Thorlund, Kristian; Druyts, Eric; Wu, Ping; Balijepalli, Chakrapani; Keohane, Denis; Mills, Edward
2015-05-01
To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. Systematic review and network meta-analysis. Individuals aged 60 and older. Data on partial response (defined as at least 50% reduction in depression score from baseline) and safety (dizziness, vertigo, syncope, falls, loss of consciousness) were extracted. A Bayesian network meta-analysis was performed on the efficacy and safety outcomes, and relative risks (RRs) with 95% credible intervals (CrIs) were produced. Fifteen randomized controlled trials were eligible for inclusion in the analysis. Citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, fluoxetine, and sertraline were represented. Reporting on partial response and dizziness was sufficient to conduct a network meta-analysis. Reporting on other outcomes was sparse. For partial response, sertraline (RR=1.28), paroxetine (RR=1.48), and duloxetine (RR=1.62) were significantly better than placebo. The remaining interventions yielded RRs lower than 1.20. For dizziness, duloxetine (RR=3.18) and venlafaxine (RR=2.94) were statistically significantly worse than placebo. Compared with placebo, sertraline had the lowest RR for dizziness (1.14) and fluoxetine the second lowest (1.31). Citalopram, escitalopram, and paroxetine all had RRs between 1.4 and 1.7. There was clear evidence of the effectiveness of sertraline, paroxetine, and duloxetine. There also appears to be a hierarchy of safety associated with the different antidepressants, although there appears to be a dearth of reporting of safety outcomes. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.
MacDonald, Shannon E; Schopflocher, Donald P; Vaudry, Wendy
2014-01-01
Children who begin but do not fully complete the recommended series of childhood vaccines by 2 y of age are a much larger group than those who receive no vaccines. While parents who refuse all vaccines typically express concern about vaccine safety, it is critical to determine what influences parents of 'partially' immunized children. This case-control study examined whether parental concern about vaccine safety was responsible for partial immunization, and whether other personal or system-level factors played an important role. A random sample of parents of partially and completely immunized 2 y old children were selected from a Canadian regional immunization registry and completed a postal survey assessing various personal and system-level factors. Unadjusted odds ratios (OR) and adjusted ORs (aOR) were calculated with logistic regression. While vaccine safety concern was associated with partial immunization (OR 7.338, 95% CI 4.138-13.012), other variables were more strongly associated and reduced the strength of the relationship between concern and partial immunization in multivariable analysis (aOR 2.829, 95% CI 1.151-6.957). Other important factors included perceived disease susceptibility and severity (aOR 4.629, 95% CI 2.017-10.625), residential mobility (aOR 3.908, 95% CI 2.075-7.358), daycare use (aOR 0.310, 95% CI 0.144-0.671), number of needles administered at each visit (aOR 7.734, 95% CI 2.598-23.025) and access to a regular physician (aOR 0.219, 95% CI 0.057-0.846). While concern about vaccine safety may be addressed through educational strategies, this study suggests that additional program and policy-level strategies may positively impact immunization uptake.
Partial least squares models for hyperspectral contaminant detection
USDA-ARS?s Scientific Manuscript database
The United States of America food supply is one of the safest in the world. However, it is not free of pathogens. For the poultry industry, the Food Safety Inspection Service (FSIS) has regulatory responsiblity for food safety and has established a hazard analysis, critical control point system (HAC...
Boma Muteb, P; Kaluila Mamba, J F J; Muhau Pfutila, P; Bilo, V; Panda Mulefu, J D; Diallo, D A
2017-11-01
The partial exchange transfusions necessary for management of some sickle-cell complications raise the issue of effectiveness in the context of limited resources and inadequate blood safety. This study evaluated the effectiveness, safety, and cost of partial exchange transfusions in 39 patients with sickle-cell anemia in Lubumbashi, looking at the patients' age and gender and the tolerability and direct cost of the transfusions. Excel and SPSS 18 were used for data entry and analysis. Chi2 and Fisher exact tests were used for comparisons. A P-value ≤ 5% was considered statistically significant. The average age of patients was 8.6 ± 6.4 years, and the majority were girls. The most frequent indications were stroke, severe infections, severe vasooclusive crises, and acute chest syndrome. Partial exchange transfusions were effective in improving hemoglobin and hematocrit as well as the percentage of HbS. No acute accident was observed during any partial exchange transfusion; one anti-Kell alloimmunization and 2 cases of iron overload were observed. The annual cost of partial exchange transfusions per patient requiring (and able to afford) regular treatment was US $ 3,345 without iron chelation and more than US $ 5000 with chelation. Partial exchange transfusions are effective and tolerated, but financially inaccessible to the majority of our sickle cell patients. Thus, an assessment is needed of the economic burden of sickle cell complications that require partial exchange transfusions in the context of countries with limited financial resources.
NASA Astrophysics Data System (ADS)
He, Shixuan; Xie, Wanyi; Zhang, Wei; Zhang, Liqun; Wang, Yunxia; Liu, Xiaoling; Liu, Yulong; Du, Chunlei
2015-02-01
A novel strategy which combines iteratively cubic spline fitting baseline correction method with discriminant partial least squares qualitative analysis is employed to analyze the surface enhanced Raman scattering (SERS) spectroscopy of banned food additives, such as Sudan I dye and Rhodamine B in food, Malachite green residues in aquaculture fish. Multivariate qualitative analysis methods, using the combination of spectra preprocessing iteratively cubic spline fitting (ICSF) baseline correction with principal component analysis (PCA) and discriminant partial least squares (DPLS) classification respectively, are applied to investigate the effectiveness of SERS spectroscopy for predicting the class assignments of unknown banned food additives. PCA cannot be used to predict the class assignments of unknown samples. However, the DPLS classification can discriminate the class assignment of unknown banned additives using the information of differences in relative intensities. The results demonstrate that SERS spectroscopy combined with ICSF baseline correction method and exploratory analysis methodology DPLS classification can be potentially used for distinguishing the banned food additives in field of food safety.
