Use of hub cutters and the volume of sharp waste and occurrence of needle-stick injuries during 2011 mass immunization campaigns against yellow fever in Ghana: a cohort study.

PubMed

Agbenu, E; Chartier, Y; Eleeza, J; Antwi-Agyei, K O; Diamenu, S; Ronveaux, O; Perea, W

2014-01-01

Current WHO best infection control practices for injections do not address the use of hub cutters due to insufficient evidence on safety and efficacy. To assess the impact of the use of hub cutters on 1) the frequency of needle-stick injuries (NSIs) and other blood exposures among workers and 2) the volume of sharps waste in a mass vaccination campaign setting. During yellow fever vaccination in Ghana, we conducted a cohort study on the use of hub cutters. We compared two groups---one group using hub cutters and a control group---for the occurrences of NSIs and the volume of sharp waste produced. In the control arm, vaccinators used 284 482 syringes in 825 vaccination sessions. In the group using hub cutter, vaccinators used 397 079 syringes in 1599 sessions. Among vaccinators, the rate of NSI was not significantly (p=0.14) different between the hub cutter users (0.15/10 000 syringes) and the control group (0.04/10 000). Factors such as workload, lack of organization and pressure seemed to have influence the occurrence of NSIs. With all the limitations of the work, the volume of sharp waste per 10 000 syringes was 0.24 m(3) in the hub cutter users and 0.41 m(3) in the control group---a reduction of 41.2%. Vaccinators found hub cutters easy to use and safe. Use of hub cutter was not associated with increased duration of work. The use of hub cutters did not increase the risk of NSIs. More training is needed to facilitate its implementation in mass campaign setting.

Nurses' infection-control practice: hand decontamination, the use of gloves and sharp instruments.

PubMed

Gould, D; Wilson-Barnett, J; Ream, E

1996-04-01

Infection is an acknowledged hospital problem. Micro-organisms are disseminated mainly via hands but there is evidence that hand decontamination, the most important means of prevention, is performed too seldom, and not always after activities likely to result in heavy contamination. Nurses themselves are exposed to risks of infection, chiefly through contact with blood and body fluids, yet it has also been reported that gloves are not always worn during contact with patients' secretions and that the handling and disposal of sharp instruments may be performed unsafely. The study reported in this paper documents nursing behaviour in relation to hand decontamination, the use of gloves and sharps, taking into consideration a number of variables which could influence practice: availability of the expertise afforded by an infection-control nurse, clinical setting, nursing workload, knowledge and the resources available to control infection. Hands were decontaminated after 28.78% of patient contacts. Hands were decontaminated after 49.85% of activities likely to result in heavy contamination. Performance was related to nursing workload and the availability of hand decontaminating agents, especially when the nurses became busy. Use of gloves when they were available also proved good, with little evidence of wasteful use. The handling and disposal of sharps were commendable for most subjects but a few grossly unsafe incidents were nevertheless witnessed, apparently not associated with any of the variables examined.

Surgical waste audit of 5 total knee arthroplasties

PubMed Central

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

2013-01-01

Background Operating rooms (ORs) are estimated to generate up to one-third of hospital waste. At the London Health Sciences Centre, prosthetics and implants represent 17% of the institution’s ecological footprint. To investigate waste production associated with total knee arthroplasties (TKAs), we performed a surgical waste audit to gauge the environmental impact of this procedure and generate strategies to improve waste management. Methods We conducted a waste audit of 5 primary TKAs performed by a single surgeon in February 2010. Waste was categorized into 6 streams: regular solid waste, recyclable plastics, biohazard waste, laundered linens, sharps and blue sterile wrap. Volume and weight of each stream was quantified. We used Canadian Joint Replacement Registry data (2008–2009) to estimate annual weight and volume totals of waste from all TKAs performed in Canada. Results The average surgical waste (excluding laundered linens) per TKA was 13.3 kg, of which 8.6 kg (64.5%) was normal solid waste, 2.5 kg (19.2%) was biohazard waste, 1.6 kg (12.1%) was blue sterile wrap, 0.3 kg (2.2%) was recyclables and 0.3 kg (2.2%) was sharps. Plastic wrappers, disposable surgical linens and personal protective equipment contributed considerably to total waste. We estimated that landfill waste from all 47 429 TKAs performed in Canada in 2008–2009 was 407 889 kg by weight and 15 272 m3 by volume. Conclusion Total knee arthroplasties produce substantial amounts of surgical waste. Environmentally friendly surgical products and waste management strategies may allow ORs to reduce the negative impacts of waste production without compromising patient care. Level of evidence Level IV, case series. PMID:23351497

Solid waste management in primary healthcare centers: application of a facilitation tool 1

PubMed Central

Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

2016-01-01

Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. PMID:27556874

Seroprevalence of hepatitis B and C among domestic and healthcare waste handlers in Belo Horizonte, Brazil.

PubMed

Mol, Marcos Pg; Gonçalves, Jéssica P; Silva, Edvania A; Scarponi, Cristiane FdO; Greco, Dirceu B; Cairncross, Sandy; Heller, Leo

2016-09-01

Infection with the hepatitis B and C viruses may occur through contact with infected body fluids, including injury with infected sharps. Collectors of domestic or healthcare wastes are potentially exposed to these infections. The aim of this article is to investigate the risk factors associated with the prevalence of hepatitis B and C viruses (HBV and HCV) infection among domestic and healthcare waste workers in Belo Horizonte, Brazil. A cross-sectional study of hepatitis B and C infection was conducted from November 2014 to January 2015, through blood sample collection and interviews about socio-demographic factors with 61 workers exposed to healthcare waste ('exposed') and 461 exposed only to domestic wastes ('unexposed'). The prevalence of antibodies to HCV (Anti-HCV) antibodies was 3.3% in 'exposed' workers and 0.9% in 'unexposed', and of antibody to hepatitis B core antigen (Anti-HBc) was 9.8% and 5.6% in 'exposed' and 'unexposed' workers, respectively. Only 207 (44.9%) of those exposed to domestic waste and 45 (73.8%) of those handling healthcare waste were effectively immunised against hepatitis B virus (HBV). Exposures to domestic waste and to healthcare wastes were associated with similar risks of infection with HBV. The risk of hepatitis C virus (HCV) infection was marginally higher among healthcare waste workers compared with domestic waste workers, probably because of needlestick accidents owing to deficient sharps management systems. Immunisation against hepatitis B and screening tests to ensure the success of vaccination should be a condition for recruitment for both groups of waste workers. © The Author(s) 2016.

Sharps Injuries and Other Blood and Body Fluid Exposures Among Home Health Care Nurses and Aides

PubMed Central

Markkanen, Pia K.; Galligan, Catherine J.; Kriebel, David; Chalupka, Stephanie M.; Kim, Hyun; Gore, Rebecca J.; Sama, Susan R.; Laramie, Angela K.; Davis, Letitia

2009-01-01

Objectives. We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. Methods. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007. Results. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Conclusions. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed. PMID:19890177

Sterilization of slide sheath anesthetic injection systems placed within sharps containers.

PubMed

Palenik, C J; Burke, F J; Bose, M; Altweis, M L

1997-01-01

The purpose of this study was to evaluate the effect that two steam autoclaves and an unsaturated chemical vapor sterilizer had on killing bacterial endospores present on commercial spore strips or applied to sterile anesthetic injection systems placed within sharps containers. Three types of sterilizers were used: a gravity steam autoclave, a high vacuum steam autoclave and an unsaturated chemical vapor sterilizer. The microbial challenge for the sterilizers were Bacillus stearothermophilus spores present on commercial spore strips or drawn into and applied onto sliding sheath anesthetic injection systems with anesthetic carpules attached. Spore-soiled items were placed into the middle of sharps containers three-quarters-filled with representative clinical waste and sterilized. If, after culturing, sterilization of all test items in a group was not achieved, additional sterilization time was applied. Spore strips were killed within a single cycle of each sterilizer. Spore-soiled injection systems and carpules could not be routinely sterilized in the gravity steam autoclave or unsaturated chemical vapor sterilizers, even after three consecutive sterilization cycles. These items, however, were sterilized by exposure to a single-treatment cycle in a high-vacuum steam autoclave. Results indicate that routine sterilization of spore contaminated anesthetic carpules or injection systems could not be accomplished in a reasonable amount of time using sterilizers commonly found in dental offices.

Healthcare waste management practices and safety indicators in Nigeria.

PubMed

Oyekale, Abayomi Samuel; Oyekale, Tolulope Olayemi

2017-09-25

Adequate management of healthcare waste (HCW) is a prerequisite for efficient delivery of healthcare services. In Nigeria, there are several constraints militating against proper management of HCW. This is raising some environmental concerns among stakeholders in the health sector. In this study, we analyzed the practices of HCW management and determinants of risky/safe indices of HCW disposal. The study used the 2013/2014 Service Delivery Indicator (SDI) data that were collected from 2480 healthcare facilities in Nigeria. Descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square (OLS) regression were used to analyze the data. The results showed that 52.20% and 38.21% of the sampled healthcare facilities from Cross River and Bauchi states possessed guidelines for HCW management, respectively. Trainings on management of HCW were attended by 67.18% and 53.19% of the healthcare facilities from Cross River and Imo states, respectively. Also, 32.32% and 29.50% of healthcare facilities from rural and urban areas previously sent some of their staff members for trainings on HCW management, respectively. Sharp and non-sharp HCW were burnt in protected pits in 45.40% and 45.36% of all the sampled healthcare facilities, respectively. Incinerators were reported to be functional in only 2.06% of the total healthcare facilities. In Bauchi and Kebbi states, 23.58% and 21.05% of the healthcare facilities respectively burnt sharp HCW without any protection. Using PCA, computed risky indices for disposal of sharp HCW were highest in Bayelsa state (0.3070) and Kebbi state (0.2172), while indices of risky disposal of non-sharp HCW were highest in Bayelsa state (0.2868) and Osun state (0.2652). The OLS results showed that at 5% level of significance, possession of medical waste disposal guidelines, staff trainings on HCW management, traveling hours from the facilities to local headquarters and being located in rural areas significantly influenced indices of risky/safe medical waste disposal (p < 0.05). The study concluded that there was low compliance with standard HCW management. It was recommended that possession of HCW management guidelines, staff training on HCW disposal and provision of requisite equipment for proper treatment of HCW would promote environmental safety in HCW disposal.

The use of failure mode and effects analysis to construct an effective disposal and prevention mechanism for infectious hospital waste

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

Ho, Chao Chung, E-mail: ho919@pchome.com.tw; Liao, Ching-Jong

Highlights: > This study is based on a real case in a regional teaching hospital in Taiwan. > We use Failure mode and effects analysis (FMEA) as the evaluation method. > We successfully identify the risk factors of infectious waste disposal. > We propose plans for the detection of exceptional cases of infectious waste. - Abstract: In recent times, the quality of medical care has been continuously improving in medical institutions wherein patient-centred care has been emphasized. Failure mode and effects analysis (FMEA) has also been promoted as a method of basic risk management and as part of total qualitymore » management (TQM) for improving the quality of medical care and preventing mistakes. Therefore, a study was conducted using FMEA to evaluate the potential risk causes in the process of infectious medical waste disposal, devise standard procedures concerning the waste, and propose feasible plans for facilitating the detection of exceptional cases of infectious waste. The analysis revealed the following results regarding medical institutions: (a) FMEA can be used to identify the risk factors of infectious waste disposal. (b) During the infectious waste disposal process, six items were scored over 100 in the assessment of uncontrolled risks: erroneous discarding of infectious waste by patients and their families, erroneous discarding by nursing staff, erroneous discarding by medical staff, cleaning drivers pierced by sharp articles, cleaning staff pierced by sharp articles, and unmarked output units. Therefore, the study concluded that it was necessary to (1) provide education and training about waste classification to the medical staff, patients and their families, nursing staff, and cleaning staff; (2) clarify the signs of caution; and (3) evaluate the failure mode and strengthen the effects.« less

Injection safety practices in a main referral hospital in Northeastern Nigeria.

PubMed

Gadzama, G B; Bawa, S B; Ajinoma, Z; Saidu, M M; Umar, A S

2014-01-01

No adherence of safe injection policies remains a major challenge, and, worldwide, annually, it leads to 21 million new hepatitis B cases and 260,000 HIV infection cases. This descriptive observational survey was conducted to determine the level of adherence to universal precaution for safe injection practices in the hospital. The study units were selected using a simple random sampling of injection services provider/phlebotomist in 27 units/wards of the hospital. The study instruments were observation checklist and interviewer administered questionnaires. EPI info (version 3.5.2) software was used for data entry and generation of descriptive statistics was done with units of analysis (units/wards) on injection safety practices of health workers, availability of logistics and supplies, and disposal methods. Only 33.3% of the units (95% CI, 16-54) had non-sharps infectious healthcare waste of any type inside containers specific for non-sharps infectious waste and 17 (77.3%) of the observed therapeutic injections were prepared on a clean, dedicated table or tray, where contamination of the equipment with blood, body fluids, or dirty swabs was unlikely. Absence of recapping of needles was observed in 11 (50.0%) units giving therapeutic injections. Only 7.4% of units surveyed had separate waste containers for infectious non-sharps. This study depicts poor knowledge and a practice of injection safety, inadequate injection safety supplies, and non-compliance to injection safety policy and guidelines.

Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

PubMed

Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

2015-04-11

Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users' sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features. Manufacturers and insurance providers can improve safety with more affordable and accessible sharps with injury prevention features for home users. Sharps disposal campaigns, free-of-charge disposal containers, and convenient disposal options remain essential. Sharps injuries are preventable through public health actions that promote needleless treatment methods, sharps with injury prevention features, and safe disposal practices. Communication about hazards regarding sharps is needed for all home healthcare stakeholders.

Hazardous Waste Cleanup: Merck Sharp & Dohme Corporation in Linden Cities, New Jersey

EPA Pesticide Factsheets

The Merck facility is located at 126 East Lincoln Avenue in Rahway and Linden Cities, Union County, New Jersey on 210 acres. The facility is bordered by residential and industrial areas. The company develops and produces pharmaceutical products.

29 CFR 1910.1030 - Bloodborne pathogens.

Code of Federal Regulations, 2010 CFR

2010-07-01

... designated representative. Engineering controls means controls (e.g., sharps disposal containers, self...-volume or high concentration production of HIV or HBV. Regulated Waste means liquid or semi-liquid blood... research-laboratory-scale amounts of HIV or HBV. Research laboratories may produce high concentrations of...

[Waste management in hospitals. Current situation in the state of North Rhine-Westphalia].

PubMed

Popp, W; Hansen, D; Hilgenhöner, M; Grandek, M; Heinemann, A; Blättler, T

2009-07-01

In 20 hospitals in North Rhine-Westphalia in-plant handling wastes and the delivery of the waste to the disposer were examined. Deficits were seen regarding risk assessment and operating instructions, support by company doctors, personal protection equipment, and break areas for the waste collecting personnel. Also the qualification of the waste management officer and his/her time contingent, correct declaration of the wastes, the training of the waste collecting personnel, the cleaning of multi-use containers and transportation vehicles, storage of the wastes at the collecting points, and the use of sharp collecting boxes were to be partly criticized. Consequences and recommendations are given, concerning the company's obligations (e.g., provide risk assessment, operating instructions), waste management officer (e.g., qualification, enough time contingent, regular inspections), waste collecting personnel (e.g., training courses), industrial safety (e.g., protection equipment, break area wash places), company doctors, transportation vehicles in the house (e.g., regular cleaning), one-way collectors (e.g., labelling at the site of the collection), multi-use collectors (e.g., cleaning), and compressing containers (e.g., larger maintenance openings).

Medical and biohazardous waste generator`s guide: Revision 1

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

Not Available

1994-09-01

This Guide describes the procedures required to comply with all federal and state laws and regulations and Lawrence Berkeley Laboratory (LBL) policy applicable to medical and biohazardous waste. The members of the LBL Biological Safety Subcommittee participated in writing these policies and procedures. The procedures and policies in this Guide apply to LBL personnel who work with infectious agents or potentially infectious agents, publicly perceived infectious items or materials (e.g., medical gloves, culture dishes), and sharps (e.g., needles, syringes, razor blades). If medical or biohazardous waste is contaminated or mixed with a hazardous chemical or material, with a radioactive material,more » or with both, the waste will be handled in accordance with the applicable federal and State of California laws and regulations for hazardous, radioactive, or mixed waste.« less

Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana.

PubMed

Udofia, Emilia Asuquo; Gulis, Gabriel; Fobil, Julius

2017-05-18

Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15-6.54). The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention.

[Biomedical waste management in five hospitals in Dakar, Senegal].

PubMed

Ndiaye, M; El Metghari, L; Soumah, M M; Sow, M L

2012-10-01

Biomedical waste is currently a real health and environmental concern. In this regard, a study was conducted in 5 hospitals in Dakar to review their management of biomedical waste and to formulate recommendations. This is a descriptive cross-sectional study conducted from 1 April to 31 July 2010 in five major hospitals of Dakar. A questionnaire administered to hospital managers, heads of departments, residents and heads of hospital hygiene departments as well as interviews conducted with healthcare personnel and operators of waste incinerators made it possible to assess mechanisms and knowledge on biomedical waste management. Content analysis of interviews, observations and a data sheet allowed processing the data thus gathered. Of the 150 questionnaires distributed, 98 responses were obtained representing a response rate of 65.3%. An interview was conducted with 75 employees directly involved in the management of biomedical waste and observations were made on biomedical waste management in 86 hospital services. Sharps as well as blood and liquid waste were found in all services except in pharmacies, pharmaceutical waste in 66 services, infectious waste in 49 services and anatomical waste in 11 services. Sorting of biomedical waste was ill-adapted in 53.5% (N = 46) of services and the use of the colour-coding system effective in 31.4% (N = 27) of services. Containers for the safe disposal of sharps were available in 82.5% (N = 71) of services and were effectively utilized in 51.1% (N = 44) of these services. In most services, an illadapted packaging was observed with the use of plastic bottles and bins for waste collection and overfilled containers. With the exception of Hôpital Principal, the main storage area was in open air, unsecured, with biomedical waste littered on the floor and often mixed with waste similar to household refuse. The transfer of biomedical waste to the main storage area was done using trolleys or carts in 67.4% (N = 58) of services and wheelbarrows in 33.7% (N = 29). Biomedical waste was disposed of in old incinerators or in artisanal ovens with a great deal of smoke emanating from these. Working conditions were deemed poor by 81.3% (N = 61) of employees interviewed and personal protection equipment was available in 45.3% (N = 39) of services. Knowledge about biomedical waste management was deemed satisfactory by 62.6% (N = 47) of interviewees and 80% (N = 60) were aware of the health risks related to biomedical waste. The poor management of biomedical waste is a reality in hospital facilities in Dakar. This can be addressed by increasing the awareness of managers for an effective application of the legislation, implementing realistic management programmes and providing the appropriate on-the-job training to staff members.

Risk management for outsourcing biomedical waste disposal - using the failure mode and effects analysis.

PubMed

Liao, Ching-Jong; Ho, Chao Chung

2014-07-01

Using the failure mode and effects analysis, this study examined biomedical waste companies through risk assessment. Moreover, it evaluated the supervisors of biomedical waste units in hospitals, and factors relating to the outsourcing risk assessment of biomedical waste in hospitals by referring to waste disposal acts. An expert questionnaire survey was conducted on the personnel involved in waste disposal units in hospitals, in order to identify important factors relating to the outsourcing risk of biomedical waste in hospitals. This study calculated the risk priority number (RPN) and selected items with an RPN value higher than 80 for improvement. These items included "availability of freezing devices", "availability of containers for sharp items", "disposal frequency", "disposal volume", "disposal method", "vehicles meeting the regulations", and "declaration of three lists". This study also aimed to identify important selection factors of biomedical waste disposal companies by hospitals in terms of risk. These findings can serve as references for hospitals in the selection of outsourcing companies for biomedical waste disposal. Copyright © 2014 Elsevier Ltd. All rights reserved.

Confirmation of the Factor Structure and Measurement Invariance of the Children's Scale of Hostility and Aggression: Reactive/Proactive in Clinic-Referred Children With and Without Autism Spectrum Disorder.

PubMed

Farmer, Cristan A; Kaat, Aaron J; Mazurek, Micah O; Lainhart, Janet E; DeWitt, Mary Beth; Cook, Edwin H; Butter, Eric M; Aman, Michael G

2016-02-01

The measurement of aggression in its different forms (e.g., physical and verbal) and functions (e.g., impulsive and instrumental) is given little attention in subjects with developmental disabilities (DD). In this study, we confirm the factor structure of the Children's Scale for Hostility and Aggression: Reactive/Proactive (C-SHARP) and demonstrate measurement invariance (consistent performance across clinical groups) between clinic-referred groups with and without autism spectrum disorder (ASD). We also provide evidence of the construct validity of the C-SHARP. Caregivers provided C-SHARP, Child Behavior Checklist (CBCL), and Proactive/Reactive Rating Scale (PRRS) ratings for 644 children, adolescents, and young adults 2-21 years of age. Five types of measurement invariance were evaluated within a confirmatory factor analytic framework. Associations among the C-SHARP, CBCL, and PRRS were explored. The factor structure of the C-SHARP had a good fit to the data from both groups, and strict measurement invariance between ASD and non-ASD groups was demonstrated (i.e., equivalent structure, factor loadings, item intercepts and residuals, and latent variance/covariance between groups). The C-SHARP Problem Scale was more strongly associated with CBCL Externalizing than with CBCL Internalizing, supporting its construct validity. Subjects classified with the PRRS as both Reactive and Proactive had significantly higher C-SHARP Proactive Scores than those classified as Reactive only, who were rated significantly higher than those classified by the PRRS as Neither Reactive nor Proactive. A similar pattern was observed for the C-SHARP Reactive Score. This study provided evidence of the validity of the C-SHARP through confirmation of its factor structure and its relationship with more established scales. The demonstration of measurement invariance demonstrates that differences in C-SHARP factor scores were the result of differences in the construct rather than to error or unmeasured/nuisance variables. These data suggest that the C-SHARP is useful for quantifying subtypes of aggressive behavior in children, adolescents, and young adults with DD.

Hazardous Waste Cleanup: Merial Barceloneta, LLC in Barceloneta, Puerto Rico

EPA Pesticide Factsheets

The Merck, Sharp & Dohme Química de Puerto Rico Ltd (MSDQ) facility is located at Road #2 km. 56.7, in the Municipality of Barceloneta, Puerto Rico. The facility is located approximately three miles south of the Atlantic Ocean and 38 miles due west of San

EXPERIMENTAL EVALUATION OF TWO SHARP FRONT MODELS FOR VADOSE ZONE NON-AQUEOUS PHASE LIQUID TRANSPORT

EPA Science Inventory

Recent research efforts on the transport of immiscible organic wastes in subsurface the development of numerical models of various levels of sophistication. Systems have focused on the site characterization data needed to obtain. However, in real field applications, the model p...

Flotation separation of waste plastics for recycling-A review.

PubMed

Wang, Chong-qing; Wang, Hui; Fu, Jian-gang; Liu, You-nian

2015-07-01

The sharp increase of plastic wastes results in great social and environmental pressures, and recycling, as an effective way currently available to reduce the negative impacts of plastic wastes, represents one of the most dynamic areas in the plastics industry today. Froth flotation is a promising method to solve the key problem of recycling process, namely separation of plastic mixtures. This review surveys recent literature on plastics flotation, focusing on specific features compared to ores flotation, strategies, methods and principles, flotation equipments, and current challenges. In terms of separation methods, plastics flotation is divided into gamma flotation, adsorption of reagents, surface modification and physical regulation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pattern of medical waste management: existing scenario in Dhaka City, Bangladesh

PubMed Central

Hassan, M Manzurul; Ahmed, Shafiul Azam; Rahman, K Anisur; Biswas, Tarit Kanti

2008-01-01

Background Medical waste is infectious and hazardous. It poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of hospitals, clinics, and diagnostic laboratories in Dhaka City, Bangladesh. However, research on this critical issue has been very limited, and there is a serious dearth of information for planning. This paper seeks to document the handling practice of waste (e.g. collection, storage, transportation and disposal) along with the types and amount of wastes generated by Health Care Establishments (HCE). A total of 60 out of the existing 68 HCE in the study areas provided us with relevant information. Methods The methodology for this paper includes empirical field observation and field-level data collection through inventory, questionnaire survey and formal and informal interviews. A structured questionnaire was designed to collect information addressing the generation of different medical wastes according to amount and sources from different HCE. A number of in-depth interviews were arranged to enhance our understanding of previous and existing management practice of medical wastes. A number of specific questions were asked of nurses, hospital managers, doctors, and cleaners to elicit their knowledge. The collected data with the questionnaire survey were analysed, mainly with simple descriptive statistics; while the qualitative mode of analysis is mainly in narrative form. Results The paper shows that the surveyed HCE generate a total of 5,562 kg/day of wastes, of which about 77.4 per cent are non-hazardous and about 22.6 per cent are hazardous. The average waste generation rate for the surveyed HCE is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical waste except in a few private HCE that segregate their infectious wastes. Some cleaners were found to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse. Conclusion The paper reveals that lack of awareness, appropriate policy and laws, and willingness are responsible for the improper management of medical waste in Dhaka City. The paper also shows that a newly designed medical waste management system currently serves a limited number of HCE. New facilities should be established for the complete management of medical waste in Dhaka City. PMID:18221548

Effect of feeding mode and dilution on the performance and microbial community population in anaerobic digestion of food waste.

PubMed

Park, Jong-Hun; Kumar, Gopalakrishnan; Yun, Yeo-Myeong; Kwon, Joong-Chun; Kim, Sang-Hyoun

2018-01-01

The effect of feeding mode and dilution was studied in anaerobic digestion of food waste. An upflow anaerobic digester with a settler was fed at six different organic loading rates (OLRs) from 4.6 to 8.6kgCOD/m 3 /d for 200days. The highest methane productivity of 2.78LCH 4 /L/d was achieved at 8.6kgCOD/m 3 /d during continuous feeding of diluted FW. Continuous feeding of diluted food waste showed more stable and efficient performance than stepwise feeding of undiluted food waste. Sharp increase in propionate concentration attributed towards deterioration of the digester performances in stepwise feeding of undiluted food waste. Microbial communities at various OLRs divulged that the microbial distribution in the continuous feeding of diluted food waste was not significantly perturbed despite the increase of OLR up to 8.6kgCOD/m 3 /d, which was contrast to the unstable distribution in stepwise feeding of undiluted food waste at 6.1kgCOD/m 3 /d. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prevalence of hepatitis C virus infection among recyclable waste collectors in Central-West Brazil

PubMed Central

Marinho, Thaís Augusto; Lopes, Carmen Luci Rodrigues; Teles, Sheila Araújo; Reis, Nádia Rúbia Silva; Carneiro, Megmar Aparecida dos Santos; de Andrade, Andreia Alves; Martins, Regina Maria Bringel

2013-01-01

The prevalence of hepatitis C virus (HCV) in a population of recyclable waste collectors (n = 431) was assessed using a cross-sectional survey in all 15 cooperatives in the city of Goiânia, Central-West Brazil. The HCV prevalence was 1.6% (95% confidence interval: 0.6-3.6) and a history of sexually transmitted infections was independently associated with this infection. HCV RNA (corresponding to genotype 1; subtypes 1a and 1b) was detected in five/seven anti-HCV-positive samples. Although the study population reported a high rate (47.3%) of sharps and needle accidents, HCV infection was not more frequent in recyclable waste collectors than in the general Brazilian population. PMID:23828009

Prevalence of hepatitis C virus infection among recyclable waste collectors in Central-West Brazil.

PubMed

Marinho, Thaís Augusto; Lopes, Carmen Luci Rodrigues; Teles, Sheila Araújo; Reis, Nádia Rúbia Silva; Carneiro, Megmar Aparecida dos Santos; de Andrade, Andreia Alves; Martins, Regina Maria Bringel

2013-06-01

The prevalence of hepatitis C virus (HCV) in a population of recyclable waste collectors (n = 431) was assessed using a cross-sectional survey in all 15 cooperatives in the city of Goiânia, Central-West Brazil. The HCV prevalence was 1.6% (95% confidence interval: 0.6-3.6) and a history of sexually transmitted infections was independently associated with this infection. HCV RNA (corresponding to genotype 1; subtypes 1a and 1b) was detected in five/seven anti-HCV-positive samples. Although the study population reported a high rate (47.3%) of sharps and needle accidents, HCV infection was not more frequent in recyclable waste collectors than in the general Brazilian population.

Implementing a sharps injury reduction program at a charity hospital in India.

PubMed

Gramling, Joshua J; Nachreiner, Nancy

2013-08-01

Health care workers in India are at high risk of developing bloodborne infections from needlestick injuries. Indian hospitals often do not have the resources to invest in safety devices and protective equipment to decrease this risk. In collaboration with hospital staff, the primary author implemented a sharps injury prevention and biomedical waste program at an urban 60-bed charity hospital in northern India. The program aligned with hospital organizational objectives and was designed to be low-cost and sustainable. Occupational health nurses working in international settings or with international workers should be aware of employee and employer knowledge and commitment to occupational health and safety. Copyright 2013, SLACK Incorporated.

Waste management in primary healthcare centres of Iran.

PubMed

Mesdaghinia, Alireza; Naddafi, Kazem; Mahvi, Amir Hossein; Saeedi, Reza

2009-06-01

The waste management practices in primary healthcare centres of Iran were investigated in the present study. A total of 120 primary healthcare centres located across the country were selected using the cluster sampling method and the current situation of healthcare waste management was determined through field investigation. The quantities of solid waste and wastewater generation per outpatient were found to be 60 g outpatient(-1) day(-1) and 26 L outpatient(-1) day(-1), respectively. In all of the facilities, sharp objects were separated almost completely, but separation of other types of hazardous healthcare solid waste was only done in 25% of the centres. The separated hazardous solid waste materials were treated by incineration, temporary incineration and open burning methods in 32.5, 8.3 and 42.5% of the healthcare centres, respectively. In 16.7% of the centres the hazardous solid wastes were disposed of without any treatment. These results indicate that the management of waste materials in primary healthcare centres in Iran faced some problems. Staff training and awareness, separation of healthcare solid waste, establishment of the autoclave method for healthcare solid waste treatment and construction of septic tanks and disinfection units in the centres that were without access to a sewer system are the major measures that are suggested for improvement of the waste management practices.

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

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

Nemathaga, Felicia; Maringa, Sally; Chimuka, Luke

2008-07-01

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

Evaluating pharmaceutical waste disposal in pediatric units.

PubMed

Almeida, Maria Angélica Randoli de; Wilson, Ana Maria Miranda Martins; Peterlini, Maria Angélica Sorgini

2016-01-01

To verify the disposal of pharmaceutical waste performed in pediatric units. A descriptive and observational study conducted in a university hospital. The convenience sample consisted of pharmaceuticals discarded during the study period. Handling and disposal during preparation and administration were observed. Data collection took place at pre-established times and was performed using a pre-validated instrument. 356 drugs disposals were identified (35.1% in the clinic, 31.8% in the intensive care unit, 23.8% in the surgical unit and 9.3% in the infectious diseases unit). The most discarded pharmacological classes were: 22.7% antimicrobials, 14.8% electrolytes, 14.6% analgesics/pain killers, 9.5% diuretics and 6.7% antiulcer agents. The most used means for disposal were: sharps' disposable box with a yellow bag (30.8%), sink drain (28.9%), sharps' box with orange bag (14.3%), and infectious waste/bin with a white bag (10.1%). No disposal was identified after drug administration. A discussion of measures that can contribute to reducing (healthcare) waste volume with the intention of engaging reflective team performance and proper disposal is necessary. Verificar o descarte dos resíduos de medicamentos realizado em unidades pediátricas. Estudo descritivo e observacional, realizado em um hospital universitário. A amostra de conveniência foi constituída pelos medicamentos descartados durante o período de estudo. Observaram-se a manipulação e o descarte durante o preparo e a administração. A coleta dos dados ocorreu em horários preestabelecidos e realizada por meio de instrumento pré-validado. Identificaram-se 356 descartes de medicamentos (35,1% na clínica, 31,8% na unidade de cuidados intensivos, 23,8% na cirúrgica e 9,3% na infectologia). As classes farmacológicas mais descartadas foram: 22,7% antimicrobianos, 14,8% eletrólitos, 14,6% analgésicos, 9,5% diuréticos e 6,7% antiulcerosos. Vias mais utilizadas: caixa descartável para perfurocortante com saco amarelo (30,8%), ralo da pia (28,9%), caixa de perfurocortante com saco laranja (14,3%) e lixeira infectante com saco branco (10,1%). Não foi identificado descarte após a administração dos fármacos. Faz-se necessária a discussão de medidas que contribuam para a redução do volume de resíduos, com o intuito de engajar a atuação reflexiva da equipe e o descarte adequado.

Application of aerial photography to the study of small scale upper ocean phenomena

NASA Technical Reports Server (NTRS)

Ichiye, T.; Carnes, M.

1981-01-01

The industrial waste dumped 180 n. miles south of Galveston was monitored in July 1977 by water sampling, hydrographic measurements, acoustic tracking on board two vessels, and by aerial photography. The plume of the waste diffused vertically and horizontally. Photodensitometry of aerial photos of the plume showed lateral dispersion of the plume in agreement with two other methods: acoustic tracking of the waste suspensoid and transmissometer sampling. In addition, the method showed small scale features like the lateral and longitudinal variations in the photodensity, indicating the waste concentration. This waste concentration showed periodic changes in its axial distance, with the spectral peak at about 160 m wave length. It shows a sharp increase at the windward edge of the plume as do the acoustic records. This phenomenon is explained in terms of the shearing current near the surface together with vertical diffusion. The periodic change along the axis is explained in terms of the Langmuir circulation and in terms of internal ship waves.

High-resolution dynamic imaging and quantitative analysis of lung cancer xenografts in nude mice using clinical PET/CT

PubMed Central

Wang, Ying Yi; Wang, Kai; Xu, Zuo Yu; Song, Yan; Wang, Chu Nan; Zhang, Chong Qing; Sun, Xi Lin; Shen, Bao Zhong

2017-01-01

Considering the general application of dedicated small-animal positron emission tomography/computed tomography is limited, an acceptable alternative in many situations might be clinical PET/CT. To estimate the feasibility of using clinical PET/CT with [F-18]-fluoro-2-deoxy-D-glucose for high-resolution dynamic imaging and quantitative analysis of cancer xenografts in nude mice. Dynamic clinical PET/CT scans were performed on xenografts for 60 min after injection with [F-18]-fluoro-2-deoxy-D-glucose. Scans were reconstructed with or without SharpIR method in two phases. And mice were sacrificed to extracting major organs and tumors, using ex vivo γ-counting as a reference. Strikingly, we observed that the image quality and the correlation between the all quantitive data from clinical PET/CT and the ex vivo counting was better with the SharpIR reconstructions than without. Our data demonstrate that clinical PET/CT scanner with SharpIR reconstruction is a valuable tool for imaging small animals in preclinical cancer research, offering dynamic imaging parameters, good image quality and accurate data quatification. PMID:28881772

High-resolution dynamic imaging and quantitative analysis of lung cancer xenografts in nude mice using clinical PET/CT.

PubMed

Wang, Ying Yi; Wang, Kai; Xu, Zuo Yu; Song, Yan; Wang, Chu Nan; Zhang, Chong Qing; Sun, Xi Lin; Shen, Bao Zhong

2017-08-08

Considering the general application of dedicated small-animal positron emission tomography/computed tomography is limited, an acceptable alternative in many situations might be clinical PET/CT. To estimate the feasibility of using clinical PET/CT with [F-18]-fluoro-2-deoxy-D-glucose for high-resolution dynamic imaging and quantitative analysis of cancer xenografts in nude mice. Dynamic clinical PET/CT scans were performed on xenografts for 60 min after injection with [F-18]-fluoro-2-deoxy-D-glucose. Scans were reconstructed with or without SharpIR method in two phases. And mice were sacrificed to extracting major organs and tumors, using ex vivo γ-counting as a reference. Strikingly, we observed that the image quality and the correlation between the all quantitive data from clinical PET/CT and the ex vivo counting was better with the SharpIR reconstructions than without. Our data demonstrate that clinical PET/CT scanner with SharpIR reconstruction is a valuable tool for imaging small animals in preclinical cancer research, offering dynamic imaging parameters, good image quality and accurate data quatification.

Risk management for outsourcing biomedical waste disposal – Using the failure mode and effects analysis

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

Liao, Ching-Jong; Ho, Chao Chung, E-mail: ho919@pchome.com.tw

Highlights: • This study is based on a real case in hospital in Taiwan. • We use Failure Mode and Effects Analysis (FMEA) as the evaluation method. • We successfully identify the evaluation factors of bio-medical waste disposal risk. - Abstract: Using the failure mode and effects analysis, this study examined biomedical waste companies through risk assessment. Moreover, it evaluated the supervisors of biomedical waste units in hospitals, and factors relating to the outsourcing risk assessment of biomedical waste in hospitals by referring to waste disposal acts. An expert questionnaire survey was conducted on the personnel involved in waste disposalmore » units in hospitals, in order to identify important factors relating to the outsourcing risk of biomedical waste in hospitals. This study calculated the risk priority number (RPN) and selected items with an RPN value higher than 80 for improvement. These items included “availability of freezing devices”, “availability of containers for sharp items”, “disposal frequency”, “disposal volume”, “disposal method”, “vehicles meeting the regulations”, and “declaration of three lists”. This study also aimed to identify important selection factors of biomedical waste disposal companies by hospitals in terms of risk. These findings can serve as references for hospitals in the selection of outsourcing companies for biomedical waste disposal.« less

Evaluating the operational risks of biomedical waste using failure mode and effects analysis.

PubMed

Chen, Ying-Chu; Tsai, Pei-Yi

2017-06-01

The potential problems and risks of biomedical waste generation have become increasingly apparent in recent years. This study applied a failure mode and effects analysis to evaluate the operational problems and risks of biomedical waste. The microbiological contamination of biomedical waste seldom receives the attention of researchers. In this study, the biomedical waste lifecycle was divided into seven processes: Production, classification, packaging, sterilisation, weighing, storage, and transportation. Twenty main failure modes were identified in these phases and risks were assessed based on their risk priority numbers. The failure modes in the production phase accounted for the highest proportion of the risk priority number score (27.7%). In the packaging phase, the failure mode 'sharp articles not placed in solid containers' had the highest risk priority number score, mainly owing to its high severity rating. The sterilisation process is the main difference in the treatment of infectious and non-infectious biomedical waste. The failure modes in the sterilisation phase were mainly owing to human factors (mostly related to operators). This study increases the understanding of the potential problems and risks associated with biomedical waste, thereby increasing awareness of how to improve the management of biomedical waste to better protect workers, the public, and the environment.

A Sharp methodology for VLSI layout

NASA Astrophysics Data System (ADS)

Bapat, Shekhar

1993-01-01

The layout problem for VLSI circuits is recognized as a very difficult problem and has been traditionally decomposed into the several seemingly independent sub-problems of placement, global routing, and detailed routing. Although this structure achieves a reduction in programming complexity, it is also typically accompanied by a reduction in solution quality. Most current placement research recognizes that the separation is artificial, and that the placement and routing problems should be solved ideally in tandem. We propose a new interconnection model, Sharp and an associated partitioning algorithm. The Sharp interconnection model uses a partitioning shape that roughly resembles the musical sharp 'number sign' and makes extensive use of pre-computed rectilinear Steiner trees. The model is designed to generate strategic routing information along with the partitioning results. Additionally, the Sharp model also generates estimates of the routing congestion. We also propose the Sharp layout heuristic that solves the layout problem in its entirety. The Sharp layout heuristic makes extensive use of the Sharp partitioning model. The use of precomputed Steiner tree forms enables the method to model accurately net characteristics. For example, the Steiner tree forms can model both the length of the net and more importantly its route. In fact, the tree forms are also appropriate for modeling the timing delays of nets. The Sharp heuristic works to minimize both the total layout area by minimizing total net length (thus reducing the total wiring area), and the congestion imbalances in the various channels (thus reducing the unused or wasted channel area). Our heuristic uses circuit element movements amongst the different partitioning blocks and selection of alternate minimal Steiner tree forms to achieve this goal. The objective function for the algorithm can be modified readily to include other important circuit constraints like propagation delays. The layout technique first computes a very high-level approximation of the layout solution (i.e., the positions of the circuit elements and the associated net routes). The approximate solution is alternately refined, objective function. The technique creates well defined sub-problems and offers intermediary steps that can be solved in parallel, as well as a parallel mechanism to merge the sub-problem solutions.

Hazardous waste incinerators under waste uncertainty: balancing and throughput maximization via heat recuperation.

PubMed

Tsiliyannis, Christos Aristeides

2013-09-01

Hazardous waste incinerators (HWIs) differ substantially from thermal power facilities, since instead of maximizing energy production with the minimum amount of fuel, they aim at maximizing throughput. Variations in quantity or composition of received waste loads may significantly diminish HWI throughput (the decisive profit factor), from its nominal design value. A novel formulation of combustion balance is presented, based on linear operators, which isolates the wastefeed vector from the invariant combustion stoichiometry kernel. Explicit expressions for the throughput are obtained, in terms of incinerator temperature, fluegas heat recuperation ratio and design parameters, for an arbitrary number of wastes, based on fundamental principles (mass and enthalpy balances). The impact of waste variations, of recuperation ratio and of furnace temperature is explicitly determined. It is shown that in the presence of waste uncertainty, the throughput may be a decreasing or increasing function of incinerator temperature and recuperation ratio, depending on the sign of a dimensionless parameter related only to the uncertain wastes. The dimensionless parameter is proposed as a sharp a' priori waste 'fingerprint', determining the necessary increase or decrease of manipulated variables (recuperation ratio, excess air, auxiliary fuel feed rate, auxiliary air flow) in order to balance the HWI and maximize throughput under uncertainty in received wastes. A 10-step procedure is proposed for direct application subject to process capacity constraints. The results may be useful for efficient HWI operation and for preparing hazardous waste blends. Copyright © 2013 Elsevier Ltd. All rights reserved.

Leptospira Exposure and Waste Pickers: A Case-Control Seroprevalence Study in Durango, Mexico.

PubMed

Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

2015-08-01

Infection with Leptospira may occur by contact with Leptospira-infected animals. Waste pickers are in contact with rodents and dogs while picking in the garbage. Whether waste pickers are at risk for Leptospira infection is largely unknown. This study was aimed to determine the association of Leptospira IgG seroprevalence with the occupation of waste picking, and to determine the epidemiological characteristics of the waste pickers with Leptospira exposure. Through a case-control study, we determined the seroprevalence of anti-Leptospira IgG antibodies in 90 waste pickers and 90 age- and gender-matched control subjects in Durango City, Mexico using an enzyme immunoassay. Data were analyzed by bivariate and multivariate analyses. The prevalence of anti-Leptospira IgG antibodies was similar in waste pickers (4/90: 4.4%) to that in control subjects (5/90: 5.6%) (P = 1.00). Bivariate analysis showed that Leptospira exposure in waste pickers was associated with increasing age (P = 0.009), no education (P = 0.008), and consumption of rat meat (P = 0.04). However, these associations were no longer found by multivariate analysis. Leptospira exposure in waste pickers was not associated with health status, duration in the activity, wearing hand gloves and facemasks, history of injuries with sharp material of the garbage, or contact with animals or soil. This is the first study about Leptospira exposure in waste pickers. Results suggest that waste pickers are not at increasing risk for Leptospira exposure in Durango City, Mexico. Further research with a larger sample size to elucidate the association of Leptospira exposure with waste picking activity is needed.

Results of a hospital waste survey in private hospitals in Fars province, Iran

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

Askarian, Mehrdad; Vakili, Mahmood; Kabir, Gholamhosein

2004-07-01

Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day,more » which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field.« less

Healthcare waste management practices and risk perceptions: findings from hospitals in the Algarve region, Portugal.

PubMed

Ferreira, Vera; Teixeira, Margarida Ribau

2010-12-01

The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.

A rare case of a sharp foreign body on the vocal cord.

PubMed

Nor Hisyam, C I; Misron, K; Mohamad, I

2017-01-01

A foreign body (FB) in the upper aerodigestive tract is a common clinical problem that presents as as acute emergency. Sharp FB, such as fish bone or chicken bone, commonly lodges in the tonsil, base of tongue, vallecula or pyriform fossa. Dislodgement of a FB into the laryngopharynx is very rare and specifically onto the vocal cord is extremely uncommon. This case report illustrates a rare case of a sharp FB that was dislodged into the airway and stuck on to the right vocal cord, which was removed under local anaesthesia.

Health care waste management practice in a hospital.

PubMed

Paudel, R; Pradhan, B

2010-10-01

Health-care waste is a by-product of health care. Its poor management exposes health-care workers, waste handlers and the community to infections, toxic effects and injuries including damage of the environment. It also creates opportunities for the collection of disposable medical equipment, its re-sale and potential re-use without sterilization, which causes an important burden of disease worldwide. The purpose of this study was to find out health care waste management practice in hospital. A cross-sectional study was conducted in Narayani Sub-Regional Hospital, Birgunj from May to October 2006 using both qualitative and quantitative methods. Study population was four different departments of the hospital (Medical/Paediatric, Surgical/Ortho, Gynae/Obstetric and Emergency), Medical Superintendent, In-charges of four different departments and all sweepers. Data was collected using interview, group discussion, observation and measurement by weight and volume. Total health-care waste generated was 128.4 kg per day while 0.8 kg per patient per day. The composition of health care waste was found to be 96.8 kg (75.4%) general waste, 24.1 kg (8.8%) hazardous waste and 7.5 kg (5.8%) sharps per day by weight. Health staffs and sweepers were not practicing the waste segregation. Occupational health and safety was not given due attention. Majority of the sweepers were unaware of waste management and need of safety measures to protect their own health. Health care waste management practice in the hospital was unsatisfactory because of the lack of waste management plan and carelessness of patients, visitors and staffs. Therefore the hospital should develop the waste management plan and strictly follow the National Health Care Waste Management Guideline.

Mutual information analysis and detection of interictal morphological differences in interictal epileptiform discharges of patients with partial epilepsies.

PubMed

Varma, N K; Kushwaha, R; Beydoun, A; Williams, W J; Drury, I

1997-10-01

The purpose of this paper is to compare the morphological features of interictal epileptiform discharges (IED) in patients with benign epilepsy of childhood with centrotemporal spikes to IED of those with symptomatic localization related epilepsies using information theory. Three patients from each clinical group were selected. Two-second epochs centered at the peak negativity of the sharp waves were analyzed from a referential montage during stage I sleep. The epochs from the two groups were compared using parametric and information theory analysis. Information analysis determined the likelihood of correctly identifying the clinical group based on the IED. Standard parametric, morphological and spectral analyses were also performed. We found no significant difference in the morphology of the sharp wave between the two groups. The after-going slow wave contained the greatest information that separated the two groups. This result was supported by morphological and spectral differences in the after-going slow wave. Greater distinguishing information is held in the after-going slow wave than the sharp wave for the identification of clinical groups. Information analysis may assist in differentiating clinical syndromes from EEG signals.

150-μm Spatial Resolution Using Photon-Counting Detector Computed Tomography Technology: Technical Performance and First Patient Images.

PubMed

Leng, Shuai; Rajendran, Kishore; Gong, Hao; Zhou, Wei; Halaweish, Ahmed F; Henning, Andre; Kappler, Steffen; Baer, Matthias; Fletcher, Joel G; McCollough, Cynthia H

2018-05-28

The aims of this study were to quantitatively assess two new scan modes on a photon-counting detector computed tomography system, each designed to maximize spatial resolution, and to qualitatively demonstrate potential clinical impact using patient data. This Health Insurance Portability Act-compliant study was approved by our institutional review board. Two high-spatial-resolution scan modes (Sharp and UHR) were evaluated using phantoms to quantify spatial resolution and image noise, and results were compared with the standard mode (Macro). Patients were scanned using a conventional energy-integrating detector scanner and the photon-counting detector scanner using the same radiation dose. In first patient images, anatomic details were qualitatively evaluated to demonstrate potential clinical impact. Sharp and UHR modes had a 69% and 87% improvement in in-plane spatial resolution, respectively, compared with Macro mode (10% modulation-translation-function values of 16.05, 17.69, and 9.48 lp/cm, respectively). The cutoff spatial frequency of the UHR mode (32.4 lp/cm) corresponded to a limiting spatial resolution of 150 μm. The full-width-at-half-maximum values of the section sensitivity profiles were 0.41, 0.44, and 0.67 mm for the thinnest image thickness for each mode (0.25, 0.25, and 0.5 mm, respectively). At the same in-plane spatial resolution, Sharp and UHR images had up to 15% lower noise than Macro images. Patient images acquired in Sharp mode demonstrated better delineation of fine anatomic structures compared with Macro mode images. Phantom studies demonstrated superior resolution and noise properties for the Sharp and UHR modes relative to the standard Macro mode and patient images demonstrated the potential benefit of these scan modes for clinical practice.

Sharp Injury and Exposure to Blood and Body Fluids among Health Care Workers in Health Care Centers of Eastern Ethiopia.

PubMed

Alemayehu, T; Worku, A; Assefa, N

2016-07-01

Health care workers are facing certain occupational hazards because of sharp injury and exposure to human blood and body fluids as a result of handling wastes. Though much attention is paid for the protection of these workers, the number of exposures and injuries do not show a sign of decline from time to time. To examine the occurrence of sharp injury and exposure to blood and body fluids in health care workers in health care centers in Ethiopia. In a case-control study, a randomly selected sample of 65 health facilities with 391 cases and 429 controls were studied. Data were collected through a self-administered questionnaire. Detailed analysis of exposure among the health care workers was done by logistic regression analysis with generalized estimating equations model to control correlation effects of responses within the cluster of health facilities. The number of health care workers who got sharp injury was 217 (26.5%). 296 (36.1%) had exposure to blood and body fluids. Working at Harari region (adjusted OR 0.44, 95% CI 0.26 to 0.75) and East Hararghea (adjusted OR 0.61, 95% CI 0.40 to 0.94), being male (adjusted OR 0.56, 95% CI 0.44 to 0.91), and a being nurse (adjusted OR 0.188, 95% CI 0.06 to 0.63) were independent risk factors of the exposure. Regardless of the anticipated low self-reporting for exposure status, the number of health care workers reported having sharp injury and exposure to blood and body fluids was high. Such high exposures indicate that health care workers are at high risk of acquiring blood-borne viral infections such as hepatitis B, hepatitis C, and HIV.

49 CFR 173.197 - Regulated medical waste.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (bio) medical waste must be rigid containers meeting the provisions of subpart B of this part. (b) Non... medical waste or clinical waste or (bio) medical waste must be UN standard packagings conforming to the... filled. (2) Liquids. Liquid regulated medical waste or clinical waste or (bio) medical waste transported...

Disposal of waste computer hard disk drive: data destruction and resources recycling.

PubMed

Yan, Guoqing; Xue, Mianqiang; Xu, Zhenming

2013-06-01

An increasing quantity of discarded computers is accompanied by a sharp increase in the number of hard disk drives to be eliminated. A waste hard disk drive is a special form of waste electrical and electronic equipment because it holds large amounts of information that is closely connected with its user. Therefore, the treatment of waste hard disk drives is an urgent issue in terms of data security, environmental protection and sustainable development. In the present study the degaussing method was adopted to destroy the residual data on the waste hard disk drives and the housing of the disks was used as an example to explore the coating removal process, which is the most important pretreatment for aluminium alloy recycling. The key operation points of the degaussing determined were: (1) keep the platter plate parallel with the magnetic field direction; and (2) the enlargement of magnetic field intensity B and action time t can lead to a significant upgrade in the degaussing effect. The coating removal experiment indicated that heating the waste hard disk drives housing at a temperature of 400 °C for 24 min was the optimum condition. A novel integrated technique for the treatment of waste hard disk drives is proposed herein. This technique offers the possibility of destroying residual data, recycling the recovered resources and disposing of the disks in an environmentally friendly manner.

A model for managing sources of groundwater pollution

USGS Publications Warehouse

Gorelick, Steven M.

1982-01-01

The waste disposal capacity of a groundwater system can be maximized while maintaining water quality at specified locations by using a groundwater pollutant source management model that is based upon linear programing and numerical simulation. The decision variables of the management model are solute waste disposal rates at various facilities distributed over space. A concentration response matrix is used in the management model to describe transient solute transport and is developed using the U.S. Geological Survey solute transport simulation model. The management model was applied to a complex hypothetical groundwater system. Large-scale management models were formulated as dual linear programing problems to reduce numerical difficulties and computation time. Linear programing problems were solved using a numerically stable, available code. Optimal solutions to problems with successively longer management time horizons indicated that disposal schedules at some sites are relatively independent of the number of disposal periods. Optimal waste disposal schedules exhibited pulsing rather than constant disposal rates. Sensitivity analysis using parametric linear programing showed that a sharp reduction in total waste disposal potential occurs if disposal rates at any site are increased beyond their optimal values.

Leptospira Exposure and Waste Pickers: A Case-Control Seroprevalence Study in Durango, Mexico

PubMed Central

Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Guido-Arreola, Carlos Alberto

2015-01-01

Background Infection with Leptospira may occur by contact with Leptospira-infected animals. Waste pickers are in contact with rodents and dogs while picking in the garbage. Whether waste pickers are at risk for Leptospira infection is largely unknown. This study was aimed to determine the association of Leptospira IgG seroprevalence with the occupation of waste picking, and to determine the epidemiological characteristics of the waste pickers with Leptospira exposure. Methods Through a case-control study, we determined the seroprevalence of anti-Leptospira IgG antibodies in 90 waste pickers and 90 age- and gender-matched control subjects in Durango City, Mexico using an enzyme immunoassay. Data were analyzed by bivariate and multivariate analyses. Results The prevalence of anti-Leptospira IgG antibodies was similar in waste pickers (4/90: 4.4%) to that in control subjects (5/90: 5.6%) (P = 1.00). Bivariate analysis showed that Leptospira exposure in waste pickers was associated with increasing age (P = 0.009), no education (P = 0.008), and consumption of rat meat (P = 0.04). However, these associations were no longer found by multivariate analysis. Leptospira exposure in waste pickers was not associated with health status, duration in the activity, wearing hand gloves and facemasks, history of injuries with sharp material of the garbage, or contact with animals or soil. Conclusions This is the first study about Leptospira exposure in waste pickers. Results suggest that waste pickers are not at increasing risk for Leptospira exposure in Durango City, Mexico. Further research with a larger sample size to elucidate the association of Leptospira exposure with waste picking activity is needed. PMID:26124911

49 CFR 173.134 - Class 6, Division 6.2-Definitions and exceptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... medical waste or clinical waste or (bio) medical waste means a waste or reusable material derived from the... clinical waste or (bio) medical waste containing a Category A infectious substance must be classed as an...

How do university education and clinical experience influence pre-registration nursing students' infection control practice? A descriptive, cross sectional survey.

PubMed

Hinkin, Jonathan; Cutter, Jayne

2014-02-01

This study aims to explore nursing students' knowledge of infection control and investigate how university education and clinical experience influence their infection control practice. In order to prevent and control healthcare associated infections all healthcare staff must be knowledgeable about infection control. However, knowledge and practice of infection control are often sub-optimal. Education has had variable results in improving the infection control knowledge of healthcare professionals yet, there have been few studies examining this issue in relation to pre-registration nursing students in the United Kingdom. This descriptive cross-sectional survey employed a questionnaire composed of predominantly closed questions for data collection. A non-probability, purposive sample of 354/444 (79.7%) nursing students from one university participated in the study. Knowledge was generally adequate in questions related to pathogen transmission, hand hygiene principles, glove use, immediate action following sharps' injuries, and risk reduction in relation to sharps and waste management. Topics that received less positive results related to the chain of infection, the use of alcohol gel and Clostridium difficile and the definition of inoculation injury. University education was the main influence on knowledge and practice (340/353, 96.3%), but mentors (322/354, 91.2%), nurses (316/353, 89.3%), doctors (175/353, 49.4%) and other members of the multi-disciplinary team (213/352, 60.2%) were also deemed influential. Workload, time, and availability of facilities and equipment also contributed to the adoption of infection control precautions. The findings illustrated the importance of both theoretical and practical knowledge, supported by competent role models. The study identified the complexities of knowledge acquisition and application in a practice based discipline. The support of a competent role model to assist in applying theory to practice is vital. The study has identified that there are many variables that affect IPC practice, both positively and negatively. © 2013.

Healthcare waste management during disasters and its effects on climate change: Lessons from 2010 earthquake and cholera tragedies in Haiti.

PubMed

Raila, Emilia M; Anderson, David O

2017-03-01

Despite growing effects of human activities on climate change throughout the world, and global South in particular, scientists are yet to understand how poor healthcare waste management practices in an emergency influences the climate change. This article presents new findings on climate change risks of healthcare waste disposal during and after the 2010 earthquake and cholera disasters in Haiti. The researchers analysed quantities of healthcare waste incinerated by the United Nations Mission in Haiti for 60 months (2009 to 2013). The aim was to determine the relationship between healthcare waste incinerated weights and the time of occurrence of the two disasters, and associated climate change effects, if any. Pearson product-moment correlation coefficient indicated a weak correlation between the quantities of healthcare waste disposed of and the time of occurrence of the actual emergencies (r (58) = 0.406, p = 0.001). Correspondingly, linear regression analysis indicated a relatively linear data trend (R 2 = 0.16, F (1, 58) = 11.42, P = 0.001) with fluctuating scenarios that depicted a sharp rise in 2012, and time series model showed monthly and yearly variations within 60 months. Given that the peak healthcare waste incineration occurred 2 years after the 2010 disasters, points at the need to minimise wastage on pharmaceuticals by improving logistics management. The Government of Haiti had no data on healthcare waste disposal and practised smoky open burning, thus a need for capacity building on green healthcare waste management technologies for effective climate change mitigation.

Reducing the carbon footprint of the operating theatre: a multicentre quality improvement report.

PubMed

Southorn, T; Norrish, A R; Gardner, K; Baxandall, R

2013-06-01

Currently, there are very few provisions for recycling in theatres. We measured the weight of clinical waste for several orthopaedic operations. This waste was then examined and sorted into domestic waste and clinical waste. With staff education it is possible to reduce the amount of clinical waste generated by the operating theatre by roughly 50%. A greater awareness of disposal options leads to a reduction in waste disposed of by incineration.

Impact of intervention on healthcare waste management practices in a tertiary care governmental hospital of Nepal.

PubMed

Sapkota, Binaya; Gupta, Gopal Kumar; Mainali, Dhiraj

2014-09-26

Healthcare waste is produced from various therapeutic procedures performed in hospitals, such as chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, autopsy, biopsy, injections, etc. These result in the production of non-hazardous waste (75-95%) and hazardous waste (10-25%), such as sharps, infectious, chemical, pharmaceutical, radioactive waste, and pressurized containers (e.g., inhaler cans). Improper healthcare waste management may lead to the transmission of hepatitis B, Staphylococcus aureus and Pseudomonas aeruginosa. This evaluation of waste management practices was carried out at gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards at Government of Nepal Civil Service Hospital, Kathmandu from February 12 to October 15, 2013, with the permission from healthcare waste management committee at the hospital. The Individualized Rapid Assessment tool (IRAT), developed by the United Nations Development Program Global Environment Facility project, was used to collect pre-interventional and post-interventional performance scores concerning waste management. The healthcare waste management committee was formed of representing various departments. The study included responses from focal nurses and physicians from the gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards, and waste handlers during the study period. Data included average scores from 40 responders. Scores were based on compliance with the IRAT. The waste management policy and standard operating procedure were developed after interventions, and they were consistent with the national and international laws and regulations. The committee developed a plan for recycling or waste minimization. Health professionals, such as doctors, nurses and waste handlers, were trained on waste management practices. The programs included segregation, collection, handling, transportation, treatment and disposal of waste, as well as occupational health and safety issues. The committee developed a plan for treatment and disposal of chemical and pharmaceutical waste. Pretest and posttest evaluation scores were 26% and 86% respectively. During the pre-intervention period, the hospital had no HCWM Committee, policy, standard operating procedure or proper color coding system for waste segregation, collection, transportation and storage and the specific well-trained waste handlers. Doctors, nurses and waste handlers were trained on HCWM practices, after interventions. Significant improvements were observed between the pre- and post-intervention periods.

Healthcare waste generation and management practice in government health centers of Addis Ababa, Ethiopia.

PubMed

Tadesse, Menelik Legesse; Kumie, Abera

2014-11-25

Healthcare wastes are hazardous organic and inorganic wastes. The waste disposal management in Addis Ababa city is seen unscientific manner. The waste management practice in the health facilities are poor and need improvement. This study will help different organizations, stakeholders and policy makers to correct and improve the existing situation of healthcare waste legislation and enforcement and training of staff in the healthcare facilities in Addis Ababa. The study aimed to assess the existing generation and management practice of healthcare waste in selected government health centers of Addis Ababa. The cross-sectional study was conducted to quantify waste generation rate and evaluate its management system. The study area was Addis Ababa. The sample size was determined by simple random sampling technique, the sampling procedure involved 10 sub-cities of Addis Ababa. Data were collected using both waste collecting and measuring equipment and check list. The Data was entered by EPI INFO version 6.04d and analyzed by and SPSS for WINDOW version15. The mean (±SD) healthcare waste generation rate was 9.61 ± 3.28 kg/day of which (38%) 3.64 ± 1.45 kg/day was general or non-hazardous waste and (62%) 5.97 ± 2.31 kg/day was hazardous. The mean healthcare waste generation rate between health centers was a significant different with Kurskal-Wallis test (χ2 = 21.83, p-value = 0.009). All health centers used safety boxes for collection of sharp wastes and all health centers used plastic buckets without lid for collection and transportation of healthcare waste. Pre treatment of infectious wastes was not practiced by any of the health centers. All health centers used incinerators and had placenta pit for disposal of pathological waste however only seven out of ten pits had proper covering material. Segregation of wastes at point of generation with appropriate collection materials and pre- treatment of infectious waste before disposal should be practiced. Training should be given to healthcare workers and waste handlers. Incinerators must be constructed in a manner that facilitates complete combustion and the lining of placenta pit should be constructed in water tight material.

Injection practices among practitioners in private medical clinics of Karachi, Pakistan.

PubMed

Yousafzai, M T; Nisar, N; Kakakhel, M F; Qadri, M H; Khalil, R; Hazara, S M

2013-06-01

The aim of this study was to determine the frequency and determinants of sharps injuries among private health practitioners in slum areas of Karachi, Pakistan. All practitioners with at least 1 year of experience in a private medical clinic were asked to complete a self-administered, structured questionnaire (317/397 responded). Only 7.9% of practitioners were qualified from medical school, 12.3% were registered nurses and 8.8% lacked any professional qualifications. At least 1 sharps injury in the previous 12 months was reported by 26.7%, mostly due to needle recapping. Only 25.2% reported using a new syringe for each patient. In multivariate regression analysis shorter work experience, < 14 years of schooling, > 20 patients per day, administering > or = 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharps injury in the past year. Better awareness and training on standard precautions is needed for private practitioners in slum areas of Karachi.

Needlestick and Sharp Instruments Injuries among Brazilian Dentistry Students

PubMed Central

Fernandes, Liege Helena Freitas; Nunes, Wanúbia Barbosa; Silva, Larissa Costa; Wanderley, Rayssa Lucena; Barros, Criseuda Maria Benício; Cavalcanti, Alessandro Leite

2017-01-01

Background: The occurrence of occupational accidents is common among students and dentists. The present study is aimed to evaluate the prevalence and characteristics of needlestick and sharp instrument injuries among dentistry students. Materials and Methods: A documentary research was carried out with data being obtained from the analysis of 137 medical records of injuries caused by needlestick and sharp instruments occurring in the period from 2012 to 2016 and were analyzed regarding the characteristics of the victim (gender and age) and the accident (year, time, environment, and time interval between exposure and search for care). Data were organized in the Statistical Package for Social Sciences software version 18 and were presented through descriptive statistics. Results: The occurrence of accidents was high (43.1%), with the predominance of female victims (66.1%) and aged up to 23 years (55.9%). The majority of events occurred in the afternoon (54.4%), in the clinical setting (70.7%), and in 75% of the cases, the search for care occurred within 2 h after exposure. Conclusion: Accidents with needlestick and sharp instruments have high frequency and involve mainly female students. They are more common in the afternoon and in the clinical setting and the time interval was between exposure and the search for care complied with recommendations of the Brazilian legislation. PMID:28566861

Clinical solid waste management practices and its impact on human health and environment - A review

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

Hossain, Md. Sohrab; Santhanam, Amutha; Nik Norulaini, N.A.

2011-04-15

Research highlights: > Appropriate waste management technology for safe handling and disposal of clinical solid waste. > Infectious risk assessment on unsafe handling of clinical solid waste. > Recycling-reuse program of clinical solid waste materials. > Effective sterilization technology to reduce exposure of infectious risk. - Abstract: The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This articlemore » summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non-specialized clinical staffs. Therefore, the adoption of SF-CO2 sterilization technology in management of clinical solid waste can reduce exposure to infectious waste, decrease labor, lower costs, and yield better compliance with regulatory. Thus healthcare facilities can both save money and provide a safe environment for patients, healthcare staffs and clinical staffs.« less

Lacosamide and Levetiracetam Have No Effect on Sharp-Wave Ripple Rate.

PubMed

Kudlacek, Jan; Chvojka, Jan; Posusta, Antonin; Kovacova, Lubica; Hong, Seung Bong; Weiss, Shennan; Volna, Kamila; Marusic, Petr; Otahal, Jakub; Jiruska, Premysl

2017-01-01

Pathological high-frequency oscillations are a novel marker used to improve the delineation of epileptogenic tissue and, hence, the outcome of epilepsy surgery. Their practical clinical utilization is curtailed by the inability to discriminate them from physiological oscillations due to frequency overlap. Although it is well documented that pathological HFOs are suppressed by antiepileptic drugs (AEDs), the effect of AEDs on normal HFOs is not well known. In this experimental study, we have explored whether physiological HFOs (sharp-wave ripples) of hippocampal origin respond to AED treatment. The results show that application of a single dose of levetiracetam or lacosamide does not reduce the rate of sharp-wave ripples. In addition, it seems that these new generation drugs do not negatively affect the cellular and network mechanisms involved in sharp-wave ripple generation, which may provide a plausible explanation for the absence of significant negative effects on cognitive functions of these drugs, particularly on memory.

Preoperative and Postoperative Photographs and Surgical Outcomes of Patients With Kyphosis.

PubMed

Albayrak, Akif; Balioglu, Mehmet Bulent; Misir, Abdulhamit; Kargin, Deniz; Tacal, Mehmet Temel; Atici, Yunus; Kaygusuz, Mehmet Akif

2016-10-01

A retrospective clinical study was performed. The aim of the study was to show patients their pre- and postoperative body photographs, and determine the effect on postoperative patient satisfaction for thoracic and thoracolumbar sharp and round angular kyphosis. Previous studies have reported the normative values of pelvic sagittal parameters and the classification of normal patterns of sagittal curvature, but no study has investigated and compared the clinical photographs of sharp and round kyphosis. In patients who underwent surgery for thoracic and thoracolumbar sharp and round angular kyphosis, whole spine anteroposterior and lateral radiographs, and clinical photographs were obtained preoperatively and at the final follow-up. Pelvic and spinal parameters were measured, and the pre- and postoperative photographs were shown to patients. The Scoliosis Research Society 22r (SRS22r) and Short Form 36 surveys were administered to all patients, and the scores were analyzed. Thirty-eight patients diagnosed with kyphosis (mean age 19.6 yr, mean follow-up duration 26.4 mo) were divided into two groups: sharp (18 patients, mean age 20.1 yr) and round (20 patients, mean age 19.6 yr) kyphosis. There was no difference between values in the sharp and round groups in terms of age, follow-up duration, and Risser score (P > 0.05). In both groups, the subscores for pain, self-image, mental health, and satisfaction, except for the function/activity score, and the total score of the SRS22r survey were, however, significantly different between pre- and postoperative photographs. In addition, there was no significant difference between the two groups in any SRS22r domain and Short Form 36 scores. The surgical treatment of kyphosis was uniformly associated with improved quality of life, regardless of the kyphosis type. Thus, showing patients their pre- and postoperative photographs may enhance patient satisfaction, as measured by SRS22r scores. 4.

A waste walk through clinical pharmacy: how do the 'seven wastes' of Lean techniques apply to the practice of clinical pharmacists.

PubMed

Green, Christopher F; Crawford, Victoria; Bresnen, Gaynor; Rowe, Philip H

2015-02-01

This study used a 'Lean' technique, the 'waste walk' to evaluate the activities of clinical pharmacists with reference to the seven wastes described in 'Lean' including 'defects', 'unnecessary motion', 'overproduction', 'transport of products or material', 'unnecessary waiting', 'unnecessary inventory' and 'inappropriate processing'. The objectives of the study were to categorise the activities of ward-based clinical pharmacists into waste and non-waste, provide detail around what constitutes waste activity and quantify the proportion of time attributed to each category. This study was carried out in a district general hospital in the North West of England. Staff were observed using work-sampling techniques, to categorise activity into waste and non-waste, with waste activities being allocated to each of the seven wastes described earlier and subdivided into recurrent themes. Twenty different pharmacists were observed for 1 h on two separate occasions. Of 1440 observations, 342 (23.8%) were categorised as waste with 'defects' and 'unnecessary motion' accounting for the largest proportions of waste activity. Observation of clinical pharmacists' activities has identified that a significant proportion of their time could be categorised as 'waste'. There are practical steps that could be implemented in order to ensure their time is used as productively as possible. Given the challenges facing the UK National Health Service, the adoption of 'Lean' techniques provides an opportunity to improve quality and productivity while reducing costs. © 2014 Royal Pharmaceutical Society.

