opportunities, it seems that the surgeon's inexperience when using mechanical staples can contribute to BPF development. A surgeon's experience can play a major role in the prevention of BPF development in patients having manual closure. Manual closure can provide a cheap and reliable technique when compared with costs incurred from using staplers, it is applicable in all situations and can be taught to surgeons in training with an acceptable risk. However, there is a lack

  7. No evidence that manual closure of the bronchial stump has a lower failure rate than mechanical stapler closure following anatomical lung resection

    PubMed Central

    Zakkar, Mustafa; Kanagasabay, Robin; Hunt, Ian

    2014-01-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether manual closure of the bronchial stump is safer with lower failure rates than mechanical closure using a stapling device following anatomical lung resection. One hundred and twenty-nine papers were identified using the search below. Eight papers presented the best evidence to answer the clinical question as they included sufficient number of patients to reach conclusions regarding the issues of interest for this review. Complications, complication rates and operation time were included in the assessment. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the papers are tabulated. When looking at manual vs mechanical staples, it was noted that stapler failure can occur in around 4% of cases. The rate of bronchopleural fistula (BPF) development varied more in patients who underwent manual closure (1.5–12.5%) than in patients who underwent mechanical closure (1–5.7%). Although most of the studies reviewed showed no statistical differences between manual and mechanical closure in terms of BPF development, one study, however, showed that manual closure was significantly associated with lower numbers of postoperative BPF, while another study showed that mechanical closure is significantly associated with lower incidence of BPF. When looking at the role of the learning curve and training opportunities, it seems that the surgeon's inexperience when using mechanical staples can contribute to BPF development. A surgeon's experience can play a major role in the prevention of BPF development in patients having manual closure. Manual closure can provide a cheap and reliable technique when compared with costs incurred from using staplers, it is applicable in all situations and can be taught to surgeons in training with an acceptable risk. However, there is a

  8. [Bath Plug Closure Method for Cerebrospinal Fluid Leakage by Endoscopic Endonasal Approach:Cooperative Treatment by Neurosurgeons and Otolaryngologists].

    PubMed

    Kawaguchi, Tomohiro; Arakawa, Kazuya; Nomura, Kazuhiro; Ogawa, Yoshikazu; Katori, Yukio; Tominaga, Teiji

    2017-12-01

    Endoscopic endonasal surgery, an innovative surgical technique, is used to approach sinus lesions, lesions of the skull base, and intradural tumors. The cooperation of experienced otolaryngologists and neurosurgeons is important to achieve safe and reliable surgical results. The bath plug closure method is a treatment option for patients with cerebrospinal fluid(CSF)leakage. Although it includes dural and/or intradural procedures, surgery tends to be performed by otolaryngologists because its indications, detailed maneuvers, and pitfalls are not well recognized by neurosurgeons. We reviewed the cases of patients with CSF leakage treated by using the bath plug closure method with an endoscopic endonasal approach at our institution. Three patients were treated using the bath plug closure method. CSF leakage was caused by a meningocele in two cases and trauma in one case. No postoperative intracranial complications or recurrence of CSF leakage were observed. The bath plug closure method is an effective treatment strategy and allows neurosurgeons to gain in-depth knowledge of the treatment options for CSF leakage by using an endoscopic endonasal approach.

  9. 40 CFR 265.142 - Cost estimate for closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... must equal the cost of final closure at the point in the facility's active life when the extent and... at all times over the life of the facility. (3) The closure cost estimate may not incorporate any... facility at the time of partial or final closure. (4) The owner or operator may not incorporate a zero cost...

  10. 40 CFR 265.142 - Cost estimate for closure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... must equal the cost of final closure at the point in the facility's active life when the extent and... at all times over the life of the facility. (3) The closure cost estimate may not incorporate any... facility at the time of partial or final closure. (4) The owner or operator may not incorporate a zero cost...

  11. Prediction of accrual closure date in multi-center clinical trials with discrete-time Poisson process models.

    PubMed

    Tang, Gong; Kong, Yuan; Chang, Chung-Chou Ho; Kong, Lan; Costantino, Joseph P

    2012-01-01

    In a phase III multi-center cancer clinical trial or a large public health study, sample size is predetermined to achieve desired power, and study participants are enrolled from tens or hundreds of participating institutions. As the accrual is closing to the target size, the coordinating data center needs to project the accrual closure date on the basis of the observed accrual pattern and notify the participating sites several weeks in advance. In the past, projections were simply based on some crude assessment, and conservative measures were incorporated in order to achieve the target accrual size. This approach often resulted in excessive accrual size and subsequently unnecessary financial burden on the study sponsors. Here we proposed a discrete-time Poisson process-based method to estimate the accrual rate at time of projection and subsequently the trial closure date. To ensure that target size would be reached with high confidence, we also proposed a conservative method for the closure date projection. The proposed method was illustrated through the analysis of the accrual data of the National Surgical Adjuvant Breast and Bowel Project trial B-38. The results showed that application of the proposed method could help to save considerable amount of expenditure in patient management without compromising the accrual goal in multi-center clinical trials. Copyright © 2012 John Wiley & Sons, Ltd.

  12. 40 CFR 280.74 - Closure records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... following ways: (a) By the owners and operators who took the UST system out of service; (b) By the current... STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.74 Closure records. Owners and operators must maintain...

  13. 40 CFR 280.74 - Closure records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... following ways: (a) By the owners and operators who took the UST system out of service; (b) By the current... STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.74 Closure records. Owners and operators must maintain...

  14. 40 CFR 280.74 - Closure records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... following ways: (a) By the owners and operators who took the UST system out of service; (b) By the current... STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.74 Closure records. Owners and operators must maintain...

  15. 40 CFR 280.74 - Closure records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... following ways: (a) By the owners and operators who took the UST system out of service; (b) By the current... STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.74 Closure records. Owners and operators must maintain...

  16. 40 CFR 280.74 - Closure records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... following ways: (a) By the owners and operators who took the UST system out of service; (b) By the current... STANDARDS AND CORRECTIVE ACTION REQUIREMENTS FOR OWNERS AND OPERATORS OF UNDERGROUND STORAGE TANKS (UST) Out-of-Service UST Systems and Closure § 280.74 Closure records. Owners and operators must maintain...

  17. 50 CFR 635.28 - Fishery closures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... closure, NMFS will also take into consideration the criteria specified in § 635.27(a)(8). (b) Sharks—(1... this section, when NMFS calculates that the landings for the shark species management group, as... of closure for that shark species, shark management group, and/or region that will be effective no...

  18. Loss of Permanent First Molars in the Mixed Dentition: Circumstances Resulting in Extraction and Requiring Orthodontic Management.

    PubMed

    Mathu-Muju, Kavita R; Kennedy, David B

    2016-10-15

    Extraction of significantly compromised permanent first molars may be indicated during the mixed dentition stage of occlusal development. The purpose of this article was to review circumstances that can result in the loss of a permanent first molar-including dental caries, molar incisor hypomineralization, eruption disturbances of permanent teeth, and failure of restorative treatment to affirm that a complete dental arch is not necessary for the existence of a functional dental arch. The extraction of permanent first molar(s) with subsequent orthodontic treatment in a young patient can be considered a cost-effective alternative to placing complex restorations that require replacement over the lifespan. Approaches to establish a functional dental arch in the event of the loss of a permanent first molar(s) are outlined. Additionally, orthodontic diagnostic and treatment principles are reviewed. Case histories are provided to illustrate the clinical management of permanent first molar extractions to achieve a functional dental arch.

  19. Subcostal closure technique for prevention of postthoracotomy pain syndrome.

    PubMed

    Hong, Kipyo; Bae, Mikyung; Han, Sora

    2016-09-01

    The purpose of this study was to evaluate the efficacy of our subcostal closure technique in prevention of postthoracotomy pain syndrome. From July 2012 to March 2015, 29 patients in whom a lobectomy was indicated underwent a thoracotomy. The thoracotomy wounds were closed using a subcostal closure technique (subcostal closure group) and outcomes were compared with 31 patients who underwent video-assisted thoracoscopic surgery (thoracoscopy group). The duration of oral opioid consumption was evaluated from medical records, and postoperative pain was evaluated by telephone interview conducted by a trained nurse practitioner who was unaware of the patient's group. Pain scores were higher in the thoracoscopy group compared to the subcostal closure group, reaching statistical significance (Numeric Rating Scale 0.55 ± 0.948 in the subcostal closure group vs. 1.84 ± 1.614 in the thoracoscopy group; p < 0.001, Clinical Pain Scale 0.24 ± 0.435 in the subcostal closure group vs. 0.81 ± 0.703 in the thoracoscopy group; p < 0.001). The number of patients who consumed oral opioids for longer than 2 months after the operation was significantly greater in the thoracoscopy group than the subcostal closure group (6.9% in the subcostal closure group vs. 32.3% in the thoracoscopy group; p = 0.022). The subcostal closure technique is useful to prevent postthoracotomy pain syndrome. © The Author(s) 2016.

  20. Particulate contamination from siliconized rubber closures for freeze drying.

    PubMed

    Gebhardt, U; Grumbridge, N A; Knoch, A

    1996-01-01

    It can be shown that siliconized closures for freeze drying may cause the opalescence and turbidity observed in freeze-dried products after reconstitution. Closures of different rubber composition show different intensities of turbidity when treated identically with the same quantity and type of silicone oil. Clear solutions are obtained after reconstitution if ETFE-coated closures are used instead of siliconized closures. Samples stored at 4 degrees C for up to 6 months show no change in the intensity of turbidity, while the turbidity of samples manufactured with siliconized closures and stored at higher temperatures increase with time. Samples with ETFE-coated closures show clear solutions when stored at 25 degrees C and 37 degrees C for up to 6 months and at 45 degrees C for 3 months. After 6 months only a very weak opalescence could be observed in these samples.

  1. Improving the Safety of Moving Lane Closures

    DOT National Transportation Integrated Search

    2009-06-01

    Moving lane closures are an increasingly utilized and inherently hazardous traffic control procedure for highway : maintenance and operations activities. To improve the safety of moving lane closures for workers and motorists, : this research studied...

  2. Permanent split capacitor single phase electric motor system

    DOEpatents

    Kirschbaum, H.S.

    1984-08-14

    A permanent split capacitor single phase electric motor achieves balanced operation at more than one operating point by adjusting the voltage supplied to the main and auxiliary windings and adjusting the capacitance in the auxiliary winding circuit. An intermediate voltage tap on an autotransformer supplies voltage to the main winding for low speed operation while a capacitive voltage divider is used to adjust the voltage supplied to the auxiliary winding for low speed operation. 4 figs.

  3. Achieving ideal donor site aesthetics with autologous breast reconstruction

    PubMed Central

    2015-01-01

    The appearance of the donor site following breast reconstruction with abdominal flaps has become an important topic for study. Given the variety of flaps that are derived from the abdomen, decisions are often based on how much muscle and fascia will be harvested. Comparisons between muscle sparing and non-muscle sparing techniques have been performed with outcomes related to function and contour. Closure techniques will vary and include primary fascial closure, mesh reinforcement and additional fascial plication all of which can produce natural and sometimes improved abdominal contours. Proper patient selection however is important. This manuscript will describe various techniques in order to achieve ideal abdominal contour following autologous reconstruction. PMID:26005646

  4. Systematization of a set of closure techniques.

    PubMed

    Hausken, Kjell; Moxnes, John F

    2011-11-01

    Approximations in population dynamics are gaining popularity since stochastic models in large populations are time consuming even on a computer. Stochastic modeling causes an infinite set of ordinary differential equations for the moments. Closure models are useful since they recast this infinite set into a finite set of ordinary differential equations. This paper systematizes a set of closure approximations. We develop a system, which we call a power p closure of n moments, where 0≤p≤n. Keeling's (2000a,b) approximation with third order moments is shown to be an instantiation of this system which we call a power 3 closure of 3 moments. We present an epidemiological example and evaluate the system for third and fourth moments compared with Monte Carlo simulations. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. The etiology and determinants of hospital closure.

    PubMed

    Longo, D R; Sohn, M W; Shortell, S M

    1996-01-01

    This article examines the etiology of hospital closure and the correlates of hospital closure and the extent of similarity in this organizational outcome between pre- and post-Prospective Payment System (PPS) implementation. It also replicates a study from an earlier time period. Findings support the study's main hypotheses: in more stringent and turbulent markets, institutional and strategic variables are more important determinants of hospital closure. Merger acquisitions are found to be similar to both system acquisitions and autonomous hospitals. Standard Metropolitan Statistical Area (SMSA) status and regulation show an effect on hospital closure and merger acquisition. While many similarities exist when compared to the replicated study and findings prior to PPS implementation, it appears that sufficient differences exist to support the hypothesis that the PPS has an impact upon hospital organizational outcome.

  6. Speckle-Tracking Echocardiography in Dogs With Patent Ductus Arteriosus: Effect of Percutaneous Closure on Cardiac Mechanics.

    PubMed

    Spalla, I; Locatelli, C; Zanaboni, A M; Brambilla, P; Bussadori, C

    2016-05-01

    Patent ductus arteriosus (PDA) is 1 of the most common congenital heart defects in dogs and percutaneous closure is effective in achieving ductal closure; PDA closure is associated with abrupt hemodynamic changes. A marked decrease in standard parameters of systolic function as assessed by M- or B-mode echocardiography after PDA closure was identified in previous studies. Speckle tracking echocardiography can provide further insight into the effect of PDA closure on cardiac mechanics in dogs affected by PDA. Twenty-five client-owned dogs with PDA. Prospective study. Dogs were recruited over a 2-year period. Complete echocardiographic evaluation was performed before and 24 hours after PDA closure, including standard (end-diastolic volumes indexed to body surface area in B- and M-mode [EDVIB /M ], end-systolic volumes indexed to body surface area in B- and M-mode [ESVIB /M ], allometric scaling in diastole [AlloD] and systole [AlloS], pulmonary flow to systemic flow [Qs/Qp], ejection fraction [EF], and fractional shortening [FS]), and advanced speckle-tracking echocardiography (STE): global longitudinal, radial, circumferential and transverse strain (S), and strain rate (SR). Patent ductus arteriosus closure was associated with statistically significant decreases in EDVIM /B and ESVIM /B , AlloD and AlloS, SI, EF, and FS. A statistically significant decrease in the absolute values of radial, transverse, and circumferential S and SR was observed, whereas longitudinal S and SR did not change significantly. Patent ductus arteriosus closure by percutaneous approach is associated with marked decreases of conventional echocardiographic parameters as a result of the changes in loading conditions, but no evidence of systolic dysfunction was identified by means of STE, as none of the S and SR values were below reference ranges. In the short term, contractility is enhanced in the long axis (long S/SR values were not statistically different before and after closure) and

  7. Evaluation of Container Closure System Integrity for Frozen Storage Drug Products.

    PubMed

    Nieto, Alejandra; Roehl, Holger; Brown, Helen; Nikoloff, Jonas; Adler, Michael; Mahler, Hanns-Christian

    2016-01-01

    Sometimes, drug product for parenteral administration is stored in a frozen state (e.g., -20 °C or -80 °C), particularly during early stages of development of some biotech molecules in order to provide sufficient stability. Shipment of frozen product could potentially be performed in the frozen state, yet possibly at different temperatures, for example, using dry ice (-80 °C). Container closure systems of drug products usually consist of a glass vial, rubber stopper, and an aluminum crimped cap. In the frozen state, the glass transition temperature (Tg) of commonly used rubber stoppers is between -55 and -65 °C. Below their Tg, rubber stoppers are known to lose their elastic properties and become brittle, and thus potentially fail to maintain container closure integrity in the frozen state. Leaks during frozen temperature storage and transportation are likely to be transient, yet, can possibly risk container closure integrity and lead to microbial contamination. After thawing, the rubber stopper is supposed to re-seal the container closure system. Given the transient nature of the possible impact on container closure integrity in the frozen state, typical container closure integrity testing methods (used at room temperature conditions) are unable to evaluate and thus confirm container closure integrity in the frozen state. Here we present the development of a novel method (thermal physical container closure integrity) for direct assessment of container closure integrity by a physical method (physical container closure integrity) at frozen conditions, using a modified He leakage test. In this study, different container closure systems were evaluated with regard to physical container closure integrity in the frozen state to assess the suitability of vial/stopper combinations and were compared to a gas headspace method. In summary, the thermal physical container closure integrity He leakage method was more sensitive in detecting physical container closure

  8. Percutaneous closure of patent arterial ducts in patients from high altitude: a sub-Saharan experience.

    PubMed

    Tefera, Endale; Qureshi, Shakeel A; Bermudez-Cañete, Ramòn; Rubio, Lola

    2015-01-01

    At high altitude, patent arterial ducts tend to be larger and associated with pulmonary hypertension. Patent ductus arteriosus device closure in this background could be challenging. We report our experience with percutaneous closure of patent arterial ducts using a variety of devices in patients residing in a high altitude. This is a retrospective review of the case records of 145 patients (age 9 months-20 years, mean 5.6 ± 3.9 years, and weight 7-54 kg, mean 17.7 ± 9.4) with duct sizes ranging between 2 and 21 mm, (mean, 5.8 ± 2.7) who underwent percutaneous closure of patent arterial ducts. One hundred thirty-six (93.8%) of the patients were from a geographic area of 2100-2800 m above sea level. Successful device closure was achieved in 143 cases. It was difficult to achieve device stability in two patients with expansile ducts. Therefore, they were treated surgically. The devices used were various types of duct occluder devices in 131 patients, while atrial and ventricular septal occluders were used in eight patients. For the group, mean systolic pulmonary artery (PA) pressure decreased from 47.0 ± 16.7 mmHg before occlusion to 29.0 ± 7.4 mmHg after occlusion (P ≤ 0.001)., mean diastolic PA pressure from 25.0 ± 10.9 mmHg to 14.8 ± 6.0 mmHg and the average mean PA pressure decreased from 35.9 ± 13.5 mmHg to 21.1 ± 6.5 mmHg. Complications (4.8%) included device and coil embolization, bleeding, and pulse loss. On follow-up (mean duration of 36.1 ± 12.1 months, range 12-62 months), 137 patients were in functional class 1, 3 had residual shunt, 2 had device migration and one patient had persisting pulse loss. Successful duct closure was achieved in the vast majority of patients, even though the ducts were larger and significant number of them had pulmonary hypertension in this high altitude group. There was a relatively higher incidence of residual shunts and device migration in this series, generally due to the nonavailability of optimal device and

  9. DNAPL Remediation: Selected Projects Approaching Regulatory Closure

    EPA Pesticide Factsheets

    This paper is a status update on the use of DNAPL source reduction remedial technologies, and provides information about recent projects where regulatory closure has been reached or projects are approaching regulatory closure, following source reduction.

  10. Photovoltaic-wind hybrid system for permanent magnet DC motor

    NASA Astrophysics Data System (ADS)

    Nasir, M. N. M.; Lada, M. Y.; Baharom, M. F.; Jaafar, H. I.; Ramani, A. N.; Sulaima, M. F.

    2015-05-01

    Hybrid system of Photovoltaic (PV) - Wind turbine (WT) generation has more advantages and reliable compared to PV or wind turbine system alone. The aim of this paper is to model and design hybrid system of PV-WT supplying 100W permanent-magnet dc motor. To achieve the objective, both of PV and WT are connected to converter in order to get the same source of DC supply. Then both sources were combined and straightly connected to 100W permanent magnet dc motor. All the works in this paper is only applied in circuit simulator by using Matlab Simulink. The output produced from each converter is expected to be suit to the motor specification. The output produced from each renewable energy system is as expected to be high as it can support the motor if one of them is breakdown

  11. Transcatheter closure of patent ductus arteriosus: 11 years of clinical experience in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

    PubMed

    Djer, Mulyadi M; Saputro, Dimas Dwi; Putra, Sukman Tulus; Idris, Nikmah Salamia

    2015-06-01

    Transcatheter closure of patent ductus arteriosus (PDA) has been suggested to be the standard treatment of PDA. Although, in general, the procedure shows a high successful rate, outcomes may vary among pediatric cardiology centers. To evaluate the effectiveness of transcatheter closure of PDA in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, this was a retrospective study on patients who underwent transcatheter closure of PDA in Cipto Mangunkusumo Hospital during the period of 2002-2013. Hospital registry was reviewed and data about patients' characteristics, PDA severity, procedure, and outcomes were retrieved. There were 298 patients, of whom 90 were males, who underwent transcatheter closure of PDA during the study period. Median age was 3.4 years (1 months-18 years), and median body weight was 12 (3.6-59) kg. The diameter of PDA ranged from 1.1 to 15.4 mm with a median of 3.7 mm. Device could be deployed in all patients, in which most were the Amplatzer ductal occluder (69.8 %) and the remainders were coils. Median fluoroscopy time was 15.4 (1.5-87) min, and procedure time was 76 (30-200) min. Complete closure was achieved in most patients (97.3 %), whereas device migration occurred in a minority (0.3 %) of patients. No major complication occurred during or after the procedure. Transient anemia and bradycardia were found in 3.7 and 1.3 % patients, respectively. Most patients were discharged from the hospital at 1 day after the procedure. Transcatheter closure method is a safe and effective procedure to close PDA.

