Regulation of matriptase and HAI-1 system, a novel therapeutic target in human endometrial cancer cells.

PubMed

Sun, Pengming; Xue, Lifang; Song, Yiyi; Mao, Xiaodan; Chen, Lili; Dong, Binhua; Braicu, Elena Loana; Sehouli, Jalid

2018-02-27

The effects of specific and non-specific regulation of matriptase on endometrial cancer cells in vitro were investigated. Messenger ribonucleic acid (mRNA) and protein expression of matriptase and hepatocyte growth factor activator inhibitor-1 (HAI-1) in RL-952, HEC-1A, and HEC-1B endometrial cancer cells were detected by real-time quantitative PCR (RT-qPCR) and western blot. The cells were infected with lentivirus-mediated small-interfering RNA (siRNA) targeted on matriptase (MA-siRNA) or treated with different cisplatin (DDP) concentrations. After treatment, invasion, migration, and cellular apoptosis were analyzed. Matriptase mRNA and protein expression significantly decreased to 80% after infection with MA-siRNA ( P < 0.01), and scratch and trans-well chamber assays showed significant inhibition of invasiveness and metastasis. Upon incubation with cisplatin at concentrations higher than the therapeutic dose for 24 h, the expressions of matriptase and HAI-1 significantly decreased ( P < 0.001). Moreover, the invasiveness, metastasis, and survival rate of HEC-1A and RL-952 endometrial cancer cells were significantly decreased ( P < 0.001) due to the down-regulation of matriptase and HAI-1 upon increasing cisplatin concentration. However, a slight increase in matriptase and HAI-1 expression was observed in cells treated with low cisplatin concentration ( P = 0.01). Moreover, matriptase expression was associated with metastasis and invasiveness. Down-regulation of matriptase by specific Ma-SiRNA or non-specific cisplatin in matriptase/HAI-1-positive endometrial cancer cells showed promising therapeutic features.

Regulation of matriptase and HAI-1 system, a novel therapeutic target in human endometrial cancer cells

PubMed Central

Sun, Pengming; Xue, Lifang; Song, Yiyi; Mao, Xiaodan; Chen, Lili; Dong, Binhua; Braicu, Elena Loana; Sehouli, Jalid

2018-01-01

The effects of specific and non-specific regulation of matriptase on endometrial cancer cells in vitro were investigated. Messenger ribonucleic acid (mRNA) and protein expression of matriptase and hepatocyte growth factor activator inhibitor-1 (HAI-1) in RL-952, HEC-1A, and HEC-1B endometrial cancer cells were detected by real-time quantitative PCR (RT-qPCR) and western blot. The cells were infected with lentivirus-mediated small-interfering RNA (siRNA) targeted on matriptase (MA-siRNA) or treated with different cisplatin (DDP) concentrations. After treatment, invasion, migration, and cellular apoptosis were analyzed. Matriptase mRNA and protein expression significantly decreased to 80% after infection with MA-siRNA (P < 0.01), and scratch and trans-well chamber assays showed significant inhibition of invasiveness and metastasis. Upon incubation with cisplatin at concentrations higher than the therapeutic dose for 24 h, the expressions of matriptase and HAI-1 significantly decreased (P < 0.001). Moreover, the invasiveness, metastasis, and survival rate of HEC-1A and RL-952 endometrial cancer cells were significantly decreased (P < 0.001) due to the down-regulation of matriptase and HAI-1 upon increasing cisplatin concentration. However, a slight increase in matriptase and HAI-1 expression was observed in cells treated with low cisplatin concentration (P = 0.01). Moreover, matriptase expression was associated with metastasis and invasiveness. Down-regulation of matriptase by specific Ma-SiRNA or non-specific cisplatin in matriptase/HAI-1–positive endometrial cancer cells showed promising therapeutic features. PMID:29560101

Defect of Hepatocyte Growth Factor Activator Inhibitor Type 1/Serine Protease Inhibitor, Kunitz Type 1 (Hai-1/Spint1) Leads to Ichthyosis-Like Condition and Abnormal Hair Development in Mice

PubMed Central

Nagaike, Koki; Kawaguchi, Makiko; Takeda, Naoki; Fukushima, Tsuyoshi; Sawaguchi, Akira; Kohama, Kazuyo; Setoyama, Mitsuru; Kataoka, Hiroaki

2008-01-01

Hepatocyte growth factor activator inhibitor type 1 (HAI-1)/serine protease inhibitor, Kunitz type 1 (SPINT1) is a membrane-bound, serine proteinase inhibitor initially identified as an inhibitor of hepatocyte growth factor activator. It also inhibits matriptase and prostasin, both of which are membrane-bound serine proteinases that have critical roles in epidermal differentiation and function. In this study, skin and hair phenotypes of mice lacking the Hai-1/Spint1 gene were characterized. Previously, we reported that the homozygous deletion of Hai-1/Spint1 in mice resulted in embryonic lethality attributable to impaired placental development. To test the role of Hai-1/Spint1 in mice, the placental function of Hai-1/Spint1-mutant mice was rescued. Injection of Hai-1/Spint1+/+ blastocysts with Hai-1/Spint1−/− embryonic stem cells successfully generated high-chimeric Hai-1/Spint1−/− embryos (B6Hai-1−/−High) with normal placentas. These embryos were delivered without apparent developmental abnormalities, confirming that embryonic lethality of Hai-1/Spint1−/− mice was caused by placental dysfunction. However, newborn B6Hai-1−/−High mice showed growth retardation and died by 16 days. These mice developed scaly skin because of hyperkeratinization, reminiscent of ichthyosis, and abnormal hair shafts that showed loss of regular cuticular septation. The interfollicular epidermis showed acanthosis with enhanced Akt phosphorylation. Immunoblot analysis revealed altered proteolytic processing of profilaggrin in Hai-1/Spint1-deleted skin with impaired generation of filaggrin monomers. These findings indicate that Hai-1/Spint1 has critical roles in the regulated keratinization of the epidermis and hair development. PMID:18832587

Device-Associated Healthcare-Associated Infections (DA-HAI) and the caveat of multiresistance in a multidisciplinary intensive care unit.

PubMed

Khan, Inam Danish; Basu, Atoshi; Kiran, Sheshadri; Trivedi, Shaleen; Pandit, Priyanka; Chattoraj, Anupam

2017-07-01

Device-Associated Healthcare-Associated Infections (DA-HAI), including Ventilator-Associated Pneumonia (VAP), Central-Line-Associated Blood Stream Infection (CLABSI), and Catheter-Related Urinary Tract Infection (CAUTI), are considered as principal contributors to healthcare hazard and threat to patient safety as they can cause prolonged hospital stay, sepsis, and mortality in the ICU. The study intends to characterize DA-HAI in a tertiary care multidisciplinary ICU of a teaching hospital in eastern India. This prospective outcome-surveillance study was conducted among 2157 ICU patients of a 760-bedded teaching hospital in Eastern India. Clinical, laboratory and environmental surveillance, and screening of HCPs were conducted using the US Centers for Disease Control and Prevention (CDC)'s National Healthcare Safety Network (NHSN) definitions and methods. With 8824 patient/bed/ICU days and 14,676 device days, pooled average device utilization ratio was 1.66, total episodes of DA-HAI were 114, and mean monthly rates of DA-HAI, VAP, CLABSI, and CAUTI were 4.75, 2, 1.4, and 1.25/1000 device days. Most common pathogens isolated from DA-HAI patients were Klebsiella pneumoniae (24.6%), Escherichia coli (21.9%), and Pseudomonas aeruginosa (20.2%). All Acinetobacter baumanii , >80% K. pneumoniae and E. coli , and >70% P. aeruginosa were susceptible only to colistin and tigecycline. One P. aeruginosa isolate was panresistant. Mean rates of VAP, CLABSI, and CAUTI were 14.4, 8.1, and 4.5 per 1000 device days, which are comparable with Indian and global ICUs. Patients and HCPs form important reservoirs of infection. Resolute conviction and sustained momentum in Infection Control Initiatives are an essential step toward patient safety.

Evaluating the Feasibility of RESCUE: An Adjunctive HAI-Based Intervention for Veterans with PTSD

DTIC Science & Technology

2016-05-01

HAI) i) Study presented at symposium: “Human-Animal Interactions in Treating Veterans with PTSD” American Psychological Association ( APA ) 123rd Annual...Interactions in Treating Veterans with PTSD” American Psychological Association ( APA ) 123rd Annual Convention on 09-AUG-2015, Toronto, Canada.  Journal

Characterization of mangrove species using ALOS-2 PALSAR in Hai Phong city, Vietnam

NASA Astrophysics Data System (ADS)

Dat Pham, Tien; Yoshino, Kunihiko

2016-06-01

Hai Phong city is located in the Northern coast of Vietnam where the mangroves are distributed between zone I and zone II among the four mangrove zones in Vietnam. This city is vulnerable to rising sea levels associated with climate change and tropical cyclones, which are forecasted to become more severe due to the impact of climate change. In the past, mangrove forests in this city have decreased markedly because of over expansion of shrimp farming. Thus, identification of mangrove forests is important to monitor and support mangrove conservation and management in the coastal zone. The objectives of this research were to identify the locations of mangrove and characterize mangrove species in Hai Phong using HH and HV backscatters of the Advanced Land Observing Satellite 2 (ALOS-2) with enhanced Phased Array L-band Synthetic Aperture Radar (PALSAR). Image segmentation was used to identify the locations of mangrove forests. Moreover, Geographic Information System (GIS) was applied to update current status of mangrove species in 2015. The results showed that the means of HH and HV backscatter coefficients of K. obovata are lower than S. caseolaris. K. obovata has HH value around -13.9 dB until -10.3 dB and HV value around -20.6 dB until -16.2 dB. Higher HH values between about -14.9 dB and -6.8 dB and HV values between roughly -20.6 dB and -14.3 dB have observed by S. caseolaris. The total area of mangrove forest in Hai Phong in the year 2015 was around 4084 hectares, of which S. caseolaris occupied over 68% and mixed mangrove species was approximately 25.6%. This research indicates the potential for the use of L-band ALOS-2 PALSAR in characterizing mangrove forest species in the coastal zone.

Definition of criteria and indicators for the prevention of Healthcare-Associated Infections (HAIs) in hospitals for the purposes of Italian institutional accreditation and performance monitoring.

PubMed

Tardivo, S; Moretti, F; Nobile, M; Agodi, A; Appignanesi, R; Arrigoni, C; Baldovin, T; Brusaferro, S; Canino, R; Carli, A; Chiesa, R; D'Alessandro, D; D'Errico, M M; Giuliani, G; Montagna, M T; Moro, M; Mura, I I; Novati, R; Orsi, G B; Pasquarella, C; Privitera, G; Ripabelli, G; Rossini, A; Saia, M; Sodano, L; Torregrossa, M V; Torri, E; Zarrilli, R; Auxilia, F; SItI, Gisio

2017-01-01

Healthcare-associated infections (HAIs) are an important issue in terms of quality of care. HAIs impact patient safety by contributing to higher rates of preventable mortality and prolonged hospitalizations. In Italy, analysis of the currently available accreditation systems shows a substantial heterogeneity of approaches for the prevention and surveillance of HAIs in hospitals. The aim of the present study is to develop and propose the use of a synthetic assessment tool that could be implemented homogenously throughout the nation. An analysis of nine international and of the 21 Italian regional accreditation systems was conducted in order to identify requirements and indicators implemented for HAI prevention and control. Two relevant reviews on this topic were further analyzed to identify additional evidence-based criteria. The project team evaluated all the requirements and indicators with consensus meeting methodology, then those applicable to the Italian context were grouped into a set of "focus areas". The analysis of international systems and Italian regional accreditation manuals led to the identification respectively of 19 and 14 main requirements, with relevant heterogeneity in their application. Additional evidence-based criteria were included from the reviews analysis. From the consensus among the project team members all the standards were compared and 20 different thematic areas were identified, with a total of 96 requirements and indicators for preventing and monitoring HAIs. The study reveals a great heterogeneity in the definition of accreditation criteria between the Italian regions. The introduction of a uniform, synthetic assessment instrument, based on the review of national and international standards, may serve as a self-assessment tool to evaluate the achievement of a minimum standards set for HAIs prevention and control in healthcare facilities. This may be used as an assessment tool by the Italian institutional accreditation system, also

Organizing the Library to Suit the Undergraduates' Information Gathering Behavior at the Tel-Hai Academic College in Israel

ERIC Educational Resources Information Center

Chai, Iris

2007-01-01

The study examined the factors influencing information gathering behavior of undergraduates at Tel-Hai Academic College, so that library services can cope effectively with this behavior. Related to the findings, we changed our circulation desk to become a "one stop shop" for directions to all library information.

Exploring the relationship between irrigation water requirements and potential yield in the Huang-Huai-Hai plain

NASA Astrophysics Data System (ADS)

Tang, Huaxiu; Zhan, Jinyan; Deng, Xiangzheng; Ma, Jinsong

2007-11-01

By using the GIS technologies, we interpolate the site-based meteorological data into climatic surface data, which are the main input parameters for the CropWat model, used to estimate the reference evapotranspiration (ET 0). And then by combining the ET 0 with the information on share of cultivated land decoded from the Landsat TM/ETM digital imagines covering the entire case study area, the Huang-Huai-Hai plain, we estimate the amount of irrigation water requirements (IWRs) in the years of 1991 and 2000. We then introduce the potential yield (PY) of cultivated land estimated from the Estimation Model for the Agricultural Productivity Potential (EMAPP) to explore the relationship between the IWRs and the PY . By conducting GIS-based spatial overlay analyses, we explore the positive correlation relationship between the IWRs and the PY of cultivated land. Finally, we conclude that the IWRs is now a constrain factor on the PY of cultivated land in the Huang-Huai-Hai plain in those areas with the irrigation water constrains. The result has offered a scientific basis for the decision makings in the exploitation and utilization of resources and energy as well as the land use planning, protection of the potential yields and the managements of irrigation water at the regional level.

Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis.

PubMed

Ahmed, Tanvir; Long, Thanh Nguyen; Huong, Phan Thi; Stewart, Donald Edwin

2015-01-29

Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices. Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants' understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used. Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend's home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: the difficulty in getting new syringes, quick withdrawal management

Rapid Ascent From Zero Quality to International Organization for Standardization Accreditation: A Case Study of Hai Duong Preventive Medicine Center in Vietnam, 2012-2013.

PubMed

Duong, Cuong Ngoc; Bond, Kyle B; Carvalho, Humberto; Thi Thu, Hien Bui; Nguyen, Thuong; Rush, Thomas

2017-04-01

In 2012, the Vietnam Ministry of Health sought to improve the quality of health laboratories by introducing international quality standards. Strengthening Laboratory Management Toward Accreditation (SLMTA), a year-long, structured, quality improvement curriculum (including projects and mentorship) was piloted in 12 laboratories. Progress was measured using a standardized audit tool (Stepwise Laboratory Quality Improvement Process Towards Accreditation). All 12 pilot laboratories (a mix of hospital and public health) demonstrated improvement; median scores rose from 44% to 78% compliance. The public health laboratory in Hai Duong Province entered the program with the lowest score of the group (28%) yet concluded with the highest score (86%). Five months after the completion of the program, without any additional external support, they were accredited. Laboratory management/staff describe factors key to their success: support from the facility senior management, how-to guidance provided by SLMTA, support from the site mentor, and strong commitment of laboratory staff. Hai Duong preventive medical center is one of only a handful of laboratories to reach accreditation after participation in SLMTA and the only laboratory to do so without additional support. Due to the success seen in Hai Duong and other pilot laboratories, Vietnam has expanded the use of SLMTA. American Society for Clinical Pathology, 2017. This work is written by US Government employees and is in the public domain in the US.

Temperature Control and Numerical Analysis for Mass Concrete Pile Cap of Hai-huang Bridge

NASA Astrophysics Data System (ADS)

Shi, Han; Hao, Yang; Yong-liang, Wang

2018-05-01

In order to study the heat of hydration in massive concrete, this paper takes Hai-huang bridge for engineering background and uses the finite element analysis software of FEA to analyze the heat of hydration effect of the cushion cap. Comparing the measured data with the theory data, the results showed that the concrete crack was controlled effectively and ensure the construction quality by adopted reasonable temperature control measures. The results of the research prove that the measured data was consistent with calculation data, and it proves the accuracy of the finite element analysis. Finally, the study provides certain reference and guiding significance for similar project.

Social representation and practices related to dementia in Hai District of Tanzania.

PubMed

Mushi, Declare; Rongai, Amen; Paddick, Stella-Maria; Dotchin, Catherine; Mtuya, Chauka; Walker, Richard

2014-03-19

With the increasing number of people surviving into old age in Africa, dementia is becoming an important public health problem. Understanding the social dynamics of dementia in resource-poor settings is critical for developing effective interventions. We explored the socio-cultural beliefs surrounding dementia and the life experience of people with dementia (PWD) and their caregivers in the Hai District of Kilimanjaro, Tanzania. Cross-sectional qualitative design. Forty one PWD were purposively sampled from the Hai District of Kilimanjaro. Twenty five paired interviews with PWD and with caregivers, and 16 with caregivers alone, were conducted. Interviews were tape recorded, transcribed verbatim and analyzed using content analysis approach. Forty one PWD (26 females), aged 70 years and older, were recruited but due to speech difficulties only 25 participated in the interviews. Married were 13, widow in 22 and widower 6. The majority, 33/41 were illiterate. PWD and carers perceived memory problems as a normal part of ageing. Dementia was commonly referred as "ugonjwa wa uzeeni" (disease of old people) or memory loss disease. The majority of PWD 13/12 and carers 7/16 did not know what dementia is or what causes it. Dementia was felt to be associated with stroke, high blood pressure, diabetes, old age, curse/witchcraft and life stress. Half of the participants had used modern care and alternative care such as herbs, prayers or traditional healers. Caregivers complained about the burden of caring for PWD and suggested that community organizations should be involved in addressing the problem. Knowledge about dementia is low and the symptoms are accepted as a problem of old age. PWD and carers demonstrate pluralistic behaviour in seeking help from modern care, prayers and traditional healers. The disease adds significant burden to family members. Family and caregivers need more education on early recognition of symptoms and cost effective management of dementia at family

Simultaneous gas-phase and total water detection for airborne applications with a multi-channel TDL spectrometer at 1.4 μm and 2.6 μm

NASA Astrophysics Data System (ADS)

Buchholz, Bernhard; Afchine, Armin; Klein, Alexander; Barthel, Jochen; Kallweit, Sören; Klostermann, Tim; Krämer, Martina; Schiller, Cornelius; Ebert, Volker

2013-04-01

Water vapor measurements especially within clouds are difficult, in particular due to numerous instrument-specific limitations in precision, time resolution and accuracy. Notably the quantification of the ice and gas-phase water content in cirrus clouds, which play an important role in the global climate system, require new high-speed hygrometers concepts which are capable of resolving large water vapor gradients. Previously we demonstrated a stationary concept of a Tunable Diode Laser Absorption Spectroscopy (TDLAS)-based quantification of the ice/liquid water by independent, but simultaneous measurements of A) the gas-phase water in an open-path configuration (optical-path 125 m) and B) the total water in an extractive version with a closed cell (30 m path) after evaporating the condensed water [1]. In this case we used laboratory TDLAS instrumentation in combination with a long absorption paths and applied those to the AIDA cloud camber [2]. Recently we developed an advanced, miniature version of the concept, suitable for mobile field applications and in particular for use on aircrafts. First tests of our new, fiber-coupled open-path TDLAS cell [3] for airborne applications were combined with the experiences of our extractive SEALDH instruments [4] and led to a new, multi-channel, "multi-phase TDL-hygrometer" called "HAI" ("Hygrometer for Atmospheric Investigations"). HAI, which is explicitly designed for the new German HALO (High Altitude and Long Range Research Aircraft) airplane, provides a similar, but improved functionality like the stationary, multi-phase TDLAS developed for AIDA. However HAI comes in a much more compact, six height units, 30 kg, electronics rack for the main unit and with a new, completely fiber-coupled, compact, 21 kg, dual-wavelength open-path TDL-cell which is placed in the aircraft's skin. HAI is much more complex and versatile than the AIDA precursor and can be seen as comprised of four TDL-spectrometers, as it simultaneously

A Review of the CDC Recommendations for Prevention of HAIs in Outpatient Settings.

PubMed

Garrett, J Hudson

2015-05-01

According to the Centers for Disease Control and Prevention (CDC), most health care-associated infections (HAIs) are caused by contamination from the hands of health care providers or patients, contamination from the environment, and contamination from the patient's own skin. To mitigate common sources of infection transmission, frontline health care providers must be compliant with basic infection-prevention interventions, including hand hygiene, environmental cleaning and disinfection, safe injection practices, and designation of a trained health care professional to be responsible for the infection prevention and control program. Integration of CDC recommendations should incorporate a bundled approach to these interventions and should be part of a comprehensive approach to infection prevention and control. Effective infection-prevention practices in outpatient settings are critical for reducing the risk of infection transmission, improving patient safety and patient outcomes, and reducing costs associated with health care delivery. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Knowledge, attitude and practices on family planning services among adolescents in secondary schools in Hai District, northern Tanzania.

PubMed

Dangat, Celina M; Njau, Bernard

2013-01-01

Almost 65% of the Tanzanian population is under the age of 24 and almost 20 % of the population is aged 15-24 years. Yet, this important group faces many significant health challenges, such as early sexual debut, early pregnancies, risky behaviours and sexually transmitted infections. The objective of this study was to assess knowledge, attitudes and practices on family planning services among adolescents in secondary schools in Hai District in northern Tanzania. A cross sectional study was conducted between April and June 2011 among 316 randomly selected students in 10 secondary schools using a self administered pre-tested questionnaire. Median age of participants was 17 years (15-19 years). Two-thirds (67.4%) of the respondents had adequate level of knowledge on family planning services (FPS) and the most popular source of information was the radio (65.8 %). Being in a lower class (χ2 =8.6; P<0.02) and attending co education schools (χ2 =12.9; P< 0.001) were predictors of inadequate level of knowledge on FPS. Most, 71.2% (225/316) respondents reported that FPS should not be used by adolescents and mentioned several reasons against its use. Less than 6 % (18/316) of all respondents had used FPS in their lifetime, with 44.4 % (8/18) in the past month, 33.3 %(6/18) in the past year, and 22.3 % (4/18) in the past 5 years. In conclusion, most secondary school students in Hai District do not utilize family planning services despite of adequate level of knowledge on FPS. Interventions to improve utilization of FPS among secondary school students should address barriers to low utilization of FPS mentioned in this study.

Investigation of Kelvin wave periods during Hai-Tang typhoon using Empirical Mode Decomposition

NASA Astrophysics Data System (ADS)

Kishore, P.; Jayalakshmi, J.; Lin, Pay-Liam; Velicogna, Isabella; Sutterley, Tyler C.; Ciracì, Enrico; Mohajerani, Yara; Kumar, S. Balaji

2017-11-01

Equatorial Kelvin waves (KWs) are fundamental components of the tropical climate system. In this study, we investigate Kelvin waves (KWs) during the Hai-Tang typhoon of 2005 using Empirical Mode Decomposition (EMD) of regional precipitation, zonal and meridional winds. For the analysis, we use daily precipitation datasets from the Global Precipitation Climatology Project (GPCP) and wind datasets from the European Centre for Medium-Range Weather Forecasts (ECMWF) Interim Re-analysis (ERA-Interim). As an additional measurement, we use in-situ precipitation datasets from rain-gauges over the Taiwan region. The maximum accumulated precipitation was approximately 2400 mm during the period July 17-21, 2005 over the southwestern region of Taiwan. The spectral analysis using the wind speed at 950 hPa found in the 2nd, 3rd, and 4th intrinsic mode functions (IMFs) reveals prevailing Kelvin wave periods of ∼3 days, ∼4-6 days, and ∼6-10 days, respectively. From our analysis of precipitation datasets, we found the Kelvin waves oscillated with periods between ∼8 and 20 days.

Heavy metals in estuarine surface sediments of the Hai River Basin, variation characteristics, chemical speciation and ecological risk.

PubMed

Lei, Pei; Zhang, Hong; Shan, Baoqing; Lv, Shucong; Tang, Wenzhong

2016-04-01

The Hai River Basin (HRB) is considered to be one of the most polluted areas in China due to the high regional population density and rapid economic development. The estuaries of the HRB, which receive pollutants from terrestrial rivers, may subsequently suffer potential pollution and result in ecological risk of heavy metals. Six heavy metals (Cd, Cr, Cu, Ni, Pb, and Zn) were measured in estuarine surface sediments from 10 estuaries of the HRB to investigate their variation characteristics and ecological risks. The spatial difference of Cr, Ni, Pb, and Zn in sediments was higher than that of the rest two elements. The Yongdingxin Estuary (YDX) and Ziyaxin Estuary (ZYX) in the Northern Hai River System (NHRS) were the most severe in terms of heavy metal contamination. According to the Risk Assessment Code (RAC) classification, Cd associated with the exchangeable and carbonate fraction (the average of 21.3 %) indicated medium risk to high risk. More than 50 % of Cr, Cu, Ni, and Zn on average were associated with the residual fraction. Based on the sum of the first three fractions (exchangeable and carbonate + reducible + oxidizable), the mobility order of these heavy metals was Cd >Pb > Zn ≈ Cu > Ni > Cr. Compared to the background values of cinnamon soil, the potential ecological risk index (RI) values ranged from 25.6 to 168, with an average of 91.2, indicating a low ecological risk in estuarine sites of the HRB. Cd and Pb were the dominant contributors to the toxic-response factor (45.8 and 25.5 %, respectively). The results give insight into the different control measures pertaining to heavy metal pollution and risk for both relatively clean estuaries and urban seriously polluted areas, respectively, for the formation of protect strategies of aquatic environment in the HRB.

Etude du risque d'inondation en aval du delta du fleuve rouge en utilisant la teledetection et les sig: Le cas du district de Bac Hung Hai

NASA Astrophysics Data System (ADS)

Bui, Duc Viet

The Bac Hung Hai zone is the greatest basin in the Red River Delta in Vietnam and also one of the most densely populated regions of the planet. It is mainly a rural region and its economy is dominated by agriculture. In the context of frequent and larger floods in the Bac Hung Hai zone, causing deep socio-economical consequences, the focus of this study is to establish cartography of the high risk areas for flooding in the Bac Hung Hai region using remote sensing and GIS to assist land management. The preparation of a map describing land management in this region is more complicated because parcels for farming are very small and not homogeneous. A consistent and precise map of land use is essential for studies of flooding. The secondary objective is to improve the land use map. To this effect, a classification has been applied to the combination of the spectral bands and textures (TM and ETM+) of Landsat and a radar image (ERS). The addition of this information to the spectral bands increases the accuracy of classification by 1% to 4%, according to the dates selected. Additionally, in the study zone where there are few days without clouds, a problem related to the optical satellite image is the cloud cover. Then, the use of radar images will provide ground information for areas hidden by clouds where spectral images are not sufficient. To reach these goals, we have determined the main biophysical considerations that influence flooding. Then, these considerations have been combined in a multi-criteria analysis to evaluate the risks of flooding in the entire basin area. The results show that high to very high risks affect 47% of the area studied and that the south-east region, center, and north-east present the greatest risk. Keywords. Flood risks, remote sensing, GIS, land use, multicriteria analysis, Red river delta, Vietnam.

Beetle and plant arrow poisons of the Ju|'hoan and Hai||om San peoples of Namibia (Insecta, Coleoptera, Chrysomelidae; Plantae, Anacardiaceae, Apocynaceae, Burseraceae).

PubMed

Chaboo, Caroline S; Biesele, Megan; Hitchcock, Robert K; Weeks, Andrea

2016-01-01

The use of archery to hunt appears relatively late in human history. It is poorly understood but the application of poisons to arrows to increase lethality must have occurred shortly after developing bow hunting methods; these early multi-stage transitions represent cognitive shifts in human evolution. This paper is a synthesis of widely-scattered literature in anthropology, entomology, and chemistry, dealing with San ("Bushmen") arrow poisons. The term San (or Khoisan) covers many indigenous groups using so-called 'click languages' in southern Africa. Beetles are used for arrow poison by at least eight San groups and one non-San group. Fieldwork and interviews with Ju|'hoan and Hai||om hunters in Namibia revealed major differences in the nature and preparation of arrow poisons, bow and arrow construction, and poison antidote. Ju|'hoan hunters use leaf-beetle larvae of Diamphidia Gerstaecker and Polyclada Chevrolat (Chrysomelidae: Galerucinae: Alticini) collected from soil around the host plants Commiphora africana (A. Rich.) Engl. and Commiphora angolensis Engl. (Burseracaeae). In the Nyae Nyae area of Namibia, Ju|'hoan hunters use larvae of Diamphidia nigroornata Ståhl. Larvae and adults live above-ground on the plants and eat leaves, but the San collect the underground cocoons to extract the mature larvae. Larval hemolymph is mixed with saliva and applied to arrows. Hai||om hunters boil the milky plant sap of Adenium bohemianum Schinz (Apocynaceae) to reduce it to a thick paste that is applied to their arrows. The socio-cultural, historical, and ecological contexts of the various San groups may determine differences in the sources and preparation of poisons, bow and arrow technology, hunting behaviors, poison potency, and perhaps antidotes.

Risk Behaviors for HIV and HCV Infection Among People Who Inject Drugs in Hai Phong, Viet Nam, 2014.

PubMed

Duong, Huong Thi; Jarlais, Don Des; Khuat, Oanh Hai Thi; Arasteh, Kamyar; Feelemyer, Jonathan; Khue, Pham Minh; Giang, Hoang Thi; Laureillard, Didier; Hai, Vinh Vu; Vallo, Roselyne; Michel, Laurent; Moles, Jean Pierre; Nagot, Nicolas

2017-06-13

We examined the potential for HIV and hepatitis C (HCV) transmission across persons who inject drugs (PWID), men-who-have-sex-with-men (MSM) and female commercial sex workers (CSW) PWID and the potential for sexual transmission of HIV from PWID to the general population in Hai Phong, Viet Nam. Using respondent driven and convenience sampling we recruited 603 participants in 2014. All participants used heroin; 24% used non-injected methamphetamine. HIV prevalence was 25%; HCV prevalence was 67%. HIV infection was associated with HCV prevalence and both infections were associated with length of injecting career. Reported injecting risk behaviors were low; unsafe sexual behavior was high among MSM-PWID and CSW-PWID. There is strong possibility of sexual transmission to primary partners facilitated by methamphetamine use. We would suggest future HIV prevention programs utilize multiple interventions including "treatment as prevention" to potential sexual transmission of HIV among MSM and CSW-PWID and from PWID to the general population.

[Applicability of established drought index in Huang-Huai-Hai region based on actual evapotranspiration.

PubMed

Wang, Ying; Wu, Rong Jun; Guo, Zhao Bing

2016-05-01

Based on the modeled products of actual evapotranspiration with NOAH land surface model, the temporal and spatial variations of actual evapotranspiration were analyzed for the Huang-Huai-Hai region in 2002-2010. In the meantime, the agricultural drought index, namely, drought severity index (DSI) was constructed, incorporated with products of MOD17 potential evapotranspiration and MOD13 NDVI. Furthermore, the applicability of established DSI in this region in the whole year of 2002 was investigated based on the Palmer drought severity index (PDSI), the yield reduction rate of winter wheat, and drought severity data. The results showed that the annual average actual evapotranspiration within the survey region increased from the northwest to the southeast, with the maximum of 800-900 mm in the southeast and the minimum less than 300 mm in the northwest. The DSI and PDSI had positive correlation (R 2 =0.61) and high concordance in change trend. They all got the low point (-0.61 and -1.33) in 2002 and reached the peak (0.81 and 0.92) in 2003. The correlation between DSI and yield reduction rate of winter wheat (R 2 =0.43) was more significant than that between PDSI and yield reduction rate of winter wheat (R 2 =0.06). So, the DSI reflected a high spatial resolution of drought pattern and could reflect the region agricultural drought severity and intensity more accurately.

Safety incidents involving confused and forgetful older patients in a specialised care setting--analysis of the safety incidents reported to the HaiPro reporting system.

PubMed

Kinnunen-Luovi, Kaisa; Saarnio, Reetta; Isola, Arja

2014-09-01

To describe the safety incidents involving confused and forgetful older patients in a specialised care setting entered in the HaiPro reporting system. About 10% of patients experience a safety incident during hospitalisation, which causes or could cause them harm. The possibility of a safety incident during hospitalisation increases significantly with age. A mild or moderate memory disorder and acute confusion are often present in the safety incidents originating with an older patient. The design of the study was action research with this study using findings from one of the first-phase studies, which included qualitative and quantitative analysed data. Data were collected from the reporting system for safety incidents (HaiPro) in a university hospital in Finland. There were 672 reported safety incidents from four acute medical wards during the years 2009-2011, which were scrutinised. Seventy-five of them were linked to a confused patient and were analysed. The majority of the safety incidents analysed involved patient-related accidents. In addition to challenging behaviour, contributing factors included ward routines, shortage of nursing staff, environmental factors and staff knowledge and skills. Nurses tried to secure the patient safety in many different ways, but the modes of actions were insufficient. Nursing staff need evidence-based information on how to assess the cognitive status of a confused patient and how to encounter such patients. The number of nursing staff and ward routines should be examined critically and put in proportion to the care intensity demands caused by the patient's confused state. The findings can be used as a starting point in the prevention of safety incidents and in improving the care of older patients. © 2013 John Wiley & Sons Ltd.

Beetle and plant arrow poisons of the Ju|’hoan and Hai||om San peoples of Namibia (Insecta, Coleoptera, Chrysomelidae; Plantae, Anacardiaceae, Apocynaceae, Burseraceae)

PubMed Central

Chaboo, Caroline S.; Biesele, Megan; Hitchcock, Robert K.; Weeks, Andrea

2016-01-01

Abstract The use of archery to hunt appears relatively late in human history. It is poorly understood but the application of poisons to arrows to increase lethality must have occurred shortly after developing bow hunting methods; these early multi-stage transitions represent cognitive shifts in human evolution. This paper is a synthesis of widely-scattered literature in anthropology, entomology, and chemistry, dealing with San (“Bushmen”) arrow poisons. The term San (or Khoisan) covers many indigenous groups using so-called ‘click languages’ in southern Africa. Beetles are used for arrow poison by at least eight San groups and one non-San group. Fieldwork and interviews with Ju|’hoan and Hai||om hunters in Namibia revealed major differences in the nature and preparation of arrow poisons, bow and arrow construction, and poison antidote. Ju|’hoan hunters use leaf-beetle larvae of Diamphidia Gerstaecker and Polyclada Chevrolat (Chrysomelidae: Galerucinae: Alticini) collected from soil around the host plants Commiphora africana (A. Rich.) Engl. and Commiphora angolensis Engl. (Burseracaeae). In the Nyae Nyae area of Namibia, Ju|’hoan hunters use larvae of Diamphidia nigroornata Ståhl. Larvae and adults live above-ground on the plants and eat leaves, but the San collect the underground cocoons to extract the mature larvae. Larval hemolymph is mixed with saliva and applied to arrows. Hai||om hunters boil the milky plant sap of Adenium bohemianum Schinz (Apocynaceae) to reduce it to a thick paste that is applied to their arrows. The socio-cultural, historical, and ecological contexts of the various San groups may determine differences in the sources and preparation of poisons, bow and arrow technology, hunting behaviors, poison potency, and perhaps antidotes. PMID:27006594

Drought evolution characteristics and precipitation intensity changes during alternating dry-wet changes in the Huang-Huai-Hai River basin

NASA Astrophysics Data System (ADS)

Yan, D. H.; Wu, D.; Huang, R.; Wang, L. N.; Yang, G. Y.

2013-03-01

According to the Chinese climate divisions and the Huang-Huai-Hai River basin digital elevation map, the basin is divided into seven sub-regions by means of cluster analysis of the basin meteorological stations using the self-organizing map (SOM) neural network method. Based on the daily precipitation data of 171 stations for the years 1961-2011, the drought frequency changes with different magnitudes are analyzed and the number of consecutive days without precipitation is used to identify the drought magnitudes. The first precipitation intensity after a drought period is analyzed with the Pearson-III frequency curve, then the relationship between rainfall intensity and different drought magnitudes is observed, as are the drought frequency changes for different years. The results of the study indicated the following: (1) the occurrence frequency of different drought level shows an overall increasing trend; there is no clear interdecadal change shown, but the spatial difference is significant. The occurrence frequencies of severe and extraordinary drought are higher on the North China Plain, Hetao Plains in Ningxia-Inner Mongolia, as well as on the Inner Mongolia and the Loess Plateaus, and in the Fen-Wei Valley basin. (2) As the drought level increases, the probability of extraordinary rainstorm becomes lower, and the frequency of occurrence of spatial changes in different precipitation intensities vary. In the areas surrounding Bo Sea, the Shandong Peninsula and the Huai River downstream, as the drought level increases, the occurrence frequency of different precipitation intensities first shows a decreasing trend, which becomes an increasing trend when extraordinary drought occurs. In the middle and upper reaches of the Huai River basin, on the Hai River basin piedmont plain and Hetao Plains in Ningxia-Inner Mongolia, Inner Mongolia and Loess Plateaus, and in the Fen-Wei Valley basin, the probability of the different precipitation intensities shows an overall

Assessment of River Habitat Quality in the Hai River Basin, Northern China.

PubMed

Ding, Yuekui; Shan, Baoqing; Zhao, Yu

2015-09-17

We applied a river habitat quality (RHQ) assessment method to the Hai River Basin (HRB); an important economic centre in China; to obtain baseline information for water quality improvement; river rehabilitation; and watershed management. The results of the assessment showed that the river habitat in the HRB is seriously degraded. Specifically; 42.41% of the sites; accounting for a river length of 3.31 × 10⁴ km; were designated poor and bad. Habitat in the plain areas is seriously deteriorated; and nearly 50% of the sites; accounting for a river length of 1.65 × 10⁴ km; had either poor or bad habitats. River habitat degradation was attributable to the limited width of the riparian zone (≤5 m); lower coverage of riparian vegetation (≤40%); artificial land use patterns (public and industrial land); frequent occurrence of farming on the river banks and high volumes of solid waste (nearly 10 m³); single flow channels; and rare aquatic plants (≤1 category). At the regional scale; intensive artificial land use types caused by urbanization had a significant impact on the RHQ in the HRB. RHQ was significantly and negatively correlated with farmland (r = 1.000; p < 0.01) and urban land (r = 0.998; p < 0.05); and was significantly and positively correlated with grassland and woodland (r = 1.000; p < 0.01). Intensive artificial land use; created through urbanization processes; has led to a loss of the riparian zone and its native vegetation; and has disrupted the lateral connectivity of the rivers. The degradation of the already essentially black rivers is exacerbated by poor longitudinal connectivity (index of connectivity is 2.08-16.56); caused by reservoirs and sluices. For river habitat rehabilitation to be successful; land use patterns need to be changed and reservoirs and sluices will have to be regulated.

Assessment of River Habitat Quality in the Hai River Basin, Northern China

PubMed Central

Ding, Yuekui; Shan, Baoqing; Zhao, Yu

2015-01-01

We applied a river habitat quality (RHQ) assessment method to the Hai River Basin (HRB); an important economic centre in China; to obtain baseline information for water quality improvement; river rehabilitation; and watershed management. The results of the assessment showed that the river habitat in the HRB is seriously degraded. Specifically; 42.41% of the sites; accounting for a river length of 3.31 × 104 km; were designated poor and bad. Habitat in the plain areas is seriously deteriorated; and nearly 50% of the sites; accounting for a river length of 1.65 × 104 km; had either poor or bad habitats. River habitat degradation was attributable to the limited width of the riparian zone (≤5 m); lower coverage of riparian vegetation (≤40%); artificial land use patterns (public and industrial land); frequent occurrence of farming on the river banks and high volumes of solid waste (nearly 10 m3); single flow channels; and rare aquatic plants (≤1 category). At the regional scale; intensive artificial land use types caused by urbanization had a significant impact on the RHQ in the HRB. RHQ was significantly and negatively correlated with farmland (r = 1.000; p < 0.01) and urban land (r = 0.998; p < 0.05); and was significantly and positively correlated with grassland and woodland (r = 1.000; p < 0.01). Intensive artificial land use; created through urbanization processes; has led to a loss of the riparian zone and its native vegetation; and has disrupted the lateral connectivity of the rivers. The degradation of the already essentially black rivers is exacerbated by poor longitudinal connectivity (index of connectivity is 2.08–16.56); caused by reservoirs and sluices. For river habitat rehabilitation to be successful; land use patterns need to be changed and reservoirs and sluices will have to be regulated. PMID:26393628

[Diversity of soil fauna in corn fields in Huang-Huai-Hai Plain of China under effects of conservation tillage].

PubMed

Zhu, Qiang-Gen; Zhu, An-Ning; Zhang, Jia-Bao; Zhang, Huan-Chao; Huang, Ping; Zhang, Cong-Zhi

2009-10-01

An investigation was made on the abundance and diversity of soil fauna in the corn fields under conventional and conservation tillage in Huang-Huai-Hai Plain of China. The abundance and diversity of soil fauna were higher at corn maturing (September) than at its jointing stage (July), and higher at jointing stage under conservation tillage than under conventional tillage. Soil fauna mainly distributed in surface soil layer (0-10 cm), but still had a larger number in 10-20 cm layer under conservation tillage. The individuals of acari, diptera, diplura, and microdrile oligochaetes, especially those of acari, were higher under conservation tillage than under conventional tillage. At maturing stage, an obvious effect of straw-returning under conservation tillage was observed, i. e., the more the straw returned, the higher the abundance of soil fauna, among which, the individuals of collembola, acari, coleopteran, and psocoptera, especially those of collembolan, increased significantly. The abundance of collembola at both jointing and maturing stages was significantly positively correlated with the quantity of straw returned, suggesting that collembola played an important role in straw decomposition and nutrient cycling.

Comparative water-quality assessment of the Hai He River basin in the People's Republic of China and three similar basins in the United States

USGS Publications Warehouse

Domagalski, Joseph L.; Xinquan, Zhou; Chao, Lin; Deguo, Zhi; Chi, Fan Lan; Kaitai, Xu; Ying, Lu; Luo, Yang; Shide, Liu; Dewen, Liu; Yong, Guo; Qi, Tian; Jing, Liu; Weidong, Yu; Shedlock, Robert; Knifong, Donna

2001-01-01

Ground-water quality with respect to nitrate, major inorganic constituents, pesticides, stable isotopes, and tritium was assessed in the agricultural Tangshan region in the Hai He River basin of the People's Republic of China and compared with three similar regions in the United States: the Delmarva Peninsula of the States of Delaware, Maryland, and Virginia, and the San Joaquin and Sacramento Valleys of the State of California. These four regions are considered similar with respect to size, land use, or climate. Median nitrate concentrations were found to be similar in the four regions in most instances, and those median concentrations were below the American nitrate drinking water standard of 10 milligrams per liter, however, higher concentrations, and a greater range of concentration, were evident for the Tangshan region.

Capacity of Commune Health Stations in Chi Linh District, Hai Duong Province, for Prevention and Control of Noncommunicable Diseases.

PubMed

Thi Thuy Nga, Nguyen; Thi My Anh, Bui; Nguyen Ngoc, Nguyen; Minh Diem, Dang; Duy Kien, Vu; Bich Phuong, Tran; Quynh Anh, Tran; Van Minh, Hoang

2017-07-01

The primary health care system in Vietnam has been playing an important role in prevention and control of diseases. This study aimed to describe the capacity of commune health stations in Chi Linh district, Hai Duong province for prevention and control of noncommunicable diseases (NCDs). A mixed-methods (quantitative and qualitative approaches) approach was applied to collect data in 20 commune health stations. The participants, including health workers, stakeholders, and patients with NCDs, were selected for the study. The findings reported that the main activities of prevention and control of NCDs at commune health stations (CHSs) still focused on information-education-community (IECs), unqualified for providing screening, diagnosis, and treatments of NCDs. The capacity for prevention and control of NCDs in CHSs was inadequate to provide health care services related to prevention and control of NCDs and unmet with the community's demands. In order to ensure the role and implementation of primary care level, there is an urgent need to improve the capacity of CHSs for prevention and control of NCDs, particularly a national budget for NCDs prevention and control, the essential equipment and medicines recommended by the World Health Organization should be provided and available at the CHSs.

Prevalence of Self-Treatment Practice and Related Factors Among Workers Aged 15 to 60 Years in Chi Linh Town, Hai Duong Province, Vietnam.

PubMed

Quynh Nguyen, Thuy; Tran, Thi Thu Thuy; Le, Thi Vui; Quyen, Thi Tu Bui; Trinh, Van Hung; Tran, Huu Bich

2017-07-01

Self-treatment is particularly prevalent in Vietnam. However, the prevalence of this practice among the working population is unclear. This study aims to describe the prevalence of self-treatment and related factors among workers aged 15 to 60 years in the suburban area of Chi Linh, Hai Duong, Vietnam. Secondary data of 3128 respondents was retrieved from the CHILILAB HDSS 2016 survey for analysis using logistic regression with a significance level of .05. Results show that 47.5% of respondents treated themselves at least once during one previous year. While rural residence and the presence of acute health symptoms and chronic diseases significantly associate with the choice of self-treatment among all investigated workers, lower education level and health insurance status only significantly relate to this practice among the formally employed workers. The findings imply the need for specific measures to manage self-treatment practices among different groups of workers.

Evaluating availability and price of essential medicines in Boston area (Massachusetts, USA) using WHO/HAI methodology.

PubMed

Sharma, Abhishek; Rorden, Lindsey; Ewen, Margaret; Laing, Richard

2016-01-01

Many patients even those with health insurance pay out-of-pocket for medicines. We investigated the availability and prices of essential medicines in the Boston area. Using the WHO/HAI methodology, availability and undiscounted price data for both originator brand (OB) and lowest price generic (LPG) equivalent versions of 25 essential medicines (14 prescription; 11 over-the-counter (OTC)) were obtained from 17 private pharmacies. The inclusion and prices of 26 essential medicines in seven pharmacy discount programs were also studied. The medicine prices were compared with international reference prices (IRPs). In surveyed pharmacies, the OB medicines were less available as compared to the generics. The OB and LPG versions of OTC medicines were 21.33 and 11.53 times the IRP, respectively. The median prices of prescription medicines were higher, with OB and LPG versions at 158.14 and 38.03 times the IRP, respectively. In studied pharmacy discount programs, the price ratios of surveyed medicines varied from 4.4-13.9. While noting the WHO target that consumers should pay no more than four times the IRPs, medicine prices were considerably higher in the Boston area. The prices for medicines included in the pharmacy discount programs were closest to WHO's target. Consumers should shop around, as medicine inclusion and prices vary across discount programs. In order for consumers to identify meaningful potential savings through comparison shopping, price transparency is needed.

Heavy Metal Accumulation by Periphyton Is Related to Eutrophication in the Hai River Basin, Northern China

PubMed Central

Tang, Wenzhong; Cui, Jingguo; Shan, Baoqing; Wang, Chao; Zhang, Wenqiang

2014-01-01

The Hai River Basin (HRB) is one of the most polluted river basins in China. The basin suffers from various types of pollutants including heavy metals and nutrients due to a high population density and rapid economic development in this area. We assessed the relationship between heavy metal accumulation by periphyton playing an important role in fluvial food webs and eutrophication in the HRB. The concentrations of the unicellular diatoms (type A), filamentous algae with diatoms (type B), and filamentous algae (type C) varied along the river, with type A dominating upstream, and types B then C increasing in concentration further downstream, and this was consistent with changes in the trophic status of the river. The mean heavy metal concentrations in the type A, B and C organisms were Cr: 18, 18 and 24 mg/kg, respectively, Ni: 9.2, 10 and 12 mg/kg, respectively, Cu: 8.4, 19 and 29 mg/kg, respectively, and Pb: 11, 9.8 and 7.1 mg/kg respectively. The bioconcentration factors showed that the abilities of the organisms to accumulate Cr, Ni and Pb decreased in the order type A, type B, then type C, but their abilities to accumulate Cu increased in that order. The Ni concentration was a good predictor of Cr, Cu and Pb accumulation by all three periphyton types. Our study shows that heavy metal accumulation by periphyton is associated with eutrophication in the rivers in the HRB. PMID:24482681

Dangerous subtlety: relationship-related determinants of consistency of condom use among female sex workers and their regular, non-commercial partners in Hai Phong, Viet Nam.

PubMed

Hoffman, Leah; Nguyen, Ha Thi Thu; Kershaw, Trace S; Niccolai, Linda M

2011-10-01

Research indicates female sex workers use condoms more consistently with their clients than with regular, non-commercial partners (partners). The purpose of this study was to better understand the relationship between couple communication and HIV risk behavior by examining (1) sex worker-partner divergence on communication measures and (2) the association between intra-couple communication divergence and consistent condom use. In this cross-sectional study, 50 sex workers and their partners in Hai Phong, Viet Nam were separately asked about their relationships and condom use. When asked about HIV risk communication in their relationship, sex workers reported significantly higher HIV communication content than their partners (p < 0.001). Higher communication divergence between partners was associated with a decreased likelihood of consistent condom use (OR 0.54 95% CI 0.30, 0.97). Sex workers urgently need interventions that build their communication skills and address their risk behavior in non-commercial relationships.

Healthcare-associated infections in Australia: time for national surveillance.

PubMed

Russo, Philip L; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

2015-02-01

Healthcare-associated infection (HAI) surveillance programs are critical for infection prevention. Australia does not have a comprehensive national HAI surveillance program. The purpose of this paper is to provide an overview of established international and Australian statewide HAI surveillance programs and recommend a pathway for the development of a national HAI surveillance program in Australia. This study examined existing HAI surveillance programs through a literature review, a review of HAI surveillance program documentation, such as websites, surveillance manuals and data reports and direct contact with program representatives. Evidence from international programs demonstrates national HAI surveillance reduces the incidence of HAIs. However, the current status of HAI surveillance activity in Australian states is disparate, variation between programs is not well understood, and the quality of data currently used to compose national HAI rates is uncertain. There is a need to develop a well-structured, evidence-based national HAI program in Australia to meet the increasing demand for validated reliable national HAI data. Such a program could be leveraged off the work of existing Australian and international programs.

Comparing topical hydrocortisone cream with Hai's Perianal Support in managing symptomatic hemorrhoids in pregnancy: a preliminary trial.

PubMed

Lim, Soo Soo; Yu, Chye Wah; Aw, Lin Da

2015-02-01

The prevalence of hemorrhoids among pregnant women is high in late pregnancy. This study was to evaluate the efficacy between drug treatment with Procort (topical hydrocortisone cream 1%) and mechanical treatment with a Hai's Perianal Support (HPS) toilet seat device in managing symptomatic hemorrhoids during the third trimester of pregnancy. A prospective randomized controlled study was conducted on 23 pregnant women with gestation above the 28th week and presented with symptomatic hemorrhoids. Pre- and post-interventional assessment was carried out to obtain data on symptoms of pain, itching, swelling, discomfort and bleeding associated with hemorrhoids. The control group was treated with topical hydrocortisone cream 1% and the test group was provided and taught to use a HPS, a posterior perineal support toilet seat device (Colorec). The results showed improvement in symptoms of pain, swelling, bleeding, itching and discomfort in both the test and control groups. However, statistically significant differences were found on symptoms of pain, swelling and discomfort between the test and control groups. There was also a statistically significant difference in well-being and overall improvement between the test and control groups. HPS has to a certain extent significantly reduced the symptoms of hemorrhoids in pregnancy and improved the well-being of pregnant women in comparison with topical treatment with hydrocortisone cream. However, more clinical trials need to be carried out to recomfirm the role of HPS in hemorrhoids in pregnancy. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

[Complete responses in patients with unresectable liver metastases from colorectal cancer with weekly high-dose 5-FU plus one-shot CDDP HAI].

PubMed

Udagawa, M; Okabe, S; Kuwabara, H; Ootsukasa, S; Arai, T; Maruyama, S; Murase, N; Yamashita, H; Iwai, T

1999-10-01

Thirty-two patients with unresectable liver metastases from colorectal cancer, treated by intermittent hepatic arterial infusion of high-dose 5-FU combined with CDDP, were assessed. As a result of this treatment, the overall response rate was 65.6%, and eight patients (25%) which contained three autopsy cases revealed a complete response. The mean doses of 5-FU and CDDP which was administered in the eight patients were 24.3 g and 65 mg, respectively. One of the eight patients showed complete disappearance of liver metastasis on the CT scan after arterial infusion of 4.5 g of 5-FU, and necrosis or disappearance of the tumor was present in more than 2/3 of the whole lesion. Autopsy showed focal or zonal necrosis, distorted reconstruction of architecture, and cholangiolitis of the liver which were administered more than 15 g of 5-FU. Intermittent hepatic arterial infusion of high-dose 5-FU combined with CDDP is proved to be a useful locoregional chemotherapy for liver metastasis from colorectal cancer. We should evolve new treatment modalities for extrahepatic metastases, as HAI combined with the systemic chemotherapeutic regimen.

Surveillance of healthcare associated infections in pediatric cancer patients between 2004 and 2009 in a public pediatric hospital in Mexico city, Mexico.

PubMed

Hernández Orozco, Hilda; Lucas Resendiz, Esperanza; Castañeda, Jose Luis; De Colsa, Agustin; Ramirez Mayans, Jaime; Johnson, Kyle M; Gonzalez, Napoleon; Caniza, Miguela A

2014-03-01

Pediatric oncology and hematology patients are at increased risk of developing healthcare associated infections (HAIs). We conducted a prospective surveillance study on children with cancer admitted to the pediatric hematology and oncology units at a public pediatric hospital in Mexico from January 2004 to December 2009. The incidence of HAIs and groups at greatest risk for HAIs were analyzed. The annual HAI incidence rate and incidence density were calculated. Risk factors such as site of infection, HAI types, and cancer diagnosis were studied. A total of 9420 patients participated, and 409 had HAIs (479 episodes). Annual HAI rates were 3.7 to 5.5 per 100 admissions and the incidence density was 5.75 to 6 HAIs per 1000 inpatient days annually. There were 272 (56.8%) bloodstream infections, 45 (9.4%) pneumonia cases, and 44 (9.2%) skin and soft tissue infections. Children with acute lymphoblastic leukemia had 37.2% and those with acute myeloid leukemia had 16.4% of the HAIs. A total of 11.5% of the HAIs were in children with osteosarcoma. The most common pathogens were Gram-negative bacteria. The HAI-associated mortality rate was 3.7%. Although the overall HAI rate is in line with published reports, the mortality rate was higher, suggesting the incorporation of more aggressive methods to treat infections at our hospital.

Correlates of Heterosexual Anal Intercourse among Women in the 2006-2010 National Survey of Family Growth.

PubMed

Benson, Lyndsey S; Martins, Summer L; Whitaker, Amy K

2015-08-01

Heterosexual anal intercourse (HAI) is common among U.S. women. Receptive anal intercourse is a known risk factor for HIV, yet there is a paucity of data on HAI frequency and distribution in the United States. Condom use is lower with HAI vs. vaginal intercourse, but little is known regarding of correlates of HAI with and without condoms. The aims of this study were to describe recent (past 12 months) and lifetime HAI among sexually active reproductive-aged U.S. women, and to characterize women who engage in HAI with and without condoms. We analyzed a sample of 10,463 heterosexually active women aged 15-44 years for whom anal intercourse data were available in the 2006-2010 National Survey of Family Growth. Weighted bivariate and multivariable analyses were used to determine HAI prevalence and correlates. Primary outcomes were lifetime HAI, recent (last 12 months) HAI, and condom use at last HAI. In our sample, 13.2% of women had engaged in recent HAI and 36.3% in lifetime HAI. Women of all racial and ethnic backgrounds and religions reported recent anal intercourse. Condom use was more common at last vaginal intercourse than at last anal intercourse (28% vs. 16.4%, P < 0.001). In multivariable analysis, correlates of recent HAI included: less frequent church attendance, younger age at first intercourse, multiple sexual partners, history of oral intercourse, history of unintended pregnancy, and treatment for sexually transmitted infections (all P < 0.05). Correlates of lifetime HAI were similar, with the addition of older age, higher education, higher income, and history of drug use (all P < 0.05). Women of all ages and ethnicities engage in HAI, at rates higher than providers might realize. Condom use is significantly lower for HAI vs. vaginal intercourse, putting these women at risk for acquisition of sexually transmitted infections. © 2015 International Society for Sexual Medicine.

Hospital-acquired infection in public hospital buildings in the Philippines: Is the type of ventilation increasing the risk?

PubMed

Vergeire-Dalmacion, Godofreda Ruiz; Itable, Jill Rafols; Baja, Emmanuel Saporna

2016-11-24

Hospital-acquired infections (HAIs) are associated with increased morbidity and mortality, especially in developing countries. However, limited information is available about the risk of HAIs in naturally ventilated wards (NVWs) and mechanically ventilated intensive care units (MVICUs) of public hospitals in the Philippines. We aimed to assess the association between HAIs and type of ventilation in an urban tertiary care hospital in the Philippines. A cross-sectional point-prevalence survey of infections was done in NVWs and MVICUs of a tertiary care hospital in December 2013. Multivariate analyses were done to examine the associations between HAIs and type of ventilation and other risk factors. Of the 224 patients surveyed, 63 (28%) patients had 69 HAIs. Pneumonia was the most common HAI (35%). Wards near areas with high vehicular activity had more respiratory HAI cases. Being immunocompromised is a risk factor for HAI for pediatric and adult patients. Among pediatric patients, staying in MVICUs had a lower risk for HAIs (adjusted odds ratio [AOR]: 0.33; 95% confidence interval [CI]: 0.10-1.08) compared to staying in NVWs. For adult patients, a higher risk for HAIs (AOR: 2.41; 95% CI: 0.29-18.20) was observed in MVICUs compared to NVWs. Type of ventilation is not a risk factor for HAIs. Patients who are immunocompromised may be at a higher risk for HAI. Indoor air pollution, proximity to congested main thoroughfare, and increased human foot traffic may contribute to the susceptibility of patients to HAIs. Hospital layout should be considered in infection control.

75 FR 4396 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

.... Proposed Project Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S... Infections (HAIs) prevalence and antimicrobial use in the United States. Preventing HAIs is a CDC priority... antimicrobial-resistant pathogens. The scope and magnitude of HAIs in the U.S. were last directly estimated in...

Quantitative Analysis of Microbial Burden on Hospital Room Environmental Surfaces Contributing to Healthcare-Associated Infections

PubMed Central

Rutala, William A; Kanamori, Hajime; Gergen, Maria; Sickbert-Bennett, Emily; Knelson, Lauren P; Chen, Luke F; Anderson, Deverick; Sexton, Daniel; Weber, David J

2017-01-01

Abstract Background Contaminated environmental surfaces are involved in the transmission of epidemiologically important pathogens. It remains unknown which level of microbial load can contribute to healthcare-associated infections (HAI). We used microbiological data obtained from the Benefits of Enhanced Terminal Room (BETR) Disinfection Study to investigate the quantitative relationship between microbial burden and risk of HAI. Methods Microbiological samples were collected from high-frequency-touch hospital room surfaces using Rodac plates (25 cm2/plate) in rooms after terminal room disinfection. All rooms were randomly assigned to standard disinfection (Quaternary ammonium [Quat]) or an enhanced disinfection (Quat/ultraviolet light [UV-C], Bleach, Bleach/UV-C). The Quat/UV-C arm was excluded from further analysis since HAI were not observed in this arm. All new patients in study rooms were monitored for HAI following terminal disinfection through the BETR study standard protocols. We analyzed the relationship between the total colony forming units (CFU) of bacterial loads from 2,395 environmental samples in 60 rooms and HAI among new patients in the room (6 patients with HAI and 54 patients without HAI). Each arm had 2 patients with HAI. Statistical significance was determined by the Wilcoxon test, and P < 0.05 was considered significant. Results Overall, samples in rooms of patients with HAI had a mean 39.3 CFU, while samples from rooms of patients without HAI had a mean 35.6 CFU (Table 1). In the standard disinfection, the sampled rooms from the HAI patients had a significantly higher number of total CFU (mean 65.1 CFU) than non-HAI group (mean 35.5 CFU) (P = 0.019). In the enhanced disinfection rooms, there was no statistical significance between HAI and non-HAI groups. Conclusion Although our sample size may have been too small to detect contaminated microbial load in a room though a large clinical trial was conducted, our data based on the Quat arm as

Spread of hospital-acquired infections: A comparison of healthcare networks

PubMed Central

Astagneau, Pascal; Crépey, Pascal

2017-01-01

Hospital-acquired infections (HAIs), including emerging multi-drug resistant organisms, threaten healthcare systems worldwide. Efficient containment measures of HAIs must mobilize the entire healthcare network. Thus, to best understand how to reduce the potential scale of HAI epidemic spread, we explore patient transfer patterns in the French healthcare system. Using an exhaustive database of all hospital discharge summaries in France in 2014, we construct and analyze three patient networks based on the following: transfers of patients with HAI (HAI-specific network); patients with suspected HAI (suspected-HAI network); and all patients (general network). All three networks have heterogeneous patient flow and demonstrate small-world and scale-free characteristics. Patient populations that comprise these networks are also heterogeneous in their movement patterns. Ranking of hospitals by centrality measures and comparing community clustering using community detection algorithms shows that despite the differences in patient population, the HAI-specific and suspected-HAI networks rely on the same underlying structure as that of the general network. As a result, the general network may be more reliable in studying potential spread of HAIs. Finally, we identify transfer patterns at both the French regional and departmental (county) levels that are important in the identification of key hospital centers, patient flow trajectories, and regional clusters that may serve as a basis for novel wide-scale infection control strategies. PMID:28837555

Sensitivity and specificity of the method used for ascertainment of healthcare-associated infections in the second Slovenian national prevalence survey.

PubMed

Serdt, Mojca; Lejko Zupanc, Tatjana; Korošec, Aleš; Klavs, Irena

2016-12-01

The second Slovenian national healthcare-associated infections (HAIs) prevalence survey (SNHPS) was conducted in acute-care hospitals in 2011. The objective was to assess the sensitivity and specificity of the method used for the ascertainment of six types of HAIs (bloodstream infections, catheter-associated infections, lower respiratory tract infections, pneumoniae, surgical site infections, and urinary tract infections) in the University Medical Centre Ljubljana (UMCL). A cross-sectional study was conducted in patients surveyed in the SNHPS in the UMCL using a retrospective medical chart review (RMCR) and European HAIs surveillance definitions. Sensitivity and specificity of the method used in the SNHPS using RMCR as a reference was computed for ascertainment of patients with any of the six selected types of HAIs and for individual types of HAIs. Agreement between the SNHPS and RMCR results was analyzed using Cohen's kappa coefficient. 1474 of 1742 (84.6%) patients surveyed in the SNHPS were included in RMCR. The sensitivity of the SNHPS method for detecting any of six HAIs was 90% (95% confidence interval (CI): 81%-95%) and specificity 99% (95% CI: 98%-99%). The sensitivity by type of HAI ranged from 63% (lower respiratory tract infections) to 92% (bloodstream infections). Specificity was at least 99% for all types of HAIs. Agreement between the two data collection approaches for HAIs overall was very good (κ=0.83). The overall sensitivity of SNHPS collection method for ascertaining HAIs overall was high and the specificity was very high. This suggests that the estimated prevalence of HAIs in the SNHPS was credible.