Graphene Oxide from Carbon Rod Waste

NASA Astrophysics Data System (ADS)

Rahmawati, F.; Prasasti, B. L. W.; Mudjijono, M.

2018-03-01

Carbon rods extracted from Zn-C primary battery waste was used as raw material for graphene oxide (GO) synthesis. The synthesis used a modified Hummers method by providing potassium permanganate-sulfuric acid as the oxidizing agent. XRD analysis confirms a significant change between the graphite waste pattern and the produced graphene oxide pattern. A major peak at 2θ 27 ° which present in the graphite waste pattern is disappeared after it converts to the product, as well as a broad peak under 25 ° referring the presence of amorphous carbon. A broad peak at low angle of 12.02 ° dominantly present in the prepared GO pattern as a characteristic peak of GO. Meanwhile, some small peaks at 2θ of 17.76 °, 28.58 °, and 37.28 ° confirming the presence of manganese oxide which was used as oxidizing agent. A sharp peak at 1700 – 1500 cm-1 in the FT-IR spectrum indicates the presence of –C=O group, and at 1600 cm-1 refers to –C=C group. It confirms that this research has produced the targeted GO. Even though, the purity is need to be enhanced by removing the rest of oxidizing agent that still exist in the material.

Creutzfeldt-Jakob Disease-Like Periodic Sharp Wave Complexes in Voltage-Gated Potassium Channel-Complex Antibodies Encephalitis: A Case Report.

PubMed

Savard, Martin; Irani, Sarosh R; Guillemette, Annie; Gosselin-Lefebvre, Stéphanie; Geschwind, Michael; Jansen, Gerard H; Gould, Peter V; Laforce, Robert

2016-02-01

Voltage-gated potassium channel-complex antibodies (VGKC-cAbs) encephalitis, a treatable autoantibody encephalopathy, has been previously reported to clinically mimic sporadic Creutzfeldt-Jakob disease. Among available clinical clues to distinguish them, periodic sharp wave complexes, a typical finding in sporadic Creutzfeldt-Jakob disease, have never been reported in association with VGKC-cAbs encephalitis. A 76-year-old man was transferred to a tertiary neurology center with a clinical history of 6-month weight loss, cognitive disturbance, and nonspecific generalized weakness. He had two seizures the month before transfer and then evolved to severe encephalopathy, requiring mechanical ventilation. Periodic sharp wave complexes every 1 to 2 seconds over slowed background were found on EEG, and MRI showed cerebellar and bifrontal cortical T2/FLAIR/DWI hypersignal without restricted diffusion on ADC mapping. Pancorporal positron emission tomography scan was negative. An immunotherapy trial did not improve the patient condition. Therefore, he died after life support withdrawal. Brain autopsy revealed mononuclear neocortex infiltrate without significant spongiosis, and the anti-VGKC test showed a seropositivity of 336 pmol/L (normal, 0-31), 3 month after the patient deceased. This is the first reported case of VGKC-cAbs encephalitis associated with periodic sharp wave complexes on EEG, which further confuse the differential diagnosis with sporadic Creutzfeldt-Jakob disease. However, the cortical DWI hypersignal without restriction seems to remain a way to discriminate these two entities appropriately, when present. These clues are of paramount importance because VGKC-cAbs encephalitis is a treatable disease.

Bio-Medical Waste Managment in a Tertiary Care Hospital: An Overview.

PubMed

Pandey, Anita; Ahuja, Sanjiv; Madan, Molly; Asthana, Ajay Kumar

2016-11-01

Bio-Medical Waste (BMW) management is of utmost importance as its improper management poses serious threat to health care workers, waste handlers, patients, care givers, community and finally the environment. Simultaneously, the health care providers should know the quantity of waste generated in their facility and try to reduce the waste generation in day-to-day work because lesser amount of BMW means a lesser burden on waste disposal work and cost saving. To have an overview of management of BMW in a tertiary care teaching hospital so that effective interventions and implementations can be carried out for better outcome. The observational study was carried out over a period of five months from January 2016 to May 2016 in Chhatrapati Shivaji Subharti Hospital, Meerut by the Infection Control Team (ICT). Assessment of knowledge was carried out by asking set of questions individually and practice regarding awareness of BMW Management among the Health Care Personnel (HCP) was carried out by direct observation in the workplace. Further, the total BMW generated from the present setup in kilogram per bed per day was calculated by dividing the mean waste generated per day by the number of occupied beds. Segregation of BMW was being done at the site of generation in almost all the areas of the hospital in color coded polythene bags as per the hospital protocol. The different types of waste being collected were infectious solid waste in red bag, soiled infectious waste in yellow bag and sharp waste in puncture proof container and blue bag. Though awareness (knowledge) about segregation of BMW was seen in 90% of the HCP, 30%-35% did not practice. Out of the total waste generated (57912 kg.), 8686.8 kg. (15%) was infectious waste. Average infectious waste generated was 0.341 Kg per bed per day. The transport, treatment and disposal of each collected waste were outsourced and carried out by 'Synergy' waste management Pvt. Ltd. The practice of BMW Management was lacking in 30-35% HCP which may lead to mixing of the 15% infectious waste with the remaining non-infectious. Therefore, training courses and awareness programs about BMW management will be carried out every month targeting smaller groups.

Scintillator high-gain avalanche rushing photoconductor active-matrix flat panel imager: Zero-spatial frequency x-ray imaging properties of the solid-state SHARP sensor structure

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

Wronski, M.; Zhao, W.; Tanioka, K.

Purpose: The authors are investigating the feasibility of a new type of solid-state x-ray imaging sensor with programmable avalanche gain: scintillator high-gain avalanche rushing photoconductor active matrix flat panel imager (SHARP-AMFPI). The purpose of the present work is to investigate the inherent x-ray detection properties of SHARP and demonstrate its wide dynamic range through programmable gain. Methods: A distributed resistive layer (DRL) was developed to maintain stable avalanche gain operation in a solid-state HARP. The signal and noise properties of the HARP-DRL for optical photon detection were investigated as a function of avalanche gain both theoretically and experimentally, and themore » results were compared with HARP tube (with electron beam readout) used in previous investigations of zero spatial frequency performance of SHARP. For this new investigation, a solid-state SHARP x-ray image sensor was formed by direct optical coupling of the HARP-DRL with a structured cesium iodide (CsI) scintillator. The x-ray sensitivity of this sensor was measured as a function of avalanche gain and the results were compared with the sensitivity of HARP-DRL measured optically. The dynamic range of HARP-DRL with variable avalanche gain was investigated for the entire exposure range encountered in radiography/fluoroscopy (R/F) applications. Results: The signal from HARP-DRL as a function of electric field showed stable avalanche gain, and the noise associated with the avalanche process agrees well with theory and previous measurements from a HARP tube. This result indicates that when coupled with CsI for x-ray detection, the additional noise associated with avalanche gain in HARP-DRL is negligible. The x-ray sensitivity measurements using the SHARP sensor produced identical avalanche gain dependence on electric field as the optical measurements with HARP-DRL. Adjusting the avalanche multiplication gain in HARP-DRL enabled a very wide dynamic range which encompassed all clinically relevant medical x-ray exposures. Conclusions: This work demonstrates that the HARP-DRL sensor enables the practical implementation of a SHARP solid-state x-ray sensor capable of quantum noise limited operation throughout the entire range of clinically relevant x-ray exposures. This is an important step toward the realization of a SHARP-AMFPI x-ray flat-panel imager.« less

The use of artificial neural networks and multiple linear regression to predict rate of medical waste generation

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

Jahandideh, Sepideh; Jahandideh, Samad; Asadabadi, Ebrahim Barzegari

2009-11-15

Prediction of the amount of hospital waste production will be helpful in the storage, transportation and disposal of hospital waste management. Based on this fact, two predictor models including artificial neural networks (ANNs) and multiple linear regression (MLR) were applied to predict the rate of medical waste generation totally and in different types of sharp, infectious and general. In this study, a 5-fold cross-validation procedure on a database containing total of 50 hospitals of Fars province (Iran) were used to verify the performance of the models. Three performance measures including MAR, RMSE and R{sup 2} were used to evaluate performancemore » of models. The MLR as a conventional model obtained poor prediction performance measure values. However, MLR distinguished hospital capacity and bed occupancy as more significant parameters. On the other hand, ANNs as a more powerful model, which has not been introduced in predicting rate of medical waste generation, showed high performance measure values, especially 0.99 value of R{sup 2} confirming the good fit of the data. Such satisfactory results could be attributed to the non-linear nature of ANNs in problem solving which provides the opportunity for relating independent variables to dependent ones non-linearly. In conclusion, the obtained results showed that our ANN-based model approach is very promising and may play a useful role in developing a better cost-effective strategy for waste management in future.« less

Public perception of hazardousness caused by current trends of municipal solid waste management.

PubMed

Al-Khatib, Issam A; Kontogianni, Stamatia; Abu Nabaa, Hendya; Alshami, Ni'meh; Al-Sari', Majed I

2015-02-01

Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) as a result of inequitable waste collection and treatment. Citizens' collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent's educational attainment and their awareness of hazardous waste (hazard perception); the results will indicate the measure taking required to avoid accidents occurred in those regions (burns from toxics, cuts from sharps, etc). National policy and legislation development based on the research outcomes will ensure equitable and accessible services are in place in order to move towards a healthier environment. Specialized health education and training programs on national scale are also needed to enhance awareness on hazardous waste. Copyright © 2014 Elsevier Ltd. All rights reserved.

A novel method to delaminate nitrate-intercalated MgAl layered double hydroxides in water and application in heavy metals removal from waste water.

PubMed

Rahman, Mir Tamzid; Kameda, Tomohito; Kumagai, Shogo; Yoshioka, Toshiaki

2018-07-01

Nitrate-intercalated MgAl layered double hydroxide (LDH) was successfully delaminated in water by a facile and effective method upon reflux at 120 °C for 24 h followed by sonication at 40 °C for 5 h. This process is environmentally friendly since water is the only solvent used. The delaminated nanosheets were characterized by microscopic, spectroscopic, and particle size analyses. The delamination process successfully produced octahedron-shaped single-layer nanosheets 50-150 nm in size. X-ray photoelectron spectroscopy (XPS) data confirmed that the surface elements and their chemical status are consistent with the basic layer of MgAl LDH. The delaminated nanosheets displayed higher adsorption capacity for removing heavy metals from waste water than the original powdered LDH. After treating the waste water, a sharp and intense peak in the X-ray powder diffraction (XRD) pattern of the precipitate confirms the restacking of the LDH nanosheets. Copyright © 2018 Elsevier Ltd. All rights reserved.

Reducing needlestick injuries: a review of a community service.

PubMed

Aziz, Ann-Marie

Community nurses provide care to patients in a variety of settings; for example, health centres, community hospitals, patients' homes, and residential and nursing homes. Administering intramuscular (IM)injections to patients in the community is an everyday activity for many nurses in clinical practice. A great deal of problems related to being 'sharps safe' are common to both community nurses and hospital staff. There had been a reported six needlestick injuries (NSIs) from community clinics administering depot IM injections, which required a review. An audit of practice was undertaken in clinics administering depot injections. The audit was undertaken to monitor compliance in sharps management and investigated how community nurses were administering IM injections. The review highlighted a lack of resources, gaps in knowledge and training deficits. The infection prevention and control nurses worked hard to improve practices and procedures. After a year, there had been a significant reduction in NSIs.

Nursing Faculty Experiences of Virtual Learning Environments for Teaching Clinical Reasoning

ERIC Educational Resources Information Center

Zacharzuk-Marciano, Tara

2017-01-01

Nurses need sharp, clinical reasoning skills to respond to critical situations and to be successful at work in a complex and challenging healthcare system. While past research has focused on using virtual learning environments to teach clinical reasoning, there has been limited research on the experiences of nursing faculty and there is a need for…

Bio-Medical Waste Managment in a Tertiary Care Hospital: An Overview

PubMed Central

Ahuja, Sanjiv; Madan, Molly; Asthana, Ajay Kumar

2016-01-01

Introduction Bio-Medical Waste (BMW) management is of utmost importance as its improper management poses serious threat to health care workers, waste handlers, patients, care givers, community and finally the environment. Simultaneously, the health care providers should know the quantity of waste generated in their facility and try to reduce the waste generation in day-to-day work because lesser amount of BMW means a lesser burden on waste disposal work and cost saving. Aim To have an overview of management of BMW in a tertiary care teaching hospital so that effective interventions and implementations can be carried out for better outcome. Materials and Methods The observational study was carried out over a period of five months from January 2016 to May 2016 in Chhatrapati Shivaji Subharti Hospital, Meerut by the Infection Control Team (ICT). Assessment of knowledge was carried out by asking set of questions individually and practice regarding awareness of BMW Management among the Health Care Personnel (HCP) was carried out by direct observation in the workplace. Further, the total BMW generated from the present setup in kilogram per bed per day was calculated by dividing the mean waste generated per day by the number of occupied beds. Results Segregation of BMW was being done at the site of generation in almost all the areas of the hospital in color coded polythene bags as per the hospital protocol. The different types of waste being collected were infectious solid waste in red bag, soiled infectious waste in yellow bag and sharp waste in puncture proof container and blue bag. Though awareness (knowledge) about segregation of BMW was seen in 90% of the HCP, 30%-35% did not practice. Out of the total waste generated (57912 kg.), 8686.8 kg. (15%) was infectious waste. Average infectious waste generated was 0.341 Kg per bed per day. The transport, treatment and disposal of each collected waste were outsourced and carried out by ‘Synergy’ waste management Pvt. Ltd. Conclusion The practice of BMW Management was lacking in 30-35% HCP which may lead to mixing of the 15% infectious waste with the remaining non-infectious. Therefore, training courses and awareness programs about BMW management will be carried out every month targeting smaller groups. PMID:28050362

Health Impact Assessment and Evaluation of a Clinical Waste Management Policy for Cameroon

PubMed Central

Mochungong, Peter Ikome Kuwoh

2013-01-01

Health impact assessment (HIA) was carried out to evaluate development of a clinical waste management policy for Cameroon. Fifteen stakeholders of different portfolios within the health sector were selected during a HIA initiating study trip to the Northwest region of Cameroon. Questionnaires were then developed and emailed to the stakeholders. The stakeholders identified cross-contamination, environmental pollution, physical injuries and poor waste management sites as potential risk factors that can be associated with poor clinical waste management. They recommended strong economic and political capital as a prerequisite for the development and implementation of a successful clinical waste policy. Local impacts on health, according to the stakeholders, should be prioritized in deciding any treatment and disposal option. The whole HIA process run through 2008-2010. PMID:28299096

Sharps injuries in UK health care: a review of injury rates, viral transmission and potential efficacy of safety devices.

PubMed

Elder, Alexander; Paterson, Caron

2006-12-01

To review the literature on sharps injuries and occupational bloodborne virus transmission in health care in the UK and the worldwide evidence for injury prevention of sharps safety devices. Literature review by online database and Internet resource search. Twenty-four relevant publications were identified regarding UK reported sharps injury rates. UK studies showed as much as a 10-fold difference between injuries reported through standard reporting systems (0.78-5.15 per 100 person-years) and rates estimated from retrospective questionnaires of clinical populations (30-284 per 100 person-years). National surveillance data from England, Wales and Northern Ireland gives a rate of 1.43 known hepatitis C virus or human immunodeficiency virus (HIV) transmissions to health care workers per annum. When extrapolated, this suggests an approximate rate of 0.009 such viral transmissions per 1000 hospital beds per annum. Risk of infection from sources with no risk factors is extremely small (less than one in one million for HIV transmission based on Scottish data). Thirty-one studies on the efficacy of sharps safety devices showed evidence of a reduction in injuries, with the greatest reductions achieved by blunt suture needles and safety cannulae. Although injuries remain common, confirmed viral transmission in the UK has been relatively rare. The degree of under-reporting of sharps injuries may be as much as 10-fold. Safety-engineered devices are likely to be effective at injury reduction.

Influence and evolution mechanism of different sharpness contact forms to mechanical property of cortical bone by nanoindentation

NASA Astrophysics Data System (ADS)

Sun, Xingdong; Guo, Yue; Li, Lijia; Liu, Zeyang; Wu, Di; Shi, Dong; Zhao, Hongwei; Zhang, Shizhong

2018-03-01

Based on different damage forms of various contact forms to bone, the mechanical response and mechanism were investigated by nanoindentation under different sharpness contact forms. For the purpose of simulating the different sharpness contact forms, two kinds of indenters were used in experiments and finite elements simulations. Through nanoindentation experiments, it was concluded that the residual depth of sharp indenter was bigger than that of blunt indenter with small penetration depth. However, the contrary law was obtained with bigger penetration depth. There was a turning point of transition from blunt tendency to sharp tendency. By calculation, it was concluded that the sharper the indenter was, the bigger the proportion of plastic energy in total energy was. Basically, results of finite elements simulation could correspond with the experimental conclusions. By the observation of FE-SEM, the surface of cortical bone compressed was more seriously directly below the blunt indenter than the lateral face. For the berkovich indenter, the surface of indentation compressed was less directly below the indenter, but seriously on three lateral faces. This research may provide some new references to the studies of bone fracture mechanism in different load patterns in the initial press-in stage and offer new explanation for bone trauma diagnosis in clinical treatment and criminal investigation.

Solid waste production and its management in dental clinics in Gorgan, northern Iran.

PubMed

Nabizadeh, R; Faraji, H; Mohammadi, A A

2014-10-01

Waste produced in dental clinics has been the topic of investigations for many years. These waste materials have important health impacts and are hazardous to humans and the environment. To investigating solid waste production and its management in dental clinics in Gorgan, northern Iran. In this cross-sectional study, 45 of 143 public dental practices and 5 of 25 private dental practices were selected and studied. From each clinic, 3 samples were taken and analyzed at the end of successive working days (Tuesday and Wednesday). Samples were manually sorted into 50 components. The measured components were then classified on the basis of their characteristics, hazard potentials, and WHO classification. The total annual amount of dental waste produced in public and private dental practices in Gorgan was 12 015.1 and 3135.0 kg, respectively. Production percentages of infectious, domestic, chemical and pharmaceutical, and toxic waste in public dental practices were 38.4%, 33.7%, 6.6%, and 0.6%, respectively. The percentages for private practices were 8.7%, 10.6%, 1.1%, and 0.1%, respectively. Dental waste management in Gorgan is inadequate; dental waste is not properly segregated, collected, and disposed, as demanded by the WHO. Employees in dentist offices must be trained in correct handling of waste products and the associated risks.

Eardrum repair

MedlinePlus

... is filled with liquid. There may be sharp, shooting pains off and on soon after the surgery. ... Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David ...

Reducing waste in the NHS: an overview of the literature and challenges for the nursing profession.

PubMed

Minogue, Virginia; Wells, Bill

2016-07-01

Waste in the NHS is estimated to account for 20% of health expenditure. This article examines the literature on reducing waste, analyses some approaches to waste reduction, and identifies the role that nurses and other health professionals can play in developing a sustainable NHS. For the purposes of the article, and to inform nursing practice, the definition of, and discussion about, waste is broader than that outlined by the Department for Environment, Food and Rural Affairs (Defra) controlled waste regulations, and the Royal College of Nursing classification. It includes clinical waste, waste arising out of clinical practice, service delivery and care, infrastructure, and carbon emissions.

Double knockout of pendrin and Na-Cl cotransporter (NCC) causes severe salt wasting, volume depletion, and renal failure.

PubMed

Soleimani, Manoocher; Barone, Sharon; Xu, Jie; Shull, Gary E; Siddiqui, Faraz; Zahedi, Kamyar; Amlal, Hassane

2012-08-14

The Na-Cl cotransporter (NCC), which is the target of inhibition by thiazides, is located in close proximity to the chloride-absorbing transporter pendrin in the kidney distal nephron. Single deletion of pendrin or NCC does not cause salt wasting or excessive diuresis under basal conditions, raising the possibility that these transporters are predominantly active during salt depletion or in response to excess aldosterone. We hypothesized that pendrin and NCC compensate for loss of function of the other under basal conditions, thereby masking the role that each plays in salt absorption. To test our hypothesis, we generated pendrin/NCC double knockout (KO) mice by crossing pendrin KO mice with NCC KO mice. Pendrin/NCC double KO mice displayed severe salt wasting and sharp increase in urine output under basal conditions. As a result, animals developed profound volume depletion, renal failure, and metabolic alkalosis without hypokalemia, which were all corrected with salt replacement. We propose that the combined inhibition of pendrin and NCC can provide a strong diuretic regimen without causing hypokalemia for patients with fluid overload, including patients with congestive heart failure, nephrotic syndrome, diuretic resistance, or generalized edema.

Double knockout of pendrin and Na-Cl cotransporter (NCC) causes severe salt wasting, volume depletion, and renal failure

PubMed Central

Soleimani, Manoocher; Barone, Sharon; Xu, Jie; Shull, Gary E.; Siddiqui, Faraz; Zahedi, Kamyar; Amlal, Hassane

2012-01-01

The Na-Cl cotransporter (NCC), which is the target of inhibition by thiazides, is located in close proximity to the chloride-absorbing transporter pendrin in the kidney distal nephron. Single deletion of pendrin or NCC does not cause salt wasting or excessive diuresis under basal conditions, raising the possibility that these transporters are predominantly active during salt depletion or in response to excess aldosterone. We hypothesized that pendrin and NCC compensate for loss of function of the other under basal conditions, thereby masking the role that each plays in salt absorption. To test our hypothesis, we generated pendrin/NCC double knockout (KO) mice by crossing pendrin KO mice with NCC KO mice. Pendrin/NCC double KO mice displayed severe salt wasting and sharp increase in urine output under basal conditions. As a result, animals developed profound volume depletion, renal failure, and metabolic alkalosis without hypokalemia, which were all corrected with salt replacement. We propose that the combined inhibition of pendrin and NCC can provide a strong diuretic regimen without causing hypokalemia for patients with fluid overload, including patients with congestive heart failure, nephrotic syndrome, diuretic resistance, or generalized edema. PMID:22847418

Managing hazardous waste in the clinical laboratory.

PubMed

Hoeltge, G A

1989-09-01

Clinical laboratories generate wastes that present chemical and biologic hazards. Ignitable, corrosive, reactive, toxic, and infectious potentials must be contained and minimized. A summary of these problems and an overview of the applicable regulations are presented. A checklist of activities to facilitate the annual review of the hazardous waste program is provided.

Prevalence and injury patterns among electronic waste workers in the informal sector in Nigeria.

PubMed

Ohajinwa, Chimere May; van Bodegom, Peter M; Vijver, Martina G; Olumide, Adesola O; Osibanjo, Oladele; Peijnenburg, Willie J G M

2018-06-01

Despite the large volume of e-waste recycled informally, the prevalence of work-related injuries among e-waste workers is unknown. Therefore, this study assessed the prevalence, patterns and factors associated with occupational injuries among e-waste workers in the informal sector in Nigeria. This cross-sectional study adopted a multistage sampling method to select 279 respondents from three cities (Ibadan, Lagos and Aba) in Nigeria. A questionnaire was used to obtain information on sociodemographics, work practices and injury occurrences from the respondents in 2015. The data were analysed using descriptive statistics and standard logistic regression. We found high injury prevalence of 38% and 68% in 1-2 weeks and 6 months preceding the study, respectively. The most common injuries were cuts (59%). Injuries were mainly caused by sharp objects (77%). The majority (82%) of the injuries occurred on the hands/fingers. Despite the high occurrence of injury, only 18% of the workers use personal protective equipment (PPE) and 51% of those that use PPE got at least an injury in 1-2 weeks and 88% got at least an injury in 6 months preceding the study. The factors associated with injury in 1-2 weeks were job designation and the geographical location, while the factors associated with injury in 6 months were job designation, geographical location and age. There is a high prevalence of injury and low use of PPE among the e-waste workers in Nigeria. Occupational injury can be reduced through health education and safety promotion programmes for e-waste workers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Public perception of hazardousness caused by current trends of municipal solid waste management

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

Al-Khatib, Issam A., E-mail: ikhatib@birzeit.edu; Kontogianni, Stamatia; Abu Nabaa, Hendya

Highlights: • Contribution to the scientific literature by examining the relationship between concern for the environment and waste disposal in the frame of household waste treatment mechanism specifically in developing countries. • The awareness of the citizens satisfaction level and the local existing capacities in developing countries significantly contribute to decision making on MSW management sustainability in Palestine and other developing countries when applied. • Identification of the differences and similarities among DC resulting to failures or success in WM field. - Abstract: Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) asmore » a result of inequitable waste collection and treatment. Citizens’ collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent’s educational attainment and their awareness of hazardous waste (hazard perception); the results will indicate the measure taking required to avoid accidents occurred in those regions (burns from toxics, cuts from sharps, etc). National policy and legislation development based on the research outcomes will ensure equitable and accessible services are in place in order to move towards a healthier environment. Specialized health education and training programs on national scale are also needed to enhance awareness on hazardous waste.« less

Highlights from the 9th Cachexia Conference.

PubMed

Ebner, Nicole; von Haehling, Stephan

2017-06-01

This article highlights updates of pathways as well as pre-clinical and clinical studies into the field of wasting disorders that were presented at the 9th Cachexia Conference held in Berlin, Germany, December 2016. This year, some interesting results from clinical trials and different new therapeutic targets were shown. This article presents the biological and clinical significance of different markers and new diagnostic tools and cut-offs of detecting skeletal muscle wasting. Effective treatments of cachexia and wasting disorders are urgently needed in order to improve the patients' quality of life and their survival. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Late onset Pott's paraplegia in patients with upper thoracic sharp kyphosis.

PubMed

Zhang, Zhengfeng

2012-02-01

The purpose of this study was to determine the clinical results of patients with late onset upper thoracic sharp Pott's kyphosis and to predict the prognosis for Pott's paraplegics. The study included five patients who developed late onset upper thoracic (T1-T4) sharp Pott's kyphosis/kyphoscoliosis within a period from 19 to 37 years after the active disease was healed. The kyphosis angle of the patients ranged from 95° to 105°. Among them, three patients suffered onset of paraplegia ranging from 26 to 31 years after spinal tuberculosis was healed. The duration of neurological deterioration before surgery ranged from four to five years. All patients underwent decompressive surgery with an attempt to correct the curve. Neurological status was evaluated using the ASIA impairment classification and the motor score. Postoperatively, kyphosis correction ranged from 20° to 30° for five patients. No neurological deficit occurred in two patients with normal neurological status. Two ASIA D paraplegics remained unchanged after surgery and no further improvement was found at one year follow-up. One ASIA C paralysis deteriorated neurologically to ASIA B after surgery and persisted to a deterioration of neurological status at one year follow-up. Upper thoracic sharp Pott's kyphosis and neurological deficits occur progressively. The neurological recovery or improvement of Pott's paraplegics with upper thoracic severe sharp kyphosis results in poor prognosis after decompressive surgery.

Marketing the health care experience: eight steps to infuse brand essence into your organization.

PubMed

Lofgren, Diane Gage; Rhodes, Sonia; Miller, Todd; Solomon, Jared

2006-01-01

One of the most elusive challenges in health care marketing is hitting on a strategy to substantially differentiate your organization in the community and drive profitable business. This article describes how Sharp HealthCare, the largest integrated health care delivery system in San Diego, has proven that focusing first on improving the health care experience for patients, physicians, and employees can provide the impetus for a vital marketing strategy that can lead to increased market share and net revenue. Over the last five years, this nonprofit health system has transformed the health care experience into tangible actions that are making a difference in the lives of all those the system serves. That difference has become Sharp's "brand essence"--a promise to the community that has been made through marketing, public relations, and advertising and then delivered through the dedicated work of Sharp's 14,000 team members. They call this performance improvement strategy The Sharp Experience. This article outlines the eight-step journey that led the organization to this brand essence marketing campaign, a campaign whose centerpiece is an award-winning 30-minute television documentary that use real-time patient stories to demonstrate Sharp's focus on service and patient-centered care against a backdrop of clinical quality and state-of-the-art technology, and documentary-style radio and television commercials.

Guidelines on disposing of medical waste in the dialysis clinic.

PubMed

Park, Lawrence K

2002-02-01

The term "medical waste" varies from state to state as to its name, definition, and scope of coverage. In this article, we will focus on the process of how a dialysis clinic ensures proper classification, labeling, packaging, tracking, and disposal of medical waste. In addition, we will reference: OSHA regulations (29CFR1910), state specific regulations, DOT regulations (49CFR) and FDA regulations that impact the disposal of medical waste.

Mobile colloid generation induced by a cementitious plume: mineral surface-charge controls on mobilization.

PubMed

Li, Dien; Kaplan, Daniel I; Roberts, Kimberly A; Seaman, John C

2012-03-06

Cementitious materials are increasingly used as engineered barriers and waste forms for radiological waste disposal. Yet their potential effect on mobile colloid generation is not well-known, especially as it may influence colloid-facilitated contaminant transport. Whereas previous papers have studied the introduction of cement colloids into sediments, this study examined the influence of cement leachate chemistry on the mobilization of colloids from a subsurface sediment collected from the Savannah River Site, USA. A sharp mobile colloid plume formed with the introduction of a cement leachate simulant. Colloid concentrations decreased to background concentrations even though the aqueous chemical conditions (pH and ionic strength) remained unchanged. Mobile colloids were mainly goethite and to a lesser extent kaolinite. The released colloids had negative surface charges and the mean particle sizes ranged primarily from 200 to 470 nm. Inherent mineralogical electrostatic forces appeared to be the controlling colloid removal mechanism in this system. In the background pH of ~6.0, goethite had a positive surface charge, whereas quartz (the dominant mineral in the immobile sediment) and kaolinite had negative surface charges. Goethite acted as a cementing agent, holding kaolinite and itself onto the quartz surfaces due to the electrostatic attraction. Once the pH of the system was elevated, as in the cementitious high pH plume front, the goethite reversed to a negative charge, along with quartz and kaolinite, then goethite and kaolinite colloids were mobilized and a sharp spike in turbidity was observed. Simulating conditions away from the cementitious source, essentially no colloids were mobilized at 1:1000 dilution of the cement leachate or when the leachate pH was ≤ 8. Extreme alkaline pH environments of cementitious leachate may change mineral surface charges, temporarily promoting the formation of mobile colloids.

Statistical Analysis for Subjective and Objective Evaluations of Dental Drill Sounds.

PubMed

Yamada, Tomomi; Kuwano, Sonoko; Ebisu, Shigeyuki; Hayashi, Mikako

2016-01-01

The sound produced by a dental air turbine handpiece (dental drill) can markedly influence the sound environment in a dental clinic. Indeed, many patients report that the sound of a dental drill elicits an unpleasant feeling. Although several manufacturers have attempted to reduce the sound pressure levels produced by dental drills during idling based on ISO 14457, the sound emitted by such drills under active drilling conditions may negatively influence the dental clinic sound environment. The physical metrics related to the unpleasant impressions associated with dental drill sounds have not been determined. In the present study, psychological measurements of dental drill sounds were conducted with the aim of facilitating improvement of the sound environment at dental clinics. Specifically, we examined the impressions elicited by the sounds of 12 types of dental drills in idling and drilling conditions using a semantic differential. The analysis revealed that the impressions of dental drill sounds varied considerably between idling and drilling conditions and among the examined drills. This finding suggests that measuring the sound of a dental drill in idling conditions alone may be insufficient for evaluating the effects of the sound. We related the results of the psychological evaluations to those of measurements of the physical metrics of equivalent continuous A-weighted sound pressure levels (LAeq) and sharpness. Factor analysis indicated that impressions of the dental drill sounds consisted of two factors: "metallic and unpleasant" and "powerful". LAeq had a strong relationship with "powerful impression", calculated sharpness was positively related to "metallic impression", and "unpleasant impression" was predicted by the combination of both LAeq and calculated sharpness. The present analyses indicate that, in addition to a reduction in sound pressure level, refining the frequency components of dental drill sounds is important for creating a comfortable sound environment in dental clinics.

Conversion of glycerol to polyglycerol over waste duck-bones as a catalyst in solvent free etherification process

NASA Astrophysics Data System (ADS)

Ayoub, Muhammad; Sufian, Suriati; Mekuria Hailegiorgis, Sintayehu; Ullah, Sami; Uemura, Yoshimitsu

2017-08-01

The alkaline catalyst derived from the duck-bones was used for conversion of glycerol to polyglycerol via solvent free etherification process. The physicochemical properties of prepared materials were duck-bones were systematically investigated as a catalyst by latest techniques of Thermo gravimetric analysis (TGA), X-ray diffraction (XRD), and Brunauer-Emmett-Teller (BET) surface properties. TGA showed different trends of duck-bones decomposition from room temperature to 1000C. XRD pattern showed a clear and sharp peaks of a crystalline phase of CaO. The activity of the catalysts was in line with the basic amount of the strong base sites, surface area, and crystalline phase in the catalysts. The prepared catalyst derived from duck-bones provided high activity (99 %) for glycerol conversion and around 68 % yield for polyglycerol production. These ample wastes of duck-bones have good potential to be used as polyglycerol production catalysts due to have high quantity of Ca compare to other types of bones like cow, chicken and fish bones.

Phenotypic and genotypic characterization of clinically relevant bacteria isolated from dental waste and waste workers' hands, mucosas and coats.

PubMed

Tagliaferri, T L; Vieira, C D; de Carvalho, M A R; Ladeira, L C D; Magalhães, P P; de Macêdo Farias, L; Dos Santos, S G

2017-10-01

Infectious wastes are potential sources of pathogenic micro-organisms, which may represent a risk to the professionals who manage them. In this study, we aimed to characterize the infectious bacteria present in dental waste and waste workers. The dental waste produced over 24 h was collected and waste workers were sampled by swabbing. Isolate resistance profiles were characterized by Vitek ® and PCR and biofilm formation by Congo Red agar, string test and microtitre assay. To assess similarity between the waste and the workers' samples, a random amplified polymorphic DNA test was used. Twenty-eight bacteria were identified as clinically relevant. The most frequent gene was bla TEM present in five Gram-negative micro-organisms, and one bla SHV in Klebsiella pneumoniae. All Pseudomonas aeruginosa were positive to extracellular polymeric substances formation, except one isolated from a worker. Klebsiella pneumoniae had negative results for the string test. Pseudomonas aeruginosa showed better adherence at 25°C after 48 h of incubation and K. pneumonia had the best biofilm formation at the same temperature, after 24 h. The similarity between P. aeruginosa recovered from dental waste and from workers was low, however, it is important to note that a pathogen was found on a worker's hands and that improvements in biosafety are required. Infectious dental waste can contain clinically relevant bacteria with important resistance and biofilm profiles. These micro-organisms could be transmitted to waste workers, other professionals and patients if the principles of biosafety measures are neglected. To our knowledge, no study has ever evaluated the microbial characterization and the potential contamination risk of dental infectious waste and waste handlers. The presence of clinically relevant bacteria in the hands and nasal mucosa of waste workers highlights the need for studies in this field to clarify the risk of these pathogens in dental healthcare services, and to stress the need for an efficient waste management. © 2017 The Society for Applied Microbiology.

Treatment of clinical solid waste using a steam autoclave as a possible alternative technology to incineration.

PubMed

Hossain, Md Sohrab; Balakrishnan, Venugopal; Rahman, Nik Norulaini Nik Ab; Sarker, Md Zaidul Islam; Kadir, Mohd Omar Ab

2012-03-01

A steam autoclave was used to sterilize bacteria in clinical solid waste in order to determine an alternative to incineration technology in clinical solid waste management. The influence of contact time (0, 5, 15, 30 and 60 min) and temperature (111 °C, 121 °C and 131 °C) at automated saturated steam pressure was investigated. Results showed that with increasing contact time and temperature, the number of surviving bacteria decreased. The optimum experimental conditions as measured by degree of inactivation of bacteria were 121 °C for 15 minutes (min) for Gram negative bacteria, 121 °C and 131 °C for 60 and 30 min for Gram positive bacteria, respectively. The re-growth of bacteria in sterilized waste was also evaluated in the present study. It was found that bacterial re-growth started two days after the inactivation. The present study recommends that the steam autoclave cannot be considered as an alternative technology to incineration in clinical solid waste management.

Assessment of microwave-based clinical waste decontamination unit.

PubMed

Hoffman, P N; Hanley, M J

1994-12-01

A clinical waste decontamination unit that used microwave-generated heat was assessed for operator safety and efficacy. Tests with loads artificially contaminated with aerosol-forming particles showed that no particles were detected outside the machine provided the seals and covers were correctly seated. Thermometric measurement of a self-generated steam decontamination cycle was used to determine the parameters needed to ensure heat disinfection of the waste reception hopper, prior to entry for maintenance or repair. Bacterial and thermometric test pieces were passed through the machine within a full load of clinical waste. These test pieces, designed to represent a worst case situation, were enclosed in aluminium foil to shield them from direct microwave energy. None of the 100 bacterial test pieces yielded growth on culture and all 100 thermal test pieces achieved temperatures in excess of 99 degrees C during their passage through the decontamination unit. It was concluded that this method may be used to render safe the bulk of of ward-generated clinical waste.

Treatment of Clinical Solid Waste Using a Steam Autoclave as a Possible Alternative Technology to Incineration

PubMed Central

Hossain, Md. Sohrab; Balakrishnan, Venugopal; Rahman, Nik Norulaini Nik Ab; Sarker, Md. Zaidul Islam; Kadir, Mohd Omar Ab

2012-01-01

A steam autoclave was used to sterilize bacteria in clinical solid waste in order to determine an alternative to incineration technology in clinical solid waste management. The influence of contact time (0, 5, 15, 30 and 60 min) and temperature (111 °C, 121 °C and 131 °C) at automated saturated steam pressure was investigated. Results showed that with increasing contact time and temperature, the number of surviving bacteria decreased. The optimum experimental conditions as measured by degree of inactivation of bacteria were 121 °C for 15 minutes (min) for Gram negative bacteria, 121 °C and 131 °C for 60 and 30 min for Gram positive bacteria, respectively. The re-growth of bacteria in sterilized waste was also evaluated in the present study. It was found that bacterial re-growth started two days after the inactivation. The present study recommends that the steam autoclave cannot be considered as an alternative technology to incineration in clinical solid waste management. PMID:22690168

The Pinnacles of Callisto

NASA Technical Reports Server (NTRS)

Moore, Jeffrey M.; Howard, Alan D.; Schenk, Paul M.

2013-01-01

Many regions of Callisto feature an unusual landscape consisting of rolling dark plains with interspersed bright knobs (pinnacles) and ridges. In earlier work we interpreted the dark plains as dusty, mass-wasted residue from sublimation from volatile-rich bedrock and the bright knobs (often crater rims) as water ice accumulations at locations sheltered from thermal reradiation from the dusty residue. We simulated evolution of Callisto's craters as a combination of bedrock volatile sublimation, mass wasting of the dark, non-coherent residue, and redeposition of ice, and concluded that the ice pinnacles and ridges might be underlain by tens to hundreds of meters of ice. Here we report the initial work of a new study of pinnacles addressing additional questions: 1) Is there an evolutionary sequence starting, e.g., from a cratered initial surface through growth and formation of a dust mantle and pinnacles, to eventual loss of ice to sublimation resulting in just a dark, dusty surface? 2) What determines the areal density and spatial scale of pinnacles - volatile content of bedrock, crater density, surface age, broad-scale topographic setting? 3) Are pinnacles still forming? Several observations address these questions. In a few places scattered high-albedo blocks approx. 25-60 m in diameter occur in the vicinity of large icy pinnacles. We interpret these blocks to be remnants from the collapse of tall pinnacles that were undermined by mass wasting. Some high-relief icy knobs have developed a skeletonized planform due to mass wasting by avalanching, or perhaps to seeding of new sites of ice deposition on mass-wasted ice blocks. Some areas nearly lack fresh craters with well-defined ejecta and ice-free rims. This may imply rapid transformation of fresh craters by sublimation, mass wasting, and ice reprecipitation. In other areas small sharp-rimmed craters occur which lack ice pinnacles, but the craters nonetheless lack visible ejecta sheets. Our preliminary interpretation is that mass wasting is very efficient on Callisto, or alternatively the dust cover is very thick and lacks competent coarse materials.

Dental solid and hazardous waste management and safety practices in developing countries: Nablus district, Palestine.

PubMed

Al-Khatib, Issam A; Monou, Maria; Mosleh, Salem A; Al-Subu, Mohammed M; Kassinos, Despo

2010-05-01

This study investigated the dental waste management practices and safety measures implemented by dentists in the Nablus district, Palestine. A comprehensive survey was conducted for 97 of the 134 dental clinics to assess the current situation. Focus was placed on hazardous waste produced by clinics and the handling, storage, treatment and disposal measures taken. Mercury, found in dental amalgam, is one of the most problematic hazardous waste. The findings revealed that there is no proper separation of dental waste by classification as demanded by the World Health Organization. Furthermore, medical waste is often mixed with general waste during production, collection and disposal. The final disposal of waste ends up in open dumping sites sometimes close to communities where the waste is burned. Correct management and safety procedures that could be effectively implemented in developing countries were examined. It was concluded that cooperation between dental associations, government-related ministries and authorities needs to be established, to enhance dental waste management and provide training and capacity building programs for all professionals in the medical waste management field.

Challenges to diagnosis of HIV-associated wasting.

PubMed

Kotler, Donald

2004-12-01

There is a wide variability in the clinical presentation of the protein energy malnutrition often characterized as wasting in patients infected with HIV. Moreover, the clinical presentation has evolved over time. Initially, protein energy malnutrition was characterized by profound weight loss and depletion of body cell mass (BCM). Recently, unrelated concurrent metabolic abnormalities, such as lipodystrophy, may complicate the diagnosis of HIV wasting. Although measures of BCM are relatively accurate for the diagnosis of HIV wasting, the optimal tools for assessing BCM are not necessarily available to the clinician. From the practical standpoint, HIV wasting may be a self-evident diagnosis in advanced stages, but effective interpretation of the early signs of HIV wasting requires familiarity with other complications included in the differential diagnosis.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

PubMed Central

Choi, Bo-Ram; Choi, Da-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul; Bae, Kwang-Hak

2012-01-01

Purpose The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively. PMID:23071969

Computer simulation of the pneumatic separator in the pneumatic-electrostatic separation system for recycling waste printed circuit boards with electronic components.

PubMed

Xue, Mianqiang; Xu, Zhenming

2013-05-07

Technologies could be integrated in different ways into automatic recycling lines for a certain kind of electronic waste according to practical requirements. In this study, a new kind of pneumatic separator with openings at the dust hooper was applied combing with electrostatic separation for recycling waste printed circuit boards. However, the flow pattern and the particles' movement behavior could not be obtained by experimental methods. To better control the separation quantity and the material size distribution, computational fluid dynamics was used to model the new pneumatic separator giving a detailed understanding of the mechanisms. Simulated results showed that the tangential velocity direction reversed with a relatively small value. Axial velocity exhibited two sharp decreases at the x axis. It is indicated that the bottom openings at the dust hopper resulted in an enormous change in the velocity profile. A new phenomenon that was named dusting was observed, which would mitigate the effect of particles with small diameter on the following electrostatic separation and avoid materials plugging caused by the waste printed circuit boards special properties effectively. The trapped materials were divided into seven grades. Experimental results showed that the mass fraction of grade 5, grade 6, and grade 7 materials were 27.54%, 15.23%, and 17.38%, respectively. Grade 1 particles' mass fraction was reduced by 80.30% compared with a traditional separator. Furthermore, the monocrystalline silicon content in silicon element in particles with a diameter of -0.091 mm was 18.9%, higher than that in the mixed materials. This study could serve as guidance for the future material flow control, automation control, waste recycling, and semiconductor storage medium destruction.

All-Russia Thermal Engineering Institute experience in using difficult to burn fuels in the power industry

NASA Astrophysics Data System (ADS)

Tugov, A. N.; Ryabov, G. A.; Shtegman, A. V.; Ryzhii, I. A.; Litun, D. S.

2016-07-01

This article presents the results of the research carried out at the All-Russia Thermal Engineering Institute (VTI) aimed at using saline coal, municipal solid waste and bark waste, sunflower husk, and nesting/ manure materials from poultry farms. The results of saline coal burning experience in Troitsk and Verkhny Tagil thermal power plants (TPP) show that when switching the boiler to this coal, it is necessary to take into account its operating reliability and environmental safety. Due to increased chlorine content in saline coal, the concentration of hydrogen chloride can make over 500 mg/m3. That this very fact causes the sharp increase of acidity in sludge and the resulting damage of hydraulic ash removal system equipment at these power stations has been proven. High concentration of HCl can trigger damage of the steam superheater due to high-temperature corrosion and result in a danger of low-temperature corrosion of air heating surfaces. Besides, increased HCl emissions worsen the environmental characteristics of the boiler operation on the whole. The data on waste-to-energy research for municipal solid waste (MSW) has been generalized. Based on the results of mastering various technologies of MSW thermal processing at special plants nos. 2 and 4 in Moscow, as well as laboratory, bench, and industrial studies, the principal technical solutions to be implemented in the modern domestic thermal power plant with the installed capacity of 24 MW and MSW as the primary fuel type has been developed. The experience of the VTI in burning various kinds of organic waste—bark waste, sunflower husk, and nesting/manure materials from poultry farms—has been analyzed.

What's in a bin: A case study of dental clinical waste composition and potential greenhouse gas emission savings.

PubMed

Richardson, J; Grose, J; Manzi, S; Mills, I; Moles, D R; Mukonoweshuro, R; Nasser, M; Nichols, A

2016-01-22

Dental practices have a unique position as dental staff use a high number of dental materials and instruments on a daily basis. It is unclear how dentists' and dental care professionals' choices and behaviours around selecting and using materials impact on the amount of unnecessary waste production. Although there are a number of articles exploring the quality and quantity of waste in dental practices, there are no studies on organisational strategies to decrease unnecessary waste. There is no clear economic analysis of the impact on associated cost to dental practices which consequently can affect the access of dental care for disadvantaged groups. This study used an audit approach to explore the potential for sustainability in dental practice by measuring the nature and quantity of dental clinical waste, and assessing the feasibility of measuring the financial costs and potential carbon savings in the management of dental clinical waste. The data from our study would appear to support the view that it is possible to reduce carbon emissions and increase profitability. Successful implementation of an environmentally sustainable approach to waste management will be dependent on the practicalities involved and the financial incentives for adopting such practices.

Evaluation of the clinical process in a critical care information system using the Lean method: a case study

PubMed Central

2012-01-01

Background There are numerous applications for Health Information Systems (HIS) that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS), known as IntelliVue Clinical Information Portfolio (ICIP), and recommends solutions to the problems that were identified during the study. Methods We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. Results We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. Conclusions The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy. PMID:23259846

Evaluation of the clinical process in a critical care information system using the Lean method: a case study.

PubMed

Yusof, Maryati Mohd; Khodambashi, Soudabeh; Mokhtar, Ariffin Marzuki

2012-12-21

There are numerous applications for Health Information Systems (HIS) that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS), known as IntelliVue Clinical Information Portfolio (ICIP), and recommends solutions to the problems that were identified during the study. We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

Postoperative pain and neuropathy after caesarean operation featuring blunt or sharp opening of the fascia: a randomised, parallel group, double-blind study.

PubMed

Yazici Yilmaz, Fatma; Aydogan Mathyk, Begum; Yildiz, Serhat; Yenigul, Nefise Nazli; Saglam, Ceren

2018-03-21

The purpose of this study was to compare postoperative pain and neuropathy after primary caesarean sections with either blunt or sharp fascial expansions. A total of 123 women undergoing primary caesarean sections were included in the study. The sharp group had 61 patients, and the blunt group had 62. In the sharp group, the fascia was incised sharply and extended using scissors. In blunt group, the fascia was bluntly opened by lateral finger-pulling. The primary outcome was postoperative pain. The long-term chronic pain scores were significantly lower in the blunt group during mobilisation (p = .012 and p = .022). Neuropathy was significantly more prevalent in the sharp group at both 1 and 3 months postoperatively (p = .043 and p = .016, respectively). The odds ratio (OR) and 95%CI for postoperative neuropathy at 1 and 3 months were as follows; OR 3.71, 95%CI 0.97-14.24 and OR 5.67, 95%CI 1.18-27.08, respectively. The OR for postoperative pain after 3 months was 3.26 (95%CI 1.09-9.73). The prevelance of postsurgical neuropathy and chronic pain at 3 months were significantly lower in the blunt group. Blunt fascial opening reduces the complication rate of postoperative pain and neuropathy after caesarean sections. Impact statement What is already known on this subject? The anatomic relationship of the abdominal fascia and the anterior abdominal wall nerves is a known fact. The fascia during caesarean sections can be opened by either a sharp or blunt extension. Data on the isolated impact of different fascial incisions on postoperative pain is limited. What do the results of this study add? The postoperative pain scores on the incision area are lower in the bluntly opened group compared to the sharp fascial incision group. By extending the fascia bluntly, a decrease in trauma and damage to nerves was observed. What are the implications of these findings for clinical practice and/or future research? The lateral extension of the fascia during caesarean sections must be done cautiously to prevent temporary damage to nerves and vessels. The blunt opening of the fascia by lateral finger pulling might be a preferred method over the sharp approach that uses scissors. We included only primary caesarean cases, however, comparisons of blunt and sharp fascial incisions in patients with more than one abdominal surgery should be explored in future studies.

The effect of high-efficiency particulate air respirator design on occupational health: a pilot study balancing risks in the real world.

PubMed

Eck, E K; Vannier, A

1997-02-01

To quantify specific factors believed to increase healthcare worker (HCW) risk for contaminated sharps injuries (eg, visibility, communication, and range of motion); to quantify the degree to which respirators of various designs impacted those same factors; and to assess HCW opinions about the suitability of selected respirators with respect to patient care and user compliance criteria. Sharps injury data from seven hospitals were analyzed to determine the potential contribution of visibility, communication, and range of motion to reported injuries. Healthcare workers representing various clinical specialties and physical characteristics were examined at baseline and while wearing five different respirators to quantify the impact of respirator design on visibility, communication, and range of motion. Healthcare workers were interviewed and completed a survey assessing each respirator. Hospital and ambulatory-care settings. Population-based and convenience sample. Communication, visibility, and range of motion were found to affect contaminated sharps injuries significantly. Selected high-efficiency particulate air (HEPA) respirators were found to have a negative impact on each of these variables. Healthcare workers involved in the study also reported compliance criteria problems with selected HEPA respirators, which may effect implementation of respiratory precautions adversely. Current HEPA respirators, because of their design, potentially increase the risk of bloodborne pathogen exposure through sharps injuries. We conclude that mandating respirators without regard to the potential impact of their design to the sharps injuries may be counterproductive to HCW safety, because they may increase, rather than decrease, overall occupational risk to HCWs.

A microbiological study to investigate the carriage and transmission-potential of Clostridium difficile spores on single-use and reusable sharps containers.

PubMed

Grimmond, Terry; Neelakanta, Anu; Miller, Barbara; Saiyed, Asif; Gill, Pam; Cadnum, Jennifer; Olmsted, Russell; Donskey, Curtis; Pate, Kimberly; Miller, Katherine

2018-05-22

A 2015 study matching use of disposable and reusable sharps containers (DSCs, RSCs) with Clostridium difficile infection (CDI) incidence found a decreased incidence with DSCs. We conducted microbiologic samplings and examined the literature and disease-transmission principles to evaluate the scientific feasibility of such an association. (i) 197 RSCs were sampled for C. difficile at processing facilities; (ii) RSCs were challenged with high C. difficile densities to evaluate efficacy of automated decontamination; and (iii) 50 RSCs and 50 DSCs were sampled in CDI patient rooms in 7 hospitals. Results were coupled with epidemiologic studies, clinical requirements, and chain-of-infection principles, and tests of evidence of disease transmission were applied. C. difficile spores were found on 9 of 197 (4.6%) RSCs prior to processing. Processing completely removed C. difficile. In CDI patient rooms, 4 of 50 RSCs (8.0%) and 8 of 50 DSCs (16.0%) had sub-infective counts of C. difficile (P = .27). DSCs were in permanent wall cabinets; RSCs were removed and decontaminated frequently. With C. difficile bioburden being sub-infective on both DSCs and RSCs, sharps containers being no-touch, and glove removal required after sharps disposal, we found 2 links in the chain of infection to be broken and 5 of 7 tests of evidence to be unmet. We conclude that sharps containers pose no risk of C. difficile transmission. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Sharp Force Injuries at the University Hospital of the West Indies, Kingston, Jamaica: A Seventeen-year Autopsy Review.

PubMed

Neblett, A; Williams, N P

2014-09-01

This study aimed to ascertain the prevalence and patterns of fatal sharp force injuries, victims' demographics, cause of death and average survival time at the University Hospital of the West Indies (UHWI), Kingston, Jamaica. The autopsy records for 1990-2010 were searched for fatal cases of sharp force injuries. The records for 1998-2001 were not located. A 17-year retrospective analysis was therefore performed and findings for the two periods, 1990-1997 and 2002-2010 were compared. All data were obtained from the provisional anatomical diagnoses (PAD) autopsy reports. During the 17-year period, 57/4264 autopsies were performed for sharp force injuries, yielding an overall autopsy prevalence rate of 1.34% (1.25%, 26/2086 (95% CI 0.77, 1.73) in Period 1 and 1.42%, 31/2178 (95% CI 0.92, 1.92) in Period 2). The majority were males (91.1%), in the age group 15-39 years (77%), mean age of 30.9 years (range = 17─65 years). Stab wounds predominated (91.3%) and the chest was the area most frequently stabbed (42.1%). In the 24 fatalities due to chest injuries only, eight (33.3%) had injuries to the heart alone. Forty-five patients (79.0%) died within 24 hours from exsanguination. Injury documentation at autopsy was deficient. Stabbing was the most common sharp force injury, mainly involving the chest and young men were at greatest risk. Most patients died from exsanguination within 24 hours of admission. Introduction of synoptic-type reports for both clinical and autopsy examination may improve documentation.

Waste in the U.S. Health care system: a conceptual framework.

PubMed

Bentley, Tanya G K; Effros, Rachel M; Palar, Kartika; Keeler, Emmett B

2008-12-01

Health care costs in the United States are much higher than those in industrial countries with similar or better health system performance. Wasteful spending has many undesirable consequences that could be alleviated through waste reduction. This article proposes a conceptual framework to guide researchers and policymakers in evaluating waste, implementing waste-reduction strategies, and reducing the burden of unnecessary health care spending. This article divides health care waste into administrative, operational, and clinical waste and provides an overview of each. It explains how researchers have used both high-level and sector- or procedure-specific comparisons to quantify such waste, and it discusses examples and challenges in both waste measurement and waste reduction. Waste is caused by factors such as health insurance and medical uncertainties that encourage the production of inefficient and low-value services. Various efforts to reduce such waste have encountered challenges, such as the high costs of initial investment, unintended administrative complexities, and trade-offs among patients', payers', and providers' interests. While categorizing waste may help identify and measure general types and sources of waste, successful reduction strategies must integrate the administrative, operational, and clinical components of care, and proceed by identifying goals, changing systemic incentives, and making specific process improvements. Classifying, identifying, and measuring waste elucidate its causes, clarify systemic goals, and specify potential health care reforms that-by improving the market for health insurance and health care-will generate incentives for better efficiency and thus ultimately decrease waste in the U.S. health care system.

Dental occlusion ties: A rapid, safe, and non‐invasive maxillo‐mandibular fixation technology

PubMed Central

2017-01-01

Objectives For decades, Erich arch bars have been a standard in establishing maxillo‐mandibular fixation (MMF). While reliable, the approach risks sharps injury, consumes operating room time, and inflicts gingival trauma. Newer technologies including screw‐based techniques and “hybrid” techniques have improved MMF by reducing sharps injuries and operating room time, but risk injury to tooth roots, nerves, and gingiva. This study aims to establish the application, strengths, and limitations of dental occlusion ties as a novel alternative in maxillo‐mandibular fixation. Study Design Prospective, non‐blinded, human feasibility clinical trial. Materials and Methods An iterative prototyping process was used to invent dental occlusion ties (brand name: Minne Ties). Development included 3D printing, cadaver prototype testing, human apical embrasure measurement, and ultimately non‐significant risk human clinical trial testing. In the IRB‐approved feasibility clinical trial, the devices were applied to mandible and maxilla fracture candidates with fractures amenable to intra‐operative MMF with open reduction with internal fixation. The ties were removed prior to extubation. Pre‐teens, comminuted fracture patients, and patients requiring post‐operative MMF were excluded. Results Manufactured, sterile prototypes secured MMF successfully in management of unilateral and bilateral mandible and maxilla fractures. All patients reported correction of pre‐operative malocclusion. Application times were typically 12–15 minutes for a single surgeon to achieve MMF. Patients incurred negligible gingival trauma from the technology as the ties require no tissue penetration for application. Conclusions Dental occlusion ties offer a non‐invasive solution featuring operating room efficiency, minimized sharps risk, and less bony and soft tissue trauma than current commercialized solutions. Level of Evidence Therapeutic, IV PMID:28894837

Space Photovoltaic Concentrator Using Robust Fresnel Lenses, 4-Junction Cells, Graphene Radiators, and Articulating Receivers

NASA Technical Reports Server (NTRS)

O'Neill, Mark; McDanal, A. J.; Brandhorst, Henry; Spence, Brian; Iqbal, Shawn; Sharps, Paul; McPheeters, Clay; Steinfeldt, Jeff; Piszczor, Michael; Myers, Matt

2016-01-01

At the 42nd PVSC, our team presented recent advances in our space photovoltaic concentrator technology. These advances include more robust Fresnel lenses for optical concentration, more thermally conductive graphene radiators for waste heat rejection, improved color-mixing lens technology to minimize chromatic aberration losses with 4-junction solar cells, and an articulating photovoltaic receiver enabling single-axis sun-tracking, while maintaining a sharp focal line despite large beta angles of incidence. In the past year, under a NASA Phase II SBIR program, our team has made much additional progress in the development of this new space photovoltaic concentrator technology, as described in this paper.

Statistical Analysis for Subjective and Objective Evaluations of Dental Drill Sounds

PubMed Central

Yamada, Tomomi; Kuwano, Sonoko; Ebisu, Shigeyuki; Hayashi, Mikako

2016-01-01

The sound produced by a dental air turbine handpiece (dental drill) can markedly influence the sound environment in a dental clinic. Indeed, many patients report that the sound of a dental drill elicits an unpleasant feeling. Although several manufacturers have attempted to reduce the sound pressure levels produced by dental drills during idling based on ISO 14457, the sound emitted by such drills under active drilling conditions may negatively influence the dental clinic sound environment. The physical metrics related to the unpleasant impressions associated with dental drill sounds have not been determined. In the present study, psychological measurements of dental drill sounds were conducted with the aim of facilitating improvement of the sound environment at dental clinics. Specifically, we examined the impressions elicited by the sounds of 12 types of dental drills in idling and drilling conditions using a semantic differential. The analysis revealed that the impressions of dental drill sounds varied considerably between idling and drilling conditions and among the examined drills. This finding suggests that measuring the sound of a dental drill in idling conditions alone may be insufficient for evaluating the effects of the sound. We related the results of the psychological evaluations to those of measurements of the physical metrics of equivalent continuous A-weighted sound pressure levels (LAeq) and sharpness. Factor analysis indicated that impressions of the dental drill sounds consisted of two factors: “metallic and unpleasant” and “powerful”. LAeq had a strong relationship with “powerful impression”, calculated sharpness was positively related to “metallic impression”, and “unpleasant impression” was predicted by the combination of both LAeq and calculated sharpness. The present analyses indicate that, in addition to a reduction in sound pressure level, refining the frequency components of dental drill sounds is important for creating a comfortable sound environment in dental clinics. PMID:27462903

Assessment of medical waste management at a primary health-care center in Sao Paulo, Brazil

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

Moreira, A.M.M., E-mail: anamariainforme@hotmail.com; Guenther, W.M.R.

Highlights: Black-Right-Pointing-Pointer Assessment of medical waste management at health-care center before/after intervention. Black-Right-Pointing-Pointer Qualitative and quantitative results of medical waste management plan are presented. Black-Right-Pointing-Pointer Adjustments to comply with regulation were adopted and reduction of waste was observed. Black-Right-Pointing-Pointer The method applied could be useful for similar establishments. - Abstract: According to the Brazilian law, implementation of a Medical Waste Management Plan (MWMP) in health-care units is mandatory, but as far as we know evaluation of such implementation has not taken place yet. The purpose of the present study is to evaluate the improvements deriving from the implementation of amore » MWMP in a Primary Health-care Center (PHC) located in the city of Sao Paulo, Brazil. The method proposed for evaluation compares the first situation prevailing at this PHC with the situation 1 year after implementation of the MWMP, thus allowing verification of the evolution of the PHC performance. For prior and post-diagnosis, the method was based on: (1) application of a tool (check list) which considered all legal requirements in force; (2) quantification of solid waste subdivided into three categories: infectious waste and sharp devices, recyclable materials and non-recyclable waste; and (3) identification of non-conformity practices. Lack of knowledge on the pertinent legislation by health workers has contributed to non-conformity instances. The legal requirements in force in Brazil today gave origin to a tool (check list) which was utilized in the management of medical waste at the health-care unit studied. This tool resulted into an adequate and simple instrument, required a low investment, allowed collecting data to feed indicators and also conquered the participation of the unit whole staff. Several non-conformities identified in the first diagnosis could be corrected by the instrument utilized. Total waste generation increased 9.8%, but it was possible to reduce the volume of non-recyclable materials (11%) and increase the volume of recyclable materials (4%). It was also possible to segregate organic waste (7%), which was forwarded for production of compost. The rate of infectious waste generation in critical areas decreased from 0.021 to 0.018 kg/procedure. Many improvements have been observed, and now the PHC complies with most of legal requirements, offers periodic training and better biosafety conditions to workers, has reduced the volume of waste sent to sanitary landfills, and has introduced indicators for monitoring its own performance. This evaluation method might subsidize the creation and evaluation of medical waste management plans in similar heath institutions.« less

Update on clinical trials of growth factors and anabolic steroids in cachexia and wasting1234

PubMed Central

Gullett, Norleena P; Hebbar, Gautam

2010-01-01

This article and others that focused on the clinical features, mechanisms, and epidemiology of skeletal muscle loss and wasting in chronic diseases, which include chronic kidney disease, cancer, and AIDS, were presented at a symposium entitled "Cachexia and Wasting: Recent Breakthroughs in Understanding and Opportunities for Intervention," held at Experimental Biology 2009. The clinical and anabolic efficacy of specific growth factors and anabolic steroids (eg, growth hormone, testosterone, megestrol acetate) in malnutrition and other catabolic states has been the subject of considerable research during the past several decades. Research on the effects of these agents in cachexia or wasting conditions, characterized by progressive loss of skeletal muscle and adipose tissue, focused on patients with AIDS in the early 1990s, when the devastating effects of the loss of body weight, lean body mass, and adipose tissue were recognized as contributors to these patients' mortality. These same agents have also been studied as methods to attenuate the catabolic responses observed in cancer-induced cachexia and in wasting induced by chronic obstructive pulmonary disease, congestive heart failure, renal failure, and other conditions. This article provides an updated review of recent clinical trials that specifically examined the potential therapeutic roles of growth hormone, testosterone, oxandrolone, and megestrol acetate and emerging data on the orexigenic peptide ghrelin, in human cachexia and wasting. PMID:20164318

Update on clinical trials of growth factors and anabolic steroids in cachexia and wasting.

PubMed

Gullett, Norleena P; Hebbar, Gautam; Ziegler, Thomas R

2010-04-01

This article and others that focused on the clinical features, mechanisms, and epidemiology of skeletal muscle loss and wasting in chronic diseases, which include chronic kidney disease, cancer, and AIDS, were presented at a symposium entitled "Cachexia and Wasting: Recent Breakthroughs in Understanding and Opportunities for Intervention," held at Experimental Biology 2009. The clinical and anabolic efficacy of specific growth factors and anabolic steroids (eg, growth hormone, testosterone, megestrol acetate) in malnutrition and other catabolic states has been the subject of considerable research during the past several decades. Research on the effects of these agents in cachexia or wasting conditions, characterized by progressive loss of skeletal muscle and adipose tissue, focused on patients with AIDS in the early 1990s, when the devastating effects of the loss of body weight, lean body mass, and adipose tissue were recognized as contributors to these patients' mortality. These same agents have also been studied as methods to attenuate the catabolic responses observed in cancer-induced cachexia and in wasting induced by chronic obstructive pulmonary disease, congestive heart failure, renal failure, and other conditions. This article provides an updated review of recent clinical trials that specifically examined the potential therapeutic roles of growth hormone, testosterone, oxandrolone, and megestrol acetate and emerging data on the orexigenic peptide ghrelin, in human cachexia and wasting.

Kinetics of phosphorus and potassium release from rock phosphate and waste mica enriched compost and their effect on yield and nutrient uptake by wheat (Triticum aestivum).

PubMed

Nishanth, D; Biswas, D R

2008-06-01

An attempt was made to study the efficient use of rice straw and indigenous source of phosphorus and potassium in crop production through composting technology. Various enriched composts were prepared using rice straw, rock phosphate (RP), waste mica and bioinoculant (Aspergillus awamori) and kinetics of release of phosphorus and potassium from enriched composts and their effect on yield and nutrient uptake by wheat (Triticum aestivum) were carried out. Results showed sharp increases in release in water-soluble P and K from all the composts at 8th to 12th day of leaching, thereafter, it decreased gradually. Maximum release of water-soluble P and K were obtained in ordinary compost than enriched composts during the initial stages of leaching, but their differences narrowed down at latter stages. Data in pot experiments revealed that enriched composts performed poorly than diammonium phosphate during initial stages of crop growth, but they out yielded at the latter stages, particularly at maturity stage, as evident from their higher yield, uptake, nutrient recoveries and fertility status of P and K in soils. Moreover, enriched composts prepared with RP and waste mica along with A. awamori resulted in significantly higher biomass yield, uptake and recoveries of P and K as well as available P and K in soils than composts prepared without inoculant. Results indicated that enriched compost could be an alternate technology for the efficient management of rice straw, low-grade RP and waste mica in crop production, which could help to reduce the reliance on costly chemical fertilizers.

Case study of a solid-waste-scavenger community with respect to health and environment

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

Kungskulniti, Nipapun.

1991-01-01

This study was an investigation of a solid waste scavenger community at the On-Nooch Dump Site in Bangkok, Thailand. The purpose was to identify the dimensions of the public health conditions of solid waste scavengers and their community. Cross-sectional field surveys and measurements were undertaken to characterize the distribution and magnitude of health-related problems and environmental conditions. Scavengers were found to be exposed to hazardous conditions due to the waste materials at the dump site. Cuts and punctures from sharp materials were the most common complaints among scavengers. Health symptoms like headache, diarrhea, respiratory illness, skin diseases and back painmore » were also reported. There was a high prevalence of childhood respiratory illness especially among those children of households where cigarette smoking was present. Children had poor nutritional status and were commonly infected by intestinal protozoa and helminths. An appreciable proportion of adult respondents was below the normal range for lung function performance. Seroprevalence of HBV infection was found to be high among male respondents in addition to six respondents that had possible HIV infections. The quality of the community water supply was low. Air pollution measurements showed acceptable ambient air levels except for particulate levels (TSP and RSP). Levels of indoor, outdoor, and personal exposure NO{sub 2} were found to be similar. Data for an inner-city project apartment community named Din-Dang were also collected for comparison. A priority rating index and recommendations for public health condition improvements were presented.« less

Waste in the U.S. Health Care System: A Conceptual Framework

PubMed Central

Bentley, Tanya G K; Effros, Rachel M; Palar, Kartika; Keeler, Emmett B

2008-01-01

Context Health care costs in the United States are much higher than those in industrial countries with similar or better health system performance. Wasteful spending has many undesirable consequences that could be alleviated through waste reduction. This article proposes a conceptual framework to guide researchers and policymakers in evaluating waste, implementing waste-reduction strategies, and reducing the burden of unnecessary health care spending. Methods This article divides health care waste into administrative, operational, and clinical waste and provides an overview of each. It explains how researchers have used both high-level and sector- or procedure-specific comparisons to quantify such waste, and it discusses examples and challenges in both waste measurement and waste reduction. Findings Waste is caused by factors such as health insurance and medical uncertainties that encourage the production of inefficient and low-value services. Various efforts to reduce such waste have encountered challenges, such as the high costs of initial investment, unintended administrative complexities, and trade-offs among patients', payers', and providers' interests. While categorizing waste may help identify and measure general types and sources of waste, successful reduction strategies must integrate the administrative, operational, and clinical components of care, and proceed by identifying goals, changing systemic incentives, and making specific process improvements. Conclusions Classifying, identifying, and measuring waste elucidate its causes, clarify systemic goals, and specify potential health care reforms that—by improving the market for health insurance and health care—will generate incentives for better efficiency and thus ultimately decrease waste in the U.S. health care system. PMID:19120983

Effect of soil disturbance on recharging fluxes: Case study on the Snake River Plain, Idaho National Laboratory, USA

USGS Publications Warehouse

Nimmo, J.R.; Perkins, K.S.