  12. 40 CFR 280.70 - Temporary closure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (UST) Out-of-Service UST Systems and Closure § 280.70 Temporary closure. (a) When an UST system is... the UST system is empty. The UST system is empty when all materials have been removed using commonly... the total capacity of the UST system, remain in the system. (b) When an UST system is temporarily...

  13. 40 CFR 280.70 - Temporary closure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (UST) Out-of-Service UST Systems and Closure § 280.70 Temporary closure. (a) When an UST system is... the UST system is empty. The UST system is empty when all materials have been removed using commonly... the total capacity of the UST system, remain in the system. (b) When an UST system is temporarily...

  14. 40 CFR 280.70 - Temporary closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (UST) Out-of-Service UST Systems and Closure § 280.70 Temporary closure. (a) When an UST system is... the UST system is empty. The UST system is empty when all materials have been removed using commonly... the total capacity of the UST system, remain in the system. (b) When an UST system is temporarily...

  15. 40 CFR 280.70 - Temporary closure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (UST) Out-of-Service UST Systems and Closure § 280.70 Temporary closure. (a) When an UST system is... the UST system is empty. The UST system is empty when all materials have been removed using commonly... the total capacity of the UST system, remain in the system. (b) When an UST system is temporarily...

  16. 40 CFR 280.70 - Temporary closure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (UST) Out-of-Service UST Systems and Closure § 280.70 Temporary closure. (a) When an UST system is... the UST system is empty. The UST system is empty when all materials have been removed using commonly... the total capacity of the UST system, remain in the system. (b) When an UST system is temporarily...

  17. Crack closure on rehydration of glass-ionomer materials.

    PubMed

    Sidhu, Sharanbir K; Pilecki, Peter; Sherriff, Martyn; Watson, Timothy F

    2004-10-01

    Moisture-sensitivity of immature glass-ionomer cements suggests that hydration-induced volumetric expansion might close and potentially heal established cracks. Crack closure in glass-ionomer cements (GICs) was observed following rehydration. Circular cavities were prepared in 15 teeth: 10 were restored with resin-modified GICs (5 with Fuji II LC and 5 with Photac-Fil) and 5 were restored with a conventional GIC (Fuji IX); all were dehydrated for 1 min with air and imaged immediately by confocal microscopy. Crack formation in each was located, after which water was placed on the surface and observed for 15 min via a CCD camera. Dehydration caused cracks with measurable gaps, while rehydration resulted in varying degrees of closure: closure was limited in the conventional GIC, and complete or near complete along part/s of the crack in the resin-modified GICs. In all, closure movement became imperceptible after the first 10 min. Statistical analysis indicated no significant difference between the closure behavior of all materials. However, the resin-modified GICs appeared to show a greater potential for closure of established cracks than the conventional GIC upon rehydration.

  18. Piagetian object permanence and its development in Eurasian jays (Garrulus glandarius).

    PubMed

    Zucca, Paolo; Milos, Nadia; Vallortigara, Giorgio

    2007-04-01

    Object permanence in Eurasian jays (Garrulus glandarius) was investigated using a complete version of the Uzgiris and Hunt scale 1. Nine hand-raised jays were studied, divided into two groups according to their different developmental stages (experiment 1, older jays: 2-3 months old, n = 4; experiment 2, younger jays: 15 days old, n = 5). In the first experiment, we investigated whether older jays could achieve piagetian stage 6 of object permanence. Tasks were administered in a fixed sequence (1-15) according to the protocols used in other avian species. The aim of the second experiment was to check whether testing very young jays before their development of "neophobia" could influence the achievement times of piagetian stages. Furthermore, in this experiment tasks were administered randomly to investigate whether the jays' achievement of stage 6 follows a fixed sequence related to the development of specific cognitive abilities. All jays tested in experiments 1 and 2 fully achieved piagetian stage 6 and no "A not B" errors were observed. Performance on visible displacement tasks was better than performance on invisible ones. The results of experiment 2 show that "neophobia" affected the response of jays in terms of achievement times; the older jays in experiment 1 took longer to pass all the tasks when compared with the younger, less neophobic, jays in experiment 2. With regard to the achieving order, jays followed a fixed sequence of acquisition in experiment 2, even if tasks were administered randomly, with the exception of one subject. The results of these experiments support the idea that piagetian stages of cognitive development exist in avian species and that they progress through relatively fixed sequences.

  19. Mechanics of Wound Closure: Emerging Tape-Based Wound Closure Technology vs. Traditional Methods.

    PubMed

    Levi, Kemal; Ichiryu, Kei; Kefel, Pelin; Keller, Juergen; Grice, Jon; Belson, Ori; Storne, Eric; Safa, Bauback

    2016-10-12

    To date, there is still a lack of understanding of how wound closure methods perform comparatively under daily bodily movement during the course of healing and how they affect the mechanics of healing. The present study is a first step in understanding and objectively quantifying the gap. The study provides both a new method of metrology for noninvasive evaluation of skin mechanics at the onset of wound healing and an emerging tape-based wound closure technology. The latter shows better performance with respect to commonly used staples and sutures, holding the wound intact and providing uniform mechanical support across the incision.

  20. Taking Closure to the Next Level - 13030

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Feist, E.T.

    2013-07-01

    The River Corridor Closure Project (RCCP) is the Hanford Site's first closure project and when it is complete, in 2015, it will have cleaned up 220 mi{sup 2} of contaminated land adjacent to the Columbia River. Washington Closure Hanford (WCH) was selected by the DOE to manage the removal and cleanup of Hanford's nuclear legacy along the River Corridor. Work began in 2005 and is now more than 85% complete with more than 2 years left in the contract. A Closure Team was commissioned in December 2009 and has since issued a closure strategy and a disciplined three-phase approach tomore » transition land parcels to DOE, Richland Operations Office (DOE-RL) as cleanup is completed. This process supports DOE-RL objectives for progressive footprint reduction based on the division of the River Corridor into geographical land parcels. It also allows for incremental area-by-area transition and turnover to the Long-Term Stewardship program. Several important milestones stand between now and the successful end of the RCCP. They include overall funding impacts, working with DOE-RL on new scope additions, meeting regulatory milestones, and maintaining a strong safety performance. (authors)« less

  1. A nonlocal fluid closure for antiparallel reconnection

    NASA Astrophysics Data System (ADS)

    Ng, J.; Hakim, A.; Bhattacharjee, A.

    2016-12-01

    The integration of kinetic effects in fluid models is an important problem in global simulations of the Earth's magnetosphere and space weather modelling. In particular, it has been shown that ion kinetics play an important role in the dynamics of large reconnecting systems, and that fluid models can account of some of these effects[1,2] . Here we introduce a new fluid model and closure for collisionless magnetic reconnection and more general applications. Taking moments of the kinetic equation, we evolve the full pressure tensor for electrons and ions, which includes the off diagonal terms necessary for reconnection. Kinetic effects are recovered by using a nonlocal heat flux closure, which approximates linear Landau damping in the fluid framework [3]. Using the island coalescence problem as a test, we show how the nonlocal ion closure improves on the typical collisional closures used for ten-moment models and circumvents the need for a colllisional free parameter. Finally, we extend the closure to study guide-field reconnection and discuss the implementation of a twenty-moment model.[1] A. Stanier et al. Phys Rev Lett (2015)[2] J. Ng et al. Phys Plasmas (2015)[3] G. Hammett et al. Phys Rev Lett (1990)

  2. Columbus Closure Project Released without Radiological Restrictions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Henderson, G.

    2007-07-01

    The Columbus Closure Project (CCP), a historic radiological research complex, was cleaned up for future use without radiological restriction in 2006. The CCP research and development site contributed to national defense, nuclear fuel fabrication, and the development of safe nuclear reactors in the United States until 1988 when research activities were concluded for site decommissioning. In November of 2003, the Ohio Field Office of the U.S. Department of Energy contracted ECC/E2 Closure Services, LLC (Closure Services) to complete the removal of radioactive contamination from of a 1955 era nuclear sciences area consisting of a large hot cell facility, research reactormore » building and underground piping. The project known as the Columbus Closure Project (CCP) was completed in 27 months and brought to a close 16 years of D and D in Columbus, Ohio. This paper examines the project innovations and challenges presented during the Columbus Closure Project. The examination of the CCP includes the project regulatory environment, the CS safety program, accelerated clean up innovation, project execution strategies and management of project waste issues and the regulatory approach to site release 'without radiological restrictions'. (authors)« less

  3. Options for Closure of the Infected Abdomen

    PubMed Central

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

    2012-01-01

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

  4. Humid site stabilization and closure

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cutshall, N.H.

    1981-01-01

    The purpose of the work described here is to identify and evaluate the importance of factors that are expected to dictate the nature of site stabilization and closure requirements. Subsequent efforts will plan for implementation of such requirements. Two principal areas of site stabilization and closure effort will be pursued initially - geological management and vegetation management. The geological effort will focus on chemical weathering and surficial erosion. Such catastrophic geologic events as landslides, flooding, earthquakes, volcanos, etc. are already considered in site selection and operation and these factors will not be emphasized initially. Vegetation management will be designed tomore » control erosion, to minimize nuclide mobilization by roots and to be compatible with natural successional pressures. It is anticipated that the results of this work will be important both to site selection and operation as well as the actual stabilization and closure procedure.« less

  5. Transcatheter closure of patent ductus arteriosus: past, present and future.

    PubMed

    Baruteau, Alban-Elouen; Hascoët, Sébastien; Baruteau, Julien; Boudjemline, Younes; Lambert, Virginie; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme; Pass, Robert

    2014-02-01

    This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Barbed suture material technique for wound closure and concomitant tube placement in uniportal VATS for pneumothorax

    PubMed Central

    2017-01-01

    Background Uniportal video-assisted thoracoscopic surgery (VATS) is an alternative modality for treatment of primary spontaneous pneumothorax (PSP) with its less invasiveness and acceptable surgical outcomes. However, a few reports have been introduced for wound management to achieve better cosmetic wound healing and for placement of the chest tube in uniportal VATS. Thus, we aimed to evaluate the feasibility of our novel method for wound closure and concomitant tube placement using continuous barbed suture material in uniportal VATS for PSP. Methods Between July 2012 and December 2015, consecutive 31 patients (22 males) underwent uniportal VATS to treat PSP. Bilateral approaches were performed in four patients, thus total 35 cases were enrolled. We divided them into two groups with one group of 17 (48.5%) cases (group A), using barbed absorbable wound closure device for knotless continuous wound closure and subsequent chest tube anchoring, and the other group of 18 (51.4%) cases (group B), using conventional suture anchoring after skin closure using absorbable suture device. Postoperative surgical outcomes were compared to assess the feasibility of this technique. Results Demographic data demonstrate no significant difference in both groups. There was no significant difference in length of hospital stay (3.7±1.2 vs. 4.1±1.2 days, P=0.267) and in median chest tube indwelling time (2.4±0.9 vs. 3.1±1.2 days, P=0.066), respectively. Operation time in group A was shorter than in group B but there was no significant difference (41.7±11.8 vs. 45.6±16.0 minutes, P=0.415). There was neither conversion to two or three port VATS in all cases. In group A, all chest tubes were removed with concomitant sealing the tube removal site by pulling the thread. Residual knots do not exist that stitch out procedure is not required. There was no wound complication in both groups during the median follow-up period of 18 months. Conclusions Knotless, barbed suture material technique

  7. Permanent medialization of the paralyzed vocal fold utilizing botulinum toxin and Gelfoam.

    PubMed

    Rontal, Eugene; Rontal, Michael

    2003-09-01

    The clinical picture of a paralyzed vocal fold often has the same appearance as a subluxated arytenoid, with anterior and medial displacement of the arytenoid and a foreshortened and lax vocal fold. Previous work by the authors has shown that a subluxated arytenoid may be permanently repositioned by reduction and selective injection of the intrinsic laryngeal musculature with botulinum toxin. The injection changes the forces within the larynx, allowing the arytenoid to be brought back to proper position on the cricoid cartilage. This concept has been extended to the paralyzed vocal fold. It has been noted that even a clinically paralyzed vocal fold has voluntary motor units that may still act on the arytenoid through residual action from the interarytenoid and synkinesis. These forces are significant enough to manipulate the arytenoid and, thus, the vocal fold, into its correct, adducted position. In this paper, the arytenoid is mobilized to free any fibrosis. The thyroarytenoid and lateral cricoarytenoid muscles are then injected to prevent any forward synkinetic pull on the arytenoid. Next, a Gelfoam injection medializes the vocal fold to create glottic closure. This rebalancing sufficiently positions the arytenoid, so that valvular function is permanently restored. In the ten patients studied for over 1 year, there was a 90% success rate as measured by videostroboscopy, phonation time, and V-RQOL analysis. There were no untoward complications. All the materials used are nonpermanent. The procedure does not limit other techniques from being performed at a later time.

  8. A comparison of two endoscopic closures: over-the-scope clip (OTSC) versus KING closure (endoloop + clips) in a randomized long-term experimental study.

    PubMed

    Dolezel, R; Ryska, O; Kollar, M; Juhasova, J; Kalvach, J; Ryska, M; Martinek, J

    2016-11-01

    Both over-the-scope clip (OTSC) and KING (endoloop + clips) closures provide reliable and safe full-thickness endoscopic closure. Nevertheless, OTSC clip demonstrated significantly inferior histological healing in the short-term follow-up. To compare OTSC versus KING closure of a perforation with regard to long-term effectiveness and macroscopic and histological quality of healing. We performed a randomized experimental study with 16 mini-pigs (mean weight 43.2 ± 11.2 kg). A standardized perforation was performed on the anterior sigmoid wall. KING closure (n = 8) was attained by approximation of an endoloop fixed to the margins of a perforation with endoclips. OTSC closure (n = 8) was performed by deploying OTSC (OVESCO) over the defect. Pigs underwent a control sigmoidoscopy 8 months after the closure to assess the macroscopic quality of healing. Then, autopsy was performed and the rectosigmoid was sent for histopathological assessment. All closures were completed successfully without air leaks. The duration of closure was similar in both techniques (OTSC 17.8 ± 7.6 min vs. KING 19.6 ± 8.8 min). At autopsy, all KING closures (100 %) were healed with a flat scar without signs of leakage. Microscopically, no inflammatory changes were observed after KING closure. In the OTSC group, microscopic ulcers were present in two pigs (25 %), cryptal abscesses in three pigs (38 %) and significant neutrophil accumulation in all eight pigs (P < 0.01). Giant cell granulomas, dysplasia or abundant scarification was not observed in either group. Both OTSC and KING closures offer a long-term reliable seal of a gastrointestinal perforation without stenosis or fistulas. KING closure provides long-term histologically superior healing.

  9. 40 CFR 264.1202 - Closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... closure of a magazine or unit which stored hazardous waste under this subpart, the owner or operator must..., and financial responsibility for magazines or units must meet all of the requirements specified in... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

  10. Extended negative pressure wound therapy-assisted dermatotraction for the closure of large open fasciotomy wounds in necrotizing fasciitis patients

    PubMed Central

    2014-01-01

    Background Necrotizing fasciitis (NF) is a rapid progressive infection of the subcutaneous tissue or fascia and may result in large open wounds. The surgical options to cover these wounds are often limited by the patient condition and result in suboptimal functional and cosmetic wound coverage. Dermatotraction can restore the function and appearance of the fasciotomy wound and is less invasive in patients with comorbidities. However, dermatotraction for scarred, stiff NF fasciotomy wounds is often ineffective, resulting in skin necrosis. The authors use extended negative pressure wound therapy (NPWT) as an assist in dermatotraction to close open NF fasciotomy wounds. The authors present the clinical results, followed by a discussion of the clinical basis of extended NPWT-assisted dermatotraction. Methods A retrospective case series of eight patients with NF who underwent open fasciotomy was approved for the study. After serial wound preparation, dermatotraction was applied in a shoelace manner using elastic vessel loops. Next, the extended NPWT was applied over the wound. The sponge was three times wider than the wound width, and the transparent covering drape almost encircled the anatomical wound area. The negative pressure of the NPWT was set at a continuous 100 mmHg by suction barometer. The clinical outcome was assessed based on wound area reduction after treatment and by the achievement of direct wound closure. Results After the first set of extended NPWT-assisted dermatotraction procedures, the mean wound area was significantly decreased (658.12 cm2 to 29.37 cm2; p = 0.002), as five out of eight patients achieved direct wound closure. One patient with a chest wall defect underwent latissimus dorsi musculocutaneous flap coverage, with primary closure of the donor site. Two Fournier’s gangrene patients underwent multiple sets of treatment and finally achieved secondary wound closure with skin grafts. The patients were followed up for 18.3 months on

  11. Highly stable and finely tuned magnetic fields generated by permanent magnet assemblies.

    PubMed

    Danieli, E; Perlo, J; Blümich, B; Casanova, F

    2013-05-03

    Permanent magnetic materials are the only magnetic source that can be used to generate magnetic fields without power consumption or maintenance. Such stand-alone magnets are very attractive for many scientific and engineering areas, but they suffer from poor temporal field stability, which arises from the strong sensitivity of the magnetic materials and mechanical support to temperature variation. In this work, we describe a highly efficient method useful to cancel the temperature coefficient of permanent magnet assemblies in a passive and accurate way. It is based on the combination of at least two units made of magnetic materials with different temperature coefficients arranged in such a way that the ratio of the fields generated by each unit matches the ratio of their effective temperature coefficients defined by both the magnetic and mechanical contributions. Although typically available magnetic materials have negative temperature coefficients, the cancellation is achieved by aligning the fields generated by each unit in the opposite direction. We demonstrate the performance of this approach by stabilizing the field generated by a dipolar Halbach magnet, recently proposed to achieve high field homogeneity. Both the field drift and the homogeneity are monitored via nuclear magnetic resonance spectroscopy experiments. The results demonstrate the compatibility of the thermal compensation approach with existing strategies useful to fine-tune the spatial dependence of the field generated by permanent magnet arrays.

  12. 10 CFR 61.29 - Post-closure observation and maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Post-closure observation and maintenance. 61.29 Section 61.29 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.29 Post-closure observation and maintenance. Following completion of closure...

  13. 10 CFR 61.29 - Post-closure observation and maintenance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Post-closure observation and maintenance. 61.29 Section 61.29 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.29 Post-closure observation and maintenance. Following completion of closure...

  14. 10 CFR 61.29 - Post-closure observation and maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Post-closure observation and maintenance. 61.29 Section 61.29 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.29 Post-closure observation and maintenance. Following completion of closure...

  15. 10 CFR 61.29 - Post-closure observation and maintenance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Post-closure observation and maintenance. 61.29 Section 61.29 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.29 Post-closure observation and maintenance. Following completion of closure...

  16. 10 CFR 61.29 - Post-closure observation and maintenance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Post-closure observation and maintenance. 61.29 Section 61.29 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.29 Post-closure observation and maintenance. Following completion of closure...

  17. Use of a counterfactual approach to evaluate the effect of area closures on fishing location in a tropical tuna fishery

    PubMed Central

    Davies, Tim K.; Mees, Chris C.; Milner-Gulland, E. J.

    2017-01-01

    Spatial closures are widely used in marine conservation and fisheries management and it is important to understand their contribution to achieving management objectives. Many previous evaluations of closed area effects have used before-after comparisons, which, without controlling for a full range of factors, cannot ascribe changes in fleet behaviour to area closures per se. In this study we used a counterfactual approach to disentangle the effect of two closed areas on fishing location from other competing effects on the behaviour of the Indian Ocean tuna purse seine fishery. Our results revealed an inconsistent effect of the one of the closed areas between years, after taking into account the influence of environmental conditions on fleet behaviour. This suggests that the policy of closing the area per se was not the main driver for the fleet allocating its effort elsewhere. We also showed a marked difference in effect between the two closed areas resulting from their different locations in the fishery area. These findings highlight the need to account for other key fleet behavioural drivers when predicting or evaluating the contribution of area closures to achieving conservation and fishery management objectives. PMID:28355269

  18. Use of a counterfactual approach to evaluate the effect of area closures on fishing location in a tropical tuna fishery.