Bioresponsive and fluorescent hyaluronic acid-iodixanol nanogels for targeted X-ray computed tomography imaging and chemotherapy of breast tumors.

PubMed

Zhu, Yaqin; Wang, Xiuxiu; Chen, Jing; Zhang, Jian; Meng, Fenghua; Deng, Chao; Cheng, Ru; Feijen, Jan; Zhong, Zhiyuan

2016-12-28

Nanotheranostics is a rapidly growing field combining disease diagnosis and therapy, which ultimately may add in the development of 'personalized medicine'. Here, we designed and developed bioresponsive and fluorescent hyaluronic acid-iodixanol nanogels (HAI-NGs) for targeted X-ray computed tomography (CT) imaging and chemotherapy of MCF-7 human breast tumors. HAI-NGs were obtained with a small size of ca. 90nm, bright green fluoresence and high serum stability from hyaluronic acid-cystamine-tetrazole and reductively degradable polyiodixanol-methacrylate via nanoprecipitation and a photo-click crosslinking reaction. Notably, paclitaxel (PTX)-loaded HAI-NGs showed a fast glutathione-responsive drug release. Confocal microscopy displayed efficient uptake of HAI-NGs by CD44 overexpressing MCF-7 cells via a receptor-mediated mechanism. MTT assays revealed that HAI-NGs were nontoxic to MCF-7 cells even at a high concentration of 1mg/mL whereas PTX-loaded HAI-NGs exhibited strong inhibition of MCF-7 cells. The in vivo pharmcokinetics, near-infrared imaging and biodistribution studies revealed that HAI-NGs significantly prolonged the blood circulation time and enhanced tumor accumulation of PTX. Interestingly, significantly enhanced CT imaging was observed for MCF-7 breast tumors in nude mice via either intratumoral or intravenous injection of HAI-NGs as compared to iodixanol. HAI-NGs fluoresence was distributed thoughout the whole tumor indicating deep tumor penetration. PTX-loaded HAI-NGs showed effective suppression of tumor growth with little systemic toxicity. HAI-NGs appear as a "smart" theranostic nanoplatform for the treatment of CD44 positive tumors. Copyright © 2016 Elsevier B.V. All rights reserved.

Associated with Health Care-Associated Infections in Cardiac Surgery

PubMed Central

Greco, Giampaolo; Shi, Wei; Michler, Robert E.; Meltzer, David O.; Ailawadi, Gorav; Hohmann, Samuel F.; Thourani, Vinod; Argenziano, Michael; Alexander, John; Sankovic, Kathy; Gupta, Lopa; Blackstone, Eugene H.; Acker, Michael A.; Russo, Mark J.; Lee, Albert; Burks, Sandra G.; Gelijns, Annetine C.; Bagiella, Emilia; Moskowitz, Alan J.; Gardner, Timothy J.

2014-01-01

BACKGROUND Health care-associated infections (HAIs) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. Current information about their economic burden is limited. OBJECTIVES To determine the cost associated with major types of HAIs during the first 2 months after cardiac surgery. METHODS Prospectively collected data from a multicenter observational study of the Cardiothoracic Surgery Clinical Trials Network, in which patients were monitored for infections for 65 days after surgery, were merged with related financial data, routinely collected by the University HealthSystem Consortium. Incremental length of stay (LOS) and cost associated with HAIs were estimated using generalized linear models, adjusting for patient demographics, clinical history, baseline laboratory values, and surgery type. RESULTS Among 4,320 cardiac surgery patients, mean age of 64 ± 13 years, 119 (2.8%) experienced a major HAI during the index hospitalization. The most common HAIs were pneumonia (48%), sepsis (20%) and C. Difficile colitis (18%). On average, the estimated incremental cost associated with a major HAI was nearly $38,000, of which 47% was related to intensive care unit services. The incremental LOS was 14 days. Overall, there were 849 readmissions, among these, 8.7% were attributed to major HAIs. The cost of readmissions due to major HAI was on average nearly three times as much as readmissions not related to HAI. CONCLUSIONS Hospital cost, length of stay, and readmissions are strongly associated with HAIs. These associations suggest the potential for large reductions in costs if HAIs following cardiac surgery can be reduced. PMID:25572505

Computer Surveillance of Hospital-Acquired Infections: A 25 year Update

PubMed Central

Evans, R. Scott; Abouzelof, Rouett H.; Taylor, Caroline W.; Anderson, Vickie; Sumner, Sharon; Soutter, Sharon; Kleckner, Ruth; Lloyd, James F.

2009-01-01

Hospital-acquired infections (HAIs) are a significant cause of patient harm and increased healthcare cost. Many states have instituted mandatory hospital-wide reporting of HAIs which will increase the workload of infection preventionists and the Center for Medicare and Medicaid Services is no longer paying hospitals to treat certain HAIs. These competing priorities for increased reporting and prevention have many hospitals worried. Manual surveillance of HAIs cannot provide the speed, accuracy and consistency of computerized surveillance. Computer tools can also improve the speed and accuracy of HAI analysis and reporting. Computerized surveillance for HAIs was implemented at LDS Hospital in 1984, but that system required manual entry of data for analysis and reporting. This paper reports on the current functionality and status of the updated computer system for HAI surveillance, analysis and reporting used at LDS Hospital and the 21 other Intermountain Healthcare hospitals. PMID:20351845

Prospective surveillance of device-associated health care-associated infection in an intensive care unit of a tertiary care hospital in New Delhi, India.

PubMed

Kumar, Shilpee; Sen, Poornima; Gaind, Rajni; Verma, Pardeep Kumar; Gupta, Poonam; Suri, Prem Rose; Nagpal, Sunita; Rai, Anil Kumar

2018-02-01

Surveillance of health care-associated infections (HAIs) plays a key role in the hospital infection control program and reduction of HAIs. In India, most of the surveillance of HAIs is reported from private sector hospitals that do not depict the situation of government sector hospitals. Other studies do not confirm with the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) surveillance criterion, or deal with ventilator-associated pneumonia (VAP) instead of ventilator-associated event (VAE). The aim of this study was to identify the incidences of 3 device-associated HAIs (DA-HAIs) (VAE, central line-associated bloodstream infection [CLABSI], and catheter-associated urinary tract infection [CAUTI]) by active surveillance using CDC's NHSN surveillance criteria and to identify the pathogens associated with these DA-HAIs. This was a prospective surveillance study (January 2015-December 2016) conducted in an intensive care unit (ICU) of a large, tertiary care, government hospital situated in Delhi, India. Targeted surveillance was done as per the CDC's NHSN 2016 surveillance criteria. There were 343 patients admitted to the ICU that were included in the study. The surveillance data was reported over 3,755 patient days. A DA-HAIs attack rate of 20.1 per 100 admissions and incidence of 18.3 per 1,000 patient days was observed. The duration of use for each device for patients with DA-HAIs was significantly longer than for patients without DA-HAIs. The device utilization ratios of central line, ventilator, and urinary catheters were 0.57, 0.85, and 0.72, respectively. The crude excess length of stay for patients with DA-HAI was 13 days, and crude excess mortality rate was 11.8%. VAE, CLABSI, and CAUTI rates were 11.8, 7.4, and 9.7 per 1,000 device days, respectively. Among 69 DA-HAIs reported, pathogens could be identified for 49 DA-HAI cases. Klebsiella spp was the most common organism isolated, accounting 28.5% for all DA-HAI

Functional analysis of a missense mutation in the serine protease inhibitor SPINT2 associated with congenital sodium diarrhea.

PubMed

Faller, Nicolas; Gautschi, Ivan; Schild, Laurent

2014-01-01

Membrane-bound serine proteases play important roles in different biological processes. Their regulation by endogenous inhibitors is poorly understood. A Y163C mutation in the SPINT2 gene encoding the serine protease inhibitor Hepatocyte Growth Factor Inhibitor HAI-2 is associated with a congenital sodium diarrhea. The functional consequences of this mutation on HAI-2 activity and its physiological targets are unknown. We established a cellular assay in Xenopus laevis oocytes to study functional interactions between HAI-2 and candidate membrane-bound serine proteases expressed in the gastro-intestinal tract. We found that the wild-type form of HAI-2 is a potent inhibitor of nine gastro-intestinal serine proteases. The Y163C mutation in the second Kunitz domain of HAI-2 resulted in a complete loss of inhibitory activity on two intestinal proteases, prostasin and tmprss13. The effect of the mutation of the homologous Y68C in the first Kunitz domain of HAI-2 is consistent with a differential contribution of the two Kunitz domains of HAI-2 in the inhibition of serine proteases. By contrast to the Tyr to Cys, the Tyr to Ser substitution did not change the inhibitory potency of HAI-2, indicating that the thiol-group of the cysteine rather than the Tyr deletion is responsible for the HAI-2 loss of function. Our functional assay allowed us to identify membrane-bound serine proteases as cellular target for inhibition by HAI-2 wild type and mutants, and to better define the role of the Tyr in the second Kunitz domain in the inhibitory activity of HAI-2.

[Healthcare-associated infections in a paediatric haematology/oncology unit in Morocco].

PubMed

Cherkaoui, Siham; Lamchahab, Mouna; Samira, Hassoun; Zerouali, Khalid; Madani, Abdallah; Benchekroun, Said; Quessar, Asmaa

2014-01-01

HAI cause considerable morbidity and mortality and are associated with prolonged hospital stay and increased health care costs. To describe the incidence of HAI in paediatric cancer patients as the first step towards improving infection control policies. A prospective surveillance study was performed in the Casablanca university hospital paediatric haematology/oncology unit over an 8-month period from January to August 2011. Data including extrinsic risk factors associated with HAI were recorded. The incidence of HAI was 28 per 1000 patient-days. The median age was 9.6 years and the most frequent diagnosis was acute myeloid leukaemia (32%). Neutropenia at diagnosis was significantly correlated with the risk of HAI. 55.7% of HAls were nosocomial fever of unknown origin. Gram-negative bacteria were the main pathogens (60%), gram-positive cocci were responsible for 26% of HAI and Candida for 14% of HAI. The length of hospital stay for patients with and without infection were 16.5 and 5 days, respectively (P < 0.001). Six of the 11 deaths were related to HAI. These findings suggest the need to evaluate infection control measures in order to reduce morbidity and mortality in paediatric haematology/oncology units.

Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric.

PubMed

Soe, Minn M; Gould, Carolyn V; Pollock, Daniel; Edwards, Jonathan

2015-12-01

To develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved. Acute care hospitals that report HAI data to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS :The cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order. Of 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal. The CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.

Understanding the patient experience of health care-associated infection: A qualitative systematic review.

PubMed

Currie, Kay; Melone, Lynn; Stewart, Sally; King, Caroline; Holopainen, Arja; Clark, Alex M; Reilly, Jacqui

2018-01-30

The global burden of health care-associated infection (HAI) is well recognized; what is less well known is the impact HAI has on patients. To develop acceptable, effective interventions, greater understanding of patients' experience of HAI is needed. This qualitative systematic review sought to explore adult patients' experiences of common HAIs. Five databases were searched. Search terms were combined for qualitative research, HAI terms, and patient experience. Study selection was conducted by 2 researchers using prespecified criteria. Critical Appraisal Skills Programme quality appraisal tools were used. Internationally recognized Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied. The Noblit and Hare (1988) approach to meta-synthesis was adopted. Seventeen studies (2001-2017) from 5 countries addressing 5 common types of HAI met the inclusion criteria. Four interrelated themes emerged: the continuum of physical and emotional responses, experiencing the response of health care professionals, adapting to life with an HAI, and the complex cultural context of HAI. The impact of different HAIs may vary; however, there are many similarities in the experience recounted by patients. The biosociocultural context of contagion was graphically expressed, with potential impact on social relationships and professional interactions highlighted. Further research to investigate contemporary patient experience in an era of antimicrobial resistance is warranted. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Multi-centre point prevalence survey of hospital-acquired infections in Ghana.

PubMed

Labi, Appiah-Korang; Obeng-Nkrumah, Noah; Owusu, Enid; Bjerrum, Stephanie; Bediako-Bowan, Antoinette; Sunkwa-Mills, Gifty; Akuffo, Christiana; Fenny, Ama Pokua; Opintan, Japheth Awuletey; Enweronu-Laryea, Christabel; Debrah, Samuel; Damale, Nelson; Bannerman, Cynthia; Newman, Mercy Jemima

2018-05-03

There is a paucity of data describing hospital acquired infections (HAIs) in Africa. To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Between September and December 2016, point prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. We reviewed medical records of eligible inpatients at or before 8am on the day of survey to identify HAIs present at the time of survey. Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5 to 14.4% with higher proportion of infections in secondary and tertiary care facilities. The most frequent HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%), and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a microorganism was reported; the most isolated microorganism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the day of survey. The strongest independent predictors for HAI were the presence of invasive device before onset of infection and duration of hospital stay. We recorded a low HAI burden compared to findings from other low and middle income countries. Copyright © 2018. Published by Elsevier Ltd.

Reducing Time-dependent Bias in Estimates of the Attributable Cost of Health Care-associated Methicillin-resistant Staphylococcus aureus Infections: A Comparison of Three Estimation Strategies.

PubMed

Nelson, Richard E; Samore, Matthew H; Jones, Makoto; Greene, Tom; Stevens, Vanessa W; Liu, Chuan-Fen; Graves, Nicholas; Evans, Martin F; Rubin, Michael A

2015-09-01

Previous estimates of the excess costs due to health care-associated infection (HAI) have scarcely addressed the issue of time-dependent bias. We examined time-dependent bias by estimating the health care costs attributable to an HAI due to methicillin-resistant Staphylococcus aureus (MRSA) using a unique dataset in the Department of Veterans Affairs (VA) that makes it possible to distinguish between costs that occurred before and after an HAI. In addition, we compare our results to those from 2 other estimation strategies. Using a historical cohort study design to estimate the excess predischarge costs attributable to MRSA HAIs, we conducted 3 analyses: (1) conventional, in which costs for the entire inpatient stay were compared between patients with and without MRSA HAIs; (2) post-HAI, which included only costs that occurred after an infection; and (3) matched, in which costs for the entire inpatient stay were compared between patients with an MRSA HAI and subset of patients without an MRSA HAI who were matched based on the time to infection. In our post-HAI analysis, estimates of the increase in inpatient costs due to MRSA HAI were $12,559 (P<0.0001) and $24,015 (P<0.0001) for variable and total costs, respectively. The excess variable and total cost estimates were 33.7% and 31.5% higher, respectively, when using the conventional methods and 14.6% and 11.8% higher, respectively, when using matched methods. This is the first study to account for time-dependent bias in the estimation of incremental per-patient health care costs attributable to HAI using a unique dataset in the VA. We found that failure to account for this bias can lead to overestimation of these costs. Matching on the timing of infection can reduce this bias substantially.

Healthcare Associated Infections in a Resource Limited Setting.

PubMed

Bammigatti, Chanaveerappa; Doradla, Saikumar; Belgode, Harish Narasimha; Kumar, Harichandra; Swaminathan, Rathinam Palamalai

2017-01-01

Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). Patients aged 13 years or more with stay of more than 48 hours in a 16 bedded Medical Intensive Care Unit (MICU) between November 2011 and April 2013 were included in the study. Patients were prospectively followed up till discharge or death for the development of HAI. Device associated HAI like Ventilator Associated Pneumonia (VAP), Catheter Related-Blood Stream Infection (CR-BSI) and Catheter Associated-Urinary Tract Infections (CA-UTI) were studied. Standard laboratory methods were used for identification of microorganisms causing HAI and to test their antibiotic sensitivity. A total of 346 patients were included in the study with median age of 38 years. Common indications for admission to Medical Intensive Care Unit (MICU) were poisoning (31.5%); neurological illness (23.4%) like Guillian-Barre syndrome, tetanus, meningitis, encephalitis; respiratory illness (14.5%) like pneumonia, acute respiratory distress syndrome and tropical infections (7.2%) like malaria, scrub typhus, leptospirosis. Fifty percent (174/346) patients developed one or more HAI with VAP being the most common. The rates of HAI per 1000 device days for VAP, CR-BSI, CA-UTI were 72.56, 3.98 and 12.4, respectively. Acinetobacter baumannii was the most common organism associated with HAI. Multidrug resistance was seen in 74% of the isolates. The burden of HAI, especially with MDR organisms, in resource constrained setting like ours is alarming. There is urgent need for infection control and monitoring

Exploring quality of life among the elderly in Hai Duong province, Vietnam: a rural–urban dialogue

PubMed Central

Huong, Nguyen Thanh; Hai Ha, Le Thi; Quynh Chi, Nguyen Thai; Hill, Peter S.; Walton, Tara

2012-01-01

Background Quality of life (QoL) is an important health index for the elderly, necessary for assessing interventions, and prioritising medical and social care needs. As the ageing population in Vietnam continues to increase, understanding important dimensions of QoL for the elderly is essential. There is a paucity of research in this area, however, and the available literature focuses on functional capacities. The purpose of this article is to explore perceptions on the dimensions of QoL among the elderly in Vietnam, to use these perceptions to broaden the concept, and to explore similarities and differences between those living in urban compared to rural areas. Method Qualitative methods included in-depth interviews (IDI) with experts in ageing and elderly persons, as well as focus group discussions (FGDs) in three communes in Hai Duong province. IDIs and FGDs were recorded and transcribed. NVivo software was used to analyse the data. Results Thematic analysis identified physical, psychological, social, environmental, religious, and economic as important dimensions of QoL. For elderly participants in both urban and rural areas, physical health, social relations, finances and economics, the physical and social environment, and psychological health were reported as important. Rural participants also identified religious practice as an important dimension of QoL. In terms of relationships, the elderly in urban areas prioritised those with their children, while the elderly in rural areas focussed their concerns on community relationships and economic conditions. Conclusion Isolating individual factors that contribute to QoL among the elderly is difficult given the inter-relations and rich cross-linkages between themes. Elderly participants in urban and rural areas broadly shared perspectives on the themes identified, in particular social relationships, but their experiences diverged around issues surrounding finances and economics, their respective physical and social

Exploring quality of life among the elderly in Hai Duong province, Vietnam: a rural-urban dialogue.

PubMed

Huong, Nguyen Thanh; Hai Ha, Le Thi; Quynh Chi, Nguyen Thai; Hill, Peter S; Walton, Tara

2012-12-22

Quality of life (QoL) is an important health index for the elderly, necessary for assessing interventions, and prioritising medical and social care needs. As the ageing population in Vietnam continues to increase, understanding important dimensions of QoL for the elderly is essential. There is a paucity of research in this area, however, and the available literature focuses on functional capacities. The purpose of this article is to explore perceptions on the dimensions of QoL among the elderly in Vietnam, to use these perceptions to broaden the concept, and to explore similarities and differences between those living in urban compared to rural areas. Qualitative methods included in-depth interviews (IDI) with experts in ageing and elderly persons, as well as focus group discussions (FGDs) in three communes in Hai Duong province. IDIs and FGDs were recorded and transcribed. NVivo software was used to analyse the data. Thematic analysis identified physical, psychological, social, environmental, religious, and economic as important dimensions of QoL. For elderly participants in both urban and rural areas, physical health, social relations, finances and economics, the physical and social environment, and psychological health were reported as important. Rural participants also identified religious practice as an important dimension of QoL. In terms of relationships, the elderly in urban areas prioritised those with their children, while the elderly in rural areas focussed their concerns on community relationships and economic conditions. Isolating individual factors that contribute to QoL among the elderly is difficult given the inter-relations and rich cross-linkages between themes. Elderly participants in urban and rural areas broadly shared perspectives on the themes identified, in particular social relationships, but their experiences diverged around issues surrounding finances and economics, their respective physical and social environments, and the contribution

Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric

PubMed Central

Soe, Minn M.; Gould, Carolyn V.; Pollock, Daniel; Edwards, Jonathan

2015-01-01

OBJECTIVE To develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved. SETTING Acute care hospitals that report HAI data to the Centers for Disease Control and Prevention’s National Healthcare Safety Network. METHODS The cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order. RESULTS Of 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal. CONCLUSION The CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal. PMID:26310913

Heterosexual anal intercourse among men in Long Beach, California.

PubMed

Hess, Kristen L; Reynolds, Grace L; Fisher, Dennis G

2014-01-01

Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.

Gender differences in heterosexual anal sex practices among women and men in substance abuse treatment.

PubMed

Calsyn, Donald A; Hatch-Maillette, Mary A; Meade, Christina S; Tross, Susan; Campbell, Aimee N C; Beadnell, Blair

2013-09-01

Heterosexual anal intercourse (HAI) is an understudied risk behavior among women and men in substance abuse treatment. Rates of HAI for women (n = 441) and men (n = 539) were identified for any, main and casual partners. More men (32.8 %) than women (27.1 %) reported engaging in HAI in the previous 90 days. These rates are higher than those reported for both men (6.0-15.9 %) and women (3.5-13.0 %) ages 25-59 in the National Survey of Sexual Health and Behavior. Men were significantly more likely to report HAI with their casual partners (34.1 %) than women (16.7 %). In a logistic regression model generated to identify associations between HAI and variables previously shown to be related to high risk sexual behavior, being younger, bisexual, and White were significantly associated with HAI. For men, having more sex partners was also a significant correlate. HAI is a logical target for increased focus in HIV prevention interventions.

Healthcare Associated Infections in a Resource Limited Setting

PubMed Central

Doradla, Saikumar; Belgode, Harish Narasimha; Kumar, Harichandra; Swaminathan, Rathinam Palamalai

2017-01-01

Introduction Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. Aim To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. Materials and Methods This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). Patients aged 13 years or more with stay of more than 48 hours in a 16 bedded Medical Intensive Care Unit (MICU) between November 2011 and April 2013 were included in the study. Patients were prospectively followed up till discharge or death for the development of HAI. Device associated HAI like Ventilator Associated Pneumonia (VAP), Catheter Related-Blood Stream Infection (CR-BSI) and Catheter Associated-Urinary Tract Infections (CA-UTI) were studied. Standard laboratory methods were used for identification of microorganisms causing HAI and to test their antibiotic sensitivity. Results A total of 346 patients were included in the study with median age of 38 years. Common indications for admission to Medical Intensive Care Unit (MICU) were poisoning (31.5%); neurological illness (23.4%) like Guillian-Barre syndrome, tetanus, meningitis, encephalitis; respiratory illness (14.5%) like pneumonia, acute respiratory distress syndrome and tropical infections (7.2%) like malaria, scrub typhus, leptospirosis. Fifty percent (174/346) patients developed one or more HAI with VAP being the most common. The rates of HAI per 1000 device days for VAP, CR-BSI, CA-UTI were 72.56, 3.98 and 12.4, respectively. Acinetobacter baumannii was the most common organism associated with HAI. Multidrug resistance was seen in 74% of the isolates. Conclusion The burden of HAI, especially with MDR organisms, in resource constrained setting like ours is alarming. There

Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review

PubMed Central

van Mourik, Maaike S M; van Duijn, Pleun Joppe; Moons, Karel G M; Bonten, Marc J M; Lee, Grace M

2015-01-01

Objective Measuring the incidence of healthcare-associated infections (HAI) is of increasing importance in current healthcare delivery systems. Administrative data algorithms, including (combinations of) diagnosis codes, are commonly used to determine the occurrence of HAI, either to support within-hospital surveillance programmes or as free-standing quality indicators. We conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. Methods Systematic search of Medline, Embase, CINAHL and Cochrane for relevant studies (1995–2013). Methodological quality assessment was performed using QUADAS-2 criteria; diagnostic accuracy estimates were stratified by HAI type and key study characteristics. Results 57 studies were included, the majority aiming to detect surgical site or bloodstream infections. Study designs were very diverse regarding the specification of their administrative data algorithm (code selections, follow-up) and definitions of HAI presence. One-third of studies had important methodological limitations including differential or incomplete HAI ascertainment or lack of blinding of assessors. Observed sensitivity and positive predictive values of administrative data algorithms for HAI detection were very heterogeneous and generally modest at best, both for within-hospital algorithms and for formal quality indicators; accuracy was particularly poor for the identification of device-associated HAI such as central line associated bloodstream infections. The large heterogeneity in study designs across the included studies precluded formal calculation of summary diagnostic accuracy estimates in most instances. Conclusions Administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended. If hospitals and policymakers choose to rely on administrative data for HAI surveillance, continued

Prevalence of Healthcare-Associated Infections and Antimicrobial Use Among Adult Inpatients in Singapore Acute-Care Hospitals: Results From the First National Point Prevalence Survey.

PubMed

Cai, Yiying; Venkatachalam, Indumathi; Tee, Nancy W; Tan, Thean Yen; Kurup, Asok; Wong, Sin Yew; Low, Chian Yong; Wang, Yang; Lee, Winnie; Liew, Yi Xin; Ang, Brenda; Lye, David C; Chow, Angela; Ling, Moi Lin; Oh, Helen M; Cuvin, Cassandra A; Ooi, Say Tat; Pada, Surinder K; Lim, Chong Hee; Tan, Jack Wei Chieh; Chew, Kean Lee; Nguyen, Van Hai; Fisher, Dale A; Goossens, Herman; Kwa, Andrea L; Tambyah, Paul A; Hsu, Li Yang; Marimuthu, Kalisvar

2017-05-15

We conducted a national point prevalence survey (PPS) to determine the prevalence of healthcare-associated infections (HAIs) and antimicrobial use (AMU) in Singapore acute-care hospitals. Trained personnel collected HAI, AMU, and baseline hospital- and patient-level data of adult inpatients from 13 private and public acute-care hospitals between July 2015 and February 2016, using the PPS methodology developed by the European Centre for Disease Prevention and Control. Factors independently associated with HAIs were determined using multivariable regression. Of the 5415 patients surveyed, there were 646 patients (11.9%; 95% confidence interval [CI], 11.1%-12.8%) with 727 distinct HAIs, of which 331 (45.5%) were culture positive. The most common HAIs were unspecified clinical sepsis (25.5%) and pneumonia (24.8%). Staphylococcus aureus (12.9%) and Pseudomonas aeruginosa (11.5%) were the most common pathogens implicated in HAIs. Carbapenem nonsusceptibility rates were highest in Acinetobacter species (71.9%) and P. aeruginosa (23.6%). Male sex, increasing age, surgery during current hospitalization, and presence of central venous or urinary catheters were independently associated with HAIs. A total of 2762 (51.0%; 95% CI, 49.7%-52.3%) patients were on 3611 systemic antimicrobial agents; 462 (12.8%) were prescribed for surgical prophylaxis and 2997 (83.0%) were prescribed for treatment. Amoxicillin/clavulanate was the most frequently prescribed (24.6%) antimicrobial agent. This survey suggested a high prevalence of HAIs and AMU in Singapore's acute-care hospitals. While further research is necessary to understand the causes and costs of HAIs and AMU in Singapore, repeated PPSs over the next decade will be useful to gauge progress at controlling HAIs and AMU. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Prospective study estimating healthcare associated infections in a paediatric hemato-oncology unit of a tertiary care hospital in North India.

PubMed

Gupta, Ayush; Kapil, Arti; Kabra, S K; Lodha, Rakesh; Sood, Seema; Dhawan, Benu; Das, Bimal K; Sreenivas, V

2013-12-01

Healthcare associated infections (HAIs) are responsible for morbidity and mortality among immunocompromised and critically ill patients. We undertook this study to estimate the burden of HAIs in the paediatric cancer patients in a tertiary care hospital in north India. This prospective, observational study, based on active surveillance for a period of 11 months was undertaken in a 4-bedded isolated, cubicle for paediatric cancer patients. Patients who stayed in the cubicle for ≥48 h, were followed prospectively for the development of HAIs. Of the 138 patients, 13 developed 14 episodes of HAIs during the study period. Patient-days calculated were 1273 days. Crude infection rate (CIR) and incidence density (ID) of all HAIs were 9.4/100 patients and 11/1000 patient-days, respectively. Of the 14 episodes of HAIs, seven (50%) were of blood stream infections (HA-BSI), five (36%) of pneumonia (HAP) and two (14%) urinary tract infections (HA-UTI). The CIRs of HA-BSI, HAP and HA-UTI were 5.1, 3.6 and 1.4/100 patients, respectively. The corresponding IDs were 5.5, 3.9 and 1.6/1000 patient-days, respectively. Mean length of stay was significantly higher in patients who developed an HAI [13.8 (range 7-30), median (Interquartile range) 12 (11-14)] vs 7.5 days [range 2-28, median (interquartile range) 7 (5-9); P<0.0001]. Also mortality was significantly higher in patients who developed an HAI [23% (3/13) vs 3% (4/125), P<0.05]. The incidence of HAIs in the paediatric cancer patients in the study was 11/1000 patient days, of which HA-BSIs were the commonest. HAIs were associated with an increase in morbidity and mortality amongst this high risk patient population.

Nursing Workload as a Risk Factor for Healthcare Associated Infections in ICU: A Prospective Study

PubMed Central

Daud-Gallotti, Renata M.; Costa, Silvia F.; Guimarães, Thais; Padilha, Katia Grillo; Inoue, Evelize Naomi; Vasconcelos, Tiago Nery; da Silva Cunha Rodrigues, Fernanda; Barbosa, Edizângela Vasconcelos; Figueiredo, Walquíria Barcelos; Levin, Anna S.

2012-01-01

Introduction Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI). This study aimed to evaluate the role of nursing workload in the occurrence of HAI, using Nursing Activities Score (NAS). Methods This prospective cohort study enrolled all patients admitted to 3 Medical ICUs and one step-down unit during 3 months (2009). Patients were followed-up until HAI, discharge or death. Information was obtained from direct daily observation of medical and nursing rounds, chart review and monitoring of laboratory system. Nursing workload was determined using NAS. Non-compliance to the nurses’ patient care plans (NPC) was identified. Demographic data, clinical severity, invasive procedures, hospital interventions, and the occurrence of other adverse events were also recorded. Patients who developed HAI were compared with those who did not. Results 195 patients were included and 43 (22%) developed HAI: 16 pneumonia, 12 urinary-tract, 8 bloodstream, 2 surgical site, 2 other respiratory infections and 3 other. Average NAS and average proportion of non compliance with NPC were significantly higher in HAI patients. They were also more likely to suffer other adverse events. Only excessive nursing workload (OR: 11.41; p: 0.019) and severity of patient’s clinical condition (OR: 1.13; p: 0.015) remained as risk factors to HAI. Conclusions Excessive nursing workload was the main risk factor for HAI, when evaluated together with other invasive devices except mechanical ventilation. To our knowledge, this study is the first to evaluate prospectively the nursing workload as a potential risk factor for HAI, using NAS. PMID:23300645

Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.

PubMed

Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D K; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

2016-04-01

Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, p<0.01). This study highlights the effect of HAI on costs for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

From the risk analysis to the development of interventions and training for the prevention and control of healthcare associated infections. The experience of G. Pini Orthopedic Institute.

PubMed

Navone, P; Conti, C; Domeniconi, G; Nobile, M

2015-01-01

Health-care associated infections (HAIs) represents a phenomenon of central importance all over Europe. Every year 4,5 millions cases are detected in European Union, with 37.000 related deaths. Surgical-site infections (SSIs) are one of the most common HAIs, that are associated with an increased length of stay, re-operation rate, intensive care admissions rate, and higher mortality rate. G. Pini Orthopedics Institute implemented in the last two years a multimodal strategy for controlling and preventing HAIs, in particular for SSIs. This paper describes the prevention's strategies adopted for prevention of HAIs, at G. Pini Orthopedic Institute. Our findings show that application of a multi modal promotion strategy was associated with an improvement in HAI prevention.

Nitrate accumulation and leaching potential reduced by coupled water and nitrogen management in the Huang-Huai-Hai Plain.

PubMed

Huang, Ping; Zhang, Jiabao; Zhu, Anning; Li, Xiaopeng; Ma, Donghao; Xin, Xiuli; Zhang, Congzhi; Wu, Shengjun; Garland, Gina; Pereira, Engil Isadora Pujol

2018-01-01

Irrigation and nitrogen (N) fertilization in excess of crop requirements are responsible for substantial nitrate accumulation in the soil profile and contamination of groundwater by nitrate leaching during intensive agricultural production. In this on-farm field trial, we compared 16 different water and N treatments on nitrate accumulation and its distribution in the soil profile (0-180cm), nitrate leaching potential, and groundwater nitrate concentration within a summer-maize (Zea mays L.) and winter-wheat (Triticum aestivum L.) rotation system in the Huang-Huai-Hai Plain over five cropping cycles (2006-2010). The results indicated that nitrate remaining in the soil profile after crop harvest and nitrate concentration of soil solutions at two depths (80cm and 180cm) declined with increasing irrigation amounts and increased greatly with increasing N application rates, especially for seasonal N application rates higher than 190kgNha -1 . During the experimental period, continuous torrential rainfall was the main cause for nitrate leaching beyond the root zone (180cm), which could pose potential risks for contamination of groundwater. Nitrate concentration of groundwater varied from 0.2 to 2.9mgL -1 , which was lower than the limit of 10mgL -1 as the maximum safe level for drinking water. In view of the balance between grain production and environmental consequences, seasonal N application rates of 190kgNha -1 and 150kgNha -1 were recommended for winter wheat and summer maize, respectively. Irrigation to the field capacity of 0-40cm and 0-60cm soil depth could be appropriate for maize and wheat, respectively. Therefore, taking grain yields, mineral N accumulation in the soil profile, nitrate leaching potential, and groundwater quality into account, coupled water and N management could provide an opportunity to promote grain production while reducing negative environmental impacts in this region. Copyright © 2017 Elsevier B.V. All rights reserved.

Health care worker perspectives of their motivation to reduce health care-associated infections.

PubMed

McClung, Laura; Obasi, Chidi; Knobloch, Mary Jo; Safdar, Nasia

2017-10-01

Health care-associated infections (HAIs) are largely preventable, but are associated with considerable health care burden. Given the significant cost of HAIs, many health care institutions have implemented bundled interventions to reduce HAIs. These complex behavioral interventions require considerable effort; however, individual behaviors and motivations crucial to successful and sustained implementation have not been adequately assessed. We evaluated health care worker motivations to reduce HAIs. This was a phenomenologic qualitative study of health care workers in different roles within a university hospital, recruited via a snowball strategy. Using constructs from the Consolidated Framework for Implementation Research model, face-to-face semi-structured interviews were used to explore perceptions of health care worker motivation to follow protocols on HAI prevention. Across all types of health care workers interviewed, patient safety and improvement in clinical outcomes were the major motivators to reducing HAIs. Other important motivators included collaborative environment that valued individual input, transparency and feedback at both organizational and individual levels, leadership involvement, and refresher trainings and workshops. We did not find policy, regulatory considerations, or financial penalties to be important motivators. Health care workers perceived patient safety and clinical outcomes as the primary motivators to reduce HAI. Leadership engagement and data-driven interventions with frequent performance feedback were also identified as important facilitators of HAI prevention. Published by Elsevier Inc.

Healthcare-associated infections in a tunisian university hospital: from analysis to action

PubMed Central

Mahjoub, Mohamed; Bouafia, Nebiha; Bannour, Waadia; Masmoudi, Tasnim; Bouriga, Rym; Hellali, Radhia; Cheikh, Asma Ben; Ezzi, Olfa; Abdeljellil, Amel Ben; Mansour, Njah

2015-01-01

Introduction Our study was conducted, in university hospital center (UHC) Farhat Hached of Sousse (city in Tunisian center-east), within healthcare-associated infections (HAI) epidemiological surveillance (ES) program, based, among others, on HAI regular prevalence surveys. Our objectives are to resituate HAI prevalence rate and to identify their risk factors (RF) in order to adjust, in our hospital, prevention programs. Methods It is a transversal descriptive study, including all patients who had been hospitalized for at least 48 hours, measuring prevalence of HAI a “given day”, with only one passage by service. Risk factors were determined using Epiinfo 6.0, by uni-varied analysis, then, logistic regression stepwise descending for the variables whose p Results The study focused on 312 patients. Infected patients prevalence was 12.5% and that of HAI was 14.5%. Infections on peripheral venous catheter (PVC) dominated (42.2%) among all HAI identified. HAI significant RF were neutropenia (p < 10−4) for intrinsic factors, and PVC for extrinsic factors (p = 0,003). Conclusion Predominance of infections on PVC should be subject of specific prevention actions, including retro-information strategy, prospective ES, professional practices evaluation and finally training and increasing awareness of health personnel with hygiene measures. Finally, development of a patient safety culture with personnel ensures best adherence to hygiene measures and HAI prevention. PMID:26113928

Pathogen exploitation of an abscisic acid- and jasmonate-inducible MAPK phosphatase and its interception by Arabidopsis immunity.

PubMed

Mine, Akira; Berens, Matthias L; Nobori, Tatsuya; Anver, Shajahan; Fukumoto, Kaori; Winkelmüller, Thomas M; Takeda, Atsushi; Becker, Dieter; Tsuda, Kenichi

2017-07-11

Phytopathogens promote virulence by, for example, exploiting signaling pathways mediated by phytohormones such as abscisic acid (ABA) and jasmonate (JA). Some plants can counteract pathogen virulence by invoking a potent form of immunity called effector-triggered immunity (ETI). Here, we report that ABA and JA mediate inactivation of the immune-associated MAP kinases (MAPKs), MPK3 and MPK6, in Arabidopsis thaliana ABA induced expression of genes encoding the protein phosphatases 2C (PP2Cs), HAI1 , HAI2 , and HAI3 through ABF/AREB transcription factors. These three HAI PP2Cs interacted with MPK3 and MPK6 and were required for ABA-mediated MPK3/MPK6 inactivation and immune suppression. The bacterial pathogen Pseudomonas syringae pv. tomato ( Pto ) DC3000 activates ABA signaling and produces a JA-mimicking phytotoxin, coronatine (COR), that promotes virulence. We found that Pto DC3000 induces HAI1 through COR-mediated activation of MYC2, a master transcription factor in JA signaling. HAI1 dephosphorylated MPK3 and MPK6 in vitro and was necessary for COR-mediated suppression of MPK3/MPK6 activation and immunity. Intriguingly, upon ETI activation, A. thaliana plants overcame the HAI1-dependent virulence of COR by blocking JA signaling. Finally, we showed conservation of induction of HAI PP2Cs by ABA and JA in other Brassicaceae species. Taken together, these results suggest that ABA and JA signaling pathways, which are hijacked by the bacterial pathogen, converge on the HAI PP2Cs that suppress activation of the immune-associated MAPKs. Also, our data unveil interception of JA-signaling activation as a host counterstrategy against the bacterial suppression of MAPKs during ETI.

Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland.

PubMed

Simon, Arne; Ammann, Roland A; Bode, Udo; Fleischhack, Gudrun; Wenchel, Hans-Martin; Schwamborn, Dorothee; Gravou, Chara; Schlegel, Paul-Gerhardt; Rutkowski, Stefan; Dannenberg, Claudia; Körholz, Dieter; Laws, Hans Jürgen; Kramer, Michael H

2008-05-23

Pediatric cancer patients face an increased risk of healthcare-associated infection (HAI). To date, no prospective multicenter studies have been published on this topic. Prospective multicenter surveillance for HAI and nosocomial fever of unknown origin (nFUO) with specific case definitions and standardized surveillance methods. 7 pediatric oncology centers (university facilities) participated from April 01, 2001 to August 31, 2005. During 54,824 days of inpatient surveillance, 727 HAIs and nFUOs were registered in 411 patients. Of these, 263 (36%) were HAIs in 181 patients, for an incidence density (ID) (number of events per 1,000 inpatient days) of 4.8 (95% CI 4.2 to 5.4; range 2.4 to 11.7; P < 0.001), and 464 (64%) were nFUO in 230 patients. Neutropenia at diagnosis correlated significantly with clinical severity of HAI. Of the 263 HAIs, 153 (58%) were bloodstream infections (BSI). Of the 138 laboratory-confirmed BSIs, 123 (89%) were associated with use of a long-term central venous catheter (CVAD), resulting in an overall ID of 2.8 per 1,000 utilization days (95% CI 2.3 to 3.3). The ID was significantly lower in Port-type than in Hickman-type CVADs. The death of 8 children was related to HAI, including six cases of aspergillosis. The attributable mortality was 3.0% without a significant association to neutropenia at time of NI diagnosis. Our study confirmed that pediatric cancer patients are at an increased risk for specific HAIs. The prospective surveillance of HAI and comparison with cumulative multicenter results are indispensable for targeted prevention of these adverse events of anticancer treatment.

Climatic effects of irrigation over the Huang-Huai-Hai Plain in China simulated by the weather research and forecasting model: Simulated Irrigation Effects in China

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

Yang, Ben; Zhang, Yaocun; Qian, Yun

In this study, we apply the Weather Research and Forecasting model coupled with an operational-like irrigation scheme to investigate the climatic effects of irrigation over the Huang-Huai-Hai plain (3HP) in China. Multiple numerical experiments with irrigation off/on during spring, summer and both spring and summer are conducted, respectively. Our results show that the warm bias in surface temperature and dry bias in soil moisture are reduced over the 3HP region during growing seasons when irrigation is turned on in the model. Air temperature during non-growing seasons is also affected by irrigation due to the persistent effects of soil moisture onmore » land-air energy exchanges and ground heat storage. Irrigation can induce a cooler planetary boundary layer (PBL) during growing seasons, causing a wetter PBL with more low-level clouds during spring but relatively dryer PBL in summer. Further analyses indicate that the dryer summer is highly related to the changes in the East Asian summer monsoon (EASM) circulation that is modified by irrigation effect. Spring irrigation may induce a decreased land-ocean thermal contrast, leading to a possible weaker EASM. Summer irrigation, however, evidently cools the atmosphere column and forces a southward shift of the upper-level jet, which results in more precipitation in Yangtze River basin but less over southern and northern China during summer.« less

Return to Activity at Altitude After High-Altitude Illness

PubMed Central

DeWeber, Kevin; Scorza, Keith

2010-01-01

Context: Sports and other activities at high altitude are popular, yet they pose the unique risk for high-altitude illness (HAI). Once those who have suffered from a HAI recover, they commonly desire or need to perform the same activity at altitude in the immediate or distant future. Evidence Acquisition: As based on key text references and peer-reviewed journal articles from a Medline search, this article reviews the pathophysiology and general treatment principles of HAI. Results: In addition to the type of HAI experienced and the current level of recovery, factors needing consideration in the return-to-play plan include physical activity requirements, flexibility of the activity schedule, and available medical equipment and facilities. Most important, adherence to prudent acclimatization protocols and gradual ascent recommendations (when above 3000 m, no more than 600-m net elevation gain per day, and 1 rest day every 1 to 2 ascent days) is powerful in its preventive value and thus strongly recommended. When these are not practical, prophylactic medications (acetazolamide, dexamethasone, salmeterol, nifedipine, or phosphodiesterase inhibitors, depending on the type of prior HAI) may be prescribed and can reduce the risk of illness. Athletes with HAI should be counseled that physical and mental performance may be adversely affected if activity at altitude continues before recovery is complete and that there is a risk of progression to a more serious HAI. Conclusion: With a thoughtful plan, most recurrent HAI in athletes can be prevented. PMID:23015950

Public health law for the collection and reporting of health care–associated infections

PubMed Central

Meier, Benjamin Mason; Stone, Patricia W.; Gebbie, Kristine M.

2015-01-01

Background State-based laws for reporting of health care-associated infections (HAI) have developed and changed dramatically in recent years, affecting the costs of reporting and impact on infection rates. It is necessary for practitioners of infection control to understand these changing legal frameworks and their application to practice. Methods Employing systematic state-based research, the researchers have documented legislation and administrative regulations for institution-specific HAI reporting, using this information to create a comprehensive resource on state-based laws for mandatory HAI reporting. Results As of August 27, 2007, 24 states have adopted laws requiring reporting of HAI rates, with an additional 7 states currently considering legislation that would require HAI reporting and 19 states employing detailed regulation in the absence of any current legislative authorization specific to HAI. This study documents (1) which states require reporting of HAI and, if so, whether this is done by legislation or administrative regulation; (2) whether the specific HAIs to be reported are identified in state law or codified generally as “diseases of public health importance,” with reporting specified by administrative regulation; and (3) what reporting policies and procedures are detailed in law. Conclusion Through analysis of the collected information, the researchers have examined the degree to which states have modernized their respective public health laws to approach mandatory reporting by way of general legislation regarding “matters of public health importance” and subsequent detailed administrative regulation to specify those matters. PMID:18926306

Public health law for the collection and reporting of health care-associated infections.

PubMed

Meier, Benjamin Mason; Stone, Patricia W; Gebbie, Kristine M

2008-10-01

State-based laws for reporting of health care-associated infections (HAI) have developed and changed dramatically in recent years, affecting the costs of reporting and impact on infection rates. It is necessary for practitioners of infection control to understand these changing legal frameworks and their application to practice. Employing systematic state-based research, the researchers have documented legislation and administrative regulations for institution-specific HAI reporting, using this information to create a comprehensive resource on state-based laws for mandatory HAI reporting. As of August 27, 2007, 24 states have adopted laws requiring reporting of HAI rates, with an additional 7 states currently considering legislation that would require HAI reporting and 19 states employing detailed regulation in the absence of any current legislative authorization specific to HAI. This study documents (1) which states require reporting of HAI and, if so, whether this is done by legislation or administrative regulation; (2) whether the specific HAIs to be reported are identified in state law or codified generally as "diseases of public health importance," with reporting specified by administrative regulation; and (3) what reporting policies and procedures are detailed in law. Through analysis of the collected information, the researchers have examined the degree to which states have modernized their respective public health laws to approach mandatory reporting by way of general legislation regarding "matters of public health importance" and subsequent detailed administrative regulation to specify those matters.

Predicting healthcare associated infections using patients' experiences

NASA Astrophysics Data System (ADS)

Pratt, Michael A.; Chu, Henry

2016-05-01

Healthcare associated infections (HAI) are a major threat to patient safety and are costly to health systems. Our goal is to predict the HAI performance of a hospital using the patients' experience responses as input. We use four classifiers, viz. random forest, naive Bayes, artificial feedforward neural networks, and the support vector machine, to perform the prediction of six types of HAI. The six types include blood stream, urinary tract, surgical site, and intestinal infections. Experiments show that the random forest and support vector machine perform well across the six types of HAI.

Using Positive Deviance in the prevention and control of MRSA infections in a Colombian hospital: a time-series analysis.

PubMed

Escobar, N M Olarte; Márquez, I A Valderrama; Quiroga, J Avila; Trujillo, T Goretty; González, F; Aguilar, M I Garzón; Escobar-Pérez, J

2017-04-01

Positive Deviance (PD) is a process to achieve a social and cultural change. This strategy has been used for the control of methicillin-resistant Staphylococcus aureus (MRSA) infection in some health institutions in the United States, but has rarely been adopted in institutions from developing countries where resources are limited. We describe our experience of PD in the control of healthcare-associated infections (HAIs) due to MRSA in a Colombian hospital with the aim of reducing HAI rates through a cultural change in processes. A time-series study was conducted based on the MRSA-HAI rate and the number of months with zero MRSA infections before and after application of PD (2001-2012). On comparing the pre-intervention and intervention periods, the mean overall rates of MRSA-HAI was 0·62 and 0·36, respectively (P = 0·0005); the number of months with zero MRSA-HAIs were 3/70 and 12/74 (odds ratio 0·264, 95% confidence interval 0·078-0·897); the percentage of MRSA-HAIs was 53·2% and 41·0%. These results are consistent with other published data. Implementation of PD was associated with a significant reduction of MRSA-HAIs, it did not involve high costs and the changes have been lasting.

3-D imaging of temporal and spatial development of Puccinia striiformis haustoria in wheat.

PubMed

Sørensen, Chris K; Justesen, Annemarie F; Hovmøller, Mogens S

2012-01-01

Differentiation of haustoria on primary infection hyphae of the fungal pathogen Puccinia striiformis was studied in wheat seedlings with two-photon microscopy in combination with a classical staining technique. Our results showed a significant increase in the average haustorium size 22, 44, 68, 92 and 116 h after inoculation (hai). After 116 hai no significant change was observed until 336 hai. Haustorium morphology also changed significantly during the time of infection. Initially small spherical haustoria were seen, but as they grew the haustoria gradually became apically branched. At 22 hai all observed haustoria were spherical, but at 44 hai most haustoria had an irregular structure, and at 92 hai all observed haustoria appeared branched. Along with the changes of the haustorial body the haustorial neck changed from narrow and slender to having an expanded appearance with a rough and invaginated structure. The structural changes were similar in two susceptible wheat varieties, 514W and Cartago, although the mean haustorium size was larger in 514W than in Cartago at all intervals.

Health anxiety and depression in patients with fibromyalgia syndrome.

PubMed

Uçar, Mehmet; Sarp, Ümit; Karaaslan, Özgül; Gül, Ali Irfan; Tanik, Nermin; Arik, Hasan Onur

2015-10-01

To investigate health anxiety and depressive symptoms in patients with fibromyalgia syndrome (FMS). Patients with FMS and healthy control subjects were recruited. All participants completed the Health Anxiety Inventory Short Form (HAI-SF) and Beck Depression Inventory (BDI). Pain was assessed in patients with FMS using the Fibromyalgia Impact Questionnaire (FIQ) and Visual Analogue Scale (VAS). This study involved 95 patients with FMS (15 male) and 95 healthy controls (17 male). Mean ± SD HAI-SF and BDI scores were significantly higher in patients with FMS = than in controls=. HAI-SF scores were 23.50 ± 10.78 and 9.38 ± 4.24 respectively; BDI scores were 18.64 ± 10.11 and 6.21 ± 4.05 respectively. There were highly significant correlations between FIQ and HAI-SF, FIQ and BDI, and HAI-SF and BDI. Patients with FMS had significantly higher HAI-SF and BDI scores than healthy controls. Psychiatric support is essential for patients with FMS. Treatment should include biological, psychological and social approaches. © The Author(s) 2015.

Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study

PubMed Central

Eckmanns, Tim; Abu Sin, Muna; Ducomble, Tanja; Harder, Thomas; Sixtensson, Madlen; Velasco, Edward; Weiß, Bettina; Kramarz, Piotr; Monnet, Dominique L.; Kretzschmar, Mirjam E.; Suetens, Carl

2016-01-01

Background Estimating the burden of healthcare-associated infections (HAIs) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of Communicable Diseases in Europe (BCoDE) project and 2011–2012 data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals, we estimated the burden of six common HAIs. Methods and Findings The included HAIs were healthcare-associated pneumonia (HAP), healthcare-associated urinary tract infection (HA UTI), surgical site infection (SSI), healthcare-associated Clostridium difficile infection (HA CDI), healthcare-associated neonatal sepsis, and healthcare-associated primary bloodstream infection (HA primary BSI). The burden of these HAIs was measured in disability-adjusted life years (DALYs). Evidence relating to the disease progression pathway of each type of HAI was collected through systematic literature reviews, in order to estimate the risks attributable to HAIs. For each of the six HAIs, gender and age group prevalence from the ECDC PPS was converted into incidence rates by applying the Rhame and Sudderth formula. We adjusted for reduced life expectancy within the hospital population using three severity groups based on McCabe score data from the ECDC PPS. We estimated that 2,609,911 new cases of HAI occur every year in the European Union and European Economic Area (EU/EEA). The cumulative burden of the six HAIs was estimated at 501 DALYs per 100,000 general population each year in EU/EEA. HAP and HA primary BSI were associated with the highest burden and represented more than 60% of the total burden, with 169 and 145 DALYs per 100,000 total population, respectively. HA UTI, SSI, HA CDI, and HA primary BSI ranked as the third to sixth syndromes in terms of burden of disease

The effectiveness of UV-C radiation for facility-wide environmental disinfection to reduce health care-acquired infections.

PubMed

Napolitano, Nathanael A; Mahapatra, Tanmay; Tang, Weiming

2015-12-01

Health care-acquired infections (HAIs) constitute an increasing threat for patients worldwide. Potential contributors of HAIs include environmental surfaces in health care settings, where ultraviolet-C radiation (UV-C) is commonly used for disinfection. This UV-C intervention-based pilot study was conducted in a hospital setting to identify any change in the incidence of HAIs before and after UV-C intervention, and to determine the effectiveness of UV-C in reducing pathogens. In a hospital in Culver City, CA, during 2012-2013, bactericidal doses of UV-C radiation (254 nm) were delivered through a UV-C-based mobile environmental decontamination unit. The UV-C dosing technology and expertise of the specifically trained personnel were provided together as a dedicated service model by a contracted company. The incidence of HAIs before and after the intervention period were determined and compared. The dedicated service model dramatically reduced HAIs (incidence difference, 1.3/1000 patient-days, a 34.2% reduction). Reductions in the total number and incidence proportions (28.8%) of HAIs were observed after increasing and maintaining the coverage of UV-C treatments. The dedicated service model was found to be effective in decreasing the incidence of HAIs, which could reduce disease morbidity and mortality in hospitalized patients. This model provides a continuously monitored and frequently UV-C-treated patient environment. This approach to UV-C disinfection was associated with a decreased incidence of HAIs. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.

PubMed

Umscheid, Craig A; Mitchell, Matthew D; Doshi, Jalpa A; Agarwal, Rajender; Williams, Kendal; Brennan, Patrick J

2011-02-01

To estimate the proportion of healthcare-associated infections (HAIs) in US hospitals that are "reasonably preventable," along with their related mortality and costs. To estimate preventability of catheter-associated bloodstream infections (CABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), and ventilator-associated pneumonia (VAP), we used a federally sponsored systematic review of interventions to reduce HAIs. Ranges of preventability included the lowest and highest risk reductions reported by US studies of "moderate" to "good" quality published in the last 10 years. We used the most recently published national data to determine the annual incidence of HAIs and associated mortality. To estimate incremental cost of HAIs, we performed a systematic review, which included costs from studies in general US patient populations. To calculate ranges for the annual number of preventable infections and deaths and annual costs, we multiplied our infection, mortality, and cost figures with our ranges of preventability for each HAI. As many as 65%-70% of cases of CABSI and CAUTI and 55% of cases of VAP and SSI may be preventable with current evidence-based strategies. CAUTI may be the most preventable HAI. CABSI has the highest number of preventable deaths, followed by VAP. CABSI also has the highest cost impact; costs due to preventable cases of VAP, CAUTI, and SSI are likely less. Our findings suggest that 100% prevention of HAIs may not be attainable with current evidence-based prevention strategies; however, comprehensive implementation of such strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars.

Surveillance of healthcare-associated infections in Piemonte, Italy: results from a second regional prevalence study

PubMed Central

2014-01-01

Background A prevalence survey of healthcare-associated infections (HAIs) was previously performed in the Piemonte region in 2000. In the decade following the survey, many studies were performed at both the regional and hospital levels, and training courses were developed to address issues highlighted by the survey. In 2010, a second regional prevalence study was performed. The aim of this paper is to present the results of the second prevalence study and discuss them within the context of the HAI prevention and control programmes that have been implemented in the decade since the original survey was conducted. Methods The study involved all public hospitals in the Piemonte region. Uni- and multivariate analyses were performed to assess the main risk factors associated with HAIs, including both overall and site-specific infections. Results A total of 7841 patients were enrolled: 6.8% were affected by at least one HAI. The highest prevalence of HAIs was found in intensive care units (18.0%, 95% CI 14.0-22.6), while UTIs presented the highest relative frequency (26.7%), followed by respiratory tract infections (21.9%). The age of the patient, hospital size and urinary and central venous catheter status were significantly associated with HAIs. Conclusions The study results showed an increase in HAI prevalence, despite prevention and control efforts, as well as training implemented after the first regional survey. Nevertheless, these data are consistent with the current literature. Furthermore, despite its limits, the prevalence approach remains an important means for involving healthcare workers, emphasising HAIs and revealing critical problems that need be addressed. PMID:24899239

The national response for preventing healthcare-associated infections: research and adoption of prevention practices.

PubMed

Kahn, Katherine L; Mendel, Peter; Leuschner, Kristin J; Hiatt, Liisa; Gall, Elizabeth M; Siegel, Sari; Weinberg, Daniel A

2014-02-01

Healthcare-associated infections (HAIs) have long been the subject of research and prevention practice. When findings show potential to significantly impact outcomes, clinicians, policymakers, safety experts, and stakeholders seek to bridge the gap between research and practice by identifying mechanisms and assigning responsibility for translating research to practice. This paper describes progress and challenges in HAI research and prevention practices, as explained through an examination of Health and Human Services (HHS) Action Plan's goals, inputs, and implementation in each area. We used the Context-Input-Process-Product evaluation model, together with an HAI prevention system framework, to assess the transformative processes associated with HAI research and adoption of prevention practices. Since the introduction of the Action Plan, HHS has made substantial progress in prioritizing research projects, translating findings from those projects into practice, and designing and implementing research projects in multisite practice settings. Research has emphasized the basic science and epidemiology of HAIs, the identification of gaps in research, and implementation science. The basic, epidemiological, and implementation science communities have joined forces to better define mechanisms and responsibilities for translating HAI research into practice. Challenges include the ongoing need for better evidence about intervention effectiveness, the growing implementation burden on healthcare providers and organizations, and challenges implementing certain practices. Although these HAI research and prevention practice activities are complex spanning multiple system functions and properties, HHS is making progress so that the right methods for addressing complex HAI problems at the interface of patient safety and clinical practice can emerge.

Healthcare associated infections in neonatal intensive care unit and its correlation with environmental surveillance.

PubMed

Kumar, Sanjay; Shankar, Binoy; Arya, Sugandha; Deb, Manorma; Chellani, Harish

Healthcare-associated infections (HAI) are frequent complications in neonatal intensive care units (NICU) with varying risk factors and bacteriological profile. There is paucity of literature comparing the bacteriological profile of organisms causing HAI with the environmental surveillance isolates. Therefore, this study aimed to evaluate demographic profile, risk factors and outcome of HAI in NICU and correlate with environmental surveillance. Three hundred newborns with signs and symptoms of sepsis were enrolled in the study group and their profile, risk factors and outcome were compared with the control group. Univariate analysis and multivariable logistic regression were performed. Environmental surveillance results were compared to the bacteriological profile of HAIs. We identified lower gestational age, male gender and apgar score less than 7 at 5min, use of peripheral vascular catheter & ventilator along with their duration as significant risk factors. Mortality rate was 29% in the study group (p<0.05). The HAI site distribution showed blood-stream infections (73%) to be the most common followed by pneumonia (12%) and meningitis (10%). Gram positive cocci were the most common isolates in HAI as well as environmental surveillance. The bacteriological profile of HAI correlates with the environmental surveillance report thus insisting for periodic surveillance and thereby avoiding irrational antibiotic usage. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries.

PubMed

Alp, Emine; Damani, Nizam

2015-10-29

Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

Implementation in the midst of complexity: Using ethnography to study health care-associated infection prevention and control.

PubMed

Knobloch, Mary Jo; Thomas, Kevin V; Patterson, Erin; Zimbric, Michele L; Musuuza, Jackson; Safdar, Nasia

2017-10-01

Contextual factors associated with health care settings make reducing health care-associated infections (HAIs) a complex task. The aim of this article is to highlight how ethnography can assist in understanding contextual factors that support or hinder the implementation of evidence-based practices for reducing HAIs. We conducted a review of ethnographic studies specifically related to HAI prevention and control in the last 5 years (2012-2017). Twelve studies specific to HAIs and ethnographic methods were found. Researchers used various methods with video-reflexive sessions used in 6 of the 12 studies. Ethnography was used to understand variation in data reporting, identify barriers to adherence, explore patient perceptions of isolation practices and highlight the influence of physical design on infection prevention practices. The term ethnography was used to describe varied research methods. Most studies were conducted outside the United States, and authors indicate insights gained using ethnographic methods (whether observations, interviews, or reflexive video recording) as beneficial to unraveling the complexities of HAI prevention. Ethnography is well-suited for HAI prevention, especially video-reflexive ethnography, for activating patients and clinicians in infection control work. In this era of increasing pressure to reduce HAIs within complex work systems, ethnographic methods can promote understanding of contextual factors and may expedite translation evidence to practice. Published by Elsevier Inc.

Basic research supported developments of chemotherapy in nonresectable isolated colorectal liver metastases to a protocol of hepatic artery infusion using mitoxantrone, 5-FU + folinic acid and mitomycin C.

PubMed

Link, K H; Kornmann, M; Leder, G; Pillasch, A F; Sunelaitis, E; Schatz, M; Pressmar, J; Beger, H G

1999-02-01

Since the developments in systemic chemotherapy of metastasized colorectal cancer have not resulted in substantial gains in survival times, we wished to improve the course of isolated nonresectable colorectal liver metastases (CPLM) by hepatic arterial infusion treatment. Patients (pts) with CRLM have a worse fate than those pts whose liver metastases could be resected. Systemic (i.v.) chemotherapy for CRLM/colorectal metastases does not improve survival to a relevant level (median survival time (med. surv.) after 5-Fluorouracil + Folinic Acid (5-FU + FA) i.v.: 6.4-14.3 months (m)). Hepatic artery infusion (HAI) with 5-Fluorode-oxyuridine (5-FUDR) has been demonstrated in a metaanalysis of randomized trials to be superior to i.v. treatment/palliative care (med. surv.: 15 vs. 10 m). The benefit of HAI with 5-FUDR, although recommended as treatment for CRLM, is severely compromised by the 5-FUDR induced hepatotoxicity, leading eventually to sclerosing cholangitis (SC)/liver scirrhosis. We have stepwise developed a protocol for HAI of CRLM, which is superior to HAI with 5-FUDR, and, most evidently, to systemic chemotherapy. Between 1982-1997, 222 CR (L) M patients were treated within subsequent protocols (Table). In protocol A, 68 CRLM pts received HAI with 5-FUDR (A1: nonrandomized pts; A2: randomized pts). In protocol B (randomized pts.), 46 pts received 5-FUDR i.a. (via HAI) + i.v. In protocol C, systemic chemotherapy with 5-FU + FA was conducted in 34 pts with metastasized colorectal cancers, including CRLM. In protocol D 5-FU + FA was delivered via HAI in 25 pts with CRLM. In protocol E, based on in vitro phase II studies and the results of protocol D, Mitoxantrone and Mitomycin C were added to 5-FU + FA (MFFM). Fifty (50) CRLM pts received HAI with MFFM. The response rates, med. surv. times, systemic toxicity and SC rates are shown in the table. HAI with MFFM produced objective responses in 66%, the med. surv. was 27.4 m, and no SC occurred. The ports surgically

Definition of healthcare-associated influenza: A review and results from an international survey.