2008-01-01

Soil structural disturbance influences the downward flow of water that percolates deep enough to become aquifer recharge. Data from identical experiments in an undisturbed silt-loam soil and in an adjacent simulated waste trench composed of the same soil material, but disturbed, included (1) laboratory- and field-measured unsaturated hydraulic properties and (2) field-measured transient water content profiles through 24 h of ponded infiltration and 75 d of redistribution. In undisturbed soil, wetting fronts were highly diffuse above 2 m depth, and did not go much deeper than 2 m. Darcian analysis suggests an average recharge rate less than 2 mm/year. In disturbed soil, wetting fronts were sharp and initial infiltration slower; water moved slowly below 2 m without obvious impediment. Richards' equation simulations with realistic conditions predicted sharp wetting fronts, as observed for disturbed soil. Such simulations were adequate for undisturbed soil only if started from a post-initial moisture distribution that included about 3 h of infiltration. These late-started simulations remained good, however, through the 76 d of data. Overall results suggest the net effect of soil disturbance, although it reduces preferential flow, may be to increase recharge by disrupting layer contrasts. ?? Springer-Verlag 2007.

Nonlinear dynamics and instability of aqueous dissolution of silicate glasses and minerals

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

Wang, Yifeng; Jove-Colon, Carlos F.; Kuhlman, Kristopher L.

2016-07-22

Aqueous dissolution of silicate glasses and minerals plays a critical role in global biogeochemical cycles and climate evolution. The reactivity of these materials is also important to numerous engineering applications including nuclear waste disposal. The dissolution process has long been considered to be controlled by a leached surface layer in which cations in the silicate framework are gradually leached out and replaced by protons from the solution. This view has recently been challenged by observations of extremely sharp corrosion fronts and oscillatory zonings in altered rims of the materials, suggesting that corrosion of these materials may proceed directly through congruentmore » dissolution followed by secondary mineral precipitation. Here we show that complex silicate material dissolution behaviors can emerge from a simple positive feedback between dissolution-induced cation release and cation-enhanced dissolution kinetics. This self-accelerating mechanism enables a systematic prediction of the occurrence of sharp dissolution fronts (vs. leached surface layers), oscillatory dissolution behaviors and multiple stages of glass dissolution (in particular the alteration resumption at a late stage of a corrosion process). In conclusion, our work provides a new perspective for predicting long-term silicate weathering rates in actual geochemical systems and developing durable silicate materials for various engineering applications.« less

Articulated Bone Block for Posterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft: Surgical Technique to Facilitate Graft Passage.

PubMed

Cugat, Ramón; Alentorn-Geli, Eduard; Cuscó, Xavier; Navarro, Jordi; Steinbacher, Gilbert; Álvarez-Díaz, Pedro; Seijas, Roberto; Barastegui, David; García-Balletbó, Montse

2018-02-01

Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented. Once the BTB is harvested, the femoral bone block is divided into 2 equal-sized blocks providing an articulated structure while preserving the tendon component. This facilitates the passage of the BTB tendon once it is entered in the posterior tibia and the graft has to make a sharp turn to reach the femoral tunnel. This easy and effective technique tip may avoid graft damage during the sharp turn, while maintaining all the advantages of a BTB autograft (bone-to-bone healing, own tissue with fast incorporation, and strong fixation and stability).

Performance of a computer-based assessment of cognitive function measures in two cohorts of seniors

USDA-ARS?s Scientific Manuscript database

Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials, however its performance in these settings has not been systematically evaluated. The Seniors Health and Activity Research Program (SHARP) pilot trial (N=73) developed a computer-based tool f...

Prostate Dose Escalation by Innovative Inverse Planning-Driven IMRT

DTIC Science & Technology

2005-11-01

Galvin, J. M.; Low, D.; Palta , J. R.; Rosen, I.; Sharpe, M. B.; Xia, P.; Xiao, Y.; Xing, L.; Yu, C. X., Guidance document on delivery, treatment planning... Palta , J., Implementing IMRT in clinical practice: ajoint document of the American Society for Therapeutic Radiology and Oncology and the American

75 FR 65657 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-International SAE...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

..., pursuant to Section 6(a) of the National Cooperative Research and Production Act of 1993, 15 U.S.C. 4301 et...; Clinical Data, Inc., Newton, MA; and Merck Sharp & Dohme Corp., Rahway, NJ, has been added as parties to...

Contribution of anorexia to tissue wasting in cachexia.

PubMed

Molfino, Alessio; Laviano, Alessandro; Rossi Fanelli, Filippo

2010-12-01

Anorexia is a severe debilitating symptom characterizing the clinical course of several chronic diseases. It negatively impacts on patient outcome by contributing to weight loss, lean body mass catabolism and adipose tissue wasting. Although disease-associated anorexia may stand alone as a clinically relevant symptom, it is now considered as a component of the cachexia syndrome. The present review discusses experimental and clinical data indicating that the pathogenic mechanisms of anorexia may also suggest a neural control of tissue wasting in cachexia. Consistent data show that selective melanocortin receptor antagonism modulates food intake and reduces wasting in experimental models of chronic disease. Consequently, ghrelin administration, whose prophagic effects are related to melanocortin antagonism, has been tested both in animal studies and human trials, with promising effects, although restoration of lean body mass has been not achieved. More interest is driven by the use of small molecules selectively antagonising hypothalamic melanocortin receptors. The 'brain-muscle axis' coordinated by the hypothalamus seems to mediate the onset of not only anorexia but also tissue wasting in cachexia, by centrally influencing energy homeostasis and the balance between anabolism and catabolism.

Current biomedical waste management practices and cross-infection control procedures of dentists in India.

PubMed

Singh, Balendra Pratap; Khan, Suleman A; Agrawal, Neeraj; Siddharth, Ramashanker; Kumar, Lakshya

2012-06-01

To investigate the knowledge, attitudes and behaviour of dentists working in dental clinics and dental hospitals regarding biomedical waste management and cross-infection control. A national survey was conducted. Self-administered questionnaires were sent to 800 dentists across India. A total of 494 dentists responded, giving a response rate of 61.8%. Of these, 228 of 323 (70.6%) general dentists reported using boiling water as a sterilising medium and 339 (68.6%) dentists reported disposing of hazardous waste such as syringes, blades and ampoules in dustbins and emptying these into municipal corporation bins. Dentists should undergo continuing education programmes on biomedical waste management and infection control guidelines. Greater cooperation between dental clinics and hospitals and pollution control boards is needed to ensure the proper handling and disposal of biomedical waste. © 2012 FDI World Dental Federation.

Selective androgen receptor modulators for the prevention and treatment of muscle wasting associated with cancer.

PubMed

Dalton, James T; Taylor, Ryan P; Mohler, Michael L; Steiner, Mitchell S

2013-12-01

This review highlights selective androgen receptor modulators (SARMs) as emerging agents in late-stage clinical development for the prevention and treatment of muscle wasting associated with cancer. Muscle wasting, including a loss of skeletal muscle, is a cancer-related symptom that begins early in the progression of cancer and affects a patient's quality of life, ability to tolerate chemotherapy, and survival. SARMs increase muscle mass and improve physical function in healthy and diseased individuals, and potentially may provide a new therapy for muscle wasting and cancer cachexia. SARMs modulate the same anabolic pathways targeted with classical steroidal androgens, but within the dose range in which expected effects on muscle mass and function are seen androgenic side-effects on prostate, skin, and hair have not been observed. Unlike testosterone, SARMs are orally active, nonaromatizable, nonvirilizing, and tissue-selective anabolic agents. Recent clinical efficacy data for LGD-4033, MK-0773, MK-3984, and enobosarm (GTx-024, ostarine, and S-22) are reviewed. Enobosarm, a nonsteroidal SARM, is the most well characterized clinically, and has consistently demonstrated increases in lean body mass and better physical function across several populations along with a lower hazard ratio for survival in cancer patients. Completed in May 2013, results for the Phase III clinical trials entitled Prevention and treatment Of muscle Wasting in patiEnts with Cancer1 (POWER1) and POWER2 evaluating enobosarm for the prevention and treatment of muscle wasting in patients with nonsmall cell lung cancer will be available soon, and will potentially establish a SARM, enobosarm, as the first drug for the prevention and treatment of muscle wasting in cancer patients.

Comparison of CO2 laser and sharp dissection techniques for excision of elongated soft palates in brachycephalic dogs

NASA Astrophysics Data System (ADS)

Davidson, Ellen B.; Davis, Michael S.; Campbell, Gregory A.; Williamson, Katherine K.; Payton, Mark E.; Healey, Tiffany A.; Bartels, Kenneth E.

2001-05-01

Elongated soft palate is the most common respiratory disease in brachycephalics. During inspiration, an elongated palate obstructs the glottal opening, causing respiratory distress. Left untreated, elongated soft palate may be life threatening. We conducted a randomized, prospective experimental trial in 20 brachycephalic dogs with redundant or elongated soft palates to compare palate resection using sharp dissection and a CO2 laser. Dogs were assigned standardized clinical scores at 0, 2, 8, 16, and 24 hours postoperatively. Tracheostomy performed at surgery significantly increased clinical scores at 3 of the 5 time measurements, but scores became equal to those without tracheostomies after tracheostomy tube removal. Clinical scores between groups were comparable at 0 and 8 hours. Biopsies of the soft palate were obtained at days 0, 3, 7, and 14. The CO2 laser initially incited greater epithelial separation, carbonization, and necrosis, but by day 3, histologic scores were similar. Inflammation peaked at day 3 in all groups; by day 14 these lesions had resolved. Mean surgical time for the laser was significantly shorter. Both techniques resulted in minimal intraoperative hemorrhage and rapid resolution of inflammation. However, many brachycephalic patients have clinical signs and secondary airway changes that predispose them to postoperative complications; the CO2 laser technique does not obviate the need for intensive care management for 24-28 hours postoperatively. Tracheostomy is not warranted in soft palate resection.

Preliminary Study of Radioactive Waste Package Made of High-Strength and Ultra Low-Permeability Concrete for Geological Disposal of TRU Wastes

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

Matsuo, T.; Kawasaki, T.; Sakamoto, H.

2003-02-27

We have been developing a radioactive waste package made of high-strength and ultra low-permeability concrete (HSULPC) for geological disposal of TRU wastes, which is expected to be much more impervious to water than conventional concrete. In this study, basic data for the HSULPC regarding its the impervious character and the thermodynamics during cement hydration were obtained through water permeability measurements using cold isostatic pressing (CIP) and adiabatic concrete hydration experiments, respectively. Then, a prediction tool to find concrete package construction conditions to avoid thermal cracking was developed, which could deal with coupled calculations of cement hydration, heat transfer, stress, andmore » cracking. The developed tool was applied to HSULPC hydration on a small-scale cylindrical model to examine whether there was any effect on cracking which depended on the ratio of concrete cylinder thickness to its inner diameter. The results were compared to experiments. For concrete with a compressive strength of 200MPa, the water permeability coefficient was 4 x 10{sup 19} m/s. Dependences of activation energy and frequency factor on degree of cement hydration had a sharp peaking due to the nucleation rate-determining step, and a gradual increase region due to the diffusion rate-determining step. From analyses of the small-scale cylindrical model, dependences of the maximum principal stress on the radius were obtained. When the ratio of the concrete thickness to the heater diameter was around 1, the risk of cracking was predicted to be minimized. These numerical predictions from the developed tool were verified by experiments.« less

Nutrition and sickle cell disease.

PubMed

Reid, Marvin

2013-03-01

A common observation in sickle cell disease is growth retardation, in particular, wasting. Wasting is associated with increased hospitalization and possibly poorer clinical outcomes. Therefore understanding the mechanism of wasting is crucial and reducing the degree of wasting by improving the nutritional status, holds the potential for modifying the course of the disease. Copyright © 2012 Académie des sciences. Published by Elsevier SAS. All rights reserved.

Comparison of the effect of the carbon dioxide laser and the bipolar coagulator on the cat brain

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

Cozzens, J.W.; Cerullo, L.J.

The carbon dioxide laser has recently received clinical acceptance in neurosurgical practice. There are, however, few studies reported in the neurosurgical literature, either clinical or experimental, concerning its safety or efficacy on a physiological level by comparison to a more conventional tool. This study is not a description of a surgical technique, but is rather a basic physiological comparison of two surgical instruments. In this study, 11 cats were pretreated with the protein-bound dye, Evans blue. A corticotomy was performed in one hemisphere with the carbon dioxide laser and in the other with a microbipolar coagulator and a sharp blade.more » The subsequent extravasation of dye was presumed to be proportional to the amount of blood-brain barrier disruption associated with each lesion. When effective power settings for the two devices were compared, the laser lesions had significantly less extravasation of blue dye. This indicated that there was less damage to the blood-brain barrier surrounding laser corticotomy than surrounding conventional bipolar coagulation and sharp dissection at comparable power settings for each modality.« less

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

Arenholt-Bindslev, D.

Increasing knowledge about the risk of toxic effects caused by anthropogenic mercury accumulation in ecosystems has resulted in a growing pressure for reduction of the discharge of mercury waste. Consequently, the mercury waste problems of dental clinics have been given increased attention, and restrictions on handling and discharge of contaminated waste have been established in several countries. Major amalgam particles from trituration surplus of those produced during the carving and burnishing of new amalgam restorations are generally collected in coarse filters and sold for refinement. Minor amalgam particles released by production of new fillings or by removal of old restorationsmore » partly sediment in tubes and drains. The remaining particles are carried with the waste water stream to the local purifying plant. In Scandinavia, the industrial discharge of mercury-contaminated waste water has been reduced to a minimum. According to recent investigations, dental clinics appear to be responsible for the major amount of mercury collected in the sludge generated in purifying plants. If threshold values for heavy metal content, including mercury, are exceeded, the sludge is not allowed to be recycled as fertilizer. Installation of an approved amalgam-separating apparatus in dental clinics is now mandatory in several countries--for example, Switzerland, Germany, Sweden, and Denmark. Approval of amalgam separators is based on national testing programs, including clinical or laboratory tests demanding 95-99% separating efficiency. 18 refs.« less

Towards machine learned quality control: A benchmark for sharpness quantification in digital pathology.

PubMed

Campanella, Gabriele; Rajanna, Arjun R; Corsale, Lorraine; Schüffler, Peter J; Yagi, Yukako; Fuchs, Thomas J

2018-04-01

Pathology is on the verge of a profound change from an analog and qualitative to a digital and quantitative discipline. This change is mostly driven by the high-throughput scanning of microscope slides in modern pathology departments, reaching tens of thousands of digital slides per month. The resulting vast digital archives form the basis of clinical use in digital pathology and allow large scale machine learning in computational pathology. One of the most crucial bottlenecks of high-throughput scanning is quality control (QC). Currently, digital slides are screened manually to detected out-of-focus regions, to compensate for the limitations of scanner software. We present a solution to this problem by introducing a benchmark dataset for blur detection, an in-depth comparison of state-of-the art sharpness descriptors and their prediction performance within a random forest framework. Furthermore, we show that convolution neural networks, like residual networks, can be used to train blur detectors from scratch. We thoroughly evaluate the accuracy of feature based and deep learning based approaches for sharpness classification (99.74% accuracy) and regression (MSE 0.004) and additionally compare them to domain experts in a comprehensive human perception study. Our pipeline outputs spacial heatmaps enabling to quantify and localize blurred areas on a slide. Finally, we tested the proposed framework in the clinical setting and demonstrate superior performance over the state-of-the-art QC pipeline comprising commercial software and human expert inspection by reducing the error rate from 17% to 4.7%. Copyright © 2017. Published by Elsevier Ltd.

Practitioner involvement in clinical evaluation.

PubMed

Penka, C E; Kirk, S A

1991-11-01

Contrary to popular belief, social workers are evaluating their practice, but what they do falls short of the use of quantitative procedures that researchers have promoted. Data obtained from a survey of social workers drawn from the National Association of Social Workers national membership list suggest that the gap between practitioners and clinical researchers may stem in part from different mindsets as well as from actual differences in the commitment to the importance of clinical evaluation. Moreover, in the minds of practitioners there appears to be a sharp distinction between formal single-subject design studies and the general evaluative tasks in which they routinely engage.

Statistical CT noise reduction with multiscale decomposition and penalized weighted least squares in the projection domain

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

Tang Shaojie; Tang Xiangyang; School of Automation, Xi'an University of Posts and Telecommunications, Xi'an, Shaanxi 710121

2012-09-15

Purposes: The suppression of noise in x-ray computed tomography (CT) imaging is of clinical relevance for diagnostic image quality and the potential for radiation dose saving. Toward this purpose, statistical noise reduction methods in either the image or projection domain have been proposed, which employ a multiscale decomposition to enhance the performance of noise suppression while maintaining image sharpness. Recognizing the advantages of noise suppression in the projection domain, the authors propose a projection domain multiscale penalized weighted least squares (PWLS) method, in which the angular sampling rate is explicitly taken into consideration to account for the possible variation ofmore » interview sampling rate in advanced clinical or preclinical applications. Methods: The projection domain multiscale PWLS method is derived by converting an isotropic diffusion partial differential equation in the image domain into the projection domain, wherein a multiscale decomposition is carried out. With adoption of the Markov random field or soft thresholding objective function, the projection domain multiscale PWLS method deals with noise at each scale. To compensate for the degradation in image sharpness caused by the projection domain multiscale PWLS method, an edge enhancement is carried out following the noise reduction. The performance of the proposed method is experimentally evaluated and verified using the projection data simulated by computer and acquired by a CT scanner. Results: The preliminary results show that the proposed projection domain multiscale PWLS method outperforms the projection domain single-scale PWLS method and the image domain multiscale anisotropic diffusion method in noise reduction. In addition, the proposed method can preserve image sharpness very well while the occurrence of 'salt-and-pepper' noise and mosaic artifacts can be avoided. Conclusions: Since the interview sampling rate is taken into account in the projection domain multiscale decomposition, the proposed method is anticipated to be useful in advanced clinical and preclinical applications where the interview sampling rate varies.« less

Analysis of sharpness increase by image noise

NASA Astrophysics Data System (ADS)

Kurihara, Takehito; Aoki, Naokazu; Kobayashi, Hiroyuki

2009-02-01

Motivated by the reported increase in sharpness by image noise, we investigated how noise affects sharpness perception. We first used natural images of tree bark with different amounts of noise to see whether noise enhances sharpness. Although the result showed sharpness decreased as noise amount increased, some observers seemed to perceive more sharpness with increasing noise, while the others did not. We next used 1D and 2D uni-frequency patterns as stimuli in an attempt to reduce such variability in the judgment. The result showed, for higher frequency stimuli, sharpness decreased as the noise amount increased, while sharpness of the lower frequency stimuli increased at a certain noise level. From this result, we thought image noise might reduce sharpness at edges, but be able to improve sharpness of lower frequency component or texture in image. To prove this prediction, we experimented again with the natural image used in the first experiment. Stimuli were made by applying noise separately to edge or to texture part of the image. The result showed noise, when added to edge region, only decreased sharpness, whereas when added to texture, could improve sharpness. We think it is the interaction between noise and texture that sharpens image.

SEM Model Medical Solid Waste Hospital Management In Medan City

NASA Astrophysics Data System (ADS)

Simarmata, Verawaty; Pandia, Setiaty; Mawengkang, Herman

2018-01-01

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

Safe disposal of cytotoxic waste: an evaluation of an air-tight system.

PubMed

Craig, Gemma; Wadey, Charlotte

2017-09-07

A 3-month evaluation was undertaken at the Kent Oncology Centre's chemotherapy day unit (CDU) to trial an air-tight sealing disposal system for cytotoxic waste management. Research has identified the potential risk to staff who handle waste products that are hazardous to health. Staff safety was a driving force behind a trial of a new way of working. This article provides an overview of the evaluation of the Pactosafe system in one clinical area, examining reviews by oncology healthcare workers, the practicalities in the clinical setting, training, cost effectiveness and the environmental benefits.

Physical space and its impact on waste management in the neonatal care setting

PubMed Central

Manzi, Sean

2014-01-01

This paper reports an investigation intended to obtain some understanding of how the working environment might influence the practice and knowledge of those involved in the management of healthcare waste. The National Health Service (NHS) has a continuing waste problem, and the way it manages waste harms the environment and consumes resources. It has been estimated that the carbon footprint of the NHS in England is approximately 20 million tons of CO2e. It has been suggested that better waste segregation could lead to more effective recycling, saving up to 42,000 tonnes of CO2. This qualitative study employed non-participant observation and semi-structured interviews. The interviews were carried out with the key informants within the participating neonatal intensive care unit. Findings from this study indicate that space and the physical arrangement of the environment are significant and influential factors in clinical practice. Where the clinical environment is not supportive, poor infection control and waste management practice is likely to occur. However, proximity of staff caused by a lack of physical space might facilitate situated learning and a collective development of knowledge in practice. The implementation of sustainable waste management practices would be more likely to succeed in an environment that facilitates correct waste segregation. PMID:28989373

Psychometric properties of the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP).

PubMed

Farmer, Cristan A; Aman, Michael G

2010-01-01

Although often lacking "malice", aggression is fairly common in children with intellectual or developmental disability (I/DD). Despite this, there are no scales available that are appropriate for an in-depth analysis of aggressive behavior in this population. Such scales are needed for the study of aggressive behavior, which is a common target symptom in clinical trials. We assessed the reliability and validity of the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP), a new aggression scale created for children with I/DD. Data are presented from a survey of 365 children with I/DD aged 3-21 years. Interrater reliability was very high for the Problem Scale, which characterizes type of aggression. Reliability was lower but largely acceptable for the Provocation Scale, which assesses motivation. Validity of the Problem Scale was supported by expected differences in children with autism, Down syndrome, comorbid disruptive behavior disorders (DBDs) and ADHD. The Provocation Scale, which categorizes behavior as proactive or reactive, showed expected differences in children with DBD, but was less effective in those with ADHD. The C-SHARP appears to have fundamentally sound psychometric characteristics, although more research is needed.

THE FINAL DEMISE OF EAST TENNESSEE TECHNOLOGY PARK BUILDING K-33 Health Physics Society Annual Meeting West Palm Beach, Florida June 27, 2011

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

David A. King

2011-06-27

Building K-33 was constructed in 1954 as the final section of the five-stage uranium enrichment cascade at the Oak Ridge Gaseous Diffusion Plant (ORGDP). The two original building (K-25 and K-27) were used to produce weapons grade highly enriched uranium (HEU). Building K-29, K-31, and K-33 were added to produce low enriched uranium (LEU) for nuclear power plant fuel. During ORGDP operations K-33 produced a peak enrichment of 2.5%. Thousands of tons of reactor tails fed into gaseous diffusion plants in the 1950s and early 1960s introducing some fission products and transuranics. Building K-33 was a two-story, 25-meters (82-feet) tallmore » structure with approximately 30 hectare (64 acres) of floor space. The Operations (first) Floor contained offices, change houses, feed vaporization rooms, and auxiliary equipment to support enrichment operations. The Cell (second) Floor contained the enrichment process equipment and was divided into eight process units (designated K-902-1 through K-902-8). Each unit contained ten cells, and each cell contained eight process stages (diffusers) for a total of 640 enrichment stages. 1985: LEU buildings were taken off-line after the anticipated demand for uranium enrichment failed to materialize. 1987: LEU buildings were placed in permanent shutdown. Process equipment were maintained in a shutdown state. 1997: DOE signed an Action Memorandum for equipment removal and decontamination of Buildings K-29, K-31, K-33; BNFL awarded contract to reindustrialize the buildings under the Three Buildings D&D and Recycle Project. 2002: Equipment removal complete and effort shifts to vacuuming, chemical cleaning, scabbling, etc. 2005: Decontamination efforts in K-33 cease. Building left with significant {sup 99}Tc contamination on metal structures and PCB contamination in concrete. Uranium, transuranics, and fission products also present on building shell. 2009: DOE targets Building K-33 for demolition. 2010: ORAU contracted to characterize Building K-33 for final disposition at the Environmental Management Waste Management Facility (EMWMF) in Oak Ridge. ORAU collected 439 samples from May and June. LATA Sharp started removing transite panels in September. 2011: LATA Sharp began demolition in January and expects the last waste shipment to EMWMF in September. Approximately 237,000 m{sup 3} (310,000 yd{sup 3}, bulked) of waste taken to EMWMF in 23,000 truckloads expected by project completion.« less

Strengthening the Regression Discontinuity Design Using Additional Design Elements: A Within-Study Comparison

ERIC Educational Resources Information Center

Wing, Coady; Cook, Thomas D.

2013-01-01

The sharp regression discontinuity design (RDD) has three key weaknesses compared to the randomized clinical trial (RCT). It has lower statistical power, it is more dependent on statistical modeling assumptions, and its treatment effect estimates are limited to the narrow subpopulation of cases immediately around the cutoff, which is rarely of…

[A man with pain in his upper jaw].

PubMed

Jaspers, Gijs; van Gool, Lex

2011-01-01

A 66-year-old man came to the hospital with pain in the frontal left side of his upper jaw. Pressure along the left nostril could evoke a sharp pain, which radiated upwards. The patient had already consulted several specialists. After extended clinical and radiological investigation a mesiodens was found that gave pressure on the nasopalatine nerve.

ADHD Delays, Rather Than Alters, Brain Development. Science Briefs

ERIC Educational Resources Information Center

National Scientific Council on the Developing Child, 2008

2008-01-01

"Science Briefs" summarize the findings and implications of a recent study in basic science or clinical research. This brief reports on the study "Attention-deficit/Hyperactivity Disorder is Characterized by a Delay in Cortical Maturation" (P. Shaw; K. Eckstrand; W. Sharp; J. Blumenthal; J. P. Lerch; D. Greenstein; L. Clasen; A. Evans; J. Giedd;…

Real-time measurement and control of waste anesthetic gases during veterinary surgeries

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

Burkhart, J.E.; Stobbe, T.J.

1990-12-01

Veterinary clinics are typically small businesses without access to sophisticated occupational safety and health programs that may exist for larger firms or hospitals. Exposures to waste anesthetic gases have been linked to a myriad of adverse health-related conditions. Excessive exposures to anesthetic agents are possible because many of the clinics use portable gas delivery carts that are not designed to capture waste gases. While scavenging systems are available to remove waste anesthetic gases, the cost may be prohibitive for smaller clinics and the effectiveness of these systems has not been fully established in veterinary clinics. The National Institute for Occupationalmore » Safety and Health (NIOSH) recommends limiting exposures to nitrous oxide (N2O) to a time-weighted average (TWA) concentration of 25 ppm and halogenated agents to 2 ppm. The NIOSH TWA is based on the weight of the agent collected from a 45-L air sample by charcoal adsorption over a sampling period not to exceed 1 hr. The NIOSH criteria state that, in most situations, control of N2O to the TWA as defined will result in levels of approximately 0.5 ppm of the halogenated agent. At present, no Occupational Safety and Health Administration (OSHA) permissible exposure level (PEL) exists for exposure to anesthetic agents; nor do specific recommendations exist for veterinary scavenging systems. Waste anesthetic gas exposures were determined using a modified MIRAN 1A at five veterinary clinics operating within the Morgantown, West Virginia, vicinity. For unscavenged systems of methoxyflurane and halothane, 1-hr time-weighted average exposures ranged from 0.5 to 45.5 ppm and 0.2 to 105.4 ppm, respectively.« less

Optimizing supercritical carbon dioxide in the inactivation of bacteria in clinical solid waste by using response surface methodology

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

Hossain, Md. Sohrab; Nik Ab Rahman, Nik Norulaini; Balakrishnan, Venugopal

2015-04-15

Highlights: • Supercritical carbon dioxide sterilization of clinical solid waste. • Inactivation of bacteria in clinical solid waste using supercritical carbon dioxide. • Reduction of the hazardous exposure of clinical solid waste. • Optimization of the supercritical carbon dioxide experimental conditions. - Abstract: Clinical solid waste (CSW) poses a challenge to health care facilities because of the presence of pathogenic microorganisms, leading to concerns in the effective sterilization of the CSW for safe handling and elimination of infectious disease transmission. In the present study, supercritical carbon dioxide (SC-CO{sub 2}) was applied to inactivate gram-positive Staphylococcus aureus, Enterococcus faecalis, Bacillus subtilis,more » and gram-negative Escherichia coli in CSW. The effects of SC-CO{sub 2} sterilization parameters such as pressure, temperature, and time were investigated and optimized by response surface methodology (RSM). Results showed that the data were adequately fitted into the second-order polynomial model. The linear quadratic terms and interaction between pressure and temperature had significant effects on the inactivation of S. aureus, E. coli, E. faecalis, and B. subtilis in CSW. Optimum conditions for the complete inactivation of bacteria within the experimental range of the studied variables were 20 MPa, 60 °C, and 60 min. The SC-CO{sub 2}-treated bacterial cells, observed under a scanning electron microscope, showed morphological changes, including cell breakage and dislodged cell walls, which could have caused the inactivation. This espouses the inference that SC-CO{sub 2} exerts strong inactivating effects on the bacteria present in CSW, and has the potential to be used in CSW management for the safe handling and recycling-reuse of CSW materials.« less

The Dental Solid Waste Management in Different Categories of Dental Laboratories in Abha City, Saudi Arabia

PubMed Central

Haralur, Satheesh B.; Al-Qahtani, Ali S.; Al-Qarni, Marie M.; Al-Homrany, Rami M.; Aboalkhair, Ayyob E.; Madalakote, Sujatha S.

2015-01-01

Aim: To study the awareness, attitude, practice and facilities among the different categories of dental laboratories in Abha city. Materials and Methods: A total of 80 dental technicians were surveyed in the study. The dental laboratories included in the study were teaching institute (Group I), Government Hospital (Group II), Private Dental Clinic (Group III) and Independent laboratory (Group IV). The pre-tested anonymous questionnaire was used to understand knowledge, attitude, facilities, practice and orientation regarding biomedical waste management. Results: The knowledge of biomedical waste categories, colour coding and segregation was better among Group I (55-65%) and Group II (65-75%). The lowest standard of waste disposal was practiced at Group IV (15-20%) and Group III (25-35%). The availability of disposal facilities was poor at Group IV. The continuous education on biomedical waste management lacked in all the Groups. Conclusion: The significant improvement in disposal facilities was required at Group III and Group IV laboratories. All dental technicians were in need of regular training of biomedical waste management. Clinical Significance: The dental laboratories are an integral part of dental practice. The dental laboratories are actively involved in the generation, handling and disposal of biomedical waste. Hence, it is important to assess the biomedical waste management knowledge, attitude, facilities and practice among different categories of dental laboratories. PMID:26962373

Needlestick and Sharps Injuries in Dermatologic Surgery: A Review of Preventative Techniques and Post-exposure Protocols

PubMed Central

Monroe, Holly; Orengo, Ida; Rosen, Theodore

2016-01-01

Background: Needlestickand sharps injuries are the leading causes of morbidity in the dermatologicfield. Among medical specialties, surgeons and dermatologists have the highest rates of needlestickand sharps injuries.The high rates of needlestickand sharps injuries in dermatology not only apply to physicians, but also to nurses, physician assistants, and technicians in the demnatologic field. Needlestickand sharps injuries are of great concern due to the monetary, opportunity, social, and emotional costs associated with their occurrence. Objective: A review of preventative techniques and post-exposure protocols for the majortypes of sharps injuries encountered in dermatologic practice. Design: The terms “needle-stick injuryT’sharps injuryTdermatologic surgery? “post-exposure prophylaxis,”and “health-care associated injury” were used in combinations to search the PubMed database. Relevant studies were reviewed for validity and included. Results The authors discuss the major types of sharps injuries that occur in the dermatologic surgery setting and summarize preventative techniques with respect to each type of sharps injury.The authors also summarize and discuss relevant post-exposure protocols in the event of a sharps injury. Conclusion: The adoption of the discussed methods, techniques, practices, and attire can result in the elimination of the vast majority of dermatologic sharps injuries. PMID:27847548

Study Design and Rationale for the Phase 3 Clinical Development Program of Enobosarm, a Selective Androgen Receptor Modulator, for the Prevention and Treatment of Muscle Wasting in Cancer Patients (POWER Trials).

PubMed

Crawford, Jeffrey; Prado, Carla M M; Johnston, Mary Ann; Gralla, Richard J; Taylor, Ryan P; Hancock, Michael L; Dalton, James T

2016-06-01

Muscle wasting in cancer is a common and often occult condition that can occur prior to overt signs of weight loss and before a clinical diagnosis of cachexia can be made. Muscle wasting in cancer is an important and independent predictor of progressive functional impairment, decreased quality of life, and increased mortality. Although several therapeutic agents are currently in development for the treatment of muscle wasting or cachexia in cancer, the majority of these agents do not directly inhibit muscle loss. Selective androgen receptor modulators (SARMs) have the potential to increase lean body mass (LBM) and hence muscle mass, without the untoward side effects seen with traditional anabolic agents. Enobosarm, a nonsteroidal SARM, is an agent in clinical development for prevention and treatment of muscle wasting in patients with cancer (POWER 1 and 2 trials). The POWER trials are two identically designed randomized, double-blind, placebo-controlled, multicenter, and multinational phase 3 trials to assess the efficacy of enobosarm for the prevention and treatment of muscle wasting in subjects initiating first-line chemotherapy for non-small-cell lung cancer (NSCLC). To assess enobosarm's effect on both prevention and treatment of muscle wasting, no minimum weight loss is required. These pivotal trials have pioneered the methodological and regulatory fields exploring a therapeutic agent for cancer-associated muscle wasting, a process hereby described. In each POWER trial, subjects will receive placebo (n = 150) or enobosarm 3 mg (n = 150) orally once daily for 147 days. Physical function, assessed as stair climb power (SCP), and LBM, assessed by dual-energy X-ray absorptiometry (DXA), are the co-primary efficacy endpoints in both trials assessed at day 84. Based on extensive feedback from the US Food and Drug Administration (FDA), the co-primary endpoints will be analyzed as a responder analysis. To be considered a physical function responder, a subject must have ≥10 % improvement in physical function compared to baseline. To meet the definition of response on LBM, a subject must have demonstrated no loss of LBM compared with baseline. Secondary endpoints include durability of response assessed at day 147 in those responding at day 84. A combined overall survival analysis for both studies is considered a key secondary safety endpoint. The POWER trials design was established with extensive clinical input and collaboration with regulatory agencies. The efficacy endpoints are a result of this feedback and discussion of the threshold for clinical benefit in patients at risk for muscle wasting. Full results from these studies will soon be published and will further guide the development of future anabolic trials. Clinical Trial ID: NCT01355484. https://clinicaltrials.gov/ct2/show/NCT01355484 , NCT01355497. https://clinicaltrials.gov/ct2/show/NCT01355497?term=g300505&rank=1 .

WHO collaboration in hazardous waste management in the Western Pacific Region

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

Ogawa, Hisashi

Since April 1989 when the World Health Organization`s (WHO`s) activities in hazardous waste management in the Western Pacific Region were presented at the Pacific Basin Conference in Singapore, WHO and its Member States have carried out a number of collaborative activities in hazardous waste management. These activities focused on three main areas: national capacity building in the management of toxic chemicals and hazardous wastes in rapidly industrializing countries, management of clinical or medical waste, and hazardous waste management in Pacific Island countries. This paper summarizes these collaborative activities, identifies the main problems and issues encountered, and discusses future prospects ofmore » WHO collaboration with its Member States in the area of hazardous waste management. 1 fig., 1 tab.« less

Workplace safety and health for the veterinary health care team.

PubMed

Gibbins, John D; MacMahon, Kathleen

2015-03-01

Veterinary clinic employers have a legal and ethical responsibility to provide a safe and healthy workplace. Clinic members are responsible for consistently using safe practices and procedures set up by their employer. Development and implementation of a customized comprehensive workplace safety and health program is emphasized, including an infection control plan. Occupational safety and health regulations are reviewed. The hazards of sharps, animal bites and scratches, and drugs are discussed. Strategies to prevent or minimize adverse health effects and resources for training and education are provided. Published by Elsevier Inc.

Surficial weathering of iron sulfide mine tailings under semi-arid climate.

PubMed

Hayes, Sarah M; Root, Robert A; Perdrial, Nicolas; Maier, Raina; Chorover, Jon

2014-09-15

Mine wastes introduce anthropogenic weathering profiles to the critical zone that often remain unvegetated for decades after mining cessation. As such, they are vulnerable to wind and water dispersion of particulate matter to adjacent ecosystems and residential communities. In sulfide-rich ore tailings, propagation to depth of the oxidative weathering front controls the depth-variation in speciation of major and trace elements. Despite the prevalence of surficial mine waste deposits in arid regions of the globe, few prior studies have been conducted to resolve the near-surface profile of sulfide ore tailings weathered under semi-arid climate. We investigated relations between gossan oxidative reaction-front propagation and the molecular speciation of iron and sulfur in tailings subjected to weathering under semi-arid climate at an EPA Superfund Site in semi-arid central Arizona (USA). Here we report a multi-method data set combining wet chemical and synchrotron-based X-ray diffraction (XRD) and X-ray absorption near-edge spectroscopy (XANES) methods to resolve the tight coupling of iron (Fe) and sulfur (S) geochemical changes in the top 2 m of tailings. Despite nearly invariant Fe and S concentration with depth (130-140 and 100-120 g kg -1 , respectively), a sharp redox gradient and distinct morphological change was observed within the top 0.5 m, associated with a progressive oxidative alteration of ferrous sulfides to (oxyhydr)oxides and (hydroxy)sulfates. Transformation is nearly complete in surficial samples. Trends in molecular-scale alteration were co-located with a decrease in pH from 7.3 to 2.3, and shifts in Fe and S lability as measured via chemical extraction. Initial weathering products, ferrihydrite and gypsum, transform to schwertmannite, then jarosite-group minerals with an accompanying decrease in pH. Interestingly, thermodynamically stable phases such as goethite and hematite were not detected in any samples, but ferrihydrite was observed even in the lowest pH samples, indicating its metastable persistence in these semiarid tailings. The resulting sharp geochemical speciation gradients in close proximity to the tailings surface have important implications for plant colonization, as well as mobility and bioavailability of co-associated toxic metal(loid)s.

Surficial weathering of iron sulfide mine tailings under semi-arid climate

PubMed Central

Hayes, Sarah M.; Root, Robert A.; Perdrial, Nicolas; Maier, Raina; Chorover, Jon

2014-01-01

Mine wastes introduce anthropogenic weathering profiles to the critical zone that often remain unvegetated for decades after mining cessation. As such, they are vulnerable to wind and water dispersion of particulate matter to adjacent ecosystems and residential communities. In sulfide-rich ore tailings, propagation to depth of the oxidative weathering front controls the depth-variation in speciation of major and trace elements. Despite the prevalence of surficial mine waste deposits in arid regions of the globe, few prior studies have been conducted to resolve the near-surface profile of sulfide ore tailings weathered under semi-arid climate. We investigated relations between gossan oxidative reaction-front propagation and the molecular speciation of iron and sulfur in tailings subjected to weathering under semi-arid climate at an EPA Superfund Site in semi-arid central Arizona (USA). Here we report a multi-method data set combining wet chemical and synchrotron-based X-ray diffraction (XRD) and X-ray absorption near-edge spectroscopy (XANES) methods to resolve the tight coupling of iron (Fe) and sulfur (S) geochemical changes in the top 2 m of tailings. Despite nearly invariant Fe and S concentration with depth (130–140 and 100–120 g kg−1, respectively), a sharp redox gradient and distinct morphological change was observed within the top 0.5 m, associated with a progressive oxidative alteration of ferrous sulfides to (oxyhydr)oxides and (hydroxy)sulfates. Transformation is nearly complete in surficial samples. Trends in molecular-scale alteration were co-located with a decrease in pH from 7.3 to 2.3, and shifts in Fe and S lability as measured via chemical extraction. Initial weathering products, ferrihydrite and gypsum, transform to schwertmannite, then jarosite-group minerals with an accompanying decrease in pH. Interestingly, thermodynamically stable phases such as goethite and hematite were not detected in any samples, but ferrihydrite was observed even in the lowest pH samples, indicating its metastable persistence in these semiarid tailings. The resulting sharp geochemical speciation gradients in close proximity to the tailings surface have important implications for plant colonization, as well as mobility and bioavailability of co-associated toxic metal(loid)s. PMID:25197102

Surficial weathering of iron sulfide mine tailings under semi-arid climate

NASA Astrophysics Data System (ADS)

Hayes, Sarah M.; Root, Robert A.; Perdrial, Nicolas; Maier, Raina M.; Chorover, Jon

2014-09-01

Mine wastes introduce anthropogenic weathering profiles to the critical zone that often remain unvegetated for decades after mining cessation. As such, they are vulnerable to wind and water dispersion of particulate matter to adjacent ecosystems and residential communities. In sulfide-rich ore tailings, propagation to depth of the oxidative weathering front controls the depth-variation in speciation of major and trace elements. Despite the prevalence of surficial mine waste deposits in arid regions of the globe, few prior studies have been conducted to resolve the near-surface profile of sulfide ore tailings weathered under semi-arid climate. We investigated relations between gossan oxidative reaction-front propagation and the molecular speciation of iron and sulfur in tailings subjected to weathering in a semi-arid climate at an EPA Superfund Site in central Arizona (USA). Here we report a multi-method data set combining wet chemical and synchrotron-based X-ray diffraction (XRD) and X-ray absorption near-edge spectroscopy (XANES) methods to resolve the tight coupling of iron (Fe) and sulfur (S) geochemical changes in the top 2 m of tailings. Despite nearly invariant Fe and S concentration with depth (130-140 and 100-120 g kg-1, respectively), a sharp redox gradient and distinct morphological change was observed within the top 0.5 m, associated with a progressive oxidative alteration of ferrous sulfides to (oxyhydr)oxides and (hydroxy)sulfates. Transformation is nearly complete in surficial samples. Trends in molecular-scale alteration were co-located with a decrease in pH from 7.3 to 2.3, and shifts in Fe and S lability as measured via chemical extraction. Initial weathering products, ferrihydrite and gypsum, transform to schwertmannite, then jarosite-group minerals with an accompanying decrease in pH. Interestingly, thermodynamically stable phases such as goethite and hematite were not detected in any samples, but ferrihydrite was observed even in samples with the lowest pH, indicating its metastable persistence in these semiarid tailings. The resulting sharp geochemical speciation gradients in close proximity to the tailings surface have important implications for plant colonization, as well as mobility and bioavailability of co-associated toxic metal(loid)s.

Evolution of a Journal: Outing Some Ghosts from the Closet

ERIC Educational Resources Information Center

McDermott, John F.

2004-01-01

In this article, the author seeks to review the history of The Journal of The American Academy of Child and Adolescent Psychiatry, it's many changes and struggles. Some would maintain that in its early years, the JAACAP was filled with clinically useful case vignettes. But then, their story goes, it took a sharp turn to the left, and now is packed…

Waste-to-Energy Systems

DTIC Science & Technology

2009-04-01

at hospitals, at schools,” or wherever there are people creating masses of trash.5 Pyrolytic Gasification Pyrolytic gasification is not a new...prevalent with both. Gasification is . . . the chemical reaction and molecular breakdown or degradation of materials. The first pyrolytic gasification...dealing with about 2 tons of mixed solid waste per day, will destroy wood, paper card, food, plastics, and sanitary, clinical, and oil waste and

Improved low-level radioactive waste management practices for hospitals and research institutions

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

Not Available

1983-07-01

This report provides a general overview and a compendium of source material on low-level radioactive waste management practices in the institutional sector. Institutional sector refers to hospitals, universities, clinics, and research facilities that use radioactive materials in scientific research and the practice of medicine, and the manufacturers of radiopharmaceuticals and radiography devices. This report provides information on effective waste management practices for institutional waste to state policymakers, regulatory agency officials, and waste generators. It is not intended to be a handbook for actual waste management, but rather a sourcebook of general information, as well as a survey of the moremore » detailed analysis.« less

Mechanism and novel therapeutic approaches to wasting in chronic disease.

PubMed

Ebner, Nicole; Springer, Jochen; Kalantar-Zadeh, Kamyar; Lainscak, Mitja; Doehner, Wolfram; Anker, Stefan D; von Haehling, Stephan

2013-07-01

Cachexia is a multifactorial syndrome defined by continuous loss of skeletal muscle mass - with or without loss of fat mass - which cannot be fully reversed by conventional nutritional support and which may lead to progressive functional impairment and increased death risk. Its pathophysiology is characterized by negative protein and energy balance driven by a variable combination of reduced food intake and abnormal metabolism. Muscle wasting is encountered in virtually all chronic disease states in particular during advanced stages of the respective illness. Several pre-clinical and clinical studies are ongoing to ameliorate this clinical problem. The mechanisms of muscle wasting and cachexia in chronic diseases such as cancer, chronic heart failure, chronic obstructive pulmonary disease and chronic kidney disease are described. We discuss therapeutic targets and such potential modulators as appetite stimulants, selective androgen receptor modulators, amino acids and naturally occurring peptide hormones. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Nursing students' attitudes towards sustainability and health care.

PubMed

Richardson, Janet; Grose, Jane; O'Connor, Anita; Bradbury, Martyn; Kelsey, Janet; Doman, Maggie

2015-06-17

Aim To evaluate attitudes towards embedding sustainability and climate change in nursing curricula among nursing students, some of whom had participated in a sustainability and health skills session, and determine whether the session could improve knowledge of sustainability. Methods Three months after the sustainability session, students who had participated along with a sample of students who had not, completed a Sustainability Attitudes in Nursing Survey questionnaire. This investigated attitudes towards climate change and sustainability in nursing curricula and the costs of clinical and domestic waste disposal. Results Nursing students were positive about sustainability and climate change and its inclusion in the curriculum, irrespective of their participation in the sustainability scenario session. Participants in the sustainability session were more likely to identify correctly the cost of clinical waste disposal in the NHS. Conclusion The sustainability and health skills session has the potential to improve nursing students' knowledge of the cost of clinical waste disposal.

Grand Rounds: An Outbreak of Toxic Hepatitis among Industrial Waste Disposal Workers

PubMed Central

Cheong, Hae-Kwan; Kim, Eun A; Choi, Jung-Keun; Choi, Sung-Bong; Suh, Jeong-Ill; Choi, Dae Seob; Kim, Jung Ran

2007-01-01

Context Industrial waste (which is composed of various toxic chemicals), changes to the disposal process, and addition of chemicals should all be monitored and controlled carefully in the industrial waste industry to reduce the health hazard to workers. Case presentation Five workers in an industrial waste plant developed acute toxic hepatitis, one of whom died after 3 months due to fulminant hepatitis. In the plant, we detected several chemicals with hepatotoxic potential, including pyridine, dimethylformamide, dimethylacetamide, and methylenedianiline. The workers had been working in the high-vapor-generating area of the plant, and the findings of pathologic examination showed typical features of acute toxic hepatitis. Discussion Infectious hepatitis and drug-induced hepatitis were excluded by laboratory findings, as well as the clinical course of hepatitis. All cases of toxic hepatitis in this plant developed after the change of the disposal process to thermochemical reaction–type treatment using unslaked lime reacted with industrial wastes. During this chemical reaction, vapor containing several toxic materials was generated. Although we could not confirm the definitive causative chemical, we suspect that these cases of hepatitis were caused by one of the hepatotoxic agents or by a synergistic interaction among several of them. Relevance to clinical or professional practice In the industrial waste treatment process, the danger of developing toxic hepatitis should be kept in mind, because any subtle change of the treatment process can generate various toxic materials and threaten the workers’ health. A mixture of hepatotoxic chemicals can induce clinical manifestations that are quite different from those predicted by the toxic property of a single agent. PMID:17366828

Spacecraft Health Automated Reasoning Prototype (SHARP): The fiscal year 1989 SHARP portability evaluations task for NASA Solar System Exploration Division's Voyager project

NASA Technical Reports Server (NTRS)

Atkinson, David J.; Doyle, Richard J.; James, Mark L.; Kaufman, Tim; Martin, R. Gaius

1990-01-01

A Spacecraft Health Automated Reasoning Prototype (SHARP) portability study is presented. Some specific progress is described on the portability studies, plans for technology transfer, and potential applications of SHARP and related artificial intelligence technology to telescience operations. The application of SHARP to Voyager telecommunications was a proof-of-capability demonstration of artificial intelligence as applied to the problem of real time monitoring functions in planetary mission operations. An overview of the design and functional description of the SHARP system is also presented as it was applied to Voyager.

Inhibition of joint damage and improved clinical outcomes with rituximab plus methotrexate in early active rheumatoid arthritis: the IMAGE trial.

PubMed

Tak, P P; Rigby, W F; Rubbert-Roth, A; Peterfy, C G; van Vollenhoven, R F; Stohl, W; Hessey, E; Chen, A; Tyrrell, H; Shaw, T M

2011-01-01

Rituximab is an effective treatment in patients with established rheumatoid arthritis (RA). The objective of the IMAGE study was to determine the efficacy of rituximab in the prevention of joint damage and its safety in combination with methotrexate (MTX) in patients initiating treatment with MTX. In this double-blind randomised controlled phase III study, 755 MTX-naïve patients with active RA were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX. The primary end point at week 52 was the change in joint damage measured using a Genant-modified Sharp score. 249, 249 and 250 patients were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX, respectively. At week 52, treatment with rituximab 2×1000 mg + MTX compared with MTX alone was associated with a reduction in progression of joint damage (mean change in total modified Sharp score 0.359 vs 1.079; p=0.0004) and an improvement in clinical outcomes (ACR50 65% vs 42%; p<0.0001); rituximab 2×500 mg + MTX improved clinical outcomes (ACR50 59% vs 42%; p<0.0001) compared with MTX alone but did not significantly reduce the progression of joint damage. Safety outcomes were similar between treatment groups. Treatment with rituximab 2×1000 mg in combination with MTX is an effective therapy for the treatment of patients with MTX-naïve RA. ClinicalTrials.gov identifier NCT00299104.

Evaluation of automatic image quality assessment in chest CT - A human cadaver study.

PubMed

Franck, Caro; De Crop, An; De Roo, Bieke; Smeets, Peter; Vergauwen, Merel; Dewaele, Tom; Van Borsel, Mathias; Achten, Eric; Van Hoof, Tom; Bacher, Klaus

2017-04-01

The evaluation of clinical image quality (IQ) is important to optimize CT protocols and to keep patient doses as low as reasonably achievable. Considering the significant amount of effort needed for human observer studies, automatic IQ tools are a promising alternative. The purpose of this study was to evaluate automatic IQ assessment in chest CT using Thiel embalmed cadavers. Chest CT's of Thiel embalmed cadavers were acquired at different exposures. Clinical IQ was determined by performing a visual grading analysis. Physical-technical IQ (noise, contrast-to-noise and contrast-detail) was assessed in a Catphan phantom. Soft and sharp reconstructions were made with filtered back projection and two strengths of iterative reconstruction. In addition to the classical IQ metrics, an automatic algorithm was used to calculate image quality scores (IQs). To be able to compare datasets reconstructed with different kernels, the IQs values were normalized. Good correlations were found between IQs and the measured physical-technical image quality: noise (ρ=-1.00), contrast-to-noise (ρ=1.00) and contrast-detail (ρ=0.96). The correlation coefficients between IQs and the observed clinical image quality of soft and sharp reconstructions were 0.88 and 0.93, respectively. The automatic scoring algorithm is a promising tool for the evaluation of thoracic CT scans in daily clinical practice. It allows monitoring of the image quality of a chest protocol over time, without human intervention. Different reconstruction kernels can be compared after normalization of the IQs. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Fludrocortisone therapy in cerebral salt wasting.

PubMed

Taplin, Craig E; Cowell, Christopher T; Silink, Martin; Ambler, Geoffrey R

2006-12-01

Cerebral salt wasting is an increasingly recognized condition in pediatrics and is characterized by inappropriate natriuresis and volume contraction in the presence of cerebral pathology. Diagnosis can be difficult and therapy challenging. A few single case reports of the successful use of fludrocortisone exist. We report 4 patients with cerebral salt wasting, all of whom presented with hyponatremia in the presence of known intracerebral pathology. All had clinically significant hyponatremia, and 3 had hyponatremic seizures. Two of the patients also satisfied clinical criteria for diabetes insipidus. They all were treated with regimens using increased sodium and fluid administration but experienced ongoing salt wasting. Fludrocortisone was instituted in all 4 patients and in 3 resulted in rapid improvement in net sodium balance, enabling the weaning of hypertonic fluids and stabilization of serum electrolytes. In 3 patients, fludrocortisone treatment was complicated by hypokalemia, and in 1 patient by hypertension, which necessitated a dose reduction or brief cessation of therapy. Duration of therapy was 4 to 125 days. Cerebral salt wasting presents considerable management challenges; however, fludrocortisone therapy can be an effective adjunct to treatment.

Subcutaneous injections: preventing needlestick injuries in the community.

PubMed

Aziz, Ann-Marie

2012-06-01

Community nurses provide care to patients in a variety of settings, for example health centres, community hospitals, patients' homes, residential and nursing homes. Administering subcutaneous injections to patients in the community is an everyday activity for many nurses in clinical practice. Many problems related to being 'sharps safe' are common to both community nurses and hospital staff. The majority of subcutaneous injections administered in the community are for patients with diabetes. Reducing needlestick injuries after the administration of subcutaneous injections in the community remains paramount to all NHS staff. This article provides information on what national standards to employ when administrating subcutaneous injections and what safety practices should be undertaken for good sharps management. Staff administering subcutaneous injections in the community need to ensure that they are updated on the latest developments in safety needle devices in order to prevent needlestick injuries and provide safe, effective and individualised care for their patients.

[Herpetic encephalitis: a clinical case].

PubMed

Dryhant, L P; Sereda, V H; Kushpiĭ, O V; Tkachenko, V V; Kravchuk, N A; Inhula, N I; Sizina, A V; Sachko, Iu Iu; Andrusenko, A S; Tytenko, Iu I; Babirad, A M

2012-01-01

An example of diagnostics and treatment of patient is in-process made with herpetic encephalitis. It is well-proven in researches, that a herpetic encephalitis is 11.5% among sharp encephalitises. Morbidity is sporadic, some researchers specify on an increase its spring. An infection can be passed tiny and pin a way. Seasonal vibrations are not incident to the herpetic encephalitis. Two peaks of morbidity are on 5-30 years and age more senior 50 years. More than in 95% cases the virus of simple herpes of type serves as an exciter of herpetic encephalitis 1. A characteristic triad of herpetic encephalitis is the sharp feverish beginning, development of cramps of dzheksonovskogo type and violation of consciousness, developing usually after a brief respirator infection. Sometimes sudden development of cramps and loss of consciousness is preceded a fever. Example of such development of disease is made an in our work.

Ethics of clinical trials in Nigeria.

PubMed

Okonta, Patrick I

2014-05-01

The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria.

Ethics of clinical trials in Nigeria

PubMed Central

Okonta, Patrick I.

2014-01-01

The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria. PMID:25013247

Isolation of clinically relevant fungal species from solid waste and environment of dental health services.

PubMed

Vieira, C D; de Carvalho, M A R; de Resende, M A; de Menezes Cussiol, N A; Alvarez-Leite, M E; dos Santos, S G; de Oliveira, M B; de Magalhães, T F F; Silva, M X; Nicoli, J R; de Macêdo Farias, L

2010-10-01

This study was undertaken to detect, identify and determine antifungal susceptibility of yeast strains isolated from dental solid waste and to evaluate airborne fungi in the Brazilian dental health care environment and in the waste storage room. A group of 17 yeast strains were identified by macroscopic and microscopic characteristics, API 20C Aux system and Multiplex PCR. All 104 airborne fungal colonies were identified by macroscopic and microscopic morphology. The CLSI broth microdilution method was utilized as the susceptibility test. Candida parapsilosis was the prevailing yeast species recovered from waste, followed by Rhodotorula glutinis. Three strains of Candida guilliermondii presented minimal inhibitory concentration values considered to be susceptible dose dependent (2 μg ml(-1)) to voriconazole. Of all airborne fungal species, 69% were recovered from the waste storage room and 31% were recovered from the clinical/surgical environment. Most of them were identified as Cladosporium spp. These findings reinforce the potential risk of waste handling and point out the need for safe management to minimize the spread of these agents to the environment. Filamentous fungi isolation in almost all sampled environments indicates that a periodic monitoring of airborne microbiota in the dental health care service environment is required. The survival of yeast strains for 48 h suggests that dental waste should be carefully controlled and monitored. © 2010 The Authors. Journal compilation © 2010 The Society for Applied Microbiology.

Clinical waste incinerators in Cameroon--a case study.

PubMed

Mochungong, Peter Ikome Kuwoh; Gulis, Gabriel; Sodemann, Morten

2012-01-01

Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study. Three incinerators were randomly selected and investigated for site, design and operating standards. Empirical field observation was adopted and data collected through inventory and informal interviews. Bottom ash samples collected from the incinerators were prepared according to standard procedures and analyzed for heavy metals using Inductively Coupled Plasma (ICP) Emission Spectroscopy. Shortcomings associated with site selection, design and operation standards were identified. Chemical analysis revealed that Cr, Cu, Fe, Mn, Ni, Pb, Zn, Mg and Ca were present in the bottom ash with mean concentration ranging from 10 mg/kg for Pb to 178080 mg/kg for Ca. For logistic reasons, feedstock quantity and quality into the incinerators were not investigated. Neither were soil samples around and away from the incinerators. Although highly favored, clinical waste incineration methods in this region have to be reconsidered. A thorough health and environmental impact assessment is suggested before subsequent decisions on choice and disposal site is made. This will curb potential negative impacts to the environment and public health. This article adds a different perspective and sheds additional information to the debate on unsatisfactory clinical waste incinerators in resources-poor countries. Alternative methods to incineration are presented that will be helpful to practitioners.

Disposing of Excess Vaccines After the Withdrawal of Oral Polio Vaccine

PubMed Central

Ramirez Gonzalez, Alejandro; Dolan, Samantha B.; Garon, Julie; Veira, Chantal Laroche; Hampton, Lee M.; Chang Blanc, Diana; Patel, Manish M.

2017-01-01

Abstract Until recently, waste management for national immunization programs was limited to sharps waste, empty vaccine vials, or vaccines that had expired or were no longer usable. However, because wild-type 2 poliovirus has been eradicated, the World Health Organization’s (WHO’s) Strategic Advisory Group of Experts on Immunization deemed that all countries must simultaneously cease use of the type 2 oral polio vaccine and recommended that all countries and territories using oral polio vaccine (OPV) “switch” from trivalent OPV (tOPV; types 1, 2, and 3 polioviruses) to bivalent OPV (bOPV; types 1 and 3 polioviruses) during a 2-week period in April 2016. Use of tOPV after the switch would risk outbreaks of paralysis related to type 2–circulating vaccine-derived poliovirus (cVDPV2). To minimize risk of vaccine-derived polio countries using OPV were asked to dispose of all usable, unexpired tOPV after the switch to bOPV. In this paper, we review the rationale for tOPV disposal and describe the global guidelines provided to countries for the safe and appropriate disposal of tOPV. These guidelines gave countries flexibility in implementing this important task within the confines of their national regulations, capacities, and resources. Steps for appropriate disposal of tOPV included removal of all tOPV vials from the cold chain, placement in appropriate bags or containers, and disposal using a recommended approach (ie, autoclaving, boiling, chemical inactivation, incineration, or encapsulation) followed by burial or transportation to a designated waste facility. This experience with disposal of tOPV highlights the adaptability of national immunization programs to new procedures, and identifies gaps in waste management policies and strategies with regard to disposal of unused vaccines. The experience also provides a framework for future policies and for developing programmatic guidance for the ultimate disposal of all OPV after the eradication of polio. PMID:28838168

Mice Lacking the Circadian Modulators SHARP1 and SHARP2 Display Altered Sleep and Mixed State Endophenotypes of Psychiatric Disorders

PubMed Central

Shahmoradi, Ali; Reinecke, Lisa; Kroos, Christina; Wichert, Sven P.; Oster, Henrik; Wehr, Michael C.; Taneja, Reshma; Hirrlinger, Johannes; Rossner, Moritz J.

2014-01-01

Increasing evidence suggests that clock genes may be implicated in a spectrum of psychiatric diseases, including sleep and mood related disorders as well as schizophrenia. The bHLH transcription factors SHARP1/DEC2/BHLHE41 and SHARP2/DEC1/BHLHE40 are modulators of the circadian system and SHARP1/DEC2/BHLHE40 has been shown to regulate homeostatic sleep drive in humans. In this study, we characterized Sharp1 and Sharp2 double mutant mice (S1/2-/-) using online EEG recordings in living animals, behavioral assays and global gene expression profiling. EEG recordings revealed attenuated sleep/wake amplitudes and alterations of theta oscillations. Increased sleep in the dark phase is paralleled by reduced voluntary activity and cortical gene expression signatures reveal associations with psychiatric diseases. S1/2-/- mice display alterations in novelty induced activity, anxiety and curiosity. Moreover, mutant mice exhibit impaired working memory and deficits in prepulse inhibition resembling symptoms of psychiatric diseases. Network modeling indicates a connection between neural plasticity and clock genes, particularly for SHARP1 and PER1. Our findings support the hypothesis that abnormal sleep and certain (endo)phenotypes of psychiatric diseases may be caused by common mechanisms involving components of the molecular clock including SHARP1 and SHARP2. PMID:25340473

Enhancements to the SHARP Build System and NEK5000 Coupling

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

McCaskey, Alex; Bennett, Andrew R.; Billings, Jay Jay

The SHARP project for the Department of Energy's Nuclear Energy Advanced Modeling and Simulation (NEAMS) program provides a multiphysics framework for coupled simulations of advanced nuclear reactor designs. It provides an overall coupling environment that utilizes custom interfaces to couple existing physics codes through a common spatial decomposition and unique solution transfer component. As of this writing, SHARP couples neutronics, thermal hydraulics, and structural mechanics using PROTEUS, Nek5000, and Diablo respectively. This report details two primary SHARP improvements regarding the Nek5000 and Diablo individual physics codes: (1) an improved Nek5000 coupling interface that lets SHARP achieve a vast increase inmore » overall solution accuracy by manipulating the structure of the internal Nek5000 spatial mesh, and (2) the capability to seamlessly couple structural mechanics calculations into the framework through improvements to the SHARP build system. The Nek5000 coupling interface now uses a barycentric Lagrange interpolation method that takes the vertex-based power and density computed from the PROTEUS neutronics solver and maps it to the user-specified, general-order Nek5000 spectral element mesh. Before this work, SHARP handled this vertex-based solution transfer in an averaging-based manner. SHARP users can now achieve higher levels of accuracy by specifying any arbitrary Nek5000 spectral mesh order. This improvement takes the average percentage error between the PROTEUS power solution and the Nek5000 interpolated result down drastically from over 23 % to just above 2 %, and maintains the correct power profile. We have integrated Diablo into the SHARP build system to facilitate the future coupling of structural mechanics calculations into SHARP. Previously, simulations involving Diablo were done in an iterative manner, requiring a large amount manual work, and left only as a task for advanced users. This report will detail a new Diablo build system that was implemented using GNU Autotools, mirroring much of the current SHARP build system, and easing the use of structural mechanics calculations for end-users of the SHARP multiphysics framework. It lets users easily build and use Diablo as a stand-alone simulation, as well as fully couple with the other SHARP physics modules. The top-level SHARP build system was modified to allow Diablo to hook in directly. New dependency handlers were implemented to let SHARP users easily build the framework with these new simulation capabilities. The remainder of this report will describe this work in full, with a detailed discussion of the overall design philosophy of SHARP, the new solution interpolation method introduced, and the Diablo integration work. We will conclude with a discussion of possible future SHARP improvements that will serve to increase solution accuracy and framework capability.« less

[Perceptual sharpness metric for visible and infrared color fusion images].

PubMed

Gao, Shao-Shu; Jin, Wei-Qi; Wang, Xia; Wang, Ling-Xue; Luo, Yuan

2012-12-01

For visible and infrared color fusion images, objective sharpness assessment model is proposed to measure the clarity of detail and edge definition of the fusion image. Firstly, the contrast sensitivity functions (CSF) of the human visual system is used to reduce insensitive frequency components under certain viewing conditions. Secondly, perceptual contrast model, which takes human luminance masking effect into account, is proposed based on local band-limited contrast model. Finally, the perceptual contrast is calculated in the region of interest (contains image details and edges) in the fusion image to evaluate image perceptual sharpness. Experimental results show that the proposed perceptual sharpness metrics provides better predictions, which are more closely matched to human perceptual evaluations, than five existing sharpness (blur) metrics for color images. The proposed perceptual sharpness metrics can evaluate the perceptual sharpness for color fusion images effectively.

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT, HVLP COATING EQUIPMENT, SHARPE MANUFACTURING COMPANY PLATINUM 2012 HVLP SPRAY GUN

EPA Science Inventory

This report presents the results of the verification test of the Sharpe Platinum 2013 high-volume, low-pressure gravity-feed spray gun, hereafter referred to as the Sharpe Platinum, which is designed for use in automotive refinishing. The test coating chosen by Sharpe Manufacturi...

MO-FG-204-09: High Spatial Resolution and Artifact-Free CT Bone Imaging at Off-Centered Positions: An Application of Model-Based Iterative Reconstruction

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

Chen, G; Li, K; Gomez-Cardona, D

Purpose: Although the anatomy of interest should be positioned as close as possible to the isocenter of CT scanners, off-centering may be inevitable during certain exams in clinical practice such as lumbar spine and elbow imaging. Off-centering degrades image sharpness, generates streak artifacts, and sometimes creates blooming artifacts due to truncation. The purpose of this work was to investigate whether the use of model-based image reconstruction (MBIR) can alleviate the negative impacts of off-centering to achieve high quality CT bone imaging. Methods: Both an anthropomorphic phantom and an ex vivo swine elbow sample were scanned at centered and off-centered positionsmore » using clinical CT bone scan protocols. The magnitude of off-centering was determined from localizer radiographs. Both FBP and MBIR reconstructions were performed. For FBP, both standard and Bone Plus kernels commonly used in bone imaging were used. Objective assessment of image sharpness, noise standard deviation, and noise nonuniformity were performed. Additionally, we retrospectively analyzed human subject data acquired under off-centered conditions as a validation study. Results: In FBP images of the phantom, off-centering by 10 cm led to a 14% increase in noise (p<1e-3) and a 68% increase in noise nonuniformity (p<0.02). A visible drop in bone sharpness was observed. In contrast, no significant difference in the noise magnitude or the noise nonuniformity between the centered and off-centered MBIR images was found. The image sharpness of off-centered MBIR images outperformed that of FBP images reconstructed with the Bone Plus kernel. In images of the swine elbow off-centered by 20 cm, not only was the noise and spatial resolution performance improved by MBIR, truncation artifacts were also elliminated. The human subject study generated similar results, in which the visibility of the off-centered lumbar spine was significantly improved. Conclusion: High quality CT bone imaging at off-centered positions can be achieved using MBIR. This work was partially supported by an NIH grant R01CA169331 and GE Healthcare. K. Li, D. Gomez-Cardona: Nothing to disclose. G.-H. Chen: Research funded, GE Healthcare; Research funded, Siemens AX. A. Budde, J. Hsieh: Employee, GE Healthcare.« less

77 FR 52061 - Notice of Proposed Exemption Involving Sharp HealthCare Located in San Diego, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

...This document contains a notice of pendency (the Notice) before the Department of Labor (the Department) of a proposed individual exemption from certain prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (the Act or ERISA). The transactions involve the Sharp HealthCare Health and Dental Plan (the Plan). The proposed exemption, if granted, would affect the Plan, its participants and beneficiaries, Sharp Healthcare (Sharp), and the Sharp Health Plan (the HMO).

Comparison of healing rate in diabetes-related foot ulcers with low frequency ultrasonic debridement versus non-surgical sharps debridement: a randomised trial protocol

PubMed Central

2014-01-01

Background Foot ulceration has been reported as the leading cause of hospital admission and amputation in individuals with diabetes. Diabetes-related foot ulcers require multidisciplinary management and best practice care, including debridement, offloading, dressings, management of infection, modified footwear and management of extrinsic factors. Ulcer debridement is a commonly applied management approach involving removal of non-viable tissue from the ulcer bed. Different methods of debridement have been reported in the literature including autolytic debridement via moist wound healing, mechanical debridement utilising wet to dry dressings, theatre based sharps debridement, biological debridement, non-surgical sharps debridement and newer technology such as low frequency ultrasonic debridement. Methods People with diabetes and a foot ulcer, referred to and treated by the Podiatry Department at Monash Health and who meet the inclusion criteria will be invited to participate in this randomised controlled trial. Participants will be randomly and equally allocated to either the non-surgical sharps debridement (control) or low frequency ultrasonic debridement (intervention) group (n = 322 ulcers/n = 108 participants). Where participants have more than one ulcer, only the participant will be randomised, not the ulcer. An investigator not involved in participant recruitment or assessment will be responsible for preparing the random allocation sequence and envelopes. Each participant will receive weekly treatment for six months including best practice podiatric management. Each ulcer will be measured on a weekly basis by calculating total area in centimetres squared. Measurement will be undertaken by a trained research assistant to ensure outcomes are blinded from the treating podiatrist. Another member of the research team will assess the final primary outcome. Discussion The primary aim of this study is to compare healing rates for diabetes-related foot ulcers using non-surgical sharps debridement versus low frequency ultrasonic debridement over a six month period. The primary outcome measure for this study is the proportion of ulcers healed by the six month follow-up period. Secondary outcomes will include a quality of life measure, assessment of pain and health care resource use between the two treatment modalities. Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12612000490875. PMID:24423411

Analysis of relevant proteins from bone graft harvested using the reamer irrigator and aspirator system (RIA) versus iliac crest (IC) bone graft and RIA waste water.