    PubMed

    Davies, Tim K; Mees, Chris C; Milner-Gulland, E J

    2017-01-01

    Spatial closures are widely used in marine conservation and fisheries management and it is important to understand their contribution to achieving management objectives. Many previous evaluations of closed area effects have used before-after comparisons, which, without controlling for a full range of factors, cannot ascribe changes in fleet behaviour to area closures per se. In this study we used a counterfactual approach to disentangle the effect of two closed areas on fishing location from other competing effects on the behaviour of the Indian Ocean tuna purse seine fishery. Our results revealed an inconsistent effect of the one of the closed areas between years, after taking into account the influence of environmental conditions on fleet behaviour. This suggests that the policy of closing the area per se was not the main driver for the fleet allocating its effort elsewhere. We also showed a marked difference in effect between the two closed areas resulting from their different locations in the fishery area. These findings highlight the need to account for other key fleet behavioural drivers when predicting or evaluating the contribution of area closures to achieving conservation and fishery management objectives.

  19. [Outcome of transcatheter closure of perimembranous ventricular septal defect with modified double-disk occluder device].

    PubMed

    Liu, Jing; You, Xiao-hua; Zhao, Xian-xian; Hu, Jian-qiang; Cao, Jiang; Xu, Rong-liang; Wu, Hong; Chen, Shao-ping; Zhang, Jian-liang; Zheng, Xing; Qin, Yong-wen

    2010-04-01

    To evaluate the efficacy and adverse effects of transcatheter closure of perimembranous ventricular septal defect (pmVSD) with modified double-disk occluder device (MDVO). Clinical data including clinical examination, electrocardiography daily after the procedure for a week, chest-X-rays and TTE before discharge and at 3-5 days after the procedure were analyzed from 604 patients underwent percutaneous closure of a pmVSD with MDVO at our department between December 2001 and December 2008. Procedure was successful in 576 out of 604 patients (95.4%) and 583 VSD occluders were placed. Endocarditis, thromboembolism, or deaths were not observed after procedure. Conduction block occurred in 81 patients (56 RBBB, 14 LBBB) and transient nonparoxysmal ventricular tachycardia in 31 patients after the procedure. Complete heart block occurred in 11 patients, 9 of them recovered in 3 weeks, permanent pacemaker was implanted in 2 patients (one had transient III degrees AVB before the procedure, the other underwent simultaneous closure of ventricular septal defect and atrial septal defect). Trivial/small residual shunts were found in 69 patients (12.0%). The residual shunts disappeared in 31 patients and remained unchanged in 38 patients (6.6%) 7 days after procedures. Aortic regurgitation developed in 5 patients (2 trivial/small, 3 small/moderate), and tricuspid regurgitation was present in 35 patients (32 trivial/small, 3 moderate). Five patients developed haemolysis (device retrieved via catheter in 1 patient due to persistent haemolysis, the other 4 patients recovered 3-14 days post procedure). Pseudoaneurysm of femoral artery occurred in 1 patient, and disappeared by pressure dressing. Device was successfully replaced in 2 patients with either device embolization (n = 1) or device misplacement (n = 1) after device retrieval by catheter. It is safe and effective to close congenital perimembranous ventricular septal defect with domestic-made occluder device.

  20. Pure natural orifice transluminal endoscopic surgery (NOTES) with ultrasonography-guided transgastric access and over-the-scope-clip closure: a porcine feasibility and survival study.

    PubMed

    Donatsky, Anders Meller; Andersen, Luise; Nielsen, Ole Lerberg; Holzknecht, Barbara Juliane; Vilmann, Peter; Meisner, Søren; Jørgensen, Lars Nannestad; Rosenberg, Jacob

    2012-07-01

    Most natural orifice transluminal endoscopic surgery (NOTES) procedures to date rely on the hybrid technique with simultaneous laparoscopic access to protect against access-related complications and to achieve adequate triangulation for dissection. This is done at the cost of the potential benefits of this new minimally invasive technique. This study aimed to evaluate the feasibility and safety of a transgastric (TG) pure-NOTES procedure in a diagnostic setting. A TG pure-NOTES procedure with endoscopic ultrasonograpy (EUS)-guided access and over-the-scope-clip (OTSC) closure was performed for 10 pigs in a survival and feasibility study. A full macroscopic necropsy with subsequent histologic evaluation was performed on postoperative day (POD) 14. The outcome parameters were uncomplicated follow-up assessment, survival, intraoperative complications, intraabdominal pathology, macroscopic full-thickness closure, and histology-proven full-thickness healing of the gastrotomy. An uncomplicated postoperative course was reported for 9 of the 10 pigs, and survival was reported for all 10 pigs. For all the pigs, EUS-guided access was performed successfully with a median duration of 25 min (range, 12-62 min) and without intraoperative complications or access-related lesions at necropsy. An OTSC closure was achieved with a median duration of 11 min (range, 3-28 min). The OTSC provided immediate closure, but according to the authors' definition of a full-thickness healing evaluated by histologic examination, this was not achieved in any of the cases. Although all the animals survived until POD 14, intraabdominal chronic abscesses were present in 3 of the 10 pigs at necropsy. The EUS-guided TG access proved to be feasible without access-related complications. Although OTSC provided an immediate closure, the histopathology raised concerns regarding the risk of perforation. Together with the high risk of intraabdominal infection, TG pure-NOTES is not yet ready for routine clinical

  1. Recombinant Amelogenin Protein Induces Apical Closure and Pulp Regeneration in Open-apex, Nonvital Permanent Canine Teeth.

    PubMed

    Mounir, Maha M F; Matar, Moustafa A; Lei, Yaping; Snead, Malcolm L

    2016-03-01

    Recombinant DNA-produced amelogenin protein was compared with calcium hydroxide in a study of immature apex closure conducted in 24 young mongrel dogs. Root canals of maxillary and mandibular right premolars (n = 240) were instrumented and left open for 14 days. Canals were cleansed, irrigated, and split equally for treatment with recombinant mouse amelogenin (n = 120) or calcium hydroxide (n = 120). After 1, 3, and 6 months, the animals were sacrificed and the treated teeth recovered for histologic assessment and immunodetection of protein markers associated with odontogenic cells. After 1 month, amelogenin-treated canals revealed calcified tissue formed at the apical foramen and a pulp chamber containing soft connective tissue and hard tissue; amelogenin-treated canals assessed after 3- and 6-month intervals further included apical tissue functionally attached to bone by a periodontal ligament. In contrast, calcified apical tissue was poorly formed in the calcium hydroxide group, and soft connective tissue within the pulp chamber was not observed. The findings from this experimental strategy suggest recombinant amelogenin protein can signal cells to enhance apex formation in nonvital immature teeth and promote soft connective tissue regeneration. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Second-order near-wall turbulence closures - A review

    NASA Technical Reports Server (NTRS)

    So, R. M. C.; Lai, Y. G.; Zhang, H. S.; Hwang, B. C.

    1991-01-01

    Advances in second-order near-wall turbulence closures are summarized. All closures under consideration are based on high-Reynolds-number models. Most near-wall closures proposed to date attempt to modify the high-Reynolds-number models for the dissipation function and the pressure redistribution term so that the resultant models are applicable all the way to the wall. The asymptotic behavior of the near-wall closures is examined and compared with the proper near-wall behavior of the exact Reynolds-stress equations. It is found that three second-order near-wall closures give the best correlations with simulated turbulence statistics. However, their predictions of near-wall Reynolds-stress budgets are considered to be incorrect. A proposed modification to the dissipitation-rate equation remedies part of those predictions. It is concluded that further improvements are required if a complete replication of all the turbulence properties and Reynolds-stress budgets by a statistical model of turbulence is desirable.

  3. Fatigue Crack Closure Analysis Using Digital Image Correlation

    NASA Technical Reports Server (NTRS)

    Leser, William P.; Newman, John A.; Johnston, William M.

    2010-01-01

    Fatigue crack closure during crack growth testing is analyzed in order to evaluate the critieria of ASTM Standard E647 for measurement of fatigue crack growth rates. Of specific concern is remote closure, which occurs away from the crack tip and is a product of the load history during crack-driving-force-reduction fatigue crack growth testing. Crack closure behavior is characterized using relative displacements determined from a series of high-magnification digital images acquired as the crack is loaded. Changes in the relative displacements of features on opposite sides of the crack are used to generate crack closure data as a function of crack wake position. For the results presented in this paper, remote closure did not affect fatigue crack growth rate measurements when ASTM Standard E647 was strictly followed and only became a problem when testing parameters (e.g., load shed rate, initial crack driving force, etc.) greatly exceeded the guidelines of the accepted standard.

  4. Vacuum assisted closure for the treatment of sternal wounds: the bridge between débridement and definitive closure.

    PubMed

    Song, David H; Wu, Liza C; Lohman, Robert F; Gottlieb, Lawrence J; Franczyk, Mieczyslawa

    2003-01-01

    A method to refine the treatment of sternal wounds using Vacuum Assisted Closure (V.A.C.) therapy as the bridge between débridement and delayed definitive closure is described. A retrospective review of 35 consecutive patients with sternal wound complications over a 2-year period (March of 1999 to March of 2001) was performed. The treatment of sternal wounds with traditional twice-a-day dressing changes was compared with the treatment with the wound V.A.C. device. An analysis of the number of days between initial débridement and closure, number of dressing changes, number and types of flaps needed for reconstruction, and complications was performed. Eighteen patients were treated with traditional twice-a-day dressing changes and 17 patients were treated with V.A.C. therapy alone. The two groups were similar regarding age, sex, type of cardiac procedure, and type of sternal wound. The V.A.C. therapy group had a trend toward a shorter interval between débridement and closure, with a mean of 6.2 days, whereas the dressing change group had mean of 8.5 days. The V.A.C. therapy group had a significantly lower number of dressing changes, with a mean of three, whereas the twice-a-day dressing change group had a mean of 17 (p < 0.05). Reconstruction required an average of 1.5 soft-tissue flaps per patient treated with traditional dressing changes versus 0.9 soft-tissue flaps per patient for those treated with V.A.C. therapy (p < 0.05). Before closure, there was one death among patients undergoing dressing changes and three in the V.A.C. therapy group, all of which were unrelated to the management of the sternal wound. Patients with sternal wounds who have benefited from V.A.C. therapy alone have a significant decrease in the number of dressing changes and number of soft-tissue flaps needed for closure. Finally, the V.A.C. therapy group had a trend toward a decreased number of days between débridement and closure.

  5. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; wastemore » characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references.« less

  6. Nonlinear closures for scale separation in supersonic magnetohydrodynamic turbulence

    NASA Astrophysics Data System (ADS)

    Grete, Philipp; Vlaykov, Dimitar G.; Schmidt, Wolfram; Schleicher, Dominik R. G.; Federrath, Christoph

    2015-02-01

    Turbulence in compressible plasma plays a key role in many areas of astrophysics and engineering. The extreme plasma parameters in these environments, e.g. high Reynolds numbers, supersonic and super-Alfvenic flows, however, make direct numerical simulations computationally intractable even for the simplest treatment—magnetohydrodynamics (MHD). To overcome this problem one can use subgrid-scale (SGS) closures—models for the influence of unresolved, subgrid-scales on the resolved ones. In this work we propose and validate a set of constant coefficient closures for the resolved, compressible, ideal MHD equations. The SGS energies are modeled by Smagorinsky-like equilibrium closures. The turbulent stresses and the electromotive force (EMF) are described by expressions that are nonlinear in terms of large scale velocity and magnetic field gradients. To verify the closures we conduct a priori tests over 137 simulation snapshots from two different codes with varying ratios of thermal to magnetic pressure ({{β }p}=0.25,1,2.5,5,25) and sonic Mach numbers ({{M}s}=2,2.5,4). Furthermore, we make a comparison to traditional, phenomenological eddy-viscosity and α -β -γ closures. We find only mediocre performance of the kinetic eddy-viscosity and α -β -γ closures, and that the magnetic eddy-viscosity closure is poorly correlated with the simulation data. Moreover, three of five coefficients of the traditional closures exhibit a significant spread in values. In contrast, our new closures demonstrate consistently high correlations and constant coefficient values over time and over the wide range of parameters tested. Important aspects in compressible MHD turbulence such as the bi-directional energy cascade, turbulent magnetic pressure and proper alignment of the EMF are well described by our new closures.

  7. Skin closure with dye-enhanced laser welding and fibrinogen.

    PubMed

    Wider, T M; Libutti, S K; Greenwald, D P; Oz, M C; Yager, J S; Treat, M R; Hugo, N E

    1991-12-01

    The topical application of wavelength-specific dye and fibrinogen has been used to enhance laser closure of vascular anastomoses. We compared the closure of skin incisions by two different dye-enhanced, fibrinogen-based laser welding systems [argon laser (power density 4.78 W/cm2) with fluorescein isothiocyanate dye (n = 32) and diode laser (power density 9.55 W/cm2) with indocyanine green dye (n = 32)] with closure by interrupted 5-0 nylon suture (n = 64) and examined tensile strength, hydroxyproline production, histology, and cosmesis. Two 3-cm full-thickness incisions were made on the shaved backs of 64 rats. One incision was closed with suture, whereas the other, after treatment with the appropriate dye, was welded with either argon- or diode-lasered fibrinogen. At postoperative days 5, 10, 15, and 28, the closure sites were harvested and sectioned for analysis. Initially, wounds closed with argon-lasered fibrinogen showed less inflammatory response, greater collagen production (34.61 +/- 0.74 mg/gm), and greater mean peak stress at rupture (64.85 lbs/in2) than those closed with suture (16.42 +/- 3.20 mg/gm, 26.68 lbs/in2) (p less than 0.05). By 15 days, both argon and diode laser closures are superior in strength and collagen production to suture closure (p less than 0.05). At 28 days, diode laser closures (1315.60 lbs/in2) are stronger than suture closures (998.09 lbs/in2), whereas both are stronger than argon laser closures (813.16 lbs/in2) (p less than 0.05). Cosmetically, argon-welded wounds consistently appeared finer and lacked cross-hatched suture scars.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Outcomes of mechanical stapling for postlaryngectomy open pharyngotomy closure.

    PubMed

    Paddle, Paul; Husain, Inna; McHugh, Lauren; Franco, Ramon

    2017-03-01

    A total laryngectomy (TL) is performed as a primary or salvage therapy for laryngeal carcinoma. Pharyngotomy closure after TL is typically performed using manual sutures. Automatic stapling devices are routinely used in thoracoabdominal surgery, but have not been widely accepted for use in pharyngotomy closure. Previously described closed stapling techniques of pharyngeal closure do not allow direct evaluation of surgical margins and are limited to endolaryngeal disease. We describe an open technique for pharyngotomy closure using a mechanical stapling device. Retrospective review. A review was conducted of 16 total laryngectomies performed from May 2008 to August 2015 utilizing an Ethicon Endopath ETS Compact-Flex 45 stapler. Sixteen patients (15 male, one female), mean age 69 years, received open TL (14 salvage, two primary) with endostapler pharyngeal closure and primary tracheoesophageal puncture (TEP). Surgical time averaged 218 minutes. Median time to swallowing was 4 days (range, 2-240 days) and mean hospital stay 6 days (range, 3-10 days). Fistula incidence was 31% (5/16) overall and 36% (5/14) in the postradiation patients. Mechanical stapling is a simple method for postlaryngectomy open pharyngotomy closure. This technique allows evaluation of margins, easy primary TEP, and the opportunity for early swallowing and shorter hospital stays. In addition, it can be performed for closure of salvage laryngectomies with rates of fistula formation similar to that found in the literature using suture closure techniques. Future studies are necessary to compare oncological results and surgical complications between the open and closed stapling techniques and to traditional suture closure. 4 Laryngoscope, 127:605-610, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Key financial ratios can foretell hospital closures.

    PubMed

    Lynn, M L; Wertheim, P

    1993-11-01

    An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.

  10. Hospital closure: Phoenix, Hydra or Titanic?

    PubMed

    Dunne, T; Davis, S

    1996-01-01

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

  11. School Closures in Rural Finnish Communities

    ERIC Educational Resources Information Center

    Autti, Outi; Hyry-Beihammer, Eeva Kaisa

    2014-01-01

    The network of small rural schools in Finland has been radically weakened since the global recession of the 1990s. This article focuses on the social role of rural schools and the phenomenon of school closures. Our aim is to look at rural schools from the viewpoint of local residents and examine how they experience school closures. We seek to hear…

  12. Spontaneous closure of traumatic macular hole

    PubMed Central

    Sanjay, Srinivasan; Yeo, Tun Kuan; Au Eong, Kah-Guan

    2012-01-01

    Macular hole formation is a well-known complication following ocular trauma. Less commonly recognised is the spontaneous closure of such holes. A 27-year-old man presented with a history of blunt trauma to his left eye. Eye evaluation showed conjunctival laceration, diffuse retinal oedema and multiple retinal haemorrhages in that eye. A month later, he developed a full thickness macular hole. Two months later, there was spontaneous complete closure of the full-thickness macular hole in the left eye as confirmed on optical coherence tomography. Spontaneous closure of hole is not uncommon. Observation for a period of up to 12 months is a reasonable management option. Macular hole surgery for traumatic macular holes may be delayed in such cases. PMID:23961017

  13. Spontaneous closure of traumatic macular hole.

    PubMed

    Sanjay, Srinivasan; Yeo, Tun Kuan; Au Eong, Kah-Guan

    2012-07-01

    Macular hole formation is a well-known complication following ocular trauma. Less commonly recognised is the spontaneous closure of such holes. A 27-year-old man presented with a history of blunt trauma to his left eye. Eye evaluation showed conjunctival laceration, diffuse retinal oedema and multiple retinal haemorrhages in that eye. A month later, he developed a full thickness macular hole. Two months later, there was spontaneous complete closure of the full-thickness macular hole in the left eye as confirmed on optical coherence tomography. Spontaneous closure of hole is not uncommon. Observation for a period of up to 12 months is a reasonable management option. Macular hole surgery for traumatic macular holes may be delayed in such cases.

  14. Simulating school closure policies for cost effective pandemic decision making

    PubMed Central

    2012-01-01

    Background Around the globe, school closures were used sporadically to mitigate the 2009 H1N1 influenza pandemic. However, such closures can detrimentally impact economic and social life. Methods Here, we couple a decision analytic approach with a mathematical model of influenza transmission to estimate the impact of school closures in terms of epidemiological and cost effectiveness. Our method assumes that the transmissibility and the severity of the disease are uncertain, and evaluates several closure and reopening strategies that cover a range of thresholds in school-aged prevalence (SAP) and closure durations. Results Assuming a willingness to pay per quality adjusted life-year (QALY) threshold equal to the US per capita GDP ($46,000), we found that the cost effectiveness of these strategies is highly dependent on the severity and on a willingness to pay per QALY. For severe pandemics, the preferred strategy couples the earliest closure trigger (0.5% SAP) with the longest duration closure (24 weeks) considered. For milder pandemics, the preferred strategies also involve the earliest closure trigger, but are shorter duration (12 weeks for low transmission rates and variable length for high transmission rates). Conclusions These findings highlight the importance of obtaining early estimates of pandemic severity and provide guidance to public health decision-makers for effectively tailoring school closures strategies in response to a newly emergent influenza pandemic. PMID:22713694

  15. Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure.

    PubMed

    Jeong, Young-Hoon; Yun, Tae-Jin; Song, Jong-Min; Park, Jung-Jun; Seo, Dong-Man; Koh, Jae-Kon; Lee, Se-Whan; Kim, Mi-Jeong; Kang, Duk-Hyun; Song, Jae-Kwan

    2007-09-01

    Left ventricular (LV) remodeling and predictors of LV systolic function late after closure of patent ductus arteriosus (PDA) in adults remain to be clearly demonstrated. In 45 patients with PDA, including 28 patients who received successful occlusion using the Amplatzer device (AD group) (AGA, Golden Valley, MN) and 17 patients who received surgical closure (OP group), echocardiography studies were performed before closure and 1 day (AD group) or within 7 days (OP group) after closure, and then were repeated at > or = 6 months (17 +/- 13 months). In both groups, LV ejection fraction (EF) and end-diastolic volume index were significantly decreased immediately after closure, whereas end-systolic volume index did not change. During the long-term follow-up period, end-systolic as well as end-diastolic volume indices decreased significantly in both groups and LV EF recovered compared to the immediate postclosure state. However, LV EF remained low compared to the preclosure state. Five patients (11.1%) including 3 patients in the AD group and 2 patients in the OP group showed persistent late LV systolic dysfunction (EF <50%). In stepwise, multiple logistic regression analysis, preclosure EF was the only independent predictor of late normal postclosure EF (odds ratio, 1.230; 95% CI, 1.054-1.434; P = .008). Receiver operating characteristic curve analysis showed that preclosure EF > or = 62% had a sensitivity of 72% and a specificity of 83% for predicting late normal LV EF after closure. Left ventricular EF remains low late after PDA closure compared with preclosure state in adults. Preclosure LV EF is the best index to predict late postclosure LV EF.