PubMed

Munier-Marion, Elodie; Bénet, Thomas; Vanhems, Philippe

2017-09-01

To describe definitions of healthcare-associated influenza (HAI) in recent literature and in hospitals participating in a survey of Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN) members. A review with PubMed search was undertaken to retrieve articles published between 2008 and 2016, focusing on the subject headings "influenza, human" and "cross infection." Definitions of clinical influenza-like illness (ILI) and HAI were identified. An invitation to participate in the survey was sent to 218 SRN members via email. Of 75 articles on HAI included in the review, 30 presented a standardized definition of clinical ILI based on fever (100%), cough (80%), and sore throat (70%). Forty studies (53%) contained a standardized HAI definition, grounded on threshold delay from admission in 29 of them, this delay ranging from 48 to 196 hour (median: 72 hour). Fifty-five SRN members responded to the survey, with a standardized definition of HAI adopted by 76% of them. This definition was based on clinical features for 24%, virological features for 31%, and both for 45%. Fever (mean threshold: 38.0°C) was part of the definition for 82%. The features required most frequently in the clinical definition were cough (46%) and sore throat (26%). Median threshold delay between admission and symptoms onset adopted for HAI definition was 48 hour (range: 24-96 hour). This work underlined the heterogeneity of HAI definitions in different countries. A standardized definition would be helpful to evaluate HAI spread, outcomes in patients and healthcare systems, and the impact of prevention measures, including vaccination. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014.

PubMed

Weiner, Lindsey M; Webb, Amy K; Limbago, Brandi; Dudeck, Margaret A; Patel, Jean; Kallen, Alexander J; Edwards, Jonathan R; Sievert, Dawn M

2016-11-01

OBJECTIVE To describe antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred in 2011-2014 and were reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS Data from central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonias, and surgical site infections were analyzed. These HAIs were reported from acute care hospitals, long-term acute care hospitals, and inpatient rehabilitation facilities. Pooled mean proportions of pathogens that tested resistant (or nonsusceptible) to selected antimicrobials were calculated by year and HAI type. RESULTS Overall, 4,515 hospitals reported that at least 1 HAI occurred in 2011-2014. There were 408,151 pathogens from 365,490 HAIs reported to the National Healthcare Safety Network, most of which were reported from acute care hospitals with greater than 200 beds. Fifteen pathogen groups accounted for 87% of reported pathogens; the most common included Escherichia coli (15%), Staphylococcus aureus (12%), Klebsiella species (8%), and coagulase-negative staphylococci (8%). In general, the proportion of isolates with common resistance phenotypes was higher among device-associated HAIs compared with surgical site infections. Although the percent resistance for most phenotypes was similar to earlier reports, an increase in the magnitude of the resistance percentages among E. coli pathogens was noted, especially related to fluoroquinolone resistance. CONCLUSION This report represents a national summary of antimicrobial resistance among select HAIs and phenotypes. The distribution of frequent pathogens and some resistance patterns appear to have changed from 2009-2010, highlighting the need for continual, careful monitoring of these data across the spectrum of HAI types. Infect Control Hosp Epidemiol 2016;1-14.

Healthcare-associated infections among pediatric oncology patients in Pakistan: risk factors and outcome.

PubMed

Siddiqui, Naveed-ur-Rehman; Wali, Rabia; Haque, Anwar-ul; Fadoo, Zehra

2012-05-14

Pediatric oncology patients are at increased risk of contracting healthcare-associated infections (HAIs), which are responsible for increased morbidity and mortality rates as well as treatment costs.  This study aimed to identify the frequency of HAIs among pediatric oncology patients and their outcome. Pediatric oncology patients admitted between January 2009 and June 2010 in a pediatric ward at Aga Khan University Hospital, Karachi, Pakistan, who developed HAIs, were analyzed. A total of 90 HAIs were identified in 32 patients in 70 admissions. The HAI rate among pediatric oncology patients was 3.1/100 admission episodes. Bloodstream infections (63 episodes, 90.0%) were the most common, followed by urinary tract infection (two episodes, 2.9%). Gram-positive infections were seen in 54 (60%) patients, followed by Gram-negative infection in 34 (37.8%), and fungi in 2 (2.8%) cases. Coagulase negative staphylococci was the most common Gram-positive and Escherichia coli and Pseudomonas aeruginosa were most common Gram-negative infections. Mortality rate among pediatric oncology patients who developed HAIs was 12.5% (4/32). Total parental nutrition use and length of stay longer than 30 days were the identified risk factors associated with increased mortality among pediatric oncology patients who developed HAIs. We report an HAI rate among pediatric oncology patients of 3.1/100 admission episodes with a mortality rate of 12.5% in Pakistan. Further studies should be done, especially in the developing world, to identify the risk factors associated with increased mortality among pediatric oncology patients so that adequate measures can be taken to reduce the mortality among these patients.

Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

PubMed Central

Cesarelli, Mario; Montuori, Paolo; Santillo, Liberatina Carmela; Triassi, Maria

2017-01-01

Abstract Rationale, aims, and objectives Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare‐associated infections (HAIs), a critical quality parameter in the healthcare sector. Methods Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016. Following the LSS define, measure, analyse, improve, and control cycle, the factors influencing the risk of HAI were identified by using typical LSS tools (statistical analyses, brainstorming sessions, and cause‐effect diagrams). Finally, corrective measures to prevent HAIs were implemented and monitored for 1 year after implementation. Results Lean Six Sigma proved to be a useful tool for identifying variables affecting the risk of HAIs and implementing corrective actions to improve the performance of the care process. A reduction in the number of patients colonized by sentinel bacteria was achieved after the improvement phase. Conclusions The implementation of an LSS approach could significantly decrease the percentage of patients with HAIs. PMID:29098756

Impact of thermal time shift on wheat phenology and yield under warming climate in the Huang-Huai-Hai Plain, China

NASA Astrophysics Data System (ADS)

Xiao, Dengpan; Qi, Yongqing; Li, Zhiqiang; Wang, Rende; Moiwo, Juana P.; Liu, Fengshan

2017-03-01

Given climate change can potentially influence crop phenology and subsequent yield, an investigation of relevant adaptation measures could increase the understanding and mitigation of these responses in the future. In this study, field observations at 10 stations in the Huang-Huai-Hai Plain of China (HHHP) are used in combination with the Agricultural Production Systems Simulator (APSIM)-Wheat model to determine the effect of thermal time shift on the phenology and potential yield of wheat from 1981-2009. Warming climate speeds up winter wheat development and thereby decreases the duration of the wheat growth period. However, APSIM-Wheat model simulation suggests prolongation of the period from flowering to maturity (Gr) of winter wheat by 0.2-0.8 d•10yr-1 as the number of days by which maturity advances, which is less than that by which flowering advances. Based on computed thermal time of the two critical growth phases of wheat, total thermal time from floral initiation to flowering (TT_floral_initiation) increasesd in seven out of the 10 investigated stations. Alternatively, total thermal time from the start of grainfilling to maturity (TT_start_ grain_fill) increased in all investigated stations, except Laiyang. It is thus concluded that thermal time shift during the past three decades (1981-2009) prolongs Gr by 0.2-3.0 d•10yr-1 in the study area. This suggests that an increase in thermal time (TT) of the wheat growth period is critical for mitigating the effect of growth period reduction due to warming climatic condition. Furthermore, climate change reduces potential yield of winter wheat in 80% of the stations by 2.3-58.8 kg•yr-1. However, thermal time shift (TTS) increases potential yield of winter wheat in most of the stations by 3.0-51.0 kg•yr-1. It is concluded that wheat cultivars with longer growth periods and higher thermal requirements could mitigate the negative effects of warming climate on crop production in the study area.

Hai Long | NREL

Science.gov Websites

research interests are broadly in computational modeling for renewable energy generation and energy ions transport in fuel cell and bioenergetics enzymes, and functional membrane structure modeling and University Featured Publications Hydroxide Degradation Pathways for Imidazolium Cations: A DFT Study, J. Phys

Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the investment?

PubMed

Raschka, Stefanie; Dempster, Linda; Bryce, Elizabeth

2013-09-01

The effect of regional consolidation of an infection prevention and control (IPC) program on reduction of selected health care-acquired infections (HAIs), the economic burden of these illnesses, and where the potential for greatest financial benefit in reducing infection rates lies was assessed. Cost-benefit analysis (in Canadian $) was used to evaluate the effectiveness of a regional IPC program in preventing incident cases of HAIs. The costs of managing these infections, as well as the operational costs of the IPC program were compared against reductions in HAI rates over a 4-year period. Benefits were calculated as cost avoided by reducing HAI cases year over year. The Health Authority spent more than $66.3 million managing 24,937 HAI cases over the 4-year evaluation period. Urinary tract infections, methicillin-resistant Staphylococcus aureus, and bacteremias incurred the greatest costs. A reduction of 4,739 HAI cases led to avoided costs of $9.1 million in 4 years; the IPC program budget was $6.7 million during this period. Regionalization of the IPC program with standardized policies, procedures, and initiatives led to a 19% reduction in selected HAIs over 4 years and a cost avoidance of at least $9 million. This was particularly evident in years 3 and 4 of the program when $7.2 million (79% of the total) savings were realized. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Epidemiology and economic impact of health care-associated infections and cost-effectiveness of infection control measures at a Thai university hospital.

PubMed

Rattanaumpawan, Pinyo; Thamlikitkul, Visanu

2017-02-01

Data on clinical and economic impact of health care-associated infections (HAIs) from resource limited countries are limited. We aimed to determine epidemiology and economic impact of HAIs and cost-effectiveness of infection prevention and control measures in a resource-limited setting. A retrospective cohort study was conducted among hospitalized patients at Siriraj Hospital, Thailand. Results from the cohort were subsequently used to conduct cost-effective analysis (CEA) to compare the comprehensive implementation of individualized bundling infection control measures (IBICMs) with regular infection control care. From February-May 2013, there were 515 hospitalizations (497 patients) with 7,848 hospitalization days. Cumulative incidence of HAIs was 23.30%, and the incidence rate of HAIs was 18.66 ± 44.19 per 1,000 hospitalization days. Hospital mortality among those with and without HAIs was 33.33% and 20.00%, respectively (P < .001). The adjusted cost attributable to HAIs was $704.72 ± $226.73 (P < .001). CEA identified IBICMs as a non-dominated strategy, with an incremental cost-effectiveness ratio of -$20,444.62 per life saved. HAI is significantly related with higher hospital mortality, longer length of stay, and higher hospitalization costs. IBICMs were confirmed to be cost-effective at Siriraj Hospital. Implementing this intervention could improve care quality and save costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Antibody responses to natural influenza A/H1N1/09 disease or following immunization with adjuvanted vaccines, in immunocompetent and immunocompromised children.

PubMed

Meier, Sara; Bel, Michael; L'huillier, Arnaud; Crisinel, Pierre-Alex; Combescure, Christophe; Kaiser, Laurent; Grillet, Stéphane; Pósfay-Barbe, Klara; Siegrist, Claire-Anne

2011-04-27

To compare antibody responses elicited by influenza A/H1N1/09 disease and immunization with adjuvanted vaccines, in immunocompetent or immunocompromised children. Prospective parallel cohort field study enrolling children with confirmed influenza A/H1N1/09 disease or immunized with 1 (immunocompetent) or 2 (immunocompromised) doses of influenza A/H1N1/09 squalene-based AS03- or MF59-adjuvanted vaccines. Antibody geometric mean titers (GMT) were measured by hemagglutination inhibition (HAI) and microneutralization (MN) assays 4-6 weeks after vaccination/disease. Vaccine adverse events were self-recorded in a 7-day diary. Antibody titers were as high in 48 immunocompetent children after a single immunization (HAI and MN seroprotection rates: 98%; HAI-GMT: 395, MN-GMT: 370) as in 51 convalescent children (seroprotection rates: 98% (HAI) and 92% (MN); GMT: 350 (HAI) and 212 (MN). Twenty-seven immunocompromised children reached slightly lower seroprotection rates (HAI: 89%, MN: 85%) but similar antibody titers (HAI-GMT: 306, MN-GMT: 225) after 2 immunizations. Adverse events increased with age (P=0.01) and were more frequent with Pandemrix® than Focetria® (P=0.03). Similarly high seroresponses may be expected in immunocompetent children after a single dose of adjuvanted vaccines as responses of convalescent children. Two vaccine doses were sufficient for most immunocompromised children. NCT0102293 and NCT01022905. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin

PubMed Central

Beetz, Andrea; Uvnäs-Moberg, Kerstin; Julius, Henri; Kotrschal, Kurt

2012-01-01

During the last decade it has become more widely accepted that pet ownership and animal assistance in therapy and education may have a multitude of positive effects on humans. Here, we review the evidence from 69 original studies on human-animal interactions (HAI) which met our inclusion criteria with regard to sample size, peer-review, and standard scientific research design. Among the well-documented effects of HAI in humans of different ages, with and without special medical, or mental health conditions are benefits for: social attention, social behavior, interpersonal interactions, and mood; stress-related parameters such as cortisol, heart rate, and blood pressure; self-reported fear and anxiety; and mental and physical health, especially cardiovascular diseases. Limited evidence exists for positive effects of HAI on: reduction of stress-related parameters such as epinephrine and norepinephrine; improvement of immune system functioning and pain management; increased trustworthiness of and trust toward other persons; reduced aggression; enhanced empathy and improved learning. We propose that the activation of the oxytocin system plays a key role in the majority of these reported psychological and psychophysiological effects of HAI. Oxytocin and HAI effects largely overlap, as documented by research in both, humans and animals, and first studies found that HAI affects the oxytocin system. As a common underlying mechanism, the activation of the oxytocin system does not only provide an explanation, but also allows an integrative view of the different effects of HAI. PMID:22866043

Comparison of the safety and immunogenicity of live attenuated and inactivated hepatitis A vaccine in healthy Chinese children aged 18 months to 16 years: results from a randomized, parallel controlled, phase IV study.

PubMed

Ma, F; Yang, J; Kang, G; Sun, Q; Lu, P; Zhao, Y; Wang, Z; Luo, J; Wang, Z

2016-09-01

For large-scale immunization of children with hepatitis A (HA) vaccines in China, accurately designed studies comparing the safety and immunogenicity of the live attenuated HA vaccine (HA-L) and inactivated HA vaccine (HA-I) are necessary. A randomized, parallel controlled, phase IV clinical trial was conducted with 6000 healthy children aged 18 months to 16 years. HA-L or HA-I was administered at a ratio of 1: 1 to randomized selected participants. The safety and immunogenicity were evaluated. Both HA-L and HA-I were well tolerated by all participants. The immunogenicity results showed that the seroconversion rates (HA-L versus HA-I: 98.0% versus 100%, respectively, p >0.05), and geometric mean concentrations in participants negative for antibodies against HA virus IgG (anti-HAV IgG) before vaccination did not differ significantly between the two types of vaccines (HA-L versus HA-I first dose: 898.9 versus 886.2 mIU/mL, respectively, p >0.05). After administration of the booster dose of HA-I, the geometric mean concentrations of anti-HAV IgG (HA-I booster dose: 2591.2 mIU/mL) was higher than that after the first dose (p <0.05) and that reported in participants administered HA-L (p <0.05). Additionally, 12 (25%) of the 48 randomized selected participants who received HA-L tested positive for HA antigen in stool samples. Hence, both HA-L and HA-I could provide acceptable immunogenicity in children. The effects of long-term immunogenicity after natural exposure to wild-type HA virus and the possibility of mutational shifts of the live vaccine virus in the field need to be studied in more detail. Copyright © 2016. Published by Elsevier Ltd.

Introduction of software tools for epidemiological surveillance in infection control in Colombia.

PubMed

Hernández-Gómez, Cristhian; Motoa, Gabriel; Vallejo, Marta; Blanco, Víctor M; Correa, Adriana; de la Cadena, Elsa; Villegas, María Virginia

2015-01-01

Healthcare-Associated Infections (HAI) are a challenge for patient safety in the hospitals. Infection control committees (ICC) should follow CDC definitions when monitoring HAI. The handmade method of epidemiological surveillance (ES) may affect the sensitivity and specificity of the monitoring system, while electronic surveillance can improve the performance, quality and traceability of recorded information. To assess the implementation of a strategy for electronic surveillance of HAI, Bacterial Resistance and Antimicrobial Consumption by the ICC of 23 high-complexity clinics and hospitals in Colombia, during the period 2012-2013. An observational study evaluating the introduction of electronic tools in the ICC was performed; we evaluated the structure and operation of the ICC, the degree of incorporation of the software HAI Solutions and the adherence to record the required information. Thirty-eight percent of hospitals (8/23) had active surveillance strategies with standard criteria of the CDC, and 87% of institutions adhered to the module of identification of cases using the HAI Solutions software. In contrast, compliance with the diligence of the risk factors for device-associated HAIs was 33%. The introduction of ES could achieve greater adherence to a model of active surveillance, standardized and prospective, helping to improve the validity and quality of the recorded information.

Reducing the risk of healthcare-associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy).

PubMed

Improta, Giovanni; Cesarelli, Mario; Montuori, Paolo; Santillo, Liberatina Carmela; Triassi, Maria

2018-04-01

Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016. Following the LSS define, measure, analyse, improve, and control cycle, the factors influencing the risk of HAI were identified by using typical LSS tools (statistical analyses, brainstorming sessions, and cause-effect diagrams). Finally, corrective measures to prevent HAIs were implemented and monitored for 1 year after implementation. Lean Six Sigma proved to be a useful tool for identifying variables affecting the risk of HAIs and implementing corrective actions to improve the performance of the care process. A reduction in the number of patients colonized by sentinel bacteria was achieved after the improvement phase. The implementation of an LSS approach could significantly decrease the percentage of patients with HAIs. © 2017 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

Introduction of software tools for epidemiological surveillance in infection control in Colombia

PubMed Central

Motoa, Gabriel; Vallejo, Marta; Blanco, Víctor M; Correa, Adriana; de la Cadena, Elsa; Villegas, María Virginia

2015-01-01

Introduction: Healthcare-Associated Infections (HAI) are a challenge for patient safety in the hospitals. Infection control committees (ICC) should follow CDC definitions when monitoring HAI. The handmade method of epidemiological surveillance (ES) may affect the sensitivity and specificity of the monitoring system, while electronic surveillance can improve the performance, quality and traceability of recorded information. Objective: To assess the implementation of a strategy for electronic surveillance of HAI, Bacterial Resistance and Antimicrobial Consumption by the ICC of 23 high-complexity clinics and hospitals in Colombia, during the period 2012-2013. Methods: An observational study evaluating the introduction of electronic tools in the ICC was performed; we evaluated the structure and operation of the ICC, the degree of incorporation of the software HAI Solutions and the adherence to record the required information. Results: Thirty-eight percent of hospitals (8/23) had active surveillance strategies with standard criteria of the CDC, and 87% of institutions adhered to the module of identification of cases using the HAI Solutions software. In contrast, compliance with the diligence of the risk factors for device-associated HAIs was 33%. Conclusions: The introduction of ES could achieve greater adherence to a model of active surveillance, standardized and prospective, helping to improve the validity and quality of the recorded information. PMID:26309340

Keeping It Local: Dispersal Limitations of Coral Larvae to the High Latitude Coral Reefs of the Houtman Abrolhos Islands.

PubMed

Markey, Kathryn L; Abdo, Dave A; Evans, Scott N; Bosserelle, Cyprien

2016-01-01

In 2011 the first recorded bleaching event for the high latitude Houtman Abrolhos Islands (HAI) coral communities was documented. This bleaching event highlighted the question of whether a supply of 'heat tolerant' coral recruits from the tropical north would be sufficient to provide a level of resistance for these reefs to future warming events. Using Lagrangian modelling we showed that due to its regional isolation, large-scale larval input from potential tropical northern source populations to the HAI is unlikely, despite the southward flowing Leeuwin current. Successful recruitment to artificial substrates was recorded following the bleaching event. However, this was negligible (0.4 ± 0.1 recruits per tile) compared to 2013 post impact recruitment (128.8 ± 15.8 recruits per tile). Our data therefore provides preliminary evidence suggesting that the connectivity of the HAI with coral communities in the north is limited, and population maintenance and recovery is likely driven primarily by self-recruitment. Given the low thermal tolerance of the HAI coral communities, the dominance of Acropora, and the apparent reliance on self-recruitment, an increased frequency of thermally anomalous conditions at the HAI (such as experienced in 2011) has the potential to reduce the long-term stability of the HAI coral populations and species that depend upon them.

Teamwork in the NICU setting and its association with healthcare-associated infections in very low birth weight infants

PubMed Central

Profit, Jochen; Sharek, Paul J.; Kan, Peiyi; Rigdon, Joseph; Desai, Manisha; Nisbet, Courtney C.; Tawfik, Daniel S.; Thomas, Eric J.; Lee, Henry C.; Sexton, J. Bryan

2018-01-01

Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale level and item level associations with healthcare-associated infection (HAI) rates in very low birth weight (VLBW) infants. Methods Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2073 of 3294 eligible (response rate 63%) NICU health professionals. The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (OR [95% CI] 0.82 [0.73-0.92], p = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion Improving teamwork may be an important element in infection control efforts. PMID:28395366

Clinical and molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus infections among children with risk factors for health care-associated infection: 2001-2003.

PubMed

Zaoutis, Theoklis E; Toltzis, Philip; Chu, Jaclyn; Abrams, Tara; Dul, Michael; Kim, Jason; McGowan, Karin L; Coffin, Susan E

2006-04-01

Methicillin-resistant Staphylococcus aureus (MRSA) has recently emerged as a common cause of infection in children in many parts of the world. The epidemiology of community-acquired MRSA (CA-MRSA) among healthy children has been recently described. However, little is known about CA-MRSA in children with underlying medical conditions. To compare the clinical and molecular epidemiology of CA-MRSA in children with and without risk factors for health care-associated infections (RF-HAI). We conducted a 3-year retrospective cohort study of children with CA-MRSA infection. RF-HAI, including hospitalization within the past year, indwelling medical devices or chronic medical condition, were identified by chart review. Genetic relatedness of CA-MRSA strains was assessed by pulsed field gel electrophoresis. Polymerase chain reaction was used to detect Panton-Valentine leukocidin and determine staphylococcal chromosomal cassette carrying the mecA methicillin-resistant gene (SCCmec) type. We identified 446 episodes of community-acquired S. aureus infections, of which 134 (30%) were caused by MRSA. During the 3-year study period, the proportion of S. aureus infections caused by MRSA rose from 15% (12 of 80) to 40% (93 of 235) (P < 0.001) with the increase noted predominately in children with skin and soft tissue infections. RF-HAI were identified in 56 (42%) patients with CA-MRSA. Among subjects with CA-MRSA, children with RF-HAI were more likely to have had an invasive infection than healthy children (32% versus 5%; P < 0.001). CA-MRSA isolates from children with RF-HAI were similar to those without RF-HAI; all laboratory-retained CA-MRSA isolates harbored the SCCmec type IV cassette, and almost all isolates were susceptible to trimethoprim-sulfamethoxazole and clindamycin. However, pulsed field gel electrophoresis revealed greater molecular diversity among CA-MRSA isolates recovered from children with RF-HAI compared with those from otherwise healthy children (P = 0

Reduced health care-associated infections in an acute care community hospital using a combination of self-disinfecting copper-impregnated composite hard surfaces and linens.

PubMed

Sifri, Costi D; Burke, Gene H; Enfield, Kyle B

2016-12-01

The purpose of this study was to determine the effectiveness of copper-impregnated composite hard surfaces and linens in an acute care hospital to reduce health care-associated infections (HAIs). We performed a quasiexperimental study with a control group, assessing development of HAIs due to multidrug resistant organisms (MDROs) and Clostridium difficile in the acute care units of a community hospital following the replacement of a 1970s-era clinical wing with a new wing outfitted with copper-impregnated composite hard surfaces and linens. The study was conducted over a 25.5-month time period that included a 3.5-month washout period. HAI rates obtained from the copper-containing new hospital wing (14,479 patient-days; 72 beds) and the unmodified hospital wing (19,177 patient-days) were compared with those from the baseline period (46,391 patient-days). The new wing had 78% (P = .023) fewer HAIs due to MDROs or C difficile, 83% (P = .048) fewer cases of C difficile infection, and 68% (P = .252) fewer infections due to MDROs relative to the baseline period. No changes in rates of HAI were observed in the unmodified hospital wing. Copper-impregnated composite hard surfaces and linens may be useful technologies to prevent HAIs in acute care hospital settings. Additional studies are needed to determine whether reduced HAIs can be attributed to the use of copper-containing antimicrobial hard and soft surfaces. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Engaging patients in the prevention of health care-associated infections: a survey of patients' awareness, knowledge, and perceptions regarding the risks and consequences of infection with methicillin-resistant Staphylococcus aureus and Clostridium difficile.

PubMed

Ottum, Andrew; Sethi, Ajay K; Jacobs, Elizabeth; Zerbel, Sara; Gaines, Martha E; Safdar, Nasia

2013-04-01

Methicillin-resistant Staphylococcus aureus (MRSA) infections and Clostridium difficile infections (CDI) are major health care-associated infections (HAIs). Little is known about patients' knowledge of these HAIs. Therefore, we surveyed patients to determine awareness, knowledge, and perceptions of MRSA infections and CDI. An interviewer-administered questionnaire. A tertiary care academic medical center. Adult patients who met at least one of the following criteria: at risk of CDI or MRSA infection, current CDI or colonization or current MRSA infection or colonization, or history of CDI or MRSA infection. Two unique surveys were developed and administered to 100 patients in 2011. Overall, 76% of patients surveyed were aware of MRSA, whereas 44% were aware of C difficile. The strongest predictor of patients' awareness of these infections was having a history of HAI. Patients with a history of HAI were significantly more likely to have heard of both MRSA (odds ratio, 13.29; 95% confidence interval, 2.84-62.14; P = .001) and C difficile (odds ratio, 9.78; 95% confidence interval, 2.66-35.95; P = .001), than those patients without a history of HAI. There was also a significant positive association between having a history of HAI and greater knowledge of the risk factors, health consequences, and prevention techniques relative to CDI and MRSA infections. There are additional opportunities to engage patients about the risks and consequences of MRSA and CDIs, particularly those without a history of HAI. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Temporal trends of healthcare associated infections and antimicrobial use in 2011-2013, observed with annual point prevalence surveys in Ferrara University Hospital, Italy.

PubMed

Antonioli, P; Manzalini, M C; Stefanati, A; Bonato, B; Verzola, A; Formaglio, A; Gabutti, G

2016-09-01

Healthcare associated infections (HAIs) and misuse of antimicrobials (AMs) represent a growing public health problem. The Point Prevalence Surveys (PPSs) find available information to be used for specific targeted interventions and evaluate their effects. The objective of this study was to estimate the prevalence of HAIs and AM use, to describe types of infections, causative pathogens and to compare data collected through three PPSs in Ferrara University Hospital (FUH), repeated in 3 different years (2011-2013). The population-based sample consists of all patients admitted to every acute care and rehabilitation Department in a single day. ECDC Protocol and Form for PPS of HAI and AM use, Version 4.2, July 2011. Risk factor analysis was performed using logistic regression. 1,239 patients were observed. Overall, HAI prevalence was 9.6%; prevalence was higher in Intensive Care Units; urinary tract infections were the most common HAIs in all 3 surveys; E.coli was the most common pathogen; AM use prevalence was 51.1%; AMs most frequently administered were fluoroquinolones, combinations of penicillins and third-generation cephalosporins. According to the regression model, urinary catheter (OR: 2.5) and invasive respiratory device (OR: 2.3) are significantly associated risk factors for HAIs (p < 0.05). PPSs are a sensitive and effective method of analysis. Yearly repetition is a useful way to maintain focus on the topic of HAIs and AM use, highlighting how changes in practices impact on the outcome of care and providing useful information to implement intervention programs targeted on specific issues.

Healthcare associated infection: good practices, knowledge and the locus of control in heatlhcare professionals.

PubMed

Taffurelli, Chiara; Sollami, Alfonso; Camera, Carmen; Federa, Francesca; Grandi, Annise; Marino, Marcella; Marrosu, Tiziano; Sarli, Leopoldo

2017-07-18

  The incidence of Healthcare Associated Infections (HAI) is an important indicator of the quality of care. The behaviors associated with the prevention of infections are not only supported by rational knowledge or motivation, but are mediated by social, emotional and often stereotyped behaviors. The awarness of the good practices related to HAI, may be a factor. Other studies, identify how the perception of the problem in healthcare professionals is often influenced by a tendency towards an external Locus of Control: the patient, the family, the other wards, other care settings. The aim of this study is to investigate the perception of healthcare professionals. In particular they have been measured their  awarness of the good practices, perceptions of the potential contamination level of some commonly used objects, knowledge about the management of invasive devices, Locus of Control.   A cross-sectional correlational design was utilized.  An ad hoc questionnaire was interviewed by 222 health professionals nurses and physicians in a northern hospital of Italy. The percentage of professionals who have attended training courses over the last 5 years was quite high, both for upgrades on HAI (78.7%) and Vascular Catheters (78.8%), while the percentage of professionals who updated on bladder catheterization (59.46%) was lower. The mean  score of good practice awareness towards HAI (5.06), is high. The perception of the potential level of contamination of some devices had a  mean ranging from 4.62 (for the drip) to 5.26 (for the door handle). The average value of the Locus of Control (43.54) indicates that participants demonstrated a value that is midway between External and Internal. The correlation test analysis revealed no significant relationships among professionals'age, knowledge about HAI, or infection related venus catheter. Also, results revealed that there were statistically significant positive relationships between professionals' Good Practices

Longitudinal Household Trends in Access to Improved Water Sources and Sanitation in Chi Linh Town, Hai Duong Province, Viet Nam and Associated Factors.

PubMed

Tuyet-Hanh, Tran Thi; Long, Tran Khanh; Van Minh, Hoang; Huong, Le Thi Thanh

2016-01-01

This study aims to characterize household trends in access to improved water sources and sanitaton in Chi Linh Town, Hai Duong Province, Vietnam, and to identify factors affecting those trends. Data were extracted from the Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS) database from 2004-2014, which included household access to improved water sources, household access to improved sanitation, and household demographic data. Descriptive statistical analysis and multinominal logistic regression were used. The results showed that over a 10-year period (2004-2014), the proportion of households with access to improved water and improved sanitation increased by 3.7% and 28.3%, respectively. As such, the 2015 Millennium Development Goal targets for safe drinking water and basic sanitation were met. However, 13.5% of households still had unimproved water and sanitation. People who are retired, work in trade or services, or other occupations were 1.49, 1.97, and 1.34 times more likely to have access to improved water and sanitation facilities than farming households, respectively ( p < 0.001). Households living in urban areas were 1.84 times more likely than those living in rural areas to have access to improved water sources and improved sanitation facilities (OR =1.84; 95% CI = 1.73-1.96). Non-poor households were 2.12 times more likely to have access to improved water sources and improved sanitation facilities compared to the poor group (OR = 2.12; 95% CI = 2.00-2.25). More efforts are required to increase household access to both improved water and sanitation in Chi Linh Town, focusing on the 13.5% of households currently without access. Similar to situations observed elsewhere in Vietnam and other low- and middle- income countries, there is a need to address socio-economic factors that are associated with inadequate access to improved water sources and sanitation facilities.

Educational interventions to improve knowledge and skills of interns towards prevention and control of hospital-associated infections.

PubMed

Dogra, Sandeep; Mahajan, Ruchita; Jad, Beena; Mahajan, Bella

2015-08-01

We believe that there is significant educational deficit amongst interns regarding up-to-date formal knowledge and skills on healthcare-associated infections (HAIs) which might compromise patient safety. This urgently requires curriculum innovations to ensure their formal training on HAIs prevention and control. Education of interns to improve their knowledge and skills toward HAIs prevention and control. This pilot study was conducted in interns using a multimodal approach consisting of a combination of videos, PowerPoint presentation, and hands-on demonstration to provide applied and practical teaching on prevention and control of HAIs. Pre- and post-test assessment of knowledge, attitude, and skills was carried out by multiple choice questions, 5-point Likert scale, and Objective Structured Practical Examination respectively. Paired t-test. A statistically significant improvement in the overall score rates between pre- and post-test of intern's was seen, suggesting that educational programs have a positive effect. Intern's felt benefitted from interventions focused on HAIs prevention and control and hoped that such sessions are integrated in the regular undergraduate curriculum. A majority of the students felt that their learning style assessment matched well with their own perception of learning preference. Assessment drives learning; hence strengthening the contribution of health-care workers to HAIs prevention programs should include measures that enhance knowledge, improve skills and develop appropriate attitudes, resulting in safety and quality of patient care.

The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use.

PubMed

Zarb, P; Coignard, B; Griskeviciene, J; Muller, A; Vankerckhoven, V; Weist, K; Goossens, Mm; Vaerenberg, S; Hopkins, S; Catry, B; Monnet, Dl; Goossens, H; Suetens, C

2012-11-15

A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe. Variables were collected at national, hospital and patient level in 66 hospitals from 23 countries. A patient-based and a unit-based protocol were available. Feasibility was assessed via national and hospital questionnaires. Of 19,888 surveyed patients, 7.1% had an HAI and 34.6% were receiving at least one antimicrobial agent. Prevalence results were highest in intensive care units, with 28.1% patients with HAI, and 61.4% patients with antimicrobial use. Pneumonia and other lower respiratory tract infections (2.0% of patients; 95% confidence interval (CI): 1.8–2.2%) represented the most common type (25.7%) of HAI. Surgical prophylaxis was the indication for 17.3% of used antimicrobials and exceeded one day in 60.7% of cases. Risk factors in the patient-based protocol were provided for 98% or more of the included patients and all were independently associated with both presence of HAI and receiving an antimicrobial agent. The patient-based protocol required more work than the unit-based protocol, but allowed collecting detailed data and analysis of risk factors for HAI and antimicrobial use.

Teamwork in the NICU Setting and Its Association with Health Care-Associated Infections in Very Low-Birth-Weight Infants.

PubMed

Profit, Jochen; Sharek, Paul J; Kan, Peiyi; Rigdon, Joseph; Desai, Manisha; Nisbet, Courtney C; Tawfik, Daniel S; Thomas, Eric J; Lee, Henry C; Sexton, J Bryan

2017-08-01

Background and Objective  Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with health care-associated infection (HAI) rates in very low-birth-weight (VLBW) infants. Methods  Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6,663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2,073 of 3,294 eligible NICU health professionals (response rate 63%). The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results  Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (odds ratio, 0.82; 95% confidence interval, 0.73-0.92, p  = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion  Improving teamwork may be an important element in infection control efforts. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The national response for preventing healthcare-associated infections: data and monitoring.

PubMed

Kahn, Katherine L; Weinberg, Daniel A; Leuschner, Kristin J; Gall, Elizabeth M; Siegel, Sari; Mendel, Peter

2014-02-01

Historically, the ability to accurately track healthcare-associated infections (HAIs) was hindered due to a lack of coordination among data sources and shortcomings in individual data sources. This paper presents the results of the evaluation of the HAI data and the monitoring component of the Action Plan, focusing on context (goals), inputs, and processes. We used the Content-Input-Process-Product framework, together with the HAI prevention system framework, to describe the transformative processes associated with data and monitoring efforts. Six HAI priority conditions in the 2009 Action Plan created a focus for the selection of goals and activities. Key Action Plan decisions included a phased-in data and monitoring approach, commitment to linking the selection of priority HAIs to highly visible national 5-year prevention targets, and the development of a comprehensive HAI database inventory. Remaining challenges relate to data validation, resources, and the opportunity to integrate electronic health and laboratory records with other provider data systems. The Action Plan's data and monitoring program has developed a sound infrastructure that builds upon technological advances and embodies a firm commitment to prioritization, coordination and alignment, accountability and incentives, stakeholder engagement, and an awareness of the need for predictable resources. With time, and adequate resources, it is likely that the investment in data-related infrastructure during the Action Plan's initial years will reap great rewards.

Clinical relevance of hepsin and hepatocyte growth factor activator inhibitor type 2 expression in renal cell carcinoma.

PubMed

Betsunoh, Hironori; Mukai, Shoichiro; Akiyama, Yutaka; Fukushima, Tsuyoshi; Minamiguchi, Naoki; Hasui, Yoshihiro; Osada, Yukio; Kataoka, Hiroaki

2007-04-01

Cell surface proteolysis is important for the generation of bioactive proteins mediating tumor progression. Recent studies suggest that the membrane-anchored cell surface proteinases matriptase and hepsin have significant roles in tumors. We analyzed the expression and clinical relevance of matriptase and hepsin, and their inhibitors hepatocyte growth factor activator inhibitor type 1 (HAI-1) and type 2 (HAI-2) in 66 cases of conventional renal cell carcinomas (RCC). The mRNA level was evaluated in paired samples from tumor and non-tumorous renal tissues by real-time reverse transcription-polymerase chain reaction. As matriptase and hepsin potently activate the proform of hepatocyte growth factor (HGF), the expression of HGF and its receptor, c-Met, was also analyzed. Although upregulation of matriptase was observed occasionally in RCC, the expression level was not associated with prognostic parameters. Hepsin was downregulated in RCC, particularly in early stage disease, but upregulated in advanced stages. There was a trend of higher hepsin expression in RCC with distant metastasis, and Kaplan-Meier survival curves showed that high hepsin expression was associated with reduced overall survival (P<0.01, log-rank test). Moreover, multivariate analysis indicated that hepsin was an independent prognostic factor. Overexpression of HGF or c-Met also showed reduced overall survival. We also observed a tendency of low HAI-2 expression with reduced overall survival and a statistical association between high hepsin and low HAI-2 level. No associations were observed between matriptase and HAI-1 and HAI-2. Our findings suggest that the balance between hepsin and its inhibitor, HAI-2, may have prognostic value in RCC.

Kinetics during the redox biotransformation of pollutants mediated by immobilized and soluble humic acids.

PubMed

Cervantes, Francisco J; Martínez, Claudia M; Gonzalez-Estrella, Jorge; Márquez, Arturo; Arriaga, Sonia

2013-03-01

The aim of this study was to elucidate the kinetic constraints during the redox biotransformation of the azo dye, Reactive Red 2 (RR2), and carbon tetrachloride (CT) mediated by soluble humic acids (HAs) and immobilized humic acids (HAi), as well as by the quinoid model compounds, anthraquinone-2,6-disulfonate (AQDS) and 1,2-naphthoquinone-4-sulfonate (NQS). The microbial reduction of both HAs and HAi by anaerobic granular sludge (AGS) was the rate-limiting step during decolorization of RR2 since the reduction of RR2 by reduced HAi proceeded at more than three orders of magnitute faster than the electron-transferring rate observed during the microbial reduction of HAi by AGS. Similarly, the reduction of RR2 by reduced AQDS proceeded 1.6- and 1.9-fold faster than the microbial reduction of AQDS by AGS when this redox mediator (RM) was supplied in soluble and immobilized form, respectively. In contrast, the reduction of NQS by AGS occurred 1.6- and 19.2-fold faster than the chemical reduction of RR2 by reduced NQS when this RM was supplied in soluble and immobilized form, respectively. The microbial reduction of HAs and HAi by a humus-reducing consortium proceeded 1,400- and 790-fold faster than the transfer of electrons from reduced HAs and HAi, respectively, to achieve the reductive dechlorination of CT to chloroform. Overall, the present study provides elucidation on the rate-limiting steps involved in the redox biotransformation of priority pollutants mediated by both HAs and HAi and offers technical suggestions to overcome the kinetic restrictions identified in the redox reactions evaluated.

How to Manage and Control Healthcare Associated Infections

NASA Astrophysics Data System (ADS)

Wijaya, L.

2018-03-01

Healthcare associated infections (HAI) are the major complications of modern medical therapy. The most important HAIs are related to invasive devices including central line- associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and surgical-site infections (SSI). Excessive use of antibiotics has also led to the emergence and the global dissemination of antibiotic resistant bacteria over the last few decades. Reducing HAIs will involve a multi-modal approach to infection control practices as well as antibiotic stewardship program.

Drought evolution characteristics and precipitation intensity changes during alternating dry-wet changes in the Huang-Huai-Hai River basin

NASA Astrophysics Data System (ADS)

Yan, D. H.; Wu, D.; Huang, R.; Wang, L. N.; Yang, G. Y.

2013-07-01

Abrupt drought-flood change events caused by atmospheric circulation anomalies have occurred frequently and widely in recent years, which has caused great losses and casualties in China. In this paper, we focus on investigating whether there will be a rainfall occurrence with higher intensity after a drought period in the Huang-Huai-Hai River basin. Combined with the Chinese climate divisions and the basin's DEM (digital elevation model), the basin is divided into seven sub-regions by means of cluster analysis of the basin meteorological stations using the self-organizing map (SOM) neural network method. Based on the daily precipitation data of 171 stations for the years 1961-2011, the changes of drought times with different magnitudes are analyzed, and the number of consecutive days without precipitation is used to identify the drought magnitudes. The first precipitation intensity after a drought period is analyzed with the Pearson-III frequency curve, then the relationship between rainfall intensity and different drought magnitudes is observed, as are the changes of drought times for different years. The results of the study indicated that the occurrence times of different drought levels show an overall increasing trend; there is no clear interdecadal change shown, but the spatial difference is significant. (2) As the drought level increases, the probability of extraordinary rainstorm becomes lower, and the frequency of occurrence of spatial changes in different precipitation intensities vary. In the areas I and II, as the drought level increases, the occurrence frequency of different precipitation intensities first shows a decreasing trend, which becomes an increasing trend when extraordinary drought occurs. In the area III, IV and V, the probability of the different precipitation intensities shows an overall decreasing trend. The areas VI and VII are located at the mountains with high altitudes where the variation of different precipitation intensities with the

Detecting borderline infection in an automated monitoring system for healthcare-associated infection using fuzzy logic.

PubMed

de Bruin, Jeroen S; Adlassnig, Klaus-Peter; Blacky, Alexander; Koller, Walter

2016-05-01

Many electronic infection detection systems employ dichotomous classification methods, classifying patient data as pathological or normal with respect to one or several types of infection. An electronic monitoring and surveillance system for healthcare-associated infections (HAIs) known as Moni-ICU is being operated at the intensive care units (ICUs) of the Vienna General Hospital (VGH) in Austria. Instead of classifying patient data as pathological or normal, Moni-ICU introduces a third borderline class. Patient data classified as borderline with respect to an infection-related clinical concept or HAI surveillance definition signify that the data nearly or partly fulfill the definition for the respective concept or HAI, and are therefore neither fully pathological nor fully normal. Using fuzzy sets and propositional fuzzy rules, we calculated how frequently patient data are classified as normal, borderline, or pathological with respect to infection-related clinical concepts and HAI definitions. In dichotomous classification methods, borderline classification results would be confounded by normal. Therefore, we also assessed whether the constructed fuzzy sets and rules employed by Moni-ICU classified patient data too often or too infrequently as borderline instead of normal. Electronic surveillance data were collected from adult patients (aged 18 years or older) at ten ICUs of the VGH. All adult patients admitted to these ICUs over a two-year period were reviewed. In all 5099 patient stays (4120 patients) comprising 49,394 patient days were evaluated. For classification, a part of Moni-ICU's knowledge base comprising fuzzy sets and rules for ten infection-related clinical concepts and four top-level HAI definitions was employed. Fuzzy sets were used for the classification of concepts directly related to patient data; fuzzy rules were employed for the classification of more abstract clinical concepts, and for top-level HAI surveillance definitions. Data for each

International Nosocomial Infection Control Consortium Findings of Device-Associated Infections Rate in an Intensive Care Unit of a Lebanese University Hospital

PubMed Central

Kanj, SS; Kanafani, ZA; Sidani, N; Alamuddin, L; Zahreddine, N; Rosenthal, VD

2012-01-01

Objectives: To determine the rates of device-associated healthcare-associated infections (DA-HAI), microbiological profile, bacterial resistance, length of stay (LOS), excess mortality and hand hygiene compliance in one intensive care unit (ICU) of a hospital member of the International Infection Control Consortium (INICC) in Beirut, Lebanon. Materials and Methods: An open label, prospective cohort, active DA-HAI surveillance study was conducted on adults admitted to a tertiary-care ICU in Lebanon from November 2007 to March 2010. The protocol and methodology implemented were developed by INICC. Data collection was performed in the participating ICUs. Data uploading and analyses were conducted at INICC headquarters on proprietary software. DA-HAI rates were recorded by applying the definitions of the National Healthcare Safety Network (NHSN) at the US Centers for Disease Control and Prevention (CDC). We analyzed the DA-HAI, mechanical ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI), and catheter-associated urinary tract infection (CAUTI) rates, microorganism profile, excess LOS, excess mortality, and hand hygiene compliance. Results: A total of 666 patients hospitalized for 5,506 days acquired 65 DA-HAIs, an overall rate of 9.8% [(95% confidence interval (CI) 7.6–12.3], and 11.8 (95% CI 9.1–15.0) DA-HAIs per 1000 ICU-days. The CLA-BSI rate was 5.2 (95% CI 2.8–8.7) per 1000 catheter-days; the VAP rate was 8.1 (95% CI 5.5–11.7) per 1000 ventilator-days; and the CAUTI rate was 4.1 (95% CI 2.6–6.2) per 1000 catheter-days. LOS of patients was 7.3 days for those without DA-HAI, 13.8 days for those with CLA-BSI, 18.8 days for those with VAP. Excess mortality was 40.9% [relative risk (RR) 3.14; P 0.004] for CLA-BSI. Mortality of VAP and CAUTI was not significantly different from patients without DA-HAI. Escherichia coli was the most common isolated microorganism. Overall hand hygiene compliance was 84.9% (95% CI 82

The network approach for prevention of healthcare-associated infections: long-term effect of participation in the Duke Infection Control Outreach Network.

PubMed

Anderson, Deverick J; Miller, Becky A; Chen, Luke F; Adcock, Linda H; Cook, Evelyn; Cromer, A Lynn; Louis, Susan; Thacker, Paul A; Sexton, Daniel J

2011-04-01

To describe the rates of several key outcomes and healthcare-associated infections (HAIs) among hospitals that participated in the Duke Infection Control Outreach Network (DICON). Prospective, observational cohort study of patients admitted to 24 community hospitals from 2003 through 2009. The following data were collected and analyzed: incidence of central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTIs), and HAIs caused by methicillin-resistant Staphylococcus aureus (MRSA); employee exposures to bloodborne pathogens (EBBPs); physician EBBPs; patient-days; central line-days; ventilator-days; and urinary catheter-days. Poisson regression was used to determine whether incidence rates of these HAIs and exposures changed during the first 5 and 7 years of participation in DICON; nonrandom clustering of each outcome was controlled for. Cost saved and lives saved were calculated on the basis of published estimates. In total, we analyzed 6.5 million patient-days, 4,783 EBPPs, 2,948 HAIs due to MRSA, and 2,076 device-related infections. Rates of employee EBBPs, HAIs due to MRSA, and device-related infections decreased significantly during the first 5 years of participation in DICON (P< .05 for all models; average decrease was approximately 50%); in contrast, physician EBBPs remained unchanged. In aggregate, 210 CLABSIs, 312 cases of VAP, 332 CAUTIs, 1,042 HAIs due to MRSA, and 1,016 employee EBBPs were prevented. Each hospital saved approximately $100,000 per year of participation, and collectively the hospitals may have prevented 52-105 deaths from CLABSI or VAP. The 7-year analysis demonstrated that these trends continued with further participation. Hospitals with long-term participation in an infection control network decreased rates of significant HAIs by approximately 50%, decreased costs, and saved lives.

A point prevalence survey of health care-associated infections in Canadian pediatric inpatients.

PubMed

Rutledge-Taylor, Katie; Matlow, Anne; Gravel, Denise; Embree, Joanne; Le Saux, Nicole; Johnston, Lynn; Suh, Kathryn; Embil, John; Henderson, Elizabeth; John, Michael; Roth, Virginia; Wong, Alice; Shurgold, Jayson; Taylor, Geoff

2012-08-01

Health care-associated infections (HAIs) cause considerable morbidity and mortality to hospitalized patients. The objective of this point prevalence study was to assess the burden of HAIs in the Canadian pediatric population, updating results reported from a similar study conducted in 2002. A point prevalence survey of pediatric inpatients was conducted in February 2009 in 30 pediatric or combined adult/pediatric hospitals. Data pertaining to one 24-hour period were collected, including information on HAIs, microorganisms isolated, antimicrobials prescribed, and use of additional (transmission based) precautions. The following prevalent infections were included: pneumonia, urinary tract infection, bloodstream infection, surgical site infection, viral respiratory infection, Clostridium difficile infection, viral gastroenteritis, and necrotizing enterocolitis. One hundred eighteen patients had 1 or more HAI, corresponding to a prevalence of 8.7% (n = 118 of 1353, 95% confidence interval: 7.2-10.2). Six patients had 2 infections. Bloodstream infections were the most frequent infection in neonates (3.0%), infants (3.1%), and children (3.5%). Among all patients surveyed, 16.3% were on additional precautions, and 40.1% were on antimicrobial agents, whereas 40.7% of patients with a HAI were on additional precautions, and 89.0% were on antimicrobial agents. Overall prevalence of HAI in 2009 has remained similar to the prevalence reported from 2002. The unchanged prevalence of these infections nonetheless warrants continued vigilance on their prevention and control. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Health care-associated infections in Iran: A national update for the year 2015.

PubMed

Eshrati, Babak; Masoumi Asl, Hossein; Afhami, Shirin; Pezeshki, Zahra; Seifi, Arash

2018-06-01

A national surveillance system for health care-associated infections (HAIs) in Iran is relatively new, and an update on incidence and mortality rates can aid clinicians and stakeholders in development of new guidelines and imperative modifications to be made. Data were extracted from the national HAIs surveillance software for more than 7 million hospitalizations during 2015. Data regarding age, gender, deaths, ward of admission, and microbiologic findings were collected and analyzed. From 491 hospitals, 7,018,393 hospitalizations were reported during 2015; 82,950 patients had been diagnosed with at least 1 HAI, 6,355 of whom died (crude fatality rate, 7.7). Men comprised 51.4% of the patients. The incidence rate was calculated to be 1.18. Urinary tract infections and pneumonia were the most commonly reported infections (27.9% and 23.8%) and 33% of patients were older than age 65 years. Intensive care units had the highest incidence rates, followed by burn units with incidence rates close to 9. Highest percentages of deaths were reported among patients with an HAI in the intensive care unit (20.6%) and those with pneumonia (39.6%). Although the underreporting of HAIs hinders accurate calculation of incidence, the present study provides a general update. The results can help in modification of national guidelines and appropriate choice of antimicrobial agents in the management of HAIs. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Simulation on Change Law of Runoff, Sediment and Non-point Source Nitrogen and Phosphorus Discharge under Different Land uses Based on SWAT Model: A Case Study of Er hai Lake Small Watershed

NASA Astrophysics Data System (ADS)

Tong, Xiao Xia; Lai Cui, Yuan; Chen, Man Yu; Hu, Bo; Xu, Wen Sheng

2018-05-01

The Er yuan watershed of Er hai district is chosen as the research area, the law of runoff and sediment and non-point source nitrogen and phosphorus discharges under different land uses during 2001 to 2014 are simulated based on SWAT model. Results of simulation indicate that the order of total runoff yield of different land use type from high to low is grassland, paddy fields, dry land. Specifically, the order of surface runoff yield from high to low is paddy fields, dry land, grassland, the order of lateral runoff yield from high to low is paddy fields, dry land, grassland, the order of groundwater runoff yield from high to low is grassland, paddy fields, dry land. The orders of sediment and nitrogen and phosphorus yield per unit area of different land use type are the same, grassland> paddy fields> dry land. It can be seen, nitrogen and phosphorus discharges from paddy fields and dry land are the main sources of agricultural non-point pollution of the irrigated area. Therefore, reasonable field management measures which can decrease the discharge of nitrogen and phosphorus of paddy fields and dry land are the key to agricultural non-point source pollution prevention and control.

'Real-time' burden of community and healthcare-related infections in medical and rehabilitation patients in a public hospital in Auckland, New Zealand.

PubMed

Read, Kerry; Bhally, Hansan; Sapsford, Sabrina; Sapsford, Thomas

2015-12-04

To determine the prevalence and spectrum of infections on admission, or acquired during hospitalisation (HAI) at Waitakere Hospital, Auckland. A questionnaire was completed on two separate days for all adult in-patients admitted to medical and rehabilitation wards for greater than 24 hours. Information obtained included patient characteristics, the presence and type of infection on admission or acquired during hospitalisation, as well as information on indwelling devices. Infection was the admitting diagnosis in 81 (41%) of 195 patients reviewed, with lower respiratory tract infection (LRTI) diagnosed in 50%, urine infections in 22% and cellulitis 18%. Only 40% LRTIs were supported by radiology or microbiological criteria. Twenty-five HAIs occurred in 21 patients (cumulative and point prevalence of 10.7% and 5.0% respectively). Urinary tract infection (UTI) was the most common HAI in 13 patients (62%), including 4 catheter-related infections. Patients with HAI were older and appeared to have had longer hospital stays, and higher urinary catheter usage. This study highlights the ongoing high burden of infections contributing to hospitalisation of adult patients in a developed country. The prevalence of HAI, patient characteristics and risk factors are comparable to previous studies in similar settings.

Evolution of gas saturation and relative permeability during gas production from hydrate-bearing sediments: Gas invasion vs. gas nucleation

NASA Astrophysics Data System (ADS)

Jang, Jaewon; Santamarina, J. Carlos

2014-01-01

Capillarity and both gas and water permeabilities change as a function of gas saturation. Typical trends established in the discipline of unsaturated soil behavior are used when simulating gas production from hydrate-bearing sediments. However, the evolution of gas saturation and water drainage in gas invasion (i.e., classical soil behavior) and gas nucleation (i.e., gas production) is inherently different: micromodel experimental results show that gas invasion forms a continuous flow path while gas nucleation forms isolated gas clusters. Complementary simulations conducted using tube networks explore the implications of the two different desaturation processes. In spite of their distinct morphological differences in fluid displacement, numerical results show that the computed capillarity-saturation curves are very similar in gas invasion and nucleation (the gas-water interface confronts similar pore throat size distribution in both cases); the relative water permeability trends are similar (the mean free path for water flow is not affected by the topology of the gas phase); and the relative gas permeability is slightly lower in nucleation (delayed percolation of initially isolated gas-filled pores that do not contribute to gas conductivity). Models developed for unsaturated sediments can be used for reservoir simulation in the context of gas production from hydrate-bearing sediments, with minor adjustments to accommodate a lower gas invasion pressure Po and a higher gas percolation threshold.

Haemagglutination inhibition antibody levels one year after natural measles infection and vaccination.

PubMed

Eghafona, N O; Ahmad, A A; Ezeokoli, C D; Emejuaiwe, S O

1991-01-01

An assessment of haemagglutination inhibition antibody (HAI) titres of 1,163 children, comprising 739 recipients of live measles vaccines and 424 patients with natural measles infection after 1 year was made in this investigation. Statistical analysis revealed a significant difference in the levels of HAI antibodies. Of the vaccinated children a significant 67.45% showed antibody titres of less than or equal to 1:16, while only 23.48% of children with natural measles showed these antibody titres. The importance and implication of such HAI antibody titres is discussed.

Life-cycle greenhouse gas emissions of shale gas, natural gas, coal, and petroleum.

PubMed

Burnham, Andrew; Han, Jeongwoo; Clark, Corrie E; Wang, Michael; Dunn, Jennifer B; Palou-Rivera, Ignasi

2012-01-17

The technologies and practices that have enabled the recent boom in shale gas production have also brought attention to the environmental impacts of its use. It has been debated whether the fugitive methane emissions during natural gas production and transmission outweigh the lower carbon dioxide emissions during combustion when compared to coal and petroleum. Using the current state of knowledge of methane emissions from shale gas, conventional natural gas, coal, and petroleum, we estimated up-to-date life-cycle greenhouse gas emissions. In addition, we developed distribution functions for key parameters in each pathway to examine uncertainty and identify data gaps such as methane emissions from shale gas well completions and conventional natural gas liquid unloadings that need to be further addressed. Our base case results show that shale gas life-cycle emissions are 6% lower than conventional natural gas, 23% lower than gasoline, and 33% lower than coal. However, the range in values for shale and conventional gas overlap, so there is a statistical uncertainty whether shale gas emissions are indeed lower than conventional gas. Moreover, this life-cycle analysis, among other work in this area, provides insight on critical stages that the natural gas industry and government agencies can work together on to reduce the greenhouse gas footprint of natural gas.

Comparison of gene expression and fatty acid profiles in concentrate and forage finished beef.

PubMed

Buchanan, J W; Garmyn, A J; Hilton, G G; VanOverbeke, D L; Duan, Q; Beitz, D C; Mateescu, R G

2013-01-01

Fatty acid profiles and intramuscular expression of genes involved in fatty acid metabolism were characterized in concentrate- (CO) and forage- (FO) based finishing systems. Intramuscular samples from the adductor were taken at slaughter from 99 heifers finished on a CO diet and 58 heifers finished on a FO diet. Strip loins were obtained at fabrication to evaluate fatty acid profiles of LM muscle for all 157 heifers by using gas chromatography fatty acid methyl ester analysis. Composition was analyzed for differences by using the General Linear Model (GLM) procedure in SAS. Differences in fatty acid profile included a greater atherogenic index, greater percentage total MUFA, decreased omega-3 to omega-6 ratio, decreased percentage total PUFA, and decreased percentage omega-3 fatty acids in CO- compared with FO-finished heifers (P<0.05). Fatty acid profiles from intramuscular samples were ranked by the atherogenic index, and 20 heifers with either a high (HAI; n=10) or low (LAI; n=10) atherogenic index were selected for gene expression analysis using real-time PCR (RT-PCR). Gene expression data for the 20 individuals were analyzed as a 2 by 2 factorial arrangement of treatments using the GLM procedure in SAS. There was no significant diet × atherogenic index interaction identified for any gene (P>0.05). Upregulation was observed for PPARγ, fatty acid synthase (FASN), and fatty acid binding protein 4 (FABP4) in FO-finished compared with CO-finished heifers in both atherogenic index categories (P<0.05). Upregulation of diglyceride acyl transferase 2 (DGAT2) was observed in FO-finished heifers with a HAI (P<0.05). Expression of steroyl Co-A desaturase (SCD) was upregulated in CO-finished heifers with a LAI, and downregulated in FO-finished heifers with a HAI (P<0.05). Expression of adiponectin (ADIPOQ) was significantly downregulated in CO-finished heifers with a HAI compared with all other categories (P<0.05). The genes identified in this study which exhibit

77 FR 34935 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Notice of Court Decision...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

...: Amanda Foods (Vietnam) Ltd.; Bac Lieu Fisheries Joint Stock Company; Cadovimex Seafood Import- Export and Processing Joint Stock Company; Cafatex Fishery Joint Stock Corporation; Cam Ranh Seafoods Processing... Export Frozen Seafood Processing Joint Stock Company (``Minh Hai Jostoco''); Minh Hai Joint-Stock...

Combined Plasma Elevation of CRP, Intestinal-Type Fatty Acid-Binding Protein (I-FABP), and sCD14 Identify Older Patients at High Risk for Health Care-Associated Infections.

PubMed

Paillaud, Elena; Bastuji-Garin, Sylvie; Plonquet, Anne; Foucat, Emile; Fournier, Bénédicte; Boutin, Emmanuelle; Le Thuaut, Aurélie; Levy, Yves; Hue, Sophie

2018-01-16

We hypothesized that low-grade inflammation was driven by microbial translocation and associated with an increased risk of health care-associated infections (HAIs). We included 121 patients aged 75 years or over in this prospective cohort study. High-sensitivity C-reactive protein (hs-CRP), I-FABP, and sCD14-as markers for low-grade inflammation, intestinal epithelial barrier integrity, and monocyte activation, respectively-were measured at admission. HAIs occurred during hospitalization in 62 (51%) patients. Elevated hs-CRP (≥6.02 mg/L, ie, the median) was associated with a significantly higher HAI risk when I-FABP was in the highest quartile (odds ratio [OR], 4; 95% confidence interval [95% CI], 1.39-11.49; p = .010). In patients with hs-CRP elevation and highest-quartile I-FABP, sCD14 elevation (≥0.65 µg/mL, ie, the median) was associated with an 11-fold higher HAI risk (OR, 10.8; 95% CI, 2.28-51.1; p = .003). Multivariate analyses adjusted for invasive procedures and comorbidities did not change the associations linking the three markers to the HAI risk. Increased levels of hs-CRP, I-FABP, and sCD14 may reflect loss of intestinal epithelial barrier integrity with microbial translocation leading to monocyte activation and low-grade inflammation. In our cohort, these markers identified patients at high risk for HAIs. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Reducing health care-associated infections by implementing separated environmental cleaning management measures by using disposable wipes of four colors.

PubMed

Wong, Swee Siang; Huang, Cheng Hua; Yang, Chiu Chu; Hsieh, Yi Pei; Kuo, Chen Ni; Chen, Yi Ru; Chen, Li Ching

2018-01-01

Environmental cleaning is a fundamental principle of infection control in health care settings. We determined whether implementing separated environmental cleaning management measures in MICU reduced the density of HAI. We performed a 4-month prospective cohort intervention study between August and December 2013, at the MICU of Cathay General hospital. We arranged a training program for all the cleaning staff regarding separated environmental cleaning management measures by using disposable wipes of four colors to clean the patients' bedside areas, areas at a high risk of contamination, paperwork areas, and public areas. Fifteen high-touch surfaces were selected for cleanliness evaluation by using the adenosine triphosphate (ATP) bioluminescence test. Then data regarding HAI densities in the MICU were collected during the baseline, intervention, and late periods. A total of 120 ATP readings were obtained. The total number of clean high-touch surfaces increased from 13% to 53%, whereas that of unclean high-touch surface decreased from 47% to 20%. The densities of HAI were 14.32‰ and 14.90‰ during the baseline and intervention periods, respectively. The HAI density did not decrease after the intervention period, but it decreased to 9.07‰ during the late period. Implementing separated environmental cleaning management measures by using disposable wipes of four colors effectively improves cleanliness in MICU environments. However, no decrease in HAI density was observed within the study period. Considering that achieving high levels of hand-hygiene adherence is difficult, improving environmental cleaning is a crucial adjunctive measure for reducing the incidence of HAIs.

An object-based image analysis approach for aquaculture ponds precise mapping and monitoring: a case study of Tam Giang-Cau Hai Lagoon, Vietnam.