PubMed

Crist, Brett D; Stoker, Aaron M; Stannard, James P; Cook, James L

2016-08-01

Femoral reaming using a Reamer Irrigator Aspirator (RIA) can produce greater than three liters of waste water per procedure, which contains cells and proteins that could promote bone healing. This purpose of this study was to determine the protein profile of RIA waste water and compare protein synthesis by cells harvested via RIA versus iliac crest (IC) bone graft. Bone graft was collected from 30 patients-15 using RIA from the femur and 15 harvested from the iliac crest. Waste water collected during the RIA procedure was analyzed in 12 patients. Cells from each graft were cultured in monolayer using growth media for 14days and inductive media for the next 14days. Media samples were collected on days 14, 21, and 28. Proteins for analysis were chosen based on their potential in bone healing, pro-inflammatory, and anti-inflammatory processes. Proteins present in RIA waste water indicate the potential for clinical use of this filtrate as an adjunct for enhancing bone production, healing, and remodeling. Similarly, cells cultured from RIA bone graft harvests compared favorably to those from iliac crest bone grafts with respect to their potential to aid in bone healing. RIA waste water has potential to serve as an autogenic and allogenic enhancer for bone healing. Continued development of processing protocols for viable commercial use of the waste water and pre-clinical studies designed to evaluate RIA waste water products for bone healing are ongoing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implementing AORN recommended practices for sharps safety.

PubMed

Ford, Donna A

2014-01-01

Prevention of percutaneous sharps injuries in perioperative settings remains a challenge. Occupational transmission of bloodborne pathogens, not only from patients to health care providers but also from health care providers to patients, is a significant concern. Legislation and position statements geared toward ensuring the safety of patients and health care workers have not resulted in significantly reduced sharps injuries in perioperative settings. Awareness and understanding of the types of percutaneous injuries that occur in perioperative settings is fundamental to developing an effective sharps injury prevention program. The AORN "Recommended practices for sharps safety" clearly delineates evidence-based recommendations for sharps injury prevention. Perioperative RNs can lead efforts to change practice for the safety of patients and perioperative team members by promoting the elimination of sharps hazards; the use of engineering, work practice, and administrative controls; and the proper use of personal protective equipment, including double gloving. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The SHARP Program: Giving Kids Chances to Excel

ERIC Educational Resources Information Center

Kenney, Rich

2007-01-01

In this article, the author describes the Sports, Habilitation, and Recreation Program (SHARP), a program of the Foundation for Blind Children in Phoenix, Arizona. The SHARP program aims to help children, who have visual impairments, achieve goals, develop independence, and make friends. One of the unique features of the SHARP program is that it…

Insulin stimulates the expression of the SHARP-1 gene via multiple signaling pathways.

PubMed

Takagi, K; Asano, K; Haneishi, A; Ono, M; Komatsu, Y; Yamamoto, T; Tanaka, T; Ueno, H; Ogawa, W; Tomita, K; Noguchi, T; Yamada, K

2014-06-01

The rat enhancer of split- and hairy-related protein-1 (SHARP-1) is a basic helix-loop-helix transcription factor. An issue of whether SHARP-1 is an insulin-inducible transcription factor was examined. Insulin rapidly increased the level of SHARP-1 mRNA both in vivo and in vitro. Then, signaling pathways involved with the increase of SHARP-1 mRNA by insulin were determined in H4IIE rat hepatoma cells. Pretreatments with LY294002, wortmannin, and staurosporine completely blocked the induction effect, suggesting the involvement of both phosphoinositide 3-kinase (PI 3-K) and protein kinase C (PKC) pathways. In fact, overexpression of a dominant negative form of atypical protein kinase C lambda (aPKCλ) significantly decreased the induction of the SHARP-1 mRNA. In addition, inhibitors for the small GTPase Rac or Jun N-terminal kinase (JNK) also blocked the induction of SHARP-1 mRNA by insulin. Overexpression of a dominant negative form of Rac1 prevented the activation by insulin. Furthermore, actinomycin D and cycloheximide completely blocked the induction of SHARP-1 mRNA by insulin. Finally, when a SHARP-1 expression plasmid was transiently transfected with various reporter plasmids into H4IIE cells, the promoter activity of PEPCK reporter plasmid was specifically decreased. Thus, we conclude that insulin induces the SHARP-1 gene expression at the transcription level via a both PI 3-K/aPKCλ/JNK- and a PI 3-K/Rac/JNK-signaling pathway; protein synthesis is required for this induction; and that SHARP-1 is a potential repressor of the PEPCK gene expression. © Georg Thieme Verlag KG Stuttgart · New York.

Background field removal technique using regularization enabled sophisticated harmonic artifact reduction for phase data with varying kernel sizes.

PubMed

Kan, Hirohito; Kasai, Harumasa; Arai, Nobuyuki; Kunitomo, Hiroshi; Hirose, Yasujiro; Shibamoto, Yuta

2016-09-01

An effective background field removal technique is desired for more accurate quantitative susceptibility mapping (QSM) prior to dipole inversion. The aim of this study was to evaluate the accuracy of regularization enabled sophisticated harmonic artifact reduction for phase data with varying spherical kernel sizes (REV-SHARP) method using a three-dimensional head phantom and human brain data. The proposed REV-SHARP method used the spherical mean value operation and Tikhonov regularization in the deconvolution process, with varying 2-14mm kernel sizes. The kernel sizes were gradually reduced, similar to the SHARP with varying spherical kernel (VSHARP) method. We determined the relative errors and relationships between the true local field and estimated local field in REV-SHARP, VSHARP, projection onto dipole fields (PDF), and regularization enabled SHARP (RESHARP). Human experiment was also conducted using REV-SHARP, VSHARP, PDF, and RESHARP. The relative errors in the numerical phantom study were 0.386, 0.448, 0.838, and 0.452 for REV-SHARP, VSHARP, PDF, and RESHARP. REV-SHARP result exhibited the highest correlation between the true local field and estimated local field. The linear regression slopes were 1.005, 1.124, 0.988, and 0.536 for REV-SHARP, VSHARP, PDF, and RESHARP in regions of interest on the three-dimensional head phantom. In human experiments, no obvious errors due to artifacts were present in REV-SHARP. The proposed REV-SHARP is a new method combined with variable spherical kernel size and Tikhonov regularization. This technique might make it possible to be more accurate backgroud field removal and help to achive better accuracy of QSM. Copyright © 2016 Elsevier Inc. All rights reserved.

Self-Calibrating Wave-Encoded Variable-Density Single-Shot Fast Spin Echo Imaging.

PubMed

Chen, Feiyu; Taviani, Valentina; Tamir, Jonathan I; Cheng, Joseph Y; Zhang, Tao; Song, Qiong; Hargreaves, Brian A; Pauly, John M; Vasanawala, Shreyas S

2018-04-01

It is highly desirable in clinical abdominal MR scans to accelerate single-shot fast spin echo (SSFSE) imaging and reduce blurring due to T 2 decay and partial-Fourier acquisition. To develop and investigate the clinical feasibility of wave-encoded variable-density SSFSE imaging for improved image quality and scan time reduction. Prospective controlled clinical trial. With Institutional Review Board approval and informed consent, the proposed method was assessed on 20 consecutive adult patients (10 male, 10 female, range, 24-84 years). A wave-encoded variable-density SSFSE sequence was developed for clinical 3.0T abdominal scans to enable high acceleration (3.5×) with full-Fourier acquisitions by: 1) introducing wave encoding with self-refocusing gradient waveforms to improve acquisition efficiency; 2) developing self-calibrated estimation of wave-encoding point-spread function and coil sensitivity to improve motion robustness; and 3) incorporating a parallel imaging and compressed sensing reconstruction to reconstruct highly accelerated datasets. Image quality was compared pairwise with standard Cartesian acquisition independently and blindly by two radiologists on a scale from -2 to 2 for noise, contrast, confidence, sharpness, and artifacts. The average ratio of scan time between these two approaches was also compared. A Wilcoxon signed-rank tests with a P value under 0.05 considered statistically significant. Wave-encoded variable-density SSFSE significantly reduced the perceived noise level and improved the sharpness of the abdominal wall and the kidneys compared with standard acquisition (mean scores 0.8, 1.2, and 0.8, respectively, P < 0.003). No significant difference was observed in relation to other features (P = 0.11). An average of 21% decrease in scan time was achieved using the proposed method. Wave-encoded variable-density sampling SSFSE achieves improved image quality with clinically relevant echo time and reduced scan time, thus providing a fast and robust approach for clinical SSFSE imaging. 1 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2018;47:954-966. © 2017 International Society for Magnetic Resonance in Medicine.

Summer High School Apprenticeship Research Program (SHARP)

NASA Technical Reports Server (NTRS)

1997-01-01

The summer of 1997 will not only be noted by NASA for the mission to Mars by the Pathfinder but also for the 179 brilliant apprentices that participated in the SHARP Program. Apprentice participation increased 17% over last year's total of 153 participants. As indicated by the End-of-the-Program Evaluations, 96% of the programs' participants rated the summer experience from very good to excellent. The SHARP Management Team began the year by meeting in Cocoa Beach, Florida for the annual SHARP Planning Conference. Participants strengthened their Education Division Computer Aided Tracking System (EDCATS) skills, toured the world-renowned Kennedy Space Center, and took a journey into space during the Alien Encounter Exercise. The participants returned to their Centers with the same goals and objectives in mind. The 1997 SHARP Program goals were: (1) Utilize NASA's mission, unique facilities and specialized workforce to provide exposure, education, and enrichment experiences to expand participants' career horizons and inspire excellence in formal education and lifelong learning. (2) Develop and implement innovative education reform initiatives which support NASA's Education Strategic Plan and national education goals. (3) Utilize established statistical indicators to measure the effectiveness of SHARP's program goals. (4) Explore new recruiting methods which target the student population for which SHARP was specifically designed. (5) Increase the number of participants in the program. All of the SHARP Coordinators reported that the goals and objectives for the overall program as well as their individual program goals were achieved. Some of the goals and objectives for the Centers were: (1) To increase the students' awareness of science, mathematics, engineering, and computer technology; (2) To provide students with the opportunity to broaden their career objectives; and (3) To expose students to a variety of enrichment activities. Most of the Center goals and objectives were consistent with the overall program goals. Modem Technology Systems, Inc., was able to meet the SHARP Apprentices, Coordinators and Mentors during their site visits to Stennis Space Center, Ames Research Center and Dryden Flight Research Center. All three Centers had very efficient programs and adhered to SHARP's general guidelines and procedures. MTSI was able to meet the apprentices from the other Centers via satellite in July during the SHARP Video-Teleconference(ViTS). The ViTS offered the apprentices and the NASA and SHARP Coordinators the opportunity to introduce themselves. The apprentices from each Center presented topical "Cutting Edge Projects". Some of the accomplishments for the 1997 SHARP Program year included: MTSI hiring apprentices from four of the nine NASA Centers, the full utilization of the EDCATS by apprentices and NASA/SHARP Coordinators, the distribution of the SHARP Apprentice College and Scholarship Directory, a reunion with former apprentices from Langley Research Center and the development of a SHARP Recruitment Poster. MTSI developed another exciting newsletter containing graphics and articles submitted by the apprentices and the SHARP Management Team.

Effects of an incinerator project on a healthcare-waste management system.

PubMed

Khammaneechan, Patthanasak; Okanurak, Kamolnetr; Sithisarankul, Pornchai; Tantrakarnapa, Kraichat; Norramit, Poonsup

2011-10-01

This evaluative research study aimed to assess the effects of the central healthcare incinerator project on waste management in Yala Province. The study data were collected twice: at baseline and during the operational phase. A combination of structured interview and observation were used during data collection. The study covered 127 healthcare facilities: government hospitals, healthcare centres, and private clinics. The results showed 63% of healthcare risk waste (HCRW) handlers attended the HCRW management training. Improvements in each stage of the HCRW management system were observed in all groups of facilities. The total cost of the HCRW management system did not change, however; the costs for hospitals decreased, whereas those for clinics increased significantly. It was concluded that the central healthcare waste incinerator project positively affected HCRW management in the area, although the costs of management might increase for a particular group. However, the benefits of changing to a more appropriately managed HCRW system will outweigh the increased costs.

Hazardous medical waste generation rates of different categories of health-care facilities.

PubMed

Komilis, Dimitrios; Fouki, Anastassia; Papadopoulos, Dimitrios

2012-07-01

Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed(-1)d(-1), using data from 132 health-care facilities in Greece. The calculations were based on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed(-1)d(-1), for the public psychiatric hospitals, to up to 0.72 kg bed(-1)d(-1), for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed(-1)d(-1), for the psychiatric clinics, to up to 0.49 kg bed(-1)d(-1), for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

Imaging the Perivascular Space as a Potential Biomarker of Neurovascular and Neurodegenerative Diseases.

PubMed

Ramirez, Joel; Berezuk, Courtney; McNeely, Alicia A; Gao, Fuqiang; McLaurin, JoAnne; Black, Sandra E

2016-03-01

Although the brain lacks conventional lymphatic vessels found in peripheral tissue, evidence suggests that the space surrounding the vasculature serves a similar role in the clearance of fluid and metabolic waste from the brain. With aging, neurodegeneration, and cerebrovascular disease, these microscopic perivascular spaces can become enlarged, allowing for visualization and quantification on structural MRI. The purpose of this review is to: (i) describe some of the recent pre-clinical findings from basic science that shed light on the potential neurophysiological mechanisms driving glymphatic and perivascular waste clearance, (ii) review some of the pathobiological etiologies that may lead to MRI-visible enlarged perivascular spaces (ePVS), (iii) describe the possible clinical implications of ePVS, (iv) evaluate existing qualitative and quantitative techniques used for measuring ePVS burden, and (v) propose future avenues of research that may improve our understanding of this potential clinical neuroimaging biomarker for fluid and metabolic waste clearance dysfunction in neurodegenerative and neurovascular diseases.

Children and Youth in Behavioural and Emotional Difficulties, Skyrocketing Diagnosis and Inclusion/Exclusion Processes in School Tendencies in Denmark

ERIC Educational Resources Information Center

Langager, Søren

2014-01-01

In parallel with a national school policy on an inclusive school with a marked reduction in the number of pupils who, due to their disruptive behaviour, are referred to educational provisions outside of the ordinary school environment, a sharp rise has been seen in the number of children and teenagers who are given a clinical diagnosis, first and…

Sharp mandibular bone irregularities after lower third molar extraction: Incidence, clinical features and risk factors

PubMed Central

Alves-Pereira, Daniela; Valmaseda-Castellón, Eduard; Laskin, Daniel M.; Berini-Aytés, Leonardo; Gay-Escoda, Cosme

2013-01-01

Objectives: The purpose of this study was to determine the incidence and clinical symptoms associated with sharp mandibular bone irregularities (SMBI) after lower third molar extraction and to identify possible risk factors for this complication. Study Design: A mixed study design was used. A retrospective cohort study of 1432 lower third molar extractions was done to determine the incidence of SMBI and a retrospective case-control study was done to determine potential demographic and etiologic factors by comparing those patients with postoperative SMBI with controls. Results: Twelve SMBI were found (0.84%). Age was the most important risk factor for this complication. The operated side and the presence of an associated radiolucent image were also significantly related to the development of mandibular bone irregularities. The depth of impaction of the tooth might also be an important factor since erupted or nearly erupted third molars were more frequent in the SMBI group. Conclusions: SMBI are a rare postoperative complication after lower third molar removal. Older patients having left side lower third molars removed are more likely to develop this problem. The treatment should be the removal of the irregularity when the patient is symptomatic. Key words:Third molar, postoperative complication, bone irregularities, age. PMID:23524429

SHARP: Spacecraft Health Automated Reasoning Prototype

NASA Technical Reports Server (NTRS)

Atkinson, David J.

1991-01-01

The planetary spacecraft mission OPS as applied to SHARP is studied. Knowledge systems involved in this study are detailed. SHARP development task and Voyager telecom link analysis were examined. It was concluded that artificial intelligence has a proven capability to deliver useful functions in a real time space flight operations environment. SHARP has precipitated major change in acceptance of automation at JPL. The potential payoff from automation using AI is substantial. SHARP, and other AI technology is being transferred into systems in development including mission operations automation, science data systems, and infrastructure applications.

Effectiveness of a clinical practice intervention in early rheumatoid arthritis.

PubMed

Descalzo, Miguel Ángel; Carbonell, Jordi; González-Álvaro, Isidoro; Sanmartí, Raimon; Balsa, Alejandro; Hernandez-Barrera, Valentín; Román-Ivorra, José Andrés; Ivorra-Cortés, José; Lisbona, Pilar; Alperi, Mercedes; Jiménez-Garcia, Rodrigo; Carmona, Loreto

2012-03-01

To compare the outcome of early rheumatoid arthritis (RA) patients in a country where early clinics were established versus the outcome of patients in nonprotocolized clinics. We compared 2 multicenter cohorts: an RA cohort derived from an early arthritis registry set in 36 reference hospitals in which a specific intervention was established (Evaluation of a Model for Arthritis Care in Spain [SERAP]), and a historical control cohort of patients with early RA attending 34 rheumatology departments (Prognosis in Rheumatoid Arthritis [PROAR] cohort). Effectiveness was tested by comparing the change in the Disease Activity Score in 28 joints (DAS28), the change in the Health Assessment Questionnaire (HAQ), and the change in the Sharp/van der Heijde radiologic score using marginal structural models. A total of 161 early RA patients were recruited in the PROAR cohort and 447 in the SERAP cohort. Being a SERAP patient was inversely correlated with activity, resulting in a decrease of -0.24 (95% confidence interval [95% CI] -0.39, -0.08) units in the population average of the DAS28 after adjustment was made. Moreover, intervention may be seen as a protective factor of radiologic damage, with a decrease of -0.05 (95% CI -0.09, -0.01) units in the logarithm of the total Sharp/van der Heijde score. On the other hand, a decrease in functional impairment was detected, but intervention was not statistically associated with HAQ changes. Preventing major radiographic progression in a 2-year term inside structured and organized special programs for the management of disease, such as early arthritis clinics, are effective compared to nonprotocolized referrals, treatment, and followup. Copyright © 2012 by the American College of Rheumatology.

Behavior of healthcare workers after injuries from sharp instruments.

PubMed

Adib-Hajbaghery, Mohsen; Lotfi, Mohammad Sajjad

2013-09-01

Injuries with sharps are common occupational hazards for healthcare workers. Such injuries predispose the staff to dangerous infections such as hepatitis B, C and HIV. The present study was conducted to investigate the behaviors of healthcare workers in Kashan healthcare centers after needle sticks and injuries with sharps in 2012. A cross-sectional study was conducted on 298 healthcare workers of medical centers governed by Kashan University of Medical Sciences. A questionnaire was used in this study. The first part included questions about demographic characteristics. The second part of the questionnaire consisted of 16 items related to the sharp instrument injuries. For data analysis, descriptive and analytical statistics (chi-square, ANOVA and Pearson correlation coefficient) SPSS version 16.0 software was used. From a total of 298 healthcare workers, 114 (38.3%) had a history of injury from needles and sharp instruments in the last six months. Most needle stick and sharp instrument injuries had occurred among the operating room nurses and midwifes; 32.5% of injuries from sharp instruments occurred in the morning shift. Needles were responsible for 46.5% of injuries. The most common actions taken after needle stick injuries were compression (27.2%) and washing the area with soap and water (15.8%). Only 44.6% of the injured personnel pursued follow-up measures after a needle stick or sharp instrument injury. More than a half of the healthcare workers with needle stick or sharp instrument injury had refused follow-up for various reasons. The authorities should implement education programs along with protocols to be implemented after needle stick injuries or sharps.

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

Haudebourg, Raphael; Fichet, Pascal; Goutelard, Florence

The detection (location and quantification) of nuclear facilities to be dismantled possible contamination with low-range particles emitters ({sup 3}H, other low-energy β emitters, a emitters) remains a tedious and expensive task. Indeed, usual remote counters show a too low sensitivity to these non-penetrating radiations, while conventional wipe tests are irrelevant for fixed radioactivity evaluation. The only method to accurately measure activity levels consists in sampling and running advanced laboratory analyses (spectroscopy, liquid scintillation counting, pyrolysis...). Such measurements generally induce sample preparation, waste production (destructive analyses, solvents), nuclear material transportation, long durations, and significant labor mobilization. Therefore, the search for themore » limitation of their number and cost easily conflicts with the necessity to perform a dense screening for sampling (to maximize the representativeness of the samples), in installations of thousands of square meters (floors, wells, ceilings), plus furniture, pipes, and other wastes. To overcome this contradiction, Digital Autoradiography (D. A.) was re-routed from bio molecular research to radiological mapping of nuclear installations under dismantling and to waste and sample analysis. After in-situ exposure to the possibly-contaminated areas to investigate, commercial reusable radiosensitive phosphor screens (of a few 100 cm{sup 2}) were scanned in the proper laboratory device and sharp quantitative images of the radioactivity could be obtained. The implementation of geostatistical tools in the data processing software enabled the exhaustive characterization of concrete floors at a rate of 2 weeks / 100 m{sup 2}, at lowest costs. Various samples such as drilled cores, or tank and wood pieces, were also successfully evaluated with this method, for decisive results. Thanks to the accurate location of potential contamination spots, this approach ensures relevant and representative sampling for further laboratory analyses and should be inserted in the range of common tools used in dismantling. (authors)« less

Trihalomethanes in marine mammal aquaria: occurrences, sources, and health risks.

PubMed

Wang, Jun-Jian; Chow, Alex T; Sweeney, Joelle M; Mazet, Jonna A K

2014-08-01

Disinfecting water containing the high levels of dissolved organic carbon (DOC) commonly generated during pinniped husbandry may cause the formation of carcinogenic disinfection byproducts (DBPs). Little information is available on DBP levels, sources, and health risks in marine mammal aquaria. Using the commonly observed trihalomethanes (THMs) as a DBP indicator, we monitored concentrations for seven months at The Marine Mammal Center in Sausalito, California, one of the largest pinniped rehabilitation facilities in the world. Concentrations of THMs ranged 1.1-144.2 μg/L in pool waters and generally increased with number of animals housed (P < 0.05). To identify the sources of THM precursors in marine mammal aquaria, we intensively monitored the mass flows of potential THM precursors (i.e. food and wastes) in an isolated system with nine individual California sea lions to evaluate the sources and reactivity of dissolved organic carbon (DOC) for 2-5 weeks. The common frozen foods used in feeding pinnipeds, including herring, sardine, and squid, produced an average of 22-34 mg-DOC/g-food in water and 836-1066 μg-THM/g-food after chlorination, whereas the fecal materials, including fresh scat, decomposed scat, and urine, produced 2-16 mg-DOC/g-waste and 116-768 μg-THM/g-waste. Food not eaten by animals could cause a sharp increase of DOC and DBP production and therefore should be removed rapidly from pools. Marine mammal husbandry staff and trainers are at risk (5.16 × 10(-4) to 1.30 × 10(-3)) through exposure of THMs, exceeding the negligible risk level (10(-6)) defined by the US Environmental Protection Agency. Copyright © 2014 Elsevier Ltd. All rights reserved.

Healthcare worker safety: a vital component of surgical capacity development in low-resource settings.

PubMed

Petroze, Robin T; Phillips, Elayne K; Nzayisenga, Albert; Ntakiyiruta, Georges; Calland, J Forrest

2012-01-01

A disparate number of occupational exposures to bloodborne pathogens occur in low-income countries where disease prevalence is high and healthcare provider-per-population ratios are low. In an effort to highlight the important role of healthcare worker safety in surgical capacity building in Rwanda, we measured self-reported presence of safety materials and compliance with personal protective equipment in the operating theatre as part of a nationwide survey to characterize emergency and essential surgical capacity in all government hospitals. We surveyed 44 hospitals. While staff report general availability of safe disposal of sharps and hazardous waste, presence of and compliance with eye protection was lacking. Staff were cognizant of prevention measures such as double-gloving and 'safe receptacles', as well as hospital policies for post-exposure prophylaxis for HIV following needlesticks, but there was little awareness of hepatitis exposure. Healthcare worker safety should be a key component of hospital-level surgical capacity.

Dawn HAMO Image 63

NASA Image and Video Library

2015-11-19

This image of Ceres from NASA's Dawn spacecraft shows hummocky terrain -- a surface covered in low, rounded hills -- with numerous impact craters of varying sizes. The two biggest craters display central peaks and many places where masses of material have collapsed and slid downward along their walls and floors -- a phenomenon geologists call "mass wasting". The sharp crater at upper right is surrounded by smooth ejecta with a streaky texture to the south. A graben -- what geologists call a linear feature where terrain has dropped -- measuring 2 to 5 miles (3 to 8 kilometers) in width, and two prominent scarps, or linear, cliff-like slopes, are located in the southeastern (lower right) part of the image. Dawn took this image on Oct. 5, 2015, from an altitude of 915 miles (1,470 kilometers). It has a resolution of 450 feet (140 meters) per pixel. http://photojournal.jpl.nasa.gov/catalog/PIA20125

On designing low pressure loss working spaces for a planar Stirling micromachine

NASA Astrophysics Data System (ADS)

Hachey, M.-A.; Léveillé, É.; Fréchette, L. G.; Formosa, F.

2015-12-01

In this paper, research was undertaken with the objective to design low pressure loss working spaces for a Stirling cycle micro heat engine operating from low temperature waste heat. This planar free-piston heat engine is anticipated to operate at the kHz level with mm3 displacement. Given the resonant nature of the free-piston configuration, the complexity of its working gas’ flow geometry and its projected high operating frequency, flow analysis is relatively complex. Design considerations were thus based on fast prototyping and experimentation. Results show that geometrical features, such as a sharp 90° corner between the regenerator and working spaces, are strong contributors to pressure losses. This research culminated into a promising revised working space configuration for engine start-up, as it considerably reduced total pressure losses, more than 80% at Re = 700, from the original design.

The impact of sharps injuries on student nurses: a systematic review.

PubMed

Hambridge, Kevin; Nichols, Andrew; Endacott, Ruth

2016-10-27

The purpose of this review was to discover the impact of sharps injuries in the student nurse population. Much is known and reported about sharps injuries in registered nurses, but there has been a lack of published evidence regarding sharps injuries within the student nurse population. A systematic review of nursing, health and psychology databases was conducted. The limits set were publications between 1980 and 2014 in the English language. Studies were identified then, following a rigorous critical and quality appraisal with validated tools, were selected for the systematic review. A total of 40 articles met the inclusion criteria, reporting studies conducted in 18 countries. Psychological and physical impacts of sharps injuries in student nurses were reported, such as fear, anxiety and depression, although these impacts were not quantified using a validated instrument. The impact of sharps injuries can be severe, both psychological and physical. This systematic review shows that further research is needed into this, especially in under-researched areas such as the UK, to establish the impact of sharps injuries within this population. Further research would also aid the education and prevention of this harmful problem. The review also emphasises the psychological issues relating to sharps injuries, the impact these can have on individuals and the support and counselling that student nurses require after injury. These findings highlight the potential psychological issues that can result from sharps injuries in this population.

An acoustofluidic micromixer based on oscillating sidewall sharp-edges.

PubMed

Huang, Po-Hsun; Xie, Yuliang; Ahmed, Daniel; Rufo, Joseph; Nama, Nitesh; Chen, Yuchao; Chan, Chung Yu; Huang, Tony Jun

2013-10-07

Rapid and homogeneous mixing inside a microfluidic channel is demonstrated via the acoustic streaming phenomenon induced by the oscillation of sidewall sharp-edges. By optimizing the design of the sharp-edges, excellent mixing performance and fast mixing speed can be achieved in a simple device, making our sharp-edge-based acoustic micromixer a promising candidate for a wide variety of applications.

Composite, ordered material having sharp surface features

DOEpatents

D'Urso, Brian R.; Simpson, John T.

2006-12-19

A composite material having sharp surface features includes a recessive phase and a protrusive phase, the recessive phase having a higher susceptibility to a preselected etchant than the protrusive phase, the composite material having an etched surface wherein the protrusive phase protrudes from the surface to form a sharp surface feature. The sharp surface features can be coated to make the surface super-hydrophobic.

Level-set-based reconstruction algorithm for EIT lung images: first clinical results.

PubMed

Rahmati, Peyman; Soleimani, Manuchehr; Pulletz, Sven; Frerichs, Inéz; Adler, Andy

2012-05-01

We show the first clinical results using the level-set-based reconstruction algorithm for electrical impedance tomography (EIT) data. The level-set-based reconstruction method (LSRM) allows the reconstruction of non-smooth interfaces between image regions, which are typically smoothed by traditional voxel-based reconstruction methods (VBRMs). We develop a time difference formulation of the LSRM for 2D images. The proposed reconstruction method is applied to reconstruct clinical EIT data of a slow flow inflation pressure-volume manoeuvre in lung-healthy and adult lung-injury patients. Images from the LSRM and the VBRM are compared. The results show comparable reconstructed images, but with an improved ability to reconstruct sharp conductivity changes in the distribution of lung ventilation using the LSRM.

Standard precautions and infection control, medical students' knowledge and behavior at a Saudi university: the need for change.

PubMed

Amin, Tarek Tawfik; Al Noaim, Khalid Ibrahim; Bu Saad, Mohammed Ahmed; Al Malhm, Turki Ahmed; Al Mulhim, Abdullah Abdulaziz; Al Awas, Marwah Abdulaziz

2013-04-21

No previous studies have reported the knowledge of Saudi medical students about Standard Precautions (SPs) and infection control. The objectives of this study were to assess medical students' knowledge in clinical years at King Faisal University, Saudi Arabia about SPs' and to explore their attitudes toward the current curricular/training in providing them with effective knowledge and necessary skills with regard to SPs. This cross sectional study targeted students in clinical stage at College of Medicine, King Faisal University, Saudi Arabia. A pre-tested anonymous self administered data collection form was used. Inquires about students' characteristics, general concepts of infection control/SPs, hand hygiene, personal protective equipment, sharp injuries and disposal, and care of health providers were included. The main source of information for each domain was also inquired. The second part dedicated to explore the attitudes toward the curricular and teaching relevant to SPs. A total of 251 students were included. Knowledge scores in all domains were considerably low, 67 (26.7%) students scored ? 24 (out of 41points) which was considered as an acceptable level of knowledge, 22.2% in 4th year, 20.5% in 5th year and 36.8% in 6th year. Sharp injuries, personal protective equipment and health care of the providers showed the least knowledge scores. The main sources of knowledge were self learning, and informal bed side practices The majority of students' believed that the current teaching and training are insufficient in providing them with the necessary knowledge and skills regarding SPs. The overall knowledge scores for SPs were low especially in the domains of hand hygiene, sharp management, and personal protective equipment reflecting insufficient and ineffective instructions received by medical students through the current curriculum posing them vulnerable to health facilities related infections. Proper curricular reform and training are required to protect students and their patients.

SU-E-J-29: Automatic Image Registration Performance of Three IGRT Systems for Prostate Radiotherapy

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

Barber, J; University of Sydney, Sydney, NSW; Sykes, J

Purpose: To compare the performance of an automatic image registration algorithm on image sets collected on three commercial image guidance systems, and explore its relationship with imaging parameters such as dose and sharpness. Methods: Images of a CIRS Virtually Human Male Pelvis phantom (VHMP) were collected on the CBCT systems of Varian TrueBeam/OBI and Elekta Synergy/XVI linear accelerators, across a range of mAs settings; and MVCT on a Tomotherapy Hi-ART accelerator with a range of pitch. Using the 6D correlation ratio algorithm of XVI, each image was registered to a mask of the prostate volume with a 5 mm expansion.more » Registrations were repeated 100 times, with random initial offsets introduced to simulate daily matching. Residual registration errors were calculated by correcting for the initial phantom set-up error. Automatic registration was also repeated after reconstructing images with different sharpness filters. Results: All three systems showed good registration performance, with residual translations <0.5mm (1σ) for typical clinical dose and reconstruction settings. Residual rotational error had larger range, with 0.8°, 1.2° and 1.9° for 1σ in XVI, OBI and Tomotherapy respectively. The registration accuracy of XVI images showed a strong dependence on imaging dose, particularly below 4mGy. No evidence of reduced performance was observed at the lowest dose settings for OBI and Tomotherapy, but these were above 4mGy. Registration failures (maximum target registration error > 3.6 mm on the surface of a 30mm sphere) occurred in 5% to 10% of registrations. Changing the sharpness of image reconstruction had no significant effect on registration performance. Conclusions: Using the present automatic image registration algorithm, all IGRT systems tested provided satisfactory registrations for clinical use, within a normal range of acquisition settings.« less

The Use of Adjuvant Nutrition to Preserve and Increase Lean Body Mass in AIDS Patients with Muscle Wasting.

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

None

2000-01-03

The studies conducted under this CRADA were aimed at determining if nutritional supplementation with HMb, in combination with glutamine and arginine can ameliorate the AIDS-associated wasting syndrome and in turn improve the clinical course of the disease.

An acoustofluidic micromixer based on oscillating sidewall sharp-edges†

PubMed Central

Huang, Po-Hsun; Xie, Yuliang; Ahmed, Daniel; Rufo, Joseph; Nama, Nitesh; Chen, Yuchao; Chan, Chung Yu; Huang, Tony Jun

2014-01-01

Rapid and homogeneous mixing inside a microfluidic channel is demonstrated via the acoustic streaming phenomenon induced by the oscillation of sidewall sharp-edges. By optimizing the design of the sharp-edges, excellent mixing performance and fast mixing speed can be achieved in a simple device, making our sharp-edge-based acoustic micromixer a promising candidate for a wide variety of applications. PMID:23896797

Costs associated with the management of waste from healthcare facilities: An analysis at national and site level.

PubMed

Vaccari, Mentore; Tudor, Terry; Perteghella, Andrea

2018-01-01

Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day -1 bed -1 ), paediatric and intensive care (3.37 kg day -1 bed -1 ) and gastroenterology-digestive endoscopy (3.09 kg day -1 bed -1 ). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg -1 , with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.

SHARP User Manual

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

Yu, Y. Q.; Shemon, E. R.; Thomas, J. W.

SHARP is an advanced modeling and simulation toolkit for the analysis of nuclear reactors. It is comprised of several components including physical modeling tools, tools to integrate the physics codes for multi-physics analyses, and a set of tools to couple the codes within the MOAB framework. Physics modules currently include the neutronics code PROTEUS, the thermal-hydraulics code Nek5000, and the structural mechanics code Diablo. This manual focuses on performing multi-physics calculations with the SHARP ToolKit. Manuals for the three individual physics modules are available with the SHARP distribution to help the user to either carry out the primary multi-physics calculationmore » with basic knowledge or perform further advanced development with in-depth knowledge of these codes. This manual provides step-by-step instructions on employing SHARP, including how to download and install the code, how to build the drivers for a test case, how to perform a calculation and how to visualize the results. Since SHARP has some specific library and environment dependencies, it is highly recommended that the user read this manual prior to installing SHARP. Verification tests cases are included to check proper installation of each module. It is suggested that the new user should first follow the step-by-step instructions provided for a test problem in this manual to understand the basic procedure of using SHARP before using SHARP for his/her own analysis. Both reference output and scripts are provided along with the test cases in order to verify correct installation and execution of the SHARP package. At the end of this manual, detailed instructions are provided on how to create a new test case so that user can perform novel multi-physics calculations with SHARP. Frequently asked questions are listed at the end of this manual to help the user to troubleshoot issues.« less

Microstructural and hardness investigations on a dissimilar metal weld between low alloy steel and Alloy 82 weld metal

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

Chen, Z.R., E-mail: raymix@aliyun.com

The investigation on microstructure and hardness at the fusion boundary (FB) region of a dissimilar metal weld (DMW) between low alloy steel (LAS) A508-III and Alloy 82 weld metal (WM) was carried out. The results indicated that there were two kinds of FBs, martensite FB and sharp FB, with obvious different microstructures, alternately distributed in the same FB. The martensite FB region had a gradual change of elemental concentration across FB, columnar WM grains with high length/width ratios, a thick martensite layer and a wide heat affected zone (HAZ) with large prior austenite grains. By comparison, the sharp FB regionmore » had a relatively sharp change of elemental concentration across the FB, WM grains with low length/width ratios and a narrow HAZ with smaller prior austenite grains. The martensite possessed a K-S orientation relationship with WM grains, while no orientation relationship was found between the HAZ grains and WM grains at the sharp FB. Compared with sharp FB there were much more Σ3 boundaries in the HAZ beside martensite FB. The hardness maximum of the martensite FB was much higher than that of the sharp FB, which was attributed to the martensite layer at the martensite FB. - Highlights: •Martensite and sharp FBs with different microstructures were found in the same FB. •There were high length/width-ratio WM grains and a wide HAZ beside martensite FB. •There were low length/width-ratio WM grains and a narrow HAZ beside sharp FB. •Compared with sharp FB, there were much more Σ3 boundaries in HAZ of martensite FB. •Hardness maximium of martensite FB was much higher than that of sharp FB.« less

Casting made simple using modified sprue design: an in vitro study.

PubMed

Baskaran, B Eswaran; Geetha Prabhu, K R; Prabhu, R; Krishna, G Phani; Eswaran, M A; Gajapathi, B

2014-01-01

Success in dental casting restorations for fixed partial dentures (FPDs) depends on the castability. Castability is described as the ability of an alloy to faithfully reproduce sharp detail and fine margins of a wax pattern. The goal of a prosthodontist is to provide the patient with restorations that fit precisely. Regardless of the alloy used for casting, the casting technique should yield a casted alloy, which should possess sufficient mass, surface hardness and minimal porosity after casting. Twenty patterns for casting were made from three-dimensional printed resin pattern simulating a 3 unit FPD and casted using modified sprue technique. Later test samples were cemented sequentially on stainless steel model using pressure indicating paste and evaluated for vertical marginal gap in eight predetermined reference areas. Marginal gap were measured in microns using Video Measuring System (VMS2010F-CIP Corporation, Korea). A portion of the axial wall of the cast abutments depicting premolar and molar were sectioned and embedded in acrylic resin and tested for micro hardness using Reichert Polyvar 2 Met Microhardness tester (Reichert, Austria) and porosity using Quantimet Image Analyzer (Quantimet Corporation London, England). The results obtained for marginal gap, micro hardness, and porosity of all test samples were tabulated, descriptive statistics were calculated and the values were found to be within the clinically acceptable range. The new sprue technique can be an alternative and convenient method for casting which would minimize metal wasting and less time consuming. However, further studies with same technique on various parameters are to be conducted for its broad acceptance.

[Advances in arterial hypertension and diabetes mellitus].

PubMed

Cordero, Alberto; Lekuona, Iñaki; Galve, Enrique; Mazón, Pilar

2012-01-01

In 2011, the importance of hypertension and diabetes mellitus as the two main risk factors responsible for the development of cardiovascular disease became clear, as did their significance as major public health issues. Compared with previous years, in which publication of the results of large clinical trials dominated scientific progress, in the last year, the focus has shifted to evidence that novel mechanisms associated with blood pressure, glucose metabolism and diabetes can influence cardiovascular disease. Of particular importance were clinical trials in the area of renal dysfunction, such as the SHARP and ROADMAP trials. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Notes on breeding sharp-shinned hawks and cooper’s hawks in Barnwell County, South Carolina

Treesearch

Mark Vukovich; John C. Kilgo

2009-01-01

Breeding records of Accipiter striatus (Sharp-shinned Hawks) in the southeastern US are scattered and isolated. We documented a Sharp-shinned Hawk and Accipiter cooperii (Cooper’s Hawk) nest while conducting a telemetry study on Melanerpes erythrocephalus (Red-headed Woodpeckers) in Barnwell County, SC in 2006 and 2007. We report the first known nest of a Sharp-shinned...

Edge Sharpness Assessment by Parametric Modeling: Application to Magnetic Resonance Imaging.

PubMed

Ahmad, R; Ding, Y; Simonetti, O P

2015-05-01

In biomedical imaging, edge sharpness is an important yet often overlooked image quality metric. In this work, a semi-automatic method to quantify edge sharpness in the presence of significant noise is presented with application to magnetic resonance imaging (MRI). The method is based on parametric modeling of image edges. First, an edge map is automatically generated and one or more edges-of-interest (EOI) are manually selected using graphical user interface. Multiple exclusion criteria are then enforced to eliminate edge pixels that are potentially not suitable for sharpness assessment. Second, at each pixel of the EOI, an image intensity profile is read along a small line segment that runs locally normal to the EOI. Third, the profiles corresponding to all EOI pixels are individually fitted with a sigmoid function characterized by four parameters, including one that represents edge sharpness. Last, the distribution of the sharpness parameter is used to quantify edge sharpness. For validation, the method is applied to simulated data as well as MRI data from both phantom imaging and cine imaging experiments. This method allows for fast, quantitative evaluation of edge sharpness even in images with poor signal-to-noise ratio. Although the utility of this method is demonstrated for MRI, it can be adapted for other medical imaging applications.

S-HARP: A parallel dynamic spectral partitioner

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

Sohn, A.; Simon, H.

1998-01-01

Computational science problems with adaptive meshes involve dynamic load balancing when implemented on parallel machines. This dynamic load balancing requires fast partitioning of computational meshes at run time. The authors present in this report a fast parallel dynamic partitioner, called S-HARP. The underlying principles of S-HARP are the fast feature of inertial partitioning and the quality feature of spectral partitioning. S-HARP partitions a graph from scratch, requiring no partition information from previous iterations. Two types of parallelism have been exploited in S-HARP, fine grain loop level parallelism and coarse grain recursive parallelism. The parallel partitioner has been implemented in Messagemore » Passing Interface on Cray T3E and IBM SP2 for portability. Experimental results indicate that S-HARP can partition a mesh of over 100,000 vertices into 256 partitions in 0.2 seconds on a 64 processor Cray T3E. S-HARP is much more scalable than other dynamic partitioners, giving over 15 fold speedup on 64 processors while ParaMeTiS1.0 gives a few fold speedup. Experimental results demonstrate that S-HARP is three to 10 times faster than the dynamic partitioners ParaMeTiS and Jostle on six computational meshes of size over 100,000 vertices.« less

Analysis of occupational exposures to blood registered in the General Hospital in Zabrze in the years 2006-2015

PubMed

Kocur, Ewelina; Śliwa-Rak, Bożena; Grosicki, Sebastian

Viral hepatitis B and C are the most common occupational diseases among health care workers. Infection occurs during performance of medical procedures which carries a risk of contact with biological material derived from a patient. The aim of the study was to analyse cases of occupational exposure to biological material as recorded by the employees of the City Hospital in Zabrze, to attempt to determine which medical procedures are of greatest risk of occupational exposure, and to identify the most important actions aimed at reduction of their number. The analysis included all cases of exposure to biological material derived from a patient, which were reported by employees of the City Hospital in Zabrze in 2006–2015. The analysis included the percentage of exposure for individual occupational groups and wards of the hospital, the type of the procedure at performance of which the exposure occurred, the type of tools affecting the skin continuity and proper conduct of the proceedings of the employee after exposure. The occupational group most frequently affected by exposures were nurses/midwives. This occupational group accounted for 41.2% of all exposed people. The next highest percentage exposure of 5.9% concerned the occupational group of doctors, further paramedics with 3.8%, orderlies – 2.6%, nurses – 2.4%. The ward of internal diseases had most frequent occurrences of exposure, but the percentage of exposure was the highest for the operating room – 7.5%. Most often the injury occurred during sampling venous blood – 20.6%. People assisting at procedures performed with a use of sharp equipment made 13.4% of employees exposed to blood. Orderlies were the third occupational group in terms of most common cuts. The employees were injured by cutting themselves while disposing of waste as often as when performing/assisting with a surgery. In 24.7% of cases immediately after exposure to biological material the employees behaved contrary to the procedure. List of exposures should not be limited only to cases of injuries caused by sharp instruments. Analysis of the circumstances and type of procedures during performance of which occur exposures allows for modification of procedures and reduction of the amount of exposures. Trainings in prevention of exposure should include all occupational groups, which are in contact with patients and medical waste.

Polymer-based alternative method to extract bromelain from pineapple peel waste.

PubMed

Novaes, Letícia Celia de Lencastre; Ebinuma, Valéria de Carvalho Santos; Mazzola, Priscila Gava; Pessoa, Adalberto

2013-01-01

Bromelain is a mixture of proteolytic enzymes present in all tissues of the pineapple (Ananas comosus Merr.), and it is known for its clinical therapeutic applications, food processing, and as a dietary supplement. The use of pineapple waste for bromelain extraction is interesting from both an environmental and a commercial point of view, because the protease has relevant clinical potential. We aimed to study the optimization of bromelain extraction from pineapple waste, using the aqueous two-phase system formed by polyethylene glycol (PEG) and poly(acrylic acid). In this work, bromelain partitioned preferentially to the top/PEG-rich phase and, in the best condition, achieved a yield of 335.27% with a purification factor of 25.78. The statistical analysis showed that all variables analyzed were significant to the process. © 2013 International Union of Biochemistry and Molecular Biology, Inc.

Investigation of Contaminated Ground Water at Solid Waste Management Unit 12, Naval Weapons Station Charleston, North Charleston, South Carolina, 2006-2007

USGS Publications Warehouse

Vroblesky, Don A.; Petkewich, Matthew D.; Lowery, Mark A.; Conlon, Kevin J.; Harrelson, Larry G.

2008-01-01

The U.S. Geological Survey investigated natural and engineered remediation of chlorinated volatile organic compound (VOC) ground-water contamination at Solid Waste Management Unit 12 at the Naval Weapons Station Charleston, North Charleston, South Carolina, beginning in 2000. The primary contaminants of interest in the study are tetrachloroethene, 1,1,1-trichloroethane, trichloroethene, cis-1,2-dichloroethene, vinyl chloride, 1,1-dichloroethane, and 1,1-dichloroethene. The permeable reactive barrier (PRB) along the main axis of the contaminant plume appears to be actively removing contamination. In contrast to the central area of the PRB, the data from the southern end of the PRB indicate that contaminants are moving around the PRB. Concentrations in wells 12MW-10S and 12MW-03S, upgradient from the PRB, showed a general decrease in VOC concentrations. VOC concentrations in some wells in the forest showed a sharp increase, followed by a decrease. In 2007, the VOC concentrations began to increase in well 12MW-12S, downgradient from the PRB and thought to be unaffected by the PRB. The VOC-concentration changes in the forest, such as at well 12MW-12S, may represent lateral shifting of the plume in response to changes in ground-water-flow direction or may represent movement of a contamination pulse through the forest.

Archaea and Bacteria Acclimate to High Total Ammonia in a Methanogenic Reactor Treating Swine Waste

PubMed Central

Parameswaran, Prathap; Rittmann, Bruce E.

2016-01-01

Inhibition by ammonium at concentrations above 1000 mgN/L is known to harm the methanogenesis phase of anaerobic digestion. We anaerobically digested swine waste and achieved steady state COD-removal efficiency of around 52% with no fatty-acid or H2 accumulation. As the anaerobic microbial community adapted to the gradual increase of total ammonia-N (NH3-N) from 890 ± 295 to 2040 ± 30 mg/L, the Bacterial and Archaeal communities became less diverse. Phylotypes most closely related to hydrogenotrophic Methanoculleus (36.4%) and Methanobrevibacter (11.6%), along with acetoclastic Methanosaeta (29.3%), became the most abundant Archaeal sequences during acclimation. This was accompanied by a sharp increase in the relative abundances of phylotypes most closely related to acetogens and fatty-acid producers (Clostridium, Coprococcus, and Sphaerochaeta) and syntrophic fatty-acid Bacteria (Syntrophomonas, Clostridium, Clostridiaceae species, and Cloacamonaceae species) that have metabolic capabilities for butyrate and propionate fermentation, as well as for reverse acetogenesis. Our results provide evidence countering a prevailing theory that acetoclastic methanogens are selectively inhibited when the total ammonia-N concentration is greater than ~1000 mgN/L. Instead, acetoclastic and hydrogenotrophic methanogens coexisted in the presence of total ammonia-N of ~2000 mgN/L by establishing syntrophic relationships with fatty-acid fermenters, as well as homoacetogens able to carry out forward and reverse acetogenesis. PMID:27725793

Archaea and Bacteria Acclimate to High Total Ammonia in a Methanogenic Reactor Treating Swine Waste.

PubMed

Esquivel-Elizondo, Sofia; Parameswaran, Prathap; Delgado, Anca G; Maldonado, Juan; Rittmann, Bruce E; Krajmalnik-Brown, Rosa

2016-01-01

Inhibition by ammonium at concentrations above 1000 mgN/L is known to harm the methanogenesis phase of anaerobic digestion. We anaerobically digested swine waste and achieved steady state COD-removal efficiency of around 52% with no fatty-acid or H 2 accumulation. As the anaerobic microbial community adapted to the gradual increase of total ammonia-N (NH 3 -N) from 890 ± 295 to 2040 ± 30 mg/L, the Bacterial and Archaeal communities became less diverse. Phylotypes most closely related to hydrogenotrophic Methanoculleus (36.4%) and Methanobrevibacter (11.6%), along with acetoclastic Methanosaeta (29.3%), became the most abundant Archaeal sequences during acclimation. This was accompanied by a sharp increase in the relative abundances of phylotypes most closely related to acetogens and fatty-acid producers ( Clostridium , Coprococcus , and Sphaerochaeta ) and syntrophic fatty-acid Bacteria ( Syntrophomonas , Clostridium , Clostridiaceae species, and Cloacamonaceae species) that have metabolic capabilities for butyrate and propionate fermentation, as well as for reverse acetogenesis. Our results provide evidence countering a prevailing theory that acetoclastic methanogens are selectively inhibited when the total ammonia-N concentration is greater than ~1000 mgN/L. Instead, acetoclastic and hydrogenotrophic methanogens coexisted in the presence of total ammonia-N of ~2000 mgN/L by establishing syntrophic relationships with fatty-acid fermenters, as well as homoacetogens able to carry out forward and reverse acetogenesis.

Induction of the SHARP-2 mRNA level by insulin is mediated by multiple signaling pathways.

PubMed

Kanai, Yukiko; Asano, Kosuke; Komatsu, Yoshiko; Takagi, Katsuhiro; Ono, Moe; Tanaka, Takashi; Tomita, Koji; Haneishi, Ayumi; Tsukada, Akiko; Yamada, Kazuya

2017-02-01

The rat enhancer of split- and hairy-related protein-2 (SHARP-2) is an insulin-inducible transcription factor which represses transcription of the rat phosphoenolpyruvate carboxykinase gene. In this study, a regulatory mechanism of the SHARP-2 mRNA level by insulin was analyzed. Insulin rapidly induced the level of SHARP-2 mRNA. This induction was blocked by inhibitors for phosphoinositide 3-kinase (PI 3-K), protein kinase C (PKC), and mammalian target of rapamycin (mTOR), actinomycin D, and cycloheximide. Whereas an adenovirus infection expressing a dominant negative form of atypical PKC lambda (aPKCλ) blocked the insulin-induction of the SHARP-2 mRNA level, insulin rapidly activated the mTOR. Insulin did not enhance transcriptional activity from a 3.7 kb upstream region of the rat SHARP-2 gene. Thus, we conclude that insulin induces the expression of the rat SHARP-2 gene at the transcription level via both a PI 3-K/aPKCλ- and a PI 3-K/mTOR- pathways and that protein synthesis is required for this induction.

Audit of sharp weapon deaths in metropolis of Karachi--an autopsy based study.

PubMed

Mirza, Farhat Hussain; Hasan, Qudsia; Memon, Akhtar Amin; Adil, Syeda Ezz-e-Rukhshan

2010-01-01

Sharp weapons are one of the most violent and abhorrent means of deaths. This study assesses the frequency of sharp weapon deaths in Karachi. This was a cross sectional study, and involves the deaths by sharp weapons autopsied in Karachi during Mar 2008-Feb 2009. This study reports that the frequency of sharp weapon deaths in Karachi is similar to some other studies conducted in different regions of Pakistan, yet it is very high as the population of Karachi is way more than any other metropolis of Pakistan. Our study reported that out of 2090 medico-legal deaths in Karachi during the study period, 91 deaths were due to sharp weapons, including 73 (80.2%) males and 18 (19.8%) females. 100% of the deaths were homicides, so none were suicides. Deaths were more frequent in age group ranging from 20-39 years (59.3%). Sharp weapon deaths continue to be a means of quite a number of deaths in Karachi. Such violence depicts intolerant and frustrated nature of the citizens.

A Framework for Measuring Low-Value Care.

PubMed

Miller, George; Rhyan, Corwin; Beaudin-Seiler, Beth; Hughes-Cromwick, Paul

2018-04-01

It has been estimated that more than 30% of health care spending in the United States is wasteful, and that low-value care, which drives up costs unnecessarily while increasing patient risk, is a significant component of wasteful spending. To address the need for an ability to measure the magnitude of low-value care nationwide, identify the clinical services that are the greatest contributors to waste, and track progress toward eliminating low-value use of these services. Such an ability could provide valuable input to the efforts of policymakers and health systems to improve efficiency. We reviewed existing methods that could contribute to measuring low-value care and developed an integrated framework that combines multiple methods to comprehensively estimate and track the magnitude and principal sources of clinical waste. We also identified a process and needed research for implementing the framework. A comprehensive methodology for measuring and tracking low-value care in the United States would provide an important contribution toward reducing waste. Implementation of the framework described in this article appears feasible, and the proposed research program will allow moving incrementally toward full implementation while providing a near-term capability for measuring low-value care that can be enhanced over time. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Mammary tumorigenesis causes bone loss and dietary selenium supplementation does not affect such bone loss in male MMTV-PyMT mice

USDA-ARS?s Scientific Manuscript database

Cancer progression is accompanied by wasting that eventually results in cachexia characterized by significant weight loss and multi-organ functional failures. Limited clinical trials indicate that bone is adversely affected by cancer-associated wasting. To determine the effects of breast cancer on...

Validation of Autoclave Protocols for Successful Decontamination of Category A Medical Waste Generated from Care of Patients with Serious Communicable Diseases

PubMed Central

Reimers, Mallory; Ernst, Neysa; Bova, Gregory; Nowakowski, Elaine; Bukowski, James; Ellis, Brandon C.; Smith, Chris; Sauer, Lauren; Dionne, Kim; Carroll, Karen C.; Maragakis, Lisa L.; Parrish, Nicole M.

2016-01-01

ABSTRACT In response to the Ebola outbreak in 2014, many hospitals designated specific areas to care for patients with Ebola and other highly infectious diseases. The safe handling of category A infectious substances is a unique challenge in this environment. One solution is on-site waste treatment with a steam sterilizer or autoclave. The Johns Hopkins Hospital (JHH) installed two pass-through autoclaves in its biocontainment unit (BCU). The JHH BCU and The Johns Hopkins biosafety level 3 (BSL-3) clinical microbiology laboratory designed and validated waste-handling protocols with simulated patient trash to ensure adequate sterilization. The results of the validation process revealed that autoclave factory default settings are potentially ineffective for certain types of medical waste and highlighted the critical role of waste packaging in successful sterilization. The lessons learned from the JHH validation process can inform the design of waste management protocols to ensure effective treatment of highly infectious medical waste. PMID:27927920

Validation of Autoclave Protocols for Successful Decontamination of Category A Medical Waste Generated from Care of Patients with Serious Communicable Diseases.

PubMed

Garibaldi, Brian T; Reimers, Mallory; Ernst, Neysa; Bova, Gregory; Nowakowski, Elaine; Bukowski, James; Ellis, Brandon C; Smith, Chris; Sauer, Lauren; Dionne, Kim; Carroll, Karen C; Maragakis, Lisa L; Parrish, Nicole M

2017-02-01

In response to the Ebola outbreak in 2014, many hospitals designated specific areas to care for patients with Ebola and other highly infectious diseases. The safe handling of category A infectious substances is a unique challenge in this environment. One solution is on-site waste treatment with a steam sterilizer or autoclave. The Johns Hopkins Hospital (JHH) installed two pass-through autoclaves in its biocontainment unit (BCU). The JHH BCU and The Johns Hopkins biosafety level 3 (BSL-3) clinical microbiology laboratory designed and validated waste-handling protocols with simulated patient trash to ensure adequate sterilization. The results of the validation process revealed that autoclave factory default settings are potentially ineffective for certain types of medical waste and highlighted the critical role of waste packaging in successful sterilization. The lessons learned from the JHH validation process can inform the design of waste management protocols to ensure effective treatment of highly infectious medical waste. Copyright © 2017 American Society for Microbiology.

Characteristics and management of infectious industrial waste in Taiwan

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

Huang, M.-C.; Lin, Jim Juimin

Infectious industrial waste management in Taiwan is based on the specific waste production unit. In other countries, management is based simply on whether the producer may lead to infectious disease. Thus, Taiwan has a more detailed classification of infectious waste. The advantage of this classification is that it is easy to identify the sources, while the disadvantage lies in the fact that it is not flexible and hence increases cost. This study presents an overview of current management practices for handling infectious industrial waste in Taiwan, and addresses the current waste disposal methods. The number of small clinics in Taiwanmore » increased from 18,183 to 18,877 between 2003 and 2005. Analysis of the data between 2003 and 2005 showed that the majority of medical waste was general industrial waste, which accounted for 76.9%-79.4% of total medical waste. Infectious industrial waste accounted for 19.3%-21.9% of total medical waste. After the SARS event in Taiwan, the amount of infectious waste reached 19,350 tons in 2004, an increase over the previous year of 4000 tons. Waste minimization was a common consideration for all types of waste treatment. In this study, we summarize the percentage of plastic waste in flammable infectious industrial waste generated by medical units, which, in Taiwan was about 30%. The EPA and Taiwan Department of Health have actively promoted different recycling and waste reduction measures. However, the wide adoption of disposable materials made recycling and waste reduction difficult for some hospitals. It has been suggested that enhancing the education of and promoting communication between medical units and recycling industries must be implemented to prevent recyclable waste from entering the incinerator.« less

Phytoremediation of spoil coal dumps in Western Donbass (Ukraine)

NASA Astrophysics Data System (ADS)

Klimkina, Iryna; Kharytonov, Mykola; Wiche, Oliver; Heilmeier, Hermann

2017-04-01

At the moment, in Ukraine about 150 thousand hectares of fertile land are occupied by spoil dumps. Moreover, this figure increases every year. According to the technology used about 1500 m3 of adjacent stratum is dumped at the surface per every 1000 tons of coal mined. Apart from land amortization, waste dumps drastically change the natural landscape and pollute air, soil and water sources as the result of water and wind erosion, as well as self-ignition processes. A serious concern exists with respect to the Western Donbass coal mining region in Ukraine, where the coal extraction is made by the subsurface way and solid wastes are represented by both spoil dumps and wastes after coal processing. Sulphides, mostly pyrite (up to 4% of waste material), are widely distributed in the waste heaps freshly removed due to coal mining in Western Donbass.The oxidation of pyrite with the presence of oxygen and water is accompanied by a sharp drop in the pH from the surface layer to the spoil dumps(from 5.2-6.2 to 3.9-4.2 in soil substrates with chernozen and from 8.3-8.4 to 6.7-7.2 in soil substrates with red-brown clay, stabilizing in dump material in both cases at 2.9-3.2). Low pH generates the transformation of a number of toxic metals and other elementspresent in waste rock (e.g. Fe, Al, Mn, Zn, Mo, Co, As, Cd, Bi, Pb, U) into mobile forms. To stabilize and reduce metal mobility the most resistant plants that occur naturally in specified ecosystems can be used. On coal spoil dumpsin Western Donbas the dominant species are Bromopsis inermis, subdominant Artemisia austriaca; widespread are also Festucas pp., Lathyrus tuberosus, Inula sp., Calamagrostis epigeios, Lotus ucrainicus, and Vicias pp. Identification of plants tolerant to target metals is a key issue in phytotechnology for soil restoration. It is hypothesized that naturally occurring plants growing on coal spoil dumps can be candidates for phytostabilization, phytoextraction (phytoaccumulation) and phytomining techniques. Results on accumulation of target elements in the above- and below ground biomass of abundant plant species will be used to discuss their phytoremediation potential for spoil coal dumps in Western Donbas. Research is being carried out in the framework of DAAD project "Biotechnology in Mining - Integration of New Technologies into Educational Practice" and cooperation between TechnischeUniversität Bergakademie Freiberg, Germany, and National Mining University, Dnipro, Ukraine.

Effectiveness of short-term, enhanced, infection control support in improving compliance with infection control guidelines and practice in nursing homes: a cluster randomized trial.

PubMed

Gopal Rao, G; Jeanes, A; Russell, H; Wilson, D; Atere-Roberts, E; O'Sullivan, D; Donaldson, N

2009-10-01

In this prospective cluster randomized controlled trial we evaluated the impact of short-term provision of enhanced infection control support on infection control practice in nursing homes in South London. Twelve nursing homes were recruited, six each in intervention (300 residents) and control (265 residents) groups. Baseline observations of hand hygiene facilities, environmental cleanliness and safe disposal of clinical waste showed poor compliance in both groups. Post-intervention observations showed improvement in both groups. There was no statistical difference between the two groups in the compliance for hand hygiene facilities (P=0.69); environmental cleanliness (P=0.43) and safe disposal of clinical waste (P=0.96). In both groups, greatest improvement was in compliance with safe disposal of clinical waste and the least improvement was in hand hygiene facilities. Since infection control practice improved in intervention and control groups, we could not demonstrate that provision of short-term, enhanced, infection control support in nursing homes had a significant impact in infection control practice.

Effect of Silymarin Administration on Cisplatin Nephrotoxicity: Report from A Pilot, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial.

PubMed

Shahbazi, Foroud; Sadighi, Sanambar; Dashti-Khavidaki, Simin; Shahi, Farhad; Mirzania, Mehrzad; Abdollahi, Alireza; Ghahremani, Mohammad-Hossein

2015-07-01

Despite several introduced preventive modalities, cisplatin nephrotoxicity remains a clinical problem. Some in vitro and in vivo studies have addressed the protective effects of silymarin against cisplatin nephrotoxicity. This study evaluated the effects of silymarin administration on cisplatin nephrotoxicity as the first human study. During this pilot, randomized, double-blinded, placebo-controlled clinical trial, the effect of oral silymarin 420 mg daily in three divided doses starting 24-48 h before the initiation of cisplatin infusion and continuing to the end of three 21-day cisplatin-containing chemotherapy courses on cisplatin-induced renal electrolytes wasting and kidney function were assessed. Cisplatin-associated acute kidney injury (AKI) occurred in 8% of the patients. Urine neutrophil gelatinase-associated lipocalin to urine creatinine ratio (NGAL/Cr) and urinary magnesium and potassium wasting increased significantly after cisplatin infusion in both groups. Significant positive correlation was found between cumulative dose of cisplatin and urine NGAL/Cr after three courses of cisplatin infusion. Incidence of AKI and the magnitude of urinary magnesium and potassium wasting did not differ between silymarin and placebo groups. No adverse reaction was reported by silymarin administration. Prophylactic administration of conventional form of silymarin tablets could not prevent cisplatin-induced urine electrolyte wasting or renal function impairment. Copyright © 2015 John Wiley & Sons, Ltd.

Using Lean Thinking at an otorhinolaryngology outpatient clinic to improve quality of care.

PubMed

van Leijen-Zeelenberg, Janneke E; Brunings, Jan Wouter; Houkes, Inge; van Raak, Arno J A; Ruwaard, Dirk; Vrijhoef, Hubertus J M; Kremer, Bernd

2016-04-01

Although Lean Thinking has led to considerable improvement in a variety of healthcare settings, its effects on otorhinolaryngology remain underexposed. This study reports on how the implementation of Lean Thinking at an otorhinolaryngology outpatient clinic has affected patient and provider satisfaction, waste reduction, and organizational culture. Prospective before-and-after design. The 18-month prospective before-and-after design used mixed methods for data collection and analysis. A survey was conducted to measure satisfaction among patients and providers. Semistructured interviews were conducted to evaluate the effect of Lean Thinking on waste and organizational culture. During the project, 69 issues were posted on the Lean board. Improvements were made on 36 inefficiency issues, not all concerning a specific type of waste. Employees reported considerable improvement in transportation, motion, and waiting. Patient satisfaction was high both at baseline and follow-up and did not change significantly. The effects on provider satisfaction were slight; satisfaction with autonomy and participation decreased significantly, but satisfaction with communication increased significantly. The implementation of Lean Thinking at an otorhinolaryngology outpatient clinic reduced waste and increased provider satisfaction with communication. Although patient satisfaction did not change significantly, it cannot be concluded that the intervention had no effect on perceived quality of care. Other approaches to measure patients' perceptions should be considered. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Economics of feeding pasteurized colostrum and pasteurized waste milk to dairy calves.

PubMed

Jamaluddin, A A; Carpenter, T E; Hird, D W; Thurmond, M C

1996-08-15

To estimate the marginal contribution of pasteurization of waste milk and colostrum to gross margin per calf at weaning and to estimate the minimum number of cattle on a dairy farm for pasteurization to be profitable. Randomized, controlled, clinical trial. 300 Holstein calves. The performance of calves fed pasteurized colostrum and waste milk was compared with the performance of calves fed nonpasteurized colostrum and waste milk. Costs, revenues, and gross margins for the 2 groups were compared. Calves fed pasteurized colostrum and waste milk were worth an extra $8.13 in gross margin/calf, compared with calves fed nonpasteurized colostrum and waste milk. The minimum number of cattle for which feeding pasteurized colostrum and waste milk was calculated to be economically feasible was 315 calves/d (1,260-cow dairy farm). An economic benefit was associated with feeding pasteurized colostrum and waste milk. Additional benefits that may accrue include higher mean weight gain and lower mortality rate of calves as well as calves that have fewer days in which they are affected with diarrhea and pneumonia.

Evaluation of a Novel Approach for Reducing Emissions of Pharmaceuticals to the Environment

NASA Astrophysics Data System (ADS)

Bean, Thomas G.; Bergstrom, Ed; Thomas-Oates, Jane; Wolff, Amy; Bartl, Peter; Eaton, Bob; Boxall, Alistair B. A.

2016-10-01

Increased interest over the levels of pharmaceuticals detected in the environment has led to the need for new approaches to manage their emissions. Inappropriate disposal of unused and waste medicines and release from manufacturing plants are believed to be important pathways for pharmaceuticals entering the environment. In situ treatment technologies, which can be used on-site in pharmacies, hospitals, clinics, and at manufacturing plants, might provide a solution. In this study we explored the use of Pyropure, a microscale combined pyrolysis and gasification in situ treatment system for destroying pharmaceutical wastes. This involved selecting 17 pharmaceuticals, including 14 of the most thermally stable compounds currently in use and three of high environmental concern to determine the technology's success in waste destruction. Treatment simulation studies were done on three different waste types and liquid, solid, and gaseous emissions from the process were analyzed for parent pharmaceutical and known active transformation products. Gaseous emissions were also analyzed for NOx, particulates, dioxins, furans, and metals. Results suggest that Pyropure is an effective treatment process for pharmaceutical wastes: over 99 % of each study pharmaceutical was destroyed by the system without known active transformation products being formed during the treatment process. Emissions of the other gaseous air pollutants were within acceptable levels. Future uptake of the system, or similar in situ treatment approaches, by clinics, pharmacists, and manufacturers could help to reduce the levels of pharmaceuticals in the environment and reduce the economic and environmental costs of current waste management practices.

A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease.

PubMed

Fouque, D; Kalantar-Zadeh, K; Kopple, J; Cano, N; Chauveau, P; Cuppari, L; Franch, H; Guarnieri, G; Ikizler, T A; Kaysen, G; Lindholm, B; Massy, Z; Mitch, W; Pineda, E; Stenvinkel, P; Treviño-Becerra, A; Trevinho-Becerra, A; Wanner, C

2008-02-01

The recent research findings concerning syndromes of muscle wasting, malnutrition, and inflammation in individuals with chronic kidney disease (CKD) or acute kidney injury (AKI) have led to a need for new terminology. To address this need, the International Society of Renal Nutrition and Metabolism (ISRNM) convened an expert panel to review and develop standard terminologies and definitions related to wasting, cachexia, malnutrition, and inflammation in CKD and AKI. The ISRNM expert panel recommends the term 'protein-energy wasting' for loss of body protein mass and fuel reserves. 'Kidney disease wasting' refers to the occurrence of protein-energy wasting in CKD or AKI regardless of the cause. Cachexia is a severe form of protein-energy wasting that occurs infrequently in kidney disease. Protein-energy wasting is diagnosed if three characteristics are present (low serum levels of albumin, transthyretin, or cholesterol), reduced body mass (low or reduced body or fat mass or weight loss with reduced intake of protein and energy), and reduced muscle mass (muscle wasting or sarcopenia, reduced mid-arm muscle circumference). The kidney disease wasting is divided into two main categories of CKD- and AKI-associated protein-energy wasting. Measures of chronic inflammation or other developing tests can be useful clues for the existence of protein-energy wasting but do not define protein-energy wasting. Clinical staging and potential treatment strategies for protein-energy wasting are to be developed in the future.