Dental Laboratory Career Ladder (AFSC 4Y1X1)
1994-08-01
analysis identified one job cluster and seven jobs: Base Dental Lab cluster, Orthodontic Appliance Fabricator job, Fixed Restoration Fabricator job, Crown...reline and repair, removable partial denture construction, crown and fixed partial denture construction, fabrication of orthodontic appliances, and...specialized prostheses. Preventive maintenance and safety precautions for dental laboratory equipment are also stressed . Entry into the career ladder
He, Shixuan; Xie, Wanyi; Zhang, Wei; Zhang, Liqun; Wang, Yunxia; Liu, Xiaoling; Liu, Yulong; Du, Chunlei
2015-02-25
A novel strategy which combines iteratively cubic spline fitting baseline correction method with discriminant partial least squares qualitative analysis is employed to analyze the surface enhanced Raman scattering (SERS) spectroscopy of banned food additives, such as Sudan I dye and Rhodamine B in food, Malachite green residues in aquaculture fish. Multivariate qualitative analysis methods, using the combination of spectra preprocessing iteratively cubic spline fitting (ICSF) baseline correction with principal component analysis (PCA) and discriminant partial least squares (DPLS) classification respectively, are applied to investigate the effectiveness of SERS spectroscopy for predicting the class assignments of unknown banned food additives. PCA cannot be used to predict the class assignments of unknown samples. However, the DPLS classification can discriminate the class assignment of unknown banned additives using the information of differences in relative intensities. The results demonstrate that SERS spectroscopy combined with ICSF baseline correction method and exploratory analysis methodology DPLS classification can be potentially used for distinguishing the banned food additives in field of food safety. Copyright © 2014 Elsevier B.V. All rights reserved.
Li, Ye; Wang, Wei; Xing, Lu; Fan, Qi; Wang, Hao
2018-02-01
As an environment friendly transportation mode, the electric vehicle (EV) has drawn an increasing amount of attention from governments, vehicle manufactories and researchers recently. One of the biggest issue impeding EV's popularization associates with the charging process. The wireless charging lane (WCL) has been proposed as a convenient charging facility for EVs. Due to the high costs, the application of WCL on the entire freeways is impractical in the near future, while the partial WCL (PWCL) may be a feasible solution. This study aims to evaluate longitudinal safety of EVs with PWCL on freeways based on simulations. The simulation experiments are firstly designed, including deployment of PWCL on freeways and distribution of state of charge (SOC) of EVs. Then, a vehicle behavior model for EVs is proposed based on the intelligent driver model (IDM). Two surrogate safety measures, derived from time-to-collision (TTC), are utilized as indicators for safety evaluations. Sensitivity analysis is also conducted for related factors. Results show that the distribution of EVs' SOC significantly affect longitudinal safety when the PWCL is utilized. The low SOC in traffic consisting of EVs has the negative effect on longitudinal safety. The randomness and incompliance of EV drivers worsens the safety performance. The sensitivity analysis indicates that the larger maximum deceleration rate results in the higher longitudinal crash risks of EVs, while the length of PWCL has no monotonous effect. Different TTC thresholds also show no impact on results. A case study shows the consistent results. Based on the findings, several suggestions are discussed for EVs' safety improvement. Results of this study provide useful information for freeway safety when EVs are applied in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.
Transformer partial discharge monitoring based on optical fiber sensing
NASA Astrophysics Data System (ADS)
Wang, Kun; Tong, Xinglin; Zhu, Xiaolong
2014-06-01
The power transformer is the most important equipment of the high voltage power grid, however, some traditional methods of online partial discharge monitoring have some limitations. Based on many advantages of the optical fiber sensing technology, we have done some research on fiber optics Fabry-Perot (FP) sensing which can be useful for the transformer on online partial discharge monitoring. This research aimed at improving the reliability of power system safety monitoring. We have done some work as follows: designing a set for fiber optics FP sensor preparation, according to the fabrication procedure strictly making out the sensors, building a reasonable signal demodulation system for fiber optics FP sensing, doing a preliminary analysis about online partial discharge signal monitoring, including the research on different discharge intensities with the same measuring distance and different measuring distances with the same discharge intensity, and then making a detailed analysis of the experimental results.