PubMed

Virdis, Salvatore Gonario Pasquale

2014-01-01

Monitoring and mapping shrimp farms, including their impact on land cover and land use, is critical to the sustainable management and planning of coastal zones. In this work, a methodology was proposed to set up a cost-effective and reproducible procedure that made use of satellite remote sensing, object-based classification approach, and open-source software for mapping aquaculture areas with high planimetric and thematic accuracy between 2005 and 2008. The analysis focused on two characteristic areas of interest of the Tam Giang-Cau Hai Lagoon (in central Vietnam), which have similar farming systems to other coastal aquaculture worldwide: the first was primarily characterised by locally referred "low tide" shrimp ponds, which are partially submerged areas; the second by earthed shrimp ponds, locally referred to as "high tide" ponds, which are non-submerged areas on the lagoon coast. The approach was based on the region-growing segmentation of high- and very high-resolution panchromatic images, SPOT5 and Worldview-1, and the unsupervised clustering classifier ISOSEG embedded on SPRING non-commercial software. The results, the accuracy of which was tested with a field-based aquaculture inventory, showed that in favourable situations (high tide shrimp ponds), the classification results provided high rates of accuracy (>95 %) through a fully automatic object-based classification. In unfavourable situations (low tide shrimp ponds), the performance degraded due to the low contrast between the water and the pond embankments. In these situations, the automatic results were improved by manual delineation of the embankments. Worldview-1 necessarily showed better thematic accuracy, and precise maps have been realised at a scale of up to 1:2,000. However, SPOT5 provided comparable results in terms of number of correctly classified ponds, but less accurate results in terms of the precision of mapped features. The procedure also demonstrated high degrees of reproducibility

Identification of barriers and research opportunities to improve the effective and efficient application of adjunct UVC surface disinfection in healthcare

NASA Astrophysics Data System (ADS)

Martinello, Richard A.; Miller, Shelly L.; Fabian, M. Patricia; Peccia, Jordan

2018-02-01

Healthcare associated infections (HAI) affect approximately 1 of every 25 hospitalized patients, lead to substantial morbidity and mortality, degrade patient experience and are costly. Risks for HAI are multifactorial and it is known that microbial contamination of the healthcare environment increases risk for HAI. Portable ultraviolet-C (UVC) surface disinfection as an adjunct to standard hospital disinfection has been shown to decrease both surface microbial contamination and HAI. However, there remain significant gaps in the understanding of the efficient and effective application of UVC in healthcare. Specific barriers identified are: 1) the variability in size, shape, and surface materials of hospital rooms as well as the presence of medical devices and furniture, which impacts the amount of UVC energy delivered to surfaces and its disinfection efficiency; 2) the significant resources needed to acquire and efficiently use UVC equipment and achieve the desired patient benefits- a particular challenge for complex healthcare facilities with limited operating margins; and 3) the lack of implementation guidance and industry standard methods for measuring the UVC output and antimicrobial effects from the multiple commercial UVC options available. An improved understanding of the efficient and effective use of UVC surface disinfection in healthcare and the implementation of standard device industry metrics may lead to increased use and decrease the burden of HAI.

Prevention of common healthcare-associated infections in humanitarian hospitals.

PubMed

Murphy, Richard A; Chua, Arlene C

2016-08-01

Humanitarian medical organizations focus on vulnerable patients with increased risk for healthcare-associated infections (HAIs) and are obligated to minimize them in inpatient departments (IPDs). However, in doing so humanitarian groups face considerable obstacles. This report will focus on approaches to reducing common HAIs that the authors have found to be helpful in humanitarian settings. HAIs are common in humanitarian contexts but there are few interventions or guidelines adapted for use in poor and conflict-affected settings to improve prevention and guide surveillance. Based on existing recommendations and studies, it appears prudent that all humanitarian IPDs introduce a basic infection prevention infrastructure, assure high adherence to hand hygiene with wide accessibility to alcohol-based hand rub, and develop pragmatic surveillance based on clinically evident nosocomial infection. Although microbiology remains out of reach for most humanitarian hospitals, rapid tests offer the possibility of improving the diagnosis of HAIs in humanitarian hospitals in the decade ahead. There is a dearth of new studies that can direct efforts to prevent HAIs in IPDs in poor and conflict-affected areas and there is a need for practical, field-adapted guidelines from professional societies, and international bodies to guide infection prevention efforts in humanitarian environments.

National infection prevention and control programmes: Endorsing quality of care.

PubMed

Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

2014-01-01

Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

Healthcare-associated infections and their prevention after extensive flooding.

PubMed

Apisarnthanarak, Anucha; Warren, David K; Mayhall, Clovus Glen

2013-08-01

This review will focus on the epidemiology of healthcare-associated infections (HAIs) after extensive blackwater flooding as well as preventive measures. There is evidence suggesting an increased incidence of HAIs and pseudo-outbreaks due to molds after extensive flooding in healthcare facilities. However, there is no strong evidence of an increased incidence of typical nosocomial infections (i.e., ventilator-associated pneumonia, healthcare-associated pneumonia, central line-associated bloodstream infection and catheter-associated urinary tract infections). The prevalence of multidrug-resistant organisms may decrease after extensive flooding, due to repeated and thorough environmental cleaning prior to re-opening hospitals. Contamination of hospital water sources by enteric Gram-negative bacteria (e.g., Aeromonas species), Legionella species and nontuberculous Mycobacterium species in flood-affected hospitals has been reported. Surveillance is an important initial step to detect potential outbreaks/pseudo-outbreaks of HAIs. Hospital preparedness policies before extensive flooding, particularly with environmental cleaning and mold remediation, are key to reducing the risk of flood-related HAIs. These policies are still lacking in most hospitals in countries that have experienced or are at risk for extensive flooding, which argues for nationwide policies to strengthen preparedness planning. Additional studies are needed to evaluate the epidemiology of flood-related HAIs and the optimal surveillance and control methods following extensive flooding.

Leadership rounds to reduce health care-associated infections.

PubMed

Knobloch, Mary Jo; Chewning, Betty; Musuuza, Jackson; Rees, Susan; Green, Christopher; Patterson, Erin; Safdar, Nasia

2018-03-01

Evidence-based guidelines exist to reduce health care-associated infections (HAIs). Leadership rounds are one tool leaders can use to ensure compliance with guidelines, but have not been studied specifically for the reduction of HAIs. This study examines HAI leadership rounds at one facility. We explored unit-based HAI leadership rounds led by 2 hospital leaders at a large academic hospital. Leadership rounds were observed on 19 units, recorded, and coded to identify themes. Themes were linked to the Consolidated Framework for Implementation Research and used to guide interviews with frontline staff members. Staff members disclosed unit-specific problems and readily engaged in problem-solving with top hospital leaders. These themes appeared over 350 times within 22 rounds. Findings revealed that leaders used words that demonstrated fallibility and modeled curiosity, 2 factors associated with learning climate and psychologic safety. These 2 themes appeared 115 and 142 times, respectively. The flexible nature of the rounds appeared to be conducive for reflection and evaluation, which was coded 161 times. Each interaction between leaders and frontline staff can foster psychologic safety, which can lead to open problem-solving to reduce barriers to implementation. Discovering specific communication and structural factors that contribute to psychologic safety may be powerful in reducing HAIs. Published by Elsevier Inc.

Could Histoplasma capsulatum Be Related to Healthcare-Associated Infections?

PubMed Central

Carreto-Binaghi, Laura Elena; Damasceno, Lisandra Serra; Mendes-Giannini, Maria José Soares; Zancopé-Oliveira, Rosely Maria; Taylor, Maria Lucia

2015-01-01

Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused by Candida spp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such as Blastomyces dermatitidis, Paracoccidioides brasiliensis, and Histoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi, H. capsulatum infection has been linked to different medical devices and surgery implants. The filamentous form of H. capsulatum may be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identified H. capsulatum in the hospital environment, molecular biology procedures could be useful in this setting. More research on H. capsulatum as a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients. PMID:26106622

Healthcare-associated infections: infection prevention and control within the Accreditation Canada Qmentum Program.

PubMed

Nicklin, Wendy; Greco, Paula; Mitchell, Jonathan I

2009-01-01

Gardam, Lemieux, Reason, van Dijk and Goel argue that healthcare-associated infections (HAIs) are "a pressing and imminent concern in the context of patient safety." Accreditation Canada supports the position taken by these authors. The prevention and control of two HAIs of great concern, methicillin-resistant Staphylococcus aureus and Clostridium difficile, are an integral part of the Accreditation Canada program. A coordinated approach to combating HAIs and developing a culture of infection prevention and control is necessary, one that involves front-line healthcare professionals, senior leadership, national and provincial partners and the public. Since 2005, Accreditation Canada has increasingly strengthened the accreditation program in this area through a number of new strategies, including enhanced standards, required organizational practices, performance measures and indicators and the introduction of education programs. Optimizing the value of accreditation through an integrative approach with organizations' quality improvement programs will contribute to effectively combating HAIs and developing a culture of infection prevention and control.

The Medicare Policy of Payment Adjustment for Health Care-Associated Infections: Perspectives on Potential Unintended Consequences

PubMed Central

Hartmann, Christine W.; Hoff, Timothy; Palmer, Jennifer A.; Wroe, Peter; Dutta-Linn, M. Maya; Lee, Grace

2014-01-01

In 2008, the Centers for Medicare & Medicaid Services introduced a new policy to adjust payment to hospitals for health care-associated infections (HAIs) not present on admission. Interviews with 36 hospital infection preventionists across the United States explored the perspectives of these key stakeholders on the potential unintended consequences of the current policy. Responses were analyzed using an iterative coding process where themes were developed from the data. Participants’ descriptions of unintended impacts of the policy centered around three themes. Results suggest the policy has focused more attention on targeted HAIs and has affected hospital staff; relatively fewer systems changes have ensued. Some consequences of the policy, such as infection preventionists having less time to devote to HAIs other than those in the policy or having less time to implement prevention activities, may have undesirable effects on HAI rates if hospitals do not recognize and react to potential time and resource gaps. PMID:21810797

Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections.

PubMed

Tawfik, D S; Sexton, J B; Kan, P; Sharek, P J; Nisbet, C C; Rigdon, J; Lee, H C; Profit, J

2017-03-01

To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory. The relation between burnout and HAI rates among VLBW (<1500 g) neonates from each NICU was evaluated using multi-level logistic regression analysis with patient-level factors as fixed effects. We found variable prevalence of burnout across the NICUs surveyed (mean 25.2±10.1%). Healthcare-associated infection rates were 8.3±5.1% during the study period. Highest burnout prevalence was found among nurses, nurse practitioners and respiratory therapists (non-physicians, 28±11% vs 17±19% physicians), day shift workers (30±3% vs 25±4% night shift) and workers with 5 or more years of service (29±2% vs 16±6% in fewer than 3 years group). Overall burnout rates showed no correlation with risk-adjusted rates of HAIs (r=-0.133). Item-level analysis showed positive association between HAIs and perceptions of working too hard (odds ratio 1.15, 95% confidence interval 1.04-1.28). Sensitivity analysis of high-volume NICUs suggested a moderate correlation between burnout prevalence and HAIs (r=0.34). Burnout is most prevalent among non-physicians, daytime workers and experienced workers. Perceptions of working too hard associate with increased HAIs in this cohort of VLBW infants, but overall burnout prevalence is not predictive.

Heritability of and mortality prediction with a longevity phenotype: the healthy aging index.

PubMed

Sanders, Jason L; Minster, Ryan L; Barmada, M Michael; Matteini, Amy M; Boudreau, Robert M; Christensen, Kaare; Mayeux, Richard; Borecki, Ingrid B; Zhang, Qunyuan; Perls, Thomas; Newman, Anne B

2014-04-01

Longevity-associated genes may modulate risk for age-related diseases and survival. The Healthy Aging Index (HAI) may be a subphenotype of longevity, which can be constructed in many studies for genetic analysis. We investigated the HAI's association with survival in the Cardiovascular Health Study and heritability in the Long Life Family Study. The HAI includes systolic blood pressure, pulmonary vital capacity, creatinine, fasting glucose, and Modified Mini-Mental Status Examination score, each scored 0, 1, or 2 using approximate tertiles and summed from 0 (healthy) to 10 (unhealthy). In Cardiovascular Health Study, the association with mortality and accuracy predicting death were determined with Cox proportional hazards analysis and c-statistics, respectively. In Long Life Family Study, heritability was determined with a variance component-based family analysis using a polygenic model. Cardiovascular Health Study participants with unhealthier index scores (7-10) had 2.62-fold (95% confidence interval: 2.22, 3.10) greater mortality than participants with healthier scores (0-2). The HAI alone predicted death moderately well (c-statistic = 0.643, 95% confidence interval: 0.626, 0.661, p < .0001) and slightly worse than age alone (c-statistic = 0.700, 95% confidence interval: 0.684, 0.717, p < .0001; p < .0001 for comparison of c-statistics). Prediction increased significantly with adjustment for demographics, health behaviors, and clinical comorbidities (c-statistic = 0.780, 95% confidence interval: 0.765, 0.794, p < .0001). In Long Life Family Study, the heritability of the HAI was 0.295 (p < .0001) overall, 0.387 (p < .0001) in probands, and 0.238 (p = .0004) in offspring. The HAI should be investigated further as a candidate phenotype for uncovering longevity-associated genes in humans.

Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center.

PubMed

Ismail, Ali; El-Hage-Sleiman, Abdul-Karim; Majdalani, Marianne; Hanna-Wakim, Rima; Kanj, Souha; Sharara-Chami, Rana

2016-06-30

Device-associated healthcare-associated infections (DA-HAIs) are the principal threat to patient safety in intensive care units (ICUs).  The primary objective of this study was to identify the most common DA-HAIs in the pediatric intensive care unit (PICU) at the American University of Beirut Medical Center (AUBMC). Length of stay (LOS) and mortality, antimicrobial resistance patterns, and suitability of empiric antibiotic choices for DA-HAIs according to the local resistance patterns were also studied. This was a retrospective study that included all patients admitted to the PICU at AUBMC between January 2007 and December 2011. All patients admitted to the PICU having a placed central line, an endotracheal tube, and/or a Foley catheter were included. Data was extracted from the patients' medical records through chart review. A total of 22 patients were identified with 25 central line-associated bloodstream infections (CLABSI), 25 ventilator-associated pneumonia (VAP), and 9 catheter-associated urinary tract infections (CAUTIs). The causing organisms, their resistance patterns, and the appropriateness of empiric antimicrobial therapy were reported. Gram-negative pathogens were found in 53% of the DA-HAIs, Gram-positive ones in 27%, and fungal organisms in 20%. A total of 80% of K. pneumonia isolates were extended-spectrum beta-lactamases (ESBL) producers, and 30% of Pseudomonas isolates were multidrug resistant. No methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) were isolated. Based on culture results, the choice of empiric antimicrobial therapy was appropriate in 64% of the DA-HAIs. After the care bundle approach is adopted in our PICU, DA-HAIs are expected to decrease further.

Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections

PubMed Central

Tawfik, D S; Sexton, J B; Kan, P; Sharek, P J; Nisbet, C C; Rigdon, J; Lee, H C; Profit, J

2017-01-01

Objective: To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. Study Design: Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory. The relation between burnout and HAI rates among VLBW (<1500 g) neonates from each NICU was evaluated using multi-level logistic regression analysis with patient-level factors as fixed effects. Results: We found variable prevalence of burnout across the NICUs surveyed (mean 25.2±10.1%). Healthcare-associated infection rates were 8.3±5.1% during the study period. Highest burnout prevalence was found among nurses, nurse practitioners and respiratory therapists (non-physicians, 28±11% vs 17±19% physicians), day shift workers (30±3% vs 25±4% night shift) and workers with 5 or more years of service (29±2% vs 16±6% in fewer than 3 years group). Overall burnout rates showed no correlation with risk-adjusted rates of HAIs (r=−0.133). Item-level analysis showed positive association between HAIs and perceptions of working too hard (odds ratio 1.15, 95% confidence interval 1.04–1.28). Sensitivity analysis of high-volume NICUs suggested a moderate correlation between burnout prevalence and HAIs (r=0.34). Conclusion: Burnout is most prevalent among non-physicians, daytime workers and experienced workers. Perceptions of working too hard associate with increased HAIs in this cohort of VLBW infants, but overall burnout prevalence is not predictive. PMID:27853320

Economic Analysis of Veterans Affairs Initiative to Prevent Methicillin-Resistant Staphylococcus aureus Infections.

PubMed

Nelson, Richard E; Stevens, Vanessa W; Khader, Karim; Jones, Makoto; Samore, Matthew H; Evans, Martin E; Douglas Scott, R; Slayton, Rachel B; Schweizer, Marin L; Perencevich, Eli L; Rubin, Michael A

2016-05-01

In an effort to reduce methicillin-resistant Staphylococcus aureus (MRSA) transmission through universal screening and isolation, the Department of Veterans Affairs (VA) launched the National MRSA Prevention Initiative in October 2007. The objective of this analysis was to quantify the budget impact and cost effectiveness of this initiative. An economic model was developed using published data on MRSA hospital-acquired infection (HAI) rates in the VA from October 2007 to September 2010; estimates of the costs of MRSA HAIs in the VA; and estimates of the intervention costs, including salaries of staff members hired to support the initiative at each VA facility. To estimate the rate of MRSA HAIs that would have occurred if the initiative had not been implemented, two different assumptions were made: no change and a downward temporal trend. Effectiveness was measured in life-years gained. The initiative resulted in an estimated 1,466-2,176 fewer MRSA HAIs. The initiative itself was estimated to cost $207 million during this 3-year period, while the cost savings from prevented MRSA HAIs ranged from $27 million to $75 million. The incremental cost-effectiveness ratios ranged from $28,048 to $56,944/life-years. The overall impact on the VA's budget was $131-$179 million. Wide-scale implementation of a national MRSA surveillance and prevention strategy in VA inpatient settings may have prevented a substantial number of MRSA HAIs. Although the savings associated with prevented infections helped offset some but not all of the cost of the initiative, this model indicated that the initiative would be considered cost effective. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Meta-analysis of hepatic arterial infusion for unresectable liver metastases from colorectal cancer: the end of an era?

PubMed

Mocellin, Simone; Pilati, Pierluigi; Lise, Mario; Nitti, Donato

2007-12-10

The treatment of unresectable liver-confined metastatic disease from colorectal cancer (CRC) is a challenging issue. Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the affected organ, the benefit in terms of overall survival (OS) is unclear. We quantitatively summarized the results of randomized controlled trials (RCT) comparing HAI with systemic chemotherapy (SCT). To date, 10 RCTs have been published, for a total of 1,277 patients enrolled. For tumor response rates, relative risks (RR) and their 95% CIs were obtained from raw data; for OS, hazard ratios (HRs) and their 95% CIs were extrapolated from the Kaplan-Meier survival curves. HAI regimens were based on floxuridine (FUDR) in nine of 10 RCTs, whereas in one RCT, fluorouracil (FU) + leucovorin was used. SCT consisted of FUDR, FU, FU + leucovorin, or a miscellany of FU and best supportive care in three, one, four, and two studies, respectively. Pooling the data, tumor response rate was 42.9% and 18.4% for HAI and SCT, respectively (RR = 2.26; 95% CI, 1.80 to 2.84; P < .0001). Mean weighted median OS times were 15.9 and 12.4 months for HAI and SCT, respectively; the meta-risk of death was not statistically different between the two study groups (HR = 0.90; 95% CI, 0.76 to 1.07; P = .24). Currently available evidence does not support the clinical or investigational use of fluoropyrimidine-based HAI alone for the treatment of patients with unresectable CRC liver metastases, at least as a first-line therapy.

Impact of laws aimed at healthcare-associated infection reduction: a qualitative study.

PubMed

Stone, Patricia W; Pogorzelska-Maziarz, Monika; Reagan, Julie; Merrill, Jacqueline A; Sperber, Brad; Cairns, Catherine; Penn, Matthew; Ramanathan, Tara; Mothershed, Elizabeth; Skillen, Elizabeth

2015-10-01

Healthcare-associated infections (HAIs) are preventable. Globally, laws aimed at reducing HAIs have been implemented. In the USA, these laws are at the federal and state levels. It is not known whether the state interventions are more effective than the federal incentives alone. The aims of this study were to explore the impact federal and state HAI laws have on state departments of health and hospital stakeholders in the USA and to explore similarities and differences in perceptions across states. A qualitative study was conducted. In 2012, we conducted semistructured interviews with key stakeholders from states with and without state-level laws to gain multiple perspectives. Interviews were transcribed and open coding was conducted. Data were analysed using content analysis and collected until theoretical saturation was achieved. Ninety interviews were conducted with stakeholders from 12 states (6 states with laws and 6 states without laws). We found an increase in state-level collaboration. The publicly reported data helped hospitals benchmark and focus leaders on HAI prevention. There were concerns about the publicly reported data (eg, lack of validation and timeliness). Resource needs were also identified. No major differences were expressed by interviewees from states with and without laws. While we could not tease out the impact of specific interventions, increased collaboration between departments of health and their partners is occurring. Harmonisation of HAI definitions and reporting between state and federal laws would minimise reporting burden. Continued monitoring of the progress of HAI prevention is needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Imbalance in the pro-hepatocyte growth factor activation system in bleomycin-induced lung fibrosis in mice.

PubMed

Phin, Sophie; Marchand-Adam, Sylvain; Fabre, Aurélie; Marchal-Somme, Joëlle; Bantsimba-Malanda, Claudie; Kataoka, Hiroaki; Soler, Paul; Crestani, Bruno

2010-03-01

Hepatocyte growth factor (HGF) is a growth factor for alveolar epithelial cells. Activation of pro-HGF to HGF is regulated by the HGF activator (HGFA), a serine protease, and a specific inhibitor (HGFA inhibitor-1, HAI-1). An imbalance in the HGFA/HAI-1 system might contribute to lung fibrosis. Pro-HGF activation capacity from bronchoalveolar lavage (BAL) fluid was evaluated 3, 7, and 14 days after the intratracheal bleomycin injection (Bleo) in mice with or without thrombin. BAL fluid from naïve mice was used as control. HGFA and HAI-1 mRNA were evaluated by QPCR in the whole lung or by Western blot in BAL fluid. BAL fluid from control mice and Bleo mice activated pro-HGF in vitro at a similar degree. Thrombin accelerated proHGF activation by Bleo BAL on Day 3 and Day 7, but not on Day 14, or in control BAL. Incubation of pro-HGF with BAL from Bleo Day 3 and Day 7 mice increased phosphorylation of HGFR on A549 cells. Thrombin-induced pro-HGF activation was inhibited by an anti-HGFA antibody and accelerated by an anti-HAI-1 antibody. Active HGFA was not detected in control BAL and was strongly induced in Bleo BAL. HGFA concentrations were higher on Day 3 and Day 7 than on Day 14. HAI-1 was detected at low levels in control BAL and increased strongly by Day 3 with stable concentrations until Day 14. By demonstrating an imbalance between HGFA and HAI-1 expression in BAL fluid, our results highlight a defective thrombin-dependent proHGF activation system at the fibrotic phase of bleomycin-induced pulmonary fibrosis.

Prevention of healthcare-associated infections: knowledge among dental students in seven Italian universities.

PubMed

Pasquarella, Cesira; Veronesi, Licia; Castiglia, Paolo; D'Alessandro, Daniela; Legnani, Pierpaolo; Minelli, Liliana; Montagna, Maria Teresa; Napoli, Christian; Righi, Elena; Strohmenger, Laura; Tesauro, Marina; Torre, Ida; Tanzi, Maria Luiza

2015-01-01

Lack of knowledge is the major reason for non-compliance with correct healthcare-associated infections (HAI) prevention procedures. The aim of this study was to evaluate knowledge of the Dental School (DSS) and Dental Hygiene (DHS) students with regard to the prevention of HAI, as basic knowledge for improving and harmonizing the educational content in the different Italian Universities. A cross-sectional study was carried out using an anonymous questionnaire that was completed by DSS (I, II, III, IV, and V year) in seven Universities and DHS (I, II, and III year) in three Universities. The questions dealt with three specific areas: healthcare-associated infections, standard precautions and hand hygiene. Factors associated with an unacceptable level of knowledge (score <17.5) were analyzed using a logistic regression model. A p value <0.05 was considered to be significant. Five hundred and four questionnaires were collected: 81.5% for DSS and 18.5% for DHS. Mean overall score (±DS) achieved by the total number of students was 18.2±2.93 on an overall perfect score of 25; 18.2±3.04 for DSS and 17.8±2.31 for DHS. Stratifying by area, the average score 2.7±1.07 (53%) for HAI, 10.3±1.61 (85.9%) for standard precautions, and 5.2±1.44 (64.8%) for hand hygiene was observed. A significantly different level of knowledge (p<0.001) between DSS and DHS was observed only for HAI (2.8±1.07 for DSS vs 2.1±0.96 for DHS). Significant differences among the academic years were found only for DSS concerning HAI and standard precautions. The logistic regression model showed that an age <23 years was a risk factor for lack of knowledge on HAI, but a protective factor for lack of knowledge about standard precautions and hand hygiene; attending DH degree course was associated with lack of knowledge on HAI. Although the overall score obtained both by DSS and DHS indicated an acceptable level of knowledge, lack of knowledge was highlighted, in particular, for hand hygiene. Therefore

Portable Ultraviolet Light Surface-Disinfecting Devices for Prevention of Hospital-Acquired Infections: A Health Technology Assessment.

PubMed

2018-01-01

Hospital-acquired infections (HAIs) are infections that patients contract while in the hospital that were neither present nor developing at the time of admission. In Canada an estimated 10% of adults with short-term hospitalization have HAIs. According to 2003 Canadian data, between 4% and 6% of these patients die from these infections. The most common HAIs in Ontario are caused by Clostridium difficile . The standard method of reducing and preventing these infections is decontamination of patient rooms through manual cleaning and disinfection. Several portable no-touch ultraviolet (UV) light systems have been proposed to supplement current hospital cleaning and disinfecting practices. We searched for studies published from inception of UV disinfection technology to January 23, 2017. We compared portable UV surface-disinfecting devices used together with standard hospital room cleaning and disinfecting versus standard hospital cleaning and disinfecting alone. The primary outcome was HAI from C. difficile . Other outcomes were combined HAIs, colonization (i.e., carrying an infectious agent without exhibiting disease symptoms), and the HAI-associated mortality rate. We used Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to rate the quality of evidence of included studies. We also performed a 5-year budget impact analysis from the hospital's perspective. This assessment was limited to portable devices and did not examine wall mounted devices, which are used in some hospitals. The database search for the clinical review yielded 10 peer-reviewed publications that met eligibility criteria. Three studies focused on mercury UV-C-based technology, seven on pulsed xenon UV technology. Findings were either inconsistent or produced very low-quality evidence using the GRADE rating system. The intervention was effective in reducing the rate of the composite outcome of HAIs (combined) and colonization (but quality of evidence was low). For the review

Genome-Wide Association Study and Linkage Analysis of the Healthy Aging Index

PubMed Central

Minster, Ryan L.; Sanders, Jason L.; Singh, Jatinder; Kammerer, Candace M.; Barmada, M. Michael; Matteini, Amy M.; Zhang, Qunyuan; Wojczynski, Mary K.; Daw, E. Warwick; Brody, Jennifer A.; Arnold, Alice M.; Lunetta, Kathryn L.; Murabito, Joanne M.; Christensen, Kaare; Perls, Thomas T.; Province, Michael A.

2015-01-01

Background. The Healthy Aging Index (HAI) is a tool for measuring the extent of health and disease across multiple systems. Methods. We conducted a genome-wide association study and a genome-wide linkage analysis to map quantitative trait loci associated with the HAI and a modified HAI weighted for mortality risk in 3,140 individuals selected for familial longevity from the Long Life Family Study. The genome-wide association study used the Long Life Family Study as the discovery cohort and individuals from the Cardiovascular Health Study and the Framingham Heart Study as replication cohorts. Results. There were no genome-wide significant findings from the genome-wide association study; however, several single-nucleotide polymorphisms near ZNF704 on chromosome 8q21.13 were suggestively associated with the HAI in the Long Life Family Study (p < 10− 6) and nominally replicated in the Cardiovascular Health Study and Framingham Heart Study. Linkage results revealed significant evidence (log-odds score = 3.36) for a quantitative trait locus for mortality-optimized HAI in women on chromosome 9p24–p23. However, results of fine-mapping studies did not implicate any specific candidate genes within this region of interest. Conclusions. ZNF704 may be a potential candidate gene for studies of the genetic underpinnings of longevity. PMID:25758594

'No touch' technologies for environmental decontamination: focus on ultraviolet devices and hydrogen peroxide systems.

PubMed

Weber, David J; Kanamori, Hajime; Rutala, William A

2016-08-01

This article reviews 'no touch' methods for disinfection of the contaminated surface environment of hospitalized patients' rooms. The focus is on studies that assessed the effectiveness of ultraviolet (UV) light devices, hydrogen peroxide systems, and self-disinfecting surfaces to reduce healthcare-associated infections (HAIs). The contaminated surface environment in hospitals plays an important role in the transmission of several key nosocomial pathogens including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., Clostridium difficile, Acinetobacter spp., and norovirus. Multiple clinical trials have now demonstrated the effectiveness of UV light devices and hydrogen peroxide systems to reduce HAIs. A limited number of studies have suggested that 'self-disinfecting' surfaces may also decrease HAIs. Many studies have demonstrated that terminal cleaning and disinfection with germicides is often inadequate and leaves environmental surfaces contaminated with important nosocomial pathogens. 'No touch' methods of room decontamination (i.e., UV devices and hydrogen peroxide systems) have been demonstrated to reduce key nosocomial pathogens on inoculated test surfaces and on environmental surfaces in actual patient rooms. Further UV devices and hydrogen peroxide systems have been demonstrated to reduce HAI. A validated 'no touch' device or system should be used for terminal room disinfection following discharge of patients on contact precautions. The use of a 'self-disinfecting' surface to reduce HAI has not been convincingly demonstrated.

Reduction of healthcare-associated infections in a long-term care brain injury ward by replacing regular linens with biocidal copper oxide impregnated linens.

PubMed

Lazary, A; Weinberg, I; Vatine, J-J; Jefidoff, A; Bardenstein, R; Borkow, G; Ohana, N

2014-07-01

Contaminated textiles in hospitals contribute to endogenous, indirect-contact, and aerosol transmission of nosocomial related pathogens. Copper oxide impregnated linens have wide-spectrum antimicrobial, antifungal, and antiviral properties. Our aim was to determine if replacing non-biocidal linens with biocidal copper oxide impregnated linens would reduce the rates of healthcare-associated infections (HAI) in a long-term care ward. We compared the rates of HAI in two analogous patient cohorts in a head injury care ward over two 6-month parallel periods before (period A) and after (period B) replacing all the regular non-biocidal linens and personnel uniforms with copper oxide impregnated biocidal products. During period B, in comparison to period A, there was a 24% reduction in the HAI per 1000 hospitalization-days (p<0.05), a 47% reduction in the number of fever days (>38.5°C) per 1000 hospitalization-days (p<0.01), and a 32.8% reduction in total number of days of antibiotic administration per 1000 hospitalization-days (p<0.0001). Accordingly there was saving of approximately 27% in costs of antibiotics, HAI-related treatments, X-rays, disposables, labor, and laundry, expenses during period B. The use of biocidal copper oxide impregnated textiles in a long-term care ward may significantly reduce HAI, fever, antibiotic consumption, and related treatment costs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A retrospective study of acute mountain sickness on Mt. Kilimanjaro using trekking company data.

PubMed

Eigenberger, Paul; Faino, Anna; Maltzahn, Joanne; Lisk, Christina; Frank, Eddie; Frank, Amy; Loomis, Zoe; Schroeder, Thies; Strand, Matthew; Irwin, David

2014-11-01

High altitude illnesses (HAI) are a risk factor for any individual who is exposed to a significant increase in altitude. To learn more about the epidemiology of HAI, we sought to determine if health records from a commercial trekking company could provide novel data on the prevalence of HAI, as well as efficacy data regarding common HAI therapeutics. Health parameters from 917 tourists ascending Mt. Kilimanjaro over a 10-yr period were analyzed for meaningful data. Of all subjects, 70% experienced at least one instance of a symptom related to HAI (headache, nausea, vomiting, diarrhea, or loss of appetite) during the trek. Acetazolamide was used at least once by 90% of subjects and, of those who used acetazolamide, 92% began taking it on day 1 of the ascent. Acetazolamide was found to improve oxygen saturation 1.2% above 9842.5 ft (3000 m). Dexamethasone use 12 h prior to ascending above 18,996 ft (5790 m) decreased the probability of a subject exhibiting at least one AMS symptom at that altitude. The prevalence of AMS symptoms was not reduced by taking 2 extra days to reach the summit of Mt. Kilimanjaro. Prophylactic acetazolamide modestly improved oxygen saturation; however, it did not reduce symptoms. Therapeutic dexamethasone, especially at higher altitudes, was effective at reducing symptoms. We conclude that meaningful high altitude physiological data can be obtained from private trekking companies.

[Seroprevalence of human toxoplasmosis in Ceuta].

PubMed

Pérez-Rendón González, J; López Caminero, A

1992-02-01

To study the association between religion and sex with seropositivity of Toxoplasma gondii. A cross-sectional observational or prevalence study, with blind, at random distribution. Clinic in Ceuta (North Africa). We studied 100 serum, 50 from people of Christian religion and 50 of Muslim religion, and in each group 25 of each sex. Selection was by order of arrival until the different groups were covered. The serological surveys consisted of indirect Immunofluorescence according to AMBROISE-THOMAS, using Evans Blue as a countercolor, and indirect Hemagglutination, using Blomerleux kits. Of the total samples, we found 51% positive serum for IFI and 64% for HAI. According to ethnic groups, in the Christian population we obtained 32% by IFI and 40% by HAI. In the Muslim population, we obtained 70% by IFI and 88% of seropositives by HAI (p less than 0.01). According to sexes, in males we obtained 46% by IFI and 64% by HAI of positives. In females we obtained 56% with IFI and 64% with HAI (p = insignificant). Our survey reflects a level of endemic above the world average in accordance with the WHO. This can be justified in the Muslim population who generally have a lower socio-economical and cultural level as well as their eating habits. Owing to the high prevalence of this zoonosis, we believe it requires greater consideration.

Gas-controlled dynamic vacuum insulation with gas gate

DOEpatents

Benson, David K.; Potter, Thomas F.

1994-06-07

Disclosed is a dynamic vacuum insulation comprising sidewalls enclosing an evacuated chamber and gas control means for releasing hydrogen gas into a chamber to increase gas molecule conduction of heat across the chamber and retrieving hydrogen gas from the chamber. The gas control means includes a metal hydride that absorbs and retains hydrogen gas at cooler temperatures and releases hydrogen gas at hotter temperatures; a hydride heating means for selectively heating the metal hydride to temperatures high enough to release hydrogen gas from the metal hydride; and gate means positioned between the metal hydride and the chamber for selectively allowing hydrogen to flow or not to flow between said metal hydride and said chamber.

Gas-controlled dynamic vacuum insulation with gas gate

DOEpatents

Benson, D.K.; Potter, T.F.

1994-06-07

Disclosed is a dynamic vacuum insulation comprising sidewalls enclosing an evacuated chamber and gas control means for releasing hydrogen gas into a chamber to increase gas molecule conduction of heat across the chamber and retrieving hydrogen gas from the chamber. The gas control means includes a metal hydride that absorbs and retains hydrogen gas at cooler temperatures and releases hydrogen gas at hotter temperatures; a hydride heating means for selectively heating the metal hydride to temperatures high enough to release hydrogen gas from the metal hydride; and gate means positioned between the metal hydride and the chamber for selectively allowing hydrogen to flow or not to flow between said metal hydride and said chamber. 25 figs.

Life-cycle analysis of shale gas and natural gas.

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

Clark, C.E.; Han, J.; Burnham, A.

2012-01-27

The technologies and practices that have enabled the recent boom in shale gas production have also brought attention to the environmental impacts of its use. Using the current state of knowledge of the recovery, processing, and distribution of shale gas and conventional natural gas, we have estimated up-to-date, life-cycle greenhouse gas emissions. In addition, we have developed distribution functions for key parameters in each pathway to examine uncertainty and identify data gaps - such as methane emissions from shale gas well completions and conventional natural gas liquid unloadings - that need to be addressed further. Our base case results showmore » that shale gas life-cycle emissions are 6% lower than those of conventional natural gas. However, the range in values for shale and conventional gas overlap, so there is a statistical uncertainty regarding whether shale gas emissions are indeed lower than conventional gas emissions. This life-cycle analysis provides insight into the critical stages in the natural gas industry where emissions occur and where opportunities exist to reduce the greenhouse gas footprint of natural gas.« less

78 FR 59700 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-27

... reporting to the CDC's current HAI surveillance system, the National Healthcare Safety Network (NHSN 0920...-day period at each of nine acute care hospitals in one U.S. city. This pilot phase was followed in 2010 by a phase 2, limited roll-out HAI and antimicrobial use prevalence survey, conducted during July...

75 FR 60074 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Notice of Correction to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-29

... Processing Company and UT-XI Aquatic Products Processing Company. \\32\\ AKA Viet Foods, Nam Hai Exports Food Stuff Limited, Nam Hai Export Foodstuff Company Ltd., Vietfoods Co. Ltd., Viet Foods Company Limited and...\\ 4.57 Phu Cuong Seafood Processing and Import-Export Company 4.57 Limited \\25\\ Phuong Nam Co. Ltd.\\26...

Gas sampling system for reactive gas-solid mixtures

DOEpatents

Daum, Edward D.; Downs, William; Jankura, Bryan J.; McCoury, Jr., John M.

1989-01-01

An apparatus and method for sampling a gas containing a reactive particulate solid phase flowing through a duct and for communicating a representative sample to a gas analyzer. A sample probe sheath 32 with an angular opening 34 extends vertically into a sample gas duct 30. The angular opening 34 is opposite the gas flow. A gas sampling probe 36 concentrically located within sheath 32 along with calibration probe 40 partly extend in the sheath 32. Calibration probe 40 extends further in the sheath 32 than gas sampling probe 36 for purging the probe sheath area with a calibration gas during calibration.

Gas sampling system for reactive gas-solid mixtures

DOEpatents

Daum, Edward D.; Downs, William; Jankura, Bryan J.; McCoury, Jr., John M.

1990-01-01

An apparatus and method for sampling gas containing a reactive particulate solid phase flowing through a duct and for communicating a representative sample to a gas analyzer. A sample probe sheath 32 with an angular opening 34 extends vertically into a sample gas duct 30. The angular opening 34 is opposite the gas flow. A gas sampling probe 36 concentrically located within sheath 32 along with calibration probe 40 partly extends in the sheath 32. Calibration probe 40 extends further in the sheath 32 than gas sampling probe 36 for purging the probe sheath area with a calibration gas during calibration.

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

A new project was initiated this quarter to develop gas/liquid membranes for natural gas upgrading. Efforts have concentrated on legal agreements, including alternative field sites. Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbingmore » liquid. These resilient membranes provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting in equipment 50-70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. Kvaerner and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project.« less

Gas mixtures for gas-filled radiation detectors

DOEpatents

Christophorou, Loucas G.; McCorkle, Dennis L.; Maxey, David V.; Carter, James G.

1982-01-05

Improved binary and ternary gas mixtures for gas-filled radiation detectors are provided. The components are chosen on the basis of the principle that the first component is one molecular gas or mixture of two molecular gases having a large electron scattering cross section at energies of about 0.5 eV and higher, and the second component is a noble gas having a very small cross section at and below about 1.0 eV, whereby fast electrons in the gaseous mixture are slowed into the energy range of about 0.5 eV where the cross section for the mixture is small and hence the electron mean free path is large. The reduction in both the cross section and the electron energy results in an increase in the drift velocity of the electrons in the gas mixtures over that for the separate components for a range of E/P (pressure-reduced electric field) values. Several gas mixtures are provided that provide faster response in gas-filled detectors for convenient E/P ranges as compared with conventional gas mixtures.

Gas mixtures for gas-filled particle detectors

DOEpatents

Christophorou, Loucas G.; McCorkle, Dennis L.; Maxey, David V.; Carter, James G.

1980-01-01

Improved binary and tertiary gas mixtures for gas-filled particle detectors are provided. The components are chosen on the basis of the principle that the first component is one gas or mixture of two gases having a large electron scattering cross section at energies of about 0.5 eV and higher, and the second component is a gas (Ar) having a very small cross section at and below aout 0.5 eV, whereby fast electrons in the gaseous mixture are slowed into the energy range of about 0.5 eV where the cross section for the mixture is small and hence the electron mean free path is large. The reduction in both the cross section and the electron energy results in an increase in the drift velocity of the electrons in the gas mixtures over that for the separate components for a range of E/P (pressure-reduced electron field) values. Several gas mixtures are provided that provide faster response in gas-filled detectors for convenient E/P ranges as compared with conventional gas mixtures.

Low-temperature gas from marine shales: wet gas to dry gas over experimental time.

PubMed

Mango, Frank D; Jarvie, Daniel M

2009-11-09

Marine shales exhibit unusual behavior at low temperatures under anoxic gas flow. They generate catalytic gas 300 degrees below thermal cracking temperatures, discontinuously in aperiodic episodes, and lose these properties on exposure to trace amounts of oxygen. Here we report a surprising reversal in hydrocarbon generation. Heavy hydrocarbons are formed before light hydrocarbons resulting in wet gas at the onset of generation grading to dryer gas over time. The effect is moderate under gas flow and substantial in closed reactions. In sequential closed reactions at 100 degrees C, gas from a Cretaceous Mowry shale progresses from predominately heavy hydrocarbons (66% C5, 2% C1) to predominantly light hydrocarbons (56% C1, 8% C5), the opposite of that expected from desorption of preexisting hydrocarbons. Differences in catalyst substrate composition explain these dynamics. Gas flow should carry heavier hydrocarbons to catalytic sites, in contrast to static conditions where catalytic sites are limited to in-place hydrocarbons. In-place hydrocarbons and their products should become lighter with conversion thus generating lighter hydrocarbon over time, consistent with our experimental results. We recognize the similarities between low-temperature gas generation reported here and the natural progression of wet gas to dry gas over geologic time. There is now substantial evidence for natural catalytic activity in source rocks. Natural gas at thermodynamic equilibrium and the results reported here add to that evidence. Natural catalysis provides a plausible and unique explanation for the origin and evolution of gas in sedimentary basins.

Immunogenicity and tolerability after two doses of non-adjuvanted, whole-virion pandemic influenza A (H1N1) vaccine in HIV-infected individuals.

PubMed

Lagler, Heimo; Grabmeier-Pfistershammer, Katharina; Touzeau-Römer, Veronique; Tobudic, Selma; Ramharter, Michael; Wenisch, Judith; Gualdoni, Guido Andrés; Redlberger-Fritz, Monika; Popow-Kraupp, Theresia; Rieger, Armin; Burgmann, Heinz

2012-01-01

During the influenza pandemic of 2009/10, the whole-virion, Vero-cell-derived, inactivated, pandemic influenza A (H1N1) vaccine Celvapan® (Baxter) was used in Austria. Celvapan® is adjuvant-free and was the only such vaccine at that time in Europe. The objective of this observational, non-interventional, prospective single-center study was to evaluate the immunogenicity and tolerability of two intramuscular doses of this novel vaccine in HIV-positive individuals. A standard hemagglutination inhibition (HAI) assay was used for evaluation of the seroconversion rate and seroprotection against the pandemic H1N1 strain. In addition, H1N1-specific IgG antibodies were measured using a recently developed ELISA and compared with the HAI results. Tolerability of vaccination was evaluated up to one month after the second dose. A total of 79 HIV-infected adults with an indication for H1N1 vaccination were evaluated. At baseline, 55 of the 79 participants had an HAI titer ≥1:40 and two patients showed a positive IgG ELISA. The seroconversion rate was 31% after the first vaccination, increasing to 41% after the second; the corresponding seroprotection rates were 92% and 83% respectively. ELISA IgG levels were positive in 25% after the first vaccination and in 37% after the second. Among the participants with baseline HAI titers <1:40, 63% seroconverted. Young age was clearly associated with lower HAI titers at baseline and with higher seroconversion rates, whereas none of the seven patients >60 years of age had a baseline HAI titer <1:40 or seroconverted after vaccination. The vaccine was well tolerated. The non-adjuvanted pandemic influenza A (H1N1) vaccine was well tolerated and induced a measurable immune response in a sample of HIV-infected individuals.

Immunogenicity and Tolerability after Two Doses of Non-Adjuvanted, Whole-Virion Pandemic Influenza A (H1N1) Vaccine in HIV-Infected Individuals

PubMed Central

Lagler, Heimo; Grabmeier-Pfistershammer, Katharina; Touzeau-Römer, Veronique; Tobudic, Selma; Ramharter, Michael; Wenisch, Judith; Gualdoni, Guido Andrés; Redlberger-Fritz, Monika; Popow-Kraupp, Theresia; Rieger, Armin; Burgmann, Heinz

2012-01-01

Background During the influenza pandemic of 2009/10, the whole-virion, Vero-cell-derived, inactivated, pandemic influenza A (H1N1) vaccine Celvapan® (Baxter) was used in Austria. Celvapan® is adjuvant-free and was the only such vaccine at that time in Europe. The objective of this observational, non-interventional, prospective single-center study was to evaluate the immunogenicity and tolerability of two intramuscular doses of this novel vaccine in HIV-positive individuals. Methods and Findings A standard hemagglutination inhibition (HAI) assay was used for evaluation of the seroconversion rate and seroprotection against the pandemic H1N1 strain. In addition, H1N1-specific IgG antibodies were measured using a recently developed ELISA and compared with the HAI results. Tolerability of vaccination was evaluated up to one month after the second dose. A total of 79 HIV-infected adults with an indication for H1N1 vaccination were evaluated. At baseline, 55 of the 79 participants had an HAI titer ≥1∶40 and two patients showed a positive IgG ELISA. The seroconversion rate was 31% after the first vaccination, increasing to 41% after the second; the corresponding seroprotection rates were 92% and 83% respectively. ELISA IgG levels were positive in 25% after the first vaccination and in 37% after the second. Among the participants with baseline HAI titers <1∶40, 63% seroconverted. Young age was clearly associated with lower HAI titers at baseline and with higher seroconversion rates, whereas none of the seven patients >60 years of age had a baseline HAI titer <1∶40 or seroconverted after vaccination. The vaccine was well tolerated. Conclusion The non-adjuvanted pandemic influenza A (H1N1) vaccine was well tolerated and induced a measurable immune response in a sample of HIV-infected individuals. PMID:22629330

Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland

PubMed Central

Kołpa, Małgorzata; Wałaszek, Marta; Gniadek, Agnieszka; Wolak, Zdzisław; Dobroś, Wiesław

2018-01-01

Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016. The study was conducted in compliance with the methodology recommended by the Healthcare-associated Infections Surveillance Network (HAI-Net) of the European Centre for Disease Prevention and Control (ECDC). During the 10 years of the study, 1849 patients hospitalized in an ICU for a total of 17,599 days acquired 510 with overall HAIs rates of 27.6% and 29.0% infections per 1000 ICU days. Intubation-associated pneumonia (IAP) posed the greatest risk (15.2 per 1000 ventilator days), followed by CLA-BSI (8.0 per 1000 catheter days) and CA-UTI (3.0 per 1000 catheter days). The most common isolated microorganism was Acinetobacter baumannii (25%) followed by Coagulaase-negativ staphylococci (15%), Escherichia coli (9%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (7%), Candida albicans (6%). Acinetobacter baumannii in 87% and were classified as extensive-drug resistant (XDR). In summary, in ICU patients pneumonia and bloodstream infections were the most frequently found. Acinetobacter baumannii strains were most often isolated from clinical materials taken from HAI patients and showed resistance to many groups of antibiotics. A trend of increasing resistance of Acinetobacter baumannii to carbapenems was observed. PMID:29324651

Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database.

PubMed

Likosky, Donald S; Wallace, Amelia S; Prager, Richard L; Jacobs, Jeffrey P; Zhang, Min; Harrington, Steven D; Saha-Chaudhuri, Paramita; Theurer, Patricia F; Fishstrom, Astrid; Dokholyan, Rachel S; Shahian, David M; Rankin, J Scott

2015-11-01

Patients undergoing coronary artery bypass grafting (CABG) are at risk for a variety of infections. Investigators have focused on predictors of these adverse sequelae, but less attention has been focused on characterizing hospital-level variability in these outcomes. Between July 2011 and December 2013, The Society of Thoracic Surgeons Adult Cardiac Surgery Database shows 365,686 patients underwent isolated CABG in 1,084 hospitals. Hospital-acquired infections (HAIs) were defined as pneumonia, sepsis/septicemia, deep sternal wound infection/mediastinitis, vein harvest/cannulation site infection, or thoracotomy infection. Hospitals were ranked by their HAI rate as low (≤ 10th percentile), medium (10th to 90th percentile), and high (>90th percentile). Differences in perioperative factors and composite morbidity and mortality end points across these groups were determined using the Wilcoxon rank sum and χ(2) tests. HAIs occurred among 3.97% of patients overall, but rates varied across hospital groups (low: <0.84%, medium: 0.84% to 8.41%, high: >8.41%). Pneumonia (2.98%) was the most common HAI, followed by sepsis/septicemia (0.84%). Patients at high-rate hospitals more often smoked, had diabetes, chronic lung disease, New York Heart Association Functional Classification III to IV, and received blood products (p < 0.001); however, they less often were prescribed the appropriate antibiotics (p < 0.001). Major morbidity and mortality occurred among 12.3% of patients, although this varied by hospital group (low: 8.6%, medium: 12.3%, high: 17.9%; p < 0.001). Substantial hospital-level variation exists in postoperative HAIs among patients undergoing CABG, driven predominantly by pneumonia. Given the relatively small absolute differences in comorbidities across hospital groups, our findings suggest factors other than case mix may explain the observed variation in HAI rates. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Sources of Variation in Hospital-level Infection Rates after Coronary Artery Bypass Grafting: An analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

PubMed Central

Likosky, Donald S.; Wallace, Amelia S.; Prager, Richard L.; Jacobs, Jeffrey P.; Zhang, Min; Harrington, Steven D.; Saha-Chaudhuri, Paramita; Theurer, Patricia F.; Fishstrom, Astrid; Dokholyan, Rachel S.; Shahian, David M.; Rankin, J. Scott

2016-01-01

Background Patients undergoing coronary artery bypass grafting (CABG) are at risk for developing a variety of infections. While investigators have focused on predictors of these adverse sequelae, less attention has been focused on characterizing hospital-level variability in these outcomes. Methods 365,686 patients in the STS Adult Cardiac Surgery Database underwent isolated CABG across 1084 hospitals between July 2011 and December 2013. Hospital-acquired infections (HAIs) were defined as: pneumonia, sepsis/septicemia, deep sternal wound infection/mediastinitis, vein harvest/cannulation, or thoracotomy. Hospitals were ranked based on their HAI rate: Low (≤10th Percentile) vs. Medium (10th–90th Percentile) and High (>90th Percentile). Differences in peri-operative factors and composite morbidity/mortality endpoints across these groups were determined using the Wilcoxon rank-sum and chi-square tests. Results HAIs occurred among 3.97% of patients overall, but rates varied across hospital groups (Low:<0.84%, Medium:0.84–8.41%, High:>8.41%). Pneumonia (2.98%) was the most common HAI, followed by sepsis/septicemia (0.84%). Patients at high rate hospitals more often smoked, had diabetes, chronic lung disease, NYHA Class III-IV, and received blood products, (p<0.001); however, they less often were prescribed the appropriate antibiotics (p<0.001). Major morbidity/mortality occurred among 12.3% of patients, although varied by hospital group (low: 8.6%, medium: 12.3%, high: 17.9%, p<0.001). Conclusions Substantial hospital-level variation exists in postoperative HAIs among patients undergoing CABG, driven predominantly by pneumonia. Given the relatively small absolute differences in comorbidities across hospital groups, our findings suggest factors other than case mix may explain the observed variation in HAI rates. PMID:26321440

Role of stranded gas in increasing global gas supplies

USGS Publications Warehouse

Attanasi, E.D.; Freeman, P.A.

2013-01-01

This report synthesizes the findings of three regional studies in order to evaluate, at the global scale, the contribution that stranded gas resources can make to global natural gas supplies. Stranded gas, as defined for this study, is natural gas in discovered conventional gas and oil fields that is currently not commercially producible for either physical or economic reasons. The regional studies evaluated the cost of bringing the large volumes of undeveloped gas in stranded gas fields to selected markets. In particular, stranded gas fields of selected Atlantic Basin countries, north Africa, Russia, and central Asia are screened to determine whether the volumes are sufficient to meet Europe’s increasing demand for gas imports. Stranded gas fields in Russia, central Asia, Southeast Asia, and Australia are also screened to estimate development, production, and transport costs and corresponding gas volumes that could be supplied to Asian markets in China, India, Japan, and South Korea. The data and cost analysis presented here suggest that for the European market and the markets examined in Asia, the development of stranded gas provides a way to meet projected gas import demands for the 2020-to-2040 period. Although this is a reconnaissance-type appraisal, it is based on volumes of gas that are associated with individual identified fields. Individual field data were carefully examined. Some fields were not evaluated because current technology was insufficient or it appeared the gas was likely to be held off the export market. Most of the evaluated stranded gas can be produced and delivered to markets at costs comparable to historical prices. Moreover, the associated volumes of gas are sufficient to provide an interim supply while additional technologies are developed to unlock gas diffused in shale and hydrates or while countries transition to making a greater use of renewable energy sources.

Exploring relationships of human-automation interaction consequences on pilots: uncovering subsystems.

PubMed

Durso, Francis T; Stearman, Eric J; Morrow, Daniel G; Mosier, Kathleen L; Fischer, Ute; Pop, Vlad L; Feigh, Karen M

2015-05-01

We attempted to understand the latent structure underlying the systems pilots use to operate in situations involving human-automation interaction (HAI). HAI is an important characteristic of many modern work situations. Of course, the cognitive subsystems are not immediately apparent by observing a functioning system, but correlations between variables may reveal important relations. The current report examined pilot judgments of 11 HAI dimensions (e.g., Workload, Task Management, Stress/Nervousness, Monitoring Automation, and Cross-Checking Automation) across 48 scenarios that required airline pilots to interact with automation on the flight deck. We found three major clusters of the dimensions identifying subsystems on the flight deck: a workload subsystem, a management subsystem, and an awareness subsystem. Relationships characterized by simple correlations cohered in ways that suggested underlying subsystems consistent with those that had previously been theorized. Understanding the relationship among dimensions affecting HAI is an important aspect in determining how a new piece of automation designed to affect one dimension will affect other dimensions as well. © 2014, Human Factors and Ergonomics Society.

Mother-adolescent conflict in African American and European American families: the role of corporal punishment, adolescent aggression, and adolescents' hostile attributions of mothers' intent.

PubMed

MacKinnon-Lewis, Carol; Lindsey, Eric W; Frabutt, James M; Chambers, Jessica Campbell

2014-08-01

The present study examined mothers' use of corporal punishment and adolescents' aggression as predictors of mother-youth conflict during early adolescence. Particular attention was given to the potential mediating role that adolescents' hostile attributions of intent (HAI) regarding mothers' behavior might play in connections between corporal punishment, youth aggression, and mother-adolescent conflict for European American (EA) and African American (AA) youth. Data were collected from 268 12- to 14-year-olds (154 European American; 114 African American; 133 girls; 135 boys) and their mothers over a period of 2 years. Questionnaires completed by both mothers and adolescents were used to assess maternal corporal punishment and adolescent aggression, and interviews concerning hypothetical situations were used to assess adolescent HAI in year one. In both year one and year two mother-adolescent conflict was observed in a laboratory interaction session. Data revealed that adolescent HAI mediated the link between maternal corporal punishment and mother-adolescent conflict for EA, but not AA youth. Adolescents' HAI mediated the link between adolescent aggression and mother-adolescent conflict for both EA and AA families. Published by Elsevier Ltd.

Antibodies Against the Current Influenza A(H1N1) Vaccine Strain Do Not Protect Some Individuals From Infection With Contemporary Circulating Influenza A(H1N1) Virus Strains.

PubMed

Petrie, Joshua G; Parkhouse, Kaela; Ohmit, Suzanne E; Malosh, Ryan E; Monto, Arnold S; Hensley, Scott E

2016-12-15

During the 2013-2014 influenza season, nearly all circulating 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) strains possessed an antigenically important mutation in hemagglutinin (K166Q). Here, we performed hemagglutination-inhibition (HAI) assays, using sera collected from 382 individuals prior to the 2013-2014 season, and we determined whether HAI titers were associated with protection from A(H1N1)pdm09 infection. Protection was associated with HAI titers against an A(H1N1)pdm09 strain possessing the K166Q mutation but not with HAI titers against the current A(H1N1)pdm09 vaccine strain, which lacks this mutation. These data indicate that contemporary A(H1N1)pdm09 strains are antigenically distinct from the current A(H1N1)pdm09 vaccine strain. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Modern trends in infection control practices in intensive care units.

PubMed

Gandra, Sumanth; Ellison, Richard T

2014-01-01

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection. © The Author(s) 2013.

High-touch surfaces: microbial neighbours at hand.

PubMed

Cobrado, L; Silva-Dias, A; Azevedo, M M; Rodrigues, A G

2017-11-01

Despite considerable efforts, healthcare-associated infections (HAIs) continue to be globally responsible for serious morbidity, increased costs and prolonged length of stay. Among potentially preventable sources of microbial pathogens causing HAIs, patient care items and environmental surfaces frequently touched play an important role in the chain of transmission. Microorganisms contaminating such high-touch surfaces include Gram-positive and Gram-negative bacteria, viruses, yeasts and parasites, with improved cleaning and disinfection effectively decreasing the rate of HAIs. Manual and automated surface cleaning strategies used in the control of infectious outbreaks are discussed and current trends concerning the prevention of contamination by the use of antimicrobial surfaces are taken into consideration in this manuscript.

A Gas Chromatographic System for the Detection of Ethylene Gas Using Ambient Air as a Carrier Gas

PubMed Central

Zaidi, Nayyer Abbas; Tahir, Muhammad Waseem; Vellekoop, Michael J.; Lang, Walter

2017-01-01

Ethylene gas is a naturally occurring gas that has an influence on the shelf life of fruit during their transportation in cargo ships. An unintentional exposure of ethylene gas during transportation results in a loss of fruit. A gas chromatographic system is presented here for the detection of ethylene gas. The gas chromatographic system was assembled using a preconcentrator, a printed 3D printed gas chromatographic column, a humidity sensor, solenoid valves, and an electrochemical ethylene gas sensor. Ambient air was used as a carrier gas in the gas chromatographic system. The flow rate was fixed to 10 sccm. It was generated through a mini-pump connected in series with a mass flow controller. The metal oxide gas sensor is discussed with its limitation in ambient air. The results show the chromatogram obtained from metal oxide gas sensor has low stability, drifts, and has uncertain peaks, while the chromatogram from the electrochemical sensor is stable and precise. Furthermore, ethylene gas measurements at higher ppb concentration and at lower ppb concentration were demonstrated with the electrochemical ethylene gas sensor. The system separates ethylene gas and humidity. The chromatograms obtained from the system are stable, and the results are 1.2% repeatable in five similar measurements. The statistical calculation of the gas chromatographic system shows that a concentration of 2.3 ppb of ethylene gas can be detected through this system. PMID:28991173

A Gas Chromatographic System for the Detection of Ethylene Gas Using Ambient Air as a Carrier Gas.

PubMed

Zaidi, Nayyer Abbas; Tahir, Muhammad Waseem; Vellekoop, Michael J; Lang, Walter

2017-10-07

Ethylene gas is a naturally occurring gas that has an influence on the shelf life of fruit during their transportation in cargo ships. An unintentional exposure of ethylene gas during transportation results in a loss of fruit. A gas chromatographic system is presented here for the detection of ethylene gas. The gas chromatographic system was assembled using a preconcentrator, a printed 3D printed gas chromatographic column, a humidity sensor, solenoid valves, and an electrochemical ethylene gas sensor. Ambient air was used as a carrier gas in the gas chromatographic system. The flow rate was fixed to 10 sccm. It was generated through a mini-pump connected in series with a mass flow controller. The metal oxide gas sensor is discussed with its limitation in ambient air. The results show the chromatogram obtained from metal oxide gas sensor has low stability, drifts, and has uncertain peaks, while the chromatogram from the electrochemical sensor is stable and precise. Furthermore, ethylene gas measurements at higher ppb concentration and at lower ppb concentration were demonstrated with the electrochemical ethylene gas sensor. The system separates ethylene gas and humidity. The chromatograms obtained from the system are stable, and the results are 1.2% repeatable in five similar measurements. The statistical calculation of the gas chromatographic system shows that a concentration of 2.3 ppb of ethylene gas can be detected through this system.

Performance management of Clostridium difficile infection in hospitals - The carrot or stick approach?

PubMed

Fitzpatrick, Fidelma; Riordan, Mary O

2016-02-01

Public and political pressure for healthcare quality indicator monitoring, specifically healthcare-associated infection (HAI) has intensified the debate regarding the merits of public reporting and target setting as policy approaches. This paper reviews the evidence for these approaches with a focus on HAI, including Clostridium difficile infection (CDI). Healthcare key performance indicators (KPIs) and associated targets have been used widely with little evaluation. While targets are associated with some HAI reductions including CDI, as their control is multi-factorial, it is likely that reductions are due to numerous, concurrent control measures. Targets may help tackle organizational-wide issues that require high level management engagement and have contributed to the increased access and influence of infection control teams. HAI public reporting has also gained traction and is mandatory in many countries despite little scientific evaluation. CDI is one of the KPIs used but there is little consensus as to the best KPI for public reporting. Countries without public reporting have also seen improvements. Using indicator-based strategies rather than evidence-based ones risk improving the KPI but not necessarily quality of care. 'Bottom-up' approaches focussing on quality improvement and innovation generated by front line staff are seen as a lever for sustainable change. Positive deviance, where the resourcefulness and problem solving abilities of staff is harnessed, enables 'bottom-up' changes with process and outcome improvements. As implementation of best practice in healthcare is dependent on behavioural and cultural change, it is most likely that a combination of 'top-down' and 'bottom-up' approaches are required for sustainable improvement. This combined approach was used to improve staff influenza vaccination rates. Regulation may initially direct the spot-light onto infection control needs but true sustainable HAI reduction will only be fostered with

Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals - United States, 2014.

PubMed

Weiner, Lindsey M; Fridkin, Scott K; Aponte-Torres, Zuleika; Avery, Lacey; Coffin, Nicole; Dudeck, Margaret A; Edwards, Jonathan R; Jernigan, John A; Konnor, Rebecca; Soe, Minn M; Peterson, Kelly; McDonald, L Clifford

2016-03-11

Health care-associated antibiotic-resistant (AR) infections increase patient morbidity and mortality and might be impossible to successfully treat with any antibiotic. CDC assessed health care-associated infections (HAI), including Clostridium difficile infections (CDI), and the role of six AR bacteria of highest concern nationwide in several types of health care facilities. During 2014, approximately 4,000 short-term acute care hospitals, 501 long-term acute care hospitals, and 1,135 inpatient rehabilitation facilities in all 50 states reported data on specific infections to the National Healthcare Safety Network. National standardized infection ratios and their percentage reduction from a baseline year for each HAI type, by facility type, were calculated. The proportions of AR pathogens and HAIs caused by any of six resistant bacteria highlighted by CDC in 2013 as urgent or serious threats were determined. In 2014, the reductions in incidence in short-term acute care hospitals and long-term acute care hospitals were 50% and 9%, respectively, for central line-associated bloodstream infection; 0% (short-term acute care hospitals), 11% (long-term acute care hospitals), and 14% (inpatient rehabilitation facilities) for catheter-associated urinary tract infection; 17% (short-term acute care hospitals) for surgical site infection, and 8% (short-term acute care hospitals) for CDI. Combining HAIs other than CDI across all settings, 47.9% of Staphylococcus aureus isolates were methicillin resistant, 29.5% of enterococci were vancomycin-resistant, 17.8% of Enterobacteriaceae were extended-spectrum beta-lactamase phenotype, 3.6% of Enterobacteriaceae were carbapenem resistant, 15.9% of Pseudomonas aeruginosa isolates were multidrug resistant, and 52.6% of Acinetobacter species were multidrug resistant. The likelihood of HAIs caused by any of the six resistant bacteria ranged from 12% in inpatient rehabilitation facilities to 29% in long-term acute care hospitals. Although

Gas amplified ionization detector for gas chromatography

DOEpatents

Huston, Gregg C.