Sumoylation of the Basic Helix-Loop-Helix Transcription Factor Sharp-1 Regulates Recruitment of the Histone Methyltransferase G9a and Function in Myogenesis*

PubMed Central

Wang, Yaju; Shankar, Shilpa Rani; Kher, Devaki; Ling, Belinda Mei Tze; Taneja, Reshma

2013-01-01

Sumoylation is an important post-translational modification that alters the activity of many transcription factors. However, the mechanisms that link sumoylation to alterations in chromatin structure, which culminate in tissue specific gene expression, are not fully understood. In this study, we demonstrate that SUMO modification of the transcription factor Sharp-1 is required for its full transcriptional repression activity and function as an inhibitor of skeletal muscle differentiation. Sharp-1 is modified by sumoylation at two conserved lysine residues 240 and 255. Mutation of these SUMO acceptor sites in Sharp-1 does not impact its subcellular localization but attenuates its ability to act as a transcriptional repressor and inhibit myogenic differentiation. Consistently, co-expression of the SUMO protease SENP1 with wild type Sharp-1 abrogates Sharp-1-dependent inhibition of myogenesis. Interestingly, sumoylation acts as a signal for recruitment of the co-repressor G9a. Thus, enrichment of G9a, and histone H3 lysine 9 dimethylation (H3K9me2), a signature of G9a activity, is dramatically reduced at muscle promoters in cells expressing sumoylation-defective Sharp-1. Our findings demonstrate how sumoylation of Sharp-1 exerts an impact on chromatin structure and transcriptional repression of muscle gene expression through recruitment of G9a. PMID:23637228

Technical Approach for Determining Key Parameters Needed for Modeling the Performance of Cast Stone for the Integrated Disposal Facility Performance Assessment

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

Yabusaki, Steven B.; Serne, R. Jeffrey; Rockhold, Mark L.

2015-03-30

Washington River Protection Solutions (WRPS) and its contractors at Pacific Northwest National Laboratory (PNNL) and Savannah River National Laboratory (SRNL) are conducting a development program to develop / refine the cementitious waste form for the wastes treated at the ETF and to provide the data needed to support the IDF PA. This technical approach document is intended to provide guidance to the cementitious waste form development program with respect to the waste form characterization and testing information needed to support the IDF PA. At the time of the preparation of this technical approach document, the IDF PA effort is justmore » getting started and the approach to analyze the performance of the cementitious waste form has not been determined. Therefore, this document looks at a number of different approaches for evaluating the waste form performance and describes the testing needed to provide data for each approach. Though the approach addresses a cementitious secondary aqueous waste form, it is applicable to other waste forms such as Cast Stone for supplemental immobilization of Hanford LAW. The performance of Cast Stone as a physical and chemical barrier to the release of contaminants of concern (COCs) from solidification of Hanford liquid low activity waste (LAW) and secondary wastes processed through the Effluent Treatment Facility (ETF) is of critical importance to the Hanford Integrated Disposal Facility (IDF) total system performance assessment (TSPA). The effectiveness of cementitious waste forms as a barrier to COC release is expected to evolve with time. PA modeling must therefore anticipate and address processes, properties, and conditions that alter the physical and chemical controls on COC transport in the cementitious waste forms over time. Most organizations responsible for disposal facility operation and their regulators support an iterative hierarchical safety/performance assessment approach with a general philosophy that modeling provides the critical link between the short-term understanding from laboratory and field tests, and the prediction of repository performance over repository time frames and scales. One common recommendation is that experiments be designed to permit the appropriate scaling in the models. There is a large contrast in the physical and chemical properties between the Cast Stone waste package and the IDF backfill and surrounding sediments. Cast Stone exhibits low permeability, high tortuosity, low carbonate, high pH, and low Eh whereas the backfill and native sediments have high permeability, low tortuosity, high carbonate, circumneutral pH, and high Eh. These contrasts have important implications for flow, transport, and reactions across the Cast Stone – backfill interface. Over time with transport across the interface and subsequent reactions, the sharp geochemical contrast will blur and there will be a range of spatially-distributed conditions. In general, COC mobility and transport will be sensitive to these geochemical variations, which also include physical changes in porosity and permeability from mineral reactions. Therefore, PA modeling must address processes, properties, and conditions that alter the physical and chemical controls on COC transport in the cementitious waste forms over time. Section 2 of this document reviews past Hanford PAs and SRS Saltstone PAs, which to date have mostly relied on the lumped parameter COC release conceptual models for TSPA predictions, and provides some details on the chosen values for the lumped parameters. Section 3 provides more details on the hierarchical modeling strategy and processes and mechanisms that control COC release. Section 4 summarizes and lists the key parameters for which numerical values are needed to perform PAs. Section 5 provides brief summaries of the methods used to measure the needed parameters and references to get more details.« less

[Clinical observation of using composite resin to fill dental attrition on occlusal surface].

PubMed

Guo, Li-juan; Xu, Yan; Chen, Guang-quan

2005-10-01

The purpose of this study was to evaluate the clinical effect of using composite resin to fill dental attrition on occlusal surface. Whether the dental attrition had enough space to the material was determined first. Sometimes grinding the sharp and steep cusps or ridges of the opposite teeth was needed. Then the dental attrition was cleaned thoroughly, and finally filled with CLEARFIL bond and composite resin without preparing cavity. The follow-up period was 1 year. Out of 70 teeth from 25 patients, 52 were successful, 16 were curative, and 2 were failed. The curative rate was 97.14%. The method avoids endangering the dental pulp. It was easily accepted by the patients and operated by dentists, and can be widely applied in clinical cases.

Waste minimization for commercial radioactive materials users generating low-level radioactive waste. Revision 1

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

Fischer, D.K.; Gitt, M.; Williams, G.A.

1991-07-01

The objective of this document is to provide a resource for all states and compact regions interested in promoting the minimization of low-level radioactive waste (LLW). This project was initiated by the Commonwealth of Massachusetts, and Massachusetts waste streams have been used as examples; however, the methods of analysis presented here are applicable to similar waste streams generated elsewhere. This document is a guide for states/compact regions to use in developing a system to evaluate and prioritize various waste minimization techniques in order to encourage individual radioactive materials users (LLW generators) to consider these techniques in their own independent evaluations.more » This review discusses the application of specific waste minimization techniques to waste streams characteristic of three categories of radioactive materials users: (1) industrial operations using radioactive materials in the manufacture of commercial products, (2) health care institutions, including hospitals and clinics, and (3) educational and research institutions. Massachusetts waste stream characterization data from key radioactive materials users in each category are used to illustrate the applicability of various minimization techniques. The utility group is not included because extensive information specific to this category of LLW generators is available in the literature.« less

Waste minimization for commercial radioactive materials users generating low-level radioactive waste

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

Fischer, D.K.; Gitt, M.; Williams, G.A.

1991-07-01

The objective of this document is to provide a resource for all states and compact regions interested in promoting the minimization of low-level radioactive waste (LLW). This project was initiated by the Commonwealth of Massachusetts, and Massachusetts waste streams have been used as examples; however, the methods of analysis presented here are applicable to similar waste streams generated elsewhere. This document is a guide for states/compact regions to use in developing a system to evaluate and prioritize various waste minimization techniques in order to encourage individual radioactive materials users (LLW generators) to consider these techniques in their own independent evaluations.more » This review discusses the application of specific waste minimization techniques to waste streams characteristic of three categories of radioactive materials users: (1) industrial operations using radioactive materials in the manufacture of commercial products, (2) health care institutions, including hospitals and clinics, and (3) educational and research institutions. Massachusetts waste stream characterization data from key radioactive materials users in each category are used to illustrate the applicability of various minimization techniques. The utility group is not included because extensive information specific to this category of LLW generators is available in the literature.« less

The Impact of Different Levels of Adaptive Iterative Dose Reduction 3D on Image Quality of 320-Row Coronary CT Angiography: A Clinical Trial

PubMed Central

Feger, Sarah; Rief, Matthias; Zimmermann, Elke; Martus, Peter; Schuijf, Joanne Désirée; Blobel, Jörg; Richter, Felicitas; Dewey, Marc

2015-01-01

Purpose The aim of this study was the systematic image quality evaluation of coronary CT angiography (CTA), reconstructed with the 3 different levels of adaptive iterative dose reduction (AIDR 3D) and compared to filtered back projection (FBP) with quantum denoising software (QDS). Methods Standard-dose CTA raw data of 30 patients with mean radiation dose of 3.2 ± 2.6 mSv were reconstructed using AIDR 3D mild, standard, strong and compared to FBP/QDS. Objective image quality comparison (signal, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contour sharpness) was performed using 21 measurement points per patient, including measurements in each coronary artery from proximal to distal. Results Objective image quality parameters improved with increasing levels of AIDR 3D. Noise was lowest in AIDR 3D strong (p≤0.001 at 20/21 measurement points; compared with FBP/QDS). Signal and contour sharpness analysis showed no significant difference between the reconstruction algorithms for most measurement points. Best coronary SNR and CNR were achieved with AIDR 3D strong. No loss of SNR or CNR in distal segments was seen with AIDR 3D as compared to FBP. Conclusions On standard-dose coronary CTA images, AIDR 3D strong showed higher objective image quality than FBP/QDS without reducing contour sharpness. Trial Registration Clinicaltrials.gov NCT00967876 PMID:25945924

Helping to combat chronic wasting disease

USGS Publications Warehouse

,

2003-01-01

Chronic wasting disease (CWD) is a disease of the nervous system that results in distinctive brain lesions. CWD affects elk, white-tailed deer, and mule deer, but has not been documented in livestock or humans. The origins of the disease, as well as the modes of transmission, remain unknown. Infected deer and elk appear robust and healthy in the early stages of CWD; clinical signs might not show for years. Mortality typically occurs within months after the appearance of clinical signs. The route of transmission is unknown; likely routes include direct transmission between infected and noninfected animals and infected animals contaminating local environments.

Residual motion compensation in ECG-gated interventional cardiac vasculature reconstruction

NASA Astrophysics Data System (ADS)

Schwemmer, C.; Rohkohl, C.; Lauritsch, G.; Müller, K.; Hornegger, J.

2013-06-01

Three-dimensional reconstruction of cardiac vasculature from angiographic C-arm CT (rotational angiography) data is a major challenge. Motion artefacts corrupt image quality, reducing usability for diagnosis and guidance. Many state-of-the-art approaches depend on retrospective ECG-gating of projection data for image reconstruction. A trade-off has to be made regarding the size of the ECG-gating window. A large temporal window is desirable to avoid undersampling. However, residual motion will occur in a large window, causing motion artefacts. We present an algorithm to correct for residual motion. Our approach is based on a deformable 2D-2D registration between the forward projection of an initial, ECG-gated reconstruction, and the original projection data. The approach is fully automatic and does not require any complex segmentation of vasculature, or landmarks. The estimated motion is compensated for during the backprojection step of a subsequent reconstruction. We evaluated the method using the publicly available CAVAREV platform and on six human clinical datasets. We found a better visibility of structure, reduced motion artefacts, and increased sharpness of the vessels in the compensated reconstructions compared to the initial reconstructions. At the time of writing, our algorithm outperforms the leading result of the CAVAREV ranking list. For the clinical datasets, we found an average reduction of motion artefacts by 13 ± 6%. Vessel sharpness was improved by 25 ± 12% on average.

T2 shuffling: Sharp, multicontrast, volumetric fast spin-echo imaging.

PubMed

Tamir, Jonathan I; Uecker, Martin; Chen, Weitian; Lai, Peng; Alley, Marcus T; Vasanawala, Shreyas S; Lustig, Michael

2017-01-01

A new acquisition and reconstruction method called T 2 Shuffling is presented for volumetric fast spin-echo (three-dimensional [3D] FSE) imaging. T 2 Shuffling reduces blurring and recovers many images at multiple T 2 contrasts from a single acquisition at clinically feasible scan times (6-7 min). The parallel imaging forward model is modified to account for temporal signal relaxation during the echo train. Scan efficiency is improved by acquiring data during the transient signal decay and by increasing echo train lengths without loss in signal-to-noise ratio (SNR). By (1) randomly shuffling the phase encode view ordering, (2) constraining the temporal signal evolution to a low-dimensional subspace, and (3) promoting spatio-temporal correlations through locally low rank regularization, a time series of virtual echo time images is recovered from a single scan. A convex formulation is presented that is robust to partial voluming and radiofrequency field inhomogeneity. Retrospective undersampling and in vivo scans confirm the increase in sharpness afforded by T 2 Shuffling. Multiple image contrasts are recovered and used to highlight pathology in pediatric patients. A proof-of-principle method is integrated into a clinical musculoskeletal imaging workflow. The proposed T 2 Shuffling method improves the diagnostic utility of 3D FSE by reducing blurring and producing multiple image contrasts from a single scan. Magn Reson Med 77:180-195, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea

PubMed Central

Tickell, Kirkby D.; Pavlinac, Patricia B.; John-Stewart, Grace C.; Denno, Donna M.; Richardson, Barbra A.; Naulikha, Jaqueline M.; Kirera, Ronald K.; Swierczewski, Brett E.; Singa, Benson O.; Walson, Judd L.

2017-01-01

Abstract. Children with acute and chronic malnutrition are at increased risk of morbidity and mortality following a diarrheal episode. To compare diarrheal disease severity and pathogen prevalence among children with and without acute and chronic malnutrition, we conducted a cross-sectional study of human immunodeficiency virus-uninfected Kenyan children aged 6–59 months, who presented with acute diarrhea. Children underwent clinical and anthropometric assessments and provided stool for bacterial and protozoal pathogen detection. Clinical and microbiological features were compared using log binomial regression among children with and without wasting (mid-upper arm circumference ≤ 125 mm) or stunting (height-for-age z score ≤ −2). Among 1,363 children, 7.0% were wasted and 16.9% were stunted. After adjustment for potential confounders, children with wasting were more likely than nonwasted children to present with at least one Integrated Management of Childhood Illness danger sign (adjusted prevalence ratio [aPR]: 1.3, 95% confidence interval [CI]: 1.0 to 1.5, P = 0.05), severe dehydration (aPR: 2.4, 95% CI: 1.5 to 3.8, P < 0.01), and enteroaggregative Escherichia coli recovered from their stool (aPR: 1.8, 1.1–2.8, P = 0.02). There were no differences in the prevalence of other pathogens by wasting status after confounder adjustment. Stunting was not associated with clinical severity or the presence of specific pathogens. Wasted children with diarrhea presented with more severe disease than children without malnutrition which may be explained by a delay in care-seeking or diminished immune response to infection. Combating social determinants and host risk factors associated with severe disease, rather than specific pathogens, may reduce the disparities in poor diarrhea-associated outcomes experienced by malnourished children. PMID:29140236

Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea.

PubMed

Tickell, Kirkby D; Pavlinac, Patricia B; John-Stewart, Grace C; Denno, Donna M; Richardson, Barbra A; Naulikha, Jaqueline M; Kirera, Ronald K; Swierczewski, Brett E; Singa, Benson O; Walson, Judd L

2017-11-01

Children with acute and chronic malnutrition are at increased risk of morbidity and mortality following a diarrheal episode. To compare diarrheal disease severity and pathogen prevalence among children with and without acute and chronic malnutrition, we conducted a cross-sectional study of human immunodeficiency virus-uninfected Kenyan children aged 6-59 months, who presented with acute diarrhea. Children underwent clinical and anthropometric assessments and provided stool for bacterial and protozoal pathogen detection. Clinical and microbiological features were compared using log binomial regression among children with and without wasting (mid-upper arm circumference ≤ 125 mm) or stunting (height-for-age z score ≤ -2). Among 1,363 children, 7.0% were wasted and 16.9% were stunted. After adjustment for potential confounders, children with wasting were more likely than nonwasted children to present with at least one Integrated Management of Childhood Illness danger sign (adjusted prevalence ratio [aPR]: 1.3, 95% confidence interval [CI]: 1.0 to 1.5, P = 0.05), severe dehydration (aPR: 2.4, 95% CI: 1.5 to 3.8, P < 0.01), and enteroaggregative Escherichia coli recovered from their stool (aPR: 1.8, 1.1-2.8, P = 0.02). There were no differences in the prevalence of other pathogens by wasting status after confounder adjustment. Stunting was not associated with clinical severity or the presence of specific pathogens. Wasted children with diarrhea presented with more severe disease than children without malnutrition which may be explained by a delay in care-seeking or diminished immune response to infection. Combating social determinants and host risk factors associated with severe disease, rather than specific pathogens, may reduce the disparities in poor diarrhea-associated outcomes experienced by malnourished children.

The Sharpness of Blades Used in Dermatologic Surgery.

PubMed

Awadalla, Farah; Hexsel, Camile; Goldberg, Leonard H

2016-01-01

There are numerous blades available for use in dermatologic procedures. There are different advantages that are inhere.nt to different blades due to their shape and size. One aspect of the blade that is instrumental to its performance, but is not objectively defined, is sharpness. This information could be useful when choosing a blade for a particular procedure. This study aims to objectively define the sharpness of blades used in dermatologic surgery. The Sharpness Tester (Cutlery and Allied Trades Research Association, Sheffield, UK) was used to test the force in Newtons a blade requires to cut through a silicone cylinder. New blades were used to determine a standard for the sharpness of new blades. Blades used for surgery were tested to determine the sharpness after use. The sharpest blade is the double-edged razor blade (0.395 N) followed by the dermablade (0.46 N), plastic handled #15 (0.541 N), #15c (0.575 N), #10 (0.647 N), and the #15 blade (0.664 N). The sharpness of a blade is an important factor in its ability to perform a task and should be taken into account when choosing a particular blade for a particular procedure.

Endobronchial ultrasonography versus mediastinoscopy: a single-institution cost analysis and waste comparison.

PubMed

Andrade, Rafael S; Podgaetz, Eitan; Rueth, Natasha M; Majumder, Kaustav; Hall, Eric; Saric, Crystal; Thelen, Lynn

2014-09-01

Mediastinoscopy (MED) and endobronchial ultrasonography with transbronchial needle aspiration (EBUS-TBNA) have similar accuracy for mediastinal lymph node sampling (MLNS). The threatened financial and environmental sustainability of our health care system mandate that surgeons consider cost and environmental impact in clinical decision making of similarly effective procedures. We performed a cost and waste comparison of MED versus EBUS-TBNA for MLNS to raise awareness of the financial and environmental implications of our practices. We conducted a retrospective review of outpatients who underwent MLNS under general anesthesia in the OR with MED or EBUS-TBNA (September 2007 to December 2009). We analyzed direct costs based on hospital charges, calculated expected payment using a decision support model, and profit margins (modeled expected payment-direct costs). Our waste comparison was measured in kilograms of solid waste per case. We performed MLNS in 148 patients (89 EBUS-TBNA, 39 MED, 20 EBUS + MED). Direct costs were lower for MED ($2,356) compared with EBUS-TBNA ($2,503), whereas expected payment was greater (MED, $3,449; EBUS-TBNA, $3,249), resulting in a profit margin that was $347 greater for MED. The amount of solid waste for each MED was 1.8 kg versus 0.5 kg for EBUS-TBNA. MED costs less than EBUS-TBNA in the OR setting but generates 3.6 times the amount of EBUS-TBNA waste. The cost of EBUS-TBNA may improve by performance in the endoscopy suite, and surgical pack revision could reduce the amount of MED solid waste. This comparison sets the stage for sophistication of our clinical decision making, taking into consideration the major threats to our health care system. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Assessing the management of healthcare waste in Hawassa city, Ethiopia.

PubMed

Israel Deneke Haylamicheal; Mohamed Aqiel Dalvie; Biruck Desalegn Yirsaw; Hanibale Atsbeha Zegeye

2011-08-01

Inadequate management of healthcare waste is a serious concern in many developing countries due to the risks posed to human health and the environment. This study aimed to evaluate healthcare waste management in Hawassa city, Ethiopia. The study was conducted in nine healthcare facilities (HCFs) including hospitals (four), health centres (two) and higher clinics (three) in two phases, first to assess the waste management aspect and second to determine daily waste generation rate. The result showed that the median quantity of waste generated at the facilities was 3.46 kg bed(-1) day(-1) (range: 1.48-8.19 kg bed(-1) day(-1)). The quantity of waste per day generated at a HCF increased as occupancy increased (p < 0.001). The percentage hazardous waste generated at government HCFs was more than at private HCFs (p < 0.05). The proportion of hazardous waste (20-63.1%) generated at the different HCFs was much higher than the WHO recommendation (10-25%). There was no waste segregation in most HCFs and only one used a complete color coding system. Solid waste and wastewater were stored, transported, treated and disposed inappropriately at all HCFs. Needle-stick injuries were prevalent in 25-100% of waste handlers employed at these HCFs. Additionally, low levels of training and awareness of waste legislation was prevalent amongst staff. The study showed that management of healthcare waste at HCFs to be poor. Waste management practices need to be improved through improved legislation and enforcement, and training of staff in the healthcare facilities in Hawassa.

Adherence to Healthcare Waste Management Guidelines among Nurses and Waste Handlers in Thika Sub-county- Kenya.

PubMed

Njue, P Mwaniki; Cheboi, K Solomon; Shadrak, Oiye

2015-10-01

Despite the set guidelines on Healthcare Waste Management in Kenya, mixing of different categories of waste, crude dumping and poor incineration are still a common phenomenon in public health facilities in Thika Subcounty, Kenya. Thika Subcounty generates 560 Kilograms of healthcare waste daily, which is risk to the many patients (admission rate of 26%). This may pose a potential environmental risk and be a source of disease diffusion. This research explored the adherence to healthcare waste management waste guidelines in health care facilities among the nurses and waste handlers. This was a cross sectional survey in which mixed methods were applied. A census and proportionate random sampling method were used. Quantitative data was analyzed using Statistical Package for Social Science (SPSS) version 20.0, while qualitative data was analyzed manually into themes. Full adherence to the seven waste disposal guidelines was low (16.3%). Knowledge on waste segregation, waste separation then disposal and means of transports were statistically significant in relation to adherence. The type of incinerator and burning status, protection maintenance and supply of adequate waste bins were also important to adherence level. Adherence level was low (16.3%,) and insignificantly different among nurses and waste handlers. From this finding, compliance remains a key challenge. Strategies targeted at contextualizing waste regulations and guidelines into local settings are necessary and important. Policy makers may design and implement standard incinerators across all the health facilities. This study is not exhaustive; therefore, it is necessary to carry out a study linking poor treatment and disposal of clinical waste to purported health outcomes in Kenya.

Waste in health information systems: a systematic review.

PubMed

Awang Kalong, Nadia; Yusof, Maryati

2017-05-08

Purpose The purpose of this paper is to discuss a systematic review on waste identification related to health information systems (HIS) in Lean transformation. Design/methodology/approach A systematic review was conducted on 19 studies to evaluate Lean transformation and tools used to remove waste related to HIS in clinical settings. Findings Ten waste categories were identified, along with their relationships and applications of Lean tool types related to HIS. Different Lean tools were used at the early and final stages of Lean transformation; the tool selection depended on the waste characteristic. Nine studies reported a positive impact from Lean transformation in improving daily work processes. The selection of Lean tools should be made based on the timing, purpose and characteristics of waste to be removed. Research limitations/implications Overview of waste and its category within HIS and its analysis from socio-technical perspectives enabled the identification of its root cause in a holistic and rigorous manner. Practical implications Understanding waste types, their root cause and review of Lean tools could subsequently lead to the identification of mitigation approach to prevent future error occurrence. Originality/value Specific waste models for HIS settings are yet to be developed. Hence, the identification of the waste categories could guide future implementation of Lean transformations in HIS settings.

Molecular mechanisms and treatment targets of muscle wasting and cachexia in heart failure: an overview.

PubMed

Ebner, Nicole; Elsner, Sebastian; Springer, Jochen; von Haehling, Stephan

2014-03-01

This article aims to describe molecular pathways involved in the development of muscle wasting and cachexia, diagnostic possibilities, and potential treatments that have seen clinical testing in recent heart failure trials. An understanding of the specific changes that cause an anabolic-catabolic imbalance is an essential first step in the development of pharmaceutical intervention strategies aimed at blocking muscle wasting. Skeletal muscle mass and muscle strength are the most important determinants of exercise capacity in patients with heart failure. In contrast to cachexia, muscle wasting is not usually associated with weight loss, implying the need for sophisticated assessment methods to correctly diagnose muscle wasting, for example the use of computed tomography, magnetic resonance imaging, or dual energy X-ray absorptiometry. Simpler techniques such as handgrip strength, exercise testing, or even a biomarker may help in determining patients with a high pre-test probability of muscle wasting. Despite intensive research efforts in the field of muscle wasting during the last couple of decades, no effective treatment of muscle wasting currently exists other than exercise training. This situation remains true even though study of the molecular pathways involved in muscle wasting suggests many therapeutic targets. Easily applicable diagnostic tools may help to identify patients at risk of developing muscle wasting.

Clinical stage of infection is critical in the antemortem diagnosis of chronic wasting disease in deer and elk

USDA-ARS?s Scientific Manuscript database

Chronic wasting disease (CWD) is an efficiently transmitted spongiform encephalopathy of cervids (e.g. deer, elk, and moose), and is the only known prion disease affecting both free-ranging wildlife and captive animals. The antemortem detection of CWD and other prion diseases has proven difficult, d...

A pilot survey of the U.S. medical waste industry to determine training needs for safely handling highly infectious waste.

PubMed

Le, Aurora B; Hoboy, Selin; Germain, Anne; Miller, Hal; Thompson, Richard; Herstein, Jocelyn J; Jelden, Katelyn C; Beam, Elizabeth L; Gibbs, Shawn G; Lowe, John J

2018-02-01

The recent Ebola outbreak led to the development of Ebola virus disease (EVD) best practices in clinical settings. However, after the care of EVD patients, proper medical waste management and disposal was identified as a crucial component to containing the virus. Category A waste-contaminated with EVD and other highly infectious pathogens-is strictly regulated by governmental agencies, and led to only several facilities willing to accept the waste. A pilot survey was administered to determine if U.S. medical waste facilities are prepared to handle or transport category A waste, and to determine waste workers' current extent of training to handle highly infectious waste. Sixty-eight percent of survey respondents indicated they had not determined if their facility would accept category A waste. Of those that had acquired a special permit, 67% had yet to modify their permit since the EVD outbreak. This pilot survey underscores gaps in the medical waste industry to handle and respond to category A waste. Furthermore, this study affirms reports a limited number of processing facilities are capable or willing to accept category A waste. Developing the proper management of infectious disease materials is essential to close the gaps identified so that states and governmental entities can act accordingly based on the regulations and guidance developed, and to ensure public safety. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

High-angular-resolution NIR astronomy with large arrays (SHARP I and SHARP II)

NASA Astrophysics Data System (ADS)

Hofmann, Reiner; Brandl, Bernhard; Eckart, Andreas; Eisenhauer, Frank; Tacconi-Garman, Lowell E.

1995-06-01

SHARP I and SHARP II are near infrared cameras for high-angular-resolution imaging. Both cameras are built around a 256 X 256 pixel NICMOS 3 HgCdTe array from Rockwell which is sensitive in the 1 - 2.5 micrometers range. With a 0.05'/pixel scale, they can produce diffraction limited K-band images at 4-m-class telescopes. For a 256 X 256 array, this pixel scale results in a field of view of 12.8' X 12.8' which is well suited for the observation of galactic and extragalactic near-infrared sources. Photometric and low resolution spectroscopic capabilities are added by photometric band filters (J, H, K), narrow band filters ((lambda) /(Delta) (lambda) approximately equals 100) for selected spectral lines, and a CVF ((lambda) /(Delta) (lambda) approximately equals 70). A cold shutter permits short exposure times down to about 10 ms. The data acquisition electronics permanently accepts the maximum frame rate of 8 Hz which is defined by the detector time constants (data rate 1 Mbyte/s). SHARP I has been especially designed for speckle observations at ESO's 3.5 m New Technology Telescope and is in operation since 1991. SHARP II is used at ESO's 3.6 m telescope together with the adaptive optics system COME-ON + since 1993. A new version of SHARP II is presently under test, which incorporates exchangeable camera optics for observations with scales of 0.035, 0.05, and 0.1'/pixel. The first scale extends diffraction limited observations down to the J-band, while the last one provides a larger field of view. To demonstrate the power of the cameras, images of the galactic center obtained with SHARP I, and images of the R136 region in 30 Doradus observed with SHARP II are presented.

The risk of capsular breakage from phacoemulsification needle contact with the lens capsule: a laboratory study.

PubMed

Meyer, Jay J; Kuo, Annie F; Olson, Randall J

2010-06-01

To determine capsular breakage risk from contact by phacoemulsification needles by machine and tip type. Experimental laboratory investigation. Infiniti (Alcon, Inc.) with Intrepid cartridges and Signature (Abbott Medical Optics, Inc.) phacoemulsification machines were tested using 19- and 20-gauge sharp and rounded tips. Actual and unoccluded flow vacuum were determined at 550 mm Hg, bottle height of 75 cm, and machine-indicated flow rate of 60 mL/minute. Breakage from brief tip contact with a capsular surrogate and human cadaveric lenses was calculated. Nineteen-gauge tips had more flow and less unoccluded flow vacuum than 20-gauge tips for both machines, with highest unoccluded flow vacuum in the Infiniti. The 19-gauge sharp tip was more likely than the 20-gauge sharp tip to cause surrogate breakage for Signature with micropulse and Ellips (Abbott Medical Optics, Inc.) ultrasound at 100% power. For Infiniti using OZil (Alcon, Inc.) ultrasound, 20-gauge sharp tips were more likely than 19-gauge sharp tips to break the membrane. For cadaveric lenses, using rounded 20-gauge tips at 100% power, breakage rates were micropulse (2.3%), Ellips (2.3%), OZil (5.3%). Breakage rates for sharp 20-gauge Ellips tips were higher than for rounded tips. Factors influencing capsular breakage may include active vacuum at the tip, flow rate, needle gauge, and sharpness. Nineteen-gauge sharp tips were more likely than 20-gauge tips to cause breakage in lower vacuum methods. For higher-vacuum methods, breakage is more likely with 20-gauge than with 19-gauge tips. Rounded-edge tips are less likely than sharp-edged tips to cause breakage. Copyright 2010 Elsevier Inc. All rights reserved.

SHARP Multiphysics Tutorials

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

Yu, Y. Q.; Shemon, E. R.; Mahadevan, Vijay S.

SHARP, developed under the NEAMS Reactor Product Line, is an advanced modeling and simulation toolkit for the analysis of advanced nuclear reactors. SHARP is comprised of three physics modules currently including neutronics, thermal hydraulics, and structural mechanics. SHARP empowers designers to produce accurate results for modeling physical phenomena that have been identified as important for nuclear reactor analysis. SHARP can use existing physics codes and take advantage of existing infrastructure capabilities in the MOAB framework and the coupling driver/solver library, the Coupled Physics Environment (CouPE), which utilizes the widely used, scalable PETSc library. This report aims at identifying the coupled-physicsmore » simulation capability of SHARP by introducing the demonstration example called sahex in advance of the SHARP release expected by Mar 2016. sahex consists of 6 fuel pins with cladding, 1 control rod, sodium coolant and an outer duct wall that encloses all the other components. This example is carefully chosen to demonstrate the proof of concept for solving more complex demonstration examples such as EBR II assembly and ABTR full core. The workflow of preparing the input files, running the case and analyzing the results is demonstrated in this report. Moreover, an extension of the sahex model called sahex_core, which adds six homogenized neighboring assemblies to the full heterogeneous sahex model, is presented to test homogenization capabilities in both Nek5000 and PROTEUS. Some primary information on the configuration and build aspects for the SHARP toolkit, which includes capability to auto-download dependencies and configure/install with optimal flags in an architecture-aware fashion, is also covered by this report. A step-by-step instruction is provided to help users to create their cases. Details on these processes will be provided in the SHARP user manual that will accompany the first release.« less

Solid waste management in primary healthcare centers: application of a facilitation tool.

PubMed

Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

2016-08-18

to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. propor instrumento para facilitar diagnóstico, elaboração e avaliação de Plano de Gerenciamento de Resíduos em Unidades Básicas de Saúde e apresentar os resultados da aplicação em quatro unidades selecionadas. pesquisa descritiva que contemplou as etapas de construção/aplicação do instrumento proposto e a avaliação de desempenho do gerenciamento de resíduos nas unidades estudadas. geração de instrumento composto por cinco formulários; proposta de indicadores específicos de geração de resíduos para unidades assistenciais de saúde sem internação e indicador de desempenho que pontua o atendimento à legislação vigente. Nas unidades estudadas, são gerados resíduos comuns (52-60%), infectantes/perfurocortantes (31-42%) e recicláveis (5-17%). As taxas médias de geração são: 0,09kg de resíduos totais/atendimento e 0,09kg de resíduos infectantes-perfurocortantes/procedimento. O atendimento à normativa, inicialmente de 26-30%, atingiu 30-38% um ano depois. o instrumento mostrou-se de fácil aplicação, contornando a existência de complexa gama de requisitos regulatórios vigentes, possibilitou identificar não conformidades, apontar medidas corretivas e avaliar o desempenho da gestão de resíduos. Nesse sentido, contribui para tomada de decisão e práticas gerenciais referentes aos resíduos, tarefas geralmente atribuídas a enfermeiros. Recomenda-se a aplicação do instrumento em unidades de saúde similares para estudos comparativos, e as adaptações necessárias para outros serviços de saúde. proponer un instrumento para facilitar el diagnóstico, elaboración y evaluación del plan de gestión de residuos en unidades básicas de salud y presentar la aplicación de los resultados en cuatro unidades seleccionadas. investigación descriptiva, cubriendo las etapas de la formulación/aplicación del instrumento propuesto y la evaluación de desempeño de la gestión de residuos en las unidades estudiadas. el instrumento está compuesto por cinco formularios; propuesta de indicadores específicos de la generación de residuos para las unidades de atención de salud sin hospitalización e indicador de desempeño que puntúa el cumplimiento de la legislación vigente. Los residuos que generan las unidades estudiadas son de tipo común (52-60%), infecciosos/punzocortantes (31-42%) y reciclables (5-17%). Las tasas promedio de generación son: total de residuos/atendimiento 0,09kg y 0,09kg de residuos infecciosos-punzocortantes/procedimiento. El cumplimiento de la normativa, inicialmente 26-30%, alcanzó 30-38% un año más tarde. el instrumento se mostró fácil de usar, evita pasar por una gama compleja de disposiciones normativas existentes, permitió identificar posibles casos de incumplimiento, señalar medidas correctivas puntuales y evaluar el desempeño de la gestión de residuos. En este sentido, contribuye a la toma de decisiones y a prácticas de gestión relativas a los residuos, tareas normalmente asignadas a los enfermeros. Se recomienda la aplicación del instrumento en unidades de salud similares para estudios comparativos, y las adaptaciones necesarias para otros servicios de salud.

Maintaining knife sharpness in industrial meat cutting: A matter of knife or meat cutter ability.

PubMed

Karltun, J; Vogel, K; Bergstrand, M; Eklund, J

2016-09-01

Knife sharpness is imperative in meat cutting. The aim of this study was to compare the impact of knife blade steel quality with meat cutters' individual ability to maintain the cutting edge sharp in an industrial production setting. Twelve meat cutters in two different companies using three different knives during normal production were studied in this quasi-experimental study. Methods included were measuring knife cutting force before and after knife use, time knives were used, ratings of sharpness and discomfort and interviews. Results showed that the meat cutters' skill of maintaining sharpness during work had a much larger effect on knife sharpness during work than the knife steel differences. The ability was also related to feelings of discomfort and to physical exertion. It was found that meat cutters using more knives were more likely to suffer from discomfort in the upper limbs, which is a risk for developing MSD. Copyright © 2016 Elsevier Ltd. All rights reserved.

NASA-Ames Summer High School Apprenticeship Research Program (SHARP)

NASA Technical Reports Server (NTRS)

Powell, P.

1983-01-01

The function of SHARP is to recognize high school juniors who have demonstrated unusually high promise for sucess in mathemtics and science. Twenty academically talented students who will be seniors in high school in September were chosen to participate in SHARP 83. Mentors were selected to provide students with first-hand experiences in a research and development environment in order that each student might try out his or her tentative professional career choice. Some special features of SHARP included field trips to private industries doing similar and related research, special lectures on topics of research here at ARC, individual and group counseling sessions, written research papers and oral reports, and primarily the opportunity to be exposed to the present frontiers in space exploration and research. The long-range goal of SHARP is to contribute to the future recruitment of needed scientists and engineers. This final report is summary of all the phases of the planning and implemenation of the 1983 Summer High School Apprenticeship Research Program (SHARP).

Weapon Use in Korean Homicide: Differences Between Homicides Involving Sharp and Blunt Instruments.

PubMed

Park, Jisun; Son, Hyeonseo

2017-10-23

On the basis of information regarding 276 homicides committed in South Korea between 1987 and 2008, we compared offenders' and victims' characteristics, injury locations, weapon-related behavior, and offending behavior between homicides involving sharp and blunt instruments. The victims of sharp-force homicide were much younger relative to those of blunt-force homicide. In addition, homicides involving blunt instruments were more likely to be committed by offenders who lived with the victims. Most sharp-force homicides involved injuries to the torso, while blunt-force homicides involved mainly head injuries. Furthermore, perpetrators of sharp-force homicides tended to preselect their weapons, while those of blunt-force homicides were likely to use weapons of opportunity. Logistic regression analysis identified a number of factors, including injury location and body transportation, which significantly predicted weapon type. As this was the first South Korean study to compare sharp- and blunt-force homicides, the results have practical implications for homicide investigations. © 2017 American Academy of Forensic Sciences.

Improvement in perception of image sharpness through the addition of noise and its relationship with memory texture

NASA Astrophysics Data System (ADS)

Wan, Xiazi; Kobayashi, Hiroyuki; Aoki, Naokazu

2015-03-01

In a preceding study, we investigated the effects of image noise on the perception of image sharpness using white noise, and one- and two-dimensional single-frequency sinusoidal patterns as stimuli. This study extends our preceding study by evaluating natural color images, rather than black-and-white patterns. The results showed that the effect of noise in improving image sharpness perception is more evident in blurred images than in sharp images. This is consistent with the results of the preceding study. In another preceding study, we proposed "memory texture" to explain the preferred granularity of images, as a concept similar to "memory color" for preferred color reproduction. We observed individual differences in type of memory texture for each object, that is, white or 1/f noise. This study discusses the relationship between improvement of sharpness perception by adding noise, and the memory texture, following its individual differences. We found that memory texture is one of the elements that affect sharpness perception.

Hazardous Waste Cleanup: Ortho-Clinical Diagnostics, Raritan, New Jersey

EPA Pesticide Factsheets

Ortho-Clinical Diagnostics (OCD) is an administration and manufacturing facility located at 1001 U.S. Route 202 North in Raritan Borough, Somerset County, New Jersey. The facility manufactures hospital and laboratory reagents used primarily for blood

Using digital photography in a clinical setting: a valid, accurate, and applicable method to assess food intake.

PubMed

Winzer, Eva; Luger, Maria; Schindler, Karin

2018-06-01

Regular monitoring of food intake is hardly integrated in clinical routine. Therefore, the aim was to examine the validity, accuracy, and applicability of an appropriate and also quick and easy-to-use tool for recording food intake in a clinical setting. Two digital photography methods, the postMeal method with a picture after the meal, the pre-postMeal method with a picture before and after the meal, and the visual estimation method (plate diagram; PD) were compared against the reference method (weighed food records; WFR). A total of 420 dishes from lunch (7 weeks) were estimated with both photography methods and the visual method. Validity, applicability, accuracy, and precision of the estimation methods, and additionally food waste, macronutrient composition, and energy content were examined. Tests of validity revealed stronger correlations for photography methods (postMeal: r = 0.971, p < 0.001; pre-postMeal: r = 0.995, p < 0.001) compared to the visual estimation method (r = 0.810; p < 0.001). The pre-postMeal method showed smaller variability (bias < 1 g) and also smaller overestimation and underestimation. This method accurately and precisely estimated portion sizes in all food items. Furthermore, the total food waste was 22% for lunch over the study period. The highest food waste was observed in salads and the lowest in desserts. The pre-postMeal digital photography method is valid, accurate, and applicable in monitoring food intake in clinical setting, which enables a quantitative and qualitative dietary assessment. Thus, nutritional care might be initiated earlier. This method might be also advantageous for quantitative and qualitative evaluation of food waste, with a resultantly reduction in costs.

[Various methods of overcoming secondary resistance to treatment developing in relation to adaptation to psychotropic drugs during long-term treatment (clinico-experimental study)].

PubMed

Avrutskiĭ, G Ia; Allikmets, L Kh; Neduva, A A; Zharkovskiĭ, A M; Beliakov, A V

1984-01-01

Clinical and experimental studies into the phenomenon of adaptation to neuroleptic agents and into the methods of its overcoming were carried out. An experimental study of the long-term administrations of haloperidol revealed the formation of adaptation to the drug which can be overcome by a zigzag-like sharp elevation of the dosage followed by rapid reduction to the baseline level. The trial of this method under clinical conditions showed that it was expedient to use on a large scale the experimental findings on the specific features of the formation and prevention of the secondary therapeutic resistance.

Surface-enhanced Raman scattering on periodic metal nanotips with tunable sharpness.

PubMed

Linn, Nicholas C; Sun, Chih-Hung; Arya, Ajay; Jiang, Peng; Jiang, Bin

2009-06-03

This paper reports on a scalable bottom-up technology for producing periodic gold nanotips with tunable sharpness as surface-enhanced Raman scattering (SERS) substrates. Inverted silicon pyramidal pits, which are templated from non-close-packed colloidal crystals prepared by a spin-coating technology, are used as structural templates to replicate arrays of polymer nanopyramids with nanoscale sharp tips. The deposition of a thin layer of gold on the polymer nanopyramids leads to the formation of SERS-active substrates with a high enhancement factor (up to 10(8)). The thickness of the deposited metal determines the sharpness of the nanotips and the resulting Raman enhancement factor. Finite-element electromagnetic modeling shows that the nanotips can significantly enhance the local electromagnetic field and the sharpness of nanotips greatly affects the SERS enhancement.

Relationship of intentional self-harm using sharp objects with depressive and dissociative tendencies in pre-adolescence-adolescence.

PubMed

Sho, Noriko; Oiji, Arata; Konno, Chizue; Toyohara, Koji; Minami, Tatsuya; Arai, Takashi; Seike, Yoji

2009-06-01

The objectives of the present study were to (i) evaluate the prevalence of children and adolescents who have engaged in intentional self-harm using a sharp object; and (ii) investigate the relationship between self-harm with sharp objects and depressive tendencies or dissociative tendencies. A total of 1938 students in grades 5-12 in Yokohama, Japan, were enrolled, and they completed anonymous self-report questionnaires including a question about intentional self-harm with a sharp object, the Depression Self-Rating Scale for Children (DSRSC) and the Adolescent Dissociative Experiences Scale (A-DES). The prevalence of self-harm using sharp object was 5.4% among male 5th-6th graders, 4.0% among female 5th-6th graders, 5.3% among male 7th-9th graders, 15.1% among female 7th-9th graders, 6.6% among male 10th-12th graders, and 9.6% among female 10th-12th graders. Categorical regression analysis showed that a small amount of variance in self-harm by sharp object was explained by DSRSC and A-DES scores. Self-harm with a sharp object was prevalent among pre-adolescents and adolescents and was associated with depressive and dissociative tendencies.

The Helioseismic and Magnetic Imager (HMI) Vector Magnetic Field Pipeline: SHARPs - Space-Weather HMI Active Region Patches

NASA Astrophysics Data System (ADS)

Bobra, M. G.; Sun, X.; Hoeksema, J. T.; Turmon, M.; Liu, Y.; Hayashi, K.; Barnes, G.; Leka, K. D.

2014-09-01

A new data product from the Helioseismic and Magnetic Imager (HMI) onboard the Solar Dynamics Observatory (SDO) called Space-weather HMI Active Region Patches ( SHARPs) is now available. SDO/HMI is the first space-based instrument to map the full-disk photospheric vector magnetic field with high cadence and continuity. The SHARP data series provide maps in patches that encompass automatically tracked magnetic concentrations for their entire lifetime; map quantities include the photospheric vector magnetic field and its uncertainty, along with Doppler velocity, continuum intensity, and line-of-sight magnetic field. Furthermore, keywords in the SHARP data series provide several parameters that concisely characterize the magnetic-field distribution and its deviation from a potential-field configuration. These indices may be useful for active-region event forecasting and for identifying regions of interest. The indices are calculated per patch and are available on a twelve-minute cadence. Quick-look data are available within approximately three hours of observation; definitive science products are produced approximately five weeks later. SHARP data are available at jsoc.stanford.edu and maps are available in either of two different coordinate systems. This article describes the SHARP data products and presents examples of SHARP data and parameters.

Grand rounds: an outbreak of toxic hepatitis among industrial waste disposal workers.

PubMed

Cheong, Hae-Kwan; Kim, Eun A; Choi, Jung-Keun; Choi, Sung-Bong; Suh, Jeong-Ill; Choi, Dae Seob; Kim, Jung Ran

2007-01-01

Industrial waste (which is composed of various toxic chemicals), changes to the disposal process, and addition of chemicals should all be monitored and controlled carefully in the industrial waste industry to reduce the health hazard to workers. Five workers in an industrial waste plant developed acute toxic hepatitis, one of whom died after 3 months due to fulminant hepatitis. In the plant, we detected several chemicals with hepatotoxic potential, including pyridine, dimethylformamide, dimethylacetamide, and methylenedianiline. The workers had been working in the high-vapor-generating area of the plant, and the findings of pathologic examination showed typical features of acute toxic hepatitis. Infectious hepatitis and drug-induced hepatitis were excluded by laboratory findings, as well as the clinical course of hepatitis. All cases of toxic hepatitis in this plant developed after the change of the disposal process to thermochemical reaction-type treatment using unslaked lime reacted with industrial wastes. During this chemical reaction, vapor containing several toxic materials was generated. Although we could not confirm the definitive causative chemical, we suspect that these cases of hepatitis were caused by one of the hepatotoxic agents or by a synergistic interaction among several of them. In the industrial waste treatment process, the danger of developing toxic hepatitis should be kept in mind, because any subtle change of the treatment process can generate various toxic materials and threaten the workers' health. A mixture of hepatotoxic chemicals can induce clinical manifestations that are quite different from those predicted by the toxic property of a single agent.

Impact of pedagogical method on Brazilian dental students' waste management practice.

PubMed

Victorelli, Gabriela; Flório, Flávia Martão; Ramacciato, Juliana Cama; Motta, Rogério Heládio Lopes; de Souza Fonseca Silva, Almenara

2014-11-01

The purpose of this study was to conduct a qualitative analysis of waste management practices among a group of Brazilian dental students (n=64) before and after implementing two different pedagogical methods: 1) the students attended a two-hour lecture based on World Health Organization standards; and 2) the students applied the lessons learned in an organized group setting aimed toward raising their awareness about socioenvironmental issues related to waste. All eligible students participated, and the students' learning was evaluated through their answers to a series of essay questions, which were quantitatively measured. Afterwards, the impact of the pedagogical approaches was compared by means of qualitative categorization of wastes generated in clinical activities. Waste categorization was performed for a period of eight consecutive days, both before and thirty days after the pedagogical strategies. In the written evaluation, 80 to 90 percent of the students' answers were correct. The qualitative assessment revealed a high frequency of incorrect waste disposal with a significant increase of incorrect disposal inside general and infectious waste containers (p<0.05). Although the students' theoretical learning improved, it was not enough to change behaviors established by cultural values or to encourage the students to adequately segregate and package waste material.

Laser Recanalization of Central Venous Occlusion to Salvage a Threatened Arteriovenous Fistula.

PubMed

Rambhia, Sagar; Janko, Matthew; Hacker, Robert I

2018-07-01

Central venous occlusion is conventionally managed with balloon angioplasty, stent extension, or sharp recanalization. Here, we describe recanalization of a chronically occluded innominate vein using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and fistula patency have been sustained 2 years postintervention. This technique may provide new hemodialysis access options for patients who would not otherwise be candidates for hemodialysis access on the ipsilateral side of a central venous occlusion. Copyright © 2018 Elsevier Inc. All rights reserved.

Cardiac cachexia: hic et nunc: "hic et nunc" - here and now.

PubMed

Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram; Lainscak, Mitja

2015-12-15

Cardiac cachexia (CC) is the clinical entity at the end of chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. Better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick-up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF.

Cardiac cachexia: hic et nunc

PubMed Central

Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram

2016-01-01

Abstract Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF. PMID:27386168

Speckle-reduction algorithm for ultrasound images in complex wavelet domain using genetic algorithm-based mixture model.

PubMed

Uddin, Muhammad Shahin; Tahtali, Murat; Lambert, Andrew J; Pickering, Mark R; Marchese, Margaret; Stuart, Iain

2016-05-20

Compared with other medical-imaging modalities, ultrasound (US) imaging is a valuable way to examine the body's internal organs, and two-dimensional (2D) imaging is currently the most common technique used in clinical diagnoses. Conventional 2D US imaging systems are highly flexible cost-effective imaging tools that permit operators to observe and record images of a large variety of thin anatomical sections in real time. Recently, 3D US imaging has also been gaining popularity due to its considerable advantages over 2D US imaging. It reduces dependency on the operator and provides better qualitative and quantitative information for an effective diagnosis. Furthermore, it provides a 3D view, which allows the observation of volume information. The major shortcoming of any type of US imaging is the presence of speckle noise. Hence, speckle reduction is vital in providing a better clinical diagnosis. The key objective of any speckle-reduction algorithm is to attain a speckle-free image while preserving the important anatomical features. In this paper we introduce a nonlinear multi-scale complex wavelet-diffusion based algorithm for speckle reduction and sharp-edge preservation of 2D and 3D US images. In the proposed method we use a Rayleigh and Maxwell-mixture model for 2D and 3D US images, respectively, where a genetic algorithm is used in combination with an expectation maximization method to estimate mixture parameters. Experimental results using both 2D and 3D synthetic, physical phantom, and clinical data demonstrate that our proposed algorithm significantly reduces speckle noise while preserving sharp edges without discernible distortions. The proposed approach performs better than the state-of-the-art approaches in both qualitative and quantitative measures.

Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: the SHARPn project.

PubMed

Rea, Susan; Pathak, Jyotishman; Savova, Guergana; Oniki, Thomas A; Westberg, Les; Beebe, Calvin E; Tao, Cui; Parker, Craig G; Haug, Peter J; Huff, Stanley M; Chute, Christopher G

2012-08-01

The Strategic Health IT Advanced Research Projects (SHARP) Program, established by the Office of the National Coordinator for Health Information Technology in 2010 supports research findings that remove barriers for increased adoption of health IT. The improvements envisioned by the SHARP Area 4 Consortium (SHARPn) will enable the use of the electronic health record (EHR) for secondary purposes, such as care process and outcomes improvement, biomedical research and epidemiologic monitoring of the nation's health. One of the primary informatics problem areas in this endeavor is the standardization of disparate health data from the nation's many health care organizations and providers. The SHARPn team is developing open source services and components to support the ubiquitous exchange, sharing and reuse or 'liquidity' of operational clinical data stored in electronic health records. One year into the design and development of the SHARPn framework, we demonstrated end to end data flow and a prototype SHARPn platform, using thousands of patient electronic records sourced from two large healthcare organizations: Mayo Clinic and Intermountain Healthcare. The platform was deployed to (1) receive source EHR data in several formats, (2) generate structured data from EHR narrative text, and (3) normalize the EHR data using common detailed clinical models and Consolidated Health Informatics standard terminologies, which were (4) accessed by a phenotyping service using normalized data specifications. The architecture of this prototype SHARPn platform is presented. The EHR data throughput demonstration showed success in normalizing native EHR data, both structured and narrative, from two independent organizations and EHR systems. Based on the demonstration, observed challenges for standardization of EHR data for interoperable secondary use are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: The SHARPn project

PubMed Central

Rea, Susan; Pathak, Jyotishman; Savova, Guergana; Oniki, Thomas A.; Westberg, Les; Beebe, Calvin E.; Tao, Cui; Parker, Craig G.; Haug, Peter J.; Huff, Stanley M.; Chute, Christopher G.

2016-01-01

The Strategic Health IT Advanced Research Projects (SHARP) Program, established by the Office of the National Coordinator for Health Information Technology in 2010 supports research findings that remove barriers for increased adoption of health IT. The improvements envisioned by the SHARP Area 4 Consortium (SHARPn) will enable the use of the electronic health record (EHR) for secondary purposes, such as care process and outcomes improvement, biomedical research and epidemiologic monitoring of the nation’s health. One of the primary informatics problem areas in this endeavor is the standardization of disparate health data from the nation’s many health care organizations and providers. The SHARPn team is developing open source services and components to support the ubiquitous exchange, sharing and reuse or ‘liquidity’ of operational clinical data stored in electronic health records. One year into the design and development of the SHARPn framework, we demonstrated end to end data flow and a prototype SHARPn platform, using thousands of patient electronic records sourced from two large healthcare organizations: Mayo Clinic and Intermountain Healthcare. The platform was deployed to (1) receive source EHR data in several formats, (2) generate structured data from EHR narrative text, and (3) normalize the EHR data using common detailed clinical models and Consolidated Health Informatics standard terminologies, which were (4) accessed by a phenotyping service using normalized data specifications. The architecture of this prototype SHARPn platform is presented. The EHR data throughput demonstration showed success in normalizing native EHR data, both structured and narrative, from two independent organizations and EHR systems. Based on the demonstration, observed challenges for standardization of EHR data for interoperable secondary use are discussed. PMID:22326800

Hazardous medical waste generation in Greece: case studies from medical facilities in Attica and from a small insular hospital.

PubMed

Komilis, Dimitrios; Katsafaros, Nikolaos; Vassilopoulos, Panagiotis

2011-08-01

The accurate calculation of the unit generation rates and composition of medical waste generated from medical facilities is necessary in order to design medical waste treatment systems. In this work, the unit medical waste generation rates of 95 public and private medical facilities in the Attica region were calculated based on daily weight records from a central medical waste incineration facility. The calculated medical waste generation rates (in kg bed(-1) day( -1)) varied widely with average values at 0.27 ± 113% and 0.24 ± 121%, for public and private medical facilities, respectively. The hazardous medical waste generation was measured, at the source, in the 40 bed hospital of the island of Ikaria for a period of 42 days during a 6 month period. The average hazardous medical waste generation rate was 1.204 kg occupied bed(-1) day(-1) or 0.33 kg (official) bed( -1) day(-1). From the above amounts, 54% resulted from the patients' room (solid and liquid wastes combined), 24% from the emergency department (solid waste), 17% from the clinical pathology lab and 6% from the X-ray lab. In average, 17% of the total hazardous medical waste was solely infectious. Conclusively, no correlation among the number of beds and the unit medical waste generation rate could be established. Each hospital should be studied separately, since medical waste generation and composition depends on the number and type of departments/laboratories at each hospital, number of external patients and number of occupied beds.

Central Diabetes Insipidus and Cisplatin-Induced Renal Salt Wasting Syndrome: A Challenging Combination.

PubMed

Cortina, Gerard; Hansford, Jordan R; Duke, Trevor

2016-05-01

We describe a 2-year-old female with a suprasellar primitive neuroectodermal tumor and central diabetes insipidus (DI) who developed polyuria with natriuresis and subsequent hyponatremia 36 hr after cisplatin administration. The marked urinary losses of sodium in combination with a negative sodium balance led to the diagnosis of cisplatin-induced renal salt wasting syndrome (RSWS). The subsequent clinical management is very challenging. Four weeks later she was discharged from ICU without neurological sequela. The combination of cisplatin-induced RSWS with DI can be confusing and needs careful clinical assessment as inaccurate diagnosis and management can result in increased neurological injury. © 2016 Wiley Periodicals, Inc.

Geology of the Early Arikareean sharps formation on the Pine Ridge Indian Reservation and surrounding areas of South Dakota and Nebraska.

PubMed

McConnell, Thomas H; Dibenedetto, Joseph N

2012-01-01

Based on geologic mapping, measured sections, and lithologic correlations, the local features of the upper and lower type areas of the Early Arikareean (30.8-20.6 million years ago) Sharps Formation are revised and correlated. The Sharps Formation above the basal Rockyford Member is divided into two members of distinct lithotypes. The upper 233 feet of massive siltstones and sandy siltstones is named the Gooseneck Road Member. The middle member, 161 feet of eolian volcaniclastic siltstones with fluvially reworked volcaniclastic lenses and sandy siltstone sheets, is named the Wolff Camp Member. An ashey zone at the base of the Sharps Formation is described and defined as the Rockyford Ash Zone (RAZ) in the same stratigraphic position as the Nonpareil Ash Zone (NPAZ) in Nebraska. Widespread marker beds of fresh water limestones at 130 feet above the base of the Sharps Formation and a widespread reddish-brown clayey siltstone at 165 feet above the base of the Sharps Formation are described. The Brown Siltstone Beds of Nebraska are shown to be a southern correlative of the Wolff Camp Member and the Rockyford Member of the Sharps Formation. Early attempts to correlate strata in the Great Plains were slow in developing. Recognition of the implications of the paleomagnetic and lithologic correlations of this paper will provide an added datum assisting researchers in future biostratigraphic studies. Based on similar lithologies, the Sharps Formation, currently assigned to the Arikaree Group, should be reassigned to the White River Group.

[Role of myostatin in wasting syndrome associated with chronic diseases].

PubMed

Zamora, Elisabet; Galán, Amparo; Simó, Rafael

2008-11-01

Muscle wasting is a common process of numerous chronic diseases. Sarcopenia is associated with poor prognosis independently of the outcome of the disease. To date, the mechanisms by which sarcopenia induces these alterations are unknown, but the complexity of muscular metabolism anticipates that many factors can be involved. Myostatin, a new family member of transforming growth factor beta, was initially described from the observation of significant muscular growing in knock out mice for myostatin. Numerous experimental and clinical studies have provided insights in the physiologic knowledge of this protein and its implication in muscle wasting conditions. In recent years different substances have been described that counteract myostatin through numerous physiopathological mecanisms and, therefore, they might be novel therapeutic strategies against the wasting syndrome associated with chronic diseases. In spite of that, more studies are needed to improve the knowledge of all processes involved in muscle wasting in order to prevent its devastating consequences.

The gravel sand transition in a disturbed catchment

NASA Astrophysics Data System (ADS)

Knighton, A. David

1999-03-01

More than 40 million cubic metres of mining waste were supplied to the Ringarooma River between 1875 and 1984, leading to successive phases of aggradation and degradation. The natural bed material is gravel but, given the volume of introduced load and the fact that much of the input was less than 5 mm in diameter, the size composition of the bed changed from gravel to sand during the phase of downstream progressive aggradation. A very sharp gravel-sand transition developed in which median grain size decreased from over 30 mm to under 3 mm in less than 500 m. With upstream supplies of mining debris becoming depleted first, degradation followed the same downstream progressive pattern as aggradation, causing the transition to migrate downstream. By 1984, the river could be regarded as a series of zones, each characterized by a particular bed condition: a natural cobble-gravel bed, unaffected by mining inputs (0-32 km); pre-disturbance bed re-exposed by degradation over 35-40 years (32-53 km); sandy substrate with a gravel armour produced by differential transport during degradation (53-65 km); sand dominated but with developing surface patches of coarser material (65-75 km); sandy bed reflecting the size composition of the original mining input (75-118 km). Although the gravel-sand transition itself is sharp, the transitional zone is lengthy (53-75 km). As degradation continues, the gravel-sand transition is expected to progress downstream but it has remained in a stable position for 12 years. Indeed, two major floods during the period released large quantities of sand from the sub-armour layer and newly-formed banks of mine tailings, causing fining both above and below the transition. Surface grain size is an adjustable component in the transitional zone as the river strives to recover from a major anthropogenic disturbance.

Observations of an aeolian landscape: From surface to orbit in Gale Crater

NASA Astrophysics Data System (ADS)

Day, Mackenzie; Kocurek, Gary

2016-12-01

Landscapes derived solely from aeolian processes are rare on Earth because of the dominance of subaqueous processes. In contrast, aeolian-derived landscapes should typify Mars because of the absence of liquid water, the long exposure times of surfaces, and the presence of wind as the default geomorphic agent. Using the full range of available orbital and Mars Science Laboratory rover Curiosity images, wind-formed features in Gale Crater were cataloged and analyzed in order to characterize the aeolian landscape and to derive the evolution of the crater wind regime over time. Inferred wind directions show a dominance of regional northerly winds over geologic time-scales, but a dominance of topography-driven katabatic winds in modern times. Landscapes in Gale Crater show a preponderance of aeolian features at all spatial scales. Interpreted processes forming these features include first-cycle aeolian abrasion of bedrock, pervasive deflation, organization of available sand into bedforms, abundant cratering, and gravity-driven wasting, all of which occur over a background of slow physical weathering. The observed landscapes are proposed to represent a spectrum of progressive surface denudation from fractured bedrock, to retreating bedrock-capped mesas, to remnant hills capped by bedrock rubble, to desert pavement plains. This model of landscape evolution provides the mechanism by which northerly winds acting over ∼3 Ga excavated tens of thousands of cubic kilometers of material from the once sediment-filled crater, thus carving the intra-crater moat and exhuming Mount Sharp (Aeolis Mons). The current crater surface is relatively sand-starved, indicating that potential sediment deflation from the crater is greater than sediment production, and that most exhumation of Mount Sharp occurred in the ancient geologic past.

A comparison of coupled freshwater-saltwater sharp-interface and convective-dispersive models of saltwater intrusion in a layered aquifer system

USGS Publications Warehouse

Hill, Mary C.

1988-01-01

Simulated results of the coupled freshwater-saltwater sharp interface and convective-dispersive numerical models are compared by using steady-state cross-sectional simulations. The results indicate that in some aquifers the calculated sharp interface is located further landward than would be expected.

Notes on distribution and ecology of Philonthus spinipes Sharp (Coleoptera: Staphylinidae) in the Polish Carpathians.

PubMed

Mazur, Andrzej; Guo, Wanyue; Górz, Andrzej

2017-11-30

Philonthus spinipes Sharp for the first time was described from East Asia (Sharp 1874). Presently the species occurs in the whole Palaearctic region. Original distribution of this species is difficult to define because it has obviously extended its distribution range westwards (Schillhammer 1999).

Development of the Adult Scale of Hostility and Aggression: Reactive-Proactive (A-SHARP)

ERIC Educational Resources Information Center

Matlock, Scott Thomas; Aman, Michael G.

2011-01-01

In this study, the authors developed the Adult Scale of Hostility and Aggression Reactive-Proactive (A-SHARP). Sixty-one caregivers rated 512 individuals with intellectual and developmental disabilities on the A-SHARP. Exploratory factor analysis revealed 5 factors on the Problem Scale: (a) Verbal Aggression, (b) Physical Aggression, (c) Hostile…

The Russian Way of War: Post Soviet Adaptations in the Russian Military

DTIC Science & Technology

2013-12-13

226Thomas Goltz , Georgia Diary (London: M. E. Sharpe, 2006), 253. 227Pavel Felgenhauer, “After August 7: The Escalation of the Russian-Georgian War,” in The...Sharpe, 2009. Goltz , Thomas. Georgia Diary. London: M. E. Sharpe, 2006. Goytisolo, Juan. Landscapes of War: From Sarajevo to Chechnya. Translated

Numerical analysis of mixing by sharp-edge-based acoustofluidic micromixer

NASA Astrophysics Data System (ADS)

Nama, Nitesh; Huang, Po-Hsun; Jun Huang, Tony; Costanzo, Francesco

2015-11-01

Recently, acoustically oscillated sharp-edges have been employed to realize rapid and homogeneous mixing at microscales (Huang, Lab on a Chip, 13, 2013). Here, we present a numerical model, qualitatively validated by experimental results, to analyze the acoustic mixing inside a sharp-edge-based micromixer. We extend our previous numerical model (Nama, Lab on a Chip, 14, 2014) to combine the Generalized Lagrangian Mean (GLM) theory with the convection-diffusion equation, while also allowing for the presence of a background flow as observed in a typical sharp-edge-based micromixer. We employ a perturbation approach to divide the flow variables into zeroth-, first- and second-order fields which are successively solved to obtain the Lagrangian mean velocity. The Langrangian mean velocity and the background flow velocity are further employed with the convection-diffusion equation to obtain the concentration profile. We characterize the effects of various operational and geometrical parameters to suggest potential design changes for improving the mixing performance of the sharp-edge-based micromixer. Lastly, we investigate the possibility of generation of a spatio-temporally controllable concentration gradient by placing sharp-edge structures inside the microchannel.

SHARP: A multi-mission artificial intelligence system for spacecraft telemetry monitoring and diagnosis

NASA Technical Reports Server (NTRS)

Lawson, Denise L.; James, Mark L.

1989-01-01

The Spacecraft Health Automated Reasoning Prototype (SHARP) is a system designed to demonstrate automated health and status analysis for multi-mission spacecraft and ground data systems operations. Telecommunications link analysis of the Voyager 2 spacecraft is the initial focus for the SHARP system demonstration which will occur during Voyager's encounter with the planet Neptune in August, 1989, in parallel with real time Voyager operations. The SHARP system combines conventional computer science methodologies with artificial intelligence techniques to produce an effective method for detecting and analyzing potential spacecraft and ground systems problems. The system performs real time analysis of spacecraft and other related telemetry, and is also capable of examining data in historical context. A brief introduction is given to the spacecraft and ground systems monitoring process at the Jet Propulsion Laboratory. The current method of operation for monitoring the Voyager Telecommunications subsystem is described, and the difficulties associated with the existing technology are highlighted. The approach taken in the SHARP system to overcome the current limitations is also described, as well as both the conventional and artificial intelligence solutions developed in SHARP.

A Note on Trader Sharpe Ratios

PubMed Central

Coates, John M.; Page, Lionel

2009-01-01

Traders in the financial world are assessed by the amount of money they make and, increasingly, by the amount of money they make per unit of risk taken, a measure known as the Sharpe Ratio. Little is known about the average Sharpe Ratio among traders, but the Efficient Market Hypothesis suggests that traders, like asset managers, should not outperform the broad market. Here we report the findings of a study conducted in the City of London which shows that a population of experienced traders attain Sharpe Ratios significantly higher than the broad market. To explain this anomaly we examine a surrogate marker of prenatal androgen exposure, the second-to-fourth finger length ratio (2D∶4D), which has previously been identified as predicting a trader's long term profitability. We find that it predicts the amount of risk taken by traders but not their Sharpe Ratios. We do, however, find that the traders' Sharpe Ratios increase markedly with the number of years they have traded, a result suggesting that learning plays a role in increasing the returns of traders. Our findings present anomalous data for the Efficient Markets Hypothesis. PMID:19946367

SHARPs - A Near-Real-Time Space Weather Data Product from HMI

NASA Astrophysics Data System (ADS)

Bobra, M.; Turmon, M.; Baldner, C.; Sun, X.; Hoeksema, J. T.

2012-12-01

A data product from the Helioseismic and Magnetic Imager (HMI) on the Solar Dynamics Observatory (SDO), called Space-weather HMI Active Region Patches (SHARPs), is now available through the SDO Joint Science Operations Center (JSOC) and the Virtual Solar Observatory. SHARPs are magnetically active regions identified on the solar disk and tracked automatically in time. SHARP data are processed within a few hours of the observation time. The SHARP data series contains active region-sized disambiguated vector magnetic field data in both Lambert Cylindrical Equal-Area and CCD coordinates on a 12 minute cadence. The series also provides simultaneous HMI maps of the line-of-sight magnetic field, continuum intensity, and velocity on the same ~0.5 arc-second pixel grid. In addition, the SHARP data series provides space weather quantities computed on the inverted, disambiguated, and remapped data. The values for each tracked region are computed and updated in near real time. We present space weather results for several X-class flares; furthermore, we compare said space weather quantities with helioseismic quantities calculated using ring-diagram analysis.

A note on trader Sharpe Ratios.

PubMed

Coates, John M; Page, Lionel

2009-11-25

Traders in the financial world are assessed by the amount of money they make and, increasingly, by the amount of money they make per unit of risk taken, a measure known as the Sharpe Ratio. Little is known about the average Sharpe Ratio among traders, but the Efficient Market Hypothesis suggests that traders, like asset managers, should not outperform the broad market. Here we report the findings of a study conducted in the City of London which shows that a population of experienced traders attain Sharpe Ratios significantly higher than the broad market. To explain this anomaly we examine a surrogate marker of prenatal androgen exposure, the second-to-fourth finger length ratio (2D:4D), which has previously been identified as predicting a trader's long term profitability. We find that it predicts the amount of risk taken by traders but not their Sharpe Ratios. We do, however, find that the traders' Sharpe Ratios increase markedly with the number of years they have traded, a result suggesting that learning plays a role in increasing the returns of traders. Our findings present anomalous data for the Efficient Markets Hypothesis.