Gao, Ran; Chan, Albert P.C.; Utama, Wahyudi P.; Zahoor, Hafiz
2016-01-01
The character of construction projects exposes front-line workers to dangers and accidents. Safety climate has been confirmed to be a predictor of safety performance in the construction industry. This study aims to explore the underlying mechanisms of the relationship between multilevel safety climate and safety performance. An integrated model was developed to study how particular safety climate factors of one level affect those of other levels, and then affect safety performance from the top down. A questionnaire survey was administered on six construction sites in Vietnam. A total of 1030 valid questionnaires were collected from this survey. Approximately half of the data were used to conduct exploratory factor analysis (EFA) and the remaining data were submitted to structural equation modeling (SEM). Top management commitment (TMC) and supervisors’ expectation (SE) were identified as factors to represent organizational safety climate (OSC) and supervisor safety climate (SSC), respectively, and coworkers’ caring and communication (CCC) and coworkers’ role models (CRM) were identified as factors to denote coworker safety climate (CSC). SEM results show that OSC factor is positively related to SSC factor and CSC factors significantly. SSC factor could partially mediate the relationship between OSC factor and CSC factors, as well as the relationship between OSC factor and safety performance. CSC factors partially mediate the relationship between OSC factor and safety performance, and the relationship between SSC factor and safety performance. The findings imply that a positive safety culture should be established both at the organizational level and the group level. Efforts from all top management, supervisors, and coworkers should be provided to improve safety performance in the construction industry. PMID:27834823
Gao, Ran; Chan, Albert P C; Utama, Wahyudi P; Zahoor, Hafiz
2016-11-08
The character of construction projects exposes front-line workers to dangers and accidents. Safety climate has been confirmed to be a predictor of safety performance in the construction industry. This study aims to explore the underlying mechanisms of the relationship between multilevel safety climate and safety performance. An integrated model was developed to study how particular safety climate factors of one level affect those of other levels, and then affect safety performance from the top down. A questionnaire survey was administered on six construction sites in Vietnam. A total of 1030 valid questionnaires were collected from this survey. Approximately half of the data were used to conduct exploratory factor analysis (EFA) and the remaining data were submitted to structural equation modeling (SEM). Top management commitment (TMC) and supervisors' expectation (SE) were identified as factors to represent organizational safety climate (OSC) and supervisor safety climate (SSC), respectively, and coworkers' caring and communication (CCC) and coworkers' role models (CRM) were identified as factors to denote coworker safety climate (CSC). SEM results show that OSC factor is positively related to SSC factor and CSC factors significantly. SSC factor could partially mediate the relationship between OSC factor and CSC factors, as well as the relationship between OSC factor and safety performance. CSC factors partially mediate the relationship between OSC factor and safety performance, and the relationship between SSC factor and safety performance. The findings imply that a positive safety culture should be established both at the organizational level and the group level. Efforts from all top management, supervisors, and coworkers should be provided to improve safety performance in the construction industry.
Can Leader–Member Exchange Contribute to Safety Performance in An Italian Warehouse?
Mariani, Marco G.; Curcuruto, Matteo; Matic, Mirna; Sciacovelli, Paolo; Toderi, Stefano
2017-01-01
Introduction: The research considers safety climate in a warehouse and wants to analyze the Leader–Member Exchange (LMX) role in respect to safety performance. Griffin and Neal’s safety model was adopted and Leader-Member Exchange was inserted as moderator in the relationships between safety climate and proximal antecedents (motivation and knowledge) of safety performance constructs (compliance and participation). Materials and Methods: Survey data were collected from a sample of 133 full-time employees in an Italian warehouse. The statistical framework of Hayes (2013) was adopted for moderated mediation analysis. Results: Proximal antecedents partially mediated the relationship between Safety climate and safety participation, but not safety compliance. Moreover, the results from the moderation analysis showed that the Leader–Member Exchange moderated the influence of safety climate on proximal antecedents and the mediation exist only at the higher level of LMX. Conclusion: The study shows that the different aspects of leadership processes interact in explaining individual proficiency in safety practices. Practical Implications: Organizations as warehouses should improve the quality of the relationship between a leader and a subordinate based upon the dimensions of respect, trust, and obligation for high level of safety performance. PMID:28553244
Can Leader-Member Exchange Contribute to Safety Performance in An Italian Warehouse?
Mariani, Marco G; Curcuruto, Matteo; Matic, Mirna; Sciacovelli, Paolo; Toderi, Stefano
2017-01-01
Introduction: The research considers safety climate in a warehouse and wants to analyze the Leader-Member Exchange (LMX) role in respect to safety performance. Griffin and Neal's safety model was adopted and Leader-Member Exchange was inserted as moderator in the relationships between safety climate and proximal antecedents (motivation and knowledge) of safety performance constructs (compliance and participation). Materials and Methods: Survey data were collected from a sample of 133 full-time employees in an Italian warehouse. The statistical framework of Hayes (2013) was adopted for moderated mediation analysis. Results: Proximal antecedents partially mediated the relationship between Safety climate and safety participation, but not safety compliance. Moreover, the results from the moderation analysis showed that the Leader-Member Exchange moderated the influence of safety climate on proximal antecedents and the mediation exist only at the higher level of LMX. Conclusion: The study shows that the different aspects of leadership processes interact in explaining individual proficiency in safety practices. Practical Implications: Organizations as warehouses should improve the quality of the relationship between a leader and a subordinate based upon the dimensions of respect, trust, and obligation for high level of safety performance.
Partial Discharge Ultrasound Detection Using the Sagnac Interferometer System
Li, Xiaomin; Gao, Yan; Zhang, Hongjuan; Wang, Dong; Jin, Baoquan
2018-01-01
Partial discharge detection is crucial for electrical cable safety evaluation. The ultrasonic signals frequently generated in the partial discharge process contains important characteristic information. However, traditional ultrasonic transducers are easily subject to strong electromagnetic interference in environments with high voltages and strong magnetic fields. In order to overcome this problem, an optical fiber Sagnac interferometer system is proposed for partial discharge ultrasound detection. Optical fiber sensing and time-frequency analysis of the ultrasonic signals excited by the piezoelectric ultrasonic transducer is realized for the first time. The effective frequency band of the Sagnac interferometer system was up to 175 kHz with the help of a designed 10 kV partial discharge simulator device. Using the cumulative histogram method, the characteristic ultrasonic frequency band of the partial discharges was between 28.9 kHz and 57.6 kHz for this optical fiber partial discharge detection system. This new ultrasound sensor can be used as an ideal ultrasonic source for the intrinsically safe detection of partial discharges in an explosive environment. PMID:29734682
ERIC Educational Resources Information Center
Alvero, Alicia M.; Struss, Kristen; Rappaport, Eva
2008-01-01
Partial-interval (PIR), whole-interval (WIR), and momentary time sampling (MTS) estimates were compared against continuous measures of safety performance for three postural behaviors: feet, back, and shoulder position. Twenty-five samples of safety performance across five undergraduate students were scored using a second-by-second continuous…
Detection of incipient defects in cables by partial discharge signal analysis
NASA Astrophysics Data System (ADS)
Martzloff, F. D.; Simmon, E.; Steiner, J. P.; Vanbrunt, R. J.