1992-01-01

A gas-amplified ionization detector for gas chromatrography which possesses increased sensitivity and a very fast response time. Solutes eluding from a gas chromatographic column are ionized by UV photoionization of matter eluting therefrom. The detector is capable of generating easily measured voltage signals by gas amplification/multiplication of electron products resulting from the UV photoionization of at least a portion of each solute passing through the detector.

Feasibility of flare gas reformation to practical energy in Farashband gas refinery: no gas flaring.

PubMed

Rahimpour, Mohammad Reaza; Jokar, Seyyed Mohammad

2012-03-30

A suggested method for controlling the level of hazardous materials in the atmosphere is prevention of combustion in flare. In this work, three methods are proposed to recover flare gas instead of conventional gas-burning in flare at the Farashband gas refinery. These methods aim to minimize environmental and economical disadvantages of burning flare gas. The proposed methods are: (1) gas to liquid (GTL) production, (2) electricity generation with a gas turbine and, (3) compression and injection into the refinery pipelines. To find the most suitable method, the refinery units that send gas to the flare as well as the required equipment for the three aforementioned methods are simulated. These simulations determine the amount of flare gas, the number of GTL barrels, the power generated by the gas turbine and the required compression horsepower. The results of simulation show that 563 barrels/day of valuable GTL products is produced by the first method. The second method provides 25 MW electricity and the third method provides a compressed natural gas with 129 bar pressure for injection to the refinery pipelines. In addition, the economics of flare gas recovery methods are studied and compared. The results show that for the 4.176MMSCFD of gas flared from the Farashband gas refinery, the electricity production gives the highest rate of return (ROR), the lowest payback period, the highest annual profit and mild capital investment. Therefore, the electricity production is the superior method economically. Copyright © 2012 Elsevier B.V. All rights reserved.

Genome-Wide Association Study and Linkage Analysis of the Healthy Aging Index.

PubMed

Minster, Ryan L; Sanders, Jason L; Singh, Jatinder; Kammerer, Candace M; Barmada, M Michael; Matteini, Amy M; Zhang, Qunyuan; Wojczynski, Mary K; Daw, E Warwick; Brody, Jennifer A; Arnold, Alice M; Lunetta, Kathryn L; Murabito, Joanne M; Christensen, Kaare; Perls, Thomas T; Province, Michael A; Newman, Anne B

2015-08-01

The Healthy Aging Index (HAI) is a tool for measuring the extent of health and disease across multiple systems. We conducted a genome-wide association study and a genome-wide linkage analysis to map quantitative trait loci associated with the HAI and a modified HAI weighted for mortality risk in 3,140 individuals selected for familial longevity from the Long Life Family Study. The genome-wide association study used the Long Life Family Study as the discovery cohort and individuals from the Cardiovascular Health Study and the Framingham Heart Study as replication cohorts. There were no genome-wide significant findings from the genome-wide association study; however, several single-nucleotide polymorphisms near ZNF704 on chromosome 8q21.13 were suggestively associated with the HAI in the Long Life Family Study (p < 10(-) (6)) and nominally replicated in the Cardiovascular Health Study and Framingham Heart Study. Linkage results revealed significant evidence (log-odds score = 3.36) for a quantitative trait locus for mortality-optimized HAI in women on chromosome 9p24-p23. However, results of fine-mapping studies did not implicate any specific candidate genes within this region of interest. ZNF704 may be a potential candidate gene for studies of the genetic underpinnings of longevity. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care-associated infection rates in a cohort of acute care general hospitals.

PubMed

Halpin, Helen Ann; McMenamin, Sara B; Simon, Lisa Payne; Jacobsen, Diane; Vanneman, Megan; Shortell, Stephen; Milstein, Arnold

2013-04-01

In 2008, hospitals were selected to participate in the California Healthcare-Associated Infection Prevention Initiative (CHAIPI). This research evaluates the impact of CHAIPI on hospital adoption and implementation of evidence-based patient safety practices and reduction of health care-associated infection (HAI) rates. Statewide computer-assisted telephone surveys of California's general acute care hospitals were conducted in 2008 and 2010 (response rates, 80% and 76%, respectively). Difference-in-difference analyses were used to compare changes in process and HAI rate outcomes in CHAIPI hospitals (n = 34) and non-CHAIPI hospitals (n = 149) that responded to both waves of the survey. Compared with non-CHAIPI hospitals, CHAIPI hospitals demonstrated greater improvements between 2008 and 2010 in adoption (P = .021) and implementation (P = .012) of written evidence-based practices for overall patient safety and prevention of HAIs and in assessing their compliance (P = .033) with these practices. However, there were no significant differences in the changes in HAI rates between CHAIPI and non-CHAIPI hospitals over this time period. Participation in the CHAIPI collaborative was associated with significant improvements in evidence-based patient safety practices in hospitals. However, determining how evidence-based practices translate into changes in HAI rates may take more time. Our results suggest that all hospitals be offered the opportunity to participate in an active learning collaborative to improve patient safety. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Perceived impact of the Medicare policy to adjust payment for health care-associated infections

PubMed Central

Lee, Grace M.; Hartmann, Christine W.; Graham, Denise; Kassler, William; Linn, Maya Dutta; Krein, Sarah; Saint, Sanjay; Goldmann, Donald A.; Fridkin, Scott; Horan, Teresa; Jernigan, John; Jha, Ashish

2014-01-01

Background In 2008, the Centers for Medicare and Medicaid Services (CMS) ceased additional payment for hospitalizations resulting in complications deemed preventable, including several health care-associated infections. We sought to understand the impact of the CMS payment policy on infection prevention efforts. Methods A national survey of infection preventionists from a random sample of US hospitals was conducted in December 2010. Results Eighty-one percent reported increased attention to HAIs targeted by the CMS policy, whereas one-third reported spending less time on nontargeted HAIs. Only 15% reported increased funding for infection control as a result of the CMS policy, whereas most reported stable (77%) funding. Respondents reported faster removal of urinary (71%) and central venous (50%) catheters as a result of the CMS policy, whereas routine urine and blood cultures on admission occurred infrequently (27% and 13%, respectively). Resource shifting (ie, less time spent on nontargeted HAIs) occurred more commonly in large hospitals (odds ratio, 2.3; 95% confidence interval: 1.0–5.1; P = .038) but less often in hospitals where front-line staff were receptive to changes in clinical processes (odds ratio, 0.5; 95% confidence interval: 0.3–0.8; P = .005). Conclusion Infection preventionists reported greater hospital attention to preventing targeted HAIs as a result of the CMS nonpayment policy. Whether the increased focus and greater engagement in HAI prevention practices has led to better patient outcomes is unclear. PMID:22541855

75 FR 13524 - Northern Natural Gas Company, Southern Natural Gas Company, Florida Gas Transmission Company, LLC...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... Natural Gas Company, Southern Natural Gas Company, Florida Gas Transmission Company, LLC, Transcontinental... notice that on March 5, 2010, Northern Natural Gas Company (Northern Natural), 1111 South 103rd Street, Omaha, Nebraska 68124- 1000, filed on behalf of itself and other owners, Southern Natural Gas Company...

Portable Ultraviolet Light Surface-Disinfecting Devices for Prevention of Hospital-Acquired Infections: A Health Technology Assessment

PubMed Central

Nikitovic-Jokic, Milica; Kabali, Conrad; Li, Chunmei; Higgins, Caroline

2018-01-01

Background Hospital-acquired infections (HAIs) are infections that patients contract while in the hospital that were neither present nor developing at the time of admission. In Canada an estimated 10% of adults with short-term hospitalization have HAIs. According to 2003 Canadian data, between 4% and 6% of these patients die from these infections. The most common HAIs in Ontario are caused by Clostridium difficile. The standard method of reducing and preventing these infections is decontamination of patient rooms through manual cleaning and disinfection. Several portable no-touch ultraviolet (UV) light systems have been proposed to supplement current hospital cleaning and disinfecting practices. Methods We searched for studies published from inception of UV disinfection technology to January 23, 2017. We compared portable UV surface-disinfecting devices used together with standard hospital room cleaning and disinfecting versus standard hospital cleaning and disinfecting alone. The primary outcome was HAI from C. difficile. Other outcomes were combined HAIs, colonization (i.e., carrying an infectious agent without exhibiting disease symptoms), and the HAI-associated mortality rate. We used Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to rate the quality of evidence of included studies. We also performed a 5-year budget impact analysis from the hospital's perspective. This assessment was limited to portable devices and did not examine wall mounted devices, which are used in some hospitals. Results The database search for the clinical review yielded 10 peer-reviewed publications that met eligibility criteria. Three studies focused on mercury UV-C–based technology, seven on pulsed xenon UV technology. Findings were either inconsistent or produced very low-quality evidence using the GRADE rating system. The intervention was effective in reducing the rate of the composite outcome of HAIs (combined) and colonization (but quality of evidence

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranes provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting inmore » equipment 50-70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. KPS and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project. Efforts this quarter have concentrated on field site selection. ChevronTexaco has nominated their Headlee Gas Plant in Odessa, TX for a commercial-scale dehydration test. Potting and module materials testing were initiated. Preliminary

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranes provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting inmore » equipment 50-70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. Kvaerner and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project. Efforts this quarter have concentrated on field site selection. ChevronTexaco has nominated their Headlee Gas Plant in Odessa, TX for a commercial-scale dehydration test. Design and cost estimation for this new site are underway

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Efforts this quarter have concentrated on legal agreements, including alternative field sites. Preliminary design of the bench-scale equipment has been initiated. Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranesmore » provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting in equipment 50--70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. Kvaerner and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project.« less

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranes provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting inmore » equipment 50-70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. KPS and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project. Efforts this quarter have concentrated on legal agreements, including alternative field sites. Preliminary design of the bench-scale equipment continues.« less

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranes provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting inmore » equipment 50-70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. Kvaerner and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project. Efforts this quarter have concentrated on legal agreements, including alternative field sites. Preliminary design of the bench-scale equipment continues.« less

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Efforts this quarter have concentrated on legal agreements, including alternative field sites. Preliminary design of the bench-scale equipment continues. Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranes provide muchmore » greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting in equipment 50--70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. Kvaerner and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project.« less

Improved gas mixtures for gas-filled radiation detectors

DOEpatents

Christophorou, L.G.; McCorkle, D.L.; Maxey, D.V.; Carter, J.G.

1980-03-28

Improved binary and ternary gas mixtures for gas-filled radiation detectors are provided. The components are chosen on the basis of the principle that the first component is one molecular gas or mixture of two molecular gases having a large electron scattering cross section at energies of about 0.5 eV and higher, and the second component is a noble gas having a very small cross section at and below about 1.0 eV, whereby fast electrons in the gaseous mixture are slowed into the energy range of about 0.5 eV where the cross section for the mixture is small and hence the electron mean free path is large. The reduction in both the cross section and the electron energy results in an increase in the drift velocity of the electrons in the gas mixtures over that for the separate components for a range of E/P (pressure-reduced electric field) values. Several gas mixtures are provided that provide faster response in gas-filled detectors for convenient E/P ranges as compared with conventional gas mixtures.

Improved gas mixtures for gas-filled particle detectors

DOEpatents

Christophorou, L.G.; McCorkle, D.L.; Maxey, D.V.; Carter, J.G.

Improved binary and tertiary gas mixture for gas-filled particle detectors are provided. The components are chosen on the basis of the principle that the first component is one gas or mixture of two gases having a large electron scattering cross section at energies of about 0.5 eV and higher, and the second component is a gas (Ar) having a very small cross section at and below about 0.5 eV; whereby fast electrons in the gaseous mixture are slowed into the energy range of about 0.5 eV where the cross section for the mixture is small and hence the electron mean free path is large. The reduction in both the cross section and the electron energy results in an increase in the drift velocity of the electrons in the gas mixtures over that for the separate components for a range of E/P (pressure-reduced electron field) values. Several gas mixtures are provided that provide faster response in gas-filled detectors for convenient E/P ranges as compared with conventional gas mixtures.

Apparatus for gas sorption measurement with integrated gas composition measurement device and gas mixing

DOEpatents

Micklash. II, Kenneth James; Dutton, Justin James; Kaye, Steven

2014-06-03

An apparatus for testing of multiple material samples includes a gas delivery control system operatively connectable to the multiple material samples and configured to provide gas to the multiple material samples. Both a gas composition measurement device and pressure measurement devices are included in the apparatus. The apparatus includes multiple selectively openable and closable valves and a series of conduits configured to selectively connect the multiple material samples individually to the gas composition device and the pressure measurement devices by operation of the valves. A mixing system is selectively connectable to the series of conduits and is operable to cause forced mixing of the gas within the series of conduits to achieve a predetermined uniformity of gas composition within the series of conduits and passages.

Gas flow path for a gas turbine engine

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

Montgomery, Matthew D.; Charron, Richard C.; Snyder, Gary D.

A duct arrangement in a can annular gas turbine engine. The gas turbine engine has a gas delivery structure for delivering gases from a plurality of combustors to an annular chamber that extends circumferentially and is oriented concentric to a gas turbine engine longitudinal axis for delivering the gas flow to a first row of blades A gas flow path is formed by the duct arrangement between a respective combustor and the annular chamber for conveying gases from each combustor to the first row of turbine blades The duct arrangement includes at least one straight section having a centerline thatmore » is misaligned with a centerline of the combustor.« less

Gas Hydrate Storage of Natural Gas

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

Rudy Rogers; John Etheridge

2006-03-31

Environmental and economic benefits could accrue from a safe, above-ground, natural-gas storage process allowing electric power plants to utilize natural gas for peak load demands; numerous other applications of a gas storage process exist. A laboratory study conducted in 1999 to determine the feasibility of a gas-hydrates storage process looked promising. The subsequent scale-up of the process was designed to preserve important features of the laboratory apparatus: (1) symmetry of hydrate accumulation, (2) favorable surface area to volume ratio, (3) heat exchanger surfaces serving as hydrate adsorption surfaces, (4) refrigeration system to remove heat liberated from bulk hydrate formation, (5)more » rapid hydrate formation in a non-stirred system, (6) hydrate self-packing, and (7) heat-exchanger/adsorption plates serving dual purposes to add or extract energy for hydrate formation or decomposition. The hydrate formation/storage/decomposition Proof-of-Concept (POC) pressure vessel and supporting equipment were designed, constructed, and tested. This final report details the design of the scaled POC gas-hydrate storage process, some comments on its fabrication and installation, checkout of the equipment, procedures for conducting the experimental tests, and the test results. The design, construction, and installation of the equipment were on budget target, as was the tests that were subsequently conducted. The budget proposed was met. The primary goal of storing 5000-scf of natural gas in the gas hydrates was exceeded in the final test, as 5289-scf of gas storage was achieved in 54.33 hours. After this 54.33-hour period, as pressure in the formation vessel declined, additional gas went into the hydrates until equilibrium pressure/temperature was reached, so that ultimately more than the 5289-scf storage was achieved. The time required to store the 5000-scf (48.1 hours of operating time) was longer than designed. The lower gas hydrate formation rate is attributed

Methods of natural gas liquefaction and natural gas liquefaction plants utilizing multiple and varying gas streams

DOEpatents

Wilding, Bruce M; Turner, Terry D

2014-12-02

A method of natural gas liquefaction may include cooling a gaseous NG process stream to form a liquid NG process stream. The method may further include directing the first tail gas stream out of a plant at a first pressure and directing a second tail gas stream out of the plant at a second pressure. An additional method of natural gas liquefaction may include separating CO.sub.2 from a liquid NG process stream and processing the CO.sub.2 to provide a CO.sub.2 product stream. Another method of natural gas liquefaction may include combining a marginal gaseous NG process stream with a secondary substantially pure NG stream to provide an improved gaseous NG process stream. Additionally, a NG liquefaction plant may include a first tail gas outlet, and at least a second tail gas outlet, the at least a second tail gas outlet separate from the first tail gas outlet.

[The current aspects of hospital infections in maternity and neonatal wards].

PubMed

Ribarova, N; Todorova, M; Khristov, Kh

1994-01-01

The epidemiologic, etiologic and clinical structure of HAI in the maternity and neonatal wards in the country for the 1982-1992 period has been specified. 934 women in child-birth and 2357 neonates acquire nosocomial infections at an average annually. A comparatively constant level in HAI epidemic process intensity is observed with inconsiderable diversions in the beginning and by the end of the studied period. Staphylococci like causative agents of HAI take up a leading place in both types of wards with especially marked incidence rate among the newborn children. The predominant clinical forms in the women in child-birth are the surgical wound infections, skin and genital infections and in the neonates--the staphylodermatites, upper respiratory airway infections, pulmonary and enteric infections.

GAS/LIQUID MEMBRANES FOR NATURAL GAS UPGRADING

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

Howard S. Meyer

Gas Technology Institute (GTI) is conducting this research program whose objective is to develop gas/liquid membranes for natural gas upgrading to assist DOE in achieving their goal of developing novel methods of upgrading low quality natural gas to meet pipeline specifications. Kvaerner Process Systems (KPS) and W. L. Gore & Associates (GORE) gas/liquid membrane contactors are based on expanded polytetrafluoroethylene (ePTFE) membranes acting as the contacting barrier between the contaminated gas stream and the absorbing liquid. These resilient membranes provide much greater surface area for transfer than other tower internals, with packing densities five to ten times greater, resulting inmore » equipment 50-70% smaller and lower weight for the same treating service. The scope of the research program is to (1) build and install a laboratory- and a field-scale gas/liquid membrane absorber; (2) operate the units with a low quality natural gas feed stream for sufficient time to verify the simulation model of the contactors and to project membrane life in this severe service; and (3) conducted an economic evaluation, based on the data, to quantify the impact of the technology. Chevron, one of the major producers of natural gas, has offered to host the test at a gas treating plant. KPS will use their position as a recognized leader in the construction of commercial amine plants for building the unit along with GORE providing the membranes. GTI will provide operator and data collection support during lab- and field-testing to assure proper analytical procedures are used. Kvaerner and GTI will perform the final economic evaluation. GTI will provide project management and be responsible for reporting and interactions with DOE on this project. Efforts this quarter have concentrated on field site selection. ChevronTexaco has nominated their Headlee Gas Plant in Odessa, TX for a commercial-scale dehydration test. Design and cost estimation for this new site are underway. A

78 FR 11638 - Michigan Consolidated Gas Company, DTE Gas Company, DTE Gas Company; Notice of Petition

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... corporate name change from MichCon to DTE Gas, and pursuant to section 284.123 of the Commissions... Gas Company (DTE Gas) filed to institute a name change to both itself from MichCon to DTE Gas and to...

Study on cyclic injection gas override in condensate gas reservoir

NASA Astrophysics Data System (ADS)

Sun, Yan; Zhu, Weiyao; Xia, Jing; Li, Baozhu

2018-02-01

Cyclic injection gas override in condensate gas reservoirs for the large density difference between injection gas and condensate gas has been studied, but no relevant mathematical models have been built. In this paper, a mathematical model of cyclic injection gas override in condensate gas reservoir is established, considering density difference between the injected gas and the remaining condensate gas in the formation. The vertical flow ratio and override degree are used to reflect the override law of injected dry gas. Combined with the actual data of Tarim gas condensate reservoir, the parameters of injected dry gas override are calculated and analysed. The results show that the radial pressure rises or falls rapidly and the pressure gradient varies greatly in the near wells. The radial pressure varies slowly and the pressure gradient changes little in the reservoir which is within a certain distance from the wells. In the near injection well, the injected dry gas mainly migrates along the radial direction, and the vertical migration is relatively not obvious. With the distance from the injection well, the vertical flow ratio and override degree of injected dry gas increases, and the vertical flow ratio reaches the maximum in the middle of the injection well and the production well.

78 FR 38309 - Northern Natural Gas Company; Southern Natural Gas Company, L.L.C.; Florida Gas Transmission...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... Natural Gas Company; Southern Natural Gas Company, L.L.C.; Florida Gas Transmission Company, LLC; Notice of Application Take notice that on June 4, 2013, Northern Natural Gas Company (Northern), 1111 South 103rd Street, Omaha, Nebraska 68124; on behalf of itself, Southern Natural Gas Company, L.L.C., and...

N-acyl homoserine lactone-degrading microbial enrichment cultures isolated from Penaeus vannamei shrimp gut and their probiotic properties in Brachionus plicatilis cultures.

PubMed

Tinh, Nguyen Thi Ngoc; Asanka Gunasekara, R A Y S; Boon, Nico; Dierckens, Kristof; Sorgeloos, Patrick; Bossier, Peter

2007-10-01

Three bacterial enrichment cultures (ECs) were isolated from the digestive tract of Pacific white shrimp Penaeus vannamei, by growing the shrimp microbial communities in a mixture of N-acyl homoserine lactone (AHL) molecules. The ECs, characterized by denaturing gradient gel electrophoresis analysis and subsequent rRNA sequencing, degraded AHL molecules in the degradation assays. Apparently, the resting cells of the ECs also degraded one of the three types of quorum-sensing signal molecules produced by Vibrio harveyi in vitro [i.e. harveyi autoinducer 1 (HAI-1)]. The most efficient AHL-degrading ECs, EC5, was tested in Brachionus experiments. EC5 degraded the V. harveyi HAI-1 autoinducer in vivo, neutralizing the negative effect of V. harveyi autoinducer 2 (AI-2) mutant, in which only the HAI-1- and CAI-1-mediated components of the quorum-sensing system are functional on the growth of Brachionus. This suggests that EC5 interferes with HAI-1-regulated metabolism in V. harveyi. These AHL-degrading ECs need to be tested in other aquatic systems for their probiotic properties, preferably in combination with specific AI-2-degrading bacteria.

Nursing job satisfaction, certification and healthcare-associated infections in critical care.

PubMed

Boev, Christine; Xue, Ying; Ingersoll, Gail L

2015-10-01

The purpose of this study was to examine the relationship between nursing job satisfaction and healthcare-associated infections (HAIs) in adult critical care. Multilevel modelling was used to examine the relationship between nursing job satisfaction and two HAIs, ventilator-associated pneumonia (VAP) and central-line associated bloodstream infections (CLABSI). Units with nurses that reported satisfaction with organisational policies were associated with a 6.08 decrease in VAP (p=0.013) and units with nurses reporting favourable perception of task requirements were associated with a 7.02 decrease in VAP (.014). Positive perception of organisational policies was associated with lower rates of CLABSI (p=0.002). Unexpected findings include a positive relationship between perception of pay and autonomy and CLABSI as well as perception of interactions and VAP. Units with a higher proportion of Critical Care Registered Nurse (CCRN) certified nurses were associated with lower rates of both CLABSI (p<0.001) and VAP (p=0.037). This study provides preliminary evidence to support the relationship between nursing job satisfaction and HAIs in critical care, although some relationships were counterintuitive. A secondary finding included significant relationships between CCRN certified nurses and HAIs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Eliminating Hospital Acquired Infections: Is It Possible? Is It Sustainable? Is It Worth It?

PubMed Central

Shannon, Richard P.

2011-01-01

An estimated 2 million hospital-acquired infections (HAI) are now reported annually in the US, and are associated with an estimated $5 billion in additional health care costs. With this, the growing incidence of HAI has become “ground zero” in the campaign to improve patient safety and eliminate waste in health care. We studied the characteristics of high-performing organizations and their leaders outside of health care to determine how such organizations become “best in class.” We then sought to apply the principles that led to this status to eliminating HAI associated with central venous catheters. Observations of the current condition of health care revealed multiple defects in various processes, that were breeding grounds for error. Redesign of these processes by the people involved in them under the guidance of a leader resulted in an 86% reduction in infections in the blood. Overall, financial performance improved by $5.1 million over a 2-year period. Mortality in intensive care units declined by 29%. Using methods borrowed from highly reliable industries and engaging workers at the point of care can have profound and sustainable effects in nearly eliminating HAI, with significant clinical and financial benefits. PMID:21686213

Prevention of Device-Related Healthcare-Associated Infections

PubMed Central

Septimus, Edward J.; Moody, Julia

2016-01-01

Healthcare-associated infections (HAIs) are a leading cause of morbidity and mortality in hospitalized patients. Up to 15% of patients develop an infection while hospitalized in the United States, which accounts for approximately 1.7 million HAIs, 99,000 deaths annually and over 10 billion dollars in costs per year. A significant percentage of HAIs are preventable using evidenced-based strategies. In terms of device-related HAIs it is estimated that 65-70% of catheter-line associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) are preventable. To prevent CLABSIs a bundle which includes hand hygiene prior to insertion and catheter manipulation, use of chlorhexidene alcohol for site preparation and maintenance, use of maximum barrier for catheter insertion, site selection, removing nonessential lines, disinfect catheter hubs before assessing line, and dressing changes are essential elements of basic practices. To prevent CAUTIs a bundle that includes hand hygiene for insertion and catheter or bag manipulation, inserting catheters for appropriate indications, insert using aseptic technique, remove catheters when no longer needed, maintain a close system keeping bag and tubing below the bladder are the key components of basic practices. PMID:26918162

Eliminating hospital acquired infections: is it possible? Is it sustainable? Is it worth it?

PubMed

Shannon, Richard P

2011-01-01

An estimated 2 million hospital-acquired infections (HAI) are now reported annually in the US, and are associated with an estimated $5 billion in additional health care costs. With this, the growing incidence of HAI has become "ground zero" in the campaign to improve patient safety and eliminate waste in health care.We studied the characteristics of high-performing organizations and their leaders outside of health care to determine how such organizations become "best in class." We then sought to apply the principles that led to this status to eliminating HAI associated with central venous catheters.Observations of the current condition of health care revealed multiple defects in various processes, that were breeding grounds for error. Redesign of these processes by the people involved in them under the guidance of a leader resulted in an 86% reduction in infections in the blood. Overall, financial performance improved by $5.1 million over a 2-year period. Mortality in intensive care units declined by 29%.Using methods borrowed from highly reliable industries and engaging workers at the point of care can have profound and sustainable effects in nearly eliminating HAI, with significant clinical and financial benefits.

Nonthermal plasma processor utilizing additive-gas injection and/or gas extraction

DOEpatents

Rosocha, Louis A.

2006-06-20

A device for processing gases includes a cylindrical housing in which an electrically grounded, metal injection/extraction gas supply tube is disposed. A dielectric tube surrounds the injection/extraction gas supply tube to establish a gas modification passage therearound. Additionally, a metal high voltage electrode circumscribes the dielectric tube. The high voltage electrode is energizable to create nonthermal electrical microdischarges between the high voltage electrode and the injection/extraction gas supply tube across the dielectric tube within the gas modification passage. An injection/extraction gas and a process gas flow through the nonthermal electrical microdischarges within the gas modification passage and a modified process gas results. Using the device contaminants that are entrained in the process gas can be destroyed to yield a cleaner, modified process gas.

Gas vesicles.

PubMed Central

Walsby, A E

1994-01-01

The gas vesicle is a hollow structure made of protein. It usually has the form of a cylindrical tube closed by conical end caps. Gas vesicles occur in five phyla of the Bacteria and two groups of the Archaea, but they are mostly restricted to planktonic microorganisms, in which they provide buoyancy. By regulating their relative gas vesicle content aquatic microbes are able to perform vertical migrations. In slowly growing organisms such movements are made more efficiently than by swimming with flagella. The gas vesicle is impermeable to liquid water, but it is highly permeable to gases and is normally filled with air. It is a rigid structure of low compressibility, but it collapses flat under a certain critical pressure and buoyancy is then lost. Gas vesicles in different organisms vary in width, from 45 to > 200 nm; in accordance with engineering principles the narrower ones are stronger (have higher critical pressures) than wide ones, but they contain less gas space per wall volume and are therefore less efficient at providing buoyancy. A survey of gas-vacuolate cyanobacteria reveals that there has been natural selection for gas vesicles of the maximum width permitted by the pressure encountered in the natural environment, which is mainly determined by cell turgor pressure and water depth. Gas vesicle width is genetically determined, perhaps through the amino acid sequence of one of the constituent proteins. Up to 14 genes have been implicated in gas vesicle production, but so far the products of only two have been shown to be present in the gas vesicle: GvpA makes the ribs that form the structure, and GvpC binds to the outside of the ribs and stiffens the structure against collapse. The evolution of the gas vesicle is discussed in relation to the homologies of these proteins. Images PMID:8177173

Comparison of transcriptome profiles by Fusarium oxysporum inoculation between Fusarium yellows resistant and susceptible lines in Brassica rapa L.

PubMed

Miyaji, Naomi; Shimizu, Motoki; Miyazaki, Junji; Osabe, Kenji; Sato, Maho; Ebe, Yusuke; Takada, Satoko; Kaji, Makoto; Dennis, Elizabeth S; Fujimoto, Ryo; Okazaki, Keiichi

2017-12-01

Resistant and susceptible lines in Brassica rapa have different immune responses against Fusarium oxysporum inoculation. Fusarium yellows caused by Fusarium oxysporum f. sp. conglutinans (Foc) is an important disease of Brassicaceae; however, the mechanism of how host plants respond to Foc is still unknown. By comparing with and without Foc inoculation in both resistant and susceptible lines of Chinese cabbage (Brassica rapa var. pekinensis), we identified differentially expressed genes (DEGs) between the bulked inoculated (6, 12, 24, and 72 h after inoculation (HAI)) and non-inoculated samples. Most of the DEGs were up-regulated by Foc inoculation. Quantitative real-time RT-PCR showed that most up-regulated genes increased their expression levels from 24 HAI. An independent transcriptome analysis at 24 and 72 HAI was performed in resistant and susceptible lines. GO analysis using up-regulated genes at 24 HAI indicated that Foc inoculation activated systemic acquired resistance (SAR) in resistant lines and tryptophan biosynthetic process and responses to chitin and ethylene in susceptible lines. By contrast, GO analysis using up-regulated genes at 72 HAI showed the overrepresentation of some categories for the defense response in susceptible lines but not in the resistant lines. We also compared DEGs between B. rapa and Arabidopsis thaliana after F. oxysporum inoculation at the same time point, and identified genes related to defense response that were up-regulated in the resistant lines of Chinese cabbage and A. thaliana. Particular genes that changed expression levels overlapped between the two species, suggesting that they are candidates for genes involved in the resistance mechanisms against F. oxysporum.

Review and analysis of existing mobile phone applications for health care-associated infection prevention.

PubMed

Schnall, Rebecca; Iribarren, Sarah J

2015-06-01

The expanding number of mobile health applications (apps) holds potential to reduce and eliminate health care-associated infections (HAIs) in clinical practice. The purpose of this review was to identify and provide an overview of the apps available to support prevention of HAIs and to assess their functionality and potential uses in clinical care. We searched 3 online mobile app stores using the following terms: infection prevention, prevention, hand hygiene, hand washing, and specific HAI terms (catheter-associated urinary tract infection [CAUTI], central line-associated bloodstream infections, surgical site infection, and ventilator associated pneumonia [VAP]). Search queries yielded a total of 2,646 potentially relevant apps, of which 17 met our final inclusion criteria. The areas of focus were CAUTI (n = 1, 5.9%), VAP (n = 1, 5.9%), environmental monitoring (n = 2, 11.8%), and hand hygiene (n = 2, 11.8%); the remainder (n = 11, 64.7%) were focused on >1 area (eg, multiple infection prevention bundles, infection prevention guidelines). Almost all of the apps (70.6%) had a maximum of two functions. Mobile apps may help reduce HAI by providing easy access to guidelines, hand hygiene monitoring support, or step-by-step procedures aimed at reducing infections at the point of clinical care. Given the dearth of available apps and the lack of functionality with those that are available, there is a need for further development of mobile apps for HAI prevention at the point of care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Development of the Hand Assessment for Infants: evidence of internal scale validity.

PubMed

Krumlinde-Sundholm, Lena; Ek, Linda; Sicola, Elisa; Sjöstrand, Lena; Guzzetta, Andrea; Sgandurra, Giuseppina; Cioni, Giovanni; Eliasson, Ann-Christin

2017-12-01

The aim of this study was to develop a descriptive and evaluative assessment of upper limb function for infants aged 3 to 12 months and to investigate its internal scale validity for use with infants at risk of unilateral cerebral palsy. The concepts of the test items and scoring criteria were developed. Internal scale validity and aspects of reliability were investigated on the basis of 156 assessments of infants at 3 to 12 months corrected age (mean 7.2mo, SD 2.5) with signs of asymmetric hand use. Rasch measurement model analysis and non-parametric statistics were used. The new test, the Hand Assessment for Infants (HAI), consists of 12 unimanual and five bimanual items, each scored on a 3-point rating scale. It demonstrated a unidimensional construct and good fit to the Rasch model requirements. The excellent person reliability enabled person separation to six significant ability strata. The HAI produced an interval-level measure of bilateral hand use as well as unimanual scores of each hand, allowing a quantification of possible asymmetry expressed as an asymmetry index. The HAI can be considered a valid assessment tool for measuring bilateral hand use and quantifying side difference between hands among infants at risk of developing unilateral cerebral palsy. The Hand Assessment for Infants (HAI) measures the use of both hands and quantifies a possible asymmetry of hand use. HAI is valid for infants at 3 to 12 months corrected age at risk of unilateral cerebral palsy. © 2017 Mac Keith Press.

Crystal Structure of a Two-domain Fragment of Hepatocyte Growth Factor Activator Inhibitor-1

PubMed Central

Hong, Zebin; De Meulemeester, Laura; Jacobi, Annemarie; Pedersen, Jan Skov; Morth, J. Preben; Andreasen, Peter A.; Jensen, Jan K.

2016-01-01

Hepatocyte growth factor activator inhibitor-1 (HAI-1) is a type I transmembrane protein and inhibitor of several serine proteases, including hepatocyte growth factor activator and matriptase. The protein is essential for development as knock-out mice die in utero due to placental defects caused by misregulated extracellular proteolysis. HAI-1 contains two Kunitz-type inhibitor domains (Kunitz), which are generally thought of as a functionally self-contained protease inhibitor unit. This is not the case for HAI-1, where our results reveal how interdomain interactions have evolved to stimulate the inhibitory activity of an integrated Kunitz. Here we present an x-ray crystal structure of an HAI-1 fragment covering the internal domain and Kunitz-1. The structure reveals not only that the previously uncharacterized internal domain is a member of the polycystic kidney disease domain family but also how the two domains engage in interdomain interactions. Supported by solution small angle x-ray scattering and a combination of site-directed mutagenesis and functional assays, we show that interdomain interactions not only stabilize the fold of the internal domain but also stimulate the inhibitory activity of Kunitz-1. By completing our structural characterization of the previously unknown N-terminal region of HAI-1, we provide new insight into the interplay between tertiary structure and the inhibitory activity of a multidomain protease inhibitor. We propose a previously unseen mechanism by which the association of an auxiliary domain stimulates the inhibitory activity of a Kunitz-type inhibitor (i.e. the first structure of an intramolecular interaction between a Kunitz and another domain). PMID:27189939

Non-invasive fibrosis tests are correlated with necroinflammatory actvity of liver in patients with chronic hepatitis B.

PubMed

Ozyalvacli, G; Kucukbayrak, A; Kurt, M; Gurel, K; Gunes, O; Ustun, C; Akdeniz, H

2014-01-01

The gold standarda method used for assessing necroinflammatory activity and fibrosis in the liver is a liver biopsy which has many disadvantages. Therefore, many investigators have been trying to develop non-invasive tests for predicting liver fibrosis score (LFS) of these patients. The aim of this study is to describe the relationship between certain non-invasive fibrosis markers with LFS and histological activity index (HAI) detected histopathologically by liver biopsy in chronic hepatitis B patients. A total of 54 patients who had undergone a liver biopsy with the diagnosis of chronic HBV infection were included in the study. Ishak scoring was used for the evaluation of liver fibrosis, and a modified Knodell HAI was used for demonstration of necroinflammation. In this study, non-invasive fibrosis tests were calculated as described in previous studies. Histological acitivity index was positively correlated with age, age/platelet index, cirrhosis discriminant score (CDS), AST/platelet ratio index (APRI), AST/platelet/GGT/AFP index (APGA), fibro-quotient (Fibro-Q), Goteburg University Cirrhosis Index (Guci), and Platelet/Age/Phosphatase/AFP/AST index (PAPAS). When divided into two groups according to HAI, Guci and APGA were found significantly different both in >4 and >4 HAI groups than the other group. In ROC analysis performed for LFS; PAPAS, APGA, FFI and APRI were the markers having the highest AUC levels, and in ROC analysis performed for HAI; Guci, APRI and APGA were the markers with the highest AUC levels. APRI, APGA and GUCI tests may be helpful in prediction of necroinflammatory scores in the liver.

Effectiveness of a hand hygiene promotion strategy using alcohol-based handrub in 6 intensive care units in Colombia.

PubMed

Barrera, Lena; Zingg, Walter; Mendez, Fabian; Pittet, Didier

2011-10-01

Hand hygiene is an effective strategy for the prevention of health care-associated infection (HAI). We investigated the effect of a hand hygiene promotion strategy introducing alcohol-based handrub (AHBR) on the incidence of HAI in a university hospital in Colombia. A Prospective cohort study was performed in 6 intensive care units from January 2001 to December 2005. HAI were identified using standard US Centers for Disease Control and Prevention definitions. Alcohol-based handrub dispensers were installed between February and June 2002. Total ABHR consumption was 5,794 L (mean, 28.9 L per 1,000 patient-days) and significantly increased over time (+9.2% per year; P < .001). Of 14,516 patients cumulating 166,498 patient-days, 2,398 (16.5%) acquired a total of 3,490 HAI episodes (20.9 per 1,000 patient-days). Incidence densities for central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia, and urinary tract infections were 7.7, 10.6, and 3.6 episodes per 1,000 device-days, respectively. A significant decrease was observed for CLABSI (-12.7% per year; P < .001) with low nurse-to-patient ratio independently associated with infection (odds ratio, 1.11; 95% confidence interval: 1.07-1.16; P < .001). Improved hand hygiene measured by increased ABHR consumption resulted in CLABSI reduction. Low nurse-to-patient ratio is independently associated with HAI in an upper-middle income country. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Optimal Cut-Off Points on the Health Anxiety Inventory, Illness Attitude Scales and Whiteley Index to Identify Severe Health Anxiety

PubMed Central

Hedman, Erik; Lekander, Mats; Ljótsson, Brjánn; Lindefors, Nils; Rück, Christian; Andersson, Gerhard; Andersson, Erik

2015-01-01

Background Health anxiety can be viewed as a dimensional phenomenon where severe health anxiety in form of DSM-IV hypochondriasis represents a cut-off where the health anxiety becomes clinically significant. Three of the most reliable and used self-report measures of health anxiety are the Health Anxiety Inventory (HAI), the Illness Attitude Scales (IAS) and the Whiteley Index (WI). Identifying the optimal cut-offs for classification of presence of a diagnosis of severe health anxiety on these measures has several advantages in clinical and research settings. The aim of this study was therefore to investigate the HAI, IAS and WI as proximal diagnostic instruments for severe health anxiety defined as DSM-IV hypochondriasis. Methods We investigated sensitivity, specificity and predictive value on the HAI, IAS and WI using a total of 347 adult participants of whom 158 had a diagnosis of severe health anxiety, 97 had obsessive-compulsive disorder and 92 were healthy non-clinical controls. Diagnostic assessments were conducted using the Anxiety Disorder Interview Schedule. Results Optimal cut-offs for identifying a diagnosis of severe health anxiety was 67 on the HAI, 47 on the IAS, and 5 on the WI. Sensitivity and specificity were high, ranging from 92.6 to 99.4%. Positive and negative predictive values ranged from 91.6 to 99.4% using unadjusted prevalence rates. Conclusions The HAI, IAS and WI have very good properties as diagnostic indicators of severe health anxiety and can be used as cost-efficient proximal estimates of the diagnosis. PMID:25849477

The national response for preventing healthcare-associated infections: infrastructure development.

PubMed

Mendel, Peter; Siegel, Sari; Leuschner, Kristin J; Gall, Elizabeth M; Weinberg, Daniel A; Kahn, Katherine L

2014-02-01

In 2009, the US Department of Health and Human Services (HHS) launched the Action Plan to Prevent Healthcare-associated Infections (HAIs). The Action Plan adopted national targets for reduction of specific infections, making HHS accountable for change across the healthcare system over which federal agencies have limited control. This article examines the unique infrastructure developed through the Action Plan to support adoption of HAI prevention practices. Interviews of federal (n=32) and other stakeholders (n=38), reviews of agency documents and journal articles (n=260), and observations of interagency meetings (n=17) and multistakeholder conferences (n=17) over a 3-year evaluation period. We extract key progress and challenges in the development of national HAI prevention infrastructure--1 of the 4 system functions in our evaluation framework encompassing regulation, payment systems, safety culture, and dissemination and technical assistance. We then identify system properties--for example, coordination and alignment, accountability and incentives, etc.--that enabled or hindered progress within each key development. The Action Plan has developed a model of interagency coordination (including a dedicated "home" and culture of cooperation) at the federal level and infrastructure for stimulating change through the wider healthcare system (including transparency and financial incentives, support of state and regional HAI prevention capacity, changes in safety culture, and mechanisms for stakeholder engagement). Significant challenges to infrastructure development included many related to the same areas of progress. The Action Plan has built a foundation of infrastructure to expand prevention of HAIs and presents useful lessons for other large-scale improvement initiatives.

Effect of Probiotics on the Incidence of Healthcare-Associated Infections in Mechanically Ventilated Neurocritical Care Patients.

PubMed

Kenna, John; Mahmoud, Leana; Zullo, Andrew R; Potter, N Stevenson; Fehnel, Corey R; Thompson, Bradford B; Wendell, Linda C

2016-02-01

Healthcare-associated infections (HAIs) are seen in 17% of critically ill patients. Probiotics, live nonpathogenic microorganisms, may aid in reducing the incidence of infection in critically ill patients. We hypothesized that administration of probiotics would be safe and reduce the incidence of HAIs among mechanically ventilated neurocritical care patients. We assembled 2 retrospective cohorts of mechanically ventilated neurocritical care patients. In the preintervention cohort from July 1, 2011, to December 31, 2011, probiotics were not used. In the postintervention group from July 1, 2012, to December 31, 2012, 1 g of a combination of Lactobacillus acidophilus and Lactobacillus helveticus was administered twice daily to all patients who were mechanically ventilated for more than 24 hours. There were a total of 167 patients included, 80 patients in the preintervention group and 87 patients in the postintervention group. No patients in the preintervention group received probiotics. Eighty-five (98%) patients in the postintervention group received probiotics for a median of 10 days (interquartile range, 4-20 days). There were 14 (18%) HAIs in the preintervention group and 8 (9%) HAIs in the postintervention group (P = .17). Ventilator days, lengths of stay, in-hospital mortality, and discharge disposition were similar between the pre- and postintervention groups. There were no cases of Lactobacillus bacteremia or other adverse events associated with probiotics use. Probiotics are safe to administer in neurocritical care patients; however, this study failed to demonstrate a significant decrease in HAIs or secondary outcomes associated with probiotics. © 2015 American Society for Parenteral and Enteral Nutrition.

Stabilization Improves Theranostic Properties of Lipiodol®-Based Emulsion During Liver Trans-arterial Chemo-embolization in a VX2 Rabbit Model.

PubMed

Deschamps, F; Farouil, G; Gonzalez, W; Robic, C; Paci, A; Mir, L M; Tselikas, L; de Baère, T

2017-06-01

To demonstrate that stability is a crucial parameter for theranostic properties of Lipiodol ® -based emulsions during liver trans-arterial chemo-embolization. We compared the theranostic properties of two emulsions made of Lipiodol ® and doxorubicin in two successive animal experiments (One VX2 tumour implanted in the left liver lobe of 30 rabbits). Emulsion-1 reproduced one of the most common way of preparation (ratio of oil/water: 1/1), and emulsion-2 was designed to obtain a water-in-oil emulsion with enhanced stability (ratio of oil/water: 3/1, plus an emulsifier). The first animal experiment compared the tumour selectivity of the two emulsions: seven rabbits received left hepatic arterial infusion (HAI) of emulsion-1 and eight received HAI of emulsion-2. 3D-CBCT acquisitions were acquired after HAI of every 0.1 mL to measure the densities' ratios between the tumours and the left liver lobes. The second animal experiment compared the plasmatic and tumour doxorubicin concentrations after HAI of 1.5 mg of doxorubicin administered either alone (n = 3) or in emulsion-1 (n = 6) or in emulsion-2 (n = 6). Emulsion-2 resulted in densities' ratios between the tumours and the left liver lobes that were significantly higher compared to emulsion-1 (up to 0.4 mL infused). Plasmatic doxorubicin concentrations (at 5 min) were significantly lower after HAI of emulsion-2 (19.0 μg/L) than emulsion-1 (275.3 μg/L, p < 0.01) and doxorubicin alone (412.0 μg/L, p < 0.001), and tumour doxorubicin concentration (day-1) was significantly higher after HAI of emulsion-2 (20,957 ng/g) than in emulsion-1 (8093 ng/g, p < 0.05) and doxorubicin alone (2221 ng/g, p < 0.01). Stabilization of doxorubicin in a water-in-oil Lipiodol ® -based emulsion results in better theranostic properties.

Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study

PubMed Central

Murni, Indah K; Duke, Trevor; Kinney, Sharon; Daley, Andrew J; Soenarto, Yati

2015-01-01

Background Prevention of hospital-acquired infections (HAI) is central to providing safe and high quality healthcare. Transmission of infection between patients by health workers, and the irrational use of antibiotics have been identified as preventable aetiological factors for HAIs. Few studies have addressed this in developing countries. Aims To implement a multifaceted infection control and antibiotic stewardship programme and evaluate its effectiveness on HAIs and antibiotic use. Methods A before-and-after study was conducted over 27 months in a teaching hospital in Indonesia. All children admitted to the paediatric intensive care unit and paediatric wards were observed daily. Assessment of HAIs was made based on the criteria from the Centers for Disease Control and Prevention. The multifaceted intervention consisted of a hand hygiene campaign, antibiotic stewardship (using the WHO Pocket Book of Hospital Care for Children guidelines as standards of antibiotic prescribing for community-acquired infections), and other elementary infection control practices. Data were collected using an identical method in the preintervention and postintervention periods. Results We observed a major reduction in HAIs, from 22.6% (277/1227 patients) in the preintervention period to 8.6% (123/1419 patients) in the postintervention period (relative risk (RR) (95% CI) 0.38 (0.31 to 0.46)). Inappropriate antibiotic use declined from 43% (336 of 780 patients who were prescribed antibiotics) to 20.6% (182 of 882 patients) (RR 0.46 (0.40 to 0.55)). Hand hygiene compliance increased from 18.9% (319/1690) to 62.9% (1125/1789) (RR 3.33 (2.99 to 3.70)). In-hospital mortality decreased from 10.4% (127/1227) to 8% (114/1419) (RR 0.78 (0.61 to 0.97)). Conclusions Multifaceted infection control interventions are effective in reducing HAI rates, improving the rational use of antibiotics, increasing hand hygiene compliance, and may reduce mortality in hospitalised children in developing

Impact of age and pre-existing influenza immune responses in humans receiving split inactivated influenza vaccine on the induction of the breadth of antibodies to influenza A strains

PubMed Central

Nuñez, Ivette A.; Carlock, Michael A.; Allen, James D.; Owino, Simon O.; Moehling, Krissy K.; Nowalk, Patricia; Susick, Michael; Diagle, Kensington; Sweeney, Kristen; Mundle, Sophia; Vogel, Thorsten U.; Delagrave, Simon; Ramgopal, Moti; Zimmerman, Richard K.; Kleanthous, Harry

2017-01-01

Most humans have pre-existing immunity to influenza viruses. In this study, volunteers (ages of 18–85 years) were vaccinated with split, inactivated Fluzone™ influenza vaccine in four consecutive influenza seasons from 2013 to 2016 seasons. The impact of repeated vaccination on breadth and durability of antibodies was assessed as a result of vaccine strain changes. Total IgG anti-hemagglutinin (HA) binding antibodies and hemagglutination-inhibition (HAI) activity increased in all age groups against both influenza A HA components in the vaccine post-vaccination (day 21). However, younger subjects maintained seroprotective titers to the vaccine strains, which resulted in higher seroconversion rates in the elderly, since the HAI titers in elderly subjects were more likely to decline prior to the next season. Young subjects had significant HAI activity against historical, as well as contemporary H1 and H3 vaccine strains from the mid-1980s to present. In contrast, elderly subjects had HAI activity to H1 strains from all years, but were more likely to have HAI activity to older strains from 1918-1950s. They also had a more restricted HAI profile against H3 viruses compared to young subjects recognizing H3N2 influenza viruses from the mid-2000s to present. Vaccine recipients were then categorized by whether subjects seroconverted from a seronegative or seropositive pre-vaccination state. Regardless of age, immunological recall or ‘back-boosting’ to antigenically related strains were associated with seroconversion to the vaccine strain. Overall, both younger and older people have the ability to mount a breadth of immune responses following influenza vaccination. This report describes how imprinting exposure differs across age groups, influences antibody cross-reactivity to past hemagglutinin antigenic variants, and shapes immune responses elicited by current split inactivated influenza vaccines. Understanding how current influenza vaccines are influenced by pre

Gas Lasers

NASA Astrophysics Data System (ADS)

Dixit, S. K.

The field of gas lasers, started with the invention of He-Ne laser in 1961, has witnessed tremendous growth in terms of technology development, research into gaseous gain medium, resonator physics and application in widely diverse arenas. This was possible due to high versatility of gas lasers in terms of operating wavelengths, power, beam quality and mode of operation. In recent years, there is a definite trend to replace the gas lasers, wherever possible, by more efficient and compact solid-state lasers. However, for many industrial, medical and military applications, the gas lasers still rule the roost due to their high-power capabilities with good beam quality at specific wavelengths. This chapter presents a short review covering the operating principle, important technical details and application potential of all the important gas lasers such as He-Ne, CO2, argon ion, copper vapour, excimer and chemical lasers. These neutral atoms, ions and molecule gas lasers are discussed as per applicable electrical, chemical and optical excitation schemes. The optically pumped gas lasers, recently experiencing resurgence, are discussed in the context of far infrared THz molecular lasers, diode-pumped alkali lasers and optically pumped gas-filled hollow-core fibre lasers.

Gas production strategy of underground coal gasification based on multiple gas sources.

PubMed

Tianhong, Duan; Zuotang, Wang; Limin, Zhou; Dongdong, Li

2014-01-01

To lower stability requirement of gas production in UCG (underground coal gasification), create better space and opportunities of development for UCG, an emerging sunrise industry, in its initial stage, and reduce the emission of blast furnace gas, converter gas, and coke oven gas, this paper, for the first time, puts forward a new mode of utilization of multiple gas sources mainly including ground gasifier gas, UCG gas, blast furnace gas, converter gas, and coke oven gas and the new mode was demonstrated by field tests. According to the field tests, the existing power generation technology can fully adapt to situation of high hydrogen, low calorific value, and gas output fluctuation in the gas production in UCG in multiple-gas-sources power generation; there are large fluctuations and air can serve as a gasifying agent; the gas production of UCG in the mode of both power and methanol based on multiple gas sources has a strict requirement for stability. It was demonstrated by the field tests that the fluctuations in gas production in UCG can be well monitored through a quality control chart method.

Life cycle water consumption for shale gas and conventional natural gas.

PubMed

Clark, Corrie E; Horner, Robert M; Harto, Christopher B

2013-10-15

Shale gas production represents a large potential source of natural gas for the nation. The scale and rapid growth in shale gas development underscore the need to better understand its environmental implications, including water consumption. This study estimates the water consumed over the life cycle of conventional and shale gas production, accounting for the different stages of production and for flowback water reuse (in the case of shale gas). This study finds that shale gas consumes more water over its life cycle (13-37 L/GJ) than conventional natural gas consumes (9.3-9.6 L/GJ). However, when used as a transportation fuel, shale gas consumes significantly less water than other transportation fuels. When used for electricity generation, the combustion of shale gas adds incrementally to the overall water consumption compared to conventional natural gas. The impact of fuel production, however, is small relative to that of power plant operations. The type of power plant where the natural gas is utilized is far more important than the source of the natural gas.

CONTINUOUS GAS ANALYZER

DOEpatents

Katz, S.; Weber, C.W.

1960-02-16

A reagent gas and a sample gas are chemically combined on a continuous basis in a reaction zone maintained at a selected temperature. The reagent gas and the sample gas are introduced to the reaction zone at preselected. constant molar rates of flow. The reagent gas and the selected gas in the sample mixture combine in the reaction zone to form a product gas having a different number of moles from the sum of the moles of the reactants. The difference in the total molar rates of flow into and out of the reaction zone is measured and indicated to determine the concentration of the selected gas.

Gas Production Strategy of Underground Coal Gasification Based on Multiple Gas Sources

PubMed Central

Tianhong, Duan; Zuotang, Wang; Limin, Zhou; Dongdong, Li

2014-01-01

To lower stability requirement of gas production in UCG (underground coal gasification), create better space and opportunities of development for UCG, an emerging sunrise industry, in its initial stage, and reduce the emission of blast furnace gas, converter gas, and coke oven gas, this paper, for the first time, puts forward a new mode of utilization of multiple gas sources mainly including ground gasifier gas, UCG gas, blast furnace gas, converter gas, and coke oven gas and the new mode was demonstrated by field tests. According to the field tests, the existing power generation technology can fully adapt to situation of high hydrogen, low calorific value, and gas output fluctuation in the gas production in UCG in multiple-gas-sources power generation; there are large fluctuations and air can serve as a gasifying agent; the gas production of UCG in the mode of both power and methanol based on multiple gas sources has a strict requirement for stability. It was demonstrated by the field tests that the fluctuations in gas production in UCG can be well monitored through a quality control chart method. PMID:25114953

Getting the gas out - developing gas networks in magmatic systems

NASA Astrophysics Data System (ADS)

Cashman, Katharine; Rust, Alison; Oppenheimer, Julie; Belien, Isolde

2015-04-01

Volcanic eruption style, and explosive potential, are strongly controlled by the pre-eruptive history of the magmatic volatiles: specifically, the more efficient the gas loss prior to eruption, the lower the likelihood of primary (magmatic) explosive activity. Commonly considered gas loss mechanisms include separated flow, where individual bubbles (or bubble clouds) travel at a rate that is faster than the host magma, and permeable flow, where gas escapes through permeable (connected) pathways developed within a (relatively) static matrix. Importantly, gas loss via separated flow is episodic, while gas loss via permeable flow is likely to be continuous. Analogue experiments and numerical models on three phase (solid-liquid-gas) systems also suggest a third mechanism of gas loss that involves the opening and closing of 'pseudo fractures'. Pseudo fractures form at a critical crystallinity that is close to the maximum particle packing. Fractures form by local rearrangement of solid particles and liquid to form a through-going gas fracture; gas escape is episodic, and modulated by the available gas volume and the rate of return flow of interstitial liquid back into the fracture. In all of the gas escape scenarios described above, a fundamental control on gas behaviour is the melt viscosity, which affects the rate of individual bubble rise, the rate of bubble expansion, the rate of film thinning (required for bubble coalescence), and the rate of melt flow into gas-generated fractures. From the perspective of magma degassing, rates of gas expansion and film thinning are key to the formation of an interconnected (permeable) gas pathway. Experiments with both analogue and natural materials show that bubble coalescence is relatively slow, and, in particle-poor melts, does not necessarily create permeable gas networks. As a result, degassing efficiency is modulated by the time scales required either (1) to produce large individual bubbles or bubble clouds (in low viscosity

Visualization of gas dissolution following upward gas migration in porous media: Technique and implications for stray gas

NASA Astrophysics Data System (ADS)

Van De Ven, C. J. C.; Mumford, Kevin G.

2018-05-01

The study of gas-water mass transfer in porous media is important in many applications, including unconventional resource extraction, carbon storage, deep geological waste storage, and remediation of contaminated groundwater, all of which rely on an understanding of the fate and transport of free and dissolved gas. The novel visual technique developed in this study provided both quantitative and qualitative observations of gas-water mass transfer. Findings included interaction between free gas architecture and dissolved plume migration, plume geometry and longevity. The technique was applied to the injection of CO2 in source patterns expected for stray gas originating from oil and gas operations to measure dissolved phase concentrations of CO2 at high spatial and temporal resolutions. The data set is the first of its kind to provide high resolution quantification of gas-water dissolution, and will facilitate an improved understanding of the fundamental processes of gas movement and fate in these complex systems.

Microminiature gas chromatograph

DOEpatents

Yu, C.M.

1996-12-10

A microminiature gas chromatograph ({mu}GC) comprising a least one silicon wafer, a gas injector, a column, and a detector. The gas injector has a normally closed valve for introducing a mobile phase including a sample gas in a carrier gas. The valve is fully disposed in the silicon wafer(s). The column is a microcapillary in silicon crystal with a stationary phase and is mechanically connected to receive the mobile phase from the gas injector for the molecular separation of compounds in the sample gas. The detector is mechanically connected to the column for the analysis of the separated compounds of sample gas with electronic means, e.g., ion cell, field emitter and PIN diode. 7 figs.

Microminiature gas chromatograph

DOEpatents

Yu, Conrad M.

1996-01-01

A microminiature gas chromatograph (.mu.GC) comprising a least one silicon wafer, a gas injector, a column, and a detector. The gas injector has a normally closed valve for introducing a mobile phase including a sample gas in a carrier gas. The valve is fully disposed in the silicon wafer(s). The column is a microcapillary in silicon crystal with a stationary phase and is mechanically connected to receive the mobile phase from the gas injector for the molecular separation of compounds in the sample gas. The detector is mechanically connected to the column for the analysis of the separated compounds of sample gas with electronic means, e.g., ion cell, field emitter and PIN diode.

National Gas Hydrate Program Expedition 01 offshore India; gas hydrate systems as revealed by hydrocarbon gas geochemistry

USGS Publications Warehouse

Lorenson, Thomas; Collett, Timothy S.

2018-01-01

The National Gas Hydrate Program Expedition 01 (NGHP-01) targeted gas hydrate accumulations offshore of the Indian Peninsula and along the Andaman convergent margin. The primary objectives of coring were to understand the geologic and geochemical controls on the accumulation of methane hydrate and their linkages to underlying petroleum systems. Four areas were investigated: 1) the Kerala-Konkan Basin in the eastern Arabian Sea, 2) the Mahanadi and 3) Krishna-Godavari Basins in the western Bay of Bengal, and 4) the Andaman forearc Basin in the Andaman Sea.Upward flux of methane at three of the four of the sites cored during NGHP-01 is apparent from the presence of seafloor mounds, seismic evidence for upward gas migration, shallow sub-seafloor geochemical evidence of methane oxidation, and near-seafloor gas composition that resembles gas from depth.The Kerala-Konkan Basin well contained only CO2 with no detectable hydrocarbons suggesting there is no gas hydrate system here. Gas and gas hydrate from the Krishna-Godavari Basin is mainly microbial methane with δ13C values ranging from −58.9 to −78.9‰, with small contributions from microbial ethane (−52.1‰) and CO2. Gas from the Mahanadi Basin was mainly methane with lower concentrations of C2-C5 hydrocarbons (C1/C2 ratios typically >1000) and CO2. Carbon isotopic compositions that ranged from −70.7 to −86.6‰ for methane and −62.9 to −63.7‰ for ethane are consistent with a microbial gas source; however deeper cores contained higher molecular weight hydrocarbon gases suggesting a small contribution from a thermogenic gas source. Gas composition in the Andaman Basin was mainly methane with lower concentrations of ethane to isopentane and CO2, C1/C2 ratios were mainly >1000 although deeper samples were <1000. Carbon isotopic compositions range from −65.2 to −80.7‰ for methane, −53.1 to −55.2‰ for ethane is consistent with mainly microbial gas sources, although one value recorded of �

Life Cycle Water Consumption for Shale Gas and Conventional Natural Gas

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

Clark, Corrie E.; Horner, Robert M.; Harto, Christopher B.

2013-10-15

Shale gas production represents a large potential source of natural gas for the nation. The scale and rapid growth in shale gas development underscore the need to better understand its environmental implications, including water consumption. This study estimates the water consumed over the life cycle of conventional and shale gas production, accounting for the different stages of production and for flowback water reuse (in the case of shale gas). This study finds that shale gas consumes more water over its life cycle (13–37 L/GJ) than conventional natural gas consumes (9.3–9.6 L/GJ). However, when used as a transportation fuel, shale gasmore » consumes significantly less water than other transportation fuels. When used for electricity generation, the combustion of shale gas adds incrementally to the overall water consumption compared to conventional natural gas. The impact of fuel production, however, is small relative to that of power plant operations. The type of power plant where the natural gas is utilized is far more important than the source of the natural gas.« less

Incorporating the gas analyzer response time in gas exchange computations.

PubMed

Mitchell, R R

1979-11-01

A simple method for including the gas analyzer response time in the breath-by-breath computation of gas exchange rates is described. The method uses a difference equation form of a model for the gas analyzer in the computation of oxygen uptake and carbon dioxide production and avoids a numerical differentiation required to correct the gas fraction wave forms. The effect of not accounting for analyzer response time is shown to be a 20% underestimation in gas exchange rate. The present method accurately measures gas exchange rate, is relatively insensitive to measurement errors in the analyzer time constant, and does not significantly increase the computation time.

The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre.

PubMed

Russo, Philip L; Bull, Ann; Bennett, Noleen; Boardman, Claire; Burrell, Simon; Motley, Jane; Berry, Kylie; Friedman, N Deborah; Richards, Michael

2006-09-01

A 1998 survey of acute Victorian public hospitals (VPH) revealed that surveillance of hospital-acquired infections (HAI) was underdeveloped, definitions and methodology varied considerably, and results disseminated inconsistently. The survey identified the need for an effective surveillance system for HAI. To develop and support a standardized surveillance program for HAIs in large acute VPH and to provide risk-adjusted, procedure-specific, HAI rates. In 2002, the independent Victorian Nosocomial Infection Surveillance System (VICNISS) Coordinating Centre (VCC) was established to develop and support the standardized surveillance program. A multidisciplinary team was recruited. A communication strategy, surveillance manual, user groups, and Web site were developed. Formal education sessions were provided to participating infection control nurse consultants (ICCs). Surveillance activities were based on the US Centers for Diseases Control and Prevention's National Nosocomial Infection Surveillance System (NNIS) surgical site infection and intensive care unit (ICU) components. NNIS methods were modified to suit local needs. Data collection was paper based or through existing hospital software. An advisory committee of key stakeholders met every second month. The surveillance program was rolled out over 12 months to all 28 large adult VPH. Data on over 20,000 surgical procedures performed at participating sites between November 11, 2002, and December 31, 2004, were submitted. Thirteen hospitals contributed to the ICU surveillance activities. Following aggregation and analysis by the VCC, hospital- and state-level results were posted on the Web page for hospitals to review. A standardized approach for surveillance of HAI was established in a short time frame in over 28 VPH. VICNISS is a tool that will continue to provide participating hospitals with a basis for continuous quality improvement.