  16. Sampling and monitoring for closure

    USGS Publications Warehouse

    McLemore, V.T.; Russell, C.C.; Smith, K.S.

    2004-01-01

    The Metals Mining Sector of the Acid Drainage Technology Initiative (ADTI-MMS) addresses technical drainage-quality issues related to metal mining and related metallurgical operations, for future and active mines, as well as, for historical mines and mining districts. One of the first projects of ADTI-MMS is to develop a handbook describing the best sampling, monitoring, predicting, mitigating, and modeling of drainage from metal mines, pit lakes and related metallurgical facilities based upon current scientific and engineering practices. One of the important aspects of planning a new mine in today's regulatory environment is the philosophy of designing a new or existing mine or expansion of operations for ultimate closure. The holistic philosophy taken in the ADTI-MMS handbook maintains that sampling and monitoring programs should be designed to take into account all aspects of the mine-life cycle. Data required for the closure of the operation are obtained throughout the mine-life cycle, from exploration through post-closure.

  17. Transcatheter closure of ventricular septal defect with Occlutech Duct Occluder.

    PubMed

    Atik-Ugan, Sezen; Saltik, Irfan Levent

    2018-04-01

    Patent ductus arteriosus occluders are used for transcatheter closure of ventricular septal defects, as well as for closure of patent ductus arteriosus. The Occlutech Duct Occluder is a newly introduced device for transcatheter closure of patent ductus arteriosus. Here, we present a case in which the Occlutech Duct Occluder was successfully used on a patient for the closure of a perimembraneous ventricular septal defect.

  18. 40 CFR 265.146 - Use of a mechanism for financial assurance of both closure and post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Use of a mechanism for financial... OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 265.146 Use of a mechanism for financial assurance of both closure and post-closure care. An owner or operator...

  19. Orthodontic space closure without contralateral extraction through mesial movement of lower molars in patients with aplastic lower second premolars.

    PubMed

    Zimmer, B; Guitard, Y

    2001-09-01

    A method is presented that allows unilateral space closure in patients with aplastic lower second premolars. Based on a straight-wire appliance, space closure was achieved with a combination of "push mechanics" using the second molar as an anchorage unit and Class II "pull mechanics", thus avoiding the application of any distalizing force on the lower incisors. The results from 13 consecutively treated subjects (five boys, eight girls, mean age 12 years and 6 months) were analyzed. Complete bodily space closure was achieved in all 13 cases within a mean treatment time of 2 years and 7 months. The desired Angle Class III molar relationship of one premolar width (+/- 1/4 premolar width) on the aplastic side was successful in eleven patients, an additional 4.7 mm of space being created for the third molar on the aplastic side compared with the contralateral side (p < or = 0.01). However, adverse effects could be kept to a minimum, with no method-dependent side effects being recorded with regard to canine and molar relationships on the contralateral side, or to overbite, overjet, or upper and lower incisor inclination. The mean lower midline shift of 0.8 mm was in accordance with the mean distal canine relationship of 1/3 premolar width on the aplastic side. These results confirm that orthodontic space closure in cases of unilateral aplastic lower second premolars can be performed successfully with the presented treatment method without the need for additional premolar extractions, prosthodontic treatment or implants. Furthermore, the prognosis for the lower wisdom tooth on the aplastic side is improved.

  20. Seven-year follow-up of percutaneous closure of patent foramen ovale.

    PubMed

    Mirzada, Naqibullah; Ladenvall, Per; Hansson, Per-Olof; Johansson, Magnus Carl; Furenäs, Eva; Eriksson, Peter; Dellborg, Mikael

    2013-12-01

    Observational studies favor percutaneous closure of patent foramen ovale (PFO) over medical treatment to reduce recurrent stroke while randomized trials fail to demonstrate significant superiority of percutaneous PFO closure. Few long-term studies are available post PFO closure. This study reports long-term clinical outcomes after percutaneous PFO closure. Between 1997 and 2006, 86 consecutive eligible patients with cerebrovascular events, presumably related to PFO, underwent percutaneous PFO closure. All 86 patients were invited to a long-term follow-up, which was carried out during 2011 and 2012. Percutaneous PFO closure was successfully performed in 85 of 86 patients. The follow-up rate was 100%. No cardiovascular or cerebrovascular deaths occurred. Two patients (both women) died from lung cancer during follow-up. Follow-up visits were conducted for 64 patients and the remaining 20 patients were followed up by phone. The mean follow-up time was 7.3 years (5 to 12.4 years). Mean age at PFO closure was 49 years. One patient had a minor stroke one month after PFO closure and a transient ischemic attack (TIA) two years afterwards. One other patient suffered from a TIA six years after closure. No long-term device-related complications were observed. Percutaneous PFO closure was associated with very low risk of recurrent stroke and is suitable in most patients. We observed no mortality and no long-term device-related complications related to PFO closure, indicating that percutaneous PFO closure is a safe and efficient treatment even in the long term.

  1. 2005 Base Closure and Realignment Commission Report

    EPA Pesticide Factsheets

    The 2005 Defense Base Closure and Realignment Commission is proud to present its Final Report for your consideration. As required by law, the Commission thoroughly and objectively reviewed the domestic installation closure and realignment recommendations proposed by the Secretary of Defense on May 13, 2005.

  2. Modeling the Interactions Between Multiple Crack Closure Mechanisms at Threshold

    NASA Technical Reports Server (NTRS)

    Newman, John A.; Riddell, William T.; Piascik, Robert S.

    2003-01-01

    A fatigue crack closure model is developed that includes interactions between the three closure mechanisms most likely to occur at threshold; plasticity, roughness, and oxide. This model, herein referred to as the CROP model (for Closure, Roughness, Oxide, and Plasticity), also includes the effects of out-of plane cracking and multi-axial loading. These features make the CROP closure model uniquely suited for, but not limited to, threshold applications. Rough cracks are idealized here as two-dimensional sawtooths, whose geometry induces mixed-mode crack- tip stresses. Continuum mechanics and crack-tip dislocation concepts are combined to relate crack face displacements to crack-tip loads. Geometric criteria are used to determine closure loads from crack-face displacements. Finite element results, used to verify model predictions, provide critical information about the locations where crack closure occurs.

  3. [Innovations in continuing/permanent education methods for the intensive care nurses].

    PubMed

    Vázquez Guillamet, B; Guillamet Lloveras, A; Martínez Estalella, G; Pérez Ramírez, F

    2014-01-01

    Intensive care nursing is carried out in a dynamic environment characterized by the continuous incorporation of new technologies, approaches to care and a request for safety, participation and transparency by the public. Continuing/permanent intensive care nursing training in the acquisition of new competencies is key in this setting. In order to achieve this goal, simulation and problem based learning should be incorporated as essential methodologies to teach these skills. At the same time research should be done on which attitudes, competences, and knowledge are necessary to increase their intellectual knowledge. The core characteristics of ICU and its nursing should allow a deep change in their approach to continuing/permanent nursing education. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

  4. 50 CFR 600.511 - Fishery closure procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Fishery closure procedures. 600.511 Section 600.511 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... Fishery closure procedures. (a) Activity Codes 1 and 2 for a fishery are automatically canceled in the...

  5. Defense Base Closure and Realignment Commission

    DTIC Science & Technology

    1993-01-01

    during, their training . DLI required Only 803 houising units oii thle Army students inl thle human intelligence field Annex, the post cýxchiaige arid...community also stressed the Navy did not proposes significantly reduccd closure costs by know the true cost of relocating or replicating taking...Warfare Center- Carderock, Annapolis Detachment, The Annapolis community stressed in 1991 theDefense Base Closure and Realignment Coin- Annapolis

  6. Granulation tissue formation at the bronchial stump is reduced after stapler closure in comparison to suture closure in dogs.

    PubMed

    Izumi, Yotaro; Kawamura, Masafumi; Gika, Masatoshi; Nomori, Hiroaki

    2010-03-01

    The aim of this study was to compare the morphology of the bronchial stump after lobectomy between mechanical stapler closure and manual suture closure. The effect of fibrin glue application on each method of closure was also observed. Right upper lobectomy was performed in beagles (n=31) using staplers (ST group) or sutures (SU group). In a separate experiment, fibrin glue was sprayed onto the stump after each respective method of closure. After one week, the stump region was examined macroscopically, and also by histology. chi(2)-Test and Mann-Whitney test were used for comparative analysis. The incidence of adhesion formation between the surrounding tissues was significantly reduced in the ST group in comparison to the SU group (22 vs. 80%, P=0.04). The thickness of granulation tissue over the stump was significantly reduced in the ST group in comparison to the SU group (0.8+/-0.2 vs. 2.5+/-0.3 mm, P<0.0001). Vessel density in the granulation tissue was also significantly reduced in the ST group in comparison to the SU group (6+/-2 vs. 16+/-2, P=0.003). Fibrin glue application after stapler closure significantly increased the incidence of adhesion formation, granulation tissue thickness, and vessel density in the granulation tissue over the stump.

  7. Decisions on repositioning of intruded permanent incisors; a review and case presentation.

    PubMed

    Hurley, E; Stewart, C; Gallagher, C; Kinirons, M

    2018-06-01

    Traumatic intrusion is a luxation type of injury where the tooth is displaced along the axis of the tooth, into the alveolus. This injury is regarded as serious because of the tissue damage that it causes. The traumatic movement is associated with severe damage to the periodontal ligament, pulpal tissue, root and alveolar socket. Despite its severity, the rare occurrence of this injury in permanent teeth has resulted in limited studies of immature and mature permanent incisors. The purpose of this paper is to review this luxation injury of permanent immature incisors, and to describe its diagnosis, treatment and management. In particular, we describe the repositioning strategies used in cases of intrusion injury. These include (i) monitoring spontaneous re-eruption, (ii) active orthodontic repositioning and (iii) surgical repositioning. Firstly, monitoring spontaneous re-eruption is observing and waiting for the intruded tooth to return to its original position. This process is not a normal developmental eruption and the outcome is not always predictable, nor is the time needed for this to happen. Secondly, active orthodontic repositioning is used to describe the process of rapidly moving the intruded tooth to its original position with the aid of an orthodontic appliance. Active orthodontic repositioning is often misunderstood as normal orthodontic movement. Orthodontic movement allows for periodontal ligament remodelling, using light intermittent forces. In contrast the active orthodontic repositioning used to move intruded incisors is rapid, and the primary aim is to achieve correct tooth position as rapidly as possible. Thirdly, surgical repositioning uses surgical intervention to bring the tooth back to its original position. A case of an intruded immature permanent incisor is presented, with a particular emphasis on these critical decisions on repositioning and showing the use of the three modalities of treatment in sequence, in order to achieve an outcome.

  8. CIRSE Vascular Closure Device Registry

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl; Mueller-Huelsbeck, Stefan; Libicher, Martin

    2011-02-15

    Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0-14.5] for antegrade access and 1.8% (95% CI 1.1-2.9) for retrograde access (Pmore » = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only <0.5% of patients. Postdeployment bleeding occurred in 6.4%, and most these (51.5%) could be managed with light manual compression. During follow-up, other device-related complications were reported in 1.3%: seven false aneurysms, three hematoma >5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.« less

  9. CIRSE Vascular Closure Device Registry

    PubMed Central

    Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

    2010-01-01

    Purpose Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only <0.5% of patients. Postdeployment bleeding occurred in 6.4%, and most these (51.5%) could be managed with light manual compression. During follow-up, other device-related complications were reported in 1.3%: seven false aneurysms, three hematoma >5.9 cm, and two vessel occlusions. Conclusion The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters. PMID:20981425

  10. Revascularization Induced Maturogenesis of Non-Vital Immature Permanent Tooth Using Platelet-Rich-Fibrin: A Case Report.

    PubMed

    Nagaveni, N B; Pathak, Sidhant; Poornima, P; Joshi, Jooie S

    2016-01-01

    The aim of this report is to describe a novel method of revascularization therapy done in a non-vital, immature permanent tooth using Platelet-rich fibrin (PRF),in a recently developed scaffold material to overcome limitations associated with the traditional method of revascularization using natural blood clot. PRF prepared from autologous blood was placed in the root canal and patient was followed up regularly at one, three, six, nine and 12 months for detailed clinical and radiographic evaluation. At 12 months, radiographic examination revealed root elongation, root end closure, continued thickening of the root dentinal walls, obliteration of root canal space, and normal periradicular anatomy. However, more long term prospective trials and histological studies are highly needed before to testify PRF a panacea for the regenerative endodontic therapy in children.

  11. Cutaneous Wound Closure Materials: An Overview and Update

    PubMed Central

    Al-Mubarak, Luluah; Al-Haddab, Mohammed

    2013-01-01

    Introduction: On a daily basis, dermasurgeons are faced with different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness can be difficult, if not tricky. Objectives: We aimed to review the available skin closure materials over the past 20 years and the scientific claims behind their effectiveness in repairing various kinds of wounds. Materials and Methods: The two authors independently searched and scrutinised the literature. The search was performed electronically using Pub Med, the Cochrane Database, Google Scholar and Ovid as search engines to find articles concerning skin closure materials written since 1990. Conclusion: Many factors are involved in the choice of skin closure material, including the type and place of the wound, available materials, physician expertise and preferences, and patient age and health. Evidence-based main uses of different skin closure materials are provided to help surgeons choose the appropriate material for different wounds. PMID:24470712

  12. On Subsurface Fracture Opening and Closure

    NASA Astrophysics Data System (ADS)

    Wang, Y.

    2016-12-01

    Mechanistic understanding of fracture opening and closure in geologic media is of significant importance to nature resource extraction and waste management, such as geothermal energy extraction, oil/gas production, radioactive waste disposal, and carbon sequestration and storage). A dynamic model for subsurface fracture opening and closure has been formulated. The model explicitly accounts for the stress concentration around individual aperture channels and the stress-activated mineral dissolution and precipitation. A preliminary model analysis has demonstrated the importance of the stress-activated dissolution mechanism in the evolution of fracture aperture in a stressed geologic medium. The model provides a reasonable explanation for some key features of fracture opening and closure observed in laboratory experiments, including a spontaneous switch from a net permeability reduction to a net permeability increase with no changes in a limestone fracture experiment.

  13. Closure device for lead-acid batteries

    DOEpatents

    Ledjeff, Konstantin

    1983-01-01

    A closure device for lead-acid batteries includes a filter of granulated activated carbon treated to be hydrophobic combined with means for preventing explosion of emitted hydrogen and oxygen gas. The explosion prevention means includes a vertical open-end tube within the closure housing for maintaining a liquid level above side wall openings in an adjacent closed end tube. Gases vent from the battery through a nozzle directed inside the closed end tube against an impingement surface to remove acid droplets. The gases then flow through the side wall openings and the liquid level to quench any possible ignition prior to entering the activated carbon filter. A wick in the activated carbon filter conducts condensed liquid back to the closure housing to replenish the liquid level limited by the open-end tube.

  14. Transcatheter Closure of Patent Foramen Ovale: Devices and Technique.

    PubMed

    Price, Matthew J

    2017-10-01

    Transcatheter closure of a patent foramen ovale (PFO) reduces the risk of recurrent cryptogenic stroke compared with medical therapy. PFO closure is a prophylactic procedure, and will not provide the patient with symptomatic improvement, except in cases of hypoxemia due to right-to-left shunt or possibly migraine headaches. Therefore, appropriate patient selection is critical, and procedural safety is paramount. Herein, we review key characteristics of the devices currently available for transcatheter PFO closure within the United States, and highlight key technical aspects of the PFO closure procedure that will maximize procedural success. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Permanent-File-Validation Utility Computer Program

    NASA Technical Reports Server (NTRS)

    Derry, Stephen D.

    1988-01-01

    Errors in files detected and corrected during operation. Permanent File Validation (PFVAL) utility computer program provides CDC CYBER NOS sites with mechanism to verify integrity of permanent file base. Locates and identifies permanent file errors in Mass Storage Table (MST) and Track Reservation Table (TRT), in permanent file catalog entries (PFC's) in permit sectors, and in disk sector linkage. All detected errors written to listing file and system and job day files. Program operates by reading system tables , catalog track, permit sectors, and disk linkage bytes to vaidate expected and actual file linkages. Used extensively to identify and locate errors in permanent files and enable online correction, reducing computer-system downtime.

  16. Vertical bone growth following autotransplantation of the developing maxillary third molar to replace a retained mandibular permanent molar: a case report.

    PubMed

    Plakwicz, Paweł; Czochrowska, Ewa Monika; Milczarek, Anna; Zadurska, Malgorzata

    2014-01-01

    A retained permanent mandibular first molar caused arrested development and a defect of the alveolar bone in a 16-year-old girl. Extraction of the ankylosed tooth was immediately followed by autotransplantation of the developing maxillary third molar. At the 3-year follow-up examination the interproximal bone level at the autotransplanted molar was equal to that of the neighboring teeth. Cone beam computed tomography showed bone at the labial aspect of the transplant. The eruption of the autotransplanted tooth stimulated vertical alveolar bone development and repaired the bone defect. Additionally, there was closure of the posterior open bite that was initially present at the ankylosed molar site.

  17. Recombinant Amelogenin Protein Induces Apical Closure and Pulp Regeneration in Open-apex, Non-vital Permanent Canine Teeth

    PubMed Central

    Mounir, Maha M.F.; Matar, Moustafa A.; Lei, Yaping; Snead, Malcolm L.

    2015-01-01

    Introduction Recombinant DNA produced amelogenin protein was compared to calcium hydroxide in a study of immature apex closure conducted in 24 young mongrel dogs. Methods Root canals of maxillary and mandibular right premolars (n = 240) were instrumented and left open for 14 days. Canals were cleansed, irrigated and split equally for treatment with recombinant mouse amelogenin (n = 120) or calcium hydroxide (n = 120). Results After 1, 3, and 6 months, the animals were sacrificed and the treated teeth recovered for histological assessment and immunodetection of protein markers associated with odontogenic cells. After 1 month, amelogenin-treated canals revealed calcified tissue formed at the apical foramen and a pulp chamber containing soft connective tissue and hard tissue; amelogenin-treated canals assessed after 3 and 6 month intervals further included apical tissue functionally attached to bone by a periodontal ligament. In contrast, calcified apical tissue was poorly formed in the calcium hydroxide group and soft connective tissue within the pulp chamber was not observed. Conclusions The findings from this experimental strategy suggest recombinant amelogenin protein can signal cells to enhance apex formation in non-vital immature teeth and promote soft connective tissue regeneration. PMID:26709200

  18. RELAP-7 Closure Correlations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zou, Ling; Berry, R. A.; Martineau, R. C.

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

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Silvas, A. J.

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

  20. New concepts and new design of permanent maglev rotary artificial heart blood pumps.

    PubMed

    Qian, K X; Zeng, P; Ru, W M; Yuan, H Y

    2006-05-01

    According to tradition, permanent maglev cannot achieve stable equilibrium. The authors have developed, to the contrary, two stable permanent maglev impeller blood pumps. The first pump is an axially driven uni-ventricular assist pump, in which the rotor with impeller is radially supported by two passive magnetic bearings, but has one point contact with the stator axially at standstill. As the pump raises its rotating speed, the increasing hydrodynamic force of fluid acting on the impeller will make the rotor taking off from contacting point and disaffiliate from the stator. Then the rotor becomes fully suspended. The second pump is a radially driven bi-ventricular assist pump, i.e., an impeller total artificial heart. Its rotor with two impellers on both ends is supported by two passive magnetic bearings, which counteract the attractive force between rotor magnets and stator coil iron core. The rotor is affiliated to the stator radially at standstill and becomes levitated during rotation. Therefore, the rotor keeps concentric with stator during rotation but eccentric at standstill, as is confirmed by rotor position detection with Honeywell sensors. It concludes that the permanent maglev needs action of a non-magnetic force to achieve stability but a rotating magnetic levitator with high speed and large inertia can maintain its stability merely with passive magnetic bearings.

  1. 46 CFR 64.41 - Stop valve closure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Stop valve closure. 64.41 Section 64.41 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Standards for an MPT § 64.41 Stop valve closure. A stop valve that operates by a screwed...

  2. On the non-closure of particle backscattering coefficient in oligotrophic oceans.

    PubMed

    Lee, ZhongPing; Huot, Yannick

    2014-11-17

    Many studies have consistently found that the particle backscattering coefficient (bbp) in oligotrophic oceans estimated from remote-sensing reflectance (Rrs) using semi-analytical algorithms is higher than that from in situ measurements. This overestimation can be as high as ~300% for some oligotrophic ocean regions. Various sources potentially responsible for this discrepancy are examined. Further, after applying an empirical algorithm to correct the impact from Raman scattering, it is found that bbp from analytical inversion of Rrs is in good agreement with that from in situ measurements, and that a closure is achieved.