1992-07-01
As one of the objectives of a program aimed at assessing test methods for in-situ detection of incipient defects in cables due to aging, a laboratory test system was implemented to demonstrate that the partial discharge analysis method can be successfully applied to low-voltage cables. Previous investigations generally involved cables rated 5 kV or higher, while the objective of the program focused on the lower voltages associated with the safety systems of nuclear power plants. The defect detection system implemented for the project was based on commercially available signal analysis hardware and software packages, customized for the specific purposes of the project. The test specimens included several cables of the type found in nuclear power plants, including artificial defects introduced at various points of the cable. The results indicate that indeed, partial discharge analysis is capable of detecting incipient defects in low-voltage cables. There are, however, some limitations of technical and non-technical nature that need further exploration before this method can be accepted in the industry.
Alolah, Turki; Stewart, Rodney A; Panuwatwanich, Kriengsak; Mohamed, Sherif
2014-07-01
In the public schools of many developing countries, numerous accidents and incidents occur because of poor safety regulations and management systems. To improve the educational environment in Saudi Arabia, the Ministry of Education seeks novel approaches to measure school safety performance in order to decrease incidents and accidents. The main objective of this research was to develop a systematic approach for measuring Saudi school safety performance using the balanced scorecard framework philosophy. The evolved third generation balanced scorecard framework is considered to be a suitable and robust framework that captures the system-wide leading and lagging indicators of business performance. The balanced scorecard architecture is ideal for adaptation to complex areas such as safety management where a holistic system evaluation is more effective than traditional compartmentalised approaches. In developing the safety performance balanced scorecard for Saudi schools, the conceptual framework was first developed and peer-reviewed by eighteen Saudi education experts. Next, 200 participants, including teachers, school executives, and Ministry of Education officers, were recruited to rate both the importance and the performance of 79 measurement items used in the framework. Exploratory factor analysis, followed by the confirmatory partial least squares method, was then conducted in order to operationalise the safety performance balanced scorecard, which encapsulates the following five salient perspectives: safety management and leadership; safety learning and training; safety policy, procedures and processes; workforce safety culture; and safety performance. Partial least squares based structural equation modelling was then conducted to reveal five significant relationships between perspectives, namely, safety management and leadership had a significant effect on safety learning and training and safety policy, procedures and processes, both safety learning and training and safety policy, procedures and processes had significant effects on workforce safety culture, and workforce safety culture had a significant effect on safety performance. Copyright © 2014 Elsevier Ltd. All rights reserved.
Systematic impact of institutional pressures on safety climate in the construction industry.
He, Qinghua; Dong, Shuang; Rose, Timothy; Li, Heng; Yin, Qin; Cao, Dongping
2016-08-01
This paper explores how three types of institutional pressure (i.e., coercive, mimetic and normative pressures) systematically impact on the safety climate of construction projects. These impacts are empirically tested by survey data collected from 186 questionnaires of construction companies operating in Shanghai, China. The results, obtained by partial least squares analysis, show that organizational management commitment to safety and employee involvement is positively related to all three institutional pressures, while the perception of responsibility for safety and health is significantly influenced by coercive and mimetic pressure. However, coercive and normative pressures have no significant effect on the applicability of safety rules and work practices, revealing the importance of external organizational pressures in improving project safety climate from a systematic view. The findings also provide insights into the use of institutional forces to facilitate the improvement of safety climate in the construction industry. Copyright © 2015 Elsevier Ltd. All rights reserved.
Relationship between locked modes and thermal quenches in DIII-D
NASA Astrophysics Data System (ADS)
Sweeney, R.; Choi, W.; Austin, M.; Brookman, M.; Izzo, V.; Knolker, M.; La Haye, R. J.; Leonard, A.; Strait, E.; Volpe, F. A.; The DIII-D Team
2018-05-01
Locked modes are known to be one of the major causes of disruptions, but the physical mechanisms by which locking leads to disruptions are not well understood. Here we analyze the evolution of the temperature profile in the presence of multiple coexisting locked modes during partial and full thermal quenches. Partial quenches are often observed to be an initial, distinct stage in the full thermal quench. Near the onset of partial quenches, locked island O-points are observed to align with each other on the midplane, and their widths are sufficient to overlap each other, as indicated by the Chirikov parameter. Energy conservation analysis of one partial thermal quench shows that the energy lost is both radiated in the divertor region, and conducted or convected to the divertor. Nonlinear resistive magnetohydrodynamic simulations support the interpretation of stochastic fields causing a partial axisymmetric collapse, though the simulated temperature profile exhibits less degradation than the experimental profiles. In discharges with minimum values of the safety factor above ∼1.2, locked modes are observed to self-stabilize by inducing, possibly via double tearing modes, a minor disruption that removes their neoclassical drive. These high q min discharges often exhibit relatively low ratios of the plasma internal inductance to the safety factor at 95% of the poloidal flux, which might imply classical stability, in agreement with the decay of the mode when the neoclassical drive is removed.