Variations in Identification of Healthcare-Associated Infections

PubMed Central

Keller, Sara C.; Linkin, Darren R.; Fishman, Neil O.; Lautenbach, Ebbing

2014-01-01

OBJECTIVE Little is known about whether those performing healthcare-associated infection (HAI) surveillance vary in their interpretations of HAI definitions developed by the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN). Our primary objective was to characterize variations in these interpretations using clinical vignettes. We also describe predictors of variation in responses. DESIGN Cross-sectional study. SETTING United States. PARTICIPANTS A sample of US-based members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. METHODS Respondents assessed whether each of 6 clinical vignettes met criteria for an NHSN-defined HAI. Individual- and institutional-level data were also gathered. RESULTS Surveys were distributed to 143 SHEA Research Network members from 126 hospitals. In total, 113 responses were obtained, representing at least 61 unique hospitals (30 respondents did not identify a hospital); 79.2% (84 of 106 nonmissing responses) were infection preventionists, and 79.4% (81 of 102 nonmissing responses) worked at academic hospitals. Among the 6 vignettes, the proportion of respondents correctly characterizing the vignettes was as low as 27.3%. Combining all 6 vignettes, the mean percentage of correct responses was 61.1% (95% confidence interval, 57.7%–63.8%). Percentage of correct responses was associated with presence of a clinical background (ie, nursing or physician degrees) but not with hospital size or infection prevention and control department characteristics. CONCLUSIONS Substantial heterogeneity exists in the application of HAI definitions in this survey of infection preventionists and hospital epidemiologists. Our data suggest a need to better clarify these definitions, especially when comparing HAI rates across institutions. PMID:23739071

Crystal Structure of a Two-domain Fragment of Hepatocyte Growth Factor Activator Inhibitor-1: FUNCTIONAL INTERACTIONS BETWEEN THE KUNITZ-TYPE INHIBITOR DOMAIN-1 AND THE NEIGHBORING POLYCYSTIC KIDNEY DISEASE-LIKE DOMAIN.

PubMed

Hong, Zebin; De Meulemeester, Laura; Jacobi, Annemarie; Pedersen, Jan Skov; Morth, J Preben; Andreasen, Peter A; Jensen, Jan K

2016-07-01

Hepatocyte growth factor activator inhibitor-1 (HAI-1) is a type I transmembrane protein and inhibitor of several serine proteases, including hepatocyte growth factor activator and matriptase. The protein is essential for development as knock-out mice die in utero due to placental defects caused by misregulated extracellular proteolysis. HAI-1 contains two Kunitz-type inhibitor domains (Kunitz), which are generally thought of as a functionally self-contained protease inhibitor unit. This is not the case for HAI-1, where our results reveal how interdomain interactions have evolved to stimulate the inhibitory activity of an integrated Kunitz. Here we present an x-ray crystal structure of an HAI-1 fragment covering the internal domain and Kunitz-1. The structure reveals not only that the previously uncharacterized internal domain is a member of the polycystic kidney disease domain family but also how the two domains engage in interdomain interactions. Supported by solution small angle x-ray scattering and a combination of site-directed mutagenesis and functional assays, we show that interdomain interactions not only stabilize the fold of the internal domain but also stimulate the inhibitory activity of Kunitz-1. By completing our structural characterization of the previously unknown N-terminal region of HAI-1, we provide new insight into the interplay between tertiary structure and the inhibitory activity of a multidomain protease inhibitor. We propose a previously unseen mechanism by which the association of an auxiliary domain stimulates the inhibitory activity of a Kunitz-type inhibitor (i.e. the first structure of an intramolecular interaction between a Kunitz and another domain). © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

Gas separating

DOEpatents

Gollan, Arye Z.

1990-12-25

Feed gas is directed tangentially along the non-skin surface of gas separation membrane modules comprising a cylindrical bundle of parallel contiguous hollow fibers supported to allow feed gas to flow from an inlet at one end of a cylindrical housing through the bores of the bundled fibers to an outlet at the other end while a component of the feed gas permeates through the fibers, each having the skin side on the outside, through a permeate outlet in the cylindrical casing.

Gas magnetometer

DOEpatents

Walker, Thad Gilbert; Lancor, Brian Robert; Wyllie, Robert

2016-05-03

Measurement of a precessional rate of a gas, such as an alkali gas, in a magnetic field is made by promoting a non-uniform precession of the gas in which substantially no net magnetic field affects the gas during a majority of the precession cycle. This allows sensitive gases that would be subject to spin-exchange collision de-phasing to be effectively used for extremely sensitive measurements in the presence of an environmental magnetic field such as the Earth's magnetic field.

Gas separating

DOEpatents

Gollan, Arye

1988-01-01

Feed gas is directed tangentially along the non-skin surface of gas separation membrane modules comprising a cylindrical bundle of parallel contiguous hollow fibers supported to allow feed gas to flow from an inlet at one end of a cylindrical housing through the bores of the bundled fibers to an outlet at the other end while a component of the feed gas permeates through the fibers, each having the skin side on the outside, through a permeate outlet in the cylindrical casing.

In Planta Stage-Specific Fungal Gene Profiling Elucidates the Molecular Strategies of Fusarium graminearum Growing inside Wheat Coleoptiles[W][OA

PubMed Central

Zhang, Xiao-Wei; Jia, Lei-Jie; Zhang, Yan; Jiang, Gang; Li, Xuan; Zhang, Dong; Tang, Wei-Hua

2012-01-01

The ascomycete Fusarium graminearum is a destructive fungal pathogen of wheat (Triticum aestivum). To better understand how this pathogen proliferates within the host plant, we tracked pathogen growth inside wheat coleoptiles and then examined pathogen gene expression inside wheat coleoptiles at 16, 40, and 64 h after inoculation (HAI) using laser capture microdissection and microarray analysis. We identified 344 genes that were preferentially expressed during invasive growth in planta. Gene expression profiles for 134 putative plant cell wall–degrading enzyme genes suggest that there was limited cell wall degradation at 16 HAI and extensive degradation at 64 HAI. Expression profiles for genes encoding reactive oxygen species (ROS)–related enzymes suggest that F. graminearum primarily scavenges extracellular ROS before a later burst of extracellular ROS is produced by F. graminearum enzymes. Expression patterns of genes involved in primary metabolic pathways suggest that F. graminearum relies on the glyoxylate cycle at an early stage of plant infection. A secondary metabolite biosynthesis gene cluster was specifically induced at 64 HAI and was required for virulence. Our results indicate that F. graminearum initiates infection of coleoptiles using covert penetration strategies and switches to overt cellular destruction of tissues at an advanced stage of infection. PMID:23266949

Testing the Quality Health Outcomes Model Applied to Infection Prevention in Hospitals.

PubMed

Gilmartin, Heather M; Sousa, Karen H

2016-01-01

To test the Quality Health Outcomes Model to investigate the relationship between health care-associated infection (HAI) prevention interventions, organizational context, and HAI outcomes using structural equation modeling. Variables for adherence to the central line bundle, organizational context, and central line-associated bloodstream infections (CLABSIs) were selected for this secondary data analysis from 614 US hospitals that participated in the Prevention of Nosocomial Infection and Cost-effectiveness-Refined study. One half of the dataset was used for exploration of the concepts, the second half for confirmation of the measurement models and testing of the structural model. The final model resulted in a good fit to the data (χ (1215) = 1906.86, P < .00; comparative fit index = 0.94; root mean square of error of approximation = 0.04). A significant relationship was noted between adherence to the central line bundle interventions and organizational context (β = 0.23, P < .01), whereas the relationship between context and CLABSIs was not significant (β = -0.20, P = .78). This study supports a relationship between greater adherence to HAI interventions and higher levels of organizational context and highlights the complexity of measuring organizational context. Given the importance of preventing HAIs, ongoing research is needed to reveal the exact aspects of context that influence interventions and outcomes.

Prevention and Control of Antimicrobial Resistant Healthcare-Associated Infections: The Microbiology Laboratory Rocks!

PubMed

Simões, Alexandra S; Couto, Isabel; Toscano, Cristina; Gonçalves, Elsa; Póvoa, Pedro; Viveiros, Miguel; Lapão, Luís V

2016-01-01

In Europe, each year, more than four milion patients acquire a healthcare-associated infection (HAI) and almost 40 thousand die as a direct consequence of it. Regardless of many stategies to prevent and control HAIs, they remain an important cause of morbidity and mortality worldwide with a significant economic impact: a recent estimate places it at the ten billion dollars/year. The control of HAIs requires a prompt and efficient identification of the etiological agent and a rapid communication with the clinician. The Microbiology Laboratory has a significant role in the prevention and control of these infections and is a key element of any Infection Control Program. The work of the Microbiology Laboratory covers microbial isolation and identification, determination of antimicrobial susceptibility patterns, epidemiological surveillance and outbreak detection, education, and report of quality assured results. In this paper we address the role and importance of the Microbiology Laboratory in the prevention and control of HAI and in Antibiotic Stewardship Programs and how it can be leveraged when combined with the use of information systems. Additionally, we critically review some challenges that the Microbiology Laboratory has to deal with, including the selection of analytic methods and the proper use of communication channels with other healthcare services.

A bubble-based microfluidic gas sensor for gas chromatographs.

PubMed

Bulbul, Ashrafuzzaman; Kim, Hanseup

2015-01-07

We report a new proof-of-concept bubble-based gas sensor for a gas chromatography system, which utilizes the unique relationship between the diameters of the produced bubbles with the gas types and mixture ratios as a sensing element. The bubble-based gas sensor consists of gas and liquid channels as well as a nozzle to produce gas bubbles through a micro-structure. It utilizes custom-developed software and an optical camera to statistically analyze the diameters of the produced bubbles in flow. The fabricated gas sensor showed that five types of gases (CO2, He, H2, N2, and CH4) produced (1) unique volumes of 0.44, 0.74, 1.03, 1.28, and 1.42 nL (0%, 68%, 134%, 191%, and 223% higher than that of CO2) and (2) characteristic linear expansion coefficients (slope) of 1.38, 2.93, 3.45, 5.06, and 5.44 nL/(kPa (μL s(-1))(-1)). The gas sensor also demonstrated that (3) different gas mixture ratios of CO2 : N2 (100 : 0, 80 : 20, 50 : 50, 20 : 80 and 0 : 100) generated characteristic bubble diameters of 48.95, 77.99, 71.00, 78.53 and 99.50 μm, resulting in a linear coefficient of 10.26 μm (μL s(-1))(-1). It (4) successfully identified an injection (0.01 μL) of pentane (C5) into a continuous carrier gas stream of helium (He) by monitoring bubble diameters and creating a chromatogram and demonstrated (5) the output stability within only 5.60% variation in 67 tests over a month.

Reduction of gas flow nonuniformity in gas turbine engines by means of gas-dynamic methods

NASA Astrophysics Data System (ADS)

Matveev, V.; Baturin, O.; Kolmakova, D.; Popov, G.

2017-08-01

Gas flow nonuniformity is one of the main sources of rotor blade vibrations in the gas turbine engines. Usually, the flow circumferential nonuniformity occurs near the annular frames, located in the flow channel of the engine. This leads to the increased dynamic stresses in blades and as a consequence to the blade damage. The goal of the research was to find an acceptable method of reducing the level of gas flow nonuniformity as the source of dynamic stresses in the rotor blades. Two different methods were investigated during this research. Thus, this study gives the ideas about methods of improving the flow structure in gas turbine engine. On the basis of existing conditions (under development or existing engine) it allows the selection of the most suitable method for reducing gas flow nonuniformity.

Gas separating

DOEpatents

Gollan, A.Z.

1990-12-25

Feed gas is directed tangentially along the non-skin surface of gas separation membrane modules comprising a cylindrical bundle of parallel contiguous hollow fibers supported to allow feed gas to flow from an inlet at one end of a cylindrical housing through the bores of the bundled fibers to an outlet at the other end while a component of the feed gas permeates through the fibers, each having the skin side on the outside, through a permeate outlet in the cylindrical casing. 3 figs.

Gas separating

DOEpatents

Gollan, A.

1988-03-29

Feed gas is directed tangentially along the non-skin surface of gas separation membrane modules comprising a cylindrical bundle of parallel contiguous hollow fibers supported to allow feed gas to flow from an inlet at one end of a cylindrical housing through the bores of the bundled fibers to an outlet at the other end while a component of the feed gas permeates through the fibers, each having the skin side on the outside, through a permeate outlet in the cylindrical casing. 3 figs.

Gas flow meter and method for measuring gas flow rate

DOEpatents

Robertson, Eric P.

2006-08-01

A gas flow rate meter includes an upstream line and two chambers having substantially equal, fixed volumes. An adjustable valve may direct the gas flow through the upstream line to either of the two chambers. A pressure monitoring device may be configured to prompt valve adjustments, directing the gas flow to an alternate chamber each time a pre-set pressure in the upstream line is reached. A method of measuring the gas flow rate measures the time required for the pressure in the upstream line to reach the pre-set pressure. The volume of the chamber and upstream line are known and fixed, thus the time required for the increase in pressure may be used to determine the flow rate of the gas. Another method of measuring the gas flow rate uses two pressure measurements of a fixed volume, taken at different times, to determine the flow rate of the gas.

Gas-Dynamic Methods to Reduce Gas Flow Nonuniformity from the Annular Frames of Gas Turbine Engines

NASA Astrophysics Data System (ADS)

Kolmakova, D.; Popov, G.

2018-01-01

Gas flow nonuniformity is one of the main sources of rotor blade vibrations in the gas turbine engines. Usually, the flow circumferential nonuniformity occurs near the annular frames, located in the flow channel of the engine. This leads to the increased dynamic stresses in blades and consequently to the blade damage. The goal of the research was to find an acceptable method of reducing the level of gas flow nonuniformity. Two different methods were investigated during this research. Thus, this study gives the ideas about methods of improving the flow structure in gas turbine engine. Based on existing conditions (under development or existing engine) it allows the selection of the most suitable method for reducing gas flow nonuniformity.

Flue gas desulfurization

DOEpatents

Im, Kwan H.; Ahluwalia, Rajesh K.

1985-01-01

A process and apparatus for removing sulfur oxide from combustion gas to form Na.sub.2 SO.sub.4 and for reducing the harmful effects of Na.sub.2 SO.sub.4 on auxiliary heat exchangers in which a sodium compound is injected into the hot combustion gas forming liquid Na.sub.2 SO.sub.4 in a gas-gas reaction and the resultant gas containing Na.sub.2 SO.sub.4 is cooled to below about 1150.degree. K. to form particles of Na.sub.2 SO.sub.4 prior to contact with at least one heat exchanger with the cooling being provided by the recycling of combustion gas from a cooled zone downstream from the introduction of the cooling gas.

Hollow fiber gas-liquid membrane contactors for acid gas capture: a review.

PubMed

Mansourizadeh, A; Ismail, A F

2009-11-15

Membrane contactors using microporous membranes for acid gas removal have been extensively reviewed and discussed. The microporous membrane acts as a fixed interface between the gas and the liquid phase without dispersing one phase into another that offers a flexible modular and energy efficient device. The gas absorption process can offer a high selectivity and a high driving force for transport even at low concentrations. Using hollow fiber gas-liquid membrane contactors is a promising alternative to conventional gas absorption systems for acid gas capture from gas streams. Important aspects of membrane contactor as an efficient energy devise for acid gas removal including liquid absorbents, membrane characteristics, combination of membrane and absorbent, mass transfer, membrane modules, model development, advantages and disadvantages were critically discussed. In addition, current status and future potential in research and development of gas-liquid membrane contactors for acid gas removal were also briefly discussed.

Survey of stranded gas and delivered costs to Europe of selected gas resources

USGS Publications Warehouse

Attanasi, E.D.; Freeman, P.A.

2011-01-01

Two important trends affecting the expected growth of global gas markets are (1) the shift by many industrialized countries from coal-fired electricity generation to the use of natural gas to generate electricity and (2) the industrialization of the heavily populated Asian countries of India and China. This paper surveys discovered gas in stranded conventional gas accumulations and presents estimates of the cost of developing and producing stranded gas in selected countries. Stranded gas is natural gas in discovered or identified fields that is not currently commercially producible for either physical or economic reasons. Published reserves of gas at the global level do not distinguish between volumes of gas in producing fields and volumes in nonproducing fields. Data on stranded gas reported here-that is the volumes, geographical distribution, and size distributions of stranded gas fields at the country and regional level-are based on the examination of individual-field data and represent a significant improvement in information available to industry and government decision makers. Globally, stranded gas is pervasive, but large volumes in large accumulations are concentrated in only a few areas. The cost component of the paper focuses on stranded conventional gas accumulations in Africa and South America that have the potential to augment supplies to Europe. The methods described for the computation of extraction and transport costs are innovative in that they use information on the sizes and geographical distribution of the identified stranded gas fields. The costs are based on industry data specific to the country and geologic basin where the stranded gas is located. Gas supplies to Europe can be increased significantly at competitive costs by the development of stranded gas. Net extraction costs of producing the identified gas depend critically on the natural-gas-liquids (NGLs) content, the prevailing prices of liquids, the size of the gas accumulation, and the

US crude oil, natural gas, and natural gas liquids reserves, 1992 annual report

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

Not Available

1993-10-18

This report presents estimates of proved reserves of crude oil, natural gas, and natural gas liquids as of December 31, 1992, as well as production volumes for the United States, and selected States and State subdivisions for the year 1992. Estimates are presented for the following four categories of natural gas: total gas (wet after lease separation), its two major components (nonassociated and associated-dissolved gas), and total dry gas (wet gas adjusted for the removal of liquids at natural gas processing plants). In addition, two components of natural gas liquids, lease condensate and natural gas plant liquids, have their reservesmore » and production data presented. Also included is information on indicated additional crude oil reserves and crude oil, natural gas, and lease condensate reserves in nonproducing reservoirs. A discussion of notable oil and gas exploration and development activities during 1992 is provided.« less

Flue gas desulfurization

DOEpatents

Im, K.H.; Ahluwalia, R.K.

1984-05-01

The invention involves a combustion process in which combustion gas containing sulfur oxide is directed past a series of heat exchangers to a stack and in which a sodium compound is added to the combustion gas in a temparature zone of above about 1400 K to form Na/sub 2/SO/sub 4/. Preferably, the temperature is above about 1800 K and the sodium compound is present as a vapor to provide a gas-gas reaction to form Na/sub 2/SO/sub 4/ as a liquid. Since liquid Na/sub 2/SO/sub 4/ may cause fouling of heat exchanger surfaces downstream from the combustion zone, the process advantageously includes the step of injecting a cooling gas downstream of the injection of the sodium compound yet upstream of one or more heat exchangers to cool the combustion gas to below about 1150 K and form solid Na/sub 2/SO/sub 4/. The cooling gas is preferably a portion of the combustion gas downstream which may be recycled for cooling. It is further advantageous to utilize an electrostatic precipitator downstream of the heat exchangers to recover the Na/sub 2/SO/sub 4/. It is also advantageous in the process to remove a portion of the combustion gas cleaned in the electrostatic precipitator and recycle that portion upstream to use as the cooling gas. 3 figures.

Fuel gas conditioning process

DOEpatents

Lokhandwala, Kaaeid A.

2000-01-01

A process for conditioning natural gas containing C.sub.3+ hydrocarbons and/or acid gas, so that it can be used as combustion fuel to run gas-powered equipment, including compressors, in the gas field or the gas processing plant. Compared with prior art processes, the invention creates lesser quantities of low-pressure gas per unit volume of fuel gas produced. Optionally, the process can also produce an NGL product.

US crude oil, natural gas, and natural gas liquids reserves 1996 annual report

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

NONE

1997-12-01

The EIA annual reserves report series is the only source of comprehensive domestic proved reserves estimates. This publication is used by the Congress, Federal and State agencies, industry, and other interested parties to obtain accurate estimates of the Nation`s proved reserves of crude oil, natural gas, and natural gas liquids. These data are essential to the development, implementation, and evaluation of energy policy and legislation. This report presents estimates of proved reserves of crude oil, natural gas, and natural gas liquids as of December 31, 1996, as well as production volumes for the US and selected States and State subdivisionsmore » for the year 1996. Estimates are presented for the following four categories of natural gas: total gas (wet after lease separation), nonassociated gas and associated-dissolved gas (which are the two major types of wet natural gas), and total dry gas (wet gas adjusted for the removal of liquids at natural gas processing plants). In addition, reserve estimates for two types of natural gas liquids, lease condensate and natural gas plant liquids, are presented. Also included is information on indicated additional crude oil reserves and crude oil, natural gas, and lease condensate reserves in nonproducing reservoirs. A discussion of notable oil and gas exploration and development activities during 1996 is provided. 21 figs., 16 tabs.« less

The diagnosis of high altitude illness by the determination of plasma dermcidin isoform 2 levels by enzyme linked immunosorbent assay.

PubMed

Bank, Sarbashri; Ghosh, Rajeshwary; Jana, Pradipta; Bhattacharya, Suman; Sinha, Asru K

2014-01-01

High altitude illness (HAI) is a cluster of syndromes which develops due to the injury of the central nervous system produced by the reduction of the partial pressure of O2 in the atmosphere which disappears on decent. The HAI also results in a prothrombotic condition leading to acute coronary syndrome (ACS), which cannot be controlled on descent to the ground level. There is no diagnosis in HAI to forewarn of the impending ACS. A protein identified to be dermcidin isoform 2 (dermcidin), produced in the system due to environmental stresses, has been reported to be a potent diabetogenic agent. Investigation was carried out to determine the systemic stimulation of dermcidin synthesis at different levels of altitudes in normal adult male volunteers to assess the feasibility of developing a diagnosis for ACS in HAI due to dermcidin synthesis. Normal, nondiabetic, normotensive male volunteers (25 - 35 years old, n = 16) participated in the study. The plasma dermcidin level was determined by enzyme linked immunosorbent assay (ELISA) and by in vitro translation of dermcidin mRNA. The plasma insulin level was determined by ELISA and blood glucose level was determined in a glucometer (Behringer). The plasma dermcidin level in the volunteers at ground level was 10 +/- 2.10 nM and increased to 80 +/- 4.62 nM at 15000 feet altitude. For each 1000 feet increase of altitude, the dermcidin level increased by 5.83 +/- 0.21 nM with a Coefficient of Correlation "r" = +0.9405. The increase of plasma dermcidin level was found to be inversely related to the decrease of plasma insulin level from 23 microunit/mL to 5 microunit/mL from sea level to 15000 feet height ("r" = -0.9951) with concomitant increase of blood sugar level from 80 +/- 3.6 mg/dL to 135 +/- 2.01 mg/dL. These results suggest the feasibility of a diagnosis of a prediabetic condition by determining the plasma dermcidin level in HAI by simple ELISA which may also be useful to forewarn of the possibility of developing an

Stabilization Improves Theranostic Properties of Lipiodol{sup ®}-Based Emulsion During Liver Trans-arterial Chemo-embolization in a VX2 Rabbit Model

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

Deschamps, F., E-mail: frederic.deschamps@gustaveroussy.fr; Farouil, G.; Gonzalez, W.

PurposeTo demonstrate that stability is a crucial parameter for theranostic properties of Lipiodol{sup ®}-based emulsions during liver trans-arterial chemo-embolization.Materials and MethodsWe compared the theranostic properties of two emulsions made of Lipiodol{sup ®} and doxorubicin in two successive animal experiments (One VX2 tumour implanted in the left liver lobe of 30 rabbits). Emulsion-1 reproduced one of the most common way of preparation (ratio of oil/water: 1/1), and emulsion-2 was designed to obtain a water-in-oil emulsion with enhanced stability (ratio of oil/water: 3/1, plus an emulsifier). The first animal experiment compared the tumour selectivity of the two emulsions: seven rabbits received leftmore » hepatic arterial infusion (HAI) of emulsion-1 and eight received HAI of emulsion-2. 3D-CBCT acquisitions were acquired after HAI of every 0.1 mL to measure the densities’ ratios between the tumours and the left liver lobes. The second animal experiment compared the plasmatic and tumour doxorubicin concentrations after HAI of 1.5 mg of doxorubicin administered either alone (n = 3) or in emulsion-1 (n = 6) or in emulsion-2 (n = 6).ResultsEmulsion-2 resulted in densities’ ratios between the tumours and the left liver lobes that were significantly higher compared to emulsion-1 (up to 0.4 mL infused). Plasmatic doxorubicin concentrations (at 5 min) were significantly lower after HAI of emulsion-2 (19.0 μg/L) than emulsion-1 (275.3 μg/L, p < 0.01) and doxorubicin alone (412.0 μg/L, p < 0.001), and tumour doxorubicin concentration (day-1) was significantly higher after HAI of emulsion-2 (20,957 ng/g) than in emulsion-1 (8093 ng/g, p < 0.05) and doxorubicin alone (2221 ng/g, p < 0.01).ConclusionStabilization of doxorubicin in a water-in-oil Lipiodol{sup ®}-based emulsion results in better theranostic properties.« less

GAS METERING PUMP

DOEpatents

George, C.M.

1957-12-31

A liquid piston gas pump is described, capable of pumping minute amounts of gas in accurately measurable quantities. The pump consists of a flanged cylindrical regulating chamber and a mercury filled bellows. Sealed to the ABSTRACTS regulating chamber is a value and having a gas inlet and outlet, the inlet being connected by a helical channel to the bellows. A gravity check valve is in the gas outlet, so the gas passes through the inlet and the helical channel to the bellows where the pumping action as well as the metering is accomplished by the actuation of the mercury filled bellows. The gas then flows through the check valve and outlet to any associated apparatus.

Multi-channel gas-delivery system

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

Rozenzon, Yan; Trujillo, Robert T.; Beese, Steven C.

One embodiment of the present invention provides a gas-delivery system for delivering reaction gas to a reactor chamber. The gas-delivery system includes a main gas-inlet port for receiving reaction gases and a gas-delivery plate that includes a plurality of gas channels. A gas channel includes a plurality of gas holes for allowing the reaction gases to enter the reactor chamber from the gas channel. The gas-delivery system further includes a plurality of sub-gas lines coupling together the main gas-inlet port and the gas-delivery plate, and a respective sub-gas line is configured to deliver a portion of the received reaction gasesmore » to a corresponding gas channel.« less

Variations in aseptic technique and implications for infection control.

PubMed

Aziz, Anne Marie

Healthcare-acquired infections (HAIs) are a serious concern, costing the NHS 1 billion pounds a year and causing 5000 deaths annually despite increased funding. A contributing factor is the variety of aseptic techniques in use in different hospitals and even within a single hospital. These cause problems for healthcare workers as well as increasing the risk of HAI. This article examines a number of traditional approaches to aseptic technique, highlighting their differences and the implications for infection control. It concludes that improvement in aseptic technique could be achieved by implementation of a single unified approach to aseptic technique that can be standardized and audited annually, such as the aseptic non-touch technique (ANTT), which has been recommended for adoption throughout the UK. It ends with suggestions for measures that could be introduced and strengthened to improve aseptic technique, and ultimately reduce the rate of HAI.

Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates

PubMed Central

Larson, Elaine L.; Quiros, Dave; Lin, Susan X.

2007-01-01

Background The diffusion of national evidence-based practice guidelines and their impact on patient outcomes often go unmeasured. Methods Our objectives were to (1) evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention (CDC) Hand Hygiene Guideline, (2) compare rates of health care-associated infections (HAI) before and after implementation of the Guideline recommendations, and (3) examine the patterns and correlates of changes in rates of HAI. We used pre- and post-Guideline implementation site visits and surveys in the setting of 40 US hospitals—members of the National Nosocomial Infections Surveillance System—and measured HAI rates 1 year before and after publication of the CDC Guideline and used direct observation of hand hygiene compliance and Guideline implementation scores. Results All study hospitals had changed their policies and procedures and provided products in compliance with Guideline recommendations; 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline. However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitals with higher rates of hand hygiene (P < .001). No impact of Guideline implementation or hand hygiene compliance on other HAI rates was identified. Other factors occurring over time could affect rates of HAI. Observed hand hygiene compliance rates were likely to overestimate rates in actual practice. The study may have been of too short duration to detect the impact of a practice guideline. Conclusion Wide dissemination of this Guideline was not sufficient to change practice. Only some hospitals had initiated multidisciplinary programs; practice change is unlikely without such multidisciplinary efforts and explicit

Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates.

PubMed

Larson, Elaine L; Quiros, Dave; Lin, Susan X

2007-12-01

The diffusion of national evidence-based practice guidelines and their impact on patient outcomes often go unmeasured. Our objectives were to (1) evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention (CDC) Hand Hygiene Guideline, (2) compare rates of health care-associated infections (HAI) before and after implementation of the Guideline recommendations, and (3) examine the patterns and correlates of changes in rates of HAI. We used pre- and post-Guideline implementation site visits and surveys in the setting of 40 US hospitals--members of the National Nosocomial Infections Surveillance System--and measured HAI rates 1 year before and after publication of the CDC Guideline and used direct observation of hand hygiene compliance and Guideline implementation scores. All study hospitals had changed their policies and procedures and provided products in compliance with Guideline recommendations; 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline. However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitals with higher rates of hand hygiene (P < .001). No impact of Guideline implementation or hand hygiene compliance on other HAI rates was identified. Other factors occurring over time could affect rates of HAI. Observed hand hygiene compliance rates were likely to overestimate rates in actual practice. The study may have been of too short duration to detect the impact of a practice guideline. Wide dissemination of this Guideline was not sufficient to change practice. Only some hospitals had initiated multidisciplinary programs; practice change is unlikely without such multidisciplinary efforts and explicit administrative support.

Hard surface biocontrol in hospitals using microbial-based cleaning products.

PubMed

Vandini, Alberta; Temmerman, Robin; Frabetti, Alessia; Caselli, Elisabetta; Antonioli, Paola; Balboni, Pier Giorgio; Platano, Daniela; Branchini, Alessio; Mazzacane, Sante

2014-01-01

Healthcare-Associated Infections (HAIs) are one of the most frequent complications occurring in healthcare facilities. Contaminated environmental surfaces provide an important potential source for transmission of many healthcare-associated pathogens, thus indicating the need for new and sustainable strategies. This study aims to evaluate the effect of a novel cleaning procedure based on the mechanism of biocontrol, on the presence and survival of several microorganisms responsible for HAIs (i.e. coliforms, Staphyloccus aureus, Clostridium difficile, and Candida albicans) on hard surfaces in a hospital setting. The effect of microbial cleaning, containing spores of food grade Bacillus subtilis, Bacillus pumilus and Bacillus megaterium, in comparison with conventional cleaning protocols, was evaluated for 24 weeks in three independent hospitals (one in Belgium and two in Italy) and approximately 20000 microbial surface samples were collected. Microbial cleaning, as part of the daily cleaning protocol, resulted in a reduction of HAI-related pathogens by 50 to 89%. This effect was achieved after 3-4 weeks and the reduction in the pathogen load was stable over time. Moreover, by using microbial or conventional cleaning alternatively, we found that this effect was directly related to the new procedure, as indicated by the raise in CFU/m2 when microbial cleaning was replaced by the conventional procedure. Although many questions remain regarding the actual mechanisms involved, this study demonstrates that microbial cleaning is a more effective and sustainable alternative to chemical cleaning and non-specific disinfection in healthcare facilities. This study indicates microbial cleaning as an effective strategy in continuously lowering the number of HAI-related microorganisms on surfaces. The first indications on the actual level of HAIs in the trial hospitals monitored on a continuous basis are very promising, and may pave the way for a novel and cost-effective strategy

Heritability of and Mortality Prediction With a Longevity Phenotype: The Healthy Aging Index

PubMed Central

2014-01-01

Background. Longevity-associated genes may modulate risk for age-related diseases and survival. The Healthy Aging Index (HAI) may be a subphenotype of longevity, which can be constructed in many studies for genetic analysis. We investigated the HAI’s association with survival in the Cardiovascular Health Study and heritability in the Long Life Family Study. Methods. The HAI includes systolic blood pressure, pulmonary vital capacity, creatinine, fasting glucose, and Modified Mini-Mental Status Examination score, each scored 0, 1, or 2 using approximate tertiles and summed from 0 (healthy) to 10 (unhealthy). In Cardiovascular Health Study, the association with mortality and accuracy predicting death were determined with Cox proportional hazards analysis and c-statistics, respectively. In Long Life Family Study, heritability was determined with a variance component–based family analysis using a polygenic model. Results. Cardiovascular Health Study participants with unhealthier index scores (7–10) had 2.62-fold (95% confidence interval: 2.22, 3.10) greater mortality than participants with healthier scores (0–2). The HAI alone predicted death moderately well (c-statistic = 0.643, 95% confidence interval: 0.626, 0.661, p < .0001) and slightly worse than age alone (c-statistic = 0.700, 95% confidence interval: 0.684, 0.717, p < .0001; p < .0001 for comparison of c-statistics). Prediction increased significantly with adjustment for demographics, health behaviors, and clinical comorbidities (c-statistic = 0.780, 95% confidence interval: 0.765, 0.794, p < .0001). In Long Life Family Study, the heritability of the HAI was 0.295 (p < .0001) overall, 0.387 (p < .0001) in probands, and 0.238 (p = .0004) in offspring. Conclusion. The HAI should be investigated further as a candidate phenotype for uncovering longevity-associated genes in humans. PMID:23913930

Hard Surface Biocontrol in Hospitals Using Microbial-Based Cleaning Products

PubMed Central

Vandini, Alberta; Temmerman, Robin; Frabetti, Alessia; Caselli, Elisabetta; Antonioli, Paola; Balboni, Pier Giorgio; Platano, Daniela; Branchini, Alessio; Mazzacane, Sante

2014-01-01

Background Healthcare-Associated Infections (HAIs) are one of the most frequent complications occurring in healthcare facilities. Contaminated environmental surfaces provide an important potential source for transmission of many healthcare-associated pathogens, thus indicating the need for new and sustainable strategies. Aim This study aims to evaluate the effect of a novel cleaning procedure based on the mechanism of biocontrol, on the presence and survival of several microorganisms responsible for HAIs (i.e. coliforms, Staphyloccus aureus, Clostridium difficile, and Candida albicans) on hard surfaces in a hospital setting. Methods The effect of microbial cleaning, containing spores of food grade Bacillus subtilis, Bacillus pumilus and Bacillus megaterium, in comparison with conventional cleaning protocols, was evaluated for 24 weeks in three independent hospitals (one in Belgium and two in Italy) and approximately 20000 microbial surface samples were collected. Results Microbial cleaning, as part of the daily cleaning protocol, resulted in a reduction of HAI-related pathogens by 50 to 89%. This effect was achieved after 3–4 weeks and the reduction in the pathogen load was stable over time. Moreover, by using microbial or conventional cleaning alternatively, we found that this effect was directly related to the new procedure, as indicated by the raise in CFU/m2 when microbial cleaning was replaced by the conventional procedure. Although many questions remain regarding the actual mechanisms involved, this study demonstrates that microbial cleaning is a more effective and sustainable alternative to chemical cleaning and non-specific disinfection in healthcare facilities. Conclusions This study indicates microbial cleaning as an effective strategy in continuously lowering the number of HAI-related microorganisms on surfaces. The first indications on the actual level of HAIs in the trial hospitals monitored on a continuous basis are very promising, and may pave the

The application of Lean Six Sigma methodology to reduce the risk of healthcare-associated infections in surgery departments.

PubMed

Montella, Emma; Di Cicco, Maria Vincenza; Ferraro, Anna; Centobelli, Piera; Raiola, Eliana; Triassi, Maria; Improta, Giovanni

2017-06-01

Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics. Data on more than 20 000 patients who underwent a wide range of surgical procedures between January 2011 and December 2014 were collected to conduct the study using the departmental information system. The most prevalent sentinel bacteria were determined among the infected patients. The preintervention (January 2011 to December 2012) and postintervention (January 2013 to December 2014) phases were compared to analyze the effects of the methodology implemented. The methodology allowed the identification of variables that influenced the risk of HAIs and the implementation of corrective actions to improve the care process, thereby reducing the percentage of infected patients. The improved process resulted in a 20% reduction in the average number of hospitalization days between preintervention and control phases, and a decrease in the mean (SD) number of days of hospitalization amounted to 36 (15.68), with a data distribution around 3 σ. The LSS is a helpful strategy that ensures a significant decrease in the number of HAIs in patients undergoing surgical interventions. The implementation of this intervention in the general surgery departments resulted in a significant reduction in both the number of hospitalization days and the number of patients affected by HAIs. This approach, together with other tools for reducing the risk of infection (surveillance, epidemiological guidelines, and training of healthcare personnel), could be applied to redesign and improve a wide range of healthcare processes. © 2016 John Wiley & Sons, Ltd.

Infection prevention and control strategies in the era of limited resources and quality improvement: a perspective paper.

PubMed

Vandijck, Dominique; Cleemput, Irina; Hellings, Johan; Vogelaers, Dirk

2013-11-01

This paper aims to describe, using an evidence-based approach, the importance of and the resources necessary for implementing effective infection prevention and control (IPC) programmes. The intrinsic and explicit values of such strategies are presented from a clinical, health-economic and patient safety perspective. Policy makers and hospital managers are committed to providing comprehensive, accessible, and affordable healthcare of high quality. Changes in the healthcare system over time accompanied with variations in demographics and case-mix have considerably affected the availability, quality and ultimately the safety of healthcare. The main goal of an IPC programme is to prevent and control healthcare-associated infections (HAI). Many patient-, healthcare provider-, and organizational factors are associated with an increased risk for acquiring HAIs and may impact both the quality and outcome of patient care. Evidence has been published in support of having an effective IPC programme. It has been estimated that about one-third of HAIs could be prevented if key elements of the evidence-based recommendations for IPC are adequately introduced and followed. However, several healthcare agencies from over the world have reported deficits in the essential resources and components of current IPC programmes. To meet its main goal, staffing, training, and infrastructure requirements are needed. Nevertheless, and given the economic crisis, policy makers and hospital managers may be tempted to not increase or even to reduce the budget as it consumes resources and does not generate sufficient visible revenue. IPC is a critical issue in patient safety, as HAIs are by far the most common complication affecting admitted patients. The significant clinical and health-economic burden HAIs place on the healthcare system speak to the importance of getting introduced effective IPC programmes. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier

Development and validation of the "Pediatric Risk of Nosocomial Sepsis (PRiNS)" score for health care-associated infections in a medical pediatric intensive care unit of a developing economy--a prospective observational cohort study.

PubMed

Saptharishi, L G; Jayashree, Muralidharan; Singhi, Sunit

2016-04-01

Given the high burden of health care-associated infections (HAIs) in resource-limited settings, there is a tendency toward overdiagnosis/treatment. This study was designed to create an easy-to-use, dynamic, bedside risk stratification model for classifying children based on their risk of developing HAIs during their pediatric intensive care unit (PICU) stay, to aid judicious resource utilization. A prospective, observational cohort study was conducted in the 12-bed PICU of a large Indian tertiary care hospital between January and October 2011. A total of 412 consecutive admissions, aged 1 month to 12 years with PICU stay greater than 48 hours were enrolled. Independent predictors for HAIs identified using multivariate regression analysis were combined to create a novel scoring system. Performance and calibration of score were assessed using receiver operating characteristic curves and Hosmer-Lemeshow statistic, respectively. Internal validation was done. Age (<5 years), Pediatric Risk of Mortality III (24 hours) score, presence of indwelling catheters, need for intubation, albumin infusion, immunomodulator, and prior antibiotic use (≥4) were independent predictors of HAIs. This model, with area under the ROC curve of 0.87, at a cutoff of 15, had a negative predictive value of 89.9% with overall accuracy of 79.3%. It reduced classification errors from 29.8% to 20.7%. All 7 predictors retained their statistical significance after bootstrapping, confirming the internal validity of the score. The "Pediatric Risk of Nosocomial Sepsis" score can reliably classify children into high- and low-risk groups, based on their risk of developing HAIs in the PICU of a resource-limited setting. In view of its high sensitivity and specificity, diagnostic and therapeutic interventions may be directed away from the low-risk group, ensuring effective utilization of limited resources. Copyright © 2015 Elsevier Inc. All rights reserved.

Compressed gas manifold

DOEpatents

Hildebrand, Richard J.; Wozniak, John J.

2001-01-01

A compressed gas storage cell interconnecting manifold including a thermally activated pressure relief device, a manual safety shut-off valve, and a port for connecting the compressed gas storage cells to a motor vehicle power source and to a refueling adapter. The manifold is mechanically and pneumatically connected to a compressed gas storage cell by a bolt including a gas passage therein.

Natural Gas Prices Forecast Comparison--AEO vs. Natural Gas Markets

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

Wong-Parodi, Gabrielle; Lekov, Alex; Dale, Larry

This paper evaluates the accuracy of two methods to forecast natural gas prices: using the Energy Information Administration's ''Annual Energy Outlook'' forecasted price (AEO) and the ''Henry Hub'' compared to U.S. Wellhead futures price. A statistical analysis is performed to determine the relative accuracy of the two measures in the recent past. A statistical analysis suggests that the Henry Hub futures price provides a more accurate average forecast of natural gas prices than the AEO. For example, the Henry Hub futures price underestimated the natural gas price by 35 cents per thousand cubic feet (11.5 percent) between 1996 and 2003more » and the AEO underestimated by 71 cents per thousand cubic feet (23.4 percent). Upon closer inspection, a liner regression analysis reveals that two distinct time periods exist, the period between 1996 to 1999 and the period between 2000 to 2003. For the time period between 1996 to 1999, AEO showed a weak negative correlation (R-square = 0.19) between forecast price by actual U.S. Wellhead natural gas price versus the Henry Hub with a weak positive correlation (R-square = 0.20) between forecasted price and U.S. Wellhead natural gas price. During the time period between 2000 to 2003, AEO shows a moderate positive correlation (R-square = 0.37) between forecasted natural gas price and U.S. Wellhead natural gas price versus the Henry Hub that show a moderate positive correlation (R-square = 0.36) between forecast price and U.S. Wellhead natural gas price. These results suggest that agencies forecasting natural gas prices should consider incorporating the Henry Hub natural gas futures price into their forecasting models along with the AEO forecast. Our analysis is very preliminary and is based on a very small data set. Naturally the results of the analysis may change, as more data is made available.« less

Gas composition and isotopic geochemistry of cuttings, core, and gas hydrate from the JAPEX/JNOC/GSC Mallik 2L-38 gas hydrate research well

USGS Publications Warehouse

Lorenson, T.D.

1999-01-01

Molecular and isotopic composition of gases from the JAPEX/JNOC/GSC Mallik 2L-38 gas hydrate research well demonstrate that the in situ gases can be divided into three zones composed of mixtures of microbial and thermogenic gases. Sediments penetrated by the well are thermally immature; thus the sediments are probably not a source of thermogenic gas. Thermogenic gas likely migrated from depths below 5000 m. Higher concentrations of gas within and beneath the gas hydrate zone suggest that gas hydrate is a partial barrier to gas migration. Gas hydrate accumulations occur wholly within zone 3, below the base of permafrost. The gas in gas hydrate resembles, in part, the thermogenic gas in surrounding sediments and gas desorbed from lignite. Gas hydrate composition implies that the primary gas hydrate form is Structure I. However, Structure II stabilizing gases are more concentrated and isotopically partitioned in gas hydrate relative to the sediment hosting the gas hydrate, implying that Structure II gas hydrate may be present in small quantities.

U.S. crude oil, natural gas, and natural gas liquids reserves 1997 annual report

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

Wood, John H.; Grape, Steven G.; Green, Rhonda S.

1998-12-01

This report presents estimates of proved reserves of crude oil, natural gas, and natural gas liquids as of December 31, 1997, as well as production volumes for the US and selected States and State subdivisions for the year 1997. Estimates are presented for the following four categories of natural gas: total gas (wet after lease separation), nonassociated gas and associated-dissolved gas (which are the two major types of wet natural gas), and total dry gas (wet gas adjusted for the removal of liquids at natural gas processing plants). In addition, reserve estimates for two types of natural gas liquids, leasemore » condensate and natural gas plant liquids, are presented. Also included is information on indicated additional crude oil reserves and crude oil, natural gas, and lease condensate reserves in nonproducing reservoirs. A discussion of notable oil and gas exploration and development activities during 1997 is provided. 21 figs., 16 tabs.« less

Scary gas: intravascular, intracranial, and intraspinal ectopic gas (part III).

PubMed

Sandstrom, Claire K; Osman, Sherif F; Linnau, Ken F

2017-08-01

While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive. Pneumocephalus arises from a communication with paranasal sinuses or mastoids more often than from meningeal infection and can usually be managed nonoperatively. In part 3 of this series, the different causes of ectopic gas in the vessels, skull, and spine are reviewed, as are the imaging features that can help to narrow the differential diagnosis.

Gas Transfer in Cellularized Collagen-Membrane Gas Exchange Devices.

PubMed

Lo, Justin H; Bassett, Erik K; Penson, Elliot J N; Hoganson, David M; Vacanti, Joseph P

2015-08-01

Chronic lower respiratory disease is highly prevalent in the United States, and there remains a need for alternatives to lung transplant for patients who progress to end-stage lung disease. Portable or implantable gas oxygenators based on microfluidic technologies can address this need, provided they operate both efficiently and biocompatibly. Incorporating biomimetic materials into such devices can help replicate native gas exchange function and additionally support cellular components. In this work, we have developed microfluidic devices that enable blood gas exchange across ultra-thin collagen membranes (as thin as 2 μm). Endothelial, stromal, and parenchymal cells readily adhere to these membranes, and long-term culture with cellular components results in remodeling, reflected by reduced membrane thickness. Functionally, acellular collagen-membrane lung devices can mediate effective gas exchange up to ∼288 mL/min/m(2) of oxygen and ∼685 mL/min/m(2) of carbon dioxide, approaching the gas exchange efficiency noted in the native lung. Testing several configurations of lung devices to explore various physical parameters of the device design, we concluded that thinner membranes and longer gas exchange distances result in improved hemoglobin saturation and increases in pO2. However, in the design space tested, these effects are relatively small compared to the improvement in overall oxygen and carbon dioxide transfer by increasing the blood flow rate. Finally, devices cultured with endothelial and parenchymal cells achieved similar gas exchange rates compared with acellular devices. Biomimetic blood oxygenator design opens the possibility of creating portable or implantable microfluidic devices that achieve efficient gas transfer while also maintaining physiologic conditions.

Gravitational Thermodynamics for Interstellar Gas and Weakly Degenerate Quantum Gas

NASA Astrophysics Data System (ADS)

Zhu, Ding Yu; Shen, Jian Qi

2016-03-01

The temperature distribution of an ideal gas in gravitational fields has been identified as a longstanding problem in thermodynamics and statistical physics. According to the principle of entropy increase (i.e., the principle of maximum entropy), we apply a variational principle to the thermodynamical entropy functional of an ideal gas and establish a relationship between temperature gradient and gravitational field strength. As an illustrative example, the temperature and density distributions of an ideal gas in two simple but typical gravitational fields (i.e., a uniform gravitational field and an inverse-square gravitational field) are considered on the basis of entropic and hydrostatic equilibrium conditions. The effect of temperature inhomogeneity in gravitational fields is also addressed for a weakly degenerate quantum gas (e.g., Fermi and Bose gas). The present gravitational thermodynamics of a gas would have potential applications in quantum fluids, e.g., Bose-Einstein condensates in Earth’s gravitational field and the temperature fluctuation spectrum in cosmic microwave background radiation.

Gas hydrate in nature

USGS Publications Warehouse

Ruppel, Carolyn D.

2018-01-17

Gas hydrate is a naturally occurring, ice-like substance that forms when water and gas combine under high pressure and at moderate temperatures. Methane is the most common gas present in gas hydrate, although other gases may also be included in hydrate structures, particularly in areas close to conventional oil and gas reservoirs. Gas hydrate is widespread in ocean-bottom sediments at water depths greater than 300–500 meters (m; 984–1,640 feet [ft]) and is also present in areas with permanently frozen ground (permafrost). Several countries are evaluating gas hydrate as a possible energy resource in deepwater or permafrost settings. Gas hydrate is also under investigation to determine how environmental change may affect these deposits.

Mechanisms of Hepatocyte Growth Factor Activation in Cancer Tissues

PubMed Central

Kawaguchi, Makiko; Kataoka, Hiroaki

2014-01-01

Hepatocyte growth factor/scatter factor (HGF/SF) plays critical roles in cancer progression through its specific receptor, MET. HGF/SF is usually synthesized and secreted as an inactive proform (pro-HGF/SF) by stromal cells, such as fibroblasts. Several serine proteases are reported to convert pro-HGF/SF to mature HGF/SF and among these, HGF activator (HGFA) and matriptase are the most potent activators. Increased activities of both proteases have been observed in various cancers. HGFA is synthesized mainly by the liver and secreted as an inactive pro-form. In cancer tissues, pro-HGFA is likely activated by thrombin and/or human kallikrein 1-related peptidase (KLK)-4 and KLK-5. Matriptase is a type II transmembrane serine protease that is expressed by most epithelial cells and is also synthesized as an inactive zymogen. Matriptase activation is likely to be mediated by autoactivation or by other trypsin-like proteases. Recent studies revealed that matriptase autoactivation is promoted by an acidic environment. Given the mildly acidic extracellular environment of solid tumors, matriptase activation may, thus, be accelerated in the tumor microenvironment. HGFA and matriptase activities are regulated by HGFA inhibitor (HAI)-1 (HAI-1) and/or HAI-2 in the pericellular microenvironment. HAIs may have an important role in cancer cell biology by regulating HGF/SF-activating proteases. PMID:25268161

Decontamination of the digestive tract and oropharynx: hospital acquired infections after discharge from the intensive care unit.

PubMed

de Smet, Anne Marie G A; Hopmans, Titia E M; Minderhoud, Albertus L C; Blok, Hetty E M; Gossink-Franssen, Annelies; Bernards, Alexandra T; Bonten, Marc J M

2009-09-01

To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC). Prospective observational study. ICUs in two tertiary care hospitals. Patients discharged from the ICU to the ward. None. Post-ICU incidences of HAI per 1,000 days at risk were 11.2, 12.9 and 8.3 for patients that had received SDD (n = 296), SOD (n = 286) or SC (n = 289) respectively in ICU, yielding relative risks, as compared to SC, of 1.49 (CI(95) 0.9-2.47) for SOD and 1.44 (CI(95) 0.87-2.39) for SDD. Incidences of surgical site infections (per 100 surgical procedures) were 4 after SC and 11.8 and 8 after SOD and SDD (p = 0.04). Among patients that succumbed in the hospital after ICU-stay (n = 58) eight (14%) had developed HAI after ICU discharge; 3 of 21 after SDD, 3 of 15 after SOD and 2 of 22 after SC. Incidences of HAI in general wards tended to be higher in patients that had received either SDD or SOD during ICU-stay, but it seems unlikely that these infections have an effect on hospital mortality rates.

Methods for computational disease surveillance in infection prevention and control: Statistical process control versus Twitter's anomaly and breakout detection algorithms.

PubMed

Wiemken, Timothy L; Furmanek, Stephen P; Mattingly, William A; Wright, Marc-Oliver; Persaud, Annuradha K; Guinn, Brian E; Carrico, Ruth M; Arnold, Forest W; Ramirez, Julio A

2018-02-01

Although not all health care-associated infections (HAIs) are preventable, reducing HAIs through targeted intervention is key to a successful infection prevention program. To identify areas in need of targeted intervention, robust statistical methods must be used when analyzing surveillance data. The objective of this study was to compare and contrast statistical process control (SPC) charts with Twitter's anomaly and breakout detection algorithms. SPC and anomaly/breakout detection (ABD) charts were created for vancomycin-resistant Enterococcus, Acinetobacter baumannii, catheter-associated urinary tract infection, and central line-associated bloodstream infection data. Both SPC and ABD charts detected similar data points as anomalous/out of control on most charts. The vancomycin-resistant Enterococcus ABD chart detected an extra anomalous point that appeared to be higher than the same time period in prior years. Using a small subset of the central line-associated bloodstream infection data, the ABD chart was able to detect anomalies where the SPC chart was not. SPC charts and ABD charts both performed well, although ABD charts appeared to work better in the context of seasonal variation and autocorrelation. Because they account for common statistical issues in HAI data, ABD charts may be useful for practitioners for analysis of HAI surveillance data. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

A positive immunoselection method to isolate villous cytotrophoblast cells from first trimester and term placenta to high purity.

PubMed

Pötgens, A J G; Kataoka, H; Ferstl, S; Frank, H-G; Kaufmann, P

2003-04-01

We developed a method for isolating highly pure villous cytotrophoblast cells from first trimester and term placenta that excludes extravillous trophoblast and syncytiotrophoblast fragments. The method is based on positive immunoselection using an antibody (mAb C76/18) reacting with hepatocyte growth factor activator inhibitor 1, HAI-1, a membrane antigen on villous cytotrophoblast. As a comparison, we also immunopurified cells using an antibody against CD105, present on syncytiotrophoblast and some extravillous trophoblast cells. The isolates were characterized by flow cytometry. HAI-1-positive cells from first trimester and term placentae were highly pure (>98 per cent cytokeratin 7-positive) mononuclear trophoblast cells. These isolations were contaminated with only very small percentages of vimentin and CD45-positive cells. HAI-1-positive trophoblast cells lacked CD105 and also HLA class I, a marker for extravillous trophoblast. In culture HAI-1-positive cells adhered, displayed an epithelial morphology, and survived for more than three days. In contrast, CD105-positive cell fractions from first trimester placenta were a heterogeneous mixture of mononuclear and multinuclear elements consisting of syncytiotrophoblast fragments, extravillous trophoblast cells, as well as around 5 per cent non-trophoblastic contaminants. In conclusion, the positive immunoselection method using antibody C76/18 yielded highly pure villous cytotrophoblast cells devoid of elements derived from syncytiotrophoblast or extravillous trophoblast.

Gas shielding apparatus

DOEpatents

Brandt, D.

1984-06-05

An apparatus for preventing oxidation by uniformly distributing inert shielding gas over the weld area of workpieces such as pipes being welded together. The apparatus comprises a chamber and a gas introduction element. The chamber has an annular top wall, an annular bottom wall, an inner side wall and an outer side wall connecting the top and bottom walls. One side wall is a screen and the other has a portion defining an orifice. The gas introduction element has a portion which encloses the orifice and can be one or more pipes. The gas introduction element is in fluid communication with the chamber and introduces inert shielding gas into the chamber. The inert gas leaves the chamber through the screen side wall and is dispersed evenly over the weld area.

Gas shielding apparatus

DOEpatents

Brandt, D.

1985-12-31

An apparatus is disclosed for preventing oxidation by uniformly distributing inert shielding gas over the weld area of workpieces such as pipes being welded together. The apparatus comprises a chamber and a gas introduction element. The chamber has an annular top wall, an annular bottom wall, an inner side wall and an outer side wall connecting the top and bottom walls. One side wall is a screen and the other has a portion defining an orifice. The gas introduction element has a portion which encloses the orifice and can be one or more pipes. The gas introduction element is in fluid communication with the chamber and introduces inert shielding gas into the chamber. The inert gas leaves the chamber through the screen side wall and is dispersed evenly over the weld area. 3 figs.

Gas shielding apparatus

DOEpatents

Brandt, Daniel

1985-01-01

An apparatus for preventing oxidation by uniformly distributing inert shielding gas over the weld area of workpieces such as pipes being welded together. The apparatus comprises a chamber and a gas introduction element. The chamber has an annular top wall, an annular bottom wall, an inner side wall and an outer side wall connecting the top and bottom walls. One side wall is a screen and the other has a portion defining an orifice. The gas introduction element has a portion which encloses the orifice and can be one or more pipes. The gas introduction element is in fluid communication with the chamber and introduces inert shielding gas into the chamber. The inert gas leaves the chamber through the screen side wall and is dispersed evenly over the weld area.

Gas stream purifier

NASA Technical Reports Server (NTRS)

Adam, Steven J.

1994-01-01

A gas stream purifier has been developed that is capable of removing corrosive acid, base, solvent, organic, inorganic, and water vapors as well as particulates from an inert mixed gas stream using only solid scrubbing agents. This small, lightweight purifier has demonstrated the ability to remove contaminants from an inert gas stream with a greater than 99 percent removal efficiency. The Gas Stream Purifier has outstanding market and sales potential in manufacturing, laboratory and science industries, medical, automotive, or any commercial industry where pollution, contamination, or gas stream purification is a concern. The purifier was developed under NASA contract NAS9-18200 Schedule A for use in the international Space Station. A patent application for the Gas Stream Purifier is currently on file with the United States Patent and Trademark Office.

Development of an Exhaled Breath Monitoring System with Semiconductive Gas Sensors, a Gas Condenser Unit, and Gas Chromatograph Columns

PubMed Central

Itoh, Toshio; Miwa, Toshio; Tsuruta, Akihiro; Akamatsu, Takafumi; Izu, Noriya; Shin, Woosuck; Park, Jangchul; Hida, Toyoaki; Eda, Takeshi; Setoguchi, Yasuhiro

2016-01-01

Various volatile organic compounds (VOCs) in breath exhaled by patients with lung cancer, healthy controls, and patients with lung cancer who underwent surgery for resection of cancer were analyzed by gas condenser-equipped gas chromatography-mass spectrometry (GC/MS) for development of an exhaled breath monitoring prototype system involving metal oxide gas sensors, a gas condenser, and gas chromatography columns. The gas condenser-GC/MS analysis identified concentrations of 56 VOCs in the breath exhaled by the test population of 136 volunteers (107 patients with lung cancer and 29 controls), and selected four target VOCs, nonanal, acetoin, acetic acid, and propanoic acid, for use with the condenser, GC, and sensor-type prototype system. The prototype system analyzed exhaled breath samples from 101 volunteers (74 patients with lung cancer and 27 controls). The prototype system exhibited a level of performance similar to that of the gas condenser-GC/MS system for breath analysis. PMID:27834896

GAS BEARING

DOEpatents

Skarstrom, C.W.

1960-09-01

A gas lubricated bearing for a rotating shaft is described. The assembly comprises a stationary collar having an annular member resiliently supported thereon. The collar and annular member are provided with cooperating gas passages arranged for admission of pressurized gas which supports and lubricates a bearing block fixed to the rotatable shaft. The resilient means for the annular member support the latter against movement away from the bearing block when the assembly is in operation.

Argentine gas system underway for Gas del Estado

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

Bosch, H.

Gas del Estado's giant 1074-mile Centro-Oeste pipeline project - designed to ultimately transport over 350 million CF/day of natural gas from the Neuquen basin to the Campo Duran-Buenos Aires pipeline system - is now underway. The COGASCO consortium of Dutch and Argentine companies awarded the construction project will also operate and maintain the system for 15 years after its completion. In addition to the 30-in. pipelines, the agreement calls for a major compressor station at the gas field, three intermediate compressor stations, a gas-treatment plant, liquids-recovery facilities, and the metering, control, communications, and maintenance equipment for the system. Fabricated inmore » Holland, the internally and externally coated pipe will be double-jointed to 80-ft lengths after shipment to Argentina; welders will use conventional manual-arc techniques to weld the pipeline in the field.« less

U.S. Natural Gas Markets: Mid-Term Prospects for Natural Gas Supply

EIA Publications

2001-01-01

This service report describes the recent behavior of natural gas markets with respect to natural gas prices, their potential future behavior, the potential future supply contribution of liquefied natural gas and increased access to federally restricted resources, and the need for improved natural gas data.

A gas-loading system for LANL two-stage gas guns

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

Gibson, Lloyd Lee; Bartram, Brian Douglas; Dattelbaum, Dana Mcgraw

A novel gas loading system was designed for the specific application of remotely loading high purity gases into targets for gas-gun driven plate impact experiments. The high purity gases are loaded into well-defined target configurations to obtain Hugoniot states in the gas phase at greater than ambient pressures.The small volume of the gas samples is challenging, as slight changing in the ambient temperature result in measurable pressure changes. Therefore, the ability to load a gas gun target and continually monitor the sample pressure prior to firing provides the most stable and reliable target fielding approach. We present the design andmore » evaluation of a gas loading system built for the LANL 50 mm bore two-stage light gas gun. Targets for the gun are made of 6061 Al or OFHC Cu, and assembled to form a gas containment cell with a volume of approximately 1.38 cc. The compatibility of materials was a major consideration in the design of the system, particularly for its use with corrosive gases. Piping and valves are stainless steel with wetted seals made from Kalrez® and Teflon®. Preliminary testing was completed to ensure proper flow rate and that the proper safety controls were in place. The system has been used to successfully load Ar, Kr, Xe, and anhydrous ammonia with purities of up to 99.999 percent. The design of the system and example data from the plate impact experiments will be shown.« less

A gas-loading system for LANL two-stage gas guns

NASA Astrophysics Data System (ADS)

Gibson, L. L.; Bartram, B. D.; Dattelbaum, D. M.; Lang, J. M.; Morris, J. S.

2017-01-01

A novel gas loading system was designed for the specific application of remotely loading high purity gases into targets for gas-gun driven plate impact experiments. The high purity gases are loaded into well-defined target configurations to obtain Hugoniot states in the gas phase at greater than ambient pressures. The small volume of the gas samples is challenging, as slight changing in the ambient temperature result in measurable pressure changes. Therefore, the ability to load a gas gun target and continually monitor the sample pressure prior to firing provides the most stable and reliable target fielding approach. We present the design and evaluation of a gas loading system built for the LANL 50 mm bore two-stage light gas gun. Targets for the gun are made of 6061 Al or OFHC Cu, and assembled to form a gas containment cell with a volume of approximately 1.38 cc. The compatibility of materials was a major consideration in the design of the system, particularly for its use with corrosive gases. Piping and valves are stainless steel with wetted seals made from Kalrez® and Teflon®. Preliminary testing was completed to ensure proper flow rate and that the proper safety controls were in place. The system has been used to successfully load Ar, Kr, Xe, and anhydrous ammonia with purities of up to 99.999 percent. The design of the system and example data from the plate impact experiments will be shown.

[Antiseptics and disinfectants: aiming at rational use. Recommendations of the Advisory Committee on Healthcare Associated Infections. Sociedad Chilena de Infectología].

PubMed

Diomedi, Alexis; Chacón, Eiiana; Delpiano, Luis; Hervé, Beatrice; Jemenao, M Irene; Medel, Myriam; Quintanilla, Marcela; Riedel, Gisela; Tinoco, Javier; Cifuentes, Marcela

2017-04-01

Proper use of antiseptics and disinfectants, is an essential tool to prevent the spread of infectious agents and to control of healthcare-associated infections (HAI). Given the increasing importance of environmental aspects, as well as several advances and updates in the field of its proper use at local and intemational level, the SOCHINF HAI Advisory Committee considers that it is necessary to develop a guide for the rational use of antiseptics and disinfectants, which it will provide consistent scientific basis with that purpose.