SHARP: A multi-mission AI system for spacecraft telemetry monitoring and diagnosis

NASA Technical Reports Server (NTRS)

Lawson, Denise L.; James, Mark L.

1989-01-01

The Spacecraft Health Automated Reasoning Prototype (SHARP) is a system designed to demonstrate automated health and status analysis for multi-mission spacecraft and ground data systems operations. Telecommunications link analysis of the Voyager II spacecraft is the initial focus for the SHARP system demonstration which will occur during Voyager's encounter with the planet Neptune in August, 1989, in parallel with real-time Voyager operations. The SHARP system combines conventional computer science methodologies with artificial intelligence techniques to produce an effective method for detecting and analyzing potential spacecraft and ground systems problems. The system performs real-time analysis of spacecraft and other related telemetry, and is also capable of examining data in historical context. A brief introduction is given to the spacecraft and ground systems monitoring process at the Jet Propulsion Laboratory. The current method of operation for monitoring the Voyager Telecommunications subsystem is described, and the difficulties associated with the existing technology are highlighted. The approach taken in the SHARP system to overcome the current limitations is also described, as well as both the conventional and artificial intelligence solutions developed in SHARP.

Comparing biosimilar SB2 with reference infliximab after 54 weeks of a double-blind trial: clinical, structural and safety results.

PubMed

Smolen, Josef S; Choe, Jung-Yoon; Prodanovic, Nenad; Niebrzydowski, Jaroslaw; Staykov, Ivan; Dokoupilova, Eva; Baranauskaite, Asta; Yatsyshyn, Roman; Mekic, Mevludin; Porawska, Wieskawa; Ciferska, Hana; Jedrychowicz-Rosiak, Krystyna; Zielinska, Agnieszka; Choi, Jasmine; Rho, Young Hee

2017-10-01

SB2 is a biosimilar to the reference infliximab (INF). Similar efficacy, safety and immunogenicity between SB2 and INF up to 30 weeks were previously reported. This report investigates such clinical similarity up to 54 weeks, including structural joint damage. In this phase III, double-blind, parallel-group, multicentre study, patients with moderate to severe RA despite MTX were randomized (1:1) to receive 3 mg/kg of either SB2 or INF at 0, 2, 6 and every 8 weeks thereafter. Dose escalation by 1.5 mg/kg up to a maximum dose of 7.5 mg/kg was allowed after week 30. Efficacy, safety and immunogenicity were measured at each visit up to week 54. Radiographic damage evaluated by modified total Sharp score was measured at baseline and week 54. A total of 584 patients were randomized to receive SB2 (n = 291) or INF (n = 293). The rate of radiographic progression was comparable between SB2 and INF (mean modified total Sharp score difference: SB2, 0.38; INF, 0.37) at 1 year. ACR responses, 28-joint DAS, Clinical Disease Activity Index and Simplified Disease Activity Index were comparable between SB2 and INF up to week 54. The incidence of treatment-emergent adverse events and anti-drug antibodies were comparable between treatment groups. Such comparable trends of efficacy, safety and immunogenicity were consistent from baseline up to 54 weeks. The pattern of dose increment was also comparable between SB2 and INF. SB2 maintained similar efficacy, safety and immunogenicity with INF up to 54 weeks in patients with moderate to severe RA. Radiographic progression was comparable at 1 year. ClinicalTrials.gov (http://clinicaltrials.gov; NCT01936181) and EudraCT (https://www.clinicaltrialsregister.eu; 2012-005733-37). © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Comparing biosimilar SB2 with reference infliximab after 54 weeks of a double-blind trial: clinical, structural and safety results

PubMed Central

Smolen, Josef S.; Choe, Jung-Yoon; Prodanovic, Nenad; Niebrzydowski, Jaroslaw; Staykov, Ivan; Dokoupilova, Eva; Baranauskaite, Asta; Yatsyshyn, Roman; Mekic, Mevludin; Porawska, Wieskawa; Ciferska, Hana; Jedrychowicz-Rosiak, Krystyna; Zielinska, Agnieszka; Choi, Jasmine; Rho, Young Hee

2017-01-01

Abstract Objectives SB2 is a biosimilar to the reference infliximab (INF). Similar efficacy, safety and immunogenicity between SB2 and INF up to 30 weeks were previously reported. This report investigates such clinical similarity up to 54 weeks, including structural joint damage. Methods In this phase III, double-blind, parallel-group, multicentre study, patients with moderate to severe RA despite MTX were randomized (1:1) to receive 3 mg/kg of either SB2 or INF at 0, 2, 6 and every 8 weeks thereafter. Dose escalation by 1.5 mg/kg up to a maximum dose of 7.5 mg/kg was allowed after week 30. Efficacy, safety and immunogenicity were measured at each visit up to week 54. Radiographic damage evaluated by modified total Sharp score was measured at baseline and week 54. Results A total of 584 patients were randomized to receive SB2 (n = 291) or INF (n = 293). The rate of radiographic progression was comparable between SB2 and INF (mean modified total Sharp score difference: SB2, 0.38; INF, 0.37) at 1 year. ACR responses, 28-joint DAS, Clinical Disease Activity Index and Simplified Disease Activity Index were comparable between SB2 and INF up to week 54. The incidence of treatment-emergent adverse events and anti-drug antibodies were comparable between treatment groups. Such comparable trends of efficacy, safety and immunogenicity were consistent from baseline up to 54 weeks. The pattern of dose increment was also comparable between SB2 and INF. Conclusion SB2 maintained similar efficacy, safety and immunogenicity with INF up to 54 weeks in patients with moderate to severe RA. Radiographic progression was comparable at 1 year. Trial registration ClinicalTrials.gov (http://clinicaltrials.gov; NCT01936181) and EudraCT (https://www.clinicaltrialsregister.eu; 2012-005733-37) PMID:28957563

Pulse-echo sound speed estimation using second order speckle statistics

NASA Astrophysics Data System (ADS)

Rosado-Mendez, Ivan M.; Nam, Kibo; Madsen, Ernest L.; Hall, Timothy J.; Zagzebski, James A.

2012-10-01

This work presents a phantom-based evaluation of a method for estimating soft-tissue speeds of sound using pulse-echo data. The method is based on the improvement of image sharpness as the sound speed value assumed during beamforming is systematically matched to the tissue sound speed. The novelty of this work is the quantitative assessment of image sharpness by measuring the resolution cell size from the autocovariance matrix for echo signals from a random distribution of scatterers thus eliminating the need of strong reflectors. Envelope data were obtained from a fatty-tissue mimicking (FTM) phantom (sound speed = 1452 m/s) and a nonfatty-tissue mimicking (NFTM) phantom (1544 m/s) scanned with a linear array transducer on a clinical ultrasound system. Dependence on pulse characteristics was tested by varying the pulse frequency and amplitude. On average, sound speed estimation errors were -0.7% for the FTM phantom and -1.1% for the NFTM phantom. In general, no significant difference was found among errors from different pulse frequencies and amplitudes. The method is currently being optimized for the differentiation of diffuse liver diseases.

Numerical modeling of perched water under Yucca Mountain, Nevada

USGS Publications Warehouse

Hinds, J.J.; Ge, S.; Fridrich, C.J.

1999-01-01

The presence of perched water near the potential high-level nuclear waste repository area at Yucca Mountain, Nevada, has important implications for waste isolation. Perched water occurs because of sharp contrasts in rock properties, in particular between the strongly fractured repository host rock (the Topopah Spring welded tuff) and the immediately underlying vitrophyric (glassy) subunit, in which fractures are sealed by clays that were formed by alteration of the volcanic glass. The vitrophyre acts as a vertical barrier to unsaturated flow throughout much of the potential repository area. Geochemical analyses (Yang et al. 1996) indicate that perched water is relatively young, perhaps younger than 10,000 years. Given the low permeability of the rock matrix, fractures and perhaps fault zones must play a crucial role in unsaturated flow. The geologic setting of the major perched water bodies under Yucca Mountain suggests that faults commonly form barriers to lateral flow at the level of the repository horizon, but may also form important pathways for vertical infiltration from the repository horizon down to the water table. Using the numerical code UNSAT2, two factors believed to influence the perched water system at Yucca Mountain, climate and fault-zone permeability, are explored. The two-dimensional model predicts that the volume of water held within the perched water system may greatly increase under wetter climatic conditions, and that perched water bodies may drain to the water table along fault zones. Modeling results also show fault flow to be significantly attenuated in the Paintbrush Tuff non-welded hydrogeologic unit.

Motion-corrected whole-heart PET-MR for the simultaneous visualisation of coronary artery integrity and myocardial viability: an initial clinical validation.

PubMed

Munoz, Camila; Kunze, Karl P; Neji, Radhouene; Vitadello, Teresa; Rischpler, Christoph; Botnar, René M; Nekolla, Stephan G; Prieto, Claudia

2018-05-12

Cardiac PET-MR has shown potential for the comprehensive assessment of coronary heart disease. However, image degradation due to physiological motion remains a challenge that could hinder the adoption of this technology in clinical practice. The purpose of this study was to validate a recently proposed respiratory motion-corrected PET-MR framework for the simultaneous visualisation of myocardial viability ( 18 F-FDG PET) and coronary artery anatomy (coronary MR angiography, CMRA) in patients with chronic total occlusion (CTO). A cohort of 14 patients was scanned with the proposed PET-CMRA framework. PET and CMRA images were reconstructed with and without the proposed motion correction approach for comparison purposes. Metrics of image quality including visible vessel length and sharpness were obtained for CMRA for both the right and left anterior descending coronary arteries (RCA, LAD), and relative increase in 18 F-FDG PET signal after motion correction for standard 17-segment polar maps was computed. Resulting coronary anatomy by CMRA and myocardial integrity by PET were visually compared against X-ray angiography and conventional Late Gadolinium Enhancement (LGE) MRI, respectively. Motion correction increased CMRA visible vessel length by 49.9% and 32.6% (RCA, LAD) and vessel sharpness by 12.3% and 18.9% (RCA, LAD) on average compared to uncorrected images. Coronary lumen delineation on motion-corrected CMRA images was in good agreement with X-ray angiography findings. For PET, motion correction resulted in an average 8% increase in 18 F-FDG signal in the inferior and inferolateral segments of the myocardial wall. An improved delineation of myocardial viability defects and reduced noise in the 18 F-FDG PET images was observed, improving correspondence to subendocardial LGE-MRI findings compared to uncorrected images. The feasibility of the PET-CMRA framework for simultaneous cardiac PET-MR imaging in a short and predictable scan time (~11 min) has been demonstrated in 14 patients with CTO. Motion correction increased visible length and sharpness of the coronary arteries by CMRA, and improved delineation of the myocardium by 18 F-FDG PET, resulting in good agreement with X-ray angiography and LGE-MRI.

F1 style MGU-H applied to the turbocharger of a gasoline hybrid electric passenger car

NASA Astrophysics Data System (ADS)

Boretti, Albert

2017-12-01

We consider a turbocharged gasoline direct injection (DI) engine featuring a motor-generator-unit (MGU-H) fitted on the turbocharger shaft. The MGU-H receives or delivers energy to the same energy storage (ES) of the hybrid power unit that comprises a motor-generator unit on the driveline (MGU-K) in addition to the internal combustion engine (ICE). The energy supply from the ES is mostly needed during sharp accelerations to avoid turbo-lag, and to boost torque at low speeds. At low speeds, it also improves the ratio of engine crankshaft power to fuel flow power, as well as the ratio of engine crankshaft plus turbocharger shaft power to fuel flow power. The energy supply to the ES is possible at high speeds and loads, where otherwise the turbine could have been waste gated, and during decelerations. This improves the ratio of engine crankshaft plus turbocharger shaft power to fuel flow power.

Critical Review of Removal of Nano Materials in Waste Streams

NASA Astrophysics Data System (ADS)

Leung, Solomon W.; Williams, Bradley; De Jesus, Karl; Lai, James C. K.

2017-05-01

Industrial applications of nanomaterials (NMs) are rising drastically in recent years and the commercial value of these materials can reach over 100 billion in 5 years. Major effort in nano research has been devoted to the utilities of the materials, only minimum effort has been directed to the disposal, reuse, and recycle of these new forms of materials. Due to their unique sizes and sharps, nanomaterials possess unique characteristics and toxicity that are not expected from their counterparts in meso/micro forms. At the present time, there are no regulations governing the handling and disposals of NMs, but recent research demonstrated that NMs are more hazardous than we realize. A main reason why less caution is being exercised by the general public regarding NMs is that the measurement and quantitation of NMs are difficult, which lead to difficulties in monitoring, thus regulation. This article critically reviewed over the issues stemming from the development of NMs, especially the challenges of measurement and disposal of these materials in landfills.

The green entrepreneur: Business opportunities that can save the Earth make you money

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

Berle, G.

1993-01-01

The Green Entrepreneur looks at business opportunities for the many small operators working their way through the landslide. Gustav Berle's book is an alarming cornucopia of good ideas, helpful references, and summaries of today's preoccupying business concerns to reduce waste, save materials, and conserve energy. This quick-read is also interspersed with a lower-octane blend of popularist solutions to such global problems as world hunger, world peace, and the world's needs for resource reallocation. The ideas spread throughout this text may trigger some start-up thoughts, and the many helpful references may assist those eager to learn how to use the backhoemore » and pick axe. Unfortunately, the small players are probably a small part of the needed answer. The momentous claim of the book - the need to combine environmentally sound concepts with sharp business plans and competent management' - isn't bad nor negligent advice for the giants, either, that still roam the globe.« less

Upgrading agricultural wastes using three different carbonization methods: Thermal, hydrothermal and vapothermal.

PubMed

Yeoh, Keat-Hor; Shafie, S A; Al-Attab, K A; Zainal, Z A

2018-06-15

In this study, three different methods for high quality solid fuel production were tested and compared experimentally. Oil palm empty fruit bunches, mesocarp fibers, palm kernel shells and rubber seeds shells were treated using thermal (TC), hydrothermal (HTC) and vapothermal (VTC) carbonization. All thermochemical methods were accomplished by using a custom made batch-type reactor. Utilization of novel single reactor equipped with suspended internal container provided efficient operation since both steam generator and raw materials were placed inside the same reactor. Highest energy densification was achieved by VTC process followed by TC and HTC processes. The heating value enhancement in VTC and TC was achieved by the increase in fixed carbon content and reduction in volatile matter. The formation of the spherical components in HTC hydrochar which gave a sharp peak at 340 °C in the DTG curves was suggested as the reason that led to the increment in energy content. Copyright © 2018 Elsevier Ltd. All rights reserved.

Diesel particulate emissions from used cooking oil biodiesel.

PubMed

Lapuerta, Magín; Rodríguez-Fernández, José; Agudelo, John R

2008-03-01

Two different biodiesel fuels, obtained from waste cooking oils with different previous uses, were tested in a DI diesel commercial engine either pure or in 30% and 70% v/v blends with a reference diesel fuel. Tests were performed under a set of engine operating conditions corresponding to typical road conditions. Although the engine efficiency was not significantly affected, an increase in fuel consumption with the biodiesel concentration was observed. This increase was proportional to the decrease in the heating value. The main objective of the work was to study the effect of biodiesel blends on particulate emissions, measured in terms of mass, optical effect (smoke opacity) and size distributions. A sharp decrease was observed in both smoke and particulate matter emissions as the biodiesel concentration was increased. The mean particle size was also reduced with the biodiesel concentration, but no significant increases were found in the range of the smallest particles. No important differences in emissions were found between the two tested biodiesel fuels.

Ordered molecular arrays as templates: A new approach to synthesis of mesoporous materials

NASA Astrophysics Data System (ADS)

Behrens, P.; Stucky, G.

There has been a growing interest in the extension of the microporous molecular sieve synthesis and applications to mesoscopic dimensions. Typical areas for the application of mesoscopic zeolite-type structures are in separation (e.g., protein separation and selective adsorption of large organic molecules from waste waters) and catalysis (e.g., processing of tar sand and of the high distillates of crude oils to valuable low-boiling products). Another is in the supramolecular assembly of molecular array and polymers for electronic and optical applications. In a new concept in the synthesis of porous material the templating agent is no longer a single, solvated, organic molecule or metal ion, but rather a self-assembled molecular array. This template leads to mesoporous materials with adjustable pore sizes between 16 and greater than 100 Angstrom, covering well the mesophorous range of greatest interest. The periodic arrangement of pores is very regular, and the pore size distribution measured by absorption is nearly as sharp as that of conventional zeolites.

Multifunctional particle-constituted microneedle arrays as cutaneous or mucosal vaccine adjuvant-delivery systems

PubMed Central

Wang, Xueting; Wang, Ning; Li, Ning; Zhen, Yuanyuan; Wang, Ting

2016-01-01

ABSTRACT To overcome drawbacks of current injection vaccines, such as causing needle phobia, needing health professionals for inoculation, and generating dangerous sharps wastes, researchers have designed novel vaccines that are combined with various microneedle arrays (MAs), in particular, with the multifunctional particle-constructed MAs (MPMAs). MPMAs prove able to enhance vaccine stability through incorporating vaccine ingredients in the carrier, and can be painlessly inoculated by minimally trained workers or by self-administration, leaving behind no metal needle pollution while eliciting robust systemic and mucosal immunity to antigens, thanks to delivering vaccines to cutaneous or mucosal compartments enriched in professional antigen-presenting cells (APCs). Especially, MPMAs can be easily integrated with functional molecules fulfilling targeting vaccine delivery or controlling immune response toward a Th1 or Th2 pathway to generate desired immunity against pathogens. Herein, we introduce the latest research and development of various MPMAs which are a novel but promising vaccine adjuvant delivery system (VADS). PMID:27159879

Occupational risks and hepatitis B vaccination status of dental auxiliaries in Nigeria.

PubMed

Azodo, C C; Ehigiator, O; Ojo, M A

2010-01-01

To assess the occupational exposure to needlestick and sharps injuries and hepatitis B vaccination status among dental auxiliaries. A descriptive cross-sectional survey of 83 dental auxiliaries was conducted that included 12 technologists, 11 therapists, 53 nurses/surgical assistants, and 7 record officers. The survey included demography, history of needlestick and sharps injury, hepatitis B vaccination, knowledge and attitude towards HIV-infected patients, and the dental auxiliaries' information needs on HIV-related issues. Of the 83 dental auxiliaries, 34 (41%) had experienced needlestick and sharps injury in the last 12 months. At the time of the study, only 43 (51.8%) had been immunized against hepatitis B. 62 (74.7%) of the respondents thought that it was easier to contract HIV than hepatitis B through needlestick in a dental clinic. 21 (25.3%) would not assist dentists treating HIV-positive patients. However, 76 (91.6%), a majority, agreed that they needed more information on HIV-related issues, with 59 (71.1%) specifying a single area of need and 17 (20.5%) more than one area of need. The single areas of need specified in descending order were infection control (n = 22, 26.5%), HIV counseling (n = 12, 14.5%), oral manifestations of HIV/AIDS (n = 11, 13.3%), postexposure prophylaxis (n = 9, 10.8%), and antiretroviral therapy (n = 5, 6.0%). The data from this survey underscore the urgent need for educational interventions to encourage safe work practices. Hepatitis B vaccination, HIV-related knowledge and proper postexposure prophylaxis are needed to prevent occupational transmission of blood-borne viruses. Copyright 2010 S. Karger AG, Basel.

How sharp is sharp? Towards quantification of the sharpness and penetration ability of kitchen knives used in stabbings.

PubMed

Hainsworth, S V; Delaney, R J; Rutty, G N

2008-07-01

Stabbing is the most common method for violent death in the UK. As part of their investigation, forensic pathologists are commonly asked to estimate or quantify the degree of force required to create a wound. The force required to penetrate the skin and body by a knife is a complex function of the sharpness of the knife, the area of the body and alignment with cleavage lines of the skin, the angle of attack and the relative movement of the person stabbing relative to the victim being stabbed. This makes it difficult for the forensic pathologist to give an objective answer to the question; hence, subjective estimations are often used. One area where some degree of quantification is more tractable is in assessing how sharp an implement (particularly a knife) is. This paper presents results of a systematic study of how the different aspects of knife geometry influence sharpness and presents a simple test for assessing knife sharpness using drop testing. The results show that the radius of the blunt edge at the tip is important for controlling the penetration ability of a kitchen knife. Using high-speed video, it also gives insight into the mechanism of knife penetration into the skin. The results of the study will aid pathologists in giving a more informed answer to the question of the degree of force used in stabbing.

The Relevance of Culturally Based Curriculum and Instruction: The Case of Nancy Sharp

ERIC Educational Resources Information Center

Lipka, Jerry; Sharp, Nancy; Brenner, Betsy; Yanez, Evelyn; Sharp, Ferdinand

2005-01-01

Ms. Sharp's case is particularly instructive as it shows how this experienced Yup'ik teacher steeped in the traditions of her culture effectively implemented a culturally based math module. Ms. Sharp's pedagogical creatively allowed her to authentically bring together a core academic content area, math, with Yup'ik traditions, knowledge, and ways…

Evaluating Continuing Education Needs and Program Effectiveness Using a Survey of Virginia's SHARP Logger Program Participants

ERIC Educational Resources Information Center

Barrett, Scott M.; Bolding, M. Chad; Munsell, John F.

2012-01-01

Virginia's SHARP logger program is a Cooperative Extension program currently providing training to over 1,500 loggers, foresters, and others. We conducted a mail survey of SHARP loggers to characterize program participants, assess programming needs, and evaluate program effectiveness. Results indicate a diverse group of participants in terms of…

78 FR 59425 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the... Service, Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas.gov... INFORMATION CONTACT: Requests for additional information or copies should be directed to Bruce A. Sharp...

77 FR 13176 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

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... 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the Bureau of the Public Debt within the Department of the.... Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas.gov . The opportunity...: Requests for additional information or copies should be directed to Bruce A. Sharp, Bureau of the Public...

77 FR 31689 - Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

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... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the.... Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas.gov . The opportunity...: Requests for additional information or copies should be directed to Bruce A. Sharp, Bureau of the Public...

77 FR 32179 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

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... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A)). Currently the.... Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas.gov . The opportunity...: Requests for additional information or copies should be directed to Bruce A. Sharp, Bureau of the Public...

78 FR 21706 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

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... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the... Public Debt, Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas... INFORMATION CONTACT: Requests for additional information or copies should be directed to Bruce A. Sharp...

77 FR 60026 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

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... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the... Public Debt, Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas... INFORMATION CONTACT: Requests for additional information or copies should be directed to Bruce A. Sharp...

77 FR 19424 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

..., as required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A..., Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.treas.gov . The...: Requests for additional information or copies should be directed to Bruce A. Sharp, Bureau of the Public...

77 FR 32180 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the... the Public Debt, Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd... INFORMATION CONTACT: Requests for additional information or copies should be directed to Bruce A. Sharp...

The Formation and Erosion History of Mt. Sharp

NASA Technical Reports Server (NTRS)

Allen, Carlton C.; Dapremont, Angela M.

2014-01-01

The Curiosity rover is exploring 155 km diameter Gale crater and Mt. Sharp, Gale's 5 km high central mound (Fig. 1). This study addresses the formation and erosion history of Mt. Sharp. Gale lies on the topographic dichotomy between the southern highlands and the northern plains - a drop of over 2 km [1,2]. Altitude differences between the north and south rim reflect this regional slope, as do altitude differences between the deep annulus north of Mt. Sharp and the southern crater floor. Orbiter and rover images demonstrate that most exposed areas on Mt. Sharp consist of thin, sub-parallel units interpreted as sedimentary layers [3]. Gale is typical of the 50 large martian craters that have been totally or partially filled with such layers [4,5]. In many craters these sediments have been deeply eroded. Central Peak and Peak Ring: The highest point on Mt. Sharp, near the crater's center, is interpreted as a central peak [6]. The peak has a massive lower portion and a thin, smooth capping deposit (Fig. 2). Gale's size is transitional between martian craters with single central peaks and craters with peak rings approximately half the crater's diameter [2,6]. The boundaries of Mt. Sharp, as well as an arc of hills to the southeast of the mountain, closely match a circle approximately 80 km in diameter (Fig. 3). This morphology suggests that the Gale impact may have formed both a central peak and a partial peak ring, which is covered by the sediments of Mt. Sharp in the north and possibly exposed in the arc of eroded hills in the southeast quadrant (Figs. 3,4).

A comprehensive numerical analysis of background phase correction with V-SHARP.

PubMed

Özbay, Pinar Senay; Deistung, Andreas; Feng, Xiang; Nanz, Daniel; Reichenbach, Jürgen Rainer; Schweser, Ferdinand

2017-04-01

Sophisticated harmonic artifact reduction for phase data (SHARP) is a method to remove background field contributions in MRI phase images, which is an essential processing step for quantitative susceptibility mapping (QSM). To perform SHARP, a spherical kernel radius and a regularization parameter need to be defined. In this study, we carried out an extensive analysis of the effect of these two parameters on the corrected phase images and on the reconstructed susceptibility maps. As a result of the dependence of the parameters on acquisition and processing characteristics, we propose a new SHARP scheme with generalized parameters. The new SHARP scheme uses a high-pass filtering approach to define the regularization parameter. We employed the variable-kernel SHARP (V-SHARP) approach, using different maximum radii (R m ) between 1 and 15 mm and varying regularization parameters (f) in a numerical brain model. The local root-mean-square error (RMSE) between the ground-truth, background-corrected field map and the results from SHARP decreased towards the center of the brain. RMSE of susceptibility maps calculated with a spatial domain algorithm was smallest for R m between 6 and 10 mm and f between 0 and 0.01 mm -1 , and for maps calculated with a Fourier domain algorithm for R m between 10 and 15 mm and f between 0 and 0.0091 mm -1 . We demonstrated and confirmed the new parameter scheme in vivo. The novel regularization scheme allows the use of the same regularization parameter irrespective of other imaging parameters, such as image resolution. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Quantitative description of solid breast nodules by ultrasound imaging

NASA Astrophysics Data System (ADS)

Sehgal, Chandra M.; Kangas, Sarah A.; Cary, Ted W.; Weinstein, Susan P.; Schultz, Susan M.; Arger, Peter H.; Conant, Emily F.

2004-04-01

Various features based on qualitative description of shape, contour, margin and echogenicity of solid breast nodules are used clinically to classify them as benign or malignant. However, there continues to be considerable overlap in the sonographic findings for the two types of lesions. This is related to the lack of precise definition of the various features as well as to the lack of agreement among observers, among other factors. The goal of this investigation is to define clinical features quantitatively and evaluate if they differ significantly in malignant and benign cases. Features based on margin sharpness and continuity, shadowing, and attenuation were defined and calculated from the images. These features were tested on digital phantoms. Following the evaluation, the features were measured on 116 breast sonograms of 58 biopsy-proven masses. Biopsy had been recommended for all of these breast lesions based on physical exams and conventional diagnostic imaging of ultrasound and/or mammography. Of the 58 masses, 20 were identified as malignant and 38 as benign histologically. Margin sharpness, margin echogenicity, and angular margin variation were significantly different for the two groups (p<0.03, two-tailed student t-test). Shadowing and attenuation of ultrasound did not show significant difference. The results of this preliminary study show that quantitative margin characteristics measured for the malignant and benign masses from the ultrasound images are different and could potentially be useful in identifying a subgroup of solid breast nodules that have low risk of being malignant.

Dental Environmental Noise Evaluation and Health Risk Model Construction to Dental Professionals.

PubMed

Ma, Kuen Wai; Wong, Hai Ming; Mak, Cheuk Ming

2017-09-19

Occupational noise is unavoidably produced from dental equipment, building facilities, and human voices in the dental environment. The purpose of this study was to investigate the effect of occupational noise exposure on the dental professionals' health condition. The psychoacoustics approach noise exposure assessment followed by the health risk assessment was carried on at the paediatric dentistry clinic and the dental laboratory in the Prince Philip Dental Hospital of Hong Kong. The A-weighted equivalent sound level, total loudness, and sharpness values were statistically significantly higher for the noise at the laboratory than that at the clinic. The degree of perceived influences and sharpness of noise were found to have the impacts on the dental professionals' working performance and health. Moreover, the risk of having a bad hearing state would a have 26% and 31% higher chance for a unit increment of the short-term and long-term impact scores, respectively. The dental professionals with the service length more than 10 years and the daily working hours of more than eight showed the highest risk to their hearing state. The worse the hearing state was, the worse the health state was found for the dental professionals. Also, the risk of dissatisfaction would be increased by 4.41 and 1.22 times for those who worked at the laboratory and a unit increment of the long-term impact score. The constructed health risk mode with the scientific and statistical evidence is hence important for the future noise management of environmental improvement.

Tomosynthesis can facilitate accurate measurement of joint space width under the condition of the oblique incidence of X-rays in patients with rheumatoid arthritis.

PubMed

Ono, Yohei; Kashihara, Rina; Yasojima, Nobutoshi; Kasahara, Hideki; Shimizu, Yuka; Tamura, Kenichi; Tsutsumi, Kaori; Sutherland, Kenneth; Koike, Takao; Kamishima, Tamotsu

2016-06-01

Accurate evaluation of joint space width (JSW) is important in the assessment of rheumatoid arthritis (RA). In clinical radiography of bilateral hands, the oblique incidence of X-rays is unavoidable, which may cause perceptional or measurement error of JSW. The objective of this study was to examine whether tomosynthesis, a recently developed modality, can facilitate a more accurate evaluation of JSW than radiography under the condition of oblique incidence of X-rays. We investigated quantitative errors derived from the oblique incidence of X-rays by imaging phantoms simulating various finger joint spaces using radiographs and tomosynthesis images. We then compared the qualitative results of the modified total Sharp score of a total of 320 joints from 20 patients with RA between these modalities. A quantitative error was prominent when the location of the phantom was shifted along the JSW direction. Modified total Sharp scores of tomosynthesis images were significantly higher than those of radiography, that is to say JSW was regarded as narrower in tomosynthesis than in radiography when finger joints were located where the oblique incidence of X-rays is expected in the JSW direction. Tomosynthesis can facilitate accurate evaluation of JSW in finger joints of patients with RA, even with oblique incidence of X-rays. Accurate evaluation of JSW is necessary for the management of patients with RA. Through phantom and clinical studies, we demonstrate that tomosynthesis may achieve more accurate evaluation of JSW.

Understanding the Hospital Sharps Injury Reporting Pathway

PubMed Central

Boden, Leslie I.; Petrofsky, Yolanta V.; Hopcia, Karen; Wagner, Gregory R.; Hashimoto, Dean

2016-01-01

Introduction Patient-care workers are frequently exposed to sharps injuries, which can involve the risk of serious illness. Underreporting of these injuries can compromise prevention efforts. Materials and Methods We linked survey responses of 1572 non-physician patient-care workers with the Occupational Health Services (OHS) database at two academic hospitals. We determined whether survey respondents who said they had sharps injuries indicated that they had reported them and whether reported injuries were recorded in the OHS database. Results Respondents said that they reported 62 of 78 sharps injuries occurring over a 12-month period. Only 28 appeared in the OHS data. Safety practices were positively associated with respondents’ saying they reported sharps injuries but not with whether reported injuries appeared in the OHS data. Conclusions Administrators should consider creating reporting mechanisms that are simpler and more direct. Administrators and researchers should attempt to understand how incidents might be lost before they are recorded. PMID:25308763

Factors governing particle number emissions in a waste-to-energy plant.

PubMed

Ozgen, Senem; Cernuschi, Stefano; Giugliano, Michele

2015-05-01

Particle number concentration and size distribution measurements were performed on the stack gas of a waste-to-energy plant which co-incinerates municipal solid waste, sewage sludge and clinical waste in two lines. Average total number of particles was found to be 4.0·10(5)cm(-3) and 1.9·10(5)cm(-3) for the line equipped with a wet flue gas cleaning process and a dry cleaning system, respectively. Ultrafine particles (dp<100nm) accounted for about 97% of total number concentration for both lines, whereas the nanoparticle (dp<50nm) contribution differed slightly between the lines (87% and 84%). The experimental data is explored statistically through some multivariate pattern identifying methods such as factor analysis and cluster analysis to help the interpretation of the results regarding the origin of the particles in the flue gas with the objective of determining the factors governing the particle number emissions. The higher moisture of the flue gas in the wet cleaning process was found to increase the particle number emissions on average by a factor of about 2 due to increased secondary formation of nanoparticles through nucleation of gaseous precursors such as sulfuric acid, ammonia and water. The influence of flue gas dilution and cooling monitored through the variation of the sampling conditions also confirms the potential effect of the secondary new particle formation in increasing the particle number emissions. This finding shows the importance of reporting the experimental conditions in detail to enable the comparison and interpretation of particle number emissions. Regarding the fuel characteristics no difference was observed in terms of particle number concentration and size distributions between the clinical waste feed and the municipal solid waste co-incineration with sludge. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparative assessment of status and opportunities for carbon Dioxide Capture and storage and Radioactive Waste Disposal In North America

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

Oldenburg, C.; Birkholzer, J.T.

Aside from the target storage regions being underground, geologic carbon sequestration (GCS) and radioactive waste disposal (RWD) share little in common in North America. The large volume of carbon dioxide (CO{sub 2}) needed to be sequestered along with its relatively benign health effects present a sharp contrast to the limited volumes and hazardous nature of high-level radioactive waste (RW). There is well-documented capacity in North America for 100 years or more of sequestration of CO{sub 2} from coal-fired power plants. Aside from economics, the challenges of GCS include lack of fully established legal and regulatory framework for ownership of injectedmore » CO{sub 2}, the need for an expanded pipeline infrastructure, and public acceptance of the technology. As for RW, the USA had proposed the unsaturated tuffs of Yucca Mountain, Nevada, as the region's first high-level RWD site before removing it from consideration in early 2009. The Canadian RW program is currently evolving with options that range from geologic disposal to both decentralized and centralized permanent storage in surface facilities. Both the USA and Canada have established legal and regulatory frameworks for RWD. The most challenging technical issue for RWD is the need to predict repository performance on extremely long time scales (10{sup 4}-10{sup 6} years). While attitudes toward nuclear power are rapidly changing as fossil-fuel costs soar and changes in climate occur, public perception remains the most serious challenge to opening RW repositories. Because of the many significant differences between RWD and GCS, there is little that can be shared between them from regulatory, legal, transportation, or economic perspectives. As for public perception, there is currently an opportunity to engage the public on the benefits and risks of both GCS and RWD as they learn more about the urgent energy-climate crisis created by greenhouse gas emissions from current fossil-fuel combustion practices.« less

A system dynamics approach for healthcare waste management: a case study in Istanbul Metropolitan City, Turkey.

PubMed

Ciplak, Nesli; Barton, John R

2012-06-01

Healthcare waste consists of various types of waste materials generated at hospitals, medical research centres, clinics and laboratories. Although 75-90% of this waste is classified as 'domestic' in nature, 20-25% is deemed to be hazardous, which if not disposed of appropriately, poses a risk to healthcare workers, patients, the environment and even the whole community. As long as healthcare waste is mixed with municipal waste and not segregated prior to disposal, costs will increase substantially. In this study, healthcare waste increases along with the potential to decrease the amounts by implementing effective segregation at healthcare facilities are projected to 2040. Our long-term aim is to develop a system to support selection and planning of the future treatment capacity. Istanbul in Turkey was used as the case study area. In order to identify the factors affecting healthcare waste generation in Istanbul, observations were made and interviews conducted in Istanbul over a 3 month period. A system dynamics approach was adopted to build a healthcare waste management model using a software package, Vensim Ple Plus. Based on reported analysis, the non-hazardous municipal fraction co-disposed with healthcare waste is around 65%. Using the projected waste generation flows, reducing a municipal fraction to 30% has the potential to avoid some 8000 t year(-1) of healthcare waste by 2025 and almost 10 000 t year(-1) by 2035. Furthermore, if segregation practices ensured healthcare waste requiring incineration was also selectively managed, 77% of healthcare waste could be diverted to alternative treatment technologies. As the throughput capacity of the only existing healthcare waste treatment facility in Istanbul, Kemerburgaz Incinerator, has already been exceeded, it is evident that improved management could not only reduce overall flows and costs but also permit alternative and cheaper treatment systems (e.g. autoclaving) to be adopted for the healthcare waste.

Scleroderma renal crisis in a case of mixed connective tissue disease.

PubMed

Vij, Mukul; Agrawal, Vinita; Jain, Manoj

2014-07-01

Mixed connective tissue disease (MCTD) is an overlap syndrome first defined in 1972 by Sharp et al. In this original study, the portrait emerged of a connective tissue disorder sharing features of systemic lupus erythematosus, systemic sclerosis (scleroderma) and polymyositis. Scleroderma renal crisis (SRC) is an extremely infrequent but serious complication that can occur in MCTD. The histologic picture of SRC is that of a thrombotic micro-angiopathic process. Renal biopsy plays an important role in confirming the clinical diagnosis, excluding overlapping/superimposed diseases that might lead to acute renal failure in MCTD patients, helping to predict the clinical outcome and optimizing patient management. We herewith report a rare case of SRC in a patient with MCTD and review the relevant literature.

Muscle wasting and cachexia in heart failure: mechanisms and therapies.

PubMed

von Haehling, Stephan; Ebner, Nicole; Dos Santos, Marcelo R; Springer, Jochen; Anker, Stefan D

2017-06-01

Body wasting is a serious complication that affects a large proportion of patients with heart failure. Muscle wasting, also known as sarcopenia, is the loss of muscle mass and strength, whereas cachexia describes loss of weight. After reaching guideline-recommended doses of heart failure therapies, the most promising approach to treating body wasting seems to be combined therapy that includes exercise, nutritional counselling, and drug treatment. Nutritional considerations include avoiding excessive salt and fluid intake, and replenishment of deficiencies in trace elements. Administration of omega-3 polyunsaturated fatty acids is beneficial in selected patients. High-calorific nutritional supplements can also be useful. The prescription of aerobic exercise training that provokes mild or moderate breathlessness has good scientific support. Drugs with potential benefit in the treatment of body wasting that have been tested in clinical studies in patients with heart failure include testosterone, ghrelin, recombinant human growth hormone, essential amino acids, and β 2 -adrenergic receptor agonists. In this Review, we summarize the pathophysiological mechanisms of muscle wasting and cachexia in heart failure, and highlight the potential treatment strategies. We aim to provide clinicians with the relevant information on body wasting to understand and treat these conditions in patients with heart failure.

Implementation of Structures in the CMS: Part 2, Weir

DTIC Science & Technology

2013-08-01

sharp - crested weir , it is between 0.55 and 0.58, and a broad - crested ...implementation, different weir coefficients are specified for the weir structure design, sharp - crested or broad - crested weir . The lowest value in the...coefficient range is used for the sharp - crested (0.55) and broad - crested (0.46) weir , respectively; the flux comparison between these two

78 FR 60376 - Proposed Collection: Direct Deposit Sign-Up Form

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

..., as required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A... Fiscal Service, Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp@bpd.... Sharp, Bureau of the Fiscal Service, 200 Third Street A4-A, Parkersburg, WV 26106-1328, (304) 480- 8150...

77 FR 38394 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... required by the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 3506(c)(2)(A). Currently the... of the Public Debt, Bruce A. Sharp, 200 Third Street A4-A, Parkersburg, WV 26106-1328, or bruce.sharp.... Sharp, Bureau of the Public Debt, 200 Third Street A4-A, Parkersburg, WV 26106-1328, (304) 480-8150...

Consideration of vision and picture quality: psychological effects induced by picture sharpness

NASA Astrophysics Data System (ADS)

Kusaka, Hideo

1989-08-01

A psychological hierarchy model of human vision(1)(2) suggests that the visual signals are processed in a serial manner from lower to higher stages: that is "sensation" - "perception" - "emotion." For designing a future television system, it is important to find out what kinds of physical factors affect the "emotion" experienced by an observer in front of the display. This paper describes the psychological effects induced by the sharpness of the picture. The subjective picture quality was evaluated for the same pictures with five different levels of sharpness. The experiment was performed on two kinds of printed pictures: (A) a woman's face, and (B) a town corner. From these experiments, it was found that the amount of high-frequency peaking (physical value of the sharpness) which psychologically gives the best picture quality, differs between pictures (A) and (B). That is, the optimum picture sharpness differs depending on the picture content. From these results, we have concluded that the psychophysical sharpness of the picture is not only determined at the stage of "perception" (e.g., resolution or signal to noise ratio, which everyone can judge immediately), but also at the stage of "emotion" (e.g., sensation of reality or beauty).

Objective assessment of knife sharpness over a working day cutting meat.

PubMed

Savescu, Adriana; Cuny-Guerrier, Aude; Wild, Pascal; Reno, Gilles; Aublet-Cuvelier, Agnès; Claudon, Laurent

2018-04-01

Knife sharpness is one of multiple factors involved in musculoskeletal disorders in industrial meat cutting. The aim of this study was to objectively evaluate, in real working situations, how knife sharpness changed over a working day cutting meat, and to analyse the impact of sharpening, steeling and meat-cutting activities on these variations. Twenty-two meat-cutting workers from three different companies participated in the study. The methods included measurements of knife sharpness in relation to real work situations and consideration of the way meat-cutting and sharpening operations were organised. Results showed that the type of meat-cutting activities, the steeling strategy adopted by the worker, including the types of tool used, and the overall organisation of the sharpening task all had a significant influence on how knife sharpness evolved over a 2-h period and over an entire working day. To improve MSD prevention, sharpening and steeling operations should not be considered as independent activities, but taken into account as a continuity of working actions. Appropriate assessment of knife sharpness by meat cutters affects how they organise meat-cutting and sharpening tasks. Copyright © 2017 Elsevier Ltd. All rights reserved.

TH-EF-BRA-03: Assessment of Data-Driven Respiratory Motion-Compensation Methods for 4D-CBCT Image Registration and Reconstruction Using Clinical Datasets

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

Riblett, MJ; Weiss, E; Hugo, GD

Purpose: To evaluate the performance of a 4D-CBCT registration and reconstruction method that corrects for respiratory motion and enhances image quality under clinically relevant conditions. Methods: Building on previous work, which tested feasibility of a motion-compensation workflow using image datasets superior to clinical acquisitions, this study assesses workflow performance under clinical conditions in terms of image quality improvement. Evaluated workflows utilized a combination of groupwise deformable image registration (DIR) and image reconstruction. Four-dimensional cone beam CT (4D-CBCT) FDK reconstructions were registered to either mean or respiratory phase reference frame images to model respiratory motion. The resulting 4D transformation was usedmore » to deform projection data during the FDK backprojection operation to create a motion-compensated reconstruction. To simulate clinically realistic conditions, superior quality projection datasets were sampled using a phase-binned striding method. Tissue interface sharpness (TIS) was defined as the slope of a sigmoid curve fit to the lung-diaphragm boundary or to the carina tissue-airway boundary when no diaphragm was discernable. Image quality improvement was assessed in 19 clinical cases by evaluating mitigation of view-aliasing artifacts, tissue interface sharpness recovery, and noise reduction. Results: For clinical datasets, evaluated average TIS recovery relative to base 4D-CBCT reconstructions was observed to be 87% using fixed-frame registration alone; 87% using fixed-frame with motion-compensated reconstruction; 92% using mean-frame registration alone; and 90% using mean-frame with motion-compensated reconstruction. Soft tissue noise was reduced on average by 43% and 44% for the fixed-frame registration and registration with motion-compensation methods, respectively, and by 40% and 42% for the corresponding mean-frame methods. Considerable reductions in view aliasing artifacts were observed for each method. Conclusion: Data-driven groupwise registration and motion-compensated reconstruction have the potential to improve the quality of 4D-CBCT images acquired under clinical conditions. For clinical image datasets, the addition of motion compensation after groupwise registration visibly reduced artifact impact. This work was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA166119. Hugo and Weiss hold a research agreement with Philips Healthcare and license agreement with Varian Medical Systems. Weiss receives royalties from UpToDate. Christensen receives funds from Roger Koch to support research.« less

A report on SHARP (Spacecraft Health Automated Reasoning Prototype) and the Voyager Neptune encounter

NASA Technical Reports Server (NTRS)

Martin, R. G. (Editor); Atkinson, D. J.; James, M. L.; Lawson, D. L.; Porta, H. J.

1990-01-01

The development and application of the Spacecraft Health Automated Reasoning Prototype (SHARP) for the operations of the telecommunications systems and link analysis functions in Voyager mission operations are presented. An overview is provided of the design and functional description of the SHARP system as it was applied to Voyager. Some of the current problems and motivations for automation in real-time mission operations are discussed, as are the specific solutions that SHARP provides. The application of SHARP to Voyager telecommunications had the goal of being a proof-of-capability demonstration of artificial intelligence as applied to the problem of real-time monitoring functions in planetary mission operations. AS part of achieving this central goal, the SHARP application effort was also required to address the issue of the design of an appropriate software system architecture for a ground-based, highly automated spacecraft monitoring system for mission operations, including methods for: (1) embedding a knowledge-based expert system for fault detection, isolation, and recovery within this architecture; (2) acquiring, managing, and fusing the multiple sources of information used by operations personnel; and (3) providing information-rich displays to human operators who need to exercise the capabilities of the automated system. In this regard, SHARP has provided an excellent example of how advanced artificial intelligence techniques can be smoothly integrated with a variety of conventionally programmed software modules, as well as guidance and solutions for many questions about automation in mission operations.

The stratigraphy and evolution of lower Mount Sharp from spectral, morphological, and thermophysical orbital data sets.

PubMed

Fraeman, A A; Ehlmann, B L; Arvidson, R E; Edwards, C S; Grotzinger, J P; Milliken, R E; Quinn, D P; Rice, M S

2016-09-01

We have developed a refined geologic map and stratigraphy for lower Mount Sharp using coordinated analyses of new spectral, thermophysical, and morphologic orbital data products. The Mount Sharp group consists of seven relatively planar units delineated by differences in texture, mineralogy, and thermophysical properties. These units are (1-3) three spatially adjacent units in the Murray formation which contain a variety of secondary phases and are distinguishable by thermal inertia and albedo differences, (4) a phyllosilicate-bearing unit, (5) a hematite-capped ridge unit, (6) a unit associated with material having a strongly sloped spectral signature at visible near-infrared wavelengths, and (7) a layered sulfate unit. The Siccar Point group consists of the Stimson formation and two additional units that unconformably overlie the Mount Sharp group. All Siccar Point group units are distinguished by higher thermal inertia values and record a period of substantial deposition and exhumation that followed the deposition and exhumation of the Mount Sharp group. Several spatially extensive silica deposits associated with veins and fractures show that late-stage silica enrichment within lower Mount Sharp was pervasive. At least two laterally extensive hematitic deposits are present at different stratigraphic intervals, and both are geometrically conformable with lower Mount Sharp strata. The occurrence of hematite at multiple stratigraphic horizons suggests redox interfaces were widespread in space and/or in time, and future measurements by the Mars Science Laboratory Curiosity rover will provide further insights into the depositional settings of these and other mineral phases.

Hazardous medical waste generation rates of different categories of health-care facilities

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

Komilis, Dimitrios, E-mail: dkomilis@env.duth.gr; Fouki, Anastassia; Papadopoulos, Dimitrios

Highlights: Black-Right-Pointing-Pointer We calculated hazardous medical waste generation rates (HMWGR) from 132 hospitals. Black-Right-Pointing-Pointer Based on a 22-month study period, HMWGR were highly skewed to the right. Black-Right-Pointing-Pointer The HMWGR varied from 0.00124 to 0.718 kg bed{sup -1} d{sup -1}. Black-Right-Pointing-Pointer A positive correlation existed between the HMWGR and the number of hospital beds. Black-Right-Pointing-Pointer We used non-parametric statistics to compare rates among hospital categories. - Abstract: Goal of this work was to calculate the hazardous medical waste unit generation rates (HMWUGR), in kg bed{sup -1} d{sup -1}, using data from 132 health-care facilities in Greece. The calculations were basedmore » on the weights of the hazardous medical wastes that were regularly transferred to the sole medical waste incinerator in Athens over a 22-month period during years 2009 and 2010. The 132 health-care facilities were grouped into public and private ones, and, also, into seven sub-categories, namely: birth, cancer treatment, general, military, pediatric, psychiatric and university hospitals. Results showed that there is a large variability in the HMWUGR, even among hospitals of the same category. Average total HMWUGR varied from 0.012 kg bed{sup -1} d{sup -1}, for the public psychiatric hospitals, to up to 0.72 kg bed{sup -1} d{sup -1}, for the public university hospitals. Within the private hospitals, average HMWUGR ranged from 0.0012 kg bed{sup -1} d{sup -1}, for the psychiatric clinics, to up to 0.49 kg bed{sup -1} d{sup -1}, for the birth clinics. Based on non-parametric statistics, HMWUGR were statistically similar for the birth and general hospitals, in both the public and private sector. The private birth and general hospitals generated statistically more wastes compared to the corresponding public hospitals. The infectious/toxic and toxic medical wastes appear to be 10% and 50% of the total hazardous medical wastes generated by the public cancer treatment and university hospitals, respectively.« less

The CROWN initiative: journal editors invite researchers to develop core outcomes in women’s health

PubMed Central

2014-01-01

Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a "core outcomes set" - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women's health have come together to support The CROWN (CoRe Outcomes in WomeN's health) Initiative. PMID:25048583

The CROWN initiative: journal editors invite researchers to develop core outcomes in women’s health

PubMed Central

2014-01-01

Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a “core outcomes set” - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women’s health have come together to support The CROWN (CoRe Outcomes in WomeN’s health) Initiative. PMID:24957208

The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health

PubMed Central

2014-01-01

Clinical trials, systematic reviews and guidelines compare beneficial and non-beneficial outcomes following interventions. Often, however, various studies on a particular topic do not address the same outcomes, making it difficult to draw clinically useful conclusions when a group of studies is looked at as a whole. This problem was recently thrown into sharp focus by a systematic review of interventions for preterm birth prevention, which found that among 103 randomised trials, no fewer than 72 different outcomes were reported. There is a growing recognition among clinical researchers that this variability undermines consistent synthesis of the evidence, and that what is needed is an agreed standardised collection of outcomes - a "core outcomes set" - for all trials in a specific clinical area. Recognising that the current inconsistency is a serious hindrance to progress in our specialty, the editors of over 50 journals related to women's health have come together to support The CROWN (CoRe Outcomes in WomeN's health) Initiative. PMID:25050130

Secure Container For Discarded Hypodermic Needles

NASA Technical Reports Server (NTRS)

Lee, Angelene M.

1992-01-01

Container designed for safe retention of discarded blood-collecting hypodermic needles and similar sharp objects used in life-science experiments aboard spacecraft. Needles inserted through self-closing lid and retained magnetically. They are inserted, sharp end first, through spring-loaded flap. Long needles and needles on syringes cannot turn around in container. Can be emptied, cleaned, and reused. Used on Earth to provide unusually secure containment of sharp objects.

Injuries caused by sharp instruments among healthcare workers--international and Polish perspectives.

PubMed

Goniewicz, Mariusz; Włoszczak-Szubzda, Anna; Niemcewicz, Marcin; Witt, Magdalena; Marciniak-Niemcewicz, Anna; Jarosz, Mirosław Jerzy

2012-01-01

Health care workers (HCW) worldwide are especially exposed to injury by sharp instruments in the course of their duty. The most often executed procedures with injury risk are: intramuscular or subcutaneous injection (22%), taking blood samples, or during intravenous cannulation (20%), and repeatedly replacing the cap on an already used needle (30%). Even a minor sharp injury with only a small loss of blood carries the risk of transfer of over 20 pathogens: Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), HIV/AIDS virus, malaria, syphilis, tuberculosis, brucellosis, herpes virus and diphtheria. The World Health Organization (WHO) estimates that more than two million health care workers experience the stressful event of a percutaneous injury with a contaminated sharp object each year (25-90% of them, however, remain unreported). These exposures result in about 16,000 infections with HCV, 66,000 with HBV and about 1,000 (200-5000) with HIV, which lead to about 1,100 deaths or significant disability. Exposures to sharp injuries and their consequences are highly preventable through simple interventions, such as HBV vaccination, education and providing containers for sharp instruments. Specific guidelines, similar to the American Occupational Safety and Health Administration (OSHA) regulations that have lowered by up to 88% of needle stabbing incidents, should be introduced by the European Union (EU) and other countries. The results of a review of reports leads to the following conclusions: 1) elaboration and implementation of new State regulations, especially in EU countries and in countries where such regulations do not exist; 2) the training of health care personnel should always be undertaken for new employees, and periodically for those already employed; 3) periodical control by appointed inspectors of knowledge of procedures for the prevention of injuries by sharp instruments among health care workers; 4) introducing and training in the use of equipment, which can prevent the sharp injuries; 5) an advanced monitoring system of sharp injuries sustained by worker should also be introduced. Successful implementation of these prevention measures will result in progress for public health and HCW's health and safety.

Muscle wasting in cancer cachexia: clinical implications, diagnosis, and emerging treatment strategies.

PubMed

Dodson, Shontelle; Baracos, Vickie E; Jatoi, Aminah; Evans, William J; Cella, David; Dalton, James T; Steiner, Mitchell S

2011-01-01

Cancer cachexia is a complex metabolic condition characterized by loss of skeletal muscle. Common clinical manifestations include muscle wasting, anemia, reduced caloric intake, and altered immune function, which contribute to increased disability, fatigue, diminished quality of life, and reduced survival. The prevalence of cachexia and the impact of this disorder on the patient and family underscore the need for effective management strategies. Dietary supplementation and appetite stimulation alone are inadequate to reverse the underlying metabolic abnormalities of cancer cachexia and have limited long-term impact on patient quality of life and survival. Therapies that can increase muscle mass and physical performance may be a promising option; however, there are currently no drugs approved for the prevention or treatment of cancer cachexia. Several agents are in clinical development, including anabolic agents, such as selective androgen receptor modulators and drugs targeting inflammatory cytokines that promote skeletal muscle catabolism.

Altered States of Consciousness Profile: An Afro-Centric Intrapsychic Evaluation Tool

PubMed Central

Bell, Carl C.; Thompson, Belinda; Shorter-Gooden, Kumea; Mays, Raymond; Shakoor, Bambade

1985-01-01

In an effort to develop an Afro-centric intrapsychic evaluation tool, the Community Mental Health Council, Inc., Altered States of Consciousness Research Team, developed a structured interview used to quantify and qualify the 17 states of consciousness1 that occurred in black control, precare, and aftercare subjects. Differences were noted in the three groups as to the incidence, prevalence, and quality of the various states of consciousness. It was also noted that the profile obtained from the interviews yielded a sharp clinical picture of the subjects' total intrapsychic propensities. PMID:4057274

Health Hazard Evaluation Report HETA 84-046-1584, Hennepin County Medical Center, Minneapolis, Minnesota. [Ethylene oxide and waste anesthetic gases

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

Daniels, W.J.; Orris, P.

1985-04-01

Personal and area air samples were analyzed for ethylene oxide and waste anesthetic gases at Hennepin County Medical Center, Minneapolis, Minnesota in February, April, and July, 1984. The survey was requested by the center to evaluate health problems among employees. Medical questionnaires were administered and interviews were conducted with 59 employees in the instrument and operating room areas of the ear, nose, and throat, and surgery clinics. Ethylene-oxide was not detected during operation of the sterilizer. Nitrous-oxide concentrations of 66 to 138ppm were detected during surgical procedures. The authors conclude that a health hazard due to exposure to waste anestheticmore » gases exists at the center. Recommendations include evaluating the ventilation system and conducting additional monitoring for waste anesthetic gases.« less

Measuring cardiac waste: the premier cardiac waste measures.

PubMed

Lowe, Timothy J; Partovian, Chohreh; Kroch, Eugene; Martin, John; Bankowitz, Richard

2014-01-01

The authors developed 8 measures of waste associated with cardiac procedures to assist hospitals in comparing their performance with peer facilities. Measure selection was based on review of the research literature, clinical guidelines, and consultation with key stakeholders. Development and validation used the data from 261 hospitals in a split-sample design. Measures were risk adjusted using Premier's CareScience methodologies or mean peer value based on Medicare Severity Diagnosis-Related Group assignment. High variability was found in resource utilization across facilities. Validation of the measures using item-to-total correlations (range = 0.27-0.78), Cronbach α (.88), and Spearman rank correlation (0.92) showed high reliability and discriminatory power. Because of the level of variability observed among hospitals, this study suggests that there is opportunity for facilities to design successful waste reduction programs targeting cardiac-device procedures.

Surface-Wave Pulse Routing around Sharp Right Angles

NASA Astrophysics Data System (ADS)

Gao, Z.; Xu, H.; Gao, F.; Zhang, Y.; Luo, Y.; Zhang, B.

2018-04-01

Surface-plasmon polaritons (SPPs), or localized electromagnetic surface waves propagating on a metal-dielectric interface, are deemed promising information carriers for future subwavelength terahertz and optical photonic circuitry. However, surface waves fundamentally suffer from scattering loss when encountering sharp corners in routing and interconnection of photonic signals. Previous approaches enabling scattering-free surface-wave guidance around sharp corners are limited to either volumetric waveguide environments or extremely narrow bandwidth, being unable to guide a surface-wave pulse (SPP wave packet) on an on-chip platform. Here, in a surface-wave band-gap crystal implemented on a single metal surface, we demonstrate in time-domain routing a surface-wave pulse around multiple sharp right angles without perceptible scattering. Our work not only offers a solution to on-chip surface-wave pulse routing along an arbitrary path, but it also provides spatiotemporal information on the interplay between surface-wave pulses and sharp corners, both of which are desirable in developing high-performance large-scale integrated photonic circuits.

Transcript profiling differentiates healthy control, sub-clinical and clinical Johne's disease in dairy cattle

USDA-ARS?s Scientific Manuscript database

Johne’s Disease (JD), a ruminant infectious disease caused by Mycobacterium avium subspecies paratuberculosis (MAP), is characterized by a long latent period followed by an aggressive acute phase in which the animal experiences diarrhea and extreme wasting. The absence of symptoms and low levels of ...

16 CFR 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2012 CFR

2012-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. 1500.48... requirements for determining a sharp point in toys and other articles intended for use by children under 8... intended for use by children under 8 years of age, and such points exposed in normal use or as a result of...

16 CFR § 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2013 CFR

2013-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. § 1500.48... by children under 8 years of age. (a) Objective. The sharp point test prescribed by paragraph (d) of... and other articles intended for use by children under 8 years of age, and such points exposed in...

16 CFR 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2011 CFR

2011-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. 1500.48... requirements for determining a sharp point in toys and other articles intended for use by children under 8... intended for use by children under 8 years of age, and such points exposed in normal use or as a result of...

16 CFR 1500.48 - Technical requirements for determining a sharp point in toys and other articles intended for use...

Code of Federal Regulations, 2014 CFR

2014-01-01

... sharp point in toys and other articles intended for use by children under 8 years of age. 1500.48... requirements for determining a sharp point in toys and other articles intended for use by children under 8... intended for use by children under 8 years of age, and such points exposed in normal use or as a result of...

Investigation of micromixing by acoustically oscillated sharp-edges

PubMed Central

Nama, Nitesh; Huang, Po-Hsun; Huang, Tony Jun; Costanzo, Francesco

2016-01-01

Recently, acoustically oscillated sharp-edges have been utilized to achieve rapid and homogeneous mixing in microchannels. Here, we present a numerical model to investigate acoustic mixing inside a sharp-edge-based micromixer in the presence of a background flow. We extend our previously reported numerical model to include the mixing phenomena by using perturbation analysis and the Generalized Lagrangian Mean (GLM) theory in conjunction with the convection-diffusion equation. We divide the flow variables into zeroth-order, first-order, and second-order variables. This results in three sets of equations representing the background flow, acoustic response, and the time-averaged streaming flow, respectively. These equations are then solved successively to obtain the mean Lagrangian velocity which is combined with the convection-diffusion equation to predict the concentration profile. We validate our numerical model via a comparison of the numerical results with the experimentally obtained values of the mixing index for different flow rates. Further, we employ our model to study the effect of the applied input power and the background flow on the mixing performance of the sharp-edge-based micromixer. We also suggest potential design changes to the previously reported sharp-edge-based micromixer to improve its performance. Finally, we investigate the generation of a tunable concentration gradient by a linear arrangement of the sharp-edge structures inside the microchannel. PMID:27158292

Investigation of micromixing by acoustically oscillated sharp-edges.

PubMed

Nama, Nitesh; Huang, Po-Hsun; Huang, Tony Jun; Costanzo, Francesco

2016-03-01

Recently, acoustically oscillated sharp-edges have been utilized to achieve rapid and homogeneous mixing in microchannels. Here, we present a numerical model to investigate acoustic mixing inside a sharp-edge-based micromixer in the presence of a background flow. We extend our previously reported numerical model to include the mixing phenomena by using perturbation analysis and the Generalized Lagrangian Mean (GLM) theory in conjunction with the convection-diffusion equation. We divide the flow variables into zeroth-order, first-order, and second-order variables. This results in three sets of equations representing the background flow, acoustic response, and the time-averaged streaming flow, respectively. These equations are then solved successively to obtain the mean Lagrangian velocity which is combined with the convection-diffusion equation to predict the concentration profile. We validate our numerical model via a comparison of the numerical results with the experimentally obtained values of the mixing index for different flow rates. Further, we employ our model to study the effect of the applied input power and the background flow on the mixing performance of the sharp-edge-based micromixer. We also suggest potential design changes to the previously reported sharp-edge-based micromixer to improve its performance. Finally, we investigate the generation of a tunable concentration gradient by a linear arrangement of the sharp-edge structures inside the microchannel.

Sample Skewness as a Statistical Measurement of Neuronal Tuning Sharpness

PubMed Central

Samonds, Jason M.; Potetz, Brian R.; Lee, Tai Sing

2014-01-01

We propose using the statistical measurement of the sample skewness of the distribution of mean firing rates of a tuning curve to quantify sharpness of tuning. For some features, like binocular disparity, tuning curves are best described by relatively complex and sometimes diverse functions, making it difficult to quantify sharpness with a single function and parameter. Skewness provides a robust nonparametric measure of tuning curve sharpness that is invariant with respect to the mean and variance of the tuning curve and is straightforward to apply to a wide range of tuning, including simple orientation tuning curves and complex object tuning curves that often cannot even be described parametrically. Because skewness does not depend on a specific model or function of tuning, it is especially appealing to cases of sharpening where recurrent interactions among neurons produce sharper tuning curves that deviate in a complex manner from the feedforward function of tuning. Since tuning curves for all neurons are not typically well described by a single parametric function, this model independence additionally allows skewness to be applied to all recorded neurons, maximizing the statistical power of a set of data. We also compare skewness with other nonparametric measures of tuning curve sharpness and selectivity. Compared to these other nonparametric measures tested, skewness is best used for capturing the sharpness of multimodal tuning curves defined by narrow peaks (maximum) and broad valleys (minima). Finally, we provide a more formal definition of sharpness using a shape-based information gain measure and derive and show that skewness is correlated with this definition. PMID:24555451

The stratigraphy and evolution of lower Mount Sharp from spectral, morphological, and thermophysical orbital data sets

PubMed Central

Ehlmann, B. L.; Arvidson, R. E.; Edwards, C. S.; Grotzinger, J. P.; Milliken, R. E.; Quinn, D. P.; Rice, M. S.

2016-01-01

Abstract We have developed a refined geologic map and stratigraphy for lower Mount Sharp using coordinated analyses of new spectral, thermophysical, and morphologic orbital data products. The Mount Sharp group consists of seven relatively planar units delineated by differences in texture, mineralogy, and thermophysical properties. These units are (1–3) three spatially adjacent units in the Murray formation which contain a variety of secondary phases and are distinguishable by thermal inertia and albedo differences, (4) a phyllosilicate‐bearing unit, (5) a hematite‐capped ridge unit, (6) a unit associated with material having a strongly sloped spectral signature at visible near‐infrared wavelengths, and (7) a layered sulfate unit. The Siccar Point group consists of the Stimson formation and two additional units that unconformably overlie the Mount Sharp group. All Siccar Point group units are distinguished by higher thermal inertia values and record a period of substantial deposition and exhumation that followed the deposition and exhumation of the Mount Sharp group. Several spatially extensive silica deposits associated with veins and fractures show that late‐stage silica enrichment within lower Mount Sharp was pervasive. At least two laterally extensive hematitic deposits are present at different stratigraphic intervals, and both are geometrically conformable with lower Mount Sharp strata. The occurrence of hematite at multiple stratigraphic horizons suggests redox interfaces were widespread in space and/or in time, and future measurements by the Mars Science Laboratory Curiosity rover will provide further insights into the depositional settings of these and other mineral phases. PMID:27867788

Relationship between sharps disposal containers and Clostridium difficile infections in acute care hospitals.

PubMed

Pogorzelska-Maziarz, Monika

2015-10-01

Sharps disposal containers are ubiquitous in health care facilities; however, there is paucity of data on their potential role in pathogen transmission. This study assessed the relationship between use of single-use versus reusable sharps containers and rates of Clostridium difficile infections in a national sample of hospitals. A 2013 survey of 1,990 hospitals collected data on the use of sharps containers. Responses were linked to the 2012 Medicare Provider Analysis and Review dataset. Bivariate and multivariable negative binomial regression were conducted to examine differences in C difficile rates between hospitals using single-use versus reusable containers. There were 604 hospitals who completed the survey; of these, 539 provided data on use of sharps containers in 2012 (27% response rate). Hospitals had, on average, 289 beds (SD ± 203) and were predominantly non-for-profit (67%) and nonteaching (63%). Most used reusable sharps containers (72%). In bivariate regression, hospitals using single-use containers had significantly lower rates of C difficile versus hospitals using reusable containers (incidence rate ratio [IRR] = 0.846, P = .001). This relationship persisted in multivariable regression (IRR = 0.870, P = .003) after controlling for other hospital characteristics. This is the first study to show a link between use of single-use sharps containers and lower C difficile rates. Future research should investigate the potential for environmental contamination of reusable containers and the role they may play in pathogen transmission. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

PubMed

Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

2016-12-01

Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Occupational safety among dental health-care workers.

PubMed

Shimoji, Shigehiro; Ishihama, Kohji; Yamada, Hidefumi; Okayama, Masaki; Yasuda, Kouichi; Shibutani, Tohru; Ogasawara, Tadashi; Miyazawa, Hiroo; Furusawa, Kiyofumi

2010-01-01

Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%), 6 splash exposures (18.8%), and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66) reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58) and 60.3% (35/58) in dentists and 88.6% (39/44) and 61.4% (27/44) in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58) for dentists and 34.1% (15/44) for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were 'splatters from the patient's mouth contain blood' (90%, 99/110) and 'dental operations at our clinic are performed based only on a questionnaire without serious examinations for HBV, HCV, and HIV' (71.8%, 79/110). The reason of low compliance of protective eyewear among dentists might relate to fine dental procedures. Appropriate information is important for the motive of wearing personal protective equipment, and an early educational program may have a potential to increase compliance with the use of that equipment.

Clinical characteristics of RA patients with secondary SS and association with joint damage.

PubMed

Brown, Lindsay E; Frits, Michelle L; Iannaccone, Christine K; Weinblatt, Michael E; Shadick, Nancy A; Liao, Katherine P

2015-05-01

Secondary SS (sSS) is a common extra-articular manifestation of RA. There are conflicting data regarding the association of sSS with worse joint damage. This study aims to characterize sSS patients in an RA cohort and study the association between sSS and joint damage. We conducted a cross-sectional study of RA patients with ≥1 year of follow-up at a large academic centre. Subjects with co-morbid diseases that can also result in sicca symptoms were excluded from the analysis. Subjects were considered to have sSS if they were reported as having sSS by their rheumatologist at recruitment into the cohort and had the diagnosis confirmed by chart review. The primary outcome was Sharp score using bilateral hand radiographs at recruitment. We constructed a linear regression model to determine the association of sSS status and Sharp score adjusted by age, gender, disease duration and ACPA and RF status. We studied 829 RA subjects, mean age 57 years, 83% female, mean RA duration 13 years, 74% seropositive; 85 subjects (10.3%) had sSS. We observed a female predominance (95.3%), longer mean disease duration (16.9 years) and higher frequency of RF or ACPA positive among patients with sSS and RA. Having sSS at baseline was associated with higher Sharp scores (P = 0.03), independent of age, gender, RA disease duration and seropositive disease. In our RA cohort, RA subjects with sSS had worse joint damage, suggesting that sSS is a marker of more aggressive disease. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Wasting and stunting are still prevalent in children with sickle cell anaemia in Lagos, Nigeria.