Safety assessment for the postictal confusional phase following complex partial seizure.
Tucker, C
1985-06-01
Misunderstanding of the postictal confusional state that follows the complex partial seizure has caused emotional and physical harm to patients. Concern about this phenomenon and its effects upon the patient prompted this study to explore, describe, and document one method of intervention to lessen these harmful effects. An evaluative descriptive research design was employed to assess patient safety during and after the postictal confusional phase following a complex partial seizure. A closed-structured questionnaire and participant observation were the methods used to collect data for this study. A Level of Safety Tool was specifically designed for this study.
PARTIAL RESTRAINING FORCE INTRODUCTION METHOD FOR DESIGNING CONSTRUCTION COUNTERMESURE ON ΔB METHOD
NASA Astrophysics Data System (ADS)
Nishiyama, Taku; Imanishi, Hajime; Chiba, Noriyuki; Ito, Takao
Landslide or slope failure is a three-dimensional movement phenomenon, thus a three-dimensional treatment makes it easier to understand stability. The ΔB method (simplified three-dimensional slope stability analysis method) is based on the limit equilibrium method and equals to an approximate three-dimensional slope stability analysis that extends two-dimensional cross-section stability analysis results to assess stability. This analysis can be conducted using conventional spreadsheets or two-dimensional slope stability computational software. This paper describes the concept of the partial restraining force in-troduction method for designing construction countermeasures using the distribution of the restraining force found along survey lines, which is based on the distribution of survey line safety factors derived from the above-stated analysis. This paper also presents the transverse distributive method of restraining force used for planning ground stabilizing on the basis of the example analysis.
Near real-time vaccine safety surveillance with partially accrued data.
Greene, Sharon K; Kulldorff, Martin; Yin, Ruihua; Yih, W Katherine; Lieu, Tracy A; Weintraub, Eric S; Lee, Grace M
2011-06-01
The Vaccine Safety Datalink (VSD) Project conducts near real-time vaccine safety surveillance using sequential analytic methods. Timely surveillance is critical in identifying potential safety problems and preventing additional exposure before most vaccines are administered. For vaccines that are administered during a short period, such as influenza vaccines, timeliness can be improved by undertaking analyses while risk windows following vaccination are ongoing and by accommodating predictable and unpredictable data accrual delays. We describe practical solutions to these challenges, which were adopted by the VSD Project during pandemic and seasonal influenza vaccine safety surveillance in 2009/2010. Adjustments were made to two sequential analytic approaches. The Poisson-based approach compared the number of pre-defined adverse events observed following vaccination with the number expected using historical data. The expected number was adjusted for the proportion of the risk window elapsed and the proportion of inpatient data estimated to have accrued. The binomial-based approach used a self-controlled design, comparing the observed numbers of events in risk versus comparison windows. Events were included in analysis only if they occurred during a week that had already passed for both windows. Analyzing data before risk windows fully elapsed improved the timeliness of safety surveillance. Adjustments for data accrual lags were tailored to each data source and avoided biasing analyses away from detecting a potential safety problem, particularly early during surveillance. The timeliness of vaccine and drug safety surveillance can be improved by properly accounting for partially elapsed windows and data accrual delays. Copyright © 2011 John Wiley & Sons, Ltd.
Ye, Mei-na; Yang, Ming; Cheng, Yi-qin; Wang, Bing; Zhu, Ying; Xia, Ya-ru; Meng, Tian; Chen, Hao; Chen, Li-ying; Cheng, Hong-feng
2015-04-01
To evaluate the safety and the clinical value of external use of jiuyi Powder (JP) in treating plasma cell mastitis using partial least-squares discriminant analysis (PLSDA). Totally 50 patients with plasma cell mastitis treated by external use of JP were observed and biochemical examinations of blood and urine detected before application, at day 4 after application, at day 1 and 14 after discontinuation. Blood mercury and urinary mercury were detected before application, at day 1, 4, and 7 after application, at day 1 and 14 after discontinuation. Urinary mercury was also detected at 28 after discontinuation and 3 months after discontinuation. The information of wound, days of external application and the total dosage of external application were recorded before application, at day 1, 4, and 7 after application, as well as at day 1 after discontinuation. Then a discriminant model covering potential safety factors was set up by PLSDA after screening safety indices with important effects. The applicability of the model was assessed using area under ROC curve. Potential safety factors were assessed using variable importance in the projection (VIP). Urinary β2-microglobulin (β2-MG), urinary N-acetyl-β-D-glucosaminidase (NAG), 24 h urinary protein, and urinary α1-microglobulin (α1-MG) were greatly affected by external use of JP in treating plasma cell mastitis. The accuracy rate of PLSDA discriminate model was 74. 00%. The sensitivity, specificity, and the area under ROC curve was 0. 7826, 0. 7037, and 0. 8084, respectively. Three factors with greater effect on the potential safety were screened as follows: pre-application volume of the sore cavity, days of external application, and the total dosage of external application. PLSDA method could be used in analyzing bioinformation of clinical Chinese medicine. Urinary β2-MG and urinary NAG were two main safety monitoring indices. Days of external application and the total dosage of external application were main factors influencing blood mercury and urine mercury. A safety classification simulation model of treating plasma cell mastitis by external therapy of JP was established by the two factors, which could be used to assess the safety of external application of JP to some extent.