Impact of climate change on potential evapotranspiration under a historical and future climate scenario in the Huang-Huai-Hai Plain, China

NASA Astrophysics Data System (ADS)

Liu, Qin; Yan, Changrong; Ju, Hui; Garré, Sarah

2018-04-01

Climate change is widely accepted to be one of the most critical problems faced by the Huang-Huai-Hai Plain (3H Plain), which is a region in which there is an over-exploitation of groundwater and where future warmer and drought conditions might intensify crop water demand. In this study, the spatiotemporal patterns of ET0 and primary driving meteorological variables were investigated based on a historical and RCP 8.5 scenario daily data set from 40 weather stations over the 3H Plain using linear regression, spline interpolation method, a partial derivative analysis, and multivariate regression. The results indicated a negative trend in all the analysed periods (except spring) of the past 54 years of which only summer and the entire year were statistically significant ( p < 0.01) with slopes of -1.09 and -1.29 mm a-1, respectively. In contrast, a positive trend was observed in all four seasons and the entire year under the RCP 8.5 scenario, with the biggest increment equal to 1.36 mm a-1 in summer and an annual increment of 3.37 mm a-1. The spatial patterns of the seasonal and annual ET0 exhibited the lowest values in southeastern regions and the highest values in northeastern parts of Shandong Province, probably because of the combined effects of various meteorological variables over the past 54 years. Relative humidity (RH) together with solar radiation (RS) were detected to be the main climatic factors controlling the reduction of ET0 in summer, autumn, and the entire year on the 3H Plain. ET0 in spring was mainly sensitive to changes in RS and RH, whereas ET0 in winter was most sensitive to changes in wind speed (WS) and decreased due to declining RH. Under the future RCP 8.5 scenario, the annual ET0 distribution displays a rich spatial structure with a clear northeast-west gradient and an area with low values in the southern regions, which is similarly detected in spring and summer. The most sensitive and primary controlling variables with respect to the

Quantum gas-liquid condensation in an attractive Bose gas

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

Koh, Shun-ichiro

Gas-liquid condensation (GLC) in an attractive Bose gas is studied on the basis of statistical mechanics. Using some results in combinatorial mathematics, the following are derived. (1) With decreasing temperature, the Bose-statistical coherence grows in the many-body wave function, which gives rise to the divergence of the grand partition function prior to Bose-Einstein condensation. It is a quantum-mechanical analogue to the GLC in a classical gas (quantum GLC). (2) This GLC is triggered by the bosons with zero momentum. Compared with the classical GLC, an incomparably weaker attractive force creates it. For the system showing the quantum GLC, we discussmore » a cold helium 4 gas at sufficiently low pressure.« less

[Effects of short-term deep vertically rotary tillage on topsoil structure of lime concretion black soil and wheat growth in Huang-Huai-Hai Plain, China].

PubMed

Zhai, Zhen; Li, Yu Yi; Zhang, Li; Pang, Bo; Pang, Huan Cheng; Wei, Ben Hui; Wang, Qing Wei; Qi, Shao Wei

2017-04-18

Annual rotary tillage can often create a compacted plough pan and shallow arable layer which hampers the high crop yield in Huang-Huai-Hai region. A brand new farming method named Vertically Rotary Tillage was introduced to solve this problem. One short-term field experiment was conducted to explore the effect of deep vertically rotary tillage on soil physical properties and photosynthetic characteristics at flowering stage of winter wheat. Two tillage treatments were designed including subsoiling tillage with 20 cm depth (SS 20 , CK) and deep vertically rotary tillage with 30 cm depth (DVR 30 ). The result showed that compared with SS 20 treatment, DVR 30 treatment could thoroughly break the plow pan and loose the arable layer. The soil bulk density at 10-20 cm and 20-30 cm layers under DVR 30 treatment was decreased by 9.5% and 11.2% respectively than that under SS 20 treatment. Meanwhile, the penetration resistance at 20-30 cm layer under DVR 30 treatment was also decreased by 42.3% than that under SS 20 treatment. Moreover, water infiltration under DVR 30 treatment and the soil water storage in the deep soil layers was then increased. The mass water content of soil increased significantly with the increase of soil depth. There was significant difference of mass water content of 30-40 cm 40-50 cm between SS 20 and DVR 30 . The mass water content 30-40 cm and 40-50 cm layers under DVR 30 treatment was increased by 16.9% and 10.6% compared with SS 20 treatment, respectively. Furthermore, DVR 30 treatment promoted the improvement of the photosynthetic capacity of wheat which could contribute to the dry matter accumulation of winter wheat. The net photosynthesis rate and SPAD at flowering stage of winter wheat leaves under DVR 30 treatment were increased by 1.3% and 15.5% respectively than that under SS 20 treatment, thereby the above and underground dry matter accumulation of winter wheat under DVR 30 was increased significantly. Due to all the superiority of DVR

30 CFR 250.1157 - How do I receive approval to produce gas-cap gas from an oil reservoir with an associated gas cap?

Code of Federal Regulations, 2010 CFR

2010-07-01

... gas from an oil reservoir with an associated gas cap? 250.1157 Section 250.1157 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE... do I receive approval to produce gas-cap gas from an oil reservoir with an associated gas cap? (a...

GHGRP Natural Gas and Natural Gas Liquids Suppliers Sector Industrial Profile

EPA Pesticide Factsheets

EPA's Greenhouse Gas Reporting Program periodically produces detailed profiles of the various industries that report under the program. The profiles available for download below contain detailed analyses for the Natural Gas and Natural Gas Suppliers indust

Recirculating rotary gas compressor

DOEpatents

Weinbrecht, J.F.

1992-02-25

A positive displacement, recirculating Roots-type rotary gas compressor is described which operates on the basis of flow work compression. The compressor includes a pair of large diameter recirculation conduits which return compressed discharge gas to the compressor housing, where it is mixed with low pressure inlet gas, thereby minimizing adiabatic heating of the gas. The compressor includes a pair of involutely lobed impellers and an associated port configuration which together result in uninterrupted flow of recirculation gas. The large diameter recirculation conduits equalize gas flow velocities within the compressor and minimize gas flow losses. The compressor is particularly suited to applications requiring sustained operation at higher gas compression ratios than have previously been feasible with rotary pumps, and is particularly applicable to refrigeration or other applications requiring condensation of a vapor. 12 figs.

Cold Gas Content and Morphology: Scaling Relationships and Gas Deficiencies

NASA Astrophysics Data System (ADS)

Zhang, Helen; Crocker, Alison

2018-01-01

Spiral arms are a key feature of spiral galaxies. They are areas of higher gas density, and thus more stars are actively being formed in these regions. Two armed spirals are commonly referred to as ‘grand design’ spirals. In constrast, many armed spirals have three or more arms that are often less distinct. Here we present the cold gas mass per unit of stellar mass (cold gas fraction) in grand design spirals versus many armed spiral galaxies using Galaxy Zoo 2 for our morphological classifications. The masses of HI and H2 gas are taken from the COLDGASS survey, which included nondetections in the form of upper limits. Through our analysis, we found that grand design galaxies have a lower cold gas fraction of both HI and H2. This is a surprising result, given that earlier studies have shown that they have comparable rates of star formation. Combined with our result, this means that grand design galaxies must be more efficient at converting H2 gas to stars.

Preliminary report on the commercial viability of gas production from natural gas hydrates

USGS Publications Warehouse

Walsh, M.R.; Hancock, S.H.; Wilson, S.J.; Patil, S.L.; Moridis, G.J.; Boswell, R.; Collett, T.S.; Koh, C.A.; Sloan, E.D.

2009-01-01

Economic studies on simulated gas hydrate reservoirs have been compiled to estimate the price of natural gas that may lead to economically viable production from the most promising gas hydrate accumulations. As a first estimate, $CDN2005 12/Mscf is the lowest gas price that would allow economically viable production from gas hydrates in the absence of associated free gas, while an underlying gas deposit will reduce the viability price estimate to $CDN2005 7.50/Mscf. Results from a recent analysis of the simulated production of natural gas from marine hydrate deposits are also considered in this report; on an IROR basis, it is $US2008 3.50-4.00/Mscf more expensive to produce marine hydrates than conventional marine gas assuming the existence of sufficiently large marine hydrate accumulations. While these prices represent the best available estimates, the economic evaluation of a specific project is highly dependent on the producibility of the target zone, the amount of gas in place, the associated geologic and depositional environment, existing pipeline infrastructure, and local tariffs and taxes. ?? 2009 Elsevier B.V.

A Noise Spectroscopy-Based Selective Gas Sensing with MOX Gas Sensors

NASA Astrophysics Data System (ADS)

Gomri, S.; Seguin, J.; Contaret, T.; Fiorido, T.; Aguir, K.

We propose a new method for obtaining a fluctuation-enhanced sensing (FES) signature of a gas using a single metal oxide (MOX) gas micro sensor. Starting from our model of adsorption-desorption (A-D) noise previously developed, we show theoretically that the product of frequency by the power spectrum density (PSD) of the gas sensing layer resistance fluctuations often has a maximum which is characteristic of the gas. This property was experimentally confirmed in the case of the detection of NO2 and O3 using a WO3 sensing layer. This method could be useful for classifying gases. Furthermore, our noise measurements confirm our previous model showing that PSD of the A-Dnoise in MOX gas sensor is a combination of Lorentzians having a low frequency magnitude and a cut-off frequency which depends on the nature of the detected gas.

Gas Jets

NASA Technical Reports Server (NTRS)

Chaplygin, S.

1944-01-01

A brief summary of the contents of this paper is presented here. In part I the differential equations of the problem of a gas flow in two dimensions is derived and the particular integrals by which the problem on jets is solved are given. Use is made of the same independent variables as Molenbroek used, but it is found to be more suitable to consider other functions. The stream function and velocity potential corresponding to the problem are given in the form of series. The investigation on the convergence of these series in connection with certain properties of the functions entering them forms the subject of part II. In part III the problem of the outflow of a gas from an infinite vessel with plane walls is solved. In part IV the impact of a gas jet on a plate is considered and the limiting case where the jet expands to infinity changing into a gas flow is taken up in more detail. This also solved the equivalent problem of the resistance of a gaseous medium to the motion of a plate. Finally, in part V, an approximate method is presented that permits a simpler solution of the problem of jet flows in the case where the velocities of the gas (velocities of the particles in the gas) are not very large.

Translating infection control guidelines into practice: implementation process within a health care institution.

PubMed

Raveis, Victoria H; Conway, Laurie J; Uchida, Mayuko; Pogorzelska-Maziarz, Monika; Larson, Elaine L; Stone, Patricia W

2014-04-01

Health-care-associated infections (HAIs) remain a major patient safety problem even as policy and programmatic efforts designed to reduce HAIs have increased. Although information on implementing effective infection control (IC) efforts has steadily grown, knowledge gaps remain regarding the organizational elements that improve bedside practice and accommodate variations in clinical care settings. We conducted in-depth, semistructured interviews in 11 hospitals across the United States with a range of hospital personnel involved in IC (n = 116). We examined the collective nature of IC and the organizational elements that can enable disparate groups to work together to prevent HAIs. Our content analysis of participants' narratives yielded a rich description of the organizational process of implementing adherence to IC. Findings document the dynamic, fluid, interactional, and reactive nature of this process. Three themes emerged: implementing adherence efforts institution-wide, promoting an institutional culture to sustain adherence, and contending with opposition to the IC mandate.

A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

PubMed

Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

2014-08-01

Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

African swine fever virus serotype-specific proteins are significant protective antigens for African swine fever.

PubMed

Burmakina, G; Malogolovkin, A; Tulman, E R; Zsak, L; Delhon, G; Diel, D G; Shobogorov, N M; Morgunov, Yu P; Morgunov, S Yu; Kutish, G F; Kolbasov, D; Rock, D L

2016-07-01

African swine fever (ASF) is an emerging disease threat for the swine industry worldwide. No ASF vaccine is available and progress is hindered by lack of knowledge concerning the extent of ASFV strain diversity and the viral antigens conferring type-specific protective immunity in pigs. Available data from vaccination/challenge experiments in pigs indicate that ASF protective immunity may be haemadsorption inhibition (HAI) serotype-specific. Recently, we have shown that two ASFV proteins, CD2v (EP402R) and C-type lectin (EP153R), are necessary and sufficient for mediating HAI serological specificity (Malogolovkin et al., 2015).. Here, using ASFV inter-serotypic chimeric viruses and vaccination/challenge experiments in pigs, we demonstrate that serotype-specific CD2v and/or C-type lectin proteins are important for protection against homologous ASFV infection. Thus, these viral proteins represent significant protective antigens for ASFV that should be targeted in future vaccine design and development. Additionally, these data support the concept of HAI serotype-specific protective immunity.

Getting to Zero: Goal Commitment to Reduce Blood Stream Infections.

PubMed

McAlearney, Ann Scheck; Hefner, Jennifer L

2016-08-01

While preventing health care-associated infections (HAIs) can save lives and reduce health care costs, efforts designed to eliminate HAIs have had mixed results. Variability in contextual factors such as work culture and management practices has been suggested as a potential explanation for inconsistent results across organizations and interventions. We examine goal-setting as a factor contributing to program outcomes in eight hospitals focused on preventing central line-associated bloodstream infections (CLABSIs). We conducted qualitative case studies to compare higher- and lower-performing hospitals, and explored differences in contextual factors that might contribute to performance variation. We present a goal commitment framework that characterizes factors associated with successful CLABSI program outcomes. Across 194 key informant interviews, internal and external moderators and characteristics of the goal itself differentiated actors' goal commitment at higher- versus lower-performing hospitals. Our findings have implications for organizations struggling to prevent HAIs, as well as informing the broader goal commitment literature. © The Author(s) 2015.

The Noble Gas Record of Gas-Water Phase Interaction in the Tight-Gas-Sand Reservoirs of the Rocky Mountains

NASA Astrophysics Data System (ADS)

Ballentine, C. J.; Zhou, Z.; Harris, N. B.

2015-12-01

The mass of hydrocarbons that have migrated through tight-gas-sandstone systems before the permeability reduces to trap the hydrocarbon gases provides critical information in the hydrocarbon potential analysis of a basin. The noble gas content (Ne, Ar, Kr, Xe) of the groundwater has a unique isotopic and elemental composition. As gas migrates through the water column, the groundwater-derived noble gases partition into the hydrocarbon phase. Determination of the noble gases in the produced hydrocarbon phase then provides a record of the type of interaction (simple phase equilibrium or open system Rayleigh fractionation). The tight-gas-sand reservoirs of the Rocky Mountains represent one of the most significant gas resources in the United States. The producing reservoirs are generally developed in low permeability (averaging <0.1mD) Upper Cretaceous fluvial to marginal marine sandstones and commonly form isolated overpressured reservoir bodies encased in even lower permeability muddy sediments. We present noble gas data from producing fields in the Greater Green River Basin, Wyoming; the the Piceance Basin, Colorado; and in the Uinta Basin, Utah. The data is consistent from all three basins. We show how in each basin the noble gases record open system gas migration through a water column at maximum basin burial. The data within an open system model indicates that the gas now in-place represents the last ~10% of hydrocarbon gas to have passed through the water column, most likely prior to permeability closedown.

Reducing gas generators and methods for generating a reducing gas

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

Scotto, Mark Vincent; Perna, Mark Anthony

One embodiment of the present invention is a unique reducing gas generator. Another embodiment is a unique method for generating a reducing gas. Other embodiments include apparatuses, systems, devices, hardware, methods, and combinations for generating reducing gas. Further embodiments, forms, features, aspects, benefits, and advantages of the present application will become apparent from the description and figures provided herewith.

Gas-partitioning tracer test to qualify trapped gas during recharge

USGS Publications Warehouse

Heilweil, Victor M.; Kip, Solomon D.; Perkins, Kim S.; Ellett, Kevin M.

2004-01-01

Dissolved helium and bromide tracers were used to evaluate trapped gas during an infiltration pond experiment. Dissolved helium preferentially partitioned into trapped gas bubbles, or other pore air, because of its low solubility in water. This produced observed helium retardation factors of as much as 12 relative to bromide. Numerical simulations of helium breakthrough with both equilibrium and kinetically limited advection/dispersion/retardation did not match observed helium concentrations. However, better fits were obtained by including a decay term representing the diffusive loss of helium through interconnected, gas-filled pores. Calculations indicate that 7% to more than 26% of the porosity beneath the pond was filled with gas. Measurements of laboratory hydraulic properties indicate that a 10% decrease in saturation would reduce the hydraulic conductivity by at least one order of magnitude in the well-sorted sandstone, but less in the overlying soils. This is consistent with in situ measurements during the experiment, which show steeper hydraulic gradients in sandstone than in soil. Intrinsic permeability of the soil doubled during the first six months of the experiment, likely caused by a combination of dissolution and thermal contraction of trapped gas. Managers of artificial recharge basins may consider minimizing the amount of trapped gas by using wet, rather than dry, tilling to optimize infiltration rates, particularly in well-sorted porous media in which reintroduced trapped gas may cause substantial reductions in permeability. Trapped gas may also inhibit the amount of focused infiltration that occurs naturally during ephemeral flood events along washes and playas.

Gas-partitioning tracer test to quantify trapped gas during recharge

USGS Publications Warehouse

Heilweil, V.M.; Solomon, D.K.; Perkins, K.S.; Ellett, K.M.

2004-01-01

Dissolved helium and bromide tracers were used to evaluate trapped gas during an infiltration pond experiment. Dissolved helium preferentially partitioned into trapped gas bubbles, or other pore air, because of its low solubility in water. This produced observed helium retardation factors of as much as 12 relative to bromide. Numerical simulations of helium breakthrough with both equilibrium and kinetically limited advection/dispersion/retardation did not match observed helium concentrations. However, better fits were obtained by including a decay term representing the diffusive loss of helium through interconnected, gas-filled pores. Calculations indicate that 7% to more than 26% of the porosity beneath the pond was filled with gas. Measurements of laboratory hydraulic properties indicate that a 10% decrease in saturation would reduce the hydraulic conductivity by at least one order of magnitude in the well-sorted sandstone, but less in the overlying soils. This is consistent with in situ measurements during the experiment, which show steeper hydraulic gradients in sandstone than in soil. Intrinsic permeability of the soil doubled during the first six months of the experiment, likely caused by a combination of dissolution and thermal contraction of trapped gas. Managers of artificial recharge basins may consider minimizing the amount of trapped gas by using wet, rather than dry, tilling to optimize infiltration rates, particularly in well-sorted porous media in which reintroduced trapped gas may cause substantial reductions in permeability. Trapped gas may also inhibit the amount of focused infiltration that occurs naturally during ephemeral flood events along washes and playas.

Fiber optic gas sensor

NASA Technical Reports Server (NTRS)

Chen, Peng (Inventor); Buric, Michael P. (Inventor); Swinehart, Philip R. (Inventor); Maklad, Mokhtar S. (Inventor)

2010-01-01

A gas sensor includes an in-fiber resonant wavelength device provided in a fiber core at a first location. The fiber propagates a sensing light and a power light. A layer of a material is attached to the fiber at the first location. The material is able to absorb the gas at a temperature dependent gas absorption rate. The power light is used to heat the material and increases the gas absorption rate, thereby increasing sensor performance, especially at low temperatures. Further, a method is described of flash heating the gas sensor to absorb more of the gas, allowing the sensor to cool, thereby locking in the gas content of the sensor material, and taking the difference between the starting and ending resonant wavelengths as an indication of the concentration of the gas in the ambient atmosphere.

Recirculating rotary gas compressor

DOEpatents

Weinbrecht, John F.

1992-01-01

A positive displacement, recirculating Roots-type rotary gas compressor which operates on the basis of flow work compression. The compressor includes a pair of large diameter recirculation conduits (24 and 26) which return compressed discharge gas to the compressor housing (14), where it is mixed with low pressure inlet gas, thereby minimizing adiabatic heating of the gas. The compressor includes a pair of involutely lobed impellers (10 and 12) and an associated port configuration which together result in uninterrupted flow of recirculation gas. The large diameter recirculation conduits equalize gas flow velocities within the compressor and minimize gas flow losses. The compressor is particularly suited to applications requiring sustained operation at higher gas compression ratios than have previously been feasible with rotary pumps, and is particularly applicable to refrigeration or other applications requiring condensation of a vapor.

Variable leak gas source

DOEpatents

Henderson, Timothy M.; Wuttke, Gilbert H.

1977-01-01

A variable leak gas source and a method for obtaining the same which includes filling a quantity of hollow glass micro-spheres with a gas, storing said quantity in a confined chamber having a controllable outlet, heating said chamber above room temperature, and controlling the temperature of said chamber to control the quantity of gas passing out of said controllable outlet. Individual gas filled spheres may be utilized for calibration purposes by breaking a sphere having a known quantity of a known gas to calibrate a gas detection apparatus.

Gas Analyzer

NASA Technical Reports Server (NTRS)

1989-01-01

The M200 originated in the 1970's under an Ames Research Center/Stanford University contract to develop a small, lightweight gas analyzer for Viking Landers. Although the unit was not used on the spacecraft, it was further developed by The National Institute for Occupational Safety and Health (NIOSH). Three researchers from the project later formed Microsensor Technology, Inc. (MTI) to commercialize the analyzer. The original version (Micromonitor 500) was introduced in 1982, and the M200 in 1988. The M200, a more advanced version, features dual gas chromatograph which separate a gaseous mixture into components and measure concentrations of each gas. It is useful for monitoring gas leaks, chemical spills, etc. Many analyses are completed in less than 30 seconds, and a wide range of mixtures can be analyzed.

Natural Gas Basics

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

None

2016-06-08

Natural gas powers about 150,000 vehicles in the United States and roughly 22 million vehicles worldwide. Natural gas vehicles (NGVs) are a good choice for high-mileage fleets -- such as buses, taxis, and refuse vehicles -- that are centrally fueled or operate within a limited area or along a route with natural gas fueling stations. This brochure highlights the advantages of natural gas as an alternative fuel, including its domestic availability, established distribution network, relatively low cost, and emissions benefits.

Natural Gas Basics

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

2016-06-01

Natural gas powers about 150,000 vehicles in the United States and roughly 22 million vehicles worldwide. Natural gas vehicles (NGVs) are a good choice for high-mileage fleets -- such as buses, taxis, and refuse vehicles -- that are centrally fueled or operate within a limited area or along a route with natural gas fueling stations. This brochure highlights the advantages of natural gas as an alternative fuel, including its domestic availability, established distribution network, relatively low cost, and emissions benefits.

A preliminary experiment to collect gas from a submarine gas plume

NASA Astrophysics Data System (ADS)

Aoyama, C.; Fukuoka, H.

2016-12-01

Thousands of gas plumes have been found on the sea floors around Japan. Most of them are associated with methane hydrates on seafloor surface and/or shallow subsurface, and those bubbles are consisting largely of methane. Concerns are emerging about large scale plumes may provide the highly efficient greenhouse gas to the atmosphere. A novel methodology is proposed in this study, to collect those gas bubbles in the plumes using membrane-made dome to reduce global greenhouse effect and to develop new energy resources. Experiment field is northeast offshore of the Sado Island, Niigata prefecture of Japan, where more than 40 gas plumes had been found, gushing out from rather shallower sea floor of 150 - 400 m depth. Authors will present the achievement obtained in the preliminary gas collection experiment which was performed in a gas plume in this sea area in March 2016.

Stakeholder Workshop Presentations: EPA Greenhouse Gas Data on Petroleum and Natural Gas Systems

EPA Pesticide Factsheets

View the summary and presentations from the November 2015 stakeholder workshop on greenhouse gas data on petroleum and natural gas systems from the Greenhouse Gas Reporting Program and U.S. Greenhouse Gas Inventory of Emissions and Sinks.

Valorization of Flue Gas by Combining Photocatalytic Gas Pretreatment with Microalgae Production.

PubMed

Eynde, Erik Van; Lenaerts, Britt; Tytgat, Tom; Blust, Ronny; Lenaerts, Silvia

2016-03-01

Utilization of flue gas for algae cultivation seems to be a promising route because flue gas from fossil-fuel combustion processes contains the high amounts of carbon (CO2) and nitrogen (NO) that are required for algae growth. NO is a poor nitrogen source for algae cultivation because of its low reactivity and solublilty in water and its toxicity for algae at high concentrations. Here, we present a novel strategy to valorize NO from flue gas as feedstock for algae production by combining a photocatalytic gas pretreatment unit with a microalgal photobioreactor. The photocatalytic air pretreatment transforms NO gas into NO2 gas and thereby enhances the absorption of NOx in the cultivation broth. The absorbed NOx will form NO2(-) and NO3(-) that can be used as a nitrogen source by algae. The effect of photocatalytic air pretreatment on the growth and biomass productivity of the algae Thalassiosira weissflogii in a semicontinuous system aerated with a model flue gas (1% CO2 and 50 ppm of NO) is investigated during a long-term experiment. The integrated system makes it possible to produce algae with NO from flue gas as the sole nitrogen source and reduces the NOx content in the exhaust gas by 84%.

Gas-path leakage seal for a gas turbine

DOEpatents

Wolfe, C.E.; Dinc, O.S.; Bagepalli, B.S.; Correia, V.H.; Aksit, M.F.

1996-04-23

A gas-path leakage seal is described for generally sealing a gas-path leakage-gap between spaced-apart first and second members of a gas turbine (such as combustor casing segments). The seal includes a generally imperforate foil-layer assemblage which is generally impervious to gas and is located in the leakage-gap. The seal also includes a cloth-layer assemblage generally enclosingly contacting the foil-layer assemblage. In one seal, the first edge of the foil-layer assemblage is left exposed, and the foil-layer assemblage resiliently contacts the first member near the first edge to reduce leakage in the ``plane`` of the cloth-layer assemblage under conditions which include differential thermal growth of the two members. In another seal, such leakage is reduced by having a first weld-bead which permeates the cloth-layer assemblage, is attached to the metal-foil-layer assemblage near the first edge, and unattachedly contacts the first member. 4 figs.

Gas-path leakage seal for a gas turbine

DOEpatents

Wolfe, Christopher E.; Dinc, Osman S.; Bagepalli, Bharat S.; Correia, Victor H.; Aksit, Mahmut F.

1996-01-01

A gas-path leakage seal for generally sealing a gas-path leakage-gap between spaced-apart first and second members of a gas turbine (such as combustor casing segments). The seal includes a generally imperforate foil-layer assemblage which is generally impervious to gas and is located in the leakage-gap. The seal also includes a cloth-layer assemblage generally enclosingly contacting the foil-layer assemblage. In one seal, the first edge of the foil-layer assemblage is left exposed, and the foil-layer assemblage resiliently contacts the first member near the first edge to reduce leakage in the "plane" of the cloth-layer assemblage under conditions which include differential thermal growth of the two members. In another seal, such leakage is reduced by having a first weld-bead which permeates the cloth-layer assemblage, is attached to the metal-foil-layer assemblage near the first edge, and unattachedly contacts the first member.

Automated measurement of respiratory gas exchange by an inert gas dilution technique

NASA Technical Reports Server (NTRS)

Sawin, C. F.; Rummel, J. A.; Michel, E. L.

1974-01-01

A respiratory gas analyzer (RGA) has been developed wherein a mass spectrometer is the sole transducer required for measurement of respiratory gas exchange. The mass spectrometer maintains all signals in absolute phase relationships, precluding the need to synchronize flow and gas composition as required in other systems. The RGA system was evaluated by comparison with the Douglas bag technique. The RGA system established the feasibility of the inert gas dilution method for measuring breath-by-breath respiratory gas exchange. This breath-by-breath analytical capability permits detailed study of transient respiratory responses to exercise.

30 CFR 250.1157 - How do I receive approval to produce gas-cap gas from an oil reservoir with an associated gas cap?

Code of Federal Regulations, 2011 CFR

2011-07-01

... gas from an oil reservoir with an associated gas cap? 250.1157 Section 250.1157 Mineral Resources... AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Production Requirements... reservoir with an associated gas cap? (a) You must request and receive approval from the Regional Supervisor...

Improved gas tagging and cover gas combination for nuclear reactor

DOEpatents

Gross, K.C.; Laug, M.T.

1983-09-26

The invention discloses the use of stable isotopes of neon and argon, sealed as tags in different cladding nuclear fuel elements to be used in a liquid metal fast breeder reactor. Cladding failure allows fission gases and these tag isotopes to escape and to combine with the cover gas. The isotopes are Ne/sup 20/, Ne/sup 21/ and Ne/sup 22/ and Ar/sup 36/, Ar/sup 38/ and Ar/sup 40/, and the cover gas is He. Serially connected cryogenically operated charcoal beds are used to clean the cover gas and to separate out the tags. The first or cover gas cleanup bed is held between 0 and -25/sup 0/C to remove the fission gases from the cover gas and tags, and the second or tag recovery system bed between -170 and -185/sup 0/C to isolate the tags from the cover gas. Spectrometric analysis is used to identify the specific tags that are recovered, and thus the specific leaking fuel element. By cataloging the fuel element tags to the location of the fuel elements in the reactor, the location of the leaking fuel element can then be determined.

Waste gas storage

NASA Technical Reports Server (NTRS)

Vickers, Brian D. (Inventor)

1994-01-01

Method for storing a waste gas mixture comprised of nitrogen, oxygen, carbon dioxide, and inert gases, the gas mixture containing corrosive contaminants including inorganic acids and bases and organic solvents, and derived from space station operations. The gas mixture is stored under pressure in a vessel formed of a filament wound composite overwrap on a metal liner, the metal liner being pre-stressed in compression by the overwrap, thereby avoiding any tensile stress in the liner, and preventing stress corrosion cracking of the liner during gas mixture storage.

Polyport atmospheric gas sampler

DOEpatents

Guggenheim, S. Frederic

1995-01-01

An atmospheric gas sampler with a multi-port valve which allows for multi, sequential sampling of air through a plurality of gas sampling tubes mounted in corresponding gas inlet ports. The gas sampler comprises a flow-through housing which defines a sampling chamber and includes a gas outlet port to accommodate a flow of gases through the housing. An apertured sample support plate defining the inlet ports extends across and encloses the sampling chamber and supports gas sampling tubes which depend into the sampling chamber and are secured across each of the inlet ports of the sample support plate in a flow-through relation to the flow of gases through the housing during sampling operations. A normally closed stopper means mounted on the sample support plate and operatively associated with each of the inlet ports blocks the flow of gases through the respective gas sampling tubes. A camming mechanism mounted on the sample support plate is adapted to rotate under and selectively lift open the stopper spring to accommodate a predetermined flow of gas through the respective gas sampling tubes when air is drawn from the housing through the outlet port.

Superdiffusive gas recovery from nanopores

NASA Astrophysics Data System (ADS)

Wu, Haiyi; He, Yadong; Qiao, Rui

2016-11-01

Understanding the recovery of gas from reservoirs featuring pervasive nanopores is essential for effective shale gas extraction. Classical theories cannot accurately predict such gas recovery and many experimental observations are not well understood. Here we report molecular simulations of the recovery of gas from single nanopores, explicitly taking into account molecular gas-wall interactions. We show that, in very narrow pores, the strong gas-wall interactions are essential in determining the gas recovery behavior both quantitatively and qualitatively. These interactions cause the total diffusion coefficients of the gas molecules in nanopores to be smaller than those predicted by kinetic theories, hence slowing down the rate of gas recovery. These interactions also lead to significant adsorption of gas molecules on the pore walls. Because of the desorption of these gas molecules during gas recovery, the gas recovery from the nanopore does not exhibit the usual diffusive scaling law (i.e., the accumulative recovery scales as R ˜t1 /2 ) but follows a superdiffusive scaling law R ˜tn (n >0.5 ), which is similar to that observed in some field experiments. For the system studied here, the superdiffusive gas recovery scaling law can be captured well by continuum models in which the gas adsorption and desorption from pore walls are taken into account using the Langmuir model.

Multiparameter Analysis of Gas Transport Phenomena in Shale Gas Reservoirs: Apparent Permeability Characterization.

PubMed

Shen, Yinghao; Pang, Yu; Shen, Ziqi; Tian, Yuanyuan; Ge, Hongkui

2018-02-08

The large amount of nanoscale pores in shale results in the inability to apply Darcy's law. Moreover, the gas adsorption of shale increases the complexity of pore size characterization and thus decreases the accuracy of flow regime estimation. In this study, an apparent permeability model, which describes the adsorptive gas flow behavior in shale by considering the effects of gas adsorption, stress dependence, and non-Darcy flow, is proposed. The pore size distribution, methane adsorption capacity, pore compressibility, and matrix permeability of the Barnett and Eagle Ford shales are measured in the laboratory to determine the critical parameters of gas transport phenomena. The slip coefficients, tortuosity, and surface diffusivity are predicted via the regression analysis of the permeability data. The results indicate that the apparent permeability model, which considers second-order gas slippage, Knudsen diffusion, and surface diffusion, could describe the gas flow behavior in the transition flow regime for nanoporous shale. Second-order gas slippage and surface diffusion play key roles in the gas flow in nanopores for Knudsen numbers ranging from 0.18 to 0.5. Therefore, the gas adsorption and non-Darcy flow effects, which involve gas slippage, Knudsen diffusion, and surface diffusion, are indispensable parameters of the permeability model for shale.

Mobile Measurements of Gas and Particle Emissions from Marcellus Shale Gas Development

NASA Astrophysics Data System (ADS)

DeCarlo, P. F.; Goetz, J. D.; Floerchinger, C. R.; Fortner, E.; Wormhoudt, J.; Knighton, W. B.; Herndon, S.; Kolb, C. E.; Shaw, S. L.; Knipping, E. M.

2013-12-01

Production of natural gas in the Marcellus shale is increasing rapidly due to the vast quantities of natural gas stored in the formation. Transient and long-term activities have associated emissions to the atmosphere of methane, volatile organic compounds, NOx, particulates and other species from gas production and transport infrastructure. In the summer of 2012, a team of researchers from Drexel University and Aerodyne Research deployed the Aerodyne mobile laboratory (AML) and measured in-situ concentrations of gas-phase and aerosol chemical components in the main gas producing regions of Pennsylvania, with the overall goal of understanding the impacts to regional ozone and particulate matter (PM) concentrations. State-of-the-art instruments including quantum cascade laser systems, proton transfer mass spectrometry, tunable diode lasers and a soot particle aerosol mass spectrometer, were used quantify concentrations of pollutants of interest. Chemical species measured include methane, ethane, NO, NO2, CO, CO2, SO2, and many volatile organic compounds, and aerosol size and chemical composition. Tracer-release techniques were employed to link sources with emissions and to quantify emission rates from gas facilities, in order to understand the regional burden of these chemical species from oil and gas development in the Marcellus. Measurements were conducted in two regions of Pennsylvania: the NE region that is predominantly dry gas (95% + methane), and the SW region where wet gas (containing greater than 5% higher hydrocarbons) is found. Regional scale measurements of current levels of air pollutants will be shown and will put into context how further development of the gas resource in one of the largest natural gas fields in the world impacts air quality in a region upwind of the highly urbanized east coast corridor.

Fast Gas Replacement in Plasma Process Chamber by Improving Gas Flow Pattern

NASA Astrophysics Data System (ADS)

Morishita, Sadaharu; Goto, Tetsuya; Akutsu, Isao; Ohyama, Kenji; Ito, Takashi; Ohmi, Tadahiro

2009-01-01

The precise and high-speed alteration of various gas species is important for realizing precise and well-controlled multiprocesses in a single plasma process chamber with high throughput. The gas replacement times in the replacement of N2 by Ar and that of H2 by Ar are measured in a microwave excited high-density and low electron-temperature plasma process chamber at various working pressures and gas flow rates, incorporating a new gas flow control system, which can avoid overshoot of the gas pressure in the chamber immediately after the valve operation, and a gradational lead screw booster pump, which can maintain excellent pumping capability for various gas species including lightweight gases such as H2 in a wide pressure region from 10-1 to 104 Pa. Furthermore, to control the gas flow pattern in the chamber, upper ceramic shower plates, which have thousands of very fine gas injection holes (numbers of 1200 and 2400) formed with optimized allocation on the plates, are adopted, while the conventional gas supply method in the microwave-excited plasma chamber uses many holes only opened at the sidewall of the chamber (gas ring). It has been confirmed that, in the replacement of N2 by Ar, a short replacement time of approximately 1 s in the cases of 133 and 13.3 Pa and approximately 3 s in the case of 4 Pa can be achieved when the upper shower plate has 2400 holes, while a replacement time longer than approximately 10 s is required for all pressure cases where the gas ring is used. In addition, thanks to the excellent pumping capability of the gradational lead screw booster pump for lightweight gases, it has also been confirmed that the replacement time of H2 by Ar is almost the same as that of N2 by Ar.

Gas energy meter for inferential determination of thermophysical properties of a gas mixture at multiple states of the gas

DOEpatents

Morrow, Thomas B [San Antonio, TX; Kelner, Eric [San Antonio, TX; Owen, Thomas E [Helotes, TX

2008-07-08

A gas energy meter that acquires the data and performs the processing for an inferential determination of one or more gas properties, such as heating value, molecular weight, or density. The meter has a sensor module that acquires temperature, pressure, CO2, and speed of sound data. Data is acquired at two different states of the gas, which eliminates the need to determine the concentration of nitrogen in the gas. A processing module receives this data and uses it to perform a "two-state" inferential algorithm.

Integrated production of fuel gas and oxygenated organic compounds from synthesis gas

DOEpatents

Moore, Robert B.; Hegarty, William P.; Studer, David W.; Tirados, Edward J.

1995-01-01

An oxygenated organic liquid product and a fuel gas are produced from a portion of synthesis gas comprising hydrogen, carbon monoxide, carbon dioxide, and sulfur-containing compounds in a integrated feed treatment and catalytic reaction system. To prevent catalyst poisoning, the sulfur-containing compounds in the reactor feed are absorbed in a liquid comprising the reactor product, and the resulting sulfur-containing liquid is regenerated by stripping with untreated synthesis gas from the reactor. Stripping offgas is combined with the remaining synthesis gas to provide a fuel gas product. A portion of the regenerated liquid is used as makeup to the absorber and the remainder is withdrawn as a liquid product. The method is particularly useful for integration with a combined cycle coal gasification system utilizing a gas turbine for electric power generation.

Efficiencies of freshwater and estuarine constructed wetlands for phenolic endocrine disruptor removal in Taiwan.

PubMed

Hsieh, Chi-Ying; Yang, Lei; Kuo, Wen-Chien; Zen, Yi-Peng

2013-10-01

We examined the distribution and removal efficiencies of phenolic endocrine disruptors (EDs), namely nonylphenol diethoxylates (NP2EO), nonylphenol monoethoxylates (NP1EO), nonylphenol (NP), and octylphenol (OP), in wastewater treated by estuarine and freshwater constructed wetland systems in Dapeng Bay National Scenic Area (DBNSA) and along the Dahan River in Taiwan. Water samples were taken bimonthly at 30 sites in three estuarine constructed wetlands (Datan, Pengcun and Linbian right bank (A and B)) in DBNSA, for eight sampling campaigns. The average removal efficiencies were in the range of 3.13-97.3% for wetlands in DBNSA. The highest average removal occurred in the east inlet to the outlet of the Tatan wetland. The most frequently detected compound was OP (57.7%), whose concentration was up to 1458.7 ng/L in DBNSA. NP was seen in only 20.5% of the samples. The temporal variation of EDs showed a decrease across seasons, where summer>spring>winter>autumn in these constructed wetlands. The removal efficiencies of EDs by estuarine wetlands, in decreasing order, were Datan>Pengcun>Linbian right bank in DBNSA. Water samples collected at 18 sites in three freshwater constructed wetlands (Daniaopi, Hsin-Hai I, and Hsin-Hai II) along the riparian area of Dahan River. NP2EO was the most abundant compound, with a concentration of up to 11,200 ng/L. Removal efficiencies ranged from 55% to 91% for NP1EO, NP2EO, and NP in Hsin-Hai I. The average removal potential of EDs in freshwater constructed wetlands, in decreasing order, was Hsin-Hai II>Daniaopi>Hsin-Hai I constructed wetlands. The lowest concentrations of the selected compounds were observed in the winter. The highest removal efficiency of the selected phenolic endocrine disruptors was achieved by Hsin-Hai I wetland. The calculated risk quotients used to evaluate the ecological risk were up to 30 times higher in the freshwater wetlands along Dahan River than in the estuarine (DBNSA) constructed wetlands, indicating

Apparatus Circulates Sterilizing Gas

NASA Technical Reports Server (NTRS)

Cross, John H.; Schwarz, Ray P.

1991-01-01

Apparatus circulates sterilizing gas containing ethylene oxide and chlorofluorocarbon through laboratory or medical equipment. Confines sterilizing gas, circulating it only through parts to be treated. Consists of two units. One delivers ethylene oxide/chlorofluorocarbon gas mixture and removes gas after treatment. Other warms, humidifies, and circulates gas through equipment to be treated. Process provides reliable sterilization with negligible residual toxicity from ethylene oxide. Particularly suitable for sterilization of interiors of bioreactors, heart/lung machines, dialyzers, or other equipment including complicated tubing.

Gas Chromatography.

ERIC Educational Resources Information Center

Karasek, Francis W.; And Others

1984-01-01

This review covers fundamental developments in gas chromatography during 1982 and 1983. Literature is considered under these headings: columns; liguid phases; solid supports; sorption processes and solvents; open tubular column gas chromatography; instrumentation; high-resolution columns and applications; other techniques; qualitative and…

Microscale Gas Chemistry

ERIC Educational Resources Information Center

Mattson, Bruce; Anderson, Michael P.

2011-01-01

The development of syringes having free movement while remaining gas-tight enabled methods in chemistry to be changed. Successfully containing and measuring volumes of gas without the need to trap them using liquids made it possible to work with smaller quantities. The invention of the LuerLok syringe cap also allowed the gas to be stored for a…

Gas sensitive materials for gas detection and method of making

DOEpatents

Trakhtenberg, Leonid Israilevich; Gerasimov, Genrikh Nikolaevich; Gromov, Vladimir Fedorovich; Rozenberg, Valeriya Isaakovna

2012-12-25

A gas sensitive material comprising SnO2 nanocrystals doped with In2O3 and an oxide of a platinum group metal, and a method of making the same. The platinum group metal is preferably Pd, but also may include Pt, Ru, Ir, and combinations thereof. The SnO2 nanocrystals have a specific surface of 7 or greater, preferably about 20 m2/g, and a mean particle size of between about 10 nm and about 100 nm, preferably about 40 nm. A gas detection device made from the gas sensitive material deposited on a substrate, the gas sensitive material configured as a part of a current measuring circuit in communication with a heat source.

Hepatic arterial infusion of floxuridine and dexamethasone plus high-dose Mitomycin C for patients with unresectable hepatic metastases from colorectal carcinoma.

PubMed

Kemeny, Nancy; Eid, Ahmed; Stockman, Jennifer; Gonen, Mithat; Schwartz, Lawrence; Tetzlaff, Eric; Paty, Philip

2005-08-01

In vitro data suggest increased cytotoxicity with Mitomycin C (Mit-C) and Floxuridine (FUDR). Based on these data, we performed a phase II trial of hepatic arterial infusion (HAI) of FUDR and Dexamethasone (Dex) plus high-dose Mit-C for patients with unresectable hepatic metastases from colorectal carcinoma. High-dose Mit-C (15 mg/m2) was added via the pump sideport to HAI FUDR and Dex for 14 days of a 28-day cycle. Mit-C was given on days 1 and 29, and FUDR was given indefinitely until disease progression or discontinuation of therapy due to toxicity. Sixty-three patients with unresectable liver metastases were entered. The chemotherapy-naïve group (n = 26) and those previously treated (n = 37) had similar response and median survival: 73% and 70%, and 23 and 20 months, respectively. The major toxicities were liver bilomas (7.9%), elevation in bilirubin level >3 (22%), and biliary sclerosis (9.5%). Hematologic and gastrointestinal toxicity was less than 2%. The addition of high-dose Mit-C to HAI FUDR and Dex produced a high response rate even in previously treated patients. The median survival was 21 months even though half the patients were previously treated with chemotherapy. Biliary toxicity was higher than expected; therefore, alternatives to high dose Mit-C should be investigated when exploring additions to HAI therapy with FUDR and Dex. Copyright 2005 Wiley-Liss, Inc.

State of infection prevention in US hospitals enrolled in the National Health and Safety Network.

PubMed

Stone, Patricia W; Pogorzelska-Maziarz, Monika; Herzig, Carolyn T A; Weiner, Lindsey M; Furuya, E Yoko; Dick, Andrew; Larson, Elaine

2014-02-01

This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent health care-associated infections (HAIs) in intensive care units (ICUs). All hospitals, except Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation involved completing a survey assessing the presence of evidence-based prevention policies and clinician adherence and joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and nonrespondents. Of the 3,374 eligible hospitals, 975 provided data (29% response rate) on 1,653 ICUs, and there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions, and the average hours per week devoted to data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and nonrespondents. Guidelines for IP staffing in acute care hospitals need to be updated. In future work, we will analyze the associations between HAI rates and infection prevention and control program characteristics, as well as the inplementation of and clinician adherence to evidence-based policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

State of Infection Prevention in US Hospitals Enrolled in NHSN

PubMed Central

Pogorzelska-Maziarz, Monika; Herzig, Carolyn T. A.; Weiner, Lindsey M.; Furuya, E. Yoko; Dick, Andrew; Larson, Elaine

2014-01-01

Background This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent healthcare associated infections (HAI) in intensive care units (ICUs). Methods All hospitals, except for Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation included: 1) completion of a survey that assessed presence of evidence-based prevention policies and clinician adherence, and 2) joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and non-respondents. Results Of the 3,374 eligible hospitals, 975 hospitals provided data (29% response rate) on 1,653 ICUs; and, there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions and the average hours per week of data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and non-respondents. Conclusions Guidelines around IP staffing in acute care hospitals should be updated. In future publications we will analyze the associations between HAI rates and infection prevention and control program characteristics, presence of and clinician adherence to evidence-based policies. PMID:24485365

Results from the First 12 Months of the National Surveillance of Healthcare Associated Outbreaks in Germany, 2011/2012

PubMed Central

Haller, Sebastian; Eckmanns, Tim; Benzler, Justus; Tolksdorf, Kristin; Claus, Hermann; Gilsdorf, Andreas; Sin, Muna Abu

2014-01-01

Background In August 2011, the German Protection against Infection Act was amended, mandating the reporting of healthcare associated infection (HAI) outbreak notifications by all healthcare workers in Germany via local public health authorities and federal states to the Robert Koch Institute (RKI). Objective To describe the reported HAI-outbreaks and the surveillance system’s structure and capabilities. Methods Information on each outbreak was collected using standard paper forms and notified to RKI. Notifications were screened daily and regularly analysed. Results Between November 2011 and November 2012, 1,326 paper forms notified 578 HAI-outbreaks, between 7 and 116 outbreaks per month. The main causative agent was norovirus (n = 414/578; 72%). Among the 108 outbreaks caused by bacteria, the most frequent pathogens were Clostridium difficile (25%) Klebsiella spp. (19%) and Staphylococcus spp. (19%). Multidrug-resistant bacteria were responsible for 54/108 (50%) bacterial outbreaks. Hospitals were affected most frequently (485/578; 84%). Hospital outbreaks due to bacteria were mostly reported from intensive care units (ICUs) (45%), followed by internal medicine wards (16%). Conclusion The mandatory HAI-outbreak surveillance system describes common outbreaks. Pathogens with a particular high potential to cause large or severe outbreaks may be identified, enabling us to further focus research and preventive measures. Increasing the sensitivity and reliability of the data collection further will facilitate identification of outbreaks able to increase in size and severity, and guide specific control measures to interrupt their propagation. PMID:24875674

Impact of implementation of the World Health Organization multimodal hand hygiene improvement strategy in a teaching hospital in Taiwan.

PubMed

Chen, Jui-Kuang; Wu, Kuan-Sheng; Lee, Susan Shin-Jung; Lin, Huey-Shyan; Tsai, Hung-Chin; Li, Ching-Hsien; Chao, Hsueh-Lan; Chou, Hsueh-Chih; Chen, Yueh-Ju; Huang, Yu-Hsiu; Ke, Chin-Mei; Sy, Cheng Len; Tseng, Yu-Ting; Chen, Yao-Shen

2016-02-01

Hand hygiene (HH) is considered to be the most simple, rapid, and economic way to prevent health care-associated infection (HAI). However, poor HH compliance has been repeatedly reported. Our objective was to evaluate the impact of implementing the updated World Health Organization (WHO) multimodal HH guidelines on HH compliance and HAI in a tertiary hospital in Taiwan. We conducted a before-and-after interventional study during 2010-2011. A multimodal HH promotion campaign was initiated. Key strategies included providing alcohol-based handrub dispensers at points of care, designing educational programs tailored to the needs of different health care workers, placement of general and individual reminders in the workplace, and establishment of evaluation and feedback for HH compliance and infection rates. Overall HH compliance increased from 62.3% to 73.3% after 1 year of intervention (P < .001). The rate of overall HAI decreased from 3.7% to 3.1% (P < .05), urinary tract infection rate decreased from 1.5% to 1.2% (P < .05), and respiratory tract infection rate decreased from 0.53% to 0.35% (P < .05). This campaign saved an estimated $940,000 and 3,564 admission patient days per year. The WHO multimodal HH guidelines are feasible and effective for the promotion of HH compliance and are associated with the reduction of HAIs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Early response of wheat antioxidant system with special reference to Fusarium head blight stress.

PubMed

Spanic, Valentina; Viljevac Vuletic, Marija; Abicic, Ivan; Marcek, Tihana

2017-06-01

Fusarium head blight (FHB) is a destructive fungal disease of wheat (Triticum aestivum L.) that causes significant grain yield losses and end-use quality reduction associated with contamination by the mycotoxin deoxynivalenol (DON). Three winter wheat varieties ('Vulkan', 'Kraljica' and 'Golubica') were screened for FHB resistance using artificial inoculation technique under field conditions. The aim of this study was to examine a relationship between FHB resistance and the effectiveness of enzyme antioxidant system of wheat varieties under different sampling times (3, 15, 24, 48, 96, 120 and 336 hai). In the time-course experiments FHB-resistant variety 'Vulkan' showed rapid induction of ascorbate peroxidase (APX) and polyphenol oxidase (PPO) activity in the early stages after infection (3 hai) and it seems that in 'Vulkan' FHB-resistance is associated with antioxidative enzymes activity. Moderately FHB resistant variety 'Kraljica' showed the higher guaiacol peroxidase (POD) activity and higher H 2 O 2 content after 24 hai, increased malondialdehyde (MDA) content at the beginning of infection (3, 15 hai) while induction of catalase (CAT), APX and PPO was delayed. FHB-susceptible variety 'Golubica' involved antioxidant enzymes in defense response much later. Based on our results the activity of antioxidant enzymes (APX and PPO) was more pronounced in 'Vulkan' than in FHB-medium resistant variety 'Kraljica' and FHB-susceptible 'Golubica'. The differences in antioxidant response of wheat varieties under Fusarium infestation could be the result of genetic properties. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Interferon-alpha-induced changes in metallothionein expression in liver biopsies from patients with chronic hepatitis C.

PubMed

Nagamine, Takeaki; Suzuki, Keiji; Kondo, Toshihiko; Nakazato, Kyomi; Kakizaki, Satoru; Takagi, Hitoshi; Nakajima, Katuyuki

2005-08-01

An association between reactive oxygen species and liver damage has been postulated in the course of hepatitis C virus (HCV) infection. Metallothionein (MT), induced by HCV core protein and interferon (IFN), plays a role in scavenging free radicals. MT expression in liver biopsies obtained from 21 patients with chronic HCV infection before and after IFN-alpha therapy was investigated. Changes in Knodell histological activity index (HAI) scores, MT protein levels (immunohistochemistry), MT-I and MT-II messenger (m)RNA expression levels (in situ hybridization) and proliferating cell nuclear antigen (PCNA) labelling index were determined and compared in serial liver specimens. MT staining was clustered around the portal tracts with inflammatory cells and fibrosis. The pattern of MT protein before IFN-alpha therapy was similar in all patients, but was higher in IFN-sustained responders than in nonresponders after IFN-alpha therapy. HAI scores and PCNA labelling indexes were significantly reduced after IFN-alpha therapy. MT-II mRNA expression correlated positively with PCNA index before therapy and with HAI scores after therapy (P<0.05). No correlation was found between MT-I mRNA and HAI scores or PCNA index. The findings indicate that IFN-alpha-induced hepatic MT may participate in the therapeutic effects of IFN-alpha for HCV. In addition, MT-II mRNA expression may be involved in cell proliferation in the livers of patients with chronic HCV infection.

Gas geochemistry of the Mount Elbert Gas Hydrate Stratigraphic Test Well, Alaska North Slope: implications for gas hydrate exploration in the Arctic

USGS Publications Warehouse

Lorenson, T.D.; Collett, T.S.; Hunter, R.B.

2011-01-01

Gases were analyzed from well cuttings, core, gas hydrate, and formation tests at the BPXA-DOE-USGS Mount Elbert Gas Hydrate Stratigraphic Test Well, drilled within the Milne Point Unit, Alaska North Slope. The well penetrated a portion of the Eileen gas hydrate deposit, which overlies the more deeply buried Prudhoe Bay, Milne Point, West Sak, and Kuparuk River oil fields. Gas sources in the upper 200 m are predominantly from microbial sources (C1 isotopic compositions ranging from −86.4 to −80.6‰). The C1 isotopic composition becomes progressively enriched from 200 m to the top of the gas hydrate-bearing sands at 600 m. The tested gas hydrates occur in two primary intervals, units D and C, between 614.0 m and 664.7 m, containing a total of 29.3 m of gas hydrate-bearing sands. The hydrocarbon gases in cuttings and core samples from 604 to 914 m are composed of methane with very little ethane. The isotopic composition of the methane carbon ranges from −50.1 to −43.9‰ with several outliers, generally decreasing with depth. Gas samples collected by the Modular Formation Dynamics Testing (MDT) tool in the hydrate-bearing units were similarly composed mainly of methane, with up to 284 ppm ethane. The methane isotopic composition ranged from −48.2 to −48.0‰ in the C sand and from −48.4 to −46.6‰ in the D sand. Methane hydrogen isotopic composition ranged from −238 to −230‰, with slightly more depleted values in the deeper C sand. These results are consistent with the concept that the Eileen gas hydrates contain a mixture of deep-sourced, microbially biodegraded thermogenic gas, with lesser amounts of thermogenic oil-associated gas, and coal gas. Thermal gases are likely sourced from existing oil and gas accumulations that have migrated up-dip and/or up-fault and formed gas hydrate in response to climate cooling with permafrost formation.

Life cycle greenhouse gas emissions and freshwater consumption of Marcellus shale gas.

PubMed

Laurenzi, Ian J; Jersey, Gilbert R

2013-05-07

We present results of a life cycle assessment (LCA) of Marcellus shale gas used for power generation. The analysis employs the most extensive data set of any LCA of shale gas to date, encompassing data from actual gas production and power generation operations. Results indicate that a typical Marcellus gas life cycle yields 466 kg CO2eq/MWh (80% confidence interval: 450-567 kg CO2eq/MWh) of greenhouse gas (GHG) emissions and 224 gal/MWh (80% CI: 185-305 gal/MWh) of freshwater consumption. Operations associated with hydraulic fracturing constitute only 1.2% of the life cycle GHG emissions, and 6.2% of the life cycle freshwater consumption. These results are influenced most strongly by the estimated ultimate recovery (EUR) of the well and the power plant efficiency: increase in either quantity will reduce both life cycle freshwater consumption and GHG emissions relative to power generated at the plant. We conclude by comparing the life cycle impacts of Marcellus gas and U.S. coal: The carbon footprint of Marcellus gas is 53% (80% CI: 44-61%) lower than coal, and its freshwater consumption is about 50% of coal. We conclude that substantial GHG reductions and freshwater savings may result from the replacement of coal-fired power generation with gas-fired power generation.

A gas circulation and purification system for gas-cell-based low-energy RI-beam production.

PubMed

Sonoda, T; Tsubota, T; Wada, M; Katayama, I; Kojima, T M; Reponen, M

2016-06-01

A gas circulation and purification system was developed at the RIKEN Radioactive Isotope Beam Factory that can be used for gas-cell-based low-energy RI-beam production. A high-flow-rate gas cell filled with one atmosphere of buffer gas (argon or helium) is used for the deceleration and thermalization of high-energy RI-beams. The exhausted buffer gas is efficiently collected using a compact dry pump and returned to the gas cell with a recovery efficiency of >97%. The buffer gas is efficiently purified using two gas purifiers as well as collision cleaning, which eliminates impurities in the gas. An impurity level of one part per billion is achieved with this method.

A gas circulation and purification system for gas-cell-based low-energy RI-beam production

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

Sonoda, T.; Wada, M.; Katayama, I.

A gas circulation and purification system was developed at the RIKEN Radioactive Isotope Beam Factory that can be used for gas-cell-based low-energy RI-beam production. A high-flow-rate gas cell filled with one atmosphere of buffer gas (argon or helium) is used for the deceleration and thermalization of high-energy RI-beams. The exhausted buffer gas is efficiently collected using a compact dry pump and returned to the gas cell with a recovery efficiency of >97%. The buffer gas is efficiently purified using two gas purifiers as well as collision cleaning, which eliminates impurities in the gas. An impurity level of one part permore » billion is achieved with this method.« less

Combustion gas properties. 2: Natural gas fuel and dry air

NASA Technical Reports Server (NTRS)

Wear, J. D.; Jones, R. E.; Trout, A. M.; Mcbride, B. J.

1985-01-01

A series of computations has been made to produce the equilibrium temperature and gas composition for natural gas fuel and dry air. The computed tables and figures provide combustion gas property data for pressures from 0.5 to 50 atmospheres and equivalence ratios from 0 to 2.0. Only samples tables and figures are provided in this report. The complete set of tables and figures is provided on four microfiche films supplied with this report.

The origin of gas seeps and shallow gas in northern part of South China Sea

NASA Astrophysics Data System (ADS)

Li, M.; Jin, X.

2003-04-01

The northern part of South China Sea is of passive continental margin, which geologic units include shelf, slope and deep sea basin. There are rifting basins forming during Paleogene (or Cretaceous ?) to Quaternary developed on shelf and slope, which sediments are dominated by fluvial and lake clastic rock of Paleogene, and marine clastic rock and carbonate of Neogene - Quaternary. The main basins include the Pearl River Mouth Basin, Beibu Gulf basin, Qiongdongnan Basin and Yinggehai basin. They contain rich oil and gas resources, and have become important industrial oil and gas producing region in South China Sea. With the increasing of petroleum exploration actives and marine petroleum engineering, it has been paid more attention to the investigation and research of gas seeps and shallow gas, for they become a potential threaten to the marine engineering while they are regarded as the indicators of industrial oil and gas. By study the distribution and geochemical characteristics of gas seeps in northeast part of Yinggehai basin and shallow gas in sediments on slope, combined with their regional geologic background, this paper deals with the origin, migration pathway and emission mechanism of gas seeps and shallow gas in northern part of South China Sea, for providing a base knowledge for the evaluation of marine engineering geology. In northeast part of Yinggehai basin gas seeps have been found and recorded for near 100 years. During 1990s, as a part of petroleum exploration, the gas seeps in the basin have been investigated and research by oil companies (Baojia Huang et al., 1992; Jiaqiong He et al., 2000). Gas seeps were found in shallow water area along southwest coast of Hainan Island, water depth usually less than 50 m. The occurrence of gas seeps can be divided into two types: (1) gas continuously emission, continuous gas bubbles groups can be detected by sonar underwater and observed on water surface. (2) gas intermittently emission, the time intervals

Noble gas magnetic resonator

DOEpatents

Walker, Thad Gilbert; Lancor, Brian Robert; Wyllie, Robert

2014-04-15

Precise measurements of a precessional rate of noble gas in a magnetic field is obtained by constraining the time averaged direction of the spins of a stimulating alkali gas to lie in a plane transverse to the magnetic field. In this way, the magnetic field of the alkali gas does not provide a net contribution to the precessional rate of the noble gas.

Gas sensitive materials for gas detection and methods of making

DOEpatents

Trakhtenberg, Leonid Israilevich; Gerasimov, Genrikh Nikolaevich; Gromov, Vladimir Fedorovich; Rozenberg, Valeriya Isaakovna

2014-07-15

A gas sensitive material comprising SnO.sub.2 nanocrystals doped with In.sub.2O.sub.3 and an oxide of a platinum group metal, and a method of making the same. The platinum group metal is preferably Pd, but also may include Pt, Ru, Ir, and combinations thereof. The SnO.sub.2 nanocrystals have a specific surface of 7 or greater, preferably about 20 m2/g, and a mean particle size of between about 10 nm and about 100 nm, preferably about 40 nm. A gas detection device made from the gas sensitive material deposited on a substrate, the gas sensitive material configured as a part of a current measuring circuit in communication with a heat source.

[Household gas poisonings].

PubMed

Maloca, Ivana; Macan, Jelena; Varnai, Veda Marija; Turk, Rajka

2006-12-01

Exposure to toxic gases which can induce serious health effects, can occur in the working as well as in general environment, including home. The severity of gas poisoning is determined by its physical and chemical characteristics, intensity and duration of exposure, and concomitant diseases and injuries in the poisoned person. Manifestations of gas toxic action involve simple asphyxia, local irritation of respiratory mucosa, systemic toxicity, and a combination of these mechanisms. This article describes the characteristics, modes of exposure and health effects of most common gases causing poisoning at home. These include gas fuels, carbon monoxide, ammonia, chlorine, and fire gases such as nitrogen and sulphur oxides, hydrogen cyanide and phosgene. First aid as well as preventive measures to avoid exposure to toxic gases and prevent fire at home are also given. The Croatian Poison Control Centre gathered data on toxic gas exposures in households between November 2005 and July 2006. During this period 30 persons (3 % of the total number of cases) were exposed to toxic gases at home, including carbon monoxide, irritating vapours from cleaning agents and disinfectants, gas fuels, septic tank gases, tear-gas, and chlorofluorocarbons from refrigerators.

35. VIEW OF DUAL VENTURI GAS WASHER IN THE GAS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. VIEW OF DUAL VENTURI GAS WASHER IN THE GAS WASHER PUMP HOUSE LOOKING NORTHEAST. - U.S. Steel Duquesne Works, Basic Oxygen Steelmaking Plant, Along Monongahela River, Duquesne, Allegheny County, PA

Natural gas leak mapper

DOEpatents

Reichardt, Thomas A [Livermore, CA; Luong, Amy Khai [Dublin, CA; Kulp, Thomas J [Livermore, CA; Devdas, Sanjay [Albany, CA

2008-05-20

A system is described that is suitable for use in determining the location of leaks of gases having a background concentration. The system is a point-wise backscatter absorption gas measurement system that measures absorption and distance to each point of an image. The absorption measurement provides an indication of the total amount of a gas of interest, and the distance provides an estimate of the background concentration of gas. The distance is measured from the time-of-flight of laser pulse that is generated along with the absorption measurement light. The measurements are formated into an image of the presence of gas in excess of the background. Alternatively, an image of the scene is superimosed on the image of the gas to aid in locating leaks. By further modeling excess gas as a plume having a known concentration profile, the present system provides an estimate of the maximum concentration of the gas of interest.