  3. Primary angle closure glaucoma in a myopic kinship.

    PubMed

    Hagan, J C; Lederer, C M

    1985-03-01

    Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

  4. Iridotomy to slow progression of angle-closure glaucoma

    PubMed Central

    Le, Jimmy T; Rouse, Benjamin; Gazzard, Gus

    2016-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective is to assess the role of iridotomy-compared with observation-in the prevention of visual field loss for individuals who have primary angle closure or primary angle-closure glaucoma in at least one eye. We will also examine the role of iridotomy in the prevention of elevated intraocular pressure (IOP) in individuals with narrow angles (primary angle-closure suspect) in at least one eye. PMID:27551238

  5. AN EVALUATION OF TWO GROUND-BASED CROWN CLOSURE ESTIMATION TECHNIQUES COMPARED TO CROWN CLOSURE ESTIMATES DERIVED FROM HIGH RESOLUTION IMAGERY

    EPA Science Inventory

    Two ground-based canopy closure estimation techniques, the Spherical Densitometer (SD) and the Vertical Tube (VT), were compared for the effect of deciduous understory on dominant/co-dominant crown closure estimates in even-aged loblolly (Pinus taeda) pine stands located in the N...

  6. AN EVALUATION OF TWO GROUND-BASED CROWN CLOSURE ESTIMATION TECHNIQUES COMPARED TO CROWN CLOSURE ESTIMATES DERIVED FROM HIGH RESOLUTION IMAGERY

    EPA Science Inventory

    Two ground-based canopy closure estimation techniques, the Spherical Densitometer (SD) and the Vertical Tube (VT), were compared for the effect of deciduous understory on dominantlco-dominant crown closure estimates in even-aged loblolly (Pinus taeda) pine stands located in the N...

  7. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series.

    PubMed

    Jung, Il-Young; Lee, Seung-Jong; Hargreaves, Kenneth M

    2012-06-01

    This case series reports the outcomes of 8 patients (ages 9-4 years) who presented with 9 immature permanent teeth with pulpal necrosis and apical periodontitis. During treatment, 5 of the teeth were found to have at least some residual vital tissue remaining in the root canal systems. After NaOCI irrigation and medication with ciprofloxacin, metronidazole, and minocycline, these teeth were sealed with mineral trioxide aggregate and restored. The other group of 4 teeth had no evidence of any residual vital pulp tissue. This second group of teeth was treated with NaOCl irrigation and medicated with ciprofloxacin, metronidazole, and minocycline followed by a revascularization procedure adopted from the trauma literature (bleeding evoked to form an intracanal blood clot). In both groups of patients, there was evidence of satisfactory postoperative clinical outcomes (1-5 years); the patients were asymptomatic, no sinus tracts were evident, apical periodontitis was resolved, and there was radiographic evidence of continuing thickness of dentinal walls, apical closure, or increased root length.

  8. Prospective, randomized, controlled trial of polymer cable ties versus standard wire closure of midline sternotomy.

    PubMed

    Marasco, Silvana F; Fuller, Louise; Zimmet, Adam; McGiffin, David; Seitz, Michael; Ch'ng, Stephanie; Gangahanumaiah, Shivanand; Bailey, Michael

    2018-04-16

    Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60). Primary outcomes were pain and analgesia requirements in the early postoperative period. Secondary outcome was sternal movement, as assessed by ultrasound at the postoperative follow-up visit. Groups were well matched in demographic and operative variables. There were no significant differences between groups in postoperative pain, analgesia, or early ventilatory requirements. Patients in the ZIPFIX group had significantly more movement in the sternum and manubrium on ultrasound at 4 weeks. ZIPFIX sternal cable ties provide reliable closure but no demonstrable benefit in this study in pain or analgesic requirements relative to standard wire closure after median sternotomy. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  9. Type of closure prevents microbial contamination of cosmetics during consumer use.

    PubMed Central

    Brannan, D K; Dille, J C

    1990-01-01

    The dispensing closure used for containers plays an important role in protecting cosmetics from in-use microbial contamination. This hypothesis was tested by aseptically packing unpreserved shampoo and skin lotion into containers with three different closure types which provided various degrees of protection against consumer and environmental microbial insults. Shampoo was packed in containers with slit-cap (n = 25), flip-cap (n = 25), or screw-cap (n = 28) closures. Skin lotion was packed in containers with pump-top (n = 21), flip-cap (n = 18), or screw-cap (n = 21) closures. The products were then used by volunteers under actual in-use conditions for 3 (shampoo) or 2 (skin lotion) weeks. After use, the products were evaluated for microbial contamination by using standard methods for enumeration and identification. The standard screw-cap closure provided only minimal protection against microbial contamination of both the shampoo (29% contamination incidence) and the skin lotion (71%). The slit-cap closure on the shampoo container and the flip-cap closure on the skin lotion container provided slightly enhanced degrees of protection (21 and 39% contamination incidence, respectively). The greatest amount of protection (i.e., lowest contamination incidence) was provided by the flip-cap closure for the shampoo container (0%) and the pump-top closure for the skin lotion container (10%). As a result, closure type plays an important role in protecting poorly preserved products from in-use microbial contamination. Images PMID:2339896

  10. Permanent-Magnet Meissner Bearing

    NASA Technical Reports Server (NTRS)

    Robertson, Glen A.

    1994-01-01

    Permanent-magnet meissner bearing features inherently stable, self-centering conical configuration. Bearing made stiffer or less stiff by selection of magnets, springs, and spring adjustments. Cylindrical permanent magnets with axial magnetization stacked coaxially on rotor with alternating polarity. Typically, rare-earth magnets used. Magnets machined and fitted together to form conical outer surface.

  11. Environmental Assessment for the Closure of the High-Level Waste Tanks in F- & H-Areas at the Savannah River Site

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    N /A

    1996-07-31

    described in 40 CFR 300.430(e)(9): ( 1) overall protection of human health and the environment; (2) compliance with applicable or relevant and appropriated requirement: (ARARs); (3) long-term effectiveness and permanence; (4) reduction of toxicity, mobility, or volume through treatment; (5) short-term effectiveness; (6) implementability; (7) cost; (8) state acceptable; and (9) community acceptance. Closure of each tank involves two separate operations after bulk waste removal has been accomplished: (1) cleaning of the tank (i.e., removing the residual contaminants), and (2) the actual closure or filling of the tank with an inert material, (e.g., grout). This process would continue until all the tanks and ancillary equipment and systems have been closed. This is expected to be about year 2028 for Type I, II, and IV tanks and associated systems. Subsequent to that, Type III tanks and systems will be closed.« less

  12. Transcatheter umbrella closure of valvular and paravalvular leaks.

    PubMed

    Hourihan, M; Perry, S B; Mandell, V S; Keane, J F; Rome, J J; Bittl, J A; Lock, J E

    1992-11-15

    Our aim was to adapt the technique of transcatheter umbrella closure of intracardiac defects for closure of valvular and paravalvular defects. The double-umbrella device developed by Rashkind and Cuaso has been safely and effectively delivered across a host of intracardiac defects, but transcatheter closure of valvular and paravalvular leaks has not been reported. Between February 1987 and September 1990, eight patients who were believed to be poor operative candidates were taken to the catheterization laboratory for transcatheter double-umbrella closure of a valvular or a paravalvular leak. Four patients had a paravalvular leak around a prosthetic aortic valve. The other four patients had a valvular leak: one patient with a regurgitant native aortic valve after a Stansel procedure and three patients with a regurgitant porcine valve in a left ventricular apex to descending aorta conduit. Placement of a double-umbrella device was attempted in seven of the eight patients and was successful in all seven. Device placement was not attempted in one patient because of the crescentic shape of his defect. Two patients required two devices for each closure; the other five required only one device each. Angiography, performed on six patients after device closure, demonstrated that three patients had a completely occluded defect, two had trivial residual flow and one patient had mild residual flow through the device. All significant complications occurred in one patient who had hemolysis and oliguria that resolved when the initial umbrella was replaced by a larger device. In addition, two devices migrated to the patient's pulmonary arteries but were retrieved in the catheterization laboratory without difficulty. No other early or late complications occurred in 21 to 50 months of follow-up. Of the four patients with a paravalvular leak, the one who did not receive a device died at operation, one patient died at operation for an associated defect (in the operating room the

  13. Transition and closeout of the Fernald Closure Project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bilson, H.E.; Terry, T.; Reising, J.

    The U.S. Department of Energy (DOE) and Fluor Fernald have completed the majority of the cleanup of the Fernald Site. The over 1,000 acre complex for processing uranium has been demolished and soil contamination has been remediated. With acres of wetlands and prairies replacing the buildings and waste pits. At the end of the project the focus shifted to developing demonstrating the completion of the project and the contract, as well as ensuring a smooth transition of the facility from the DOE's Environmental Management (EM) Program to the DOE's Legacy Management (LM) Program. Working with the DOE, each portion ofmore » the closure contract was examined for specific closure definition. From this negotiation effort the Comprehensive Exit and Transition Plan (CE/T Plan) was written. The CE/T Plan is intended to assist DOE in the analysis that the site is ready for transfer into long-term stewardship (LTS) (also referred to as legacy management) and that Fluor Fernald, Inc. has satisfactorily completed the closure contract statement of work elements. Following the Lessons Learned from the closure of the Rocky Flats Site, the DOE's Legacy Management Program created a matrix of Transition Elements required to ensure adequate information was in place to allow the new prime contractor to perform the Legacy Management scope of work. The transition plan included over 1,000 elements broken down into functional areas and relied on specific Fernald Responsibility Transition Packages (RTPs) for detailed transition actions. The template for Closure and Transition Planning used at the Fernald Site was developed using the best Lessons Learned from across the DOE Complex. The template could be used for other sites, and lessons learned from this closure and transition will be appropriate for all closure projects. (authors)« less

  14. Hamiltonian closures in fluid models for plasmas

    NASA Astrophysics Data System (ADS)

    Tassi, Emanuele

    2017-11-01

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

  15. Monitoring calculation of closure change of Extradosed Cable-stayed Bridge

    NASA Astrophysics Data System (ADS)

    Shi, Jing Xian; Ran, Zhi Hong

    2018-06-01

    During the construction of extradosed cable-stayed bridge in Yunnan province, China, the construction unit has made certain changes in the construction process of the closure section due to environmental restrictions: remove the hanging basket after the closure, the sling shall not be provided in closure section, the function of the sling is realized by the hanging basket on the 16th beam. In case of this change, the bridge has been constructed to section 15th. In order to ensure the smooth and orderly progress of each stage in the closure phase, this article is arranged according to the construction plan, appropriate adjustment of related procedures, checking the bridge safety at all stages of construction, the stress and force of the main girder are compared to ensure the safety of the construction after closure changes. Adjust the height of the beam of the 16th and 17th to adapt the new construction plan, and the bridge closure smoothly.

  16. 45 CFR 303.11 - Case closure criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the best interests of the child to establish paternity in a case involving incest or forcible rape, or... 45 Public Welfare 2 2011-10-01 2011-10-01 false Case closure criteria. 303.11 Section 303.11... STANDARDS FOR PROGRAM OPERATIONS § 303.11 Case closure criteria. (a) The IV-D agency shall establish a...

  17. 22 CFR 401.3 - Permanent offices.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Permanent offices. 401.3 Section 401.3 Foreign... Permanent offices. The permanent offices of the Commission shall be at Washington, in the District of... of the Commission shall have full charge and control of said offices, respectively. ...

  18. Decoupling analysis of a novel bearingless flux-switching permanent magnet motor

    NASA Astrophysics Data System (ADS)

    Zhao, Chenyin; Zhu, Huangqiu; Qin, Yuemei

    2017-05-01

    In this paper, a novel 12/10 stator/rotor pole bearingless flux-switching permanent magnet (BFSPM) motor is proposed to overcome the drawbacks of rotor permanent magnet type bearingless motors. The basic motor configuration, including motor configuration and winding configuration, is introduced firstly. Then, based on the principle of reverse direction magnetization for symmetrical rotor teeth, the radial suspension forces generation principle is analyzed in detail. Finally, decoupling performances between suspension force windings and torque windings are investigated. The results show that the proposed BFSPM not only ensures the merits of high torque output capability compared with conventional 12/10 stator/rotor pole FSPM motor, but also achieves stable radial suspension forces which have little mutual effect with torque. The validity of the proposed structure has been verified by finite element analysis (FEA).

  19. Maximizing the Performance and Job-Related Behaviors of Contract and Permanent IT Workers

    ERIC Educational Resources Information Center

    Pai, Tanusree

    2010-01-01

    As the use of contracting for Information Technology (IT) services steadily increases, IT managers are challenged with reconciling the need for flexibility achieved through the use of contract workers, with the need to understand the factors that maximize the performance and behaviors of contract and permanent IT workers. While several research…

  20. 31 CFR 515.335 - Permanent resident alien.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  1. 31 CFR 515.335 - Permanent resident alien.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  2. 31 CFR 515.335 - Permanent resident alien.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  3. 31 CFR 515.335 - Permanent resident alien.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  4. 31 CFR 515.335 - Permanent resident alien.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

  5. Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients.

    PubMed

    Chen, L; Shen, J; Shan, X; Wang, F; Kan, T; Tang, X; Zhao, X; Qin, Y

    2017-07-19

    Adult patients with undiagnosed atrial septal defect (ASD) may have right heart cavity enlargement and functional tricuspid valve insufficiency. Moderate or more severe tricuspid regurgitation has been associated with a worse prognosis, and more serious complications are typically seen in older patients. This study aimed to evaluate the improvement in functional tricuspid regurgitation and heart geometry after transcatheter ASD closure in older patients. The data of 111 patients over 60 years of age with moderate or severe tricuspid regurgitation before ASD closure were analyzed. At the 1‑month and 6‑month follow-up after closure, both tricuspid regurgitation jet area and right atrial volume decreased significantly. Right ventricular volume decreased 1 month after closure, showing a further decrease at the end of the 6‑month follow-up. However, 24 patients (21.6%) still had persistent severe tricuspid regurgitation after the procedure. Multivariate analysis revealed that patient age at ASD closure and pulmonary artery systolic pressure determined by echocardiography before closure were predictors of persistent tricuspid regurgitation after closure. Transcatheter ASD closure in older patients could significantly decrease tricuspid regurgitation and improve right heart geometry.

  6. 21 CFR 886.4445 - Permanent magnet.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Permanent magnet. 886.4445 Section 886.4445 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4445 Permanent magnet. (a) Identification. A permanent magnet is a nonelectric device that generates a magnetic field intended to find and remove metallic...

  7. Tissue adhesives for closure of surgical incisions.

    PubMed

    Coulthard, P; Worthington, H; Esposito, M; Elst, M; Waes, O J F

    2004-01-01

    Sutures, staples and adhesive tapes are the traditional methods of wound closure, whilst tissue adhesives have entered clinical practice more recently. Closure of wounds with sutures enables meticulous closure, but sutures may induce tissue reactivity and they usually require removal. Tissue adhesives offer the advantages there are no sutures to remove later for the patient and no risk of needlestick injury to the surgeon. Tissue adhesives have been used primarily in emergency rooms but this review looks at the use of tissue adhesives in the operating room where surgeons are increasingly using these for the closure of surgical skin incisions. To determine the relative effects of various tissue adhesives and conventional skin closure techniques on the healing of surgical wounds. The Cochrane Wounds Group Specialised Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Bibliographies of review articles were checked for studies outside the handsearched journals and wound care product manufacturers were contacted. Randomised controlled clinical trials only. Screening of eligible studies and data extraction was conducted independently and in triplicate whilst assessment of the methodological quality of the trials was conducted independently and in duplicate. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk with 95% confidence intervals for dichotomous outcomes. Heterogeneity was investigated including both clinical and methodological factors. Eight RCTs were included (630 patients). No statistically significant differences were found between various tissue adhesives and sutures (8 trials) for dehiscence, infection, satisfaction with cosmetic appearance when assessed by patients' or surgeons' general satisfaction. Nor were differences found between a tissue adhesive and tapes (2 trials) for infection, patients' assessment of cosmetic

  8. 40 CFR 264.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in accordance with § 264.145(i). (f) Financial test and corporate guarantee for post-closure care. (1... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Financial assurance for post-closure... DISPOSAL FACILITIES Financial Requirements § 264.145 Financial assurance for post-closure care. The owner...

  9. 40 CFR 264.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... in accordance with § 264.145(i). (f) Financial test and corporate guarantee for post-closure care. (1... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Financial assurance for post-closure... DISPOSAL FACILITIES Financial Requirements § 264.145 Financial assurance for post-closure care. The owner...

  10. 40 CFR 264.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in accordance with § 264.145(i). (f) Financial test and corporate guarantee for post-closure care. (1... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Financial assurance for post-closure... DISPOSAL FACILITIES Financial Requirements § 264.145 Financial assurance for post-closure care. The owner...

  11. 40 CFR 264.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in accordance with § 264.145(i). (f) Financial test and corporate guarantee for post-closure care. (1... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Financial assurance for post-closure... DISPOSAL FACILITIES Financial Requirements § 264.145 Financial assurance for post-closure care. The owner...

  12. 40 CFR 264.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in accordance with § 264.145(i). (f) Financial test and corporate guarantee for post-closure care. (1... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Financial assurance for post-closure... DISPOSAL FACILITIES Financial Requirements § 264.145 Financial assurance for post-closure care. The owner...

  13. An uncommon case of intermittent Pourfour du Petit Syndrome associated with acute angle-closure glaucoma successfully treated by laser iridotomy.

    PubMed

    Farci, Roberta; Napoli, Pietro Emanuele; Fossarello, Maurizio

    2017-07-03

    To describe a case of acute angle-closure glaucoma secondary to intermittent mydriasis related to Pourfour du Petit Syndrome caused by tracheal deviation. A 70-year-old Caucasian woman visited the Emergency Room of the University Eye Clinic complaining of blurring of vision and difficulty to move superior eyelid in her right eye. Examination revealed reactive mydriasis, and upper lid retraction on the right side. The rest of the ophthalmological examination was normal, and a cranial computed tomography (CT) did not identify any abnormalities. A cervical CT showed the presence of an accentuated lateral right convex deviation of the trachea, attributable to a fibrothorax. A right Pourfour du Petit syndrome was suspected. Although the mydriasis had in the meantime vanished, the patient was admitted to the Neurological Clinic. Five days later she suffered acute pain in her right eye. Ophthalmological examination of the right eye revealed conjunctival hyperemia, marked corneal edema, reduced depth of anterior chamber, permanent mydriasis. As assessed by Goldmann applanation tonometry, intraocular pressure (IOP) was 48 mm Hg. Fundus examination was normal in both eyes. Gonioscopy revealed angle closure in all quadrants. Slit lamp examination of the contralateral eye was normal; IOP was 10 mm Hg. After hypotensive medical therapy, iridotomy with YAG laser was performed. Thereafter, IOP stabilized at 12 mm Hg. This is the first report in the literature of a case of acute angle-closure glaucoma secondary to mydriasis related to Pourfour du Petit Syndrome caused by tracheal deviation.