29 CFR 1952.6 - Partial approval of State plans.
Code of Federal Regulations, 2010 CFR
2010-07-01
... requirements of part 1902; (2) The plan covers more than one occupational safety and health issue; and (3... 29 Labor 9 2010-07-01 2010-07-01 false Partial approval of State plans. 1952.6 Section 1952.6 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION...
29 CFR 1952.6 - Partial approval of State plans.
Code of Federal Regulations, 2011 CFR
2011-07-01
... requirements of part 1902; (2) The plan covers more than one occupational safety and health issue; and (3... 29 Labor 9 2011-07-01 2011-07-01 false Partial approval of State plans. 1952.6 Section 1952.6 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION...
Relationship between locked modes and thermal quenches in DIII-D
Sweeney, R.; Choi, W.; Austin, M.; ...
2018-03-28
Locked modes are known to be one of the major causes of disruptions, but the physical mechanisms by which locking leads to disruptions are not well understood. For this study, we analyze the evolution of the temperature profile in the presence of multiple coexisting locked modes during partial and full thermal quenches. Partial quenches are often observed to be an initial, distinct stage in the full thermal quench. Near the onset of partial quenches, locked island O-points are observed to align with each other on the midplane, and their widths are sufficient to overlap each other, as indicated by themore » Chirikov parameter. Energy conservation analysis of one partial thermal quench shows that the energy lost is both radiated in the divertor region, and conducted or convected to the divertor. Nonlinear resistive magnetohydrodynamic simulations support the interpretation of stochastic fields causing a partial axisymmetric collapse, though the simulated temperature profile exhibits less degradation than the experimental profiles. In discharges with minimum values of the safety factor above ~1.2, locked modes are observed to self-stabilize by inducing, possibly via double tearing modes, a minor disruption that removes their neoclassical drive. These high q min discharges often exhibit relatively low ratios of the plasma internal inductance to the safety factor at 95% of the poloidal flux, which might imply classical stability, in agreement with the decay of the mode when the neoclassical drive is removed.« less
Relationship between locked modes and thermal quenches in DIII-D
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sweeney, R.; Choi, W.; Austin, M.
Locked modes are known to be one of the major causes of disruptions, but the physical mechanisms by which locking leads to disruptions are not well understood. For this study, we analyze the evolution of the temperature profile in the presence of multiple coexisting locked modes during partial and full thermal quenches. Partial quenches are often observed to be an initial, distinct stage in the full thermal quench. Near the onset of partial quenches, locked island O-points are observed to align with each other on the midplane, and their widths are sufficient to overlap each other, as indicated by themore » Chirikov parameter. Energy conservation analysis of one partial thermal quench shows that the energy lost is both radiated in the divertor region, and conducted or convected to the divertor. Nonlinear resistive magnetohydrodynamic simulations support the interpretation of stochastic fields causing a partial axisymmetric collapse, though the simulated temperature profile exhibits less degradation than the experimental profiles. In discharges with minimum values of the safety factor above ~1.2, locked modes are observed to self-stabilize by inducing, possibly via double tearing modes, a minor disruption that removes their neoclassical drive. These high q min discharges often exhibit relatively low ratios of the plasma internal inductance to the safety factor at 95% of the poloidal flux, which might imply classical stability, in agreement with the decay of the mode when the neoclassical drive is removed.« less
78 FR 11097 - Artificial Island Anchorage No. 2 Partial Closure, Delaware River; Salem, NJ
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-15
... 1625-AA00 Artificial Island Anchorage No. 2 Partial Closure, Delaware River; Salem, NJ AGENCY: Coast... safety zone around the southern portion of Anchorage 2 (Artificial Island Anchorage) below position 39... will cross the closed portion of the anchorage. This regulation is necessary to provide for the safety...
The role of leader influence tactics and safety climate in engaging employees' safety participation.
Clarke, Sharon; Ward, Katie
2006-10-01
This study examines the effect of leader influence tactics on employee safety participation in a U.K.-based manufacturing organization, examining the role of safety climate as a mediator. Structural equation modeling showed that leader influence tactics associated with a transformational leadership style had significant relationships with safety participation that were partially mediated by the safety climate (consultation) or fully mediated by the safety climate (inspirational appeals). In addition, leader influence tactics associated with a transactional leadership style had significant relationships with safety participation: rational persuasion (partially mediated by safety climate) and coalition tactics (direct effect). Thus, leaders may encourage safety participation using a combination of influence tactics, based on rational arguments, involvement in decision making, and generating enthusiasm for safety. The influence of building trust in managers is discussed as an underlying mechanism in this relationship. Practical implications are highlighted, including the design of leadership development programs, which may be particularly suited to high-reliability organizations.