Gas venting system

DOEpatents

Khan, Amjad; Dreier, Ken Wayne; Moulthrop, Lawrence Clinton; White, Erik James

2010-06-29

A system to vent a moist gas stream is disclosed. The system includes an enclosure and an electrochemical cell disposed within the enclosure, the electrochemical cell productive of the moist gas stream. A first vent is in fluid communication with the electrochemical cell for venting the moist gas stream to an exterior of the enclosure, and a second vent is in fluid communication with an interior of the enclosure and in thermal communication with the first vent for discharging heated air to the exterior of the enclosure. At least a portion of the discharging heated air is for preventing freezing of the moist gas stream within the first vent.

Gas-Recovery System

DOEpatents

Heckman, R. A.

1971-12-14

Nuclear explosions have been proposed as a means for recovering gas from underground gas-bearing rock formations. In present practice, the nuclear device is positioned at the end of a long pipe which is subsequently filled with grout or concrete. After the device is exploded, the grout is drilled through to provide a flow path for the released gas to the ground surface. As settled grout is brittle, often the compressive shock of the explosion fractures the grout and deforms the pipe so that it may not be removed nor reused. In addition, the pipe is sometimes pinched off completely and the gas flow is totally obstructed. (2 claims)

Gas-recovery system

DOEpatents

Heckman, R.A.

1971-12-14

Nuclear explosions have been proposed as a means for recovering gas from underground gas-bearing rock formations. In present practice, the nuclear device is positioned at the end of a long pipe which is subsequently filled with grout or concrete. After the device is exploded, the grout is drilled through to provide a flow path for the released gas to the ground surface. As settled grout is brittle, often the compressive shock of the explosion fractures the grout and deforms the pipe so that it may not be removed nor reused. In addition, the pipe is sometimes pinched off completely and the gas flow is totally obstructed. (2 claims)

Gas processing handbook

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

Not Available

1982-04-01

Brief details are given of processes including: BGC-Lurgi slagging gasification, COGAS, Exxon catalytic coal gasification, FW-Stoic 2-stage, GI two stage, HYGAS, Koppers-Totzek, Lurgi pressure gasification, Saarberg-Otto, Shell, Texaco, U-Gas, W-D.IGI, Wellman-Galusha, Westinghouse, and Winkler coal gasification processes; the Rectisol process; the Catacarb and the Benfield processes for removing CO/SUB/2, H/SUB/2s and COS from gases produced by the partial oxidation of coal; the selectamine DD, Selexol solvent, and Sulfinol gas cleaning processes; the sulphur-tolerant shift (SSK) process; and the Super-meth process for the production of high-Btu gas from synthesis gas.

Inflammation, negative nitrogen balance, and outcome after aneurysmal subarachnoid hemorrhage.

PubMed

Badjatia, Neeraj; Monahan, Aimee; Carpenter, Amanda; Zimmerman, Jacqueline; Schmidt, J Michael; Claassen, Jan; Connolly, E Sander; Mayer, Stephan A; Karmally, Wahida; Seres, David

2015-02-17

To analyze the impact of inflammation and negative nitrogen balance (NBAL) on nutritional status and outcomes after subarachnoid hemorrhage (SAH). This was a prospective observational study of SAH patients admitted between May 2008 and June 2012. Measurements of C-reactive protein (CRP), transthyretin (TTR), resting energy expenditure (REE), and NBAL (g/day) were performed over 4 preset time periods during the first 14 postbleed days (PBD) in addition to daily caloric intake. Factors associated with REE and NBAL were analyzed with multivariable linear regression. Hospital-acquired infections (HAI) were tracked daily for time-to-event analyses. Poor outcome at 3 months was defined as a modified Rankin Scale score ≥ 4 and assessed by multivariable logistic regression. There were 229 patients with an average age of 55 ± 15 years. Higher REE was associated with younger age (p = 0.02), male sex (p < 0.001), higher Hunt Hess grade (p = 0.001), and higher modified Fisher score (p = 0.01). Negative NBAL was associated with lower caloric intake (p < 0.001), higher body mass index (p < 0.001), aneurysm clipping (p = 0.03), and higher CRP:TTR ratio (p = 0.03). HAIs developed in 53 (23%) patients on mean PBD 8 ± 3. Older age (p = 0.002), higher Hunt Hess (p < 0.001), lower caloric intake (p = 0.001), and negative NBAL (p = 0.04) predicted time to first HAI. Poor outcome at 3 months was associated with higher Hunt Hess grade (p < 0.001), older age (p < 0.001), negative NBAL (p = 0.01), HAI (p = 0.03), higher CRP:TTR ratio (p = 0.04), higher body mass index (p = 0.03), and delayed cerebral ischemia (p = 0.04). Negative NBAL after SAH is influenced by inflammation and associated with an increased risk of HAI and poor outcome. Underfeeding and systemic inflammation are potential modifiable risk factors for negative NBAL and poor outcome after SAH. © 2015 American Academy of Neurology.

Inflammation, negative nitrogen balance, and outcome after aneurysmal subarachnoid hemorrhage

PubMed Central

Monahan, Aimee; Carpenter, Amanda; Zimmerman, Jacqueline; Schmidt, J. Michael; Claassen, Jan; Connolly, E. Sander; Mayer, Stephan A.; Karmally, Wahida; Seres, David

2015-01-01

Objective: To analyze the impact of inflammation and negative nitrogen balance (NBAL) on nutritional status and outcomes after subarachnoid hemorrhage (SAH). Methods: This was a prospective observational study of SAH patients admitted between May 2008 and June 2012. Measurements of C-reactive protein (CRP), transthyretin (TTR), resting energy expenditure (REE), and NBAL (g/day) were performed over 4 preset time periods during the first 14 postbleed days (PBD) in addition to daily caloric intake. Factors associated with REE and NBAL were analyzed with multivariable linear regression. Hospital-acquired infections (HAI) were tracked daily for time-to-event analyses. Poor outcome at 3 months was defined as a modified Rankin Scale score ≥4 and assessed by multivariable logistic regression. Results: There were 229 patients with an average age of 55 ± 15 years. Higher REE was associated with younger age (p = 0.02), male sex (p < 0.001), higher Hunt Hess grade (p = 0.001), and higher modified Fisher score (p = 0.01). Negative NBAL was associated with lower caloric intake (p < 0.001), higher body mass index (p < 0.001), aneurysm clipping (p = 0.03), and higher CRP:TTR ratio (p = 0.03). HAIs developed in 53 (23%) patients on mean PBD 8 ± 3. Older age (p = 0.002), higher Hunt Hess (p < 0.001), lower caloric intake (p = 0.001), and negative NBAL (p = 0.04) predicted time to first HAI. Poor outcome at 3 months was associated with higher Hunt Hess grade (p < 0.001), older age (p < 0.001), negative NBAL (p = 0.01), HAI (p = 0.03), higher CRP:TTR ratio (p = 0.04), higher body mass index (p = 0.03), and delayed cerebral ischemia (p = 0.04). Conclusions: Negative NBAL after SAH is influenced by inflammation and associated with an increased risk of HAI and poor outcome. Underfeeding and systemic inflammation are potential modifiable risk factors for negative NBAL and poor outcome after SAH. PMID:25596503

Characterizing Gas Transport in Wetland Soil-Root Systems with Dissolved Gas Tracer Techniques

NASA Astrophysics Data System (ADS)

Reid, M. C.; Jaffe, P. R.

2016-12-01

Soil fluxes of methane (CH4), nitrous oxide (N2O), and other biogenic gases depend on coupling between microbial and physiochemical processes within soil media. The importance of plant-mediated transport in wetland CH4 emissions is well known, but a generalized understanding of gas transfer between pore water and root aerenchyma, and how this process competes with biogeochemical production/consumption of gases beyond CH4, is incomplete [1]. A lack of experimental approaches to characterize transport processes in complex soil-water-plant systems at field scale has limited efforts to close this knowledge gap. In this presentation we describe dissolved gas tracer techniques to tease apart effects of transport from simultaneous biochemical reaction on trace gas dynamics in soils. We discuss a push-pull test with helium and sulfur hexafluoride gas tracers to quantify in situ root-mediated gas transfer kinetics in a wetland soil [2]. A Damköhler number analysis is introduced to interpret the results and evaluate the balance between biochemical reaction and root-driven gas transfer in controlling the fate of CH4 and N2O in vegetated wetland soils. We conclude with a brief discussion of other problems in soil gas dynamics that can be addressed with gas tracer approaches. [1] Blagodatsky and Smith 2012. Soil physics meets soil biology: Towards better mechanistic prediction of greenhouse gas emissions from soil. Soil Biology and Biochemistry 47, 78-92. [2] Reid et al. 2015. Dissolved gas dynamics in wetland soils: Root-mediated gas transfer kinetics determind via push-pull tracer tests. Water Resour. Res. 51, doi:10.1002/2014WR016803.

Gas shale/oil shale

USGS Publications Warehouse

Fishman, N.S.; Bereskin, S.R.; Bowker, K.A.; Cardott, B.J.; Chidsey, T.C.; Dubiel, R.F.; Enomoto, C.B.; Harrison, W.B.; Jarvie, D.M.; Jenkins, C.L.; LeFever, J.A.; Li, Peng; McCracken, J.N.; Morgan, C.D.; Nordeng, S.H.; Nyahay, R.E.; Schamel, Steven; Sumner, R.L.; Wray, L.L.

2011-01-01

The production of natural gas from shales continues to increase in North America, and shale gas exploration is on the rise in other parts of the world since the previous report by this committee was published by American Association of Petroleum Geologists, Energy Minerals Division (2009). For the United States, the volume of proved reserves of natural gas increased 11% from 2008 to 2009, the increase driven largely by shale gas development (Energy Information Administration 2010c). Furthermore, shales have increasingly become targets of exploration for oil and condensate as well as gas, which has served to greatly expand their significance as ‘‘unconventional’’ petroleum reservoirs.This report provides information about specific shales across North America and Europe from which gas (biogenic or thermogenic), oil, or natural gas liquids are produced or is actively being explored. The intent is to reflect the recently expanded mission of the Energy Minerals Division (EMD) Gas Shales Committee to serve as a single point of access to technical information on shales regardless of the type of hydrocarbon produced from them. The contents of this report were drawn largely from contributions by numerous members of the EMD Gas Shales Advisory Committee, with much of the data being available from public websites such as state or provincial geological surveys or other public institutions. Shales from which gas or oil is being produced in the United States are listed in alphabetical order by shale name. Information for Canada is presented by province, whereas for Europe, it is presented by country.

Residual gas analysis device

DOEpatents

Thornberg, Steven M [Peralta, NM

2012-07-31

A system is provided for testing the hermeticity of a package, such as a microelectromechanical systems package containing a sealed gas volume, with a sampling device that has the capability to isolate the package and breach the gas seal connected to a pulse valve that can controllably transmit small volumes down to 2 nanoliters to a gas chamber for analysis using gas chromatography/mass spectroscopy diagnostics.

Gas and Bloating

PubMed Central

2006-01-01

Gaseous symptoms including eructation, flatulence, and bloating occur as a consequence of excess gas production, altered gas transit, or abnormal perception of normal amounts of gas within the gastrointestinal tract. There are many causes of gas and bloating including aerophagia, luminal obstructive processes, carbohydrate intolerance syndromes, small intestinal bacterial overgrowth, diseases of gut motor activity, and functional bowel disorders including irritable bowel syndrome (IBS). Because of the prominence of gaseous complaints in IBS, recent investigations have focused on new insights into pathogenesis and novel therapies of bloating. The evaluation of the patient with unexplained gas and bloating relies on careful exclusion of organic disease with further characterization of the underlying condition with directed functional testing. Treatment of gaseous symptomatology should be targeted to pathophysiologic defects whenever possible. Available therapies include lifestyle alterations, dietary modifications, enzyme preparations, adsorbents and agents which reduce surface tension, treatments that alter gut flora, and drugs that modulate gut transit. PMID:28316536

Gas-heat-pump development

NASA Astrophysics Data System (ADS)

Creswick, F. A.

Incentives for the development of gas heat pumps are discussed. Technical progress made on several promising technologies was reviewed. The status of development of gas-engine-driven heat pumps, the absorption cycle for the near- and long-term gas heat pump systems, the Stirling engine, the small Rankine-cycle engines, and gas-turbine-driven heat pump systems were briefly reviewed. Progress in the US, Japan, and Europe is noted.

78 FR 27218 - Mountaineer Gas Company v. Washington Gas Light Company: Notice of Complaint

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... Gas Company v. Washington Gas Light Company: Notice of Complaint Take notice that on April 30, 2013, Mountaineer Gas Company (Mountaineer or Complainant) filed a complaint against Washington Gas Light Company... Light Company as listed on the Commission's list of Corporate Officials. Any person desiring to...

Relevance of anisotropy and spatial variability of gas diffusivity for soil-gas transport

NASA Astrophysics Data System (ADS)

Schack-Kirchner, Helmer; Kühne, Anke; Lang, Friederike

2017-04-01

Models of soil gas transport generally do not consider neither direction dependence of gas diffusivity, nor its small-scale variability. However, in a recent study, we could provide evidence for anisotropy favouring vertical gas diffusion in natural soils. We hypothesize that gas transport models based on gas diffusion data measured with soil rings are strongly influenced by both, anisotropy and spatial variability and the use of averaged diffusivities could be misleading. To test this we used a 2-dimensional model of soil gas transport to under compacted wheel tracks to model the soil-air oxygen distribution in the soil. The model was parametrized with data obtained from soil-ring measurements with its central tendency and variability. The model includes vertical parameter variability as well as variation perpendicular to the elongated wheel track. Different parametrization types have been tested: [i)]Averaged values for wheel track and undisturbed. em [ii)]Random distribution of soil cells with normally distributed variability within the strata. em [iii)]Random distributed soil cells with uniformly distributed variability within the strata. All three types of small-scale variability has been tested for [j)] isotropic gas diffusivity and em [jj)]reduced horizontal gas diffusivity (constant factor), yielding in total six models. As expected the different parametrizations had an important influence to the aeration state under wheel tracks with the strongest oxygen depletion in case of uniformly distributed variability and anisotropy towards higher vertical diffusivity. The simple simulation approach clearly showed the relevance of anisotropy and spatial variability in case of identical central tendency measures of gas diffusivity. However, until now it did not consider spatial dependency of variability, that could even aggravate effects. To consider anisotropy and spatial variability in gas transport models we recommend a) to measure soil-gas transport parameters

Gas hydrate prospecting using well cuttings and mud-gas geochemistry from 35 wells, North Slope, Alaska

USGS Publications Warehouse

Lorenson, T.D.; Collett, Timothy S.

2011-01-01

Gas hydrate deposits are common on the North Slope of Alaska around Prudhoe Bay; however, the extent of these deposits is unknown outside of this area. As part of a U.S. Geological Survey (USGS) and Bureau of Land Management gas hydrate research collaboration, well-cutting and mud-gas samples have been collected and analyzed from mainly industry-drilled wells on the North Slope for the purpose of prospecting for gas hydrate deposits. On the Alaska North Slope, gas hydrates are now recognized as an element within a petroleum systems approach or "total petroleum system." Since 1979, 35 wells have been sampled from as far west as Wainwright to Prudhoe Bay in the east. Regionally, the USGS has assessed the gas hydrate resources of the North Slope and determined that there is about 85.4 trillion cubic feet of technically recoverable hydrate-bound gas within three assessment units. The assessment units are defined mainly by three separate stratigraphic sections and constrained by the physical temperatures and pressures where gas hydrate can form. Geochemical studies of known gas hydrate occurrences on the North Slope have shown a link between gas hydrate and more deeply buried conventional oil and gas deposits. The link is established when hydrocarbon gases migrate from depth and charge the reservoir rock within the gas hydrate stability zone. It is likely gases migrated into conventional traps as free gas and were later converted to gas hydrate in response to climate cooling concurrent with permafrost formation. Results from this study indicate that some thermogenic gas is present in 31 of the wells, with limited evidence of thermogenic gas in four other wells and only one well with no thermogenic gas. Gas hydrate is known to occur in one of the sampled wells, likely present in 22 others on the basis of gas geochemistry, and inferred by equivocal gas geochemistry in 11 wells, and one well was without gas hydrate. Gas migration routes are common in the North Slope and

Selective Gas Capture Ability of Gas-Adsorbent-Incorporated Cellulose Nanofiber Films.

PubMed

Shah, Kinjal J; Imae, Toyoko

2016-05-09

The 2,2,6,6-tetramethylpiperidine-1-oxyl radical-oxidized cellulose nanofibers (TOCNF) were hybridized with cation and anion-exchange organoclays, where poly(amido amine) dendrimers were loaded to enhance the functionality of gas adsorption, since dendrimers have the high adsorbability and the enough selectivity on the gas adsorption. The thin films were prepared from the organoclay-TOCNF hybrids and supplied to the gas adsorption. The adsorption of CO2 and NH3 gases increased with an increasing amount of organoclays in TOCNF films, but the behavior of the increase depended on gases, clays, and dendrimers. The hydrotalcite organoclay-TOCNF films displayed the highest adsorption of both gases, but the desorption of CO2 gas from hydrotalcite organoclay-TOCNF films was drastically high in comparison with the other systems. While the CO2 gas is adsorbed and remained on cationic dendrimer sites in cation-exchange organoclay-TOCNF films, the CO2 gas is adsorbed on cationic clay sites in anion exchange organoclay-TOCNF films, and it is easily desorbed from the films. The NH3 adsorption is inversive to the CO2 adsorption. Then the CO2 molecules adsorbed on the cationic dendrimers and the NH3 molecules adsorbed on the anionic dendrimers are preferably captured in these adsorbents. The present research incorporated dendrimers will be contributing to the development of gas-specialized adsorbents, which are selectively storable only in particular gases.

Gas cleaning system and method

DOEpatents

Newby, Richard Allen

2006-06-06

A gas cleaning system for removing at least a portion of contaminants, such as halides, sulfur, particulates, mercury, and others, from a synthesis gas (syngas). The gas cleaning system may include one or more filter vessels coupled in series for removing halides, particulates, and sulfur from the syngas. The gas cleaning system may be operated by receiving gas at a first temperature and pressure and dropping the temperature of the syngas as the gas flows through the system. The gas cleaning system may be used for an application requiring clean syngas, such as, but not limited to, fuel cell power generation, IGCC power generation, and chemical synthesis.

Natural Gas Exports from Iran

EIA Publications

2012-01-01

This assessment of the natural gas sector in Iran, with a focus on Iran’s natural gas exports, was prepared pursuant to section 505 (a) of the Iran Threat Reduction and Syria Human Rights Act of 2012 (Public Law No: 112-158). As requested, it includes: (1) an assessment of exports of natural gas from Iran; (2) an identification of the countries that purchase the most natural gas from Iran; (3) an assessment of alternative supplies of natural gas available to those countries; (4) an assessment of the impact a reduction in exports of natural gas from Iran would have on global natural gas supplies and the price of natural gas, especially in countries identified under number (2); and (5) such other information as the Administrator considers appropriate.

Accounting for fuel price risk: Using forward natural gas prices instead of gas price forecasts to compare renewable to natural gas-fired generation

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

Bolinger, Mark; Wiser, Ryan; Golove, William

2003-08-13

Against the backdrop of increasingly volatile natural gas prices, renewable energy resources, which by their nature are immune to natural gas fuel price risk, provide a real economic benefit. Unlike many contracts for natural gas-fired generation, renewable generation is typically sold under fixed-price contracts. Assuming that electricity consumers value long-term price stability, a utility or other retail electricity supplier that is looking to expand its resource portfolio (or a policymaker interested in evaluating different resource options) should therefore compare the cost of fixed-price renewable generation to the hedged or guaranteed cost of new natural gas-fired generation, rather than to projectedmore » costs based on uncertain gas price forecasts. To do otherwise would be to compare apples to oranges: by their nature, renewable resources carry no natural gas fuel price risk, and if the market values that attribute, then the most appropriate comparison is to the hedged cost of natural gas-fired generation. Nonetheless, utilities and others often compare the costs of renewable to gas-fired generation using as their fuel price input long-term gas price forecasts that are inherently uncertain, rather than long-term natural gas forward prices that can actually be locked in. This practice raises the critical question of how these two price streams compare. If they are similar, then one might conclude that forecast-based modeling and planning exercises are in fact approximating an apples-to-apples comparison, and no further consideration is necessary. If, however, natural gas forward prices systematically differ from price forecasts, then the use of such forecasts in planning and modeling exercises will yield results that are biased in favor of either renewable (if forwards < forecasts) or natural gas-fired generation (if forwards > forecasts). In this report we compare the cost of hedging natural gas price risk through traditional gas-based hedging

Liquid slip over gas nanofilms

NASA Astrophysics Data System (ADS)

Ramisetti, Srinivasa B.; Borg, Matthew K.; Lockerby, Duncan A.; Reese, Jason M.

2017-08-01

We propose the rarefied-gas-cushion model (r-GCM), as an extended version of the gas-cushion model (GCM), to estimate the apparent slip of water flowing over a gas layer trapped at a solid surface. Nanobubbles or gas nanofilms may manifest rarefied-gas effects and the r-GCM incorporates kinetic boundary conditions for the gas component in the slip Knudsen regime. These enable an apparent hydrodynamic slip length to be calculated given the gas thickness, the Knudsen number, and the bulk fluid viscosities. We assess the r-GCM through nonequilibrium molecular dynamics (NEMD) simulations of shear-driven liquid flow over an infinite gas nanofilm covering a solid surface, from the gas slip regime to the early transition regime, beyond which NEMD is computationally impractical. We find that, over the flow regimes examined, the r-GCM provides better predictions of the apparent liquid slip and retrieves both the GCM and the free-molecular behavior in the appropriate limits.

Liquid propellant gas generators

NASA Technical Reports Server (NTRS)

1972-01-01

The design of gas generators intended to provide hot gases for turbine drive is discussed. Emphasis is placed on the design and operation of bipropellant gas generators because of their wider use. Problems and limitations involved in turbine operation due to temperature effects are analyzed. Methods of temperature control of gas turbines and combustion products are examined. Drawings of critical sections of gas turbines to show their operation and areas of stress are included.

[Poisoning by exhaust gas of the imperfect combustion of natural gas: 22 cases study].

PubMed

Dong, Li-Min; Zhao, Hai; Zhang, Ming-Chang; He, Meng

2014-10-01

To analyze the case characteristics of poisoning by exhaust gas of the imperfect combustion of natural gas and provide references for forensic identification and prevention of such accidents. Twenty-two cases of poisoning by exhaust gas of the imperfect combustion of natural gas in Minhang District during 2004 to 2013 were collected. Some aspects such as general conditions of deaths, incidence time, weather, field investigation, and autopsy were retrospectively analyzed. In the 22 cases, there were 15 males and 16 females. The age range was between 2 and 82 years old. The major occurring time was in January or February (8 cases in each) and the cases almost occurred in small area room (21 cases). There was wide crack next to the exhaust port when the gas water heater was been used in all cases. There are more prone to occurrence of exhaust gas poisoning of imperfect combustion of natural gas in small area room with a ventilation window near the exhaust port of gas water heated. It shows that the scene of combustion exhaust gas poisoning should be more concerned in the cold season.

Gas sensor

DOEpatents

Schmid, Andreas K.; Mascaraque, Arantzazu; Santos, Benito; de la Figuera, Juan

2014-09-09

A gas sensor is described which incorporates a sensor stack comprising a first film layer of a ferromagnetic material, a spacer layer, and a second film layer of the ferromagnetic material. The first film layer is fabricated so that it exhibits a dependence of its magnetic anisotropy direction on the presence of a gas, That is, the orientation of the easy axis of magnetization will flip from out-of-plane to in-plane when the gas to be detected is present in sufficient concentration. By monitoring the change in resistance of the sensor stack when the orientation of the first layer's magnetization changes, and correlating that change with temperature one can determine both the identity and relative concentration of the detected gas. In one embodiment the stack sensor comprises a top ferromagnetic layer two mono layers thick of cobalt deposited upon a spacer layer of ruthenium, which in turn has a second layer of cobalt disposed on its other side, this second cobalt layer in contact with a programmable heater chip.

Oil and Gas Supply Modeling

NASA Astrophysics Data System (ADS)

Gass, S. I.

1982-05-01

The theoretical and applied state of the art of oil and gas supply models was discussed. The following areas were addressed: the realities of oil and gas supply, prediction of oil and gas production, problems in oil and gas modeling, resource appraisal procedures, forecasting field size and production, investment and production strategies, estimating cost and production schedules for undiscovered fields, production regulations, resource data, sensitivity analysis of forecasts, econometric analysis of resource depletion, oil and gas finding rates, and various models of oil and gas supply.

Nitric oxide charged catheters as a potential strategy for prevention of hospital acquired infections.

PubMed

Margel, David; Mizrahi, Mark; Regev-Shoshani, Gili; Ko, Mary; Moshe, Maya; Ozalvo, Rachel; Shavit-Grievink, Liat; Baniel, Jack; Kedar, Daniel; Yossepowitch, Ofer; Lifshitz, David; Nadu, Andrei; Greenberg, David; Av-Gay, Yossef

2017-01-01

Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents bacterial colonization and biofilm formation onto catheter surfaces. The aim of the study was to assess the anti-infective properties of NO-charged catheters exposed to low concentration (up to 103 CFU/ml) of microbial cells in-vitro. We assessed NO-charged tracheal tubes using Pseudomonas aeruginosa, dialysis and biliary catheters using Escherichia coli, and urinary catheters using E. coli, Candida albicans or Enterococcus faecalis. Safety and tolerability of NO-charged urinary catheters were evaluated in a phase 1 clinical study in 12 patients. Six patients were catheterized with NO-charged catheters (NO-group), followed by 6 patients catheterized with regular control catheters (CT-group). Comparison of safety parameters between the study groups was performed. NO-charged tracheal, dialysis biliary and urinary catheters prevented P. aeruginosa, E. coli and C. albicans attachment and colonization onto their surfaces and eradicated corresponding planktonic microbial cells in the surrounding media after 24-48 hours, while E. faecalis colonization onto urinary catheters was reduced by 1 log compared to controls. All patients catheterized with an NO-charged urinary catheter successfully completed the study without experiencing NO-related AE's or serious AE's (SAE's). These data highlight the potential of NO-based technology as potential platform for preventing catheter-associated HAI's.

Nitric oxide charged catheters as a potential strategy for prevention of hospital acquired infections

PubMed Central

Regev-Shoshani, Gili; KO, Mary; Moshe, Maya; Ozalvo, Rachel; Shavit-Grievink, Liat; Baniel, Jack; Kedar, Daniel; Yossepowitch, Ofer; Lifshitz, David; Nadu, Andrei; Greenberg, David; Av-Gay, Yossef

2017-01-01

Background Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents bacterial colonization and biofilm formation onto catheter surfaces. Aims and methods The aim of the study was to assess the anti-infective properties of NO-charged catheters exposed to low concentration (up to 103 CFU/ml) of microbial cells in-vitro. We assessed NO-charged tracheal tubes using Pseudomonas aeruginosa, dialysis and biliary catheters using Escherichia coli, and urinary catheters using E. coli, Candida albicans or Enterococcus faecalis. Safety and tolerability of NO-charged urinary catheters were evaluated in a phase 1 clinical study in 12 patients. Six patients were catheterized with NO-charged catheters (NO-group), followed by 6 patients catheterized with regular control catheters (CT-group). Comparison of safety parameters between the study groups was performed. Results NO-charged tracheal, dialysis biliary and urinary catheters prevented P. aeruginosa, E. coli and C. albicans attachment and colonization onto their surfaces and eradicated corresponding planktonic microbial cells in the surrounding media after 24–48 hours, while E. faecalis colonization onto urinary catheters was reduced by 1 log compared to controls. All patients catheterized with an NO-charged urinary catheter successfully completed the study without experiencing NO-related AE's or serious AE's (SAE's). Conclusion These data highlight the potential of NO-based technology as potential platform for preventing catheter-associated HAI's. PMID:28410367

Improving Students' Understanding of the Connections between the Concepts of Real-Gas Mixtures, Gas Ideal-Solutions, and Perfect-Gas Mixtures

ERIC Educational Resources Information Center

Privat, Romain; Jaubert, Jean-Noël; Moine, Edouard

2016-01-01

In many textbooks of chemical-engineering thermodynamics, a gas mixture obeying the fundamental law pV[subscript m] = RT is most often called ideal-gas mixture (in some rare cases, the term perfect-gas mixture can be found). These textbooks also define the fundamental concept of ideal solution which in theory, can be applied indifferently to…

Water-saving liquid-gas conditioning system

DOEpatents

Martin, Christopher; Zhuang, Ye

2014-01-14

A method for treating a process gas with a liquid comprises contacting a process gas with a hygroscopic working fluid in order to remove a constituent from the process gas. A system for treating a process gas with a liquid comprises a hygroscopic working fluid comprising a component adapted to absorb or react with a constituent of a process gas, and a liquid-gas contactor for contacting the working fluid and the process gas, wherein the constituent is removed from the process gas within the liquid-gas contactor.

Gas separation membrane module assembly

DOEpatents

Wynn, Nicholas P [Palo Alto, CA; Fulton, Donald A [Fairfield, CA

2009-03-31

A gas-separation membrane module assembly and a gas-separation process using the assembly. The assembly includes a set of tubes, each containing gas-separation membranes, arranged within a housing. The housing contains a tube sheet that divides the space within the housing into two gas-tight spaces. A permeate collection system within the housing gathers permeate gas from the tubes for discharge from the housing.

Atmospheric deposition as an important nitrogen load to a typical agro-ecosystem in the Huang-Huai-Hai Plain. 2. Seasonal and inter-annual variations and their implications (2008-2012)

NASA Astrophysics Data System (ADS)

Huang, Ping; Zhang, Jiabao; Ma, Donghao; Wen, Zhaofei; Wu, Shengjun; Garland, Gina; Pereira, Engil Isadora Pujol; Zhu, Anning; Xin, Xiuli; Zhang, Congzhi

2016-03-01

Atmospheric nitrogen (N) deposition, an important N source to agro-ecosystems, has increased intensively in China during recent decades. However, knowledge on temporal variations of total N deposition and their influencing factors is limited due to lack of systematic monitoring data. In this study, total N deposition, including dry and wet components, was monitored using the water surrogate surface method for a typical agro-ecosystem with a winter wheat (Triticum aestivum L.) and summer maize (Zea mays L.) rotation system in the Huang-Huai-Hai Plain from May 2008 to April 2012. The results indicated that annual total N deposition ranged from 23.8 kg N ha-1 (2009-2010) to 40.3 kg N ha-1 (2008-2009) and averaged 31.8 kg N ha-1. Great inter-annual variations were observed during the sampling period, due to differences in annual rainfall and gaseous N losses from farmlands. Monthly total N deposition varied greatly, from less than 0.6 kg N ha-1 (January, 2010) to over 8.0 kg N ha-1 (August, 2008), with a mean value of 2.6 kg N ha-1. In contrast to wet deposition, dry portions generally contributed more to the total, except in the precipitation-intensive months, accounting for 65% in average. NH4+ -N was the dominant species in N deposition and its contribution to total deposition varied from 6% (December, 2009) to 79% (July, 2008), averaging 53%. The role of organic N (O-N) in both dry and wet deposition was equal to or even greater than that of NO3- -N. Influencing factors such as precipitation and its seasonal distribution, reactive N sources, vegetation status, field management practices, and weather conditions were responsible for the temporal variations of atmospheric N deposition and its components. These results are helpful for reducing the knowledge gaps in the temporal variations of atmospheric N deposition and their influencing factors in different ecosystems, to improve the understandings on N budget in the typical agro-ecosystem, and to provide references

Pulsed gas laser

DOEpatents

Anderson, Louis W.; Fitzsimmons, William A.

1978-01-01

A pulsed gas laser is constituted by Blumlein circuits wherein space metal plates function both as capacitors and transmission lines coupling high frequency oscillations to a gas filled laser tube. The tube itself is formed by spaced metal side walls which function as connections to the electrodes to provide for a high frequency, high voltage discharge in the tube to cause the gas to lase. Also shown is a spark gap switch having structural features permitting a long life.

Gas hydrate and humans

USGS Publications Warehouse

Kvenvolden, K.A.

2000-01-01

The potential effects of naturally occurring gas hydrate on humans are not understood with certainty, but enough information has been acquired over the past 30 years to make preliminary assessments possible. Three major issues are gas hydrate as (1) a potential energy resource, (2) a factor in global climate change, and (3) a submarine geohazard. The methane content is estimated to be between 1015 to 1017 m3 at STP and the worldwide distribution in outer continental margins of oceans and in polar regions are significant features of gas hydrate. However, its immediate development as an energy resource is not likely because there are various geological constraints and difficult technological problems that must be solved before economic recovery of methane from hydrate can be achieved. The role of gas hydrate in global climate change is uncertain. For hydrate methane to be an effective greenhouse gas, it must reach the atmosphere. Yet there are many obstacles to the transfer of methane from hydrate to the atmosphere. Rates of gas hydrate dissociation and the integrated rates of release and destruction of the methane in the geo/hydro/atmosphere are not adequately understood. Gas hydrate as a submarine geohazard, however, is of immediate and increasing importance to humans as our industrial society moves to exploit seabed resources at ever-greater depths in the waters of our coastal oceans. Human activities and installations in regions of gas-hydrate occurrence must take into account the presence of gas hydrate and deal with the consequences of its presence.

Investigation of shallow gas hydrate occurrence and gas seep activity on the Sakhalin continental slope, Russia

NASA Astrophysics Data System (ADS)

Jin, Young Keun; Baranov, Boris; Obzhirov, Anatoly; Salomatin, Alexander; Derkachev, Alexander; Hachikubo, Akihiro; Minami, Hrotsugu; Kuk Hong, Jong

2016-04-01

The Sakhalin continental slope has been a well-known gas hydrate area since the first finding of gas hydrate in 1980's. This area belongs to the southernmost glacial sea in the northern hemisphere where most of the area sea is covered by sea ice the winter season. Very high organic carbon content in the sediment, cold sea environment, and active tectonic regime in the Sakhalin slope provide a very favorable condition for occurring shallow gas hydrate accumulation and gas emission phenomena. Research expeditions under the framework of a Korean-Russian-Japanese long-term international collaboration projects (CHAOS, SSGH-I, SSGH-II projects) have been conducted to investigate gas hydrate occurrence and gas seepage activities on the Sakhalin continental slope, Russia from 2003 to 2015. During the expeditions, near-surface gas hydrate samples at more than 30 sites have been retrieved and hundreds of active gas seepage structures on the seafloor were newly registered by multidisciplinary surveys. The gas hydrates occurrence at the various water depths from about 300 m to 1000 m in the study area were accompanied by active gas seepage-related phenomena in the sub-bottom, on the seafloor, and in the water column: well-defined upward gas migration structures (gas chimney) imaged by high-resolution seismic, hydroacoustic anomalies of gas emissions (gas flares) detected by echosounders, seafloor high backscatter intensities (seepage structures) imaged by side-scan sonar and bathymetric structures (pockmarks and mounds) mapped by single/multi-beam surveys, and very shallow SMTZ (sulphate-methane transition zone) depths, strong microbial activities and high methane concentrations measured in sediment/seawater samples. The highlights of the expeditions are shallow gas hydrate occurrences around 300 m in the water depth which is nearly closed to the upper boundary of gas hydrate stability zone in the area and a 2,000 m-high gas flare emitted from the deep seafloor.

Scary gas: pathways in the axial body for soft tissue gas dissection (part I).

PubMed

Sandstrom, Claire K; Osman, Sherif F; Linnau, Ken F

2017-10-01

Gas is often encountered in abnormal locations in the torso, including within soft tissue compartments, vessels, and bones. The clinical significance of this gas ranges from incidental, benign, and self-limited to aggressive infection requiring immediate surgery. As a result of fascial interconnectivity and pressure differences between compartments, gas can dissect distant from its source. Gas can easily dissect between spaces of the extrapleural thorax, subperitoneal abdomen, deep cervical spaces, and subcutaneous tissues. The pleural and peritoneal cavities are normally isolated but may communicate with the other spaces in select situations. Dissection of gas may cause confusion as to its origin, potentially delaying treatment or prompting unnecessary and/or distracting workup and therapies. The radiologist might be the first to suggest and identify a remote source of dissecting gas when the clinical manifestation alone might be misleading. The purpose of this paper, the first in a three-part series on soft tissue gas, is to explore the various pathways by which gas dissects through the superficial and deep compartments of the torso.

Welding torch gas cup extension

NASA Technical Reports Server (NTRS)

Gordon, Stephen S. (Inventor)

1988-01-01

The invention relates to a gas shielded electric arc welding torch having a detachable gas cup extension which may be of any desired configuration or length. The gas cup extension assembly is mounted on a standard electric welding torch gas cup to enable welding in areas with limited access. The gas cup assembly has an upper tubular insert that fits within the gas cup such that its lower portion protrudes thereform and has a lower tubular extension that is screwed into the lower portion. The extension has a rim to define the outer perimeter of the seat edge about its entrance opening so a gasket may be placed to effect an airtight seal between the gas cup and extension. The tubular extension may be made of metal or cermaic material that can be machined. The novelty lies in the use of an extension assembly for a standard gas cup of an electric arc welding torch which extension assembly is detachable permitting the use of a number of extensions which may be of different configurations and materials and yet fit the standard gas cup.

Upscaling gas permeability in tight-gas sandstones

NASA Astrophysics Data System (ADS)

Ghanbarian, B.; Torres-Verdin, C.; Lake, L. W.; Marder, M. P.

2017-12-01

Klinkenberg-corrected gas permeability (k) estimation in tight-gas sandstones is essential for gas exploration and production in low-permeability porous rocks. Most models for estimating k are a function of porosity (ϕ), tortuosity (τ), pore shape factor (s) and a characteristic length scale (lc). Estimation of the latter, however, has been the subject of debate in the literature. Here we invoke two different upscaling approaches from statistical physics: (1) the EMA and (2) critical path analysis (CPA) to estimate lc from pore throat-size distribution derived from mercury intrusion capillary pressure (MICP) curve. τ is approximated from: (1) concepts of percolation theory and (2) formation resistivity factor measurements (F = τ/ϕ). We then estimate k of eighteen tight-gas sandstones from lc, τ, and ϕ by assuming two different pore shapes: cylindrical and slit-shaped. Comparison with Klinkenberg-corrected k measurements showed that τ was estimated more accurately from F measurements than from percolation theory. Generally speaking, our results implied that the EMA estimated k within a factor of two of the measurements and more precisely than CPA. We further found that the assumption of cylindrical pores yielded more accurate k estimates when τ was estimated from concepts of percolation theory than the assumption of slit-shaped pores. However, the EMA with slit-shaped pores estimated k more precisely than that with cylindrical pores when τ was estimated from F measurements.

Chemical Discrimination in Turbulent Gas Mixtures with MOX Sensors Validated by Gas Chromatography-Mass Spectrometry

PubMed Central

Fonollosa, Jordi; Rodríguez-Luján, Irene; Trincavelli, Marco; Vergara, Alexander; Huerta, Ramón

2014-01-01

Chemical detection systems based on chemo-resistive sensors usually include a gas chamber to control the sample air flow and to minimize turbulence. However, such a kind of experimental setup does not reproduce the gas concentration fluctuations observed in natural environments and destroys the spatio-temporal information contained in gas plumes. Aiming at reproducing more realistic environments, we utilize a wind tunnel with two independent gas sources that get naturally mixed along a turbulent flow. For the first time, chemo-resistive gas sensors are exposed to dynamic gas mixtures generated with several concentration levels at the sources. Moreover, the ground truth of gas concentrations at the sensor location was estimated by means of gas chromatography-mass spectrometry. We used a support vector machine as a tool to show that chemo-resistive transduction can be utilized to reliably identify chemical components in dynamic turbulent mixtures, as long as sufficient gas concentration coverage is used. We show that in open sampling systems, training the classifiers only on high concentrations of gases produces less effective classification and that it is important to calibrate the classification method with data at low gas concentrations to achieve optimal performance. PMID:25325339

Chemical discrimination in turbulent gas mixtures with MOX sensors validated by gas chromatography-mass spectrometry.

PubMed

Fonollosa, Jordi; Rodríguez-Luján, Irene; Trincavelli, Marco; Vergara, Alexander; Huerta, Ramón

2014-10-16

Chemical detection systems based on chemo-resistive sensors usually include a gas chamber to control the sample air flow and to minimize turbulence. However, such a kind of experimental setup does not reproduce the gas concentration fluctuations observed in natural environments and destroys the spatio-temporal information contained in gas plumes. Aiming at reproducing more realistic environments, we utilize a wind tunnel with two independent gas sources that get naturally mixed along a turbulent flow. For the first time, chemo-resistive gas sensors are exposed to dynamic gas mixtures generated with several concentration levels at the sources. Moreover, the ground truth of gas concentrations at the sensor location was estimated by means of gas chromatography-mass spectrometry. We used a support vector machine as a tool to show that chemo-resistive transduction can be utilized to reliably identify chemical components in dynamic turbulent mixtures, as long as sufficient gas concentration coverage is used. We show that in open sampling systems, training the classifiers only on high concentrations of gases produces less effective classification and that it is important to calibrate the classification method with data at low gas concentrations to achieve optimal performance.

Bacterial infections in HIV-infected children admitted with severe acute malnutrition in Durban, South Africa.

PubMed

Archary, Moherndran; Adler, Hugh; La Russa, Philip; Mahabeer, Prasha; Bobat, Raziya A

2017-02-01

Bacterial infections in HIV-infected children admitted with severe acute malnutrition (SAM) contribute to higher mortality and poorer outcomes. This study describes the spectrum of bacterial infections in antiretroviral treatment (ART)-naïve, HIV-infected children admitted with SAM. Between July 2012 and February 2015, 82 children were prospectively enrolled in the King Edward VIII Hospital, Durban. Specimens obtained on and during admission for microbiological evaluation, if clinically indicated, included blood, urine (obtained by catheterisation or suprapubic aspiration), induced sputum and cerebrospinal fluid. All positive bacterial cultures between admission and 30 days after enrollment were documented and characterised into samples taken either within 2 days of admission (infections on admission) or within 2-30 days of admission (hospital-acquired infections, HAIs). On admission, 67% of patients had abnormal white blood cell counts (WBCC) (>12 or <4 × 10 9 /L) and 70% had elevated CRP; 65% were classified as severely immunosuppressed according to the WHO immunological classification. 1 A pathogen was isolated on the admission blood culture in four patients (6%) and in 27% of urine specimens. HAIs were predominately Gram-negative (39/43), and 39.5% were extended-spectrum β-lactamase-positive. Mortality was not significantly associated with isolation of a bacterial pathogen. Routine pre-hospital administration of antibiotics as per the Integrated Management of Childhood Illness (IMCI) guidelines may be responsible for the low rates of positive admission blood cultures. HAIs with drug-resistant Gram-negative organisms are an area of concern and strategies to improve the prevention of HAIs in this vulnerable population are urgently needed.

Role of a multimodal educational strategy on health care workers' handwashing.

PubMed

Watson, Jo Andrea

2016-04-01

Good hand hygiene is the single most important strategy used to prevent health care-associated infections (HAIs); however, health care workers' (HCWs') hand hygiene compliance rates range between 25% and 51%. This study aims to determine if a multimodal strategy using the World Health Organization's (WHO's) My 5 Moments for Hand Hygiene methodology increases HCWs' compliance with handwashing and awareness of the importance of good hand hygiene in the prevention of HAIs. A quasi-experimental, 1-group pre-post survey design was used to test awareness and knowledge. A simple interrupted time series methodology at baseline and 3 months was used to monitor hand hygiene compliance. Overall, HCWs' hand hygiene compliance increased from 51.3% to 98.6%, with an odds ratio of 71.10. The pre-post survey demonstrated HCWs were aware and knowledgeable of the importance of good hand hygiene. Eight postsurvey questions focusing on the strategies used to promote hand hygiene demonstrated statistical significance using a 1-sample t test, with P values ranging from .000-.024. A multimodal approach using the WHO's My 5 Moments for Hand Hygiene does increase HCWs' hand hygiene compliance and awareness and knowledge of the importance of hand hygiene in the prevention of HAIs. Using this approach can produce a positive social change by reducing preventable disease and decreasing HAIs not only within a facility but also in the community. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Effect of regional and systemic fluorinated pyrimidine chemotherapy on quality of life in colorectal liver metastasis patients.

PubMed

Earlam, S; Glover, C; Davies, M; Fordy, C; Allen-Mersh, T G

1997-05-01

Since systemic and regional (HAI) fluorinated pyrimidine chemotherapies offer similar survival benefit in treatment of colorectal liver metastases (CLM), we sought to identify their impact on quality of life (QoL), which might be a useful indicator of treatment preference. We compared QoL in 135 CLM patients managed by symptom control (n = 49 patients), systemic fluorouracil (5FU)/folinic acid (n = 35), or hepatic arterial floxuridine (FUDR) (n = 51). Full blood count and liver function tests, World Health Organization (WHO) toxicity criteria, and QoL (Rotterdam Symptom Checklist [RSC], the Sickness Impact Profile [SIP], and the Hospital Anxiety and Depression scale [HAD]) were measured monthly in all patients. The HAD anxiety score was significantly increased in symptom control compared with chemotherapy patients 1 month after randomization. There was a significant increase in RSC physical score (repeated measures, P = .05), and in scores for sore mouth (P < .01), dry mouth (P < .01), and tingling hands and feet (P < .01) in systemic chemotherapy compared with symptom control patients. Significant QoL differences (repeated measures and Mann-Whitney U [MWU]) between HAI and symptom control patients were not detected. Systemic chemotherapy patients lived for significantly longer (log-rank test, P < or = .0001) with abnormal HAD anxiety, RSC psychosocial, or RSC sore mouth scores compared with HAI patients, but there were no overall survival differences. Randomization to symptom control only was associated with increased anxiety. QoL with systemic chemotherapy was impaired by side effects. HAI was associated with similar survival to systemic chemotherapy but with better sustained QoL.

Live imaging of symbiosis: spatiotemporal infection dynamics of a GFP-labelled Burkholderia symbiont in the bean bug Riptortus pedestris

PubMed Central

Kikuchi, Yoshitomo; Fukatsu, Takema

2014-01-01

Many insects possess endosymbiotic bacteria inside their body, wherein intimate interactions occur between the partners. While recent technological advancements have deepened our understanding of metabolic and evolutionary features of the symbiont genomes, molecular mechanisms underpinning the intimate interactions remain difficult to approach because the insect symbionts are generally uncultivable. The bean bug Riptortus pedestris is associated with the betaproteobacterial Burkholderia symbiont in a posterior region of the midgut, which develops numerous crypts harbouring the symbiont extracellularly. Distinct from other insect symbiotic systems, R. pedestris acquires the Burkholderia symbiont not by vertical transmission but from the environment every generation. By making use of the cultivability and the genetic tractability of the symbiont, we constructed a transgenic Burkholderia strain labelled with green fluorescent protein (GFP), which enabled detailed observation of spatiotemporal dynamics and the colonization process of the symbiont in freshly prepared specimens. The symbiont live imaging revealed that, at the second instar, colonization of the symbiotic midgut M4 region started around 6 h after inoculation (hai). By 24 hai, the symbiont cells appeared in the main tract and also in several crypts of the M4. By 48 hai, most of the crypts were colonized by the symbiont cells. By 72 hai, all the crypts were filled up with the symbiont cells and the symbiont localization pattern continued during the subsequent nymphal development. Quantitative PCR of the symbiont confirmed the infection dynamics quantitatively. These results highlight the stinkbug-Burkholderia gut symbiosis as an unprecedented model for comprehensive understanding of molecular mechanisms underpinning insect symbiosis. PMID:24103110

Mathematical modeling of non-stationary gas flow in gas pipeline

NASA Astrophysics Data System (ADS)

Fetisov, V. G.; Nikolaev, A. K.; Lykov, Y. V.; Duchnevich, L. N.

2018-03-01

An analysis of the operation of the gas transportation system shows that for a considerable part of time pipelines operate in an unsettled regime of gas movement. Its pressure and flow rate vary along the length of pipeline and over time as a result of uneven consumption and selection, switching on and off compressor units, shutting off stop valves, emergence of emergency leaks. The operational management of such regimes is associated with difficulty of reconciling the operating modes of individual sections of gas pipeline with each other, as well as with compressor stations. Determining the grounds that cause change in the operating mode of the pipeline system and revealing patterns of these changes determine the choice of its parameters. Therefore, knowledge of the laws of changing the main technological parameters of gas pumping through pipelines in conditions of non-stationary motion is of great importance for practice.

A new gas lesion syndrome in man, induced by 'isobaric gas counterdiffusion'

NASA Technical Reports Server (NTRS)

Lambertsen, C. J.; Idicula, J.

1975-01-01

Normal men have been found to develop pruritis and gas bubble lesions in the skin, and disruption of vestibular function, when breathing nitrogen or neon with oxygen while surrounded by helium at increased ambient pressure. This phenomenon, which occurs at stable ambient pressures, at 1 or many ATA, has been designated the isobaric gas counterdiffusion syndrome. In a series of analyses and experiments in vivo and in vitro the cause of the syndrome has been established as due to gas accumulation and development of gas bubbles in tissues as a result of differences in selective diffusivities, for various respired and ambient gases, in the tissue substances between capillary blood and the surrounding atmosphere. The phenomenon described in man is an initial stage of a process shown later in animals to progress to continuous, massive, lethal, intravascular gas embolization.

Natural gas monthly, August 1993

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

Not Available

1993-08-25

The Natural Gas Monthly (NGM) is prepared in the Data Operations Branch of the Reserves and Natural Gas Division, Office of Oil and Gas, Energy Information Administration (EIA), US Department of Energy (DOE). The NGM highhghts activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information.

Gas in Attack and Gas in Defense

DTIC Science & Technology

1919-07-01

and to the fact that it affects the skin, the eyes, the throat and lungs, as well as the digestive’ tract if’ food be eaten that has been exposed to...zfYx~r its firat uzje by the Germanic before tile first Allied mustard gas at- $ack took place, This was made by the Franch in the vicinity of Com...of bicarbonate of soda &Uxr and their eyes, ears, mouth and nasal pasa gee washed with the same, PROTECTING FOOD FROM MUSTARD GAS, ‘9 It was very

GAS DISCHARGE DEVICES

DOEpatents

Arrol, W.J.; Jefferson, S.

1957-08-27

The construction of gas discharge devices where the object is to provide a gas discharge device having a high dark current and stabilized striking voltage is described. The inventors have discovered that the introduction of tritium gas into a discharge device with a subsequent electrical discharge in the device will deposit tritium on the inside of the chamber. The tritium acts to emit beta rays amd is an effective and non-hazardous way of improving the abovementioned discharge tube characteristics

Gas gangrene (image)

MedlinePlus

Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. It generally ... causing painful swelling and destruction of involved tissue. Gas gangrene is rapidly progressive and often fatal.

Gas turbine engine

DOEpatents

Lawlor, Shawn P.; Roberts, II, William Byron

2016-03-08

A gas turbine engine with a compressor rotor having compressor impulse blades that delivers gas at supersonic conditions to a stator. The stator includes a one or more aerodynamic ducts that each have a converging portion and a diverging portion for deceleration of the selected gas to subsonic conditions and to deliver a high pressure oxidant containing gas to flameholders. The flameholders may be provided as trapped vortex combustors, for combustion of a fuel to produce hot pressurized combustion gases. The hot pressurized combustion gases are choked before passing out of an aerodynamic duct to a turbine. Work is recovered in a turbine by expanding the combustion gases through impulse blades. By balancing the axial loading on compressor impulse blades and turbine impulse blades, asymmetrical thrust is minimized or avoided.

NREL + Southern California Gas

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

Berdahl, Sonja E

2017-10-09

NREL and Southern California Gas Company are evaluating a new 'power-to-gas' approach - one that produces methane through a biological pathway and uses the expansive natural gas infrastructure to store it. This approach has the potential to change how the power industry approaches renewable generation and energy storage.

Gas gangrene (image)

MedlinePlus

Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. Patients with ... vascular diseases are more prone to spontaneously develop gas gangrene, which is rapidly progressive and often fatal.

RADIOLYTIC GAS PRODUCTION RATES OF POLYMERS EXPOSED TO TRITIUM GAS

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

Clark, E.

Data from previous reports on studies of polymers exposed to tritium gas is further analyzed to estimate rates of radiolytic gas production. Also, graphs of gas release during tritium exposure from ultrahigh molecular weight polyethylene (UHMW-PE), polytetrafluoroethylene (PTFE, a trade name is Teflon®), and Vespel® polyimide are re-plotted as moles of gas as a function of time, which is consistent with a later study of tritium effects on various formulations of the elastomer ethylene-propylene-diene monomer (EPDM). These gas production rate estimates may be useful while considering using these polymers in tritium processing systems. These rates are valid at least formore » the longest exposure times for each material, two years for UHMW-PE, PTFE, and Vespel®, and fourteen months for filled and unfilled EPDM. Note that the production “rate” for Vespel® is a quantity of H{sub 2} produced during a single exposure to tritium, independent of length of time. The larger production rate per unit mass for unfilled EPDM results from the lack of filler- the carbon black in filled EPDM does not produce H{sub 2} or HT. This is one aspect of how inert fillers reduce the effects of ionizing radiation on polymers.« less

The Noble Gas Fingerprint in a UK Unconventional Gas Reservoir

NASA Astrophysics Data System (ADS)

McKavney, Rory; Gilfillan, Stuart; Györe, Domokos; Stuart, Fin

2016-04-01

In the last decade, there has been an unprecedented expansion in the development of unconventional hydrocarbon resources. Concerns have arisen about the effect of this new industry on groundwater quality, particularly focussing on hydraulic fracturing, the technique used to increase the permeability of the targeted tight shale formations. Methane contamination of groundwater has been documented in areas of gas production1 but conclusively linking this to fugitive emissions from unconventional hydrocarbon production has been controversial2. A lack of baseline measurements taken before drilling, and the equivocal interpretation of geochemical data hamper the determination of possible contamination. Common techniques for "fingerprinting" gas from discrete sources rely on gas composition and isotopic ratios of elements within hydrocarbons (e.g. δ13CCH4), but the original signatures can be masked by biological and gas transport processes. The noble gases (He, Ne, Ar, Kr, Xe) are inert and controlled only by their physical properties. They exist in trace quantities in natural gases and are sourced from 3 isotopically distinct environments (atmosphere, crust and mantle)3. They are decoupled from the biosphere, and provide a separate toolbox to investigate the numerous sources and migration pathways of natural gases, and have found recent utility in the CCS4 and unconventional gas5 industries. Here we present a brief overview of noble gas data obtained from a new coal bed methane (CBM) field, Central Scotland. We show that the high concentration of helium is an ideal fingerprint for tracing fugitive gas migration to a shallow groundwater. The wells show variation in the noble gas signatures that can be attributed to differences in formation water pumping from the coal seams as the field has been explored for future commercial development. Dewatering the seams alters the gas/water ratio and the degree to which noble gases degas from the formation water. Additionally the

Determination of anabolic steroids with gas chromatography-ion trap mass spectrometry using hydrogen as carrier gas.

PubMed

Impens, S; De Wasch, K; De Brabander, H

2001-01-01

Helium is considered to be the ideal carrier gas for gas chromatography/mass spectrometry (GC/MS) in general, and for use with an ion trap in particular. Helium is an inert gas, can be used without special precautions for security and, moreover, it is needed as a damping gas in the trap. A disadvantage of helium is the high viscosity resulting in long GC run times. In this work hydrogen was tested as an alternative carrier gas for GC in performing GC/MS analyses. A hydrogen generator was used as a safe source of hydrogen gas. It is demonstrated that hydrogen can be used as a carrier gas for the gas chromatograph in combination with helium as make-up gas for the trap. The analysis time was thus shortened and the chromatographic performance was optimized. Although hydrogen has proven useful as a carrier gas in gas chromatography coupled to standard detectors such as ECD or FID, its use is not mentioned extensively in the literature concerning gas chromatography-ion trap mass spectrometry. However, it is worth considering as a possibility because of its chromatographic advantages and its advantageous price when using a hydrogen generator. Copyright 2001 John Wiley & Sons, Ltd.

The Researches on Reasonable Well Spacing of Gas Wells in Deep and low Permeability Gas Reservoirs

NASA Astrophysics Data System (ADS)

Bei, Yu Bei; Hui, Li; Lin, Li Dong

2018-06-01

This Gs64 gas reservoir is a condensate gas reservoir which is relatively integrated with low porosity and low permeability found in Dagang Oilfield in recent years. The condensate content is as high as 610g/m3. At present, there are few reports about the well spacing of similar gas reservoirs at home and abroad. Therefore, determining the reasonable well spacing of the gas reservoir is important for ensuring the optimal development effect and economic benefit of the gas field development. This paper discusses the reasonable well spacing of the deep and low permeability gas reservoir from the aspects of percolation mechanics, gas reservoir engineering and numerical simulation. considering there exist the start-up pressure gradient in percolation process of low permeability gas reservoir, this paper combined with productivity equation under starting pressure gradient, established the formula of gas well spacing with the formation pressure and start-up pressure gradient. The calculation formula of starting pressure gradient and well spacing of gas wells. Adopting various methods to calculate values of gas reservoir spacing are close to well testing' radius, so the calculation method is reliable, which is very important for the determination of reasonable well spacing in low permeability gas reservoirs.

Demonstrating the Gas Laws.

ERIC Educational Resources Information Center

Holko, David A.

1982-01-01

Presents a complete computer program demonstrating the relationship between volume/pressure for Boyle's Law, volume/temperature for Charles' Law, and volume/moles of gas for Avagadro's Law. The programing reinforces students' application of gas laws and equates a simulated moving piston to theoretical values derived using the ideal gas law.…

Hazard Assessment Computer System HACS/UIM Users’ Operation Manual. Volume II.

DTIC Science & Technology

1981-09-01

AMMONIUM OXALATE FAS FERROUS AMMONIUM SULFATE FCL FERRIC CHLORIDE FCP FERRIC GLYCEROPHOSPHATE FEC FERROUS CHLORIDE FFA FURFURAL FFB FERROUS FLUOROBORATE...FAL FFA FFBi FMA FNS FSA FSL FXX BAK GAT SAY SCM GCR GCS SOC SOS SPL SRF GSR STA J-2 HAC HAI HAL HEIR HCC HCL HCN HDC HE’S HDZ HFA HFX HMD HMI HPA...ENP EOEI EOP EOT EPC ETA ETC ETD ETf3 ETI FAL FFA FFB FMA FMS VSL OCR GOS GIA MAC HAI HCL Ht’Z HFA HMD HMI HPA HPdkt HPO HSS HXG IAA IAC IAL IAN IBR

Plumbing of hospital premises is a reservoir for opportunistically pathogenic microorganisms: a review.

PubMed

Williams, Margaret M; Armbruster, Catherine R; Arduino, Matthew J

2013-01-01

Several bacterial species that are natural inhabitants of potable water distribution system biofilms are opportunistic pathogens important to sensitive patients in healthcare facilities. Waterborne healthcare-associated infections (HAI) may occur during the many uses of potable water in the healthcare environment. Prevention of infection is made more challenging by lack of data on infection rate and gaps in understanding of the ecology, virulence, and infectious dose of these opportunistic pathogens. Some healthcare facilities have been successful in reducing infections by following current water safety guidelines. This review describes several infections, and remediation steps that have been implemented to reduce waterborne HAIs.

Advanced Control System Increases Helicopter Safety

NASA Technical Reports Server (NTRS)

2008-01-01

With support and funding from a Phase II NASA SBIR project from Ames Research Center, Hoh Aeronautics Inc. (HAI), of Lomita, California, produced HeliSAS, a low-cost, lightweight, attitude-command-attitude-hold stability augmentation system (SAS) for civil helicopters and unmanned aerial vehicles. HeliSAS proved itself in over 160 hours of flight testing and demonstrations in a Robinson R44 Raven helicopter, a commercial helicopter popular with news broadcasting and police operations. Chelton Flight Systems, of Boise, Idaho, negotiated with HAI to develop, market, and manufacture HeliSAS, now available as the Chelton HeliSAS Digital Helicopter Autopilot.

Compressed sodium chloride as a fast-acting antimicrobial surface: results of a pilot study.

PubMed

Whitlock, B D; Smith, S W

2016-10-01

Antimicrobial surfaces are currently being studied as an aid to reduce transmission of pathogens leading to healthcare-associated infections (HAIs). Among the most harmful and costly pathogens that cause HAIs is meticillin-resistant Staphylococcus aureus (MRSA). Currently available and previously investigated antimicrobial surface technologies that are effective against MRSA (e.g. copper alloy surfaces) take 30min to several hours to achieve significant reduction. This article presents a new antimicrobial surface technology made of compressed sodium chloride that reduces MRSA 20-30 times faster than copper alloy surfaces. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Health care-associated infection outbreaks in pediatric long-term care facilities.

PubMed

Murray, Meghan T; Pavia, Marianne; Jackson, Olivia; Keenan, Mary; Neu, Natalie M; Cohen, B; Saiman, Lisa; Larson, Elaine L

2015-07-01

Children in pediatric long-term care facilities (pLTCFs) have complex medical conditions and increased risk for health care-associated infections (HAIs). We performed a retrospective study from January 2010-December 2013 at 3 pLTCFs to describe HAI outbreaks and associated infection control interventions. There were 62 outbreaks involving 700 cases in residents and 250 cases in staff. The most common interventions were isolation precautions and education and in-services. Further research should examine interventions to limit transmission of infections in pLTCFs. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Greenhouse gas impacts of natural gas: Influence of deployment choice, methane leak rate, and methane GWP

NASA Astrophysics Data System (ADS)

Cohan, D. S.

2015-12-01

Growing supplies of natural gas have heightened interest in the net impacts of natural gas on climate. Although its production and consumption result in greenhouse gas emissions, natural gas most often substitutes for other fossil fuels whose emission rates may be higher. Because natural gas can be used throughout the sectors of the energy economy, its net impacts on greenhouse gas emissions will depend not only on the leak rates of production and distribution, but also on the use for which natural gas is substituted. Here, we present our estimates of the net greenhouse gas emissions impacts of substituting natural gas for other fossil fuels for five purposes: light-duty vehicles, transit buses, residential heating, electricity generation, and export for electricity generation overseas. Emissions are evaluated on a fuel cycle basis, from production and transport of each fuel through end use combustion, based on recent conditions in the United States. We show that displacement of existing coal-fired electricity and heating oil furnaces yield the largest reductions in emissions. The impact of compressed natural gas replacing petroleum-based vehicles is highly uncertain, with the sign of impact depending on multiple assumptions. Export of liquefied natural gas for electricity yields a moderate amount of emissions reductions. We further show how uncertainties in upstream emission rates for natural gas and in the global warming potential of methane influence the net greenhouse gas impacts. Our presentation will make the case that how natural gas is deployed is crucial to determining how it will impact climate.