  14. Patent ductus arteriosus closure using Occlutech® Duct Occluder, experience in Port Elizabeth, South Africa

    PubMed Central

    Pepeta, Lungile; Greyling, Adele; Nxele, Mahlubandile Fintan; Makrexeni, Zongezile Masonwabe

    2017-01-01

    Background: Percutaneous closure of patent ductus arteriosus (PDA) has become standard therapy. Experience with the Occlutech® Duct Occluder is limited. Methods: Data regarding ductal closure using Occlutech® Duct Occluder were reviewed and prospectively collected. Demographics, hemodynamic and angiographic characteristics, complications, and outcomes were documented. Results: From March 2013 to June 2016, 65 patients (43 females and 22 males) underwent percutaneous closure of the PDA using Occlutech® Duct Occluder. The median age of the patients was 11 months (range, 1–454 months) and the median weight was 8.5 kg (range 2.5–78 kg). The mean pulmonary artery median pressure was 27 mmHg (range, 12–100 mmHg) and the QP: Qs ratio median was 1.8 (range, 1–7.5), with a pulmonary vascular resistance mean of 2.7 WU (standard deviation [SD] ±2.1). Thirty-two patients had Krichenko Type A duct (49%); 7, Type C (11%); 4, Type D (6%); and 22, Type E (34%). The ductal size (narrowest diameter at the pulmonic end) mean was 3.5 mm (SD ± 1.9 mm). The screening time mean was 17.3 min (SD ± 11.6). Out of 63 patients with successful closure of the PDA using Occlutech® Duct Occluder, there were 15 patients with small PDAs; 25 with moderate PDAs, and 23 with large PDAs. In one patient, the device dislodged to the descending aorta, and in two patients, to the right pulmonary artery immediately following deployment, with successful percutaneous (two) and surgical (one) retrieval. Complete ductal occlusion was achieved in all 63 patients on day one. Conclusion: The Occlutech® Duct Occluder is a safe and effective device for closure of ducts in appropriately selected patients. PMID:28566820

  15. Patent ductus arteriosus closure using Occlutech® Duct Occluder, experience in Port Elizabeth, South Africa.

    PubMed

    Pepeta, Lungile; Greyling, Adele; Nxele, Mahlubandile Fintan; Makrexeni, Zongezile Masonwabe

    2017-01-01

    Percutaneous closure of patent ductus arteriosus (PDA) has become standard therapy. Experience with the Occlutech® Duct Occluder is limited. Data regarding ductal closure using Occlutech® Duct Occluder were reviewed and prospectively collected. Demographics, hemodynamic and angiographic characteristics, complications, and outcomes were documented. From March 2013 to June 2016, 65 patients (43 females and 22 males) underwent percutaneous closure of the PDA using Occlutech® Duct Occluder. The median age of the patients was 11 months (range, 1-454 months) and the median weight was 8.5 kg (range 2.5-78 kg). The mean pulmonary artery median pressure was 27 mmHg (range, 12-100 mmHg) and the QP: Qs ratio median was 1.8 (range, 1-7.5), with a pulmonary vascular resistance mean of 2.7 WU (standard deviation [SD] ±2.1). Thirty-two patients had Krichenko Type A duct (49%); 7, Type C (11%); 4, Type D (6%); and 22, Type E (34%). The ductal size (narrowest diameter at the pulmonic end) mean was 3.5 mm (SD ± 1.9 mm). The screening time mean was 17.3 min (SD ± 11.6). Out of 63 patients with successful closure of the PDA using Occlutech® Duct Occluder, there were 15 patients with small PDAs; 25 with moderate PDAs, and 23 with large PDAs. In one patient, the device dislodged to the descending aorta, and in two patients, to the right pulmonary artery immediately following deployment, with successful percutaneous (two) and surgical (one) retrieval. Complete ductal occlusion was achieved in all 63 patients on day one. The Occlutech® Duct Occluder is a safe and effective device for closure of ducts in appropriately selected patients.

  16. Does omphalocele major undergo spontaneous closure?

    PubMed Central

    Emordi, Victor C.; Osifo, David O.

    2017-01-01

    Abstract The early surgical management of omphalocele major in Africa predisposes neonates to surgical complications which are often worsened by the presence of associated anomalies. Conservative management using available escharotics results in early skin cover by secondary wound healing. This delays the need for fascial closure and avoids neonatal surgical risks thus improving survival. We present a case of omphalocele major that underwent spontaneous closure during conservative management with honey dressing without surgical intervention. PMID:28928917

  17. [Permanent education in health: a review].

    PubMed

    Miccas, Fernanda Luppino; Batista, Sylvia Helena Souza da Silva

    2014-02-01

    To undertake a meta-synthesis of the literature on the main concepts and practices related to permanent education in health. A bibliographical search was conducted for original articles in the PubMed, Web of Science, LILACS, IBECS and SciELO databases, using the following search terms: "public health professional education", "permanent education", "continuing education", "permanent education health". Of the 590 articles identified, after applying inclusion and exclusion criteria, 48 were selected for further analysis, grouped according to the criteria of key elements, and then underwent meta-synthesis. The 48 original publications were classified according to four thematic units of key elements: 1) concepts, 2) strategies and difficulties, 3) public policies and 4) educational institutions. Three main conceptions of permanent education in health were found: problem-focused and team work, directly related to continuing education and education that takes place throughout life. The main strategies for executing permanent education in health are discussion, maintaining an open space for permanent education , and permanent education clusters. The most limiting factor is mainly related to directly or indirect management. Another highlight is the requirement for implementation and maintenance of public policies, and the availability of financial and human resources. The educational institutions need to combine education and service aiming to form critical-reflexive graduates. The coordination between health and education is based as much on the actions of health services as on management and educational institutions. Thus, it becomes a challenge to implement the teaching-learning processes that are supported by critical-reflexive actions. It is necessary to carry out proposals for permanent education in health involving the participation of health professionals, teachers and educational institutions. To undertake a meta-synthesis of the literature on the main concepts and

  18. 40 CFR 264.144 - Cost estimate for post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

  19. 40 CFR 264.144 - Cost estimate for post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

  20. 40 CFR 264.144 - Cost estimate for post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

  1. 40 CFR 264.144 - Cost estimate for post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

  2. 40 CFR 258.72 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... care. 258.72 Section 258.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID... dollars, of the cost of hiring a third party to conduct post-closure care for the MSWLF unit in compliance with the post-closure plan developed under § 258.61 of this part. The post-closure cost estimate used...

  3. Fracture mechanics analyses of partial crack closure in shell structures

    NASA Astrophysics Data System (ADS)

    Zhao, Jun

    2007-12-01

    This thesis presents the theoretical and finite element analyses of crack-face closure behavior in shells and its effect on the stress intensity factor under a bending load condition. Various shell geometries, such as spherical shell, cylindrical shell containing an axial crack, cylindrical shell containing a circumferential crack and shell with double curvatures, are all studied. In addition, the influence of material orthotropy on the crack closure effect in shells is also considered. The theoretical formulation is developed based on the shallow shell theory of Delale and Erdogan, incorporating the effect of crack-face closure at the compressive edges. The line-contact assumption, simulating the crack-face closure at the compressive edges, is employed so that the contact force at the closure edges is introduced, which can be translated to the mid-plane of the shell, accompanied by an additional distributed bending moment. The unknown contact force is computed by solving a mixed-boundary value problem iteratively, that is, along the crack length, either the normal displacement of the crack face at the compressive edges is equal to zero or the contact pressure is equal to zero. It is found that due to the curvature effects crack closure may not always occur on the entire length of the crack, depending on the direction of the bending load and the geometry of the shell. The crack-face closure influences significantly the magnitude of the stress intensity factors; it increases the membrane component but decreases the bending component. The maximum stress intensity factor is reduced by the crack-face closure. The significant influence of geometry and material orthotropy on rack closure behavior in shells is also predicted based on the analytical solutions. Three-dimensional FEA is performed to validate the theoretical solutions. It demonstrates that the crack face closure occurs actually over an area, not on a line, but the theoretical solutions of the stress intensity

  4. Regional neural tube closure defined by the Grainy head-like transcription factors.

    PubMed

    Rifat, Yeliz; Parekh, Vishwas; Wilanowski, Tomasz; Hislop, Nikki R; Auden, Alana; Ting, Stephen B; Cunningham, John M; Jane, Stephen M

    2010-09-15

    Primary neurulation in mammals has been defined by distinct anatomical closure sites, at the hindbrain/cervical spine (closure 1), forebrain/midbrain boundary (closure 2), and rostral end of the forebrain (closure 3). Zones of neurulation have also been characterized by morphologic differences in neural fold elevation, with non-neural ectoderm-induced formation of paired dorso-lateral hinge points (DLHP) essential for neural tube closure in the cranial and lower spinal cord regions, and notochord-induced bending at the median hinge point (MHP) sufficient for closure in the upper spinal region. Here we identify a unifying molecular basis for these observations based on the function of the non-neural ectoderm-specific Grainy head-like genes in mice. Using a gene-targeting approach we show that deletion of Grhl2 results in failed closure 3, with mutants exhibiting a split-face malformation and exencephaly, associated with failure of neuro-epithelial folding at the DLHP. Loss of Grhl3 alone defines a distinct lower spinal closure defect, also with defective DLHP formation. The two genes contribute equally to closure 2, where only Grhl gene dosage is limiting. Combined deletion of Grhl2 and Grhl3 induces severe rostral and caudal neural tube defects, but DLHP-independent closure 1 proceeds normally in the upper spinal region. These findings provide a molecular basis for non-neural ectoderm mediated formation of the DLHP that is critical for complete neuraxis closure. (c) 2010 Elsevier Inc. All rights reserved.

  5. Permanent transvenous pacemaker implantation in an Ibizan hound cross with persistent atrial standstill

    PubMed Central

    MacAulay, Kevin

    2002-01-01

    An Ibizan hound cross was referred with a 1-year history of syncope and exercise intolerance. An electrocardiogram showed bradycardia and no P waves; atrial standstill was diagnosed. A permanent artificial endocardial pacemaker was implanted. The lead dislodged and was reimplanted into the right ventricular apex. Capture was once again achieved. PMID:12395764

  6. Periodic permanent magnet focused klystron

    DOEpatents

    Ferguson, Patrick; Read, Michael; Ives, R Lawrence

    2015-04-21

    A periodic permanent magnet (PPM) klystron has beam transport structures and RF cavity structures, each of which has permanent magnets placed substantially equidistant from a beam tunnel formed about the central axis, and which are also outside the extent of a cooling chamber. The RF cavity sections also have permanent magnets which are placed substantially equidistant from the beam tunnel, but which include an RF cavity coupling to the beam tunnel for enhancement of RF carried by an electron beam in the beam tunnel.

  7. Oral Paracetamol for Patent Ductus Arteriosus Rescue Closure.

    PubMed

    Pharande, Pramod; Watson, Hadley; Tan, Kenneth; Sehgal, Arvind

    2018-01-01

    The objective of this study was to ascertain the efficacy of oral paracetamol in closing a symptomatic patent ductus arteriosus (PDA) when used as 'rescue' option. After obtaining ethics approval, a retrospective appraisal of the data from April 2014 to July 2015 was performed. Infants who were administered oral paracetamol either after unsuccessful therapy with ibuprofen or where it was considered contraindicated were included. A previously published echocardiographic scoring schema to stratify for ductal disease severity was used. Using univariate analysis, characteristics of infants with successful closure were compared with partial (a priori reduction in composite score by ≥ 50% of pretreatment) or no closure. Twenty infants with gestation age and birthweight of 25.7 ± 1.5 weeks and 724.1 ± 143 g, respectively, were studied. Complete closure was noted in 10 (50%) infants with additional four infants showing a significant reduction in haemodynamic shunting. Gestational age at birth and at therapy, chronological age at therapy, birthweight and total fluid intake were comparable between the two groups. The pre-therapy composite score had a significant association with successful closure (the higher the echocardiographic score, the lesser the closure). Concomitant furosemide therapy and late-onset sepsis had a high likelihood ratio of unsuccessful closure (11.01 [2-tailed, p = 0.005] and 5.3 [2-tailed, p = 0.07]), respectively. Oral paracetamol may be a possible therapeutic option in premature infants where therapy with first-line agents is unsuccessful or contraindicated. Concomitant sepsis and furosemide administration may affect successful therapy.

  8. Tissue adhesives for closure of surgical incisions.

    PubMed

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

    2014-11-28

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

  9. 40 CFR 265.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of this section in accordance with § 265.145(h). (e) Financial test and corporate guarantee for post... closure and post-closure cost estimates to be covered by the test; (iv) Specify the date ending the owner... Regional Administrator may approve a decrease in the current post-closure cost estimate for which this test...

  10. 40 CFR 265.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of this section in accordance with § 265.145(h). (e) Financial test and corporate guarantee for post... closure and post-closure cost estimates to be covered by the test; (iv) Specify the date ending the owner... Regional Administrator may approve a decrease in the current post-closure cost estimate for which this test...

  11. 40 CFR 265.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of this section in accordance with § 265.145(h). (e) Financial test and corporate guarantee for post... closure and post-closure cost estimates to be covered by the test; (iv) Specify the date ending the owner... Regional Administrator may approve a decrease in the current post-closure cost estimate for which this test...

  12. 40 CFR 265.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of this section in accordance with § 265.145(h). (e) Financial test and corporate guarantee for post... closure and post-closure cost estimates to be covered by the test; (iv) Specify the date ending the owner... Regional Administrator may approve a decrease in the current post-closure cost estimate for which this test...

  13. 40 CFR 265.145 - Financial assurance for post-closure care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of this section in accordance with § 265.145(h). (e) Financial test and corporate guarantee for post... closure and post-closure cost estimates to be covered by the test; (iv) Specify the date ending the owner... Regional Administrator may approve a decrease in the current post-closure cost estimate for which this test...

  14. [Acute angle-closure glaucoma after total hip replacement surgery].

    PubMed

    Ujino, H; Morimoto, O; Yukioka, H; Fujimori, M

    1997-06-01

    Acute angle-closure glaucoma is a rare complication of surgery. We experienced a case of postoperative acute glaucoma after total hip replacement under general anesthesia. A 49-year-old female without signs or symptoms of glaucoma was premedicated with the intramuscular administration of secobarbital, atropine and ranitidine. Following rapid induction with thiopental and vecuronium, anesthesia was maintained with N2O-O2-sevoflurane. PGE1 was administered intravenously for induced hypotension during the surgery. Hemorrhagic shock with a systolic blood pressure of 60 mmHg continued for 15 min during the surgery. Large amounts of fluid and ephedrine were required for treating this hypotensive episode. Vecuronium was reversed by bolus injection of neostigmine and atropine at the end of surgery. Soon after recovery from anesthesia, she complained of pain and blurred vision in her both eyes. The consulting ophthalmologist made a diagnosis of acute glaucoma due to high intraocular pressure (IOP). Treatment with glycerol and pilocarpine had no effect on the elevated IOP. The laser iridotomy performed on her at 5th and 7th post-operative days improved her vision completely. The post-operative glaucoma may cause serious permanent loss of vision. An early diagnosis of this post-operative complication and its treatment with drugs and surgery should be emphasized.

  15. Military Base Closures: Updated Status of Prior Base Realignments and Closures

    EPA Pesticide Factsheets

    As the Department of Defense (DOD) prepares for the 2005 base realignment and closure (BRAC) round, questions continue to be raised about the transfer and environmental cleanup of unneeded property arising from the prior four BRAC rounds and their impact on cost and savings and on local economies.

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

    USGS Publications Warehouse

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

    2015-01-01

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

  17. Crack closure and sequential effects in fatigue: A literature survey

    NASA Astrophysics Data System (ADS)

    Holmgren, M.

    A literature survey of the phenomenon of crack closure is reported here. The state of the art is reviewed and several empirical formulas for determining the crack closure are compared with each other. Their properties, advantages and disadvantages are briefly discussed. Experimental techniques for determining the crack closure stress are presented and experimental data from the literature are reported.

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

    PubMed

    Kam, Jason P; Zepeda, Emily M; Ding, Leona; Wen, Joanne C

    2017-01-01

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

  19. Angle closure glaucoma in congenital ectropion uvea.

    PubMed

    Wang, Grace M; Thuente, Daniel; Bohnsack, Brenda L

    2018-06-01

    Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea. Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months) and required additional surgery (cycloablation or trabeculectomy). Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control.

  20. Alarm sensor apparatus for closures

    DOEpatents

    Carlson, J.A.; Stoddard, L.M.

    1984-01-31

    An alarm sensor apparatus for closures such as doors and windows, and particularly for closures having loose tolerances such as overhead doors, garage doors or the like, the sensor apparatus comprising a pair of cooperating bracket members, one being attached to the door facing or framework and the other to the door member, two magnetic sensor elements carried by said bracket members, the bracket members comprising a pair of cooperating orthogonal guide slots and plates and a stop member engageable with one of the sensors for aligning the sensors with respect to each other in all three orthogonal planes when the door is closed.

  1. Alarm sensor apparatus for closures

    DOEpatents

    Carlson, James A.; Stoddard, Lawrence M.

    1986-01-01

    An alarm sensor apparatus for closures such as doors and windows, and particularly for closures having loose tolerances such as overhead doors, garage doors or the like, the sensor apparatus comprising a pair of cooperating bracket members, one being attached to the door facing or frame work and the other to the door member, two magnetic sensor elements carried by said bracket members, the bracket members comprising a pair of cooperating orthogonal guide slots and plates and a stop member engageable with one of the sensors for aligning the sensors with respect to each other in all three orthogonal planes when the door is closed.

  2. Object permanence in lemurs.

    PubMed

    Deppe, Anja M; Wright, Patricia C; Szelistowski, William A

    2009-03-01

    Object permanence, the ability to mentally represent objects that have disappeared from view, should be advantageous to animals in their interaction with the natural world. The objective of this study was to examine whether lemurs possess object permanence. Thirteen adult subjects representing four species of diurnal lemur (Eulemur fulvus rufus, Eulemur mongoz, Lemur catta and Hapalemur griseus) were presented with seven standard Piagetian visible and invisible object displacement tests, plus one single visible test where the subject had to wait predetermined times before allowed to search, and two invisible tests where each hiding place was made visually unique. In all visible tests lemurs were able to find an object that had been in clear view before being hidden. However, when lemurs were not allowed to search for up to 25-s, performance declined with increasing time-delay. Subjects did not outperform chance on any invisible displacements regardless of whether hiding places were visually uniform or unique, therefore the upper limit of object permanence observed was Stage 5b. Lemur species in this study eat stationary foods and are not subject to stalking predators, thus Stage 5 object permanence is probably sufficient to solve most problems encountered in the wild.

  3. 36 CFR 13.1328 - EGDA closures and restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... otherwise restrict activities in the EGDA to protect public health, safety, or park resources, or to provide for the equitable and orderly use of park facilities. Information on closures and restrictions will be available at the park visitor information center. Violating closures or restrictions is prohibited. ...

  4. 36 CFR 13.1328 - EGDA closures and restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... otherwise restrict activities in the EGDA to protect public health, safety, or park resources, or to provide for the equitable and orderly use of park facilities. Information on closures and restrictions will be available at the park visitor information center. Violating closures or restrictions is prohibited. ...

  5. 36 CFR 13.1328 - EGDA closures and restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... otherwise restrict activities in the EGDA to protect public health, safety, or park resources, or to provide for the equitable and orderly use of park facilities. Information on closures and restrictions will be available at the park visitor information center. Violating closures or restrictions is prohibited. ...

  6. 36 CFR 13.1328 - EGDA closures and restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... otherwise restrict activities in the EGDA to protect public health, safety, or park resources, or to provide for the equitable and orderly use of park facilities. Information on closures and restrictions will be available at the park visitor information center. Violating closures or restrictions is prohibited. ...

  7. PFO and Migraine: Is There a Role for Closure?

    PubMed

    Rayhill, Melissa; Burch, Rebecca

    2017-03-01

    Observational studies suggest that closure of a patent foramen ovale for other indications may reduce or even eliminate migraine attacks, particularly migraine with aura. The first randomized clinical trial of patent foramen ovale (PFO) closure for prevention of migraine, the MIST trial, showed negative results. The results of the other two completed studies in this area have recently been published in the last year. PRIMA and PREMIUM were also both negative for their primary endpoints. The PREMIUM trial did show a reduction in headache days in the migraine with aura subgroup but the final results of this subset analysis have not been published. There may be an as yet undetermined subgroup of patients with migraine who would benefit from closure, but slow recruitment has been a barrier to further study. Several potentially life-threatening procedure-related adverse events occurred in the clinical trials. At this time, we recommend against offering PFO closure as a preventive treatment for migraine. Based on available observational data, patients for whom PFO closure is indicated for other reasons may see some improvement in their migraines.

  8. 300 Area waste acid treatment system closure plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    LUKE, S.N.

    1999-05-17

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

  9. Mechanics of epithelial closure over non-adherent environments

    NASA Astrophysics Data System (ADS)

    Vedula, Sri Ram Krishna; Peyret, Grégoire; Cheddadi, Ibrahim; Chen, Tianchi; Brugués, Agustí; Hirata, Hiroaki; Lopez-Menendez, Horacio; Toyama, Yusuke; Neves de Almeida, Luís; Trepat, Xavier; Lim, Chwee Teck; Ladoux, Benoit

    2015-01-01

    The closure of gaps within epithelia is crucial to maintain its integrity during biological processes such as wound healing and gastrulation. Depending on the distribution of extracellular matrix, gap closure occurs through assembly of multicellular actin-based contractile cables or protrusive activity of border cells into the gap. Here we show that the supracellular actomyosin contractility of cells near the gap edge exerts sufficient tension on the surrounding tissue to promote closure of non-adherent gaps. Using traction force microscopy, we observe that cell-generated forces on the substrate at the gap edge first point away from the centre of the gap and then increase in the radial direction pointing into the gap as closure proceeds. Combining with numerical simulations, we show that the increase in force relies less on localized purse-string contractility and more on large-scale remodelling of the suspended tissue around the gap. Our results provide a framework for understanding the assembly and the mechanics of cellular contractility at the tissue level.

  10. Cystic Duct Closure by Sealing With Bipolar Electrocoagulation

    PubMed Central

    Damgaard, B.; Jorgensen, L. N.; Larsen, S. S.; Kristiansen, V. B.