French, JA; Baroldi, P; Brittain, ST; Johnson, JK
2014-01-01
Objective To evaluate the efficacy, tolerability, and safety of once-daily 1200 mg and 2400 mg SPN-804 (Oxtellar XR™, Supernus Pharmaceuticals), an extended-release tablet formulation of oxcarbazepine (OXC), added to 1-3 concomitant antiepileptic drugs (AEDs) in adults with refractory partial-onset seizures, with or without secondary generalization. Methods The Prospective, Randomized Study of OXC XR in Subjects with Partial Epilepsy Refractory (PROSPER) study was a multinational, randomized, double-blind, parallel-group Phase 3 study. The primary efficacy endpoint was median percent reduction from baseline in monthly (28-day) seizure frequency for the 16-week double-blind treatment period in the intent-to-treat (ITT) population with analyzable seizure data. Other efficacy analyses included proportion of patients with ≥ 50% seizure reduction, proportion of patients seizure free, and the relationship between clinical response and plasma concentration. Results Median percent reduction was -28.7% for placebo, −38.2% (P = 0.08 vs placebo) for once-daily SPN-804 1200 mg, and −42.9% (P = 0.003) for SPN-804 2400 mg. Responder rates were 28.1%, 36.1% (P = 0.08), and 40.7% (P = 0.02); 16-week seizure-free rates in a pragmatic ITT analysis were 3.3%, 4.9% (P = 0.59), and 11.4% (P = 0.008), respectively. When data were analyzed separately for study site clusters, a post hoc analysis demonstrated that both SPN-804 dosages were significantly superior to placebo in median percent seizure reduction (placebo: −13.3%; 1200 mg: −34.5%, P = 0.02; 2400 mg: −52.7%, P = 0.006) in the North American study site cluster. A concentration–response analysis also supported a clinically meaningful effect for 1200 mg. Adverse event types reflected the drug's established profile. Adverse event frequency was consistent with a pharmacokinetic profile in which SPN-804 produces lower peak plasma concentrations vs immediate-release OXC. Once-daily dosing was not associated with any new safety signals. Conclusions Adjunctive once-daily SPN-804 improved seizure control in patients with inadequately controlled partial-onset seizures. Adverse event occurrence and discontinuations due to adverse events suggest improved tolerability vs previously published data with immediate-release OXC. PMID:24359313
Uthman, Basim M; Bazil, Carl W; Beydoun, Ahmad; Schulze-Bonhage, Andreas; Benabou, Reina; Whalen, Ed; Emir, Birol; Griesing, Teresa; Leon, Teresa
2010-06-01
To evaluate the safety, tolerability, and efficacy of long-term pregabalin as add-on therapy for patients with poorly controlled partial seizures. Analysis of data from six long-term clinical trials involving 2,061 patients receiving open-label pregabalin 75-600 mg/day adjunctive therapy for partial onset epilepsy refractory to multiple antiepileptic drugs. Total pregabalin exposure was 3,877 person-years. The mean duration of pregabalin treatment was 534 days (range 0.3-8 years) and 59% completed 1 year. One-third of patients discontinued for lack of efficacy. The most common dose was >or=300 mg/day; over half took >or=450 mg/day. There was a mean reduction in the 28-day seizure rate of 25-40%, and more than 40% of all patients had a >or=50% reduction in seizures from baseline during the last 3 months of treatment. Twelve percent of all patients had a 6-month period continuously free of seizures. In the last year, 6% were seizure-free for the entire year. Pregabalin was generally well-tolerated and the safety profile favorable in patients treated for up to several years, with an adverse event (AE) profile similar to short-term placebo-controlled trials. Common AEs included CNS symptoms (dizziness, somnolence, headache, and asthenia), accidental injury, and weight gain. CNS AEs tended to be mild and transient. Rates of sudden unexpected death in epilepsy (SUDEP), mortality, cancer, and status epilepticus were within the expected range for this population. Adjunctive pregabalin was effective, generally well tolerated, and safe in the long-term treatment of partial seizures, and provided clinically meaningful seizure reduction and freedom without evidence of tolerance over 2 years of follow-up.
On Space Exploration and Human Error: A Paper on Reliability and Safety
NASA Technical Reports Server (NTRS)
Bell, David G.; Maluf, David A.; Gawdiak, Yuri
2005-01-01
NASA space exploration should largely address a problem class in reliability and risk management stemming primarily from human error, system risk and multi-objective trade-off analysis, by conducting research into system complexity, risk characterization and modeling, and system reasoning. In general, in every mission we can distinguish risk in three possible ways: a) known-known, b) known-unknown, and c) unknown-unknown. It is probably almost certain that space exploration will partially experience similar known or unknown risks embedded in the Apollo missions, Shuttle or Station unless something alters how NASA will perceive and manage safety and reliability
Development and applicability of Hospital Survey on Patient Safety Culture (HSOPS) in Japan.
Ito, Shinya; Seto, Kanako; Kigawa, Mika; Fujita, Shigeru; Hasegawa, Toshihiko; Hasegawa, Tomonori
2011-02-07
Patient safety culture at healthcare organizations plays an important role in guaranteeing, improving and promoting overall patient safety. Although several conceptual frameworks have been proposed in the past, no standard measurement tool has yet been developed for Japan. In order to examine possibilities to introduce the Hospital Survey on Patient Safety Culture (HSOPS) in Japan, the authors of this study translated the HSOPS into Japanese, and evaluated its factor structure, internal consistency, and construct validity. Healthcare workers (n = 6,395) from 13 acute care general hospitals in Japan participated in this survey. Confirmatory factor analysis indicated that the Japanese HSOPS' 12-factor model was selected as the most pertinent, and showed a sufficiently high standard partial regression coefficient. The internal reliability of the subscale scores was 0.46-0.88. The construct validity of each safety culture sub-dimension was confirmed by polychoric correlation, and by an ordered probit analysis. The results of the present study indicate that the factor structures of the Japanese and the American HSOPS are almost identical, and that the Japanese HSOPS has acceptable levels of internal reliability and construct validity. This shows that the HSOPS can be introduced in Japan.
Silla, Inmaculada; Navajas, Joaquin; Koves, G Kenneth
2017-06-01
A safety-conscious work environment allows high-reliability organizations to be proactive regarding safety and enables employees to feel free to report any concern without fear of retaliation. Currently, research on the antecedents to safety-conscious work environments is scarce. Structural equation modeling was applied to test the mediating role of employee communication satisfaction in the relationship between constructive culture and a safety-conscious work environment in several nuclear power plants. Employee communication satisfaction partially mediated the positive relationships between a constructive culture and a safety-conscious work environment. Constructive cultures in which cooperation, supportive relationships, individual growth and high performance are encouraged facilitate the establishment of a safety-conscious work environment. This influence is partially explained by increased employee communication satisfaction. Constructive cultures should be encouraged within organizations. In addition, managers should promote communication policies and practices that support a safety-conscious work environment. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.