PubMed

Esezobor, Christopher I; Akintan, Patricia; Akinsulie, Adebola; Temiye, Edamisan; Adeyemo, Titilope

2016-05-04

Sickle cell anaemia (SCA) is associated with growth failure. However, recent reports indicate high rates of overweight or obesity among children with SCA in developed countries. It is unclear whether overweight or obesity is also common in children with SCA in developing countries. The objectives of the study were to determine the prevalence of overweight or obesity, wasting and stunting and identify predictors of wasting and stunting among children with SCA in Nigeria. Children with SCA attending a public-funded tertiary hospital clinic were studied. Weight, height, haemoglobin, haemoglobin fractions and white cell count were measured. Anthropometric values were converted to z scores and referenced to the WHO Child Growth Standards and WHO Reference 2007. The proportions with wasting, stunting and overweight or obesity were determined. Regression analysis was used to identify the predictors of wasting and stunting. Two hundred and thirty-three children [mean (±SD) age of 9.0 (±4.0) years, 60.9 % males] participated in the study. Wasting, stunting and overweight or obesity rates were 22.7 %, 11.6 % and 1.7 %, respectively. Boys and children from low socioeconomic class were 3.25 (1.45-7.29) and 2.42 (1.14-5.18) times more likely to be wasted respectively, while both wasting and stunting were more common with increasing age [adjusted OR of 1.33 (1.18-1.51) and 1.15 (1.01-1.32) respectively]. Sickle cell-related complications and intake of oral penicillin and hydroxyurea were not associated with wasting and stunting. Overweight or obesity is uncommon while wasting and stunting are still prevalent in children with SCA in Lagos. The strongest predictors of wasting and stunting were older age, male gender and low socioeconomic status.

Sediment Scaling for Mud Mountain Fish Barrier Structure

DTIC Science & Technology

2017-06-28

2nd Int. Conf. on the Application of Physical Modeling to Port and Coastal Protection – Coastlab ’08, International Association for Hydro...Structure by Jeremy A. Sharp, Gary L. Brown, and Gary L. Bell PURPOSE: This Coastal and Hydraulics Laboratory technical note describes the process of... Coastal and Hydraulics Laboratory. Questions about this technical note can be addressed to Mr. Sharp at 601-634-4212 or Jeremy.A.Sharp@usace.army.mil

A faunistic study of genus Chasmogenus Sharp, 1882 of China (Coleoptera, Hydrophilidae).

PubMed

Jia, Fenglong; Tang, Yu-Dan

2018-01-01

Chasmogenus Sharp, 1882 is newly reported from the Chinese Mainland. A new species, C. parorbus sp. n. , is described from China (Yunnan). Chasmogenus orbus Watanabe, 1987 is reported from Hong Kong, the first record outside Japan. Chasmogenus abnormalis (Sharp, 1890) is reported from the Chinese mainland for the first time. The male genitalia of each species are illustrated. A key to the Chinese species of the genus is provided.

Novel Laser-Based Technique for Measurements of Primary Atomization Characteristics of Liquid Jets

DTIC Science & Technology

2012-08-22

worth noting that round supercavitating nozzles were used that had sharp edged inlets and exits, with length-to-diameter ratios smaller than 3. This...noting that round supercavitating nozzles were used that had sharp edged inlets and exits, with length-to-diameter ratios smaller than 3. This...breakup. It is worth noting that round supercavitating nozzles were used that had sharp edged inlets and exits, with length-to-diameter ratios

Occurrence of Greater Sage-Grouse X Sharp-tailed Grouse hybrids in Alberta

USGS Publications Warehouse

Aldridge, Cameron L.; Oyler-McCance, S.J.; Brigham, R.M.

2001-01-01

Two distinct grouse were regularly observed at two Greater Sage-Grouse (Centrocercus urophasianus) leks in both 1999 and 2000 in southeastern Alberta. Physically and behaviorally, the birds exhibited characteristics of both Greater Sage-Grouse and Sharp-tailed Grouse (Tympanuchus phasianellus), suggesting they were hybrids. DNA analyses of blood and feather samples indicated that both birds were males with Greater Sage-Grouse mothers and thus, fathers that were likely Sharp-tailed Grouse.

UHTC Research at NASA Ames

NASA Technical Reports Server (NTRS)

Johnson, Sylvia M.

2011-01-01

For enhanced aerodynamic performance. Materials for sharp leading edges can be reusable but need different properties because of geometry and very high temperatures. Require materials with significantly higher temperature capabilities, but for short duration. Current shuttle RCC leading edge materials: T approx. 1650 C. Materials for vehicles with sharp leading edges: T>2000 C. >% Figure depicts: High Temperature at Tip and Steep Temperature Gradient. Passive cooling is simplest option to manage the intense heating on sharp leading edges.

Testing local-realism and macro-realism under generalized dichotomic measurements

NASA Astrophysics Data System (ADS)

Das, Debarshi; Mal, Shiladitya; Home, Dipankar

2018-04-01

Generalized quantum measurements with two outcomes are fully characterized by two real parameters, dubbed as sharpness parameter and biasedness parameter and they can be linked with different aspects of the experimental setup. It is known that sharpness parameter characterizes precision of the measurements and decreasing sharpness parameter of the measurements reduces the possibility of probing quantum features like quantum mechanical (QM) violation of local-realism (LR) or macro-realism (MR). Here we investigate the effect of biasedness together with that of sharpness of measurements and find a trade-off between those two parameters in the context of probing QM violations of LR and MR. Interestingly, we also find that the above mentioned trade-off is more robust in the latter case.

The Case for Using Blunt-Tipped Lightning Rods as Strike Receptors.

NASA Astrophysics Data System (ADS)

Moore, C. B.; Aulich, G. D.; Rison, William

2003-07-01

Conventional lightning rods used in the United States have sharp tips, a practice derived from Benjamin Franklin's discovery of a means to obtain protection from lightning. However, the virtue of sharp tips for strike reception has never been established. An examination of the relevant physics shows that very strong electric fields are required above the tips of rods in order that they function as strike receptors but that the gradients of the field strength over sharp-tipped rods are so great that, at distances of a few millimeters, the local fields are often too weak for the development of upward-going streamers. In field tests, rods with rounded tips have been found to be better strike receptors than were nearby sharp-tipped rods.

Riga-Fede disease: a histological study and case report.

PubMed

Taghi, Azizi; Motamedi, Mohammad Hosein Kalantar

2009-01-01

Acute traumatic ulcerations and granulomas of the oral mucosa may result from physical damage via sharp foodstuffs, accidental biting, or talking. Most ulcerations heal within days. Others become chronic, reactive, and exophytic. A histopathologically unique type of chronic traumatic ulceration is the traumatic ulcerative granuloma with stromal eosinophilia (TUGSE). TUGSE exhibits a deep "pseudoinvasive" inflammatory reaction. This lesion may occur under the tongue in infants as a result of chronic mucosal trauma caused by mandibular anterior primary teeth during nursing and is termed Riga-Fede disease (RFD). The clinical presentation many resemble squamous cell carcinoma causing concern. RFD, although not uncommon, is not frequently reported. Thus, dental practitioners are unfamiliar with such lesions. We present a large Riga-Fede lesion in an infant along with the clinical management.

Don Sharp Home Improvements Information Sheet

EPA Pesticide Factsheets

Don Sharp Home Improvements (the Company) is located in Bartlett, Tennessee. The settlement involves renovation activities conducted at property constructed prior to 1978, located in Memphis, Tennessee.

North American experience with Low protein diet for Non-dialysis-dependent chronic kidney disease.

PubMed

Kalantar-Zadeh, Kamyar; Moore, Linda W; Tortorici, Amanda R; Chou, Jason A; St-Jules, David E; Aoun, Arianna; Rojas-Bautista, Vanessa; Tschida, Annelle K; Rhee, Connie M; Shah, Anuja A; Crowley, Susan; Vassalotti, Joseph A; Kovesdy, Csaba P

2016-07-19

Whereas in many parts of the world a low protein diet (LPD, 0.6-0.8 g/kg/day) is routinely prescribed for the management of patients with non-dialysis-dependent chronic kidney disease (CKD), this practice is infrequent in North America. The historical underpinnings related to LPD in the USA including the non-conclusive results of the Modification of Diet in Renal Disease Study may have played a role. Overall trends to initiate dialysis earlier in the course of CKD in the US allowed less time for LPD prescription. The usual dietary intake in the US includes high dietary protein content, which is in sharp contradistinction to that of a LPD. The fear of engendering or worsening protein-energy wasting may be an important handicap as suggested by a pilot survey of US nephrologists; nevertheless, there is also potential interest and enthusiasm in gaining further insight regarding LPD's utility in both research and in practice. Racial/ethnic disparities in the US and patients' adherence are additional challenges. Adherence should be monitored by well-trained dietitians by means of both dietary assessment techniques and 24-h urine collections to estimate dietary protein intake using urinary urea nitrogen (UUN). While keto-analogues are not currently available in the USA, there are other oral nutritional supplements for the provision of high-biologic-value proteins along with dietary energy intake of 30-35 Cal/kg/day available. Different treatment strategies related to dietary intake may help circumvent the protein- energy wasting apprehension and offer novel conservative approaches for CKD management in North America.

Carbon-constrained health care enterprise.

PubMed

Gell, Michael

2010-02-01

The health economy is a significant part of a national economy accounting typically for about 8% of GDP spent. As national economies respond to the dual challenges of severe economic turbulence on the global scale and climate change mitigation, the health economy is coming under increasing pressure to respond. Indications for sharp reductions in budgets and reductions in greenhouse gas emissions, such as carbon dioxide, are widespread. In this paper an analysis is undertaken of the diverse forces acting on a typical health care enterprise. The forces, both economic and carbon related, are investigated in terms of their effects through the enterprise and across its boundaries on the supply, demand and waste sides. The overall aim is to show how the enterprise and whole supply chains may flip synchronously into a low-carbon evolutionary pathway. By illustrating how different elements of the health care enterprise may respond to these developments, diverse opportunities for cost reduction, carbon reduction and product (goods and services) development are identified. These opportunities involve a variety of waste reduction and energy and materials conservation measures as well as new ways of collaborating with other enterprises going through similar transformations. The overall objective is to show that the carbon-constrained health care enterprise and the low-carbon health economy in which it sits may broaden its role in the coming decades to include a degree of responsibility for the health of the environment. This broader role is likely to supplement and entangle with the traditional role of the health economy, currently focused narrowly on human health, and lead to extensive organisational transformation, and infrastructure and product developments.

Health care transformation through collaboration on open-source informatics projects: integrating a medical applications platform, research data repository, and patient summarization.

PubMed

Klann, Jeffrey G; McCoy, Allison B; Wright, Adam; Wattanasin, Nich; Sittig, Dean F; Murphy, Shawn N

2013-05-30

The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service "cells" that expose the SMART application programming interface (API), and we made changes to the Web interface of i2b2 to host a "carousel" of SMART apps. We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container. It displays a problem-oriented view of medications and presents a line-graph display of laboratory results. This summarization app can be run in any EHR environment that either supports SMART or runs SMART-enabled i2b2. This i2b2 "clinical bridge" demonstrates a pathway for reusable app development that does not require EHR vendors to immediately adopt the SMART API. Apps can be developed in SMART and run by clinicians in the i2b2 repository, reusing clinical data extracted from EHRs. This may encourage the adoption of SMART by supporting SMART app development until EHRs adopt the platform. It also allows a new variety of clinical SMART apps, fueled by the broad aggregation of data types available in research repositories. The app (including its knowledge base) and SMART-i2b2 are open-source and freely available for download.

Surfing-related ocular injuries.

PubMed

Kim, J W; McDonald, H R; Rubsamen, P E; Luttrull, J K; Drouilhet, J H; Frambach, D A; Boyer, D S; Lambrou, F H; Hendrick, A; Weiss, J N; Engstrom, R E; Ing, M

1998-01-01

This report evaluates the clinical characteristics of surfing-related ocular trauma to learn the nature of such injuries and propose possible preventive measures. The authors reviewed 11 cases of surfing-related eye injuries caused by direct trauma from the surfboard, studying their mechanism of injury, the associated ocular complications, and the anatomic and visual outcomes of surgical repair. Surfing-related ocular injuries occurred exclusively in young males (mean age, 24.8 years; range, 14-37 years). The mechanism of injury most frequently responsible was impact with the sharp nose of the surfboard following a fall. Serious posterior segment complications were observed in all 11 patients, with nine patients suffering ruptured globes. Despite immediate medical attention, five patients did not recover ambulatory levels of visual acuity (>5/200). Surfing-related ocular trauma presenting to the retinal specialist typically leaves the patient with a permanent visual disability. Important factors contributing to these high-velocity injuries include the sharply pointed nose of the surfboard and the leash keeping the surfer in close proximity to the board following a fall. A simple modification in surfboard design such as blunting the sharp nose of the surfboard, or appropriate protective guards fitted over the surfboard nose, should lessen the severity of such injuries.

Esophageal foreign bodies in adults with different durations of time from ingestion to effective treatment

PubMed Central

Zhang, Xiaowen; Jiang, Yan; Fu, Tao; Zhang, Xiaoheng; Tu, Chunmei

2017-01-01

Objective This study was performed to identify the differences in clinical characteristics, operative methods, complications, and postoperative hospitalization stays for adults with esophageal foreign bodies with different durations of time from ingestion to effective treatment. Methods We retrospectively reviewed the medical records of 221 patients with a diagnosis of a foreign body in the esophagus, confirmed by rigid esophagoscopy, flexible esophagoscopy, or surgery. The differences between the two groups (Group A, ≤24 hours from ingestion to effective treatment; Group B, >24 hours from ingestion to effective treatment) were analyzed. Results Sharp foreign bodies comprised the majority of objects in the two groups, including jujube pits, bones (excluding fish bones), fish bones, dentures, and seafood shells. Foreign bodies located in the upper esophagus were more commonly observed in Group A than B. Significant differences were observed in the complication rate and length of postoperative hospitalization stays. Adults with esophageal foreign bodies had a high complication rate. Conclusions Rigid esophagoscopy can be used to remove sharp and bulky foreign bodies if more effective methods are unavailable. Effective treatment within 24 hours resulted in fewer complications and shorter postoperative hospitalization stays. PMID:28606025

Illness perceptions amongst individuals with dental caries.

PubMed

Mafla, A C; Villalobos-Galvis, F H; Heft, M W

2018-03-01

To assess individuals' perception of dental caries, in order to explain how illness representations might influence their coping with the disease. Cross-sectional questionnaire study. 520 consecutive patients (aged ≥18 years) of the General Dentistry Clinic at Universidad Cooperativa de Colombia, Pasto, Colombia who had experienced dental caries. Illness perception of dental caries was assessed using the Illness Perception Questionnaire Revised (IPQ-R). The most frequent self-reported symptoms associated with dental caries were "toothache" (56.2%), "tooth sensitivity" (53.8%) and "mild to sharp pain when eating or drinking" (51.2%). The dimensions of illness perception were related to socio-economic status (SES). Symptoms of "loose or separating teeth" and "pus in your tooth" were associated with dental caries by low SES participants, while "bleeding while brushing, flossing or eating hard food" and "mild to sharp pain when eating or drinking something sweet, hot or cold" were related more to higher SES. Perceptions of caries were related to socioeconomic status. Interventions to promote health literacy in order to improve the capacity to obtain, process and understand basic oral health information could increase an early detection of caries. Copyright© 2018 Dennis Barber Ltd.

Sarcopenia, cachexia, and muscle performance in heart failure: Review update 2016.

PubMed

Saitoh, Masakazu; Ishida, Junichi; Doehner, Wolfram; von Haehling, Stephan; Anker, Markus S; Coats, Andrew J S; Anker, Stefan D; Springer, Jochen

2017-07-01

Cachexia in the context of heart failure (HF) has been termed cardiac cachexia, and represents a progressive involuntary weight loss. Cachexia is mainly the result of an imbalance in the homeostasis of muscle protein synthesis and degradation due to a lower activity of protein synthesis pathways and an over-activation of protein degradation. In addition, muscle wasting leads to of impaired functional capacity, even after adjusting for clinical relevant variables in patients with HF. However, there is no sufficient therapeutic strategy in muscle wasting in HF patients and very few studies in animal models. Exercise training represents a promising intervention that can prevent or even reverse the process of muscle wasting, and worsening the muscle function and performance in HF with muscle wasting and cachexia. The pathological mechanisms and effective therapeutic approach of cardiac cachexia remain uncertain, because of the difficulty to establish animal cardiac cachexia models, thus novel animal models are warranted. Furthermore, the use of improved animal models will lead to a better understanding of the pathways that modulate muscle wasting and therapeutics of muscle wasting of cardiac cachexia. Copyright © 2017 Elsevier B.V. All rights reserved.

The image evaluation of iterative motion correction reconstruction algorithm PROPELLER T2-weighted imaging compared with MultiVane T2-weighted imaging

NASA Astrophysics Data System (ADS)

Lee, Suk-Jun; Yu, Seung-Man

2017-08-01

The purpose of this study was to evaluate the usefulness and clinical applications of MultiVaneXD which was applying iterative motion correction reconstruction algorithm T2-weighted images compared with MultiVane images taken with a 3T MRI. A total of 20 patients with suspected pathologies of the liver and pancreatic-biliary system based on clinical and laboratory findings underwent upper abdominal MRI, acquired using the MultiVane and MultiVaneXD techniques. Two reviewers analyzed the MultiVane and MultiVaneXD T2-weighted images qualitatively and quantitatively. Each reviewer evaluated vessel conspicuity by observing motion artifacts and the sharpness of the portal vein, hepatic vein, and upper organs. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated by one reviewer for quantitative analysis. The interclass correlation coefficient was evaluated to measure inter-observer reliability. There were significant differences between MultiVane and MultiVaneXD in motion artifact evaluation. Furthermore, MultiVane was given a better score than MultiVaneXD in abdominal organ sharpness and vessel conspicuity, but the difference was insignificant. The reliability coefficient values were over 0.8 in every evaluation. MultiVaneXD (2.12) showed a higher value than did MultiVane (1.98), but the difference was insignificant ( p = 0.135). MultiVaneXD is a motion correction method that is more advanced than MultiVane, and it produced an increased SNR, resulting in a greater ability to detect focal abdominal lesions.

SHARP's systems engineering challenge: rectifying integrated product team requirements with performance issues in an evolutionary spiral development acquisition

NASA Astrophysics Data System (ADS)

Kuehl, C. Stephen

2003-08-01

Completing its final development and early deployment on the Navy's multi-role aircraft, the F/A-18 E/F Super Hornet, the SHAred Reconnaissance Pod (SHARP) provides the war fighter with the latest digital tactical reconnaissance (TAC Recce) Electro-Optical/Infrared (EO/IR) sensor system. The SHARP program is an evolutionary acquisition that used a spiral development process across a prototype development phase tightly coupled into overlapping Engineering and Manufacturing Development (EMD) and Low Rate Initial Production (LRIP) phases. Under a tight budget environment with a highly compressed schedule, SHARP challenged traditional acquisition strategies and systems engineering (SE) processes. Adopting tailored state-of-the-art systems engineering process models allowd the SHARP program to overcome the technical knowledge transition challenges imposed by a compressed program schedule. The program's original goal was the deployment of digital TAC Recce mission capabilities to the fleet customer by summer of 2003. Hardware and software integration technical challenges resulted from requirements definition and analysis activities performed across a government-industry led Integrated Product Team (IPT) involving Navy engineering and test sites, Boeing, and RTSC-EPS (with its subcontracted hardware and government furnished equipment vendors). Requirements development from a bottoms-up approach was adopted using an electronic requirements capture environment to clarify and establish the SHARP EMD product baseline specifications as relevant technical data became available. Applying Earned-Value Management (EVM) against an Integrated Master Schedule (IMS) resulted in efficiently managing SE task assignments and product deliveries in a dynamically evolving customer requirements environment. Application of Six Sigma improvement methodologies resulted in the uncovering of root causes of errors in wiring interconnectivity drawings, pod manufacturing processes, and avionics requirements specifications. Utilizing the draft NAVAIR SE guideline handbook and the ANSI/EIA-632 standard: Processes for Engineering a System, a systems engineering tailored process approach was adopted for the accelerated SHARP EMD prgram. Tailoring SE processes in this accelerated product delivery environment provided unique opportunities to be technically creative in the establishment of a product performance baseline. This paper provides an historical overview of the systems engineering activities spanning the prototype phase through the EMD SHARP program phase, the performance requirement capture activities and refinement process challenges, and what SE process improvements can be applied to future SHARP-like programs adopting a compressed, evolutionary spiral development acquisition paradigm.

[Outsourcing: theory and practice at a clinical hospital in Szczecin exemplified by medical waste transport and treatment service].

PubMed

Kotlega, Dariusz; Nowacki, Przemysław; Lewiński, Dariusz; Chmurowicz, Ryszard; Ciećwiez, Sylwester

2011-01-01

Outsourcing proves to be a useful tool in the difficult process of improving the financial result of hospitals. Outsourcing means separation of some functions and services in one entity and their transfer to another. The aim of this study was to analyze the use of outsourcing at the Second Independent Public University Hospital of the Pomeranian Medical University (SPSK 2 PUM) in Szczecin. We studied the transport and treatment of medical waste. Outsourcing of waste treatment services led to financial savings. The cost of treatment of one kilogram of waste by an external company was PLN 2.53. The same service provided by the hospital would cost approximately PLN 7 per kilogram. Appropriate attention should be paid to the quality of services. It seems useful to have appropriate tools for quality control and monitoring. SPSK 2 PUM can serve as a good example of effective use of outsourcing.

Highlights of the mechanistic and therapeutic cachexia and sarcopenia research 2010 to 2012 and their relevance for cardiology.

PubMed

Anker, Markus S; von Haehling, Stephan; Springer, Jochen; Banach, Maciej; Anker, Stefan D

2013-01-10

Sarcopenia and cachexia are significant medical problems with a high disease related burden in cardiovascular illness. Muscle wasting and weight loss are very frequent particularly in chronic heart failure and they relate to poor prognosis. Although clinically largely underestimated, the fields of cachexia and sarcopenia are of great relevance to cardiologists. In cachexia and sarcopenia a significant number of research publications related to basic science questions of muscle wasting and lipolysis were published between 2010 and 2012. Recently, the two processes of muscle wasting and lipolysis were found to be closely linked. Treatment research in pre-clinical models involves studies on a number of different therapeutic entities, including ghrelin, selective androgen receptor modulators (SARMs), as well as drugs targeting myostatin or melanocortin-4. In the human setting, studies using enobosarm (a SARM) and anamorelin (ghrelin) are in phase III. The last 3 years has seen significant efforts to define the field using consensus statements. In the future, these definitions should also be considered for guidelines and treatment trials in cardiovascular medicine. The current review aims to summarize important information and development in the fields of muscle wasting, sarcopenia and cachexia focussing on findings in cardiovascular research, in order for cardiologists to have a better understanding of the progress in the still not well enough known field. Copyright © 2012. Published by Elsevier Ireland Ltd.

SHARP Demonstration Flight: Video Broadcast System for Research in Intelligent Flight Characterization and Control

NASA Technical Reports Server (NTRS)

Kitts, Christopher

2001-01-01

The NASA Ames Research Center (Thermal Protection Materials and Systems Branch) is investigating new ceramic materials for the thermal protection of atmospheric entry vehicles. An incremental approach to proving the capabilities of these materials calls for a lifting entry flight test of a sharp leading edge component on the proposed SHARP (Slender Hypervelocity Aerothermodynamic Research Probe) vehicle. This flight test will establish the aerothermal performance constraint under real lifting entry conditions. NASA Ames has been developing the SHARP test flight with SSDL (responsible for the SHARP S I vehicle avionics), Montana State University (responsible for the SHARP S I vehicle airframe), the Wickman Spacecraft and Propulsion Company (responsible for the sounding rocket and launch operations), and with the SCU Intelligent Robotics Program, The SCU team was added well after the rest of the development team had formed. The SCU role was to assist with the development of a real-time video broadcast system which would relay onboard flight video to a communication groundstation. The SCU team would also assist with general vehicle preparation as well as flight operations. At the time of the submission of the original SCU proposal, a test flight in Wyoming was originally targeted for September 2000. This date was moved several times into the Fall of 2000. It was then postponed until the Spring of 2001, and later pushed into late Summer 2001. To date, the flight has still not taken place. These project delays resulted in SCU requesting several no-cost extensions to the project. Based on the most recent conversations with the project technical lead, Paul Kolodjiez, the current plan is for the overall SHARP team to assemble what exists of the vehicle, to document the system, and to 'mothball' the vehicle in anticipation of future flight and funding opportunities.

Computed tomography coronary stent imaging with iterative reconstruction: a trade-off study between medium kernel and sharp kernel.

PubMed

Zhou, Qijing; Jiang, Biao; Dong, Fei; Huang, Peiyu; Liu, Hongtao; Zhang, Minming

2014-01-01

To evaluate the improvement of iterative reconstruction in image space (IRIS) technique in computed tomographic (CT) coronary stent imaging with sharp kernel, and to make a trade-off analysis. Fifty-six patients with 105 stents were examined by 128-slice dual-source CT coronary angiography (CTCA). Images were reconstructed using standard filtered back projection (FBP) and IRIS with both medium kernel and sharp kernel applied. Image noise and the stent diameter were investigated. Image noise was measured both in background vessel and in-stent lumen as objective image evaluation. Image noise score and stent score were performed as subjective image evaluation. The CTCA images reconstructed with IRIS were associated with significant noise reduction compared to that of CTCA images reconstructed using FBP technique in both of background vessel and in-stent lumen (the background noise decreased by approximately 25.4% ± 8.2% in medium kernel (P

Langley Full-scale-tunnel Investigation of Maximum Lift and Stability Characteristics of an Airplane Having Approximately Triangular Plan Form (DM-1 Glider)

NASA Technical Reports Server (NTRS)

Lovell, J Calvin; Wilson, Herbert A JR

1947-01-01

An investigation of the DM-1 Glider, which had approximately triangular plan form, an aspect ratio of 1.8 and a 60 degree sweptback leading edge, has been conducted in the Langley full-scale tunnel. The investigation consisted of the determination of the separate effects of the following modifications made to the glider on its maximum lift and stability characteristics: (a) installation of sharp leading edges over the inboard semispan of the wing, (b) removal of the vertical fin, (c) sealing of the elevon control-balance slots, (d) installation of redesigned thin vertical surfaces, (e) installation of faired sharp leading edges, and (f) installation of canopy. The maximum lift coefficient of the DM-1 glider was increased from 0.61 to 1.01 by the installation of semispan sharp leading edges, and from 1.01 to 1.24 by the removal of the vertical fin and sealing of the elevon control-balance slots. The highest maximum lift coefficient (1.32) was obtained when the faired sharp leading edges and the thin vertical surfaces were attached to the glider. The original DM-1 glider was longitudinally stable. The semispan sharp leading edges shifted the neutral point forward approximately 3 percent of the root chord at moderate lift coefficients, and the glider configuration with these sharp leading edges attached was longitudinally unstable, for the assumed center-of-gravity location, at lift coefficients above 0.73. Sealing the elevon control-balance slots and installing the faired sharp leading edges, the thin vertical surfaces, and the canopy shifted the neutral point forward approximately 8 percent of the root chord.

Nano Electronics on Atomically Controlled van der Waals Quantum Heterostructures

DTIC Science & Technology

2015-03-30

for the structural of the atomically sharp interface between hBN and Bi2Te3. Finally, we have developed unprecedentedly clean graphene supercoductor...crystals by MBE method. We also use transmission electron microscopy (TEM) analysis for the structural of the atomically sharp interface between hBN and...by MBE method. We also use transmission electron microscopy (TEM) analysis for the structural of the atomically sharp interface between hBN and Bi2Te3

Sharp-front wave of strong magnetic field diffusion in solid metal

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

Xiao, Bo; Gu, Zhuo-wei; Kan, Ming-xian

When a strong magnetic field diffuses into a solid metal, if the metal's resistance possesses an abrupt rise at some critical temperature and the magnetic field strength is above some critical value, the magnetic field will diffuse into the metal in the form of a sharp-front wave. Formulas for the critical conditions under which a sharp-front magnetic diffusion wave emerges and a formula for the wave-front velocity are derived in this work.

Aerothermodynamic Reentry Flight Experiments - EXPERT

DTIC Science & Technology

2005-10-01

IXV ( PRE-X – USV ) 3. IN FLIGHT RESEARCH VEHICLES e.g. - SHARP B1, B2 FLIGHTS, HYSHOT, X43, - IRDT, PAET, RAMC, FIRE - MIRKA, EXPRESS, SHEFEX ...PRE-X – USV ) 3. IN FLIGHT RESEARCH VEHICLES e.g. - SHARP B1, B2 FLIGHTS, HYSHOT, X43, - IRDT, PAET, RAMC, FIRE - MIRKA, EXPRESS, SHEFEX , SFYFE...RESEARCH VEHICLES e.g. - SHARP B1, B2 FLIGHTS, HYSHOT, X43, - IRDT, PAET, RAMC, FIRE - MIRKA, EXPRESS, SHEFEX , SFYFE - EXPERT Hypersonic Flight

Variational Implicit Solvation with Solute Molecular Mechanics: From Diffuse-Interface to Sharp-Interface Models.

PubMed

Li, Bo; Zhao, Yanxiang

2013-01-01

Central in a variational implicit-solvent description of biomolecular solvation is an effective free-energy functional of the solute atomic positions and the solute-solvent interface (i.e., the dielectric boundary). The free-energy functional couples together the solute molecular mechanical interaction energy, the solute-solvent interfacial energy, the solute-solvent van der Waals interaction energy, and the electrostatic energy. In recent years, the sharp-interface version of the variational implicit-solvent model has been developed and used for numerical computations of molecular solvation. In this work, we propose a diffuse-interface version of the variational implicit-solvent model with solute molecular mechanics. We also analyze both the sharp-interface and diffuse-interface models. We prove the existence of free-energy minimizers and obtain their bounds. We also prove the convergence of the diffuse-interface model to the sharp-interface model in the sense of Γ-convergence. We further discuss properties of sharp-interface free-energy minimizers, the boundary conditions and the coupling of the Poisson-Boltzmann equation in the diffuse-interface model, and the convergence of forces from diffuse-interface to sharp-interface descriptions. Our analysis relies on the previous works on the problem of minimizing surface areas and on our observations on the coupling between solute molecular mechanical interactions with the continuum solvent. Our studies justify rigorously the self consistency of the proposed diffuse-interface variational models of implicit solvation.

Long working hours increase the risk of sharp and needlestick injury in nurses: the need for new policy implication.

PubMed

Ilhan, Mustafa N; Durukan, Elif; Aras, Evin; Türkçüoğlu, Sertaç; Aygün, Remzi

2006-12-01

This paper reports a study to determine the sharp and needlestick injury incidence in nurses working at a university hospital and the contributing factors. Although it is generally felt that working in the healthcare sector is clean and without risk, healthcare staff and especially physicians and nurses who generally work very long hours are actually exposed to various occupational risks. Sharps and needlestick injuries are important problems for healthcare workers as they increase the risk of spread of infection. A self-administered questionnaire was completed in October 2005 by 449 of the 516 nurses working at a Turkish hospital (response rate 87.0%). The percentage of nurses experiencing a sharp or needlestick injury during their professional life was 79.7%. The incidence of exposure to sharp or needlestick injury in the last year was 68.4%. The factors increasing the rate of sharp and needlestick injury were: age 24 years and less,

Analysis of regulatory mechanisms of an insulin-inducible SHARP-2 gene by (S)-Equol.

PubMed

Haneishi, Ayumi; Takagi, Katsuhiro; Asano, Kosuke; Yamamoto, Taichi; Tanaka, Takashi; Nakamura, Soichiro; Noguchi, Tamio; Yamada, Kazuya

2012-09-01

Small compounds that activate the insulin-dependent signaling pathway have potential therapeutic applications in controlling type 2 diabetes mellitus. The rat enhancer of split- and hairy-related protein-2 (SHARP-2) is an insulin-inducible transcription factor that decreases expression of the phosphoenolpyruvate carboxykinase gene, a gluconeogenic enzyme gene. In this study, we screened for soybean isoflavones that can induce the rat SHARP-2 gene expression and analyzed their mechanism(s). Genistein and (S)-Equol, a metabolite of daidzein, induced rat SHARP-2 gene expression in H4IIE rat hepatoma cells. The (S)-Equol induction was mediated by both the phosphoinositide 3-kinase- and protein kinase C (PKC)-pathways. When a dominant negative form of atypical PKC lambda (aPKCλ) was expressed, the induction of SHARP-2 mRNA level by (S)-Equol was inhibited. In addition, Western blot analyses showed that (S)-Equol rapidly activated both aPKCλ and classical PKC alpha. Furthermore, the (S)-Equol induction was inhibited by treatment with a RNA polymerase inhibitor or a protein synthesis inhibitor. Finally, a reporter gene assay revealed that the transcriptional stimulation by (S)-Equol was mediated by nucleotide sequences located between -4687 and -4133 of the rat SHARP-2 gene. Thus, we conclude that (S)-Equol is an useful dietary supplement to control type 2 diabetes mellitus. Copyright © 2012 Elsevier Inc. All rights reserved.

Design of multiplier-less sharp transition width non-uniform filter banks using gravitational search algorithm

NASA Astrophysics Data System (ADS)

Bindiya T., S.; Elias, Elizabeth

2015-01-01

In this paper, multiplier-less near-perfect reconstruction tree-structured filter banks are proposed. Filters with sharp transition width are preferred in filter banks in order to reduce the aliasing between adjacent channels. When sharp transition width filters are designed as conventional finite impulse response filters, the order of the filters will become very high leading to increased complexity. The frequency response masking (FRM) method is known to result in linear-phase sharp transition width filters with low complexity. It is found that the proposed design method, which is based on FRM, gives better results compared to the earlier reported results, in terms of the number of multipliers when sharp transition width filter banks are needed. To further reduce the complexity and power consumption, the tree-structured filter bank is made totally multiplier-less by converting the continuous filter bank coefficients to finite precision coefficients in the signed power of two space. This may lead to performance degradation and calls for the use of a suitable optimisation technique. In this paper, gravitational search algorithm is proposed to be used in the design of the multiplier-less tree-structured uniform as well as non-uniform filter banks. This design method results in uniform and non-uniform filter banks which are simple, alias-free, linear phase and multiplier-less and have sharp transition width.

Clinical care & finance: can this marriage be saved?

PubMed

Craig, Teresa R

2003-11-01

Financial staff and clinical staff do not necessarily see eye-to-eye. However, mutual understanding of one another's areas of expertise is essential to the success of a hospice. Financial and clinical staff can work together to streamline employee reporting, such as on time sheets and during annual reviews, to ensure that important data is being collected and staff don't waste time reporting on and analyzing extraneous data.

Inter-Observer and Intra-Observer Reliability of Clinical Assessments in Knee Osteoarthritis

PubMed Central

Maricar, Nasimah; Callaghan, Michael J; Parkes, Matthew J; Felson, David T; O’Neill, Terence W

2016-01-01

Background Clinical examination of the knee is subject to measurement error. The aim of this analysis was to determine inter- and intra-observer reliability of commonly used clinical tests in patients with knee osteoarthritis(OA). Methods We studied subjects with symptomatic knee OA who were participants in an open-label clinical trial of intra-articular steroid therapy. Following standardisation of the clinical test procedures, two clinicians assessed 25 subjects independently at the same visit, and the same clinician assessed 88 subjects over an interval period of 2–10 weeks; in both cases prior to the steroid intervention. Clinical examination included assessment of bony enlargement, crepitus, quadriceps wasting, knee effusion, joint-line and anserine tenderness and knee range of movement(ROM). Intra-class correlation coefficients(ICC), estimated kappa(κ), weighted kappa(κω) and Bland and Altman plots were used to determine inter- and intra-observer levels of agreement. Results Using Landis and Koch criteria, inter-observer kappa scores were moderate for patellofemoral joint(κ=0.53) and anserine tenderness(κ=0.48); good for bony enlargement(κ=0.66), quadriceps wasting(κ=0.78), crepitus(κ=0.78), medial tibiofemoral joint tenderness(κ=0.76), and effusion assessed by ballottement(κ=0.73) and bulge sign(κω =0.78); and excellent for lateral tibiofemoral joint tenderness(κ=1.00), flexion(ICC=0.97) and extension(ICC=0.87) ROM. Intra-observer kappa scores were moderate for lateral tibiofemoral joint tenderness(κ=0.60), good for crepitus(κ=0.78), effusion assessed by ballottement test(κ=0.77), patellofemoral joint(κ=0.66), medial tibiofemoral joint(κ=0.64) and anserine(κ=0.73) tenderness and excellent for effusion assessed by bulge sign(κω =0.83), bony enlargement(κ=0.98), quadriceps wasting(κ=0.83), flexion(ICC=0.99) and extension(ICC=0.96) ROM. Conclusion Among individuals with symptomatic knee OA, the reliability of clinical examination of the knee was at least good for the majority of clinical signs of knee OA. PMID:27909143

HIV Transmission

MedlinePlus

... stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health ... stuck with an HIV-contaminated needle or other sharp object. However, even this risk is small. Scientists ...

Dangers of dermatologic surgery: protect your feet.

PubMed

Barr, Jerome; Siegel, Daniel

2004-12-01

Dermatologists frequently utilize scalpels, which are reported to be to culprit in around seven percent of the 385,000 sharps-related injuries sustained by healthcare personnel a year. Injuries from sharp devices are associated with the occupational transmission of more than 20 pathogens. Dropped scalpels may penetrate unprotected lower extremity skin, and there is no published data regarding what a shoe's actual degree of protection is against the danger of falling sharps. The purpose of this study was to evaluate and determine which types of shoes will protect their wearers. Although every shoe decreased falling sharp's degree of penetration into the feet, shoes cannot be relied on to prevent injury. More than half of the shoes allowed the scalpel blade to pass through the shoes and penetrate into the meat.

Artificial intelligence for multi-mission planetary operations

NASA Technical Reports Server (NTRS)

Atkinson, David J.; Lawson, Denise L.; James, Mark L.

1990-01-01

A brief introduction is given to an automated system called the Spacecraft Health Automated Reasoning Prototype (SHARP). SHARP is designed to demonstrate automated health and status analysis for multi-mission spacecraft and ground data systems operations. The SHARP system combines conventional computer science methodologies with artificial intelligence techniques to produce an effective method for detecting and analyzing potential spacecraft and ground systems problems. The system performs real-time analysis of spacecraft and other related telemetry, and is also capable of examining data in historical context. Telecommunications link analysis of the Voyager II spacecraft is the initial focus for evaluation of the prototype in a real-time operations setting during the Voyager spacecraft encounter with Neptune in August, 1989. The preliminary results of the SHARP project and plans for future application of the technology are discussed.

Motion Compensation in Extremity Cone-Beam CT Using a Penalized Image Sharpness Criterion

PubMed Central

Sisniega, A.; Stayman, J. W.; Yorkston, J.; Siewerdsen, J. H.; Zbijewski, W.

2017-01-01

Cone-beam CT (CBCT) for musculoskeletal imaging would benefit from a method to reduce the effects of involuntary patient motion. In particular, the continuing improvement in spatial resolution of CBCT may enable tasks such as quantitative assessment of bone microarchitecture (0.1 mm – 0.2 mm detail size), where even subtle, sub-mm motion blur might be detrimental. We propose a purely image based motion compensation method that requires no fiducials, tracking hardware or prior images. A statistical optimization algorithm (CMA-ES) is used to estimate a motion trajectory that optimizes an objective function consisting of an image sharpness criterion augmented by a regularization term that encourages smooth motion trajectories. The objective function is evaluated using a volume of interest (VOI, e.g. a single bone and surrounding area) where the motion can be assumed to be rigid. More complex motions can be addressed by using multiple VOIs. Gradient variance was found to be a suitable sharpness metric for this application. The performance of the compensation algorithm was evaluated in simulated and experimental CBCT data, and in a clinical dataset. Motion-induced artifacts and blurring were significantly reduced across a broad range of motion amplitudes, from 0.5 mm to 10 mm. Structure Similarity Index (SSIM) against a static volume was used in the simulation studies to quantify the performance of the motion compensation. In studies with translational motion, the SSIM improved from 0.86 before compensation to 0.97 after compensation for 0.5 mm motion, from 0.8 to 0.94 for 2 mm motion and from 0.52 to 0.87 for 10 mm motion (~70% increase). Similar reduction of artifacts was observed in a benchtop experiment with controlled translational motion of an anthropomorphic hand phantom, where SSIM (against a reconstruction of a static phantom) improved from 0.3 to 0.8 for 10 mm motion. Application to a clinical dataset of a lower extremity showed dramatic reduction of streaks and improvement in delineation of tissue boundaries and trabecular structures throughout the whole volume. The proposed method will support new applications of extremity CBCT in areas where patient motion may not be sufficiently managed by immobilization, such as imaging under load and quantitative assessment of subchondral bone architecture. PMID:28327471

Potential for unreliable interpretation of EEG recorded with microelectrodes.

PubMed

Stacey, William C; Kellis, Spencer; Greger, Bradley; Butson, Christopher R; Patel, Paras R; Assaf, Trevor; Mihaylova, Temenuzhka; Glynn, Simon

2013-08-01

Recent studies in epilepsy, cognition, and brain machine interfaces have shown the utility of recording intracranial electroencephalography (iEEG) with greater spatial resolution. Many of these studies utilize microelectrodes connected to specialized amplifiers that are optimized for such recordings. We recently measured the impedances of several commercial microelectrodes and demonstrated that they will distort iEEG signals if connected to clinical EEG amplifiers commonly used in most centers. In this study we demonstrate the clinical implications of this effect and identify some of the potential difficulties in using microelectrodes. Human iEEG data were digitally filtered to simulate the signal recorded by a hybrid grid (two macroelectrodes and eight microelectrodes) connected to a standard EEG amplifier. The filtered iEEG data were read by three trained epileptologists, and high frequency oscillations (HFOs) were detected with a well-known algorithm. The filtering method was verified experimentally by recording an injected EEG signal in a saline bath with the same physical acquisition system used to generate the model. Several electrodes underwent scanning electron microscopy (SEM). Macroelectrode recordings were unaltered compared to the source iEEG signal, but microelectrodes attenuated low frequencies. The attenuated signals were difficult to interpret: all three clinicians changed their clinical scoring of slowing and seizures when presented with the same data recorded on different sized electrodes. The HFO detection algorithm was oversensitive with microelectrodes, classifying many more HFOs than when the same data were recorded with macroelectrodes. In addition, during experimental recordings the microelectrodes produced much greater noise as well as large baseline fluctuations, creating sharply contoured transients, and superimposed "false" HFOs. SEM of these microelectrodes demonstrated marked variability in exposed electrode surface area, lead fractures, and sharp edges. Microelectrodes should not be used with low impedance (<1 GΩ) amplifiers due to severe signal attenuation and variability that changes clinical interpretations. The current method of preparing microelectrodes can leave sharp edges and nonuniform amounts of exposed wire. Even when recorded with higher impedance amplifiers, microelectrode data are highly prone to artifacts that are difficult to interpret. Great care must be taken when analyzing iEEG from high impedance microelectrodes. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Final Report: Identification and Manipulation of Novel Topological Phases

DTIC Science & Technology

2016-02-09

ps at TG and then exhibits a marked change in temperature dependence below TG [Fig. 4(d)]. A sharp rise in relaxation time at TN typically signifies...description, which predicts sharp first-order MITs like in V2O3.28 Although our measurements do not rule out gaps beginning to form in microscopically...Sr2IrO4 defies a strictMott-Hubbard description.We rule out the possibility of a disorder broadened TMIT in our samples based on their sharp magnetic

Numerical Modeling of Compressible Flow and Its Control

DTIC Science & Technology

2014-03-01

surface just outbound of the fin . This impinging jet is believed to be responsible for the high surface pressure, skin friction, and heat transfer in...and fine grid simulations over predict the heat transfer by roughly 13% for this case. E. LF12 Case, Sharp Fin at 12° In the LF12 case, a sharp...Dolling, D. S., and Knight, D. D., “An Experimental/Computational Study of Heat Transfer in Sharp Fin Induced Turbulent Interactions at Mach 5,” AIAA

Recommended methods for the disposal of sanitary wastes from temporary field medical facilities.

PubMed

Reed, R A; Dean, P T

1994-12-01

Emergency field medical facilities constructed after a disaster are frequently managed by medical staff even though many of the day-to-day problems of hospital management are unrelated to medicine. In this paper we discuss the short-term management of one of these problems, namely the control and disposal of sanitary wastes. It is aimed at persons in the medical profession who may find themselves responsible for a temporary hospital and have little or no previous experience of managing such situations. The wastes commonly generated are excreta, sullage and refuse. In addition, surface water must also be considered because its inadequate disposal is a potential health hazard. The paper concentrates on short-term measures appropriate for the first six months of the hospital or clinic's existence. Facilities expected to last longer are recommended to install conventional waste management systems appropriate to the local community and conditions. In most situations, wastes should be disposed of underground either by burial (for solids) or infiltration (for liquids). The design, construction and management of appropriate disposal systems are described.

Mitochondrial plasticity in cancer-related muscle wasting: potential approaches for its management.

PubMed

Vitorino, Rui; Moreira-Gonçalves, Daniel; Ferreira, Rita

2015-05-01

Cancer cachexia represents a critical problem in clinical oncology due to its negative impact on patients' quality of life, therapeutic tolerance and survival. This paraneoplasic condition is characterized by significant weight loss mainly from skeletal muscle wasting. Understanding the molecular mechanisms underlying cancer cachexia is urgent in order to develop and apply efficient therapeutic strategies. Mitochondrial dysfunction is an early event in cancer-induced muscle wasting. Decreased ability for ATP synthesis, impaired mitochondrial biogenesis, increased oxidative stress, impairment of protein quality control systems, increased susceptibility to mitophagy and to apoptosis were all shown to mediate contractile dysfunction and wasting in cancer cachexia. Anti-inflammatory therapies as well as exercise training seem to counteract muscle mass loss in part by improving mitochondrial functionality. Given its central role in muscle wasting, mitochondrial plasticity should be viewed as a key therapeutic target for the preservation of muscle mass in cancer cachexia. Few studies have addressed the mitochondrial events modulated by cancer cachexia and contradictory data were reported. Scarcer studies have focused on the mitochondrial adaptation to anticancer cachexia strategies.

Combined central diabetes insipidus and cerebral salt wasting syndrome in children.

PubMed

Lin, Jainn-Jim; Lin, Kuang-Lin; Hsia, Shao-Hsuan; Wu, Chang-Teng; Wang, Huei-Shyong

2009-02-01

Central diabetes insipidus, a common consequence of acute central nervous system injury, causes hypernatremia; cerebral salt wasting syndrome can cause hyponatremia. The two conditions occurring simultaneous are rarely described in pediatric patients. Pediatric cases of combined diabetes insipidus and cerebral salt wasting after acute central nervous system injury between January 2000 and December 2007 were retrospectively reviewed, and clinical characteristics were systemically assessed. Sixteen patients, aged 3 months to 18 years, met study criteria: 11 girls and 5 boys. The most common etiologies were severe central nervous system infection (n = 7, 44%) and hypoxic-ischemic event (n = 4, 25%). In 15 patients, diabetes insipidus was diagnosed during the first 3 days after acute central nervous system injury. Onset of cerebral salt wasting syndrome occurred 2-8 days after the onset of diabetes insipidus. In terms of outcome, 13 patients died (81%) and 3 survived under vegetative status (19%). Central diabetes insipidus and cerebral salt wasting syndrome may occur after acute central nervous system injury. A combination of both may impede accurate diagnosis. Proper differential diagnoses are critical, because the treatment strategy for each entity is different.

Cuts and puncture wounds

MedlinePlus

... pointed object such as a nail, knife, or sharp tooth. Symptoms Symptoms include: Bleeding Problems with function ... the last 10 years. Prevention Keep knives, scissors, sharp objects, firearms, and fragile items out of the ...

Cardiac implications for the use of β2-adrenoceptor agonists for the management of muscle wasting

PubMed Central

Molenaar, Peter; Chen, Lu; Parsonage, William A

2006-01-01

There are proposals for the implementation of β2-adrenoceptor agonists for the management of muscle wasting diseases. The idea has been initiated by studies in animal models which show that β2-adrenoceptor agonists cause hypertrophy of skeletal muscle. Their use in clinical practice will also need an understanding of possible effects of activation of human heart β2-adrenoceptors. Consequences could include an increased probability of arrhythmias in susceptible patients. PMID:16432500

Influence of zeolite precipitation on borosilicate glass alteration under hyperalkaline conditions

NASA Astrophysics Data System (ADS)

Mercado-Depierre, S.; Fournier, M.; Gin, S.; Angeli, F.

2017-08-01

This study enables a better understanding of how nucleation-growth of zeolites affects glass dissolution kinetics in hyperalkaline solutions characteristic of cement waters. A 20-oxide borosilicate glass, an inactive surrogate of a typical intermediate level waste glass, was altered in static mode at 50 °C in a hyperalkaline solution rich in Na+, K+ and Ca2+ and at an initial pH50°C of 12.6. Experiments were performed at four glass-surface-area-to-solution-volume (S/V) ratios to investigate various reaction progresses. Two types of glass alteration kinetics were obtained: (i) at low S/V, a sharp alteration resumption occurred after a rate drop regime, (ii) at high S/V, a high dissolution rate was maintained throughout the test duration with a slight progressive slow-down. In all the experiments, zeolites precipitated but the time taken to form stable zeolite nuclei varied dramatically depending on the S/V. Resulting changes in pH affected zeolite composition, morphology, solubility and growth rate. A change in a critical parameter such as S/V affected all the processes controlling glass dissolution.

Electrocoagulation for the treatment of textile wastewaters with Al or Fe electrodes: compared variations of COD levels, turbidity and absorbance.

PubMed

Zongo, Inoussa; Maiga, Amadou Hama; Wéthé, Joseph; Valentin, Gérard; Leclerc, Jean-Pierre; Paternotte, Gérard; Lapicque, Francois

2009-09-30

Electrocoagulation technique has been used for the treatment of two wastewaters issued by textile industry. Treatment was carried out in a discontinuous system provided with aluminium or iron electrodes, and with recirculation of the liquid. The efficiency of the technique was followed depending on the electrode material in terms of water treatment, current efficiency of the dissolution, cell voltage, energy consumption to reach the same COD or turbidity abatement: regardless of the quality of the phase separation in the flocculation section downstream of the electrocoagulation cell, the two metals were found to be of comparable efficiency. Besides COD and absorbance were shown to follow similar, regular variations along the treatment; experimental data could be interpreted by a simple model involving the overall equilibrium between the metal dissolved--in the form of hydroxides--and the polluting substance. Abatement of the waste turbidity was observed to obey another law, with a sharp reduction of turbidity after a preliminary phase, where accumulation of metal hydroxide has no effect on this variable.

The clinical presentation and surgical treatment of verrucous dermatitis lesions in a draught horse.

PubMed

Poore, Luke A B; Else, Rod W; Licka, Theresia L

2012-02-01

Verrucous pastern dermatitis is a progressive inflammatory skin disease commonly involving the palmar or plantar aspects of the pasterns of horses. There are no reports of successful surgical treatment for multifocal circumscribed verrucous masses in the chronic stages of verrucous pastern dermatitis. A combination of sharp dissection and electrocautery was used to resect numerous multifocal circumscribed verrucous masses from the distal hindlimb of an 11-year-old gelding draught horse. There was no evidence of significant regrowth or complications at a 24 month postoperative examination. © 2011 The Authors. Veterinary Dermatology. © 2011 ESVD and ACVD.

Chronic relapsing pancreatitis from a scorpion sting in Trinidad.

PubMed

George Angus, L D; Salzman, S; Fritz, K; Ramirez, J; Yaman, M; Gintautas, J

1995-12-01

Chronic relapsing pancreatitis is a rare cause of abdominal pain in children and exceptionally rarely is related to a scorpion sting. We describe a 13-year-old girl who, following envenoming by a scorpion, developed recurrent attacks of sharp, intermittent pain in the umbilical region associated with fever, nausea, anorexia and vomiting, and changes in her psychological behaviour. Thorough clinical evaluation, including CT scanning, disclosed unabated pancreatitis. A modified Puestow procedure was performed with very good results. Physicians should be aware that in chronic relapsing pancreatitis, particularly in children, a scorpion sting should be considered an aetiological possibility.

SHARP-B2: Flight Test Objectives, Project Implementation and Initial Results

NASA Technical Reports Server (NTRS)

Salute, Joan; Bull, Jeff; Rasky, Dan; Keese, David; Arnold, Jim (Technical Monitor)

2001-01-01

On September 28, 2000 the SHARP-B2 flight experiment was launched from Vandenberg Air Force Base, California. SHARP-B2 is the 2nd Ballistic flight test in the SHARP (Slender Hypervelocity Aerothermodynamic Research Probes) program which develops and tests new thermal protection materials and sharp body concepts. The flight tested Ultra-High Temperature Ceramics (UHTCs), which may radically change the design and performance of future aerospace vehicles. The new designs may overturn an age-old tenet of aerodynamics: that blunt-body aerospace vehicles, but not those with sharp leading edges, can survive the searing temperatures created as the vehicles tear through the atmosphere. Sharp leading edges offer numerous advantages over the blunt-body design currently in use. They could allow a space shuttle or crew return vehicle to maneuver in space more like an airplane and potentially allow astronauts to return to Earth from anywhere on orbit. They may allow improved astronaut safety by decreasing the risk of aborting into the ocean. They may reduce the electromagnetic interference that causes the communications blackouts that plague reentering blunt-body space vehicles. Reducing the amount of drag could lead to a reduction in propulsion requirements. Planetary probes could make use of sharp-body technology for aerobraking and to maximize their maneuvering capability. SHARP-B2 was a joint effort among NASA Ames, Sandia National Laboratories, the U.S. Air Force and the U.S. Army. It was funded by the Pathfinder Program at NASA's Marshall Space Flight Center. The SHARP-B2 payload was carried aboard a U.S. Air Force Minuteman III missile carrying a modified Mk 12A reentry vehicle (RV), which blasted off from Vandenberg Air Force Base near Lompoc, CA, at 3:01 a.m. PDT on Sept. 28. The RV was equipped with four 5. 1 inch-long strakes, or sharp leading edges. Each strake contained three UHTCs: ZrB2/SiC/C; ZrB2/SiC; and HfB2/SiC. Once it reached an altitude of about 400 nautical miles, the RV was released, returning through Earth's atmosphere at speeds exceeding Mach 22. One pair of strakes was designed to retract just before reaching temperatures high enough to cause the material to begin ablating. The other pair was designed to retract shortly after ablation began, at an expected temperature of nearly 5,100 degrees Fahrenheit. Sensors in the strakes measured how closely performance matched pre-flight calculations, and data was successfully collected throughout the 23-minute flight. A parachute was deployed (but not fully inflated) and the RV splashed down in a lagoon at the Kwajalein missile range in the Pacific Ocean. Within 3 hours radar track analysis showed ocean entry to be precisely at the latitude/longitude coordinates estimated during pre-flight simulation. An hour later a ship was deployed by the Army to recover the reentry vehicle, which was recovered in 165 feet of water, just 500 feet from its planned splash-down point. This is the first RV recovery in over a decade.

Driving out waste: a framework to enhance value in clinical care.

PubMed

Burton, David A

2013-06-01

Many healthcare providers today are seeking to improve the value of the care they deliver by implementing standardized clinical practice guidelines aimed at reducing variations in care, avoiding complications, and lowering costs. To succeed, such an initiative requires the full support and participation of the clinicians who will use the guidelines. Providers also should have a fully developed infrastructure consisting of a clinical content system, an analytics system, and a deployment system.

Mount Sharp Inside Gale Crater, Mars

NASA Image and Video Library

2012-03-28

Curiosity, the big rover of NASA Mars Science Laboratory mission, will land in August 2012 near the foot of a mountain inside Gale Crater. The mission project science group is calling the mountain Mount Sharp.

10 CFR 960.5-2-7 - Transportation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of sharp curves or steep grades and are not likely to be affected by landslides or rock slides. (v... highways and railroads such that steep grades, sharp switchbacks, rivers, lakes, landslides, rock slides...

Behold Mount Sharp!

NASA Image and Video Library

2012-08-06

This image taken by NASA Curiosity shows what lies ahead for the rover -- its main science target, informally called Mount Sharp. The rover shadow can be seen in the foreground, and the dark bands beyond are dunes.

Knowledge Base Editor (SharpKBE)

NASA Technical Reports Server (NTRS)

Tikidjian, Raffi; James, Mark; Mackey, Ryan

2007-01-01

The SharpKBE software provides a graphical user interface environment for domain experts to build and manage knowledge base systems. Knowledge bases can be exported/translated to various target languages automatically, including customizable target languages.

View from west sharp perspective, foundry/propeller shop. Naval Base ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View from west sharp perspective, foundry/propeller shop. - Naval Base Philadelphia-Philadelphia Naval Shipyard, Foundry-Propeller Shop, North of Porter Avenue, west of Third Street West, Philadelphia, Philadelphia County, PA

The Heights of Mount Sharp

NASA Image and Video Library

2012-08-20

With the addition of four high-resolution Navigation Camera, or Navcam, images, taken on Aug. 18 Sol 12, Curiosity 360-degree landing-site panorama now includes the highest point on Mount Sharp visible from the rover.

American Association for Pediatric Ophthalmology and Strabismus

MedlinePlus

... to the emergency room or ophthalmologist. If a sharp object has penetrated the eye (like a fish ... room as soon as possible. Other blunt or sharp injuries should be examined by an ophthalmologist, since ...

Spectrophotometer properties of vein blood plasma in UF-region patients with sharp surgical pathology of abdominal region organs

NASA Astrophysics Data System (ADS)

Guminestskij, S. G.; Polianski, I. J.; Motrich, A. V.; Grunchuk, F. W.

2006-05-01

It is set that there are two maximums in UF- region absorption of vein blood plasma of a man: at λ = 235 nm and at λ = 280 nm. It is shown that there are the substantial changes of values of the optical density D comparative with controls (for donors) exactly in a maximum at development of sharp surgical diseases of organs of abdominal region λ = 280 nm, in that time as maximum at λ = 235 nm in this plan is not informing. Resulted results of researches of dynamics of changes of optical properties of vein blood plasma in UF- region of patients with pathology of abdominal region organs in after operating period (sharp appendicitis, sharp pancreatitis, intestinal impassability and others like that), which can have the diagnostic value.

Summer High School Apprenticeship Research Program (SHARP) of the National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

1984-01-01

A total of 125 talented high school students had the opportunity to gain first hand experience about science and engineering careers by working directly with a NASA scientist or engineer during the summer. This marked the fifth year of operation for NASA's Summer High School Apprenticehsip Research Program (SHARP). Ferguson Bryan served as the SHARP contractor and worked closely with NASA staff at Headquarters and the eight participating sites to plan, implement, and evaluate the Program. The main objectives were to strengthen SHARP and expand the number of students in the Program. These eight sites participated in the Program: Ames Research Center North, Ames' Dryden Flight Research Facility, Goddard Space Flight Center, Goddard's Wallops Flight Facility, Kennedy Space Center, Langley Research Center, Lewis Research Center, and Marshall Space Flight Center.

Splitting hairs: differentiating between entomological activity, taphonomy, and sharp force trauma on hair.

PubMed

Mazzarelli, Debora; Vanin, Stefano; Gibelli, Daniele; Maistrello, Lara; Porta, Davide; Rizzi, Agostino; Cattaneo, Cristina

2015-03-01

The analysis of hair can provide useful information for the correct evaluation of forensic cases, but studies of trauma on hair are extremely rare. Hair may present lesions caused by traumatic events or by animals: in fact, signs of sharp force weapons on hair may provide important information for the reconstruction of the manner of death, and, for example, may suggest fetishist practice. This study stemmed from a judicial case where it was fundamental to distinguish between sharp force lesions and insect activity on hair. In order to highlight differences between sharp force lesions and insect feeding activity, different experiments were performed with high power microscopy: hair samples were subjected to several lesions by blunt and sharp force trauma; then samples were used as pabulum for two taxa of insects: the common clothes moth (Tineola bisselliella Lepidoptera, Tineidae) and the carpet beetle (Anthrenus sp., Coleoptera, Dermestidae). Hairs were examined from a macroscopic and microscopic point of view by stereomicroscopy and scanning electron microscopy (SEM): the morphological characteristics of the lesions obtained from the different experimental samples were compared. Results show that sharp force trauma produces lesions with regular edges, whereas insects leave concave lesions caused by their "gnawing" activity. These two types of lesions are easily distinguishable from breaking and tearing using SEM. This study demonstrates that insect activity leaves very specific indications on hair and sheds some light on different hair lesions that may be found in forensic cases.

What's in a Name? Sound Symbolism and Gender in First Names.

PubMed

Sidhu, David M; Pexman, Penny M

2015-01-01

Although the arbitrariness of language has been considered one of its defining features, studies have demonstrated that certain phonemes tend to be associated with certain kinds of meaning. A well-known example is the Bouba/Kiki effect, in which nonwords like bouba are associated with round shapes while nonwords like kiki are associated with sharp shapes. These sound symbolic associations have thus far been limited to nonwords. Here we tested whether or not the Bouba/Kiki effect extends to existing lexical stimuli; in particular, real first names. We found that the roundness/sharpness of the phonemes in first names impacted whether the names were associated with round or sharp shapes in the form of character silhouettes (Experiments 1a and 1b). We also observed an association between femaleness and round shapes, and maleness and sharp shapes. We next investigated whether this association would extend to the features of language and found the proportion of round-sounding phonemes was related to name gender (Analysis of Category Norms). Finally, we investigated whether sound symbolic associations for first names would be observed for other abstract properties; in particular, personality traits (Experiment 2). We found that adjectives previously judged to be either descriptive of a figuratively 'round' or a 'sharp' personality were associated with names containing either round- or sharp-sounding phonemes, respectively. These results demonstrate that sound symbolic associations extend to existing lexical stimuli, providing a new example of non-arbitrary mappings between form and meaning.

Taxonomic revision of Afrotropical Laccophilus Leach, 1815 (Coleoptera, Dytiscidae)

PubMed Central

Biström, Olof; Nilsson, Anders N.; Bergsten, Johannes

2015-01-01

Abstract The African species of the genus Laccophilus Leach, 1815, are revised, on the basis of study of adult specimens. In all, 105 species are now recognized. A phenetic character-analysis was undertaken, which resulted in a split of the genus into 17 species groups. Diagnoses and a description of each species are given together with keys for identification of species groups and species. We also provide habitus photos, illustration of male genitalia and distribution maps for all species. New species are described as follows: Laccophilus grossus sp. n. (Angola, Namibia), Laccophilus rocchii sp. n. (Tanzania, Namibia, Botswana, Mozambique), Laccophilus ferrugo sp. n. (Mozambique), Laccophilus furthi sp. n. (Madagascar), Laccophilus isamberti sp. n. (Madagascar), Laccophilus inobservatus sp. n. (Gambia, Senegal, Mali, Niger, Sudan, Chad, Ethiopia, Burkina Faso, Ivory Coast, Ghana, Nigeria, Cameroon, Zaire and Asia: Yemen), Laccophilus cryptos sp. n. (Zaire, Mozambique, Zimbabwe, Namibia, Botswana, South Africa), Laccophilus enigmaticus sp. n. (Nigeria, Sudan), Laccophilus bellus sp. n. (Benin, Nigeria), Laccophilus guentheri sp. n. (Guinea, Ghana), Laccophilus guineensis sp. n. (Guinea), Laccophilus decorosus sp. n. (Uganda), Laccophilus empheres sp. n. (Kenya), Laccophilus inconstans sp. n. (Guinea, Ivory Coast, Ghana, Nigeria, Cameroon), Laccophilus brancuccii sp. n. (Central African Republic), Laccophilus incomptus sp. n. (Cameroon), Laccophilus australis sp. n. (Tanzania, South Africa), Laccophilus minimus sp. n. (Namibia), Laccophilus eboris sp. n. (Ivory Coast), Laccophilus insularum sp. n. (Madagascar), Laccophilus occidentalis sp. n. (Gambia, Senegal, Mali, Guinea, Sierra Leone, Ivory Coast, Ghana, Benin, Nigeria, Central African Republic, Zaire) and Laccophilus transversovittatus sp. n. (Madagascar). Laccophilus restrictus Sharp, 1882, is restored as good species; not junior synonym of Laccophilus pictipennis Sharp, 1882. New synonyms are established as follows: Laccophilus continentalis Gschwendtner, 1935 = Laccophilus perplexus Omer-Cooper, 1970, syn. n., Laccophilus taeniolatus Régimbart, 1889 = Laccophilus congener Omer-Cooper, 1957, syn. n., Laccophilus adspersus Boheman, 1848 = Laccophilus vitshumbii Guignot, 1959, syn. n. = Laccophilus adspersus nigeriensis Omer-Cooper, 1970, syn. n. = Laccophilus adspersus sudanensis Omer-Cooper, 1970, syn. n., Laccophilus modestus Régimbart, 1895 = Laccophilus espanyoli Hernando, 1990, syn. n., Laccophilus flaveolus Régimbart, 1906 = Laccophilus pampinatus Guignot, 1941, syn. n., Laccophilus trilineola Régimbart, 1889 = Laccophilus simulator Omer-Cooper, 1958, syn. n., Laccophilus mediocris Guignot, 1952 = Laccophilus meii Rocchi, 2000, syn. n., Laccophilus epinephes Guignot, 1955 = Laccophilus castaneus Guignot, 1956, syn. n., Laccophilus saegeri Guignot, 1958 = Laccophilus comoensis Pederzani & Reintjes, 2002, syn. n., Laccophilus restrictus Sharp, 1882 = Laccophilus evanescens Régimbart, 1895, syn. n., Laccophilus incrassatus Gschwendtner, 1933 = Laccophilus virgatus Guignot, 1953, syn. n., Laccophilus cyclopis Sharp, 1882 = Laccophilus shephardi Omer-Cooper, 1965, syn. n., Laccophilus burgeoni Gschwendtner, 1930 = Laccophilus wittei Guignot, 1952, syn. n., Laccophilus secundus Régimbart, 1895 = Laccophilus torquatus Guignot, 1956, syn. n., Laccophilus desintegratus Régimbart, 1895 = Laccophilus sanguinosus Régimbart, 1895, syn. n. and Laccophilus flavopictus Régimbart, 1889 = Laccophilus bergeri Guignot, 1953, syn. n. = Laccophilus segmentatus Omer-Cooper, 1957, syn. n. Lectotypes are designated for the following taxa: Laccophilus productus Régimbart, 1906, Laccophilus ruficollis Zimmermann, 1919, Laccophilus sordidus Sharp, 1882, Laccophilus alluaudi Régimbart, 1899, Laccophilus pictipennis Sharp, 1882, Laccophilus wehnckei Sharp, 1882, Laccophilus continentalis Gschwendtner, 1935, Laccophilus simplicistriatus Gschwendtner, 1932, Laccophilus complicatus Sharp, 1882, Laccophilus rivulosus Klug, 1833, Laccophilus ampliatus Régimbart, 1895, Laccophilus pilitarsis Régimbart, 1906, Laccophilus adspersus Boheman, 1848, Laccophilus livens Régimbart, 1895, Laccophilus modestus Régimbart, 1895, Laccophilus nodieri Régimbart, 1895, Laccophilus flaveolus Régimbart, 1906, Laccophilus pallescens Régimbart, 1903, Laccophilus restrictus Sharp, 1882, Laccophilus vermiculosus Gerstaecker, 1867, Laccophilus mocquerysi Régimbart, 1895, Laccophilus bizonatus Régimbart, 1895, Laccophilus tschoffeni Régimbart, 1895, Laccophilus persimilis Régimbart, 1895, Laccophilus poecilus Klug, 1834, Laccophilus lateralis Sharp, 1882, Laccophilus lateralis var. polygrammus Régimbart, 1903, Laccophilus cyclopis Sharp, 1882, Laccophilus shephardi Omer-Cooper, 1965, Laccophilus conjunctus Guignot, 1950, Laccophilus grammicus Sharp, 1882, Laccophilus flavoscriptus Régimbart, 1895, Laccophilus flavosignatus Régimbart, 1895, Laccophilus brevicollis Sharp, 1882, Laccophilus secundus Régimbart, Laccophilus desintegratus Régimbart, 1895, Laccophilus gutticollis Régimbart, 1895, Laccophilus luctuosus Sharp, 1882 and Laccophilus inornatus Zimmermann, 1926. Laccophilus remex Guignot, 1952, comprises a species complex with uncertain taxonomic delimitation; the complex includes Laccophilus concisus Guignot, 1953, Laccophilus turneri Omer-Cooper, 1957 and Laccophilus praeteritus Omer-Cooper, 1957, as tentative synonyms of Laccophilus remex Guignot, 1952. PMID:26798285

Drug treatment of hypertensive crisis in children.

PubMed

Thomas, Christopher A

2011-10-01

Hypertensive crisis is a relatively rare event and is associated with significant morbidity and mortality in adults and pediatric patients alike. Rapid, safe, and effective treatment is imperative to alleviate immediate presenting clinical symptoms, prevent devastating morbidity, preserve long-term quality of life, and prevent mortality. Many medications in the hypertensive crisis arsenal have been used for nearly half a century. Nearly all treatment options have been utilized in children for decades, yet reliable data and sound clinical literature remain elusive. Every agent considered to be a first-line, second-line, or adjunctive option has yet to be evaluated in a randomized controlled trial in pediatric patients. With a paucity of clinical data to form evidence-based decisions, the clinician must rely entirely on the extrapolation from adult data and small retrospective studies, case series, and case reports of medication use in pediatric patients. Although more research in the treatment of pediatric hypertensive crisis is desperately needed, current practice demands a sharp knowledge of the pediatric clinical literature and pharmacology in this area as an essential tool to consistently improve patient outcomes with respect to morbidity and mortality.