    2010-01-01

    Background: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure®) for closure of the cystic duct. Methods: The records from consecutive laparoscopic cholecystectomies performed in 2 hospitals with closure of the cystic duct with LigaSure after informed consent were recorded and complications and morbidity registered. The records were compared with those of patients undergoing laparoscopic cholecystectomy with closure of the cystic duct with clips during the same period. Results: During the study period, 218 laparoscopic cholecystectomies were performed; 102 of these were performed with the LigaSure. One patient was excluded due to violation of the protocol. We experienced no cases of cystic duct leakage, but in one patient, bile leakage from the gallbladder bed was observed probably due to a small aberrant duct. Conclusion: The LigaSure system was safe and effective for closure and division of the cystic duct in laparoscopic cholecystectomy. PMID:20412641

  11. Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis.

    PubMed

    Zhou, Wei; Lv, Ran; Wang, Xianfa; Mou, Yiping; Cai, Xiujun; Herr, Ingrid

    2010-10-01

    Suture closure and stapler closure of the pancreatic remnant after distal pancreatectomy are the techniques used most often. The ideal choice remains a matter of debate. Five bibliographic databases covering 1970 to July 2009 were searched. Sixteen articles met the inclusion criteria. Stapler closure was performed in 671 patients, while suture closure was conducted in 1,615 patients. The pancreatic fistula rate ranged from 0% to 40.0% for stapler closure of the pancreatic stump and from 9.3% to 45.7% for the suture closure technique. There were no significant difference between the stapler and suture closure groups with respect to the pancreatic fistula formation rate (22.1% vs 31.2%; odds ratio, .85; 95% confidence interval, .66-1.08), although there was a trend toward favoring stapler closure. In 4 studies including 437 patients, stapler closure was associated with a trend (not statistically significant) toward a reduction in intra-abdominal abscess (odds ratio, .53; 95% confidence interval, .24-1.15). No significant differences occur between suture and stapler closure with respect to the pancreatic fistula or intra-abdominal abscess after distal pancreatectomy, though there is a trend favoring stapler closure. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Prospective Comparison of Collagen Plug (Angio-Seal™) and Suture-Mediated (the Closer S™) Closure Devices at Femoral Access Sites

    PubMed Central

    Park, Yulri; Choo, Sung Wook; Lee, Sung Hoon; Shin, Sung Wook; Do, Young Soo; Byun, Hong Sik; Park, Kwang Bo; Jeon, Pyoung

    2005-01-01

    Objective Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). Materials and Methods From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1,676 cases of 1,180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. Results Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S (p < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. Conclusion The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred. PMID:16374083

  13. EASApprox® skin-stretching system: A secure and effective method to achieve wound closure.

    PubMed

    Song, Mingzhi; Zhang, Zhen; Liu, Tao; Liu, Song; Li, Gang; Liu, Zhaochang; Huang, Jingyang; Chen, Song; Li, Linan; Guo, Li; Qiu, Yang; Wan, Jiajia; Liu, Yuejian; Wu, Tao; Wang, Xiaoyong; Lu, Ming; Wang, Shouyu

    2017-07-01

    Large skin defects are commonly observed in the clinic and have attracted much attention recently. Therefore, finding an effective solution for large skin defects is a global problem. The objective of the present study was to assess the effectiveness of the EASApprox ® skin-stretching system for closing large skin defects. Skin defects (5×5 cm) were created on the forearms of 9 Bama miniature pigs, which were randomly divided into the following three groups: Direct suture, the new EASApprox ® skin-stretching device and Kirschner wires. Microcirculation was assessed before surgery and after wound closure. Following the different treatments, the defects were sutured, and wound healing was assessed based on a clinical score. Furthermore, microscopic and ultramicroscopic structures were evaluated, including collagen, elastic fibers and the microvessel density. Significant differences in the clinical score and microvessel density were observed among the groups. Additionally, the mean length obtained for elastic fibers was larger than that obtained for the other two groups. Finally, the new EASApprox ® skin-stretching device resulted in successful wound management and with only minor side effects on skin histology and microcirculation. Therefore, this method has the potential to be used for healing large skin defects.

  14. The Rising Rate of Rural Hospital Closures.

    PubMed

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

    2016-01-01

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

  15. Analytical and Experimental Study of Near-Threshold Interactions Between Crack Closure Mechanisms

    NASA Technical Reports Server (NTRS)

    Newman, John A.; Riddell, William T.; Piascik, Robert S.

    2003-01-01

    The results of an analytical closure model that considers contributions and interactions between plasticity-, roughness-, and oxide-induced crack closure mechanisms are presented and compared with experimental data. The analytical model is shown to provide a good description of the combined influences of crack roughness, oxide debris, and plasticity in the near-threshold regime. Furthermore, analytical results indicate that closure mechanisms interact in a non-linear manner such that the total amount of closure is not the sum of closure contributions for each mechanism.

  16. A comparison of three algebraic stress closures for combustor flow calculations

    NASA Technical Reports Server (NTRS)

    Nikjooy, M.; So, R. M. C.; Hwang, B. C.

    1985-01-01

    A comparison is made of the performance of two locally nonequilibrium and one equilibrium algebraic stress closures in calculating combustor flows. Effects of four different pressure-strain models on these closure models are also analyzed. The results show that the pressure-strain models have a much greater influence on the calculated mean velocity and turbulence field than the algebraic stress closures, and that the best mean strain model for the pressure-strain terms is that proposed by Launder, Reece and Rodi (1975). However, the equilibrium algebraic stress closure with the Rotta return-to-isotropy model (1951) for the pressure-strain terms gives as good a correlation with measurements as when the Launder et al. mean strain model is included in the pressure-strain model. Finally, comparison of the calculations with the standard k-epsilon closure results show that the algebraic stress closures are better suited for simple turbulent flow calculations.

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

    PubMed

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

    2017-10-01

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

  18. Permanent-magnet multipole with adjustable strength

    DOEpatents

    Halbach, K.

    1982-09-20

    Two or more magnetically soft pole pieces are symmetrically positioned along a longitudinal axis to provide a magnetic field within a space defined by the pole pieces. Two or more permanent magnets are mounted to an external magnetically-soft cylindrical sleeve which rotates to bring the permanent magnets into closer coupling with the pole pieces and thereby adjustably control the field strength of the magnetic field produced in the space defined by the pole pieces. The permanent magnets are preferably formed of rare earth cobalt (REC) material which has a high remanent magnetic field and a strong coercive force. The pole pieces and the permanent magnets have corresponding cylindrical surfaces which are positionable with respect to each other to vary the coupling there between. Auxiliary permanent magnets are provided between the pole pieces to provide additional magnetic flux to the magnetic field without saturating the pole pieces.

  19. Permanent magnet multipole with adjustable strength

    DOEpatents

    Halbach, Klaus

    1985-01-01

    Two or more magnetically soft pole pieces are symmetrically positioned along a longitudinal axis to provide a magnetic field within a space defined by the pole pieces. Two or more permanent magnets are mounted to an external magnetically-soft cylindrical sleeve which rotates to bring the permanent magnets into closer coupling with the pole pieces and thereby adjustably control the field strength of the magnetic field produced in the space defined by the pole pieces. The permanent magnets are preferably formed of rare earth cobalt (REC) material which has a high remanent magnetic field and a strong coercive force. The pole pieces and the permanent magnets have corresponding cylindrical surfaces which are positionable with respect to each other to vary the coupling therebetween. Auxiliary permanent magnets are provided between the pole pieces to provide additional magnetic flux to the magnetic field without saturating the pole pieces.

  20. Closure of the patent ductus arteriosus with the Amplatzer Duct Occluder II: a clinical experience.

    PubMed

    Karagöz, Tevfik; Akin, Alper; Ertuğrul, Ilker; Aykan, Hayrettin Hakan; Alehan, Dursun; Ozer, Sema; Ozkutlu, Süheyla

    2012-12-01

    The aim of our study was to share our clinical experience on cases with patent ductus arteriosus treated with the Amplatzer Duct Occluder II. Between 2008 and 2012, 26 of 31 patients with patent ductus arteriosus underwent successful transcatheter closure of patent ductus arteriosus using the Amplatzer Duct Occluder II. Mean age was 3.3 years and mean weight was 15.7 kilograms. The presence of a residual shunt, left pulmonary artery or aortic obstruction was explored by administering contrast material during the procedure. The patients were discharged 24 hours after the procedure. The procedure was successful in 26 of 31 patients and failed in five patients. According to the Krichenko classification, 26 patients had type A, one patient had type B and 4 patients had type C ductus. The mean narrowest ductus diameter was 3.2 mm and the mean ductus length was 6.7 mm. Complete angiographic occlusion occurred immediately after the procedure in 22 out of 26 patients in whom the ductus was closed successfully with the Amplatzer Duct Occluder II. Complete occlusion was achieved in the remaining patients with residual shunt one month after the procedure. The procedure was preceded by closure with an Amplatzer Duct Occluder I in two patients and an Amplatzer Vascular Plug I in one patient. Amplatzer Duct Occluder II is highly effective in transcatheter closure of patent ductus arteriosus. We think that an alternative closure device and alternative techniques can be attempted in patients with type C ductus. The success rate could increase with accumulating experience.

  1. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Minko, Peter, E-mail: peterminko@yahoo.com; Katoh, Marcus; Graeber, Stefan

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI),more » presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10{sup 9}/l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m{sup 2}; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.« less

  2. Transapical access closure: the TA PLUG device†

    PubMed Central

    Brinks, Henriette; Nietlispach, Fabian; Göber, Volkhard; Englberger, Lars; Wenaweser, Peter; Meier, Bernhard; Carrel, Thierry; Huber, Christoph

    2013-01-01

    OBJECTIVES Percutaneous closure of the transapical (TA) access site for large-calibre devices is an unsolved issue. We report the first experimental data on the TA PLUG device for true-percutaneous closure following large apical access for transcatheter aortic valve implantation. METHODS The TA PLUG, a self-sealing full-core closure device, was implanted in an acute animal study in six pigs (60.2 ± 0.7 kg). All the pigs received 100 IU/kg of heparin. The targeted activated clotting time was left to normalize spontaneously. After accessing the left ventricular apex with a 39 French introducer, the closure plug device was delivered with a 33 French over-the-wire system under fluoroscopic guidance into the apex. Time to full haemostasis as well as rate of bleeding was recorded. Self-anchoring properties were assessed by haemodynamic push stress under adrenalin challenge. An additional feasibility study was conducted in four pigs (58.4 ± 1.1 kg) with full surgical exposure of the apex, and assessed device anchoring by pull-force measurements with 0.5 Newton (N) increments. All the animals were electively sacrified. Post-mortem analysis of the heart was performed and the renal embolic index assessed. RESULTS Of six apical closure devices, five were correctly inserted and fully deployed at the first attempt. One became blocked in the delivery system and was placed successfully at the second attempt. In all the animals, complete haemostasis was immediate and no leak was recorded during the 5-h observation period. Neither leak nor any device dislodgement was observed under haemodynamic push stress with repeated left ventricular peak pressure of up to 220 mmHg. In the feasibility study assessing pull-stressing, device migration occurred at a force of 3.3 ± 0.5 N corresponding to 247.5 mmHg. Post-mortem analyses confirmed full expansion of all devices at the intended target. No macroscopic damage was identified at the surrounding myocardium. The renal embolic index was

  3. Biological constraints do not entail cognitive closure.

    PubMed

    Vlerick, Michael

    2014-12-01

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

  4. Self-Centering Reciprocating-Permanent-Magnet Machine

    NASA Technical Reports Server (NTRS)

    Bhate, Suresh; Vitale, Nick

    1988-01-01

    New design for monocoil reciprocating-permanent-magnet electric machine provides self-centering force. Linear permanent-magnet electrical motor includes outer stator, inner stator, and permanent-magnet plunger oscillateing axially between extreme left and right positions. Magnets arranged to produce centering force and allows use of only one coil of arbitrary axial length. Axial length of coil chosen to provide required efficiency and power output.

  5. Fish allergy causing angioedema and secondary angle-closure glaucoma.

    PubMed

    Calder, Donovan; Calder, Jennifer

    2013-03-06

    A 56-year-old woman with a history of primary angle-closure glaucoma presented with acute generalised swelling, and facial angioedema following a fish meal. She complained of nausea, vomiting, headache, pain in both eyes and acute loss of vision. Her visual acuity was reduced and intraocular pressures (IOP) were elevated. Gonioscopy revealed complete angle closure in the left eye and complete to partial closure in the right eye. Through existing peripheral iridotomies the anterior capsules were seen pressed up against the iris of both eyes. A diagnosis of angle-closure glaucoma was made, medications were started to reduce the elevated intraocular pressure and systemic antihistamine to counter the allergic reaction. She was hospitalised for further management. A follow-up at 2 years revealed her visual acuities and IOP had remained normal.

  6. 40 CFR 265.143 - Financial assurance for closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., except as provided in § 265.143(f), divided by the number of years in the pay-in period. (ii) Subsequent... bills for partial or final closure activities, the Regional Administrator will instruct the trustee to... facility over its remaining operating life. Within 60 days after receiving bills for closure activities...

  7. 40 CFR 264.143 - Financial assurance for closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in § 264.143(g), divided by the number of years in the pay-in period. Subsequent payments must be... for partial or final closure activities, the Regional Administrator will instruct the trustee to make... operating life. Within 60 days after receiving bills for closure activities, the Regional Administrator will...

  8. Challenges in device closure of a large patent ductus arteriosus in infants weighing less than 6 kg.

    PubMed

    Vijayalakshmi, I B; Chitra, Narasimhan; Praveen, Jayan; Prasanna, Simha Rao

    2013-02-01

    Transcatheter closure of patent ductus arteriosus (PDA) has replaced surgery in most institutions. Despite improvements in techniques and the devices available, closure of large PDA in very small infants remains a challenge. To assess the challenges, feasibility, and efficacy of device closure of large PDA, in infants weighing ≤6 kg. Analysis of device closure of a PDA was done in 61 infants ≤6 kg. Their ages, ranged from 9 days-12 months (mean 8.9 months), weight ranged from 2.2 to 6 kg (mean 5.3 kg), and PDA measured 3.2-8.7 mm (mean 4.8 mm). The fluoroscopy time was 3-18 minutes. The largest device used was 12 × 10 mm. Successful device placement was achieved in 60/61 infants (98.4%). Mild aortic obstruction occurred in 2 cases (3.3%), as the device got displaced towards the aorta after release. The device embolized in 2 cases (3.3%). In one it was retrieved by a novel method like fastening the screw in the aorta and was closed with a 4 × 6 ADO II. In the other infant, with a single kidney, died of uremia after device retrieval. Mild left pulmonary artery (LPA) obstruction occurred in one case (1.6%). Four cases (6.6%) had minor vascular complications. The postprocedure weight gain after 3 months was between 2.5 kg ± 250 mg. Device closure of large PDA in infants weighing ≤6 kg with left ventricular failure is challenging but possible, safe and effective. Retrieval of embolized device could be tricky. © 2012, Wiley Periodicals, Inc.

  9. A novel technique for transcatheter patent ductus arteriosus closure in extremely preterm infants using commercially available technology.

    PubMed

    Zahn, Evan M; Nevin, Phillip; Simmons, Charles; Garg, Ruchira

    2015-02-01

    To describe a new technique for transcatheter patent ductus arteriosus (PDA) closure in extremely preterm infants using commercially available technology. PDA in premature neonates continues to be a significant clinical problem contributing importantly to both morbidity and mortality. Surgical ligation and medical therapy both have their drawbacks. Hospital records and catheterization reports of all premature neonates (< 32 weeks gestation) who underwent transcatheter PDA closure between March 2013 and February 2014 were reviewed. Particular attention was paid to procedural details, complications, and short and mid-term outcomes. Six premature infants born at gestational ages ranging between 26 and 31 weeks (median, 26 weeks) underwent attempted transcatheter PDA closure using the Amplatzer Vascular Plug II (AVP II). Median age and weight was 21.5 days (16-80 days) and 1,180 g (870-2,240 g), respectively. Fluoroscopy and echocardiography were used to guide device. Contrast angiography was not used in any patient. Complete closure was achieved in all patients with no major procedural complications. Median fluoroscopy and procedural times were 9.4 (0-19.5) and 51.5 (33-87) min, respectively. All patients were alive at the time of this report. There were no instances of device migration, left pulmonary artery (LPA), or aortic coarctation. This preliminary study demonstrates that transcatheter PDA closure can be successfully performed in extremely preterm neonates using currently available technology with a high success rate and a low incidence of complications. This report also describes a novel transvenous approach using a combination of echocardiography and judicious use of fluoroscopy to avoid arterial access in this fragile patient population. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

  10. 40 CFR 265.117 - Post-closure care and use of property.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 265.117 Section 265.117 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID.... (a)(1) Post-closure care for each hazardous waste management unit subject to the requirements of... this part. (2) Any time preceding closure of a hazardous waste management unit subject to post-closure...

  11. Catheter-based closure of the patent ductus arteriosus in lower weight infants.

    PubMed

    Pavlek, Leeann R; Slaughter, Jonathan L; Berman, Darren P; Backes, Carl H

    2018-06-13

    Risks associated with drug therapy and surgical ligation have led health care providers to consider alternative strategies for patent ductus arteriosus (PDA) closure. Catheter-based PDA closure is the procedure of choice for ductal closure in adults, children, and infants ≥6kg. Given evidence among older counterparts, interest in catheter-based closure of the PDA in lower weight (<6kg) infants is growing. Among these smaller infants, the goals of this review are to: (1) provide an overview of the procedure; (2) review the types of PDA closure devices; (3) review the technical success (feasibility); (4) review the risks (safety profile); (5) discuss the quality of evidence on procedural efficacy; (6) consider areas for future research. The review provided herein suggests that catheter-based PDA closure is technically feasible, but the lack of comparative trials precludes determination of the optimal strategy for ductal closure in this subgroup of infants. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Permanent education in health: a review

    PubMed Central

    Miccas, Fernanda Luppino; Batista, Sylvia Helena Souza da Silva

    2014-01-01

    OBJECTIVE To undertake a meta-synthesis of the literature on the main concepts and practices related to permanent education in health. METHODS A bibliographical search was conducted for original articles in the PubMed, Web of Science, LILACS, IBECS and SciELO databases, using the following search terms: “public health professional education”, “permanent education”, “continuing education”, “permanent education health”. Of the 590 articles identified, after applying inclusion and exclusion criteria, 48 were selected for further analysis, grouped according to the criteria of key elements, and then underwent meta-synthesis. RESULTS The 48 original publications were classified according to four thematic units of key elements: 1) concepts, 2) strategies and difficulties, 3) public policies and 4) educational institutions. Three main conceptions of permanent education in health were found: problem-focused and team work, directly related to continuing education and education that takes place throughout life. The main strategies for executing permanent education in health are discussion, maintaining an open space for permanent education, and permanent education clusters. The most limiting factor is mainly related to directly or indirect management. Another highlight is the requirement for implementation and maintenance of public policies, and the availability of financial and human resources. The educational institutions need to combine education and service aiming to form critical-reflexive graduates. CONCLUSIONS The coordination between health and education is based as much on the actions of health services as on management and educational institutions. Thus, it becomes a challenge to implement the teaching-learning processes that are supported by critical-reflexive actions. It is necessary to carry out proposals for permanent education in health involving the participation of health professionals, teachers and educational institutions. PMID:24789649

  13. Overload retardation due to plasticity-induced crack closure

    NASA Technical Reports Server (NTRS)

    Fleck, N. A.; Shercliff, H. R.

    1989-01-01

    Experiments are reported which show that plasticity-induced crack closure can account for crack growth retardation following an overload. The finite element method is used to provide evidence which supports the experimental observations of crack closure. Finally, a simple model is presented which predicts with limited success the retardation transient following an overload.

  14. Comparison of rate of surgical wound infection, length of hospital stay and patient convenience in complicated appendicitis between primary closure and delayed primary closure.

    PubMed

    Khan, Khizar Ishtiaque; Mahmood, Shahid; Akmal, Muhammad; Waqas, Ahmed

    2012-06-01

    To compare the difference in the rate of surgical wound infection, patient's convenience and length of hospital stay between Primary Closure and Delayed Primary Closure in cases of complicated appendicitis in adults. This randomised control trial was conducted at the Combined Military Hospital, Kharian and Malir from June 5, 2006, to September 10, 2009. Patients > or = 15 years of both gender who underwent appendectomy through grid iron or Lanz incision and having complicated appendicitis were included. The 100 patients who were included in the study out of the initial size of 393, were randomised into two equal groups of 50 each (Group A: Primary Closure; Group B: Delayed Primary Closure) using a computer-generated table. All the surgeries were done by the same surgeon and the operative steps and antibiotic coverage were standardised. The rate of surgical wound infection, patient's convenience (on visual analogue scale in mm) and the length of hospital stay were recorded. Data was analysed using SPSS version 11, and p value was calculated. Demographic data, comorbids and medication of both the groups was comparable. There was no significant difference in rate of surgical wound infection (p > 0.05). The difference in patient's convenience and length of hospital stay were significant (p < 0.05), showing superiority of Primary Closure over Delayed Primary Closure with no added morbidity/mortality. Primary Closure in complicated appendicitis not only reduces the cost of treatment, but is also more convenient and satisfying for the patients, with no added risk of surgical wound infection.

  15. Recent progress in developing durable and permanent impeller pump.

    PubMed

    Qian, K X; Zeng, P; Ru, W M; Yuan, H Y

    2002-04-01

    Since 1980s, the author's impeller pump has successively achieved the device implantability, blood compatibility and flow pulsatility. In order to realize a performance durability, the author has concentrated in past years on solving the bearing problems of the impeller pump. Recent progress has been obtained in developing durable and permanent impeller blood pumps. At first, a durable impeller pump with rolling bearing and purge system has been developed, in which the wear-less rollers made of super-high-molecular weight polythene make the pump to work for years without mechanical wear; and the purge system enables the bearing to work in saline and heparin, and no thrombus therefore could be formed. Secondly, a durable centrifugal pump with rolling bearing and axially reciprocating impeller has been developed, the axial reciprocation of rotating impeller makes the fresh blood in and out of the bearing and to wash the rollers once a circle; in such way, no thrombus could be formed and no fluid infusion is necessary, which may bring inconvenience and discomfort to the receptors. Finally, a permanent maglev impeller pump has been developed, its rotor is suspended and floating in the blood under the action of permanent magnetic force and nonmagnetic forces, without need for position measurement and feed-back control. In conclusion, an implantable, pulsatile, and blood compatible impeller pump with durability may have more extensive applications than ever before and could replace the donor heart for transplantation in the future.

  16. Canadian Eskimo permanent tooth emergence timing.

    PubMed

    Mayhall, J T; Belier, P L; Mayhall, M F

    1978-08-01

    To identify the times of emergence of the permanent teeth of Canadian Eskimos (Inuit), 368 children and adolescents were examined. The presence or absence of all permanent teeth except the third molars was recorded and these data subjected to probit analysis. Female emergence times were advanced over males. Generally, the Inuit of both sexes showed statistically significant earlier emergence times than Montreal children, except for the incisors. The present results do not support hypotheses indicating that premature extraction of the deciduous teeth advances the emergence of their succedaneous counterparts. There is some indication the controls of deciduous tooth emergence continue to play some part in emergence of the permanent dentition, especially the first permanent teeth that emerge.

  17. Data-driven non-Markovian closure models

    NASA Astrophysics Data System (ADS)

    Kondrashov, Dmitri; Chekroun, Mickaël D.; Ghil, Michael

    2015-03-01

    This paper has two interrelated foci: (i) obtaining stable and efficient data-driven closure models by using a multivariate time series of partial observations from a large-dimensional system; and (ii) comparing these closure models with the optimal closures predicted by the Mori-Zwanzig (MZ) formalism of statistical physics. Multilayer stochastic models (MSMs) are introduced as both a generalization and a time-continuous limit of existing multilevel, regression-based approaches to closure in a data-driven setting; these approaches include empirical model reduction (EMR), as well as more recent multi-layer modeling. It is shown that the multilayer structure of MSMs can provide a natural Markov approximation to the generalized Langevin equation (GLE) of the MZ formalism. A simple correlation-based stopping criterion for an EMR-MSM model is derived to assess how well it approximates the GLE solution. Sufficient conditions are derived on the structure of the nonlinear cross-interactions between the constitutive layers of a given MSM to guarantee the existence of a global random attractor. This existence ensures that no blow-up can occur for a broad class of MSM applications, a class that includes non-polynomial predictors and nonlinearities that do not necessarily preserve quadratic energy invariants. The EMR-MSM methodology is first applied to a conceptual, nonlinear, stochastic climate model of coupled slow and fast variables, in which only slow variables are observed. It is shown that the resulting closure model with energy-conserving nonlinearities efficiently captures the main statistical features of the slow variables, even when there is no formal scale separation and the fast variables are quite energetic. Second, an MSM is shown to successfully reproduce the statistics of a partially observed, generalized Lotka-Volterra model of population dynamics in its chaotic regime. The challenges here include the rarity of strange attractors in the model's parameter

  18. Colostomy closure: how to avoid complications

    PubMed Central

    Levitt, Marc A.; Lawal, Taiwo A.; Peña, Alberto

    2010-01-01

    Purpose Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. Methods The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48–72 h after the operation. Results The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung’s disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic

  19. Colostomy closure: how to avoid complications.

    PubMed

    Bischoff, Andrea; Levitt, Marc A; Lawal, Taiwo A; Peña, Alberto

    2010-11-01

    Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48-72 h after the operation. The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung's disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic stricture and no mortality. Based on

  20. Permanent right ventricular pacing through an anomalous left superior vena cava.

    PubMed Central

    Amikam, S; Lemer, J; Riss, E

    1977-01-01

    A persistent left superior vena cava can complicate the implantation of a transvenous pacemaker. In a patient who required a permanent pacemaker, this venous anomaly was discovered during the insertion of the electrode but it did not prevent long-term right ventricular pacing. This was achieved after the electrode had been manipulated through the coronary sinus and right atrium. A plan of management is proposed for dealing with this unexpected problem. Images PMID:601745

  1. [The Object Permanence Fallacy.] Commentary.

    ERIC Educational Resources Information Center

    Bradley, Ben S.

    1996-01-01

    Suggests that Greenberg's challenge to the centrality of object permanence in developmental thinking reveals that developmentalists' theories about childhood speak about their own self-images. Notes that developmentalists have been guilty of not only the object permanence fallacy but also the genetic fallacy, or the mistaken belief that describing…

  2. [Perforated peptic ulcer closure: laparoscopic or open?

    PubMed

    Alekberzade, A V; Krylov, N N; Rustamov, E A; Badalov, D A; Popovtsev, M A

    To compare laparoscopic and open closure of perforated peptic ulcer (PPU). The study included 153 patients who underwent PPU suturing. 78 patients underwent laparoscopic closure (laparoscopic group) and open suturing via upper midline laparotomy was performed in 75 cases (open group). Surgery time, postoperative pain severity, time of analgesics intake, postoperative complications, hospital-stay and and cosmetic effect were compared. Laparoscopic PPU closure may be effective and accessible in experienced endoscopic surgeon. It significantly reduces postoperative pain severity, need for analgesics, incidence of postoperative complications and provides excellent cosmetic effect. However, there is greater time of surgery compared with open intervention. There were no significant differences in hspital-stay between groups. Laparoscopic PPU suturing can be considered a good alternative to open surgery. Further researches are needed for standardization, assessment of safety, real advantages and disadvantages of laparoscopic technique.

  3. Household responses to school closure resulting from outbreak of influenza B, North Carolina.

    PubMed

    Johnson, April J; Moore, Zack S; Edelson, Paul J; Kinnane, Lynda; Davies, Megan; Shay, David K; Balish, Amanda; McCarron, Meg; Blanton, Lenee; Finelli, Lyn; Averhoff, Francisco; Bresee, Joseph; Engel, Jeffrey; Fiore, Anthony

    2008-07-01

    School closure is a proposed strategy for reducing influenza transmission during a pandemic. Few studies have assessed how families respond to closures, or whether other interactions during closure could reduce this strategy's effect. Questionnaires were administered to 220 households (438 adults and 355 children) with school-age children in a North Carolina county during an influenza B virus outbreak that resulted in school closure. Closure was considered appropriate by 201 (91%) households. No adults missed work to solely provide childcare, and only 22 (10%) households required special childcare arrangements; 2 households incurred additional costs. Eighty-nine percent of children visited at least 1 public location during the closure despite county recommendations to avoid large gatherings. Although behavior and attitudes might differ during a pandemic, these results suggest short-term closure did not cause substantial hardship for parents. Pandemic planning guidance should address the potential for transmission in public areas during school closure.

  4. [Epidemiologic and economic effectiveness of school closure during influenza epidemics and pandemics].

    PubMed

    Gendon, Iu Z; Vasil'ev, Iu M

    2012-01-01

    Epidemiologic and economic effectiveness of school closure during influenza epidemics and pandemics is discussed. Optimal effect of school closure is observed when this measure is taken at the start of the epidemic or pandemic and for a sufficiently long time. School closure during high morbidity among schoolchildren, in the middle (at the peak) and by the end of epidemic or pandemic does not influence significantly the spread of influenza or morbidity. Significant economic losses and other negative consequences of school closure are noted. School closure may be the most appropriate during the emergence of influenza pandemic when the pandemic vaccine is not yet available, however timely mass immunization of schoolchildren against influenza may be a more appropriate measure than school closure for the reduction of influenza morbidity and spread during seasonal influenza epidemics.

  5. The Finishing Touch: Anatomy of Expert Lesson Closures

    ERIC Educational Resources Information Center

    Webster, Collin A.; Connolly, Graeme; Schempp, Paul G.

    2009-01-01

    Background: Based on the idea that students remember best what is presented last, the lesson closure is commonly identified as an important component of effective teaching and has recently surfaced as a routine practice of expert teachers in sport. Despite its link to both effective and expert instruction, the lesson closure has seen scarce…

  6. Navigating the Closure Process. Authorizing Matters. Issue Brief

    ERIC Educational Resources Information Center

    Shaw, Matthew

    2011-01-01

    Charter school closure, though sometimes challenging and emotionally charged, is an essential aspect of the charter school movement. The purpose of this Issue Brief is to provide a practice-oriented resource for authorizers and other charter school stakeholders to navigate the closure process after the decision to close a school has been made. In…

  7. 40 CFR 267.142 - Cost estimate for closure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... that on-site disposal capacity will exist at all times over the life of the facility. (3) The closure...) The owner or operator must keep the following at the facility during the operating life of the... PERMIT Financial Requirements § 267.142 Cost estimate for closure. (a) The owner or operator must have at...

  8. 40 CFR 267.142 - Cost estimate for closure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... that on-site disposal capacity will exist at all times over the life of the facility. (3) The closure...) The owner or operator must keep the following at the facility during the operating life of the... PERMIT Financial Requirements § 267.142 Cost estimate for closure. (a) The owner or operator must have at...

  9. Impact of lane closures on roadway capacity, phase 2.

    DOT National Transportation Integrated Search

    2014-01-01

    This project is a follow-up to Florida Department of Transportation (FDOT) research project BD545-61, Impact of : Lane Closures on Roadway Capacity (specifically, Part A: Development of a Two-Lane Work Zone Lane Closure : Analysis Procedure and...

  10. Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke.

    PubMed

    Søndergaard, Lars; Kasner, Scott E; Rhodes, John F; Andersen, Grethe; Iversen, Helle K; Nielsen-Kudsk, Jens E; Settergren, Magnus; Sjöstrand, Christina; Roine, Risto O; Hildick-Smith, David; Spence, J David; Thomassen, Lars

    2017-09-14

    The efficacy of closure of a patent foramen ovale (PFO) in the prevention of recurrent stroke after cryptogenic stroke is uncertain. We investigated the effect of PFO closure combined with antiplatelet therapy versus antiplatelet therapy alone on the risks of recurrent stroke and new brain infarctions. In this multinational trial involving patients with a PFO who had had a cryptogenic stroke, we randomly assigned patients, in a 2:1 ratio, to undergo PFO closure plus antiplatelet therapy (PFO closure group) or to receive antiplatelet therapy alone (antiplatelet-only group). Imaging of the brain was performed at the baseline screening and at 24 months. The coprimary end points were freedom from clinical evidence of ischemic stroke (reported here as the percentage of patients who had a recurrence of stroke) through at least 24 months after randomization and the 24-month incidence of new brain infarction, which was a composite of clinical ischemic stroke or silent brain infarction detected on imaging. We enrolled 664 patients (mean age, 45.2 years), of whom 81% had moderate or large interatrial shunts. During a median follow-up of 3.2 years, clinical ischemic stroke occurred in 6 of 441 patients (1.4%) in the PFO closure group and in 12 of 223 patients (5.4%) in the antiplatelet-only group (hazard ratio, 0.23; 95% confidence interval [CI], 0.09 to 0.62; P=0.002). The incidence of new brain infarctions was significantly lower in the PFO closure group than in the antiplatelet-only group (22 patients [5.7%] vs. 20 patients [11.3%]; relative risk, 0.51; 95% CI, 0.29 to 0.91; P=0.04), but the incidence of silent brain infarction did not differ significantly between the study groups (P=0.97). Serious adverse events occurred in 23.1% of the patients in the PFO closure group and in 27.8% of the patients in the antiplatelet-only group (P=0.22). Serious device-related adverse events occurred in 6 patients (1.4%) in the PFO closure group, and atrial fibrillation occurred in 29

  11. Mechanics of epithelial closure over non-adherent environments

    PubMed Central

    Vedula, Sri Ram Krishna; Peyret, Grégoire; Cheddadi, Ibrahim; Chen, Tianchi; Brugués, Agustí; Hirata, Hiroaki; Lopez-Menendez, Horacio; Toyama, Yusuke; Neves de Almeida, Luís; Trepat, Xavier; Lim, Chwee Teck; Ladoux, Benoit

    2015-01-01

    The closure of gaps within epithelia is crucial to maintain its integrity during biological processes such as wound healing and gastrulation. Depending on the distribution of extracellular matrix, gap closure occurs through assembly of multicellular actin-based contractile cables or protrusive activity of border cells into the gap. Here we show that the supracellular actomyosin contractility of cells near the gap edge exerts sufficient tension on the surrounding tissue to promote closure of non-adherent gaps. Using traction force microscopy, we observe that cell-generated forces on the substrate at the gap edge first point away from the centre of the gap and then increase in the radial direction pointing into the gap as closure proceeds. Combining with numerical simulations, we show that the increase in force relies less on localized purse-string contractility and more on large-scale remodelling of the suspended tissue around the gap. Our results provide a framework for understanding the assembly and the mechanics of cellular contractility at the tissue level. PMID:25608921

  12. Modified off-midline closure of pilonidal sinus disease.

    PubMed

    Saber, Aly

    2014-05-01

    Numerous surgical procedures have been described for pilonidal sinus disease, but treatment failure and disease recurrence are frequent. Conventional off-midline flap closures have relatively favorable surgical outcomes, but relatively unfavorable cosmetic outcomes. The author reported outcomes of a new simplified off-midline technique for closure of the defect after complete excision of the sinus tracts. Two hundred patients of both sexes were enrolled for modified D-shaped excisions were used to include all sinuses and their ramifications, with a simplified procedure to close the defect. The overall wound infection rate was 12%, (12.2% for males and 11.1% for females). Wound disruption was necessitating laying the whole wound open and management as open technique. The overall wound disruption rate was 6%, (6.1% for males and 5.5% for females) and the overall recurrence rate was 7%. Our simplified off-midline closure without flap appeared to be comparable to conventional off-midline closure with flap, in terms of wound infection, wound dehiscence, and recurrence. Advantages of the simplified procedure include potentially reduced surgery complexity, reduced surgery time, and improved cosmetic outcome.

  13. Vaccum assisted closure: an alternative strategy in the management of degloving injuries of the foot.

    PubMed

    Josty, I C; Ramaswamy, R; Laing, J H

    2001-06-01

    A case of a degloving injury to the foot is presented in a patient who also sustained severe contralateral lower-limb trauma. We report a technique for salvaging the foot by replacing the degloved skin as a full-thickness graft and securing it using the vacuum-assisted closure (VAC) device. A good outcome was achieved and technical tips are provided to facilitate reproduction of the procedure. Copyright 2001 The British Association of Plastic Surgeons.

  14. Estimation of crown closure from AVIRIS data using regression analysis

    NASA Technical Reports Server (NTRS)

    Staenz, K.; Williams, D. J.; Truchon, M.; Fritz, R.

    1993-01-01

    Crown closure is one of the input parameters used for forest growth and yield modelling. Preliminary work by Staenz et al. indicates that imaging spectrometer data acquired with sensors such as the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) have some potential for estimating crown closure on a stand level. The objectives of this paper are: (1) to establish a relationship between AVIRIS data and the crown closure derived from aerial photography of a forested test site within the Interior Douglas Fir biogeoclimatic zone in British Columbia, Canada; (2) to investigate the impact of atmospheric effects and the forest background on the correlation between AVIRIS data and crown closure estimates; and (3) to improve this relationship using multiple regression analysis.

  15. Generalized kinetic-neoclassical closure for parallel viscosity in a tokamak.

    NASA Astrophysics Data System (ADS)

    Smolyakov, A.; Callen, J. D.; Hegna, C.

    2000-10-01

    We develop a drift-kinetic equation for a Chapman Enskog-type calculations of the parallel viscosity in a tokamak. This approach allows us to uniformly obtain closure relations for the parallel viscosity that include the kinetic effects of wave-particle interactions, such as those of Hammet-Perkins closures, as well as standard neoclassical moment closures induced by collisions and the magnetic field strength variation along field lines. Closures for both these cases can be obtained from our expressions; also, their mutual influences can be investigated. The developed equations allow calculation of parallel vicosity in general kinetic-neoclassical regimes while the main conservation properties remain correct even with an approximate treatment of the collisional operator.

  16. Frictionless segmented mechanics for controlled space closure

    PubMed Central

    Andrade, Ildeu

    2017-01-01

    ABSTRACT Extraction spaces may be needed to achieve specific orthodontic goals of positioning the dentition in harmony with the craniofacial complex. However, the fundamental reality that determines the occlusion final position is the control exerted by the orthodontist while closing the extraction spaces. A specific treatment objective may require the posterior teeth to remain in a constant position anteroposteriorly as well as vertically, while the anterior teeth occupy the entire extraction site. Another treatment objective may require the opposite, or any number of intentional alternatives of extraction site closure. The present case report describes a simple controlled segmented mechanic system that permitted definable and predictable force systems to be applied and allowed to predict the treatment outcome with confidence. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) in partial fulfillment of the requirements for Diplomate certification. PMID:28444016

  17. Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix.

    PubMed

    Emodi, Omri; Ginini, Jiriys George; van Aalst, John A; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

    2018-03-01

    Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

  18. Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix

    PubMed Central

    Emodi, Omri; van Aalst, John A.; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

    2018-01-01

    Summary: Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate. PMID:29707449

  19. Transcatheter closure of patent ductus arteriosus in children weighing 10 kg or less: Initial experience at Sohag University Hospital.

    PubMed

    Ali, Safaa; El Sisi, Amel

    2016-04-01

    To assess the challenges, feasibility, and efficacy of device closure of patent ductus arteriosus (PDA) in small children weighing ⩽10 kg for different types of devices used in an initial experience at Sohag University hospital. Between March 2011 and September 2014, 91 patients with PDA underwent transcatheter closure in our institute, among whom 54 weighed ⩽10 kg. All of these patients underwent transcatheter closure of PDA using either a Cook Detachable Coil, PFM Nit-Occlud, or Amplatzer duct occluder. A retrospective review of the treatment results and adverse events was performed. Successful device placement was achieved in 53/54 small children (98.1%). The median minimum PDA diameter was 2.4 mm [interquartile range (IQR, 1.8-3.5 mm), median weight 8 kg (IQR, 7-10 kg), and median age 10 months (IQR, 8-17 months)]. Mild aortic obstruction occurred in one case (1.9%), as the device became displaced towards the aorta after release. The device embolized in one case (1.9%) and no retrieval attempt was made. Five cases (9.3%) had minor vascular complications. With the current availability of devices for PDA closure, transcatheter closure of PDA is considered safe and efficacious in small children weighing ⩽10 kg with good mid-term outcome. The procedure had a low rate of high-severity adverse events even with the initial experience of the catheterization laboratory.

  20. Topology optimized permanent magnet systems

    NASA Astrophysics Data System (ADS)

    Bjørk, R.; Bahl, C. R. H.; Insinga, A. R.

    2017-09-01

    Topology optimization of permanent magnet systems consisting of permanent magnets, high permeability iron and air is presented. An implementation of topology optimization for magnetostatics is discussed and three examples are considered. The Halbach cylinder is topology optimized with iron and an increase of 15% in magnetic efficiency is shown. A topology optimized structure to concentrate a homogeneous field is shown to increase the magnitude of the field by 111%. Finally, a permanent magnet with alternating high and low field regions is topology optimized and a Λcool figure of merit of 0.472 is reached, which is an increase of 100% compared to a previous optimized design.