Clinical Results of Flexor Tendon Repair in Zone II Using a six Strand Double Loop Technique.

PubMed

Savvidou, Christiana; Tsai, Tsu-Min

2015-06-01

The purpose of this study is to report the clinical results after repair of flexor tendon zone II injuries utilizing a 6-strand double-loop technique and early post-operative active rehabilitation. We retrospectively reviewed 22 patients involving 51 cases with zone II flexor tendon repair using a six strand double loop technique from September 1996 to December 2012. Most common mechanism of injuries was sharp lacerations (86.5 %). Tendon injuries occurred equally in manual and non-manual workers and were work-related in 33 % of the cases. The Strickland score for active range of motion (ROM) postoperatively was excellent and good in the majority of the cases (81 %). The rupture rate was 1.9 %. The six strand double loop technique for Zone II flexor tendon repair leads to good and excellent motion in the majority of patients and low re- rupture rate. It is clinically effective and allows for early postoperative active rehabilitation.

Environmental health risks of toxic waste site exposures--an epidemiological perspective.

PubMed

von Schirnding, Y E; Ehrlich, R I

1992-06-06

A general account is given of the problems of assessing the impact of human exposure to toxic waste sites, including the identification of truly exposed populations and of exposure pathways. Epidemiological studies of populations at risk are briefly reviewed and methodological problems summarised. These include the use of relatively weak study designs, inadequate exposure assessment and recall biases associated with symptom reporting among anxious residents living in the vicinity of waste sites. In South Africa, health risks associated with exposure to toxic waste sites need to be viewed in the context of current community health concerns, competing causes of disease and ill-health, and the relative lack of knowledge about environmental contamination and associated health effects. A nonspecific deterioration of health and well-being is more likely to result from waste site exposures than is overt clinical disease. Socially acceptable policies and controls may have to be based on criteria other than demonstrable ill-health. Detailed inventories and registries of the nature of disposed materials need to be maintained, sites of poorly controlled disposal in the past identified and selective environmental monitoring conducted. Epidemiological studies may be justified in situations where exposures well in excess of acceptable norms are demonstrated. An integrated national waste management policy for the country is urgently needed.

Cutting moments and grip forces in meat cutting operations and the effect of knife sharpness.

PubMed

McGorry, Raymond W; Dowd, Peter C; Dempsey, Patrick G

2003-07-01

The force exposure associated with meat cutting operations and the effect of knife sharpness on performance and productivity have not been well documented. Specialized hardware was used to measure grip force and reactive moments with 15 professional meat cutters performing lamb shoulder boning, beef rib trimming and beef loin trim operations in a field study conducted in two meat packing plants. A system for measuring relative blade sharpness was developed for this study. Mean and peak cutting moments observed for the meat cutting operations, averaged across subjects were 4.7 and 17.2 Nm for the shoulder boning, 3.5 and 12.9 Nm for the rib trim, and 2.3 and 10.6 Nm for the loin trim, respectively. Expressed as percent of MVC, mean grip forces of 28.3% and peak grip forces of 72.6% were observed overall. Blade sharpness was found to effect grip forces, cutting moments and cutting time, with sharper blades requiring statistically significantly lower peak and mean cutting moments, and grip forces than dull knives. Efforts aimed at providing and maintaining sharp blades could have a significant impact on force exposure.

Household medical waste disposal policy in Israel.

PubMed

Barnett-Itzhaki, Zohar; Berman, Tamar; Grotto, Itamar; Schwartzberg, Eyal

2016-01-01

Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminating waste-water, water resources and even drinking water. There is evidence that pharmaceutical active ingredients reach the environment, including food, however the risk to public health from low level exposure to pharmaceuticals in the environment is currently unknown. In Israel, there is no legislation regarding household medical waste collection and disposal. Furthermore, only less than 14 % of Israelis return unused medications to Health Maintenance Organization (HMO) pharmacies. In this study, we investigated world-wide approaches and programs for household medical waste collection and disposal. In many countries around the world there are programs for household medical waste collection. In many countries there is legislation to address the issue of household medical waste, and this waste is collected in hospitals, clinics, law enforcement agencies and pharmacies. Furthermore, in many countries, medication producers and pharmacies pay for the collection and destruction of household medical waste, following the "polluter pays" principle. Several approaches and methods should be considered in Israel: (a) legislation and regulation to enable a variety of institutes to collect household medical waste (b) implementing the "polluter pays" principle and enforcing medical products manufactures to pay for the collection and destruction of household medical waste. (c) Raising awareness of patients, pharmacists, and other medical health providers regarding the health and environmental risks in accumulation of drugs and throwing them to the garbage, sink or toilet. (d) Adding specific instructions regarding disposal of the drug, in the medication label and leaflet. (e) Examining incentives for returning medications to pharmacies. (f) Examining drug collection from deceased in retirement homes and hospitals.

After an exposure to sharps or body fluids

MedlinePlus

... the area with soap and water. For a splash exposure to the nose, mouth, or skin, flush ... designing, implementing, and evaluating a sharps injury prevention program. www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf . ...

Next generation fire suppressants

NASA Technical Reports Server (NTRS)

Brown, Jerry A.

1995-01-01

Spectrex, Inc., located in Cedar Grove, NJ is a manufacturer of fire detection and suppression equipment. Spectrex is one of the original pioneers in high speed fire detection and suppression systems for combat vehicles. Spectrex has installed fire suppressions systems in thousands of combat vehicles and ships throughout the world. Additionally, they manufacture flame explosion detectors, ship damage control systems, and optical gas and vapor detectors. The culmination of several years of research and development has recently produced an innovative electro-optical continuous monitoring systems called SharpEye 20/20I IR(sup 3) and SAFEYE that provide fast and reliable gas, vapor, aerosol, flame, and explosion detection. SharpEye 20/20I IR(sup 3) is a self-contained triple spectrum flame detector which scans for oscillating IR radiation (1 to 10 Hz) in the spectral bands ranging from 4.0 to 5.0 microns and uses programmed algorithms to check the ratio and correlation of data received by the three sensors to make the system highly immune to false alarms. It is extremely sensitive as it can detect a 1 x 1 square foot gasoline pan fire at 200 feet in less than 3 seconds. The sensitivity is user programmable, offering 4 ranges of detection. SAFEYE is comprised of a selected number of multispectral ban microprocessors controlled detectors which are in communication with one or more radiation sources that is projected along a 600 feet optical path. The signals from the selected narrow bands are processed and analyzed by highly sophisticated algorithms. It is ideal for high risk, remote, large areas such as petroleum and chemical manufacturing sites, waste dumps, aircraft cargo bays, and ship compartments. The SAFEYE will perform direct readings of the presence or rate of rise of concentrations of gases, vapors, or aerosols at the range of parts per million and provide alarms at various set points at different levels of concentrations.

Phytate degrading activities of lactic acid bacteria isolated from traditional fermented food

NASA Astrophysics Data System (ADS)

Damayanti, Ema; Ratisiwi, Febiyani Ndaru; Istiqomah, Lusty; Sembiring, Langkah; Febrisiantosa, Andi

2017-03-01

The objective of this study was to determine the potential of LAB with phytate degrading activity from fermented traditional food grain-based and legume-based. Lactic acid bacteria were isolated from different sources of traditional fermented food from Gunungkidul Yogyakarta Indonesia such as gembus tempeh (tofu waste), soybean tempeh, lamtoro tempeh (Leucaena bean) and kara tempeh. Isolation of LAB was performed using Total Plate Count (TPC) on de Man Rogosa Sharpe Agar (MRSA) medium supplemented with CaCO3. They were screened for their ability to degrade myo-inositol hexaphosphate or IP6 by using qualitative streak platemethod with modified de Man Rogosa-MorpholinoPropanesulfonic Acid Sharpe (MRS-MOPS) medium contained sodium salt of phytic acid as substrate and cobalt chloride staining (plate assay) method. The selected isolates were further assayed for phytase activities using quantitative method with spectrophotometer and the two selected isolates growth were optimized. Furthermore, thhe isolates that shown the highest phytase activity was characterized and identified using API 50 CH kitand 16S rRNA gene sequencing. The results showed that there were 18 LAB isolates obtained from samplesand 13 isolates were able to degrade sodium phytate based on qualitative screening. According to quantitative assay, the highest phytate degrading activities were found in TG-2(23.562 U/mL) and TG-1 (19.641 U/mL) isolated from gembus tempeh. The phytate activity of TG-2 was optimum at 37 °C with agitation, while the phytate activity of TG-1 was optimum at 45 °C without agitation. Characterization and identification of TG-2 isolate with the highest phytate degrading activity using API 50 CH and 16S rRNA showed that TG-2had homology with Lactobacillus fermentum. It could be concluded that LAB from from fermented traditional food grain-based and legume-based produced the extracellular phytase. Keywords: lactic acid bacteria, tempeh, phytatedegrading activity

The role of trainees as clinical teachers of medical students in psychiatry.

PubMed

Hickie, Catherine; Nash, Louise; Kelly, Brian

2013-12-01

To consider the role of specialty trainees as clinical teachers of medical students in psychiatry. We discuss the role of specialty trainees as teachers and approaches to improving their skills and capacity, giving examples from the local and international literature and our own experience as psychiatry medical educators. Good clinical teaching is crucial for medical students' learning but sharp increases in numbers combined with economic and workforce pressures have stretched capacity. Specialty trainees do much of the medical student teaching during their clinical placements but infrequently receive instruction on how to teach. The two common approaches to increasing capacity are, first, establishing education rotations for individual trainees and, second, providing workshops to improve trainees' confidence and skill. Psychiatry trainees surveyed in New South Wales welcomed the role of teacher and the opportunity to improve their teaching capacity. Further support from supervisors, health services and medical schools is needed to assist trainees in their teaching role. The role that trainees play as clinical teachers should be acknowledged and supported. Further development of research and scholarship in medical education is needed to determine how best to teach trainees to teach.

Drugs for solid cancer: the productivity crisis prompts a rethink

PubMed Central

Rösel, Daniel; Brábek, Jan; Veselý, Pavel; Fernandes, Michael

2013-01-01

Despite remarkable progress in cancer-drug discovery, the delivery of novel, safe, and sustainably effective products to the clinic has stalled. Using Src as a model, we examine key steps in drug development. The preclinical evidence on the relationship between Src and solid cancer is in sharp contrast with the modest anticancer effect noted in conventional clinical trials. Here, we consider Src inhibitors as an example of a promising drug class directed to invasion and metastasis and identify roadblocks in translation. We question the assumption that a drug-induced tumor shrinkage in preclinical and clinical studies predicts a successful outcome. Our analysis indicates that the key areas requiring attention are related, and include preclinical models (in vitro and mouse models), meaningful clinical trial end points, and an appreciation of the role of metastasis in morbidity and mortality. Current regulations do not reflect the natural history of the disease, and may be unrelated to the key complications: local invasion, metastasis, and the development of resistance. Alignment of preclinical and clinical studies and regulations based on mechanistic trial end points and platforms may help in overcoming these roadblocks. Viewed kaleidoscopically, most elements necessary and sufficient for a novel translational paradigm are in place. PMID:23836990

National Dam Inspection Program. Lake Catalpa Dam (NDS-ID Number PA-560), (DER-ID Number 40-57) Susquehanna River Basin, Falls Creek, Luzerne County, Pennsylvania. Phase I Inspection Report,

DTIC Science & Technology

1980-09-01

Ogee spillway crest 1269.5 Sharp crest weir (rigid fish screen) 1271.5 N Upstream invert of spillway 1265.4 Downstream invert of spillway 1260.9 Maximum...Sluice gate Access Valve house upstream Regulating facilities Sluice gate i. Spillway. Type Concrete ogee to sharp crested weir Length 26 feet Ogee... crest elevation 1269.5 Sharp crest weir (rigid fish screen) 1271.5 Upstream channel Lake Downstream channel Reinforced concrete channel for

Sharps container

NASA Technical Reports Server (NTRS)

Lee, Angelene M. (Inventor)

1992-01-01

This invention relates to a system for use in disposing of potentially hazardous items and more particularly a Sharps receptacle for used hypodermic needles and the like. A Sharps container is constructed from lightweight alodined nonmagnetic metal material with a cup member having an elongated tapered shape and length greater than its transverse dimensions. A magnet in the cup member provides for metal retention in the container. A nonmagnetic lid member has an opening and spring biased closure flap member. The flap member is constructed from stainless steel. A Velcro patch on the container permits selective attachment at desired locations.

Automated Geometry assisted PEC for electron beam direct write nanolithography

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

Ocola, Leonidas E.; Gosztola, David J.; Rosenmann, Daniel

Nanoscale geometry assisted proximity effect correction (NanoPEC) is demonstrated to improve PEC for nanoscale structures over standard PEC, in terms of feature sharpness for sub-100 nm structures. The method was implemented onto an existing commercially available PEC software. Plasmonic arrays of crosses were fabricated using regular PEC and NanoPEC, and optical absorbance was measured. Results confirm that the improved sharpness of the structures leads to increased sharpness in the optical absorbance spectrum features. We also demonstrated that this method of PEC is applicable to arbitrary shaped structures beyond crosses.

Hollow structure formation of intense ion beams with sharp edge in background plasmas

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

Hu, Zhang-Hu; Wang, You-Nian, E-mail: ynwang@dlut.edu.cn

The transport of intense ion beams with sharp radial beam edge in plasmas has been studied with two-dimensional electromagnetic particle simulations. The initial solid beam evolves into a hollow beam due to the nonlinear sharp transverse force peak in the regions of beam edge. The magnitude and nonlinearity of this peak are enhanced as the ion beam travels further into the plasma, due to the self-consistent interactions between the beam ions and the plasma electrons. This structure formation is shown to be independent on the beam radius.

Hypophosphataemic osteomalacia in patients on adefovir dipivoxil.

PubMed

Girgis, Christian M; Wong, Tang; Ngu, Meng C; Emmett, Louise; Archer, Katherine A; Chen, Roger C Y; Seibel, Markus J

2011-01-01

Fanconi syndrome results from generalised renal tubular toxicity and, owing to phosphate wasting can cause hypophosphataemic osteomalacia. Large clinical trials advocated the safety of adefovir dipivoxil at a daily dose of 10 mg, the standard dose given to patients with hepatitis B. We diagnosed Fanconi syndrome in conjunction with severe osteomalacia in 2 hepatitis B-positive patients on standard-dose adefovir therapy. The first patient was a 40-year-old male with a 5 month history of bone pain involving his knees, ankles, and ribs. He had been receiving adefovir dipivoxil for 27 months before the development of hypophosphataemia, urinary phosphate wasting, and aminoaciduria. These abnormalities resolved within weeks of discontinuation of adefovir dipivoxil and supplementation with elemental phosphate, calcium carbonate, and cholecalciferol. The second patient was a 53-year-old female with a 6 month history of lethargy, cachexia, and generalized bone pain. She had been receiving adefovir for 64 months before the development of these symptoms. She had hypophosphataemia, hypocalcaemia, metabolic acidosis, and severe vitamin D deficiency, but initially no urinary phosphate wasting. Four months of high-dose cholecalciferol supplementation unmasked her Fanconi syndrome including significant urinary phosphate wasting. The patient improved within weeks of discontinuation of adefovir and supplementation with elemental phosphate, calcium carbonate, and calcitriol. Despite large clinical trials advocating the safety of adefovir dipivoxil at 10-mg daily, long-term use of this agent may be nephrotoxic and in rare cases, cause Fanconi syndrome and severe hypophosphataemic osteomalacia. Clinicians prescribing this drug should be aware of this potential complication.

The application of a "6S Lean" initiative to improve workflow for emergency eye examination rooms.

PubMed

Nazarali, Samir; Rayat, Jaspreet; Salmonson, Hilary; Moss, Theodora; Mathura, Pamela; Damji, Karim F

2017-10-01

Ophthalmology residents on call at the Royal Alexandra Hospital identified workplace disorganization and lack of standardization in emergency eye examination rooms as an impediment to efficient patient treatment. The aim of the study was to use the "6S Lean" model to improve workflow in eye examination rooms at the Royal Alexandra Hospital. With the assistance of quality improvement consultants, the "6S Lean" model was applied to the current operation of the emergency eye clinic examination rooms. This model, considering 8 waste categories, was then used to recommend and implement changes to the examination rooms and to workplace protocols to enhance efficiency and safety. Eye examination rooms were improved with regards to setup, organization of supplies, inventory control, and maintenance. All targets were achieved, and the 5S audit checklist score increased by 33 points from 44 to 77. Implementation of the 6S methodology is a simple approach that removes inefficiencies from the workplace. The ophthalmology clinic removed waste from all 8 waste categories, increased audit results, mitigated patient and resident safety risks, and ultimately redirected resident time back to patient care delivery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Heterogeneous sharpness for cross-spectral face recognition

NASA Astrophysics Data System (ADS)

Cao, Zhicheng; Schmid, Natalia A.

2017-05-01

Matching images acquired in different electromagnetic bands remains a challenging problem. An example of this type of comparison is matching active or passive infrared (IR) against a gallery of visible face images, known as cross-spectral face recognition. Among many unsolved issues is the one of quality disparity of the heterogeneous images. Images acquired in different spectral bands are of unequal image quality due to distinct imaging mechanism, standoff distances, or imaging environment, etc. To reduce the effect of quality disparity on the recognition performance, one can manipulate images to either improve the quality of poor-quality images or to degrade the high-quality images to the level of the quality of their heterogeneous counterparts. To estimate the level of discrepancy in quality of two heterogeneous images a quality metric such as image sharpness is needed. It provides a guidance in how much quality improvement or degradation is appropriate. In this work we consider sharpness as a relative measure of heterogeneous image quality. We propose a generalized definition of sharpness by first achieving image quality parity and then finding and building a relationship between the image quality of two heterogeneous images. Therefore, the new sharpness metric is named heterogeneous sharpness. Image quality parity is achieved by experimentally finding the optimal cross-spectral face recognition performance where quality of the heterogeneous images is varied using a Gaussian smoothing function with different standard deviation. This relationship is established using two models; one of them involves a regression model and the other involves a neural network. To train, test and validate the model, we use composite operators developed in our lab to extract features from heterogeneous face images and use the sharpness metric to evaluate the face image quality within each band. Images from three different spectral bands visible light, near infrared, and short-wave infrared are considered in this work. Both error of a regression model and validation error of a neural network are analyzed.

Investigation of a Major Stratigraphic Unconformity with the Curiosity Rover

NASA Astrophysics Data System (ADS)

Lewis, K. W.; Grotzinger, J. P.; Gupta, S.; Rubin, D. M.

2015-12-01

Since its departure from the plains of Aeolis Palus, the Curiosity rover has traversed through a number of new geologic units at the base of Mount Sharp in Gale crater. These have included both units inferred to comprise the lower strata of Mount Sharp itself, along with units that appear to superpose Mount Sharp. Over the last 100 sols, Curiosity has documented several occurrences of a stratigraphic contact between fine-grained mudstones of the Murray Formation, and coarser sandstones of the overlying Stimson Unit. Detailed mapping from both orbital and rover image and topographic data suggests an unconformable relationship between the two units. From orbit, inferred exposures of the unconformity span at least several tens of meters, climbing up the lowermost slopes of Mount Sharp. Although the absolute timing of the two units is poorly constrained, this unconformity between likely represents a geologically significant gap in time. Deposition of the overlying Stimson Unit is inferred to post-date the large-scale erosion of Mount Sharp, likely requiring late stage aqueous interaction in the lithification of the Stimson Unit. From the rover, stereo imaging reveals the small-scale topography preserved at the Murray-Stimson contact, and allows the determination of bedding geometries within the units. Where laminations are expressed, the basal Mount Sharp rocks exhibit planar stratification at low angles to horizontal. In contrast, the coarser-grained Stimson Unit exhibits large-scale cross stratification. Three dimensional bedding geometry within this unit indicates a predominant southward transport direction uphill towards Mount Sharp. The observation of rounded calcium sulfate clasts in the lowermost Stimson Unit, interpreted to be reworked veins from the underlying Murray formation, supports the interpretation of an erosional unconformity. Investigations at the boundary between these two distinct units present a unique opportunity to probe the long-term environmental history of the Gale crater basin.

Life-cycle assessment of a Waste-to-Energy plant in central Norway: Current situation and effects of changes in waste fraction composition.

PubMed

Lausselet, Carine; Cherubini, Francesco; Del Alamo Serrano, Gonzalo; Becidan, Michael; Strømman, Anders Hammer

2016-12-01

Waste-to-Energy (WtE) plants constitute one of the most common waste management options to deal with municipal solid waste. WtE plants have the dual objective to reduce the amount of waste sent to landfills and simultaneously to produce useful energy (heat and/or power). Energy from WtE is gaining steadily increasing importance in the energy mix of several countries. Norway is no exception, as energy recovered from waste currently represents the main energy source of the Norwegian district heating system. Life-cycle assessments (LCA) of WtE systems in a Norwegian context are quasi-nonexistent, and this study assesses the environmental performance of a WtE plant located in central Norway by combining detailed LCA methodology with primary data from plant operations. Mass transfer coefficients and leaching coefficients are used to trace emissions over the various life-cycle stages from waste logistics to final disposal of the ashes. We consider different fractions of input waste (current waste mix, insertion of 10% car fluff, 5% clinical waste and 10% and 50% wood waste), and find a total contribution to Climate Change Impact Potential ranging from 265 to 637gCO 2 eq/kg of waste and 25 to 61gCO 2 eq/MJ of heat. The key drivers of the environmental performances of the WtE system being assessed are the carbon biogenic fraction and the lower heating value of the incoming waste, the direct emissions at the WtE plant, the leaching of the heavy metals at the landfill sites and to a lesser extent the use of consumables. We benchmark the environmental performances of our WtE systems against those of fossil energy systems, and we find better performance for the majority of environmental impact categories, including Climate Change Impact Potential, although some trade-offs exist (e.g. higher impacts on Human Toxicity Potential than natural gas, but lower than coal). Also, the insertion of challenging new waste fractions is demonstrated to be an option both to cope with the excess capacity of the Norwegian WtE sector and to reach Norway's ambitious political goals for environmentally friendly energy systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does Previous Hip Surgery Effect the Outcome of Tönnis Triple Periacetabular Osteotomy? Mid-Term Results.

PubMed

Konya, Mehmet Nuri; Aydn, Bahattin Kerem; Yldrm, Timur; Sofu, Hakan; Gürsu, Sarper

2016-03-01

Hip dysplasia (HD) is 1 of the major reasons of coxarthrosis. The goal of the treatment of HD by Tönnis triple pelvic osteotomy (TPAO) is to improve the function of hip joint while relieving pain, delaying and possibly preventing end-stage arthritis. The aim of this study is to compare the clinical and radiological results of TPAO to determine if previous surgery has a negative effect on TPAO.Patients operated with TPAO between 2005 and 2010, included in this study. Patients divided into 2 groups: primary acetabular dysplasia (PAD) and residual acetabular dysplasia (RAD). Prepostoperatively, hip range of motion, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) hip score, visual analog scores (VAS), impingement tests, and also the presence of Trendelenburg sign (TS) were investigated for clinical evaluation. For radiological analysis pre-postoperative, anterior-posterior (AP) pelvis and faux profile radiographs were used. Acetabular index, lateral center edge (LCE) angle, and Sharp angles were measured by AP pelvis; anterior center edge (ACE) angle were measured by faux profile radiography. All the clinical and radiological data of the groups were analyzed separately for the pre-postoperative scores also the amount of improvement in all parameters were analyzed.SPSS20 (SPSS Inc., Chicago, IL) was used for statistical analysis. Wilcoxon test, McNemar test, paired t tests, and Mann-Whitney U tests were used to compare the groups. P < 0.05 were defined as statistically significant.Study included 27 patients: 17 patients were in PAD and 10 patients were in RAD. The mean follow-up period was 6.2 years (5.2-10.3 years). In all patients, the radiological and the clinical outcomes were better after TPAO except the flexion of the hip parameter. When the patient groups were evaluated as pre-postoperatively, more statistically significant parameters were found in the PAD group when compared with RAD group. Extension, impingement, TS, VAS, HHS, WOMAC score parameters in clinical outcome and LCE, ACE, Sharp angle, coverage ratio in radiological results were significantly better in PAD group postoperatively but in RAD group; only extension, VAS, HHS, and WOMAC parameters were clinically and LCE and Coverage ratio were significantly different compared with the preoperative measurements. The change of the parameters that used for the evaluation of clinical and radiological results did not show a significant difference between groups.Our data suggest that TPAO can be performed on patients with HD for both groups. Although there were fewer parameters which changed significantly after TPAO in RAD patients; the improvement of radiological and clinical results was similar for groups. Further long-term follow-up studies with large number of patients are needed to determine the proper results of TPAO.

Awareness of biomedical waste management among dental professionals and auxiliary staff in Amritsar, India.

PubMed

Narang, Ramandeep S; Manchanda, Adesh; Singh, Simarpreet; Verma, Nitin; Padda, Sarfaraz

2012-12-01

The aim of this study was to determine awareness of biomedical waste (BMW) management policies and practices among dental professionals and auxiliary staff in a dental hospital/clinics in Amritsar, India, to inform the development of future policies for effective implementation of BMW rules. The study involved 160 staff members at the Amritsar hospital/clinics (80 dentists and 80 auxiliary staff) to whom a questionnaire was distributed regarding policies, practices and awareness relating to BMW. The questionnaire was first piloted. Completed questionnaires were returned anonymously. The resulting data were statistically tested using the chi-square test for differences between the dentists and auxiliary staff. In respect of BMW management policies, there was a highly significant difference in the responses of the dentists, whose answers suggested far greater knowledge than that of the auxiliaries (P<0.001). Regarding BMW management practices, the dentists were significantly more aware (P<0.001) of the method of waste collection in the hospital and the disposal of various items into different colour-coded bags. As for employee education/awareness, there was a significant difference (P<0.05) between the dentists and the auxiliaries on the question regarding records of BMW maintained in the hospital and the other responses to questions on these topics had a highly significant (P<0.001) difference between the two groups in favour of the dentists. The results of this study have demonstrated a lack of awareness of most aspects of BMW management among dental auxiliary staff in the dental hospital/clinics in Amritsar and a lack of awareness of some aspects among dentists who work in the hospital/clinics. The results provide the hospital authorities with data upon which they can develop a strategy for improving BMW management.

Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review.

PubMed

Wandrag, L; Brett, S J; Frost, G; Hickson, M

2015-08-01

Muscle wasting during critical illness impairs recovery. Dietary strategies to minimise wasting include nutritional supplements, particularly essential amino acids. We reviewed the evidence on enteral supplementation with amino acids or their metabolites in the critically ill and in muscle wasting illness with similarities to critical illness, aiming to assess whether this intervention could limit muscle wasting in vulnerable patient groups. Citation databases, including MEDLINE, Web of Knowledge, EMBASE, the meta-register of controlled trials and the Cochrane Collaboration library, were searched for articles from 1950 to 2013. Search terms included 'critical illness', 'muscle wasting', 'amino acid supplementation', 'chronic obstructive pulmonary disease', 'chronic heart failure', 'sarcopenia' and 'disuse atrophy'. Reviews, observational studies, sport nutrition, intravenous supplementation and studies in children were excluded. One hundred and eighty studies were assessed for eligibility and 158 were excluded. Twenty-two studies were graded according to standardised criteria using the GRADE methodology: four in critical care populations, and 18 from other clinically relevant areas. Methodologies, interventions and outcome measures used were highly heterogeneous and meta-analysis was not appropriate. Methodology and quality of studies were too varied to draw any firm conclusion. Dietary manipulation with leucine enriched essential amino acids (EAA), β-hydroxy-β-methylbutyrate and creatine warrant further investigation in critical care; EAA has demonstrated improvements in body composition and nutritional status in other groups with muscle wasting illness. High-quality research is required in critical care before treatment recommendations can be made. © 2014 The British Dietetic Association Ltd.

Grand Canyon Similar to Mount Sharp

NASA Image and Video Library

2012-08-27

Before NASA Curiosity rover landed on Mars, the strata exposed in Mount Sharp were compared to those in the Grand Canyon of the western United States, shown here. Scientists are surprised by just how close the similarities are.

Confidence Hills -- The First Mount Sharp Drilling Site

NASA Image and Video Library

2014-11-04

This image shows the first holes drilled by NASA Mars rover Curiosity at Mount Sharp. The loose material near the drill holes is drill tailings and an accumulation of dust that slid down the rock during drilling.

Needles and Other Sharps (Safe Disposal Outside of Health Care Settings)

MedlinePlus

... sharps containers are generally available through pharmacies, medical supply companies, health care providers and online. These containers are made of puncture-resistant plastic with leak-resistant sides and bottom. They also have a ...

Mount Sharp Panorama in Raw Colors

NASA Image and Video Library

2013-03-15

This mosaic of images from the Mastcam onboard NASA Mars rover Curiosity shows Mount Sharp in raw color. Raw color shows the scene colors as they would look in a typical smart-phone camera photo, before any adjustment.

Best Way to Get Rid of Used Needles and Other Sharps

MedlinePlus

... other options are not available. If traveling by plane, check the Transportation Security Administration (TSA) website for ... be thrown away in the common trash. Additional Consumer Information How to Get Rid of a Sharps ...

First Sampling Hole in Mount Sharp

NASA Image and Video Library

2014-09-25

This image from the Mars Hand Lens Imager MAHLI camera on NASA Curiosity Mars rover shows the first sample-collection hole drilled in Mount Sharp, the layered mountain that is the science destination of the rover extended mission.

Microfabricated instruments and methods to treat recurrent corneal erosions

DOEpatents

Britton, Jr., Charles L.; D'urso, Brian R.; Chaum, Edward; Simpson, John T.; Baba, Justin S.; Ericson, M. Nance; Warmack, Robert J.

2015-06-02

In one embodiment, the present invention provides a device and method for treating recurrent corneal erosion. In one embodiment, the method includes the steps of contacting an epithelium layer of a cornea with an array of glass micro-rods including a plurality of sharp features having a length that penetrates a Bowman's layer of the eye, wherein the plurality of sharp features of the array of glass micro-rods produces a plurality of punctures in the Bowman's layer of the eye that are of micro-scale or less. In another embodiment, the present invention provides a method and device for drug delivery. In one embodiment, the device includes an array of glass micro-rods, wherein at least one glass micro-rod of the array of glass micro-rods includes a sharp feature opposite a base of the array of glass micro-rods, wherein the sharp feature includes a treated surface for delivering a chemical compound to the eye.

Microfabricated instruments and methods to treat recurrent corneal erosion

DOEpatents

Britton, Charles L; D& #x27; Urso, Brian R; Chaum, Edward; Simpson, John T; Baba, Justin S; Ericson, M. Nance; Warmack, Robert J

2013-11-26

In one embodiment, the present invention provides a device and method for treating recurrent corneal erosion. In one embodiment, the method includes the steps of contacting an epithelium layer of a cornea with an array of glass micro-rods including a plurality of sharp features having a length that penetrates a Bowman's layer of the eye, wherein the plurality of sharp features of the array of glass micro-rods produces a plurality of punctures in the Bowman's layer of the eye that are of micro-scale or less. In another embodiment, the present invention provides a method and device for drug delivery. In one embodiment, the device includes an array of glass micro-rods, wherein at least one glass micro-rod of the array of glass micro-rods includes a sharp feature opposite a base of the array of glass micro-rods, wherein the sharp feature includes a treated surface for delivering a chemical compound to the eye.

Measurements of lightning rod responses to nearby strikes

NASA Astrophysics Data System (ADS)

Moore, C. B.; Aulich, G. D.; Rison, W.

2000-05-01

Following Benjamin Franklin's invention of the lightning rod, based on his discovery that electrified objects could be discharged by approaching them with a metal needle in hand, conventional lightning rods in the U.S. have had sharp tips. In recent years, the role of the sharp tip in causing a lightning rod to act as a strike receptor has been questioned leading to experiments in which pairs of various sharp-tipped and blunt rods have been exposed beneath thunderclouds to determine the better strike receptor. After seven years of tests, none of the sharp Franklin rods or of the so-called “early streamer emitters” has been struck, but 12 blunt rods with tip diameters ranging from 12.7 mm to 25.4 mm have taken strikes. Our field experiments and our analyses indicate that the strike-reception probabilities of Franklin's rods are greatly increased when their tips are made moderately blunt.

The Role of the Clinical Laboratory in the Future of Health Care: Lean Microbiology

PubMed Central

Samuel, Linoj

2014-01-01

This commentary will introduce lean concepts into the clinical microbiology laboratory. The practice of lean in the clinical microbiology laboratory can remove waste, increase efficiency, and reduce costs. Lean, Six Sigma, and other such management initiatives are useful tools and can provide dividends but must be accompanied by organizational leadership commitment to sustaining the lean culture in the laboratory setting and providing resources and time to work through the process. PMID:24574289

Four cases of type 1 diabetes mellitus showing sharp serum transaminase increases and hepatomegaly due to glycogenic hepatopathy.

PubMed

Ikarashi, Yuichi; Kogiso, Tomomi; Hashimoto, Etsuko; Yamamoto, Kuniko; Kodama, Kazuhisa; Taniai, Makiko; Torii, Nobuyuki; Takaike, Hiroko; Uchigata, Yasuko; Tokushige, Katsutoshi

2017-03-01

Poorly controlled diabetes mellitus (DM) patients sometimes show serum transaminase elevations due to steatohepatitis. However, we experienced four cases with type 1 DM with sharp elevations in serum transaminases that could not be explained by steatohepatitis alone and showed bright liver. They were diagnosed with glycogenic hepatopathy (GH) clinicopathologically. The four patients had a median age of 22.5 years (range, 19-29 years) and 12.5 (4-15)-year histories of type 1 DM and showed marked increases in serum transaminases (aspartate aminotransferase, 698 U/L [469-2763 U/L]; alanine transaminase, 255 U/L [216-956 U/L]). Diabetes mellitus control was poor and hemoglobin A1c was 12.7% (11-16.5%). Three cases had a past history of diabetic ketoacidosis. Hepatomegaly and hyperdense liver were seen on computed tomography scans. Magnetic resonance imaging showed low intensity in T2-weighted images. The pathological findings revealed pale and swollen hepatocytes and glycogenated nuclei. The architecture of the liver was preserved, and steatosis and fibrosis were mild. The cytoplasm of hepatocytes stained densely positive with periodic acid-Schiff, and the positive staining disappeared after diastase digestion, suggesting glycogen deposition. No other cause of hepatitis was evident, and the diagnosis was GH. Elevated transaminases improved within 1 month with good glycemic control. Transaminase elevations were observed several times in three cases with poor glycemic control. Glycogenic hepatopathy is rare, but extremely high serum elevations of transaminases are important to identify clinically. Despite showing a good clinical course in general, GH sometimes recurs and requires strict glycemic control. Clinicians should be aware of and recognize GH when dealing with uncontrolled DM patients. © 2016 The Japan Society of Hepatology.

EEG Differences in Two Clinically Similar Rapid Dementias: Voltage-Gated Potassium Channel Complex-Associated Autoimmune Encephalitis and Creutzfeldt-Jakob Disease.

PubMed

Freund, Brin; Probasco, John C; Cervenka, Mackenzie C; Sutter, Raoul; Kaplan, Peter W

2018-05-01

Distinguishing treatable causes for rapidly progressive dementia from those that are incurable is vital. Creutzfeldt-Jakob disease (CJD) and voltage-gated potassium channel complex-associated autoimmune encephalitis (VGKC AE) are 2 such conditions with disparate outcomes and response to treatment. To determine the differences in electroencephalography between CJD and VGKC AE, we performed a retrospective review of medical records and examined clinical data, neuroimaging, and electroencephalographs performed in patients admitted for evaluation for rapidly progressive dementia diagnosed with CJD and VGKC AE at the Johns Hopkins Hospital and Bayview Medical Center between January 1, 2007 and December 31, 2015. More patients in the VGKC AE group had seizures (12/17) than those with CJD (3/14; P = .008). Serum sodium levels were lower in those with VGKC AE ( P = .001). Cerebrospinal fluid (CSF) white blood cell count was higher in VGKC AE ( P = .008). CSF protein 14-3-3 ( P = .018) was more commonly detected in CJD, and tau levels were higher in those with CJD ( P < .006). On neuroimaging, diffusion restriction in the cortex ( P = .001), caudate ( P < .001), and putamen ( P = .001) was more frequent in CJD. Periodic sharp wave complexes ( P = .001) and generalized suppressed activity ( P = .008) were more common on initial EEG in CJD. On serial EEGs, generalized periodic discharges ( P = .004), generalized suppressed activity (P=0.008), and periodic sharp wave complexes ( P < .001) were detected more in CJD. This study shows that there are a number of differentiating features between CJD and VGKC AE, and electroencephalography can aid in their diagnoses. Performing serial EEGs better delineates these conditions.

Making sense: duty hours, work flow, and waste in graduate medical education.

PubMed

Bush, Roger W; Philibert, Ingrid

2009-12-01

Parsimony, and not industry, is the immediate cause of the increase of capital. Industry, indeed, provides the subject which parsimony accumulates. But whatever industry might acquire, if parsimony did not save and store up, the capital would never be the greater.Adam Smith, The Wealth of Nations, book 2, chapter 31In 2003, the Accreditation Council for Graduate Medical Education implemented resident duty hour limits that included a weekly limit and limits on continuous hours. Recent recommendations for added reductions in resident duty hours have produced concern about concomitant reductions in future graduates' preparedness for independent practice. The current debate about resident hours largely does not consider whether all hours residents spend in the educational and clinical-care environment contribute meaningfully either to residents' learning or to effective patient care. This may distract the community from waste in the current clinical-education model. We propose that use of "lean production" and quality improvement methods may assist teaching institutions in attaining a deeper understanding of work flow and waste. These methods can be used to assign value to patient- and learner-centered activities and outputs and to optimize the competing and synergistic aspects of all desired outcomes to produce the care the Institute of Medicine recommends: safe, effective, efficient, patient-centered, timely, and equitable. Finally, engagement of senior clinical faculty in determining the culture of the care and education system will contribute to an advanced social-learning and care network.

Making Sense: Duty Hours, Work Flow, and Waste in Graduate Medical Education

PubMed Central

Bush, Roger W.; Philibert, Ingrid

2009-01-01

Parsimony, and not industry, is the immediate cause of the increase of capital. Industry, indeed, provides the subject which parsimony accumulates. But whatever industry might acquire, if parsimony did not save and store up, the capital would never be the greater. Adam Smith, The Wealth of Nations, book 2, chapter 31 In 2003, the Accreditation Council for Graduate Medical Education implemented resident duty hour limits that included a weekly limit and limits on continuous hours. Recent recommendations for added reductions in resident duty hours have produced concern about concomitant reductions in future graduates' preparedness for independent practice. The current debate about resident hours largely does not consider whether all hours residents spend in the educational and clinical-care environment contribute meaningfully either to residents' learning or to effective patient care. This may distract the community from waste in the current clinical-education model. We propose that use of “lean production” and quality improvement methods may assist teaching institutions in attaining a deeper understanding of work flow and waste. These methods can be used to assign value to patient- and learner-centered activities and outputs and to optimize the competing and synergistic aspects of all desired outcomes to produce the care the Institute of Medicine recommends: safe, effective, efficient, patient-centered, timely, and equitable. Finally, engagement of senior clinical faculty in determining the culture of the care and education system will contribute to an advanced social-learning and care network. PMID:21976000

Myostatin inhibitors as therapies for muscle wasting associated with cancer and other disorders

PubMed Central

Smith, Rosamund C.; Lin, Boris K.

2013-01-01

Purpose of review This review summarizes recent progress in the development of myostatin inhibitors for the treatment of muscle wasting disorders. It also focuses on findings in myostatin biology that may have implications for the development of antimyostatin therapies. Recent findings There has been progress in evaluating antimyostatin therapies in animal models of muscle wasting disorders. Some programs have progressed into clinical development with initial results showing positive impact on muscle volume. In normal mice myostatin deficiency results in enlarged muscles with increased total force but decreased specific force (total force/total mass). An increase in myofibrillar protein synthesis without concomitant satellite cell proliferation and fusion leads to muscle hypertrophy with unchanged myonuclear number. A specific force reduction is not observed when atrophied muscle, the predominant therapeutic target of myostatin inhibitor therapy, is made myostatindeficient. Myostatin has been shown to be expressed by a number of tumor cell lines in mice and man. Summary Myostatin inhibition remains a promising therapeutic strategy for a range of muscle wasting disorders. PMID:24157714

Myostatin inhibitors as therapies for muscle wasting associated with cancer and other disorders.

PubMed

Smith, Rosamund C; Lin, Boris K

2013-12-01

This review summarizes recent progress in the development of myostatin inhibitors for the treatment of muscle wasting disorders. It also focuses on findings in myostatin biology that may have implications for the development of antimyostatin therapies. There has been progress in evaluating antimyostatin therapies in animal models of muscle wasting disorders. Some programs have progressed into clinical development with initial results showing positive impact on muscle volume.In normal mice myostatin deficiency results in enlarged muscles with increased total force but decreased specific force (total force/total mass). An increase in myofibrillar protein synthesis without concomitant satellite cell proliferation and fusion leads to muscle hypertrophy with unchanged myonuclear number. A specific force reduction is not observed when atrophied muscle, the predominant therapeutic target of myostatin inhibitor therapy, is made myostatindeficient.Myostatin has been shown to be expressed by a number of tumor cell lines in mice and man. Myostatin inhibition remains a promising therapeutic strategy for a range of muscle wasting disorders.

Lock-in of elastically mounted airfoils at a 90° angle of attack

NASA Astrophysics Data System (ADS)

Ehrmann, R. S.; Loftin, K. M.; Johnson, S.; White, E. B.

2014-01-01

Reducing vortex-induced vibration (VIV) of elastically mounted cylinders has applications to petroleum, nuclear, and civil engineering. One simple method is streamlining the cylinder into an airfoil shape. However, if flow direction changes, an elastic airfoil could experience similar oscillations with even more drag. To better understand a general airfoil's response, three elastically mounted airfoil shapes are tested at a 90° angle of attack in a 3 ft by 4 ft wind tunnel. The shapes are a NACA 0018, a sharp leading- and trailing-edge (sharp-sharp) model, and a round leading- and trailing-edge (round-round) model. Mass-damping ranges from 0.96 to 1.44. For comparison to canonical VIV research, a cylinder is also tested. Since lock-in occurs near Rec=125×103, the models are also tested with a trip strip. The NACA 0018 and sharp-sharp configuration show nearly identical responses. The cylinder and round-round airfoil have responses five to eight times larger. Thus, the existence of a single sharp edge is sufficient to greatly reduce VIV at 90° angle of attack. Whereas the cylinder and round-round maximum response amplitudes are similar, cylinder lock-in occurs over a velocity range three times larger than the round-round. The tripped cylinder and round-round models' response is attenuated by 70% compared to their respective clean configurations. Hysteresis is only observed in the circular cylinder and round-round models. Hotwire data indicates the clean cylinder has a unique vortex pattern compared to the other configurations.

Mount Sharp Panorama in White-Balanced Colors

NASA Image and Video Library

2013-03-15

This mosaic of images from the Mast Camera Mastcam on NASA Mars rover Curiosity shows Mount Sharp in a white-balanced color adjustment that makes the sky look overly blue but shows the terrain as if under Earth-like lighting.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey.

PubMed

Lo, Wen-Yen; Chiou, Shu-Ti; Huang, Nicole; Chien, Li-Yin

2016-12-01

Needlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed. To examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan. Cross-sectional survey. This analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan. Participants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model. More than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41-50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04-1.32), 1.51 times (95% C.I.=1.32-1.72), and 1.45 times (95% C.I.=1.25-1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17-1.42), 1.37 times (95% C.I.=1.23-1.53), and 1.56 times (95% C.I.=1.37-1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia. This nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Occupational hazards among the abattoir workers associated with noncompliance to the meat processing and waste disposal laws in Malaysia

PubMed Central

Abdullahi, Auwalu; Hassan, Azmi; Kadarman, Norizhar; Junaidu, Yakubu Muhammad; Adeyemo, Olanike Kudrat; Lua, Pei Lin

2016-01-01

Purpose This study aims to investigate the occupational hazards among the abattoir workers associated with noncompliance to the meat processing and waste disposal laws in Terengganu State, Malaysia. Occupational hazards are the major source of morbidity and mortality among the animal workers due to exposure to many hazardous situations in their daily practices. Occupational infections mostly contracted by abattoir workers could be caused by iatrogenic or transmissible agents, including viruses, bacteria, fungi, and parasites and the toxins produced by these organisms. Materials and methods The methodology was based on a cross-sectional survey using cluster sampling technique in the four districts of Terengganu State, Malaysia. One hundred and twenty-one abattoir workers from five abattoirs were assessed using a validated structured questionnaire and an observation checklist. Results The mean and standard deviation of occupational hazards scores of the workers were 2.32 (2.721). Physical, chemical, biological, psychosocial, musculoskeletal, and ergonomics hazards were the major findings of this study. However, the highest prevalence of occupational hazards identified among the workers was injury by sharp equipment such as a knife (20.0%), noise exposure (17.0%), and due to offensive odor within the abattoir premises (12.0%). Conclusion The major occupational hazards encountered by the workers in the study area were physical, chemical, biological, psychosocial, musculoskeletal, and ergonomics hazards. To ensure proper control of occupational health hazards among the abattoir workers, standard design and good environmental hygiene must be taken into consideration all the time. Exposure control plan, which includes risk identification, risk characterization, assessment of workers at risk, risk control, workers’ education/training, and implementation of safe work procedures, should be implemented by the government and all the existing laws governing the abattoir operation in the country should be enforced. PMID:27471416

Evaluation of Strength Characteristics of Laterized Concrete with Corn Cob Ash (CCA) Blended Cement

NASA Astrophysics Data System (ADS)

Ikponmwosa, E. E.; Salau, M. A.; Kaigama, W. B.

2015-11-01

Agricultural wastes are dumped in landfills or left on land in which they constitute nuisance. This study presents the results of investigation of strength characteristics of reinforced laterized concrete beams with cement partially replaced with corn cob (agricultural wastes) ash (CCA). Laterized concrete specimen of 25% laterite and 75% sharp sand were made by blending cement with corn cob ash at 0 to 40% in steps of 10%. A concrete mix ratio of 1:2:4 was used to cast 54 cubes of 150×150×150mm size and 54 beams of dimension 750×150×150mm. The results show that the consistency and setting time of cement increased as the percentage replacement of cement with CCA increased while the workability and density of concrete decreased as the percentage of CCA increased. There was a decrease in compressive strength when laterite was introduced to the concrete from 25.04 to 22.96N/mm2 after 28 days and a continual reduction in strength when CCA was further added from 10% to 40% at steps of 10%. Generally, the beam specimens exhibited majorly shear failure with visible diagonal cracks extending from support points to the load points. The corresponding central deflection in beams, due to two points loading, increased as the laterite was added to the concrete mix but reduced and almost approaching that of the control as 10% CCA was added. The deflection then increased as the CCA content further increased to 20%, 30% and 40% in the mix. It was also noted that the deflection of all percentage replacement including 40% CCA is less than the standard recommended maximum deflection of the beam. The optimal flexural strength occurred with 10% CCA content.

Thermal and thermomechanical calculations of deep-rock nuclear waste disposal with the enhanced SANGRE code

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

Heuze, F.E.

1983-03-01

An attempt to model the complex thermal and mechanical phenomena occurring in the disposal of high-level nuclear wastes in rock at high power loading is described. Such processes include melting of the rock, convection of the molten material, and very high stressing of the rock mass, leading to new fracturing. Because of the phase changes and the wide temperature ranges considered, realistic models must provide for coupling of the thermal and mechanical calculations, for large deformations, and for steady-state temperature-depenent creep of the rock mass. Explicit representation of convection would be desirable, as would the ability to show fracture developmentmore » and migration of fluids in cracks. Enhancements to SNAGRE consisted of: array modifications to accommodate complex variations of thermal and mechanical properties with temperature; introduction of the ability of calculate thermally induced stresses; improved management of the minimum time step and minimum temperature step to increase code efficiency; introduction of a variable heat-generation algorithm to accommodate heat decay of the nuclear materials; streamlining of the code by general editing and extensive deletion of coding used in mesh generation; and updating of the program users' manual. The enhanced LLNL version of the code was renamed LSANGRE. Phase changes were handled by introducing sharp variations in the specific heat of the rock in a narrow range about the melting point. The accuracy of this procedure was tested successfully on a melting slab problem. LSANGRE replicated the results of both the analytical solution and calculations with the finite difference TRUMP code. Following enhancement and verification, a purely thermal calculation was carried to 105 years. It went beyond the extent of maximum melt and into the beginning of the cooling phase.« less

Mycelial fungi completely remediate di(2-ethylhexyl)phthalate, the hazardous plasticizer in PVC blood storage bag.

PubMed

Pradeep, S; Benjamin, Sailas

2012-10-15

This pioneering work describes how simply, inexpensively and efficiently novel fungi utilize the alarming plasticizer, di(2-ethylhexyl)phthalate (DEHP) blended in PVC blood storage bags (BB). In order to quantify total DEHP (33.5%, w/w) present in BB, it was extracted using n-hexane and confirmed by GC-MS. Three mycelial fungi, viz., Aspergillus parasiticus, Fusarium subglutinans and Penicillium funiculosum isolated in our laboratory form heavily plastics-contaminated soil - either singly or in consortium - completely consumed intact DEHP physically bound to BB by static submerged growth (28 °C) in simple basal salt medium (BSM). A two-stage cultivation strategy was adopted for the complete removal of DEHP from BB in situ. During the first growth stage, almost 70% DEHP contained in the BB was consumed in 2 weeks, accompanied by increased fungal biomass (~0.15-0.35 g/g BB; OD ~7 at 600 nm) and a sharp declining (3.3) of initial pH (7.2). Spent BSM was replaced at this stagnant growth state (low pH), thus in the second stage, remaining DEHP bound to BB utilized completely (over 99%). Furthermore, A. parasiticus and F. subglutinans also grew well on scrapes of PVC water pipes in BSM. F. subglutinans was as efficient independently as consortium in completely utilizing the DEHP bound to BB, and these fungi offer great potentials for the inexpensive and eco-friendly bioremediation of phthalates in medical and allied PVC wastes on a large scale through a batch process in alleviating the plactics waste management issue. Copyright © 2012 Elsevier B.V. All rights reserved.

Dynamic changes of nutrient composition throughout the entire life cycle of black soldier fly

PubMed Central

Liu, Xiu; Chen, Xuan; Wang, Hui; Yang, Qinqin; ur Rehman, Kashif; Li, Wu; Cai, Minmin; Li, Qing; Mazza, Lorenzo; Zhang, Jibin; Yu, Ziniu

2017-01-01

Black soldier fly (BSF) larvae, Hermetia illucens L., develops on organic wastes, reducing ecological pollution and converting waste biomass into protein and fat rich insect biomass. BSF can replace increasingly expensive protein sources used in poultry, aquaculture and livestock compound diet formulation, such as fish meal and soybean meal, which holds the potential to alleviate future food and feed insecurity. The fate of nutritional spectra in BSF during its life cycle phases is still poorly understood. This study assessed metabolic changes in nutrition composition of BSF from egg to adult. A rapid increase of crude fat content was observed since the development of 4–14 days of larvae with its maximum level reaching 28.4% in dry mass, whereas the crude protein displayed a continuous decreasing trend in the same development phases with minimum level of 38% at larval phase (12 days) and peak level of 46.2% at early pupa stage. A sharp drop in crude fat was noticed from early prepupae to late pupae (24.2%, 8.2% respectively). However crude protein shows its maximum value being 57.6% at postmortem adult stage with 21.6% fat level. In addition, fatty acids, amino acids, minerals and vitamins composition in different development stages of BSF were presented and compared. Findings from this study could provide podium to food and feed industry for framing a strategy for specific molecular nutritional component intake into the diets of humans, aquaculture and animals. It is also indicated that BSF is a possible insect which can be applied to combating the food scarcity of countries where micronutrient deficiency is prevalent. Moreover it contributes to advance exploring for developmental and metabolic biology of this edible insect. PMID:28796830

The use of evidence-informed sustainability scenarios in the nursing curriculum: development and evaluation of teaching methods.

PubMed

Richardson, Janet; Grose, Jane; Doman, Maggie; Kelsey, Janet

2014-04-01

Climate change and resource scarcity pose challenges for healthcare in the future, yet there is little to raise awareness about these issues in the nursing curriculum and nurses are poorly equipped to practice in a changing climate. The aims of this paper are to describe how an evidence-informed 'sustainability and health' scenario based on two sustainability issues (resource depletion and waste management) was introduced into a nursing clinical skills session, and to report the evaluation of the session. Based on evidence from our own research on waste management, sustainable procurement and resource scarcity, a practical hands-on skill session was delivered to 30 second year student nurses as part of a scheduled clinical skills day. The session was observed by one of the facilitators and interactions recorded and this was followed by a brief questionnaire completed by participants. Observations of the group sessions and discussion found that students demonstrated limited knowledge about natural resources (such as oil) used in the production of items used in healthcare; they engaged in discussions following the use of Internet resources, and were able to segregate waste appropriately. Thirty (100%) students completed the evaluation questionnaire, found the resources used in the skill session helpful, and thought that the scenarios were realistic. Nineteen reported being more aware of peak oil; 30 were more aware of risks to patient experience and service delivery if resources become unavailable; 30 reported greater awareness of the management of waste in healthcare. Comments on the questionnaire indicated a high level of engagement and interest in the subject. The problem of climate change and resource scarcity can too easily be seen as a distant or intractable problem. However one way to make this topic real for students is through the use of clinically relevant scenarios in skill sessions. © 2013.

Impact of Image Filters and Observations Parameters in CBCT for Identification of Mandibular Osteolytic Lesions

PubMed Central

Monteiro, Bruna Moraes; Nobrega Filho, Denys Silveira; Lopes, Patrícia de Medeiros Loureiro; de Sales, Marcelo Augusto Oliveira

2012-01-01

The aim of this study was to analyze the influence of filters (algorithms) to improve the image of Cone Beam Computed Tomography (CBCT) in diagnosis of osteolytic lesions of the mandible, in order to establish the protocols for viewing images more suitable for CBCT diagnostics. 15 dry mandibles in which perforations were performed, simulating lesions, were submitted to CBCT examination. Two examiners analyzed the images, using filters to improve image Hard, Normal, and Very Sharp, contained in the iCAT Vision software, and protocols for assessment: axial; sagittal and coronal; and axial, sagittal and coronal planes simultaneously (MPR), on two occasions. The sensitivity and specificity (validity) of the cone beam computed tomography (CBCT) have been demonstrated as the values achieved were above 75% for sensitivity and above 85% for specificity, reaching around 95.5% of sensitivity and 99% of specificity when we used the appropriate observation protocol. It was concluded that the use of filters (algorithms) to improve the CBCT image influences the diagnosis, due to the fact that all measured values were correspondingly higher when it was used the filter Very Sharp, which justifies its use for clinical activities, followed by Hard and Normal filters, in order of decreasing values. PMID:22956955

Functional imaging of sleep vertex sharp transients.

PubMed

Stern, John M; Caporro, Matteo; Haneef, Zulfi; Yeh, Hsiang J; Buttinelli, Carla; Lenartowicz, Agatha; Mumford, Jeanette A; Parvizi, Josef; Poldrack, Russell A

2011-07-01

The vertex sharp transient (VST) is an electroencephalographic (EEG) discharge that is an early marker of non-REM sleep. It has been recognized since the beginning of sleep physiology research, but its source and function remain mostly unexplained. We investigated VST generation using functional MRI (fMRI). Simultaneous EEG and fMRI were recorded from seven individuals in drowsiness and light sleep. VST occurrences on EEG were modeled with fMRI using an impulse function convolved with a hemodynamic response function to identify cerebral regions correlating to the VSTs. A resulting statistical image was thresholded at Z>2.3. Two hundred VSTs were identified. Significantly increased signal was present bilaterally in medial central, lateral precentral, posterior superior temporal, and medial occipital cortex. No regions of decreased signal were present. The regions are consistent with electrophysiologic evidence from animal models and functional imaging of human sleep, but the results are specific to VSTs. The regions principally encompass the primary sensorimotor cortical regions for vision, hearing, and touch. The results depict a network comprising the presumed VST generator and its associated regions. The associated regions functional similarity for primary sensation suggests a role for VSTs in sensory experience during sleep. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Impact of Image Filters and Observations Parameters in CBCT for Identification of Mandibular Osteolytic Lesions.

PubMed

Monteiro, Bruna Moraes; Nobrega Filho, Denys Silveira; Lopes, Patrícia de Medeiros Loureiro; de Sales, Marcelo Augusto Oliveira

2012-01-01

The aim of this study was to analyze the influence of filters (algorithms) to improve the image of Cone Beam Computed Tomography (CBCT) in diagnosis of osteolytic lesions of the mandible, in order to establish the protocols for viewing images more suitable for CBCT diagnostics. 15 dry mandibles in which perforations were performed, simulating lesions, were submitted to CBCT examination. Two examiners analyzed the images, using filters to improve image Hard, Normal, and Very Sharp, contained in the iCAT Vision software, and protocols for assessment: axial; sagittal and coronal; and axial, sagittal and coronal planes simultaneously (MPR), on two occasions. The sensitivity and specificity (validity) of the cone beam computed tomography (CBCT) have been demonstrated as the values achieved were above 75% for sensitivity and above 85% for specificity, reaching around 95.5% of sensitivity and 99% of specificity when we used the appropriate observation protocol. It was concluded that the use of filters (algorithms) to improve the CBCT image influences the diagnosis, due to the fact that all measured values were correspondingly higher when it was used the filter Very Sharp, which justifies its use for clinical activities, followed by Hard and Normal filters, in order of decreasing values.

Frequent sleep-related bitemporal focal seizures in transient epileptic amnesia syndrome: Evidence from ictal video-EEG.

PubMed

Burkholder, David B; Jones, Amy L; Jones, David T; Fabris, Rachel R; Britton, Jeffrey W; Lagerlund, Terrence D; So, Elson L; Cascino, Gregory D; Worrell, Gregory A; Shin, Cheolsu; St Louis, Erik K

2017-06-01

Two patients who shared similar presenting clinical features of anterograde and retrograde autobiographical amnesia typical of transient epileptic amnesia (TEA) underwent prolonged video electroencephalogram (VEEG) monitoring and were found to have sleep-activated epileptiform activity and frequent subclinical bitemporal seizures predominantly during sleep. Case 1 is a 59-year-old woman whose presenting complaint was memory impairment. Over 18 months, she had three distinct 8-h-long episodes of confusion and disorientation with persistent anterograde and retrograde autobiographical amnesia. VEEG recorded frequent interictal bitemporal sharp waves confined to sleep, and 14 subclinical seizures, also mostly during sleep. Case 2 is a 50-year-old woman with known focal epilepsy also presented with memory complaints. Over the course of 1 year, she had two discrete 2-h-long episodes of amnesia, with ongoing anterograde and retrograde autobiographical amnesia. VEEG recorded independent bitemporal sharp waves, and 14 subclinical seizures during sleep and drowsiness. Memory impairment improved in both patients with successful treatment of their seizures. Although the etiology of accelerated long-term forgetting (ALF) and remote memory impairment (RMI) in transient epileptic amnesia (TEA) is unknown, these cases suggest frequent sleep-related seizures may contribute, and they highlight the importance of video-EEG monitoring.

Reproducibility of radiomics for deciphering tumor phenotype with imaging

NASA Astrophysics Data System (ADS)

Zhao, Binsheng; Tan, Yongqiang; Tsai, Wei-Yann; Qi, Jing; Xie, Chuanmiao; Lu, Lin; Schwartz, Lawrence H.

2016-03-01

Radiomics (radiogenomics) characterizes tumor phenotypes based on quantitative image features derived from routine radiologic imaging to improve cancer diagnosis, prognosis, prediction and response to therapy. Although radiomic features must be reproducible to qualify as biomarkers for clinical care, little is known about how routine imaging acquisition techniques/parameters affect reproducibility. To begin to fill this knowledge gap, we assessed the reproducibility of a comprehensive, commonly-used set of radiomic features using a unique, same-day repeat computed tomography data set from lung cancer patients. Each scan was reconstructed at 6 imaging settings, varying slice thicknesses (1.25 mm, 2.5 mm and 5 mm) and reconstruction algorithms (sharp, smooth). Reproducibility was assessed using the repeat scans reconstructed at identical imaging setting (6 settings in total). In separate analyses, we explored differences in radiomic features due to different imaging parameters by assessing the agreement of these radiomic features extracted from the repeat scans reconstructed at the same slice thickness but different algorithms (3 settings in total). Our data suggest that radiomic features are reproducible over a wide range of imaging settings. However, smooth and sharp reconstruction algorithms should not be used interchangeably. These findings will raise awareness of the importance of properly setting imaging acquisition parameters in radiomics/radiogenomics research.

Positive temporal sharp waves in preterm infants with and without brain ultrasound lesions.

PubMed

Castro Conde, José Ramón; Martínez, Eduardo Doménech; Campo, Candelaria González; Pérez, Arturo Méndez; McLean, Michael Lee

2004-11-01

Clinical significance of neonatal positive temporal sharp waves (PTS) is controversial. The aim of this work is to study (1) PTS incidence in preterm infants with or without major ultrasound lesion (MUL) per gestational age (GA), and (2) the relationship between PTS in both sleep states and other electroencephalographic (EEG) findings with poor prognoses. 97 preterm infants of <27-36 weeks GA, and 12 full-term healthy infants were presented. Prospective study included (1) neurodevelopmental assessment at 40-42 weeks conceptional age (CA), (2) serial neurosonography, and (3) EEG recording at postnatal week 1, 2, 4 and at 40-42 weeks CA. In 50 neonates without MUL, peak PTS was at 31-32 weeks GA. In 47 neonates with MUL, PTS increased significantly from week 2 after birth, descending at the 4th. Neonates of <33 weeks GA with MUL showed significantly increased PTS at term. A significant relationship was found between PTS and other EEG abnormalities with poor neurologic prognoses. PTS incidence varied with sleep states, being predominant in indeterminate sleep in neonates with MUL. PTS increased significantly in infants with MUL, mainly at week 2 of postnatal life, persisting high until term CA, and correlated with other abnormal EEG findings. PTS are highly sensitive to MUL.

Living laboratory: whole-genome sequencing as a learning healthcare enterprise.

PubMed

Angrist, M; Jamal, L

2015-04-01

With the proliferation of affordable large-scale human genomic data come profound and vexing questions about management of such data and their clinical uncertainty. These issues challenge the view that genomic research on human beings can (or should) be fully segregated from clinical genomics, either conceptually or practically. Here, we argue that the sharp distinction between clinical care and research is especially problematic in the context of large-scale genomic sequencing of people with suspected genetic conditions. Core goals of both enterprises (e.g. understanding genotype-phenotype relationships; generating an evidence base for genomic medicine) are more likely to be realized at a population scale if both those ordering and those undergoing sequencing for diagnostic reasons are routinely and longitudinally studied. Rather than relying on expensive and lengthy randomized clinical trials and meta-analyses, we propose leveraging nascent clinical-research hybrid frameworks into a broader, more permanent instantiation of exploratory medical sequencing. Such an investment could enlighten stakeholders about the real-life challenges posed by whole-genome sequencing, such as establishing the clinical actionability of genetic variants, returning 'off-target' results to families, developing effective service delivery models and monitoring long-term outcomes. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sex Differences in Muscle Wasting.

PubMed

Anderson, Lindsey J; Liu, Haiming; Garcia, Jose M

2017-01-01

With aging and other muscle wasting diseases, men and women undergo similar pathological changes in skeletal muscle: increased inflammation, enhanced oxidative stress, mitochondrial dysfunction, satellite cell senescence, elevated apoptosis and proteasome activity, and suppressed protein synthesis and myocyte regeneration. Decreased food intake and physical activity also indirectly contribute to muscle wasting. Sex hormones also play important roles in maintaining skeletal muscle homeostasis. Testosterone is a potent anabolic factor promoting muscle protein synthesis and muscular regeneration. Estrogens have a protective effect on skeletal muscle by attenuating inflammation; however, the mechanisms of estrogen action in skeletal muscle are less well characterized than those of testosterone. Age- and/or disease-induced alterations in sex hormones are major contributors to muscle wasting. Hence, men and women may respond differently to catabolic conditions because of their hormonal profiles. Here we review the similarities and differences between men and women with common wasting conditions including sarcopenia and cachexia due to cancer, end-stage renal disease/chronic kidney disease, liver disease, chronic heart failure, and chronic obstructive pulmonary disease based on the literature in clinical studies. In addition, the responses in men and women to the commonly used therapeutic agents and their efficacy to improve muscle mass and function are also reviewed.

Control of food intake and muscle wasting in cachexia.

PubMed

Amitani, Marie; Asakawa, Akihiro; Amitani, Haruka; Inui, Akio

2013-10-01

Cachexia is characterized by anorexia, weakness, weight loss, and muscle wasting. Anorexia and muscle wasting are the key features of cachexia and they affect mortality, morbidity, and quality of life. Consistent studies have found that feeding-regulating peptides such as melanocortin, ghrelin, and leptin are related to muscle metabolism, and the balance of catabolism and anabolism in muscle is regulated in the hypothalamus, which also regulates appetite and energy expenditure. In cachexia, proinflammatory cytokines, such as TNF-α, IL-1, IL-6 and Angiotensin II induce muscle atrophy. The mechanism is suggested via upregulation of MuRF1 and MAFbx. In contrast, the orexigenic peptide, AgRP and ghrelin have the effect to decrease proinflammatory cytokines and increase body weight, food intake, and muscle mass. The understandings of the pathological mechanism of anorexia and muscle metabolism in view of the crosstalk between brain and muscle will open the new way for the management of cachexia. In this review, we describe recent experimental and clinical studies that have examined the regulation of food intake and muscle wasting in cachexia. This article is part of a Directed Issue entitled: Molecular basis of muscle wasting. Copyright © 2013 Elsevier Ltd. All rights reserved.

Chronic Wasting Disease

USGS Publications Warehouse

Richards, Bryan

2007-01-01

Chronic wasting disease (CWD) is an always-fatal, neurological illness occurring in North American cervids (members of the deer family), including white-tailed deer, mule deer, elk and moose. Since its discovery in 1967, CWD has spread geographically and increased in prevalence locally. CWD is contagious; it can be transmitted freely within and among free-ranging populations. It is likely that diseased animals can transmit CWD to healthy animals long before they become clinically ill. Managing CWD in free-ranging populations is extremely difficult, therefore preventative measures designed to reduce the chance for disease spread are critically important.

Flow-field in a vortex with breakdown above sharp edged delta wings

NASA Technical Reports Server (NTRS)

Hayashi, Y.; Nakaya, T.

1978-01-01

The behavior of vortex-flow, accompanied with breakdown, formed above sharp-edged delta wings, was studied experimentally as well as theoretically. Emphasis is placed particularly on the criterion for the breakdown at sufficiently large Reynolds numbers

Sharp Crater Rim with Dark Material and Boulders

NASA Image and Video Library

2012-03-02

This image from NASA Dawn spacecraft shows part of the sharp, fresh rim of a large crater on asteroid Vesta. There is some bright material slumping towards the center of this crater but this is mostly overshadowed by the dark material.

LLNL contributions to ANL Report ANL/NE-16/6 "Sharp User Manual"

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

Solberg, J. M.

Diablo is a Multiphysics implicit finite element code with an emphasis on coupled structural/thermal analysis. In the SHARP framework, it is used as the structural solver, and may also be used as the mesh smoother.

The Space High Angular Resolution Probe for the Infrared (SHARP-IR)

NASA Technical Reports Server (NTRS)

Rinehart, S. A.; Rizzo, M. J.; Leisawitz, D. T.; Staguhn, J. G.; Dipirro, M.; Mentzell, J. E.; Juanola-Parramon, R.; Dhabal, A.; Mundy, L. G.; Moseley, S. H.;

[Overview of sharps injuries among health-care workers].

PubMed

Gopar-Nieto, Rodrigo; Juárez-Pérez, Cuauhtémoc Arturo; Cabello-López, Alejandro; Haro-García, Luis Cuauhtémoc; Aguilar-Madrid, Guadalupe

2015-01-01

Sharps injuries are one of the most frequent health-care related accidents. It is estimated globally that 35 million workers are at risk; in Mexico there is no data available for this type of injuries. They are associated with lack of training, instrument and procedure risk, fatigue and stress. The occupational distribution is nurses 45 %, technicians 20 %, doctors 20 % and maintenance workers 5 %. The most commonly associated procedures are injection, venipuncture, suture, and insertion and manipulation of IV catheters. Hepatitis B is the most commonly transmitted agent. Emotional distress is huge as well as the cost of prophylaxis and follow-up. More than half of the injuries are not notified. The most common reasons for not reporting are: the belief that the exposure has low risk of infection, the lack of knowledge of reporting systems and the assumption that it is difficult to notify. Many strategies have been created to reduce the incidence of sharps injuries, such as: identifying the risk of blood exposure, the creation of politics to minimize the risk, the education and training to create a safe workplace, the enhancing of the reporting system, the use of double-gloving and using safety-engineered sharps devices. In many countries these politics have reduced the incidence of sharps injuries as well as the economic burden.