Ren, Tong; Liu, Yan; Zhao, Xiaowen; Ni, Shaobin; Zhang, Cheng; Guo, Changgang; Ren, Minghua
2014-01-01
To compare the efficiency and safety of the transperitoneal approaches with retroperitoneal approaches in laparoscopic partial nephrectomy for renal cell carcinoma and provide evidence-based medicine support for clinical treatment. A systematic computer search of PUBMED, EMBASE, and the Cochrane Library was executed to identify retrospective observational and prospective randomized controlled trials studies that compared the outcomes of the two approaches in laparoscopic partial nephrectomy. Two reviewers independently screened, extracted, and evaluated the included studies and executed statistical analysis by using software STATA 12.0. Outcomes of interest included perioperative and postoperative variables, surgical complications and oncological variables. There were 8 studies assessed transperitoneal laparoscopic partial nephrectomy (TLPN) versus retroperitoneal laparoscopic partial nephrectomy (RLPN) were included. RLPN had a shorter operating time (SMD = 1.001,95%confidence interval[CI] 0.609-1.393,P<0.001), a lower estimated blood loss (SMD = 0.403,95%CI 0.015-0.791,P = 0.042) and a shorter length of hospital stay (WMD = 0.936 DAYS,95%CI 0.609-1.263,P<0.001) than TLPN. There were no significant differences between the transperitoneal and retroperitoneal approaches in other outcomes of interest. This meta-analysis indicates that, in appropriately selected patients, especially patients with intraperitoneal procedures history or posteriorly located renal tumors, the RLPN can shorten the operation time, reduce the estimated blood loss and shorten the length of hospital stay. RLPN may be equally safe and be faster compared with the TLPN.
Conversion to eslicarbazepine acetate monotherapy: A pooled analysis of 2 phase III studies.
Sperling, Michael R; French, Jacqueline; Jacobson, Mercedes P; Pazdera, Ladislav; Gough, Mallory; Cheng, Hailong; Grinnell, Todd; Blum, David
2016-03-22
To assess the efficacy and safety of eslicarbazepine acetate (ESL) monotherapy. This post hoc pooled analysis of 2 randomized double-blind studies (093-045 and -046) included adults with partial-onset seizures medically uncontrolled by 1 or 2 antiepileptic drugs (AEDs). Following the baseline period (8 weeks), eligible patients were randomized 2:1 to receive ESL 1,600 mg or 1,200 mg once daily for 18 weeks; the primary endpoint was study exit by meeting predefined exit criteria (signifying worsening seizure control). In each study, treatment was considered effective if the upper 95% confidence limit for exit rate was lower than the historical control threshold (65.3%). Pooled exit rates were as follows: ESL 1,600 mg = 20.6% (95% confidence interval: 15.6%-26.8%); ESL 1,200 mg = 30.8% (23.0%-40.5%). Use of 2 baseline AEDs or rescue medication, US location, epilepsy duration ≥20 years, and higher maximum baseline seizure frequency were associated with higher exit risks. Median percent reductions in standardized seizure frequency between baseline and the 18-week double-blind period were as follows: ESL 1,600 mg = 43.2%; ESL 1,200 mg = 35.7%; baseline carbamazepine use was associated with smaller reductions. Safety profiles were similar between ESL doses. Exit rates for ESL monotherapy (1,600 mg and 1,200 mg once daily) were lower than the historical control threshold, irrespective of baseline AED use and region, with no additional safety concerns identified. Clinical factors and location clearly influence treatment responses in conversion-to-monotherapy trials. This pooled analysis provides Class IV evidence that for adults with medically uncontrolled partial-onset seizures, ESL monotherapy is well tolerated and effective. © 2016 American Academy of Neurology.
Hao, Lu; Li, Tongtong; Chang, Lung-Ji; Chen, Xiaochuan
2017-08-01
Adoptive infusion of chimeric antigen receptor transduced T-cells (CAR-T) is a powerful tool of immunotherapy for hematological malignancies, as evidenced by recently published and unpublished clinical results. In this report, we performed a meta-analysis to evaluate the efficacy and side effects of CAR-T on relapsed B-cell malignancies, including leukemia and lymphoma. Clinical studies investigating efficacy and safety of CAR-T in acute and chronic lymphocytic leukemia and lymphoma were identified by searching PubMed and EMBASE. Outcomes of efficacy subjected to analysis were the rates of complete remission (CR) and partial remission (PR). The safety parameters were the prevalence of adverse effects including fever, hypotension, and acute renal failure. Meta analyses were performed using R software. Weighted hazard ratio (HR) with 95% confidence intervals was calculated for each outcome. Fixed or random-effects models were employed depending on the heterogeneity across the included studies. Nineteen published clinical studies, with a total of 391 patients were included for the meta-analysis. The pooled rate of complete remission was 55% (95% CI 41%-69%); the pooled rate of partial remission was 25% (95% CI: 19%-33%). The prevalence of fever was 62% (95% CI: 41%-79%); the hypotension was 22% (95% CI: 15%-31%); acute renal failure was 24% (95% CI: 16%-34%). All adverse effects were manageable and no death was reported due to toxicity. CD19-targeted CAR-T is an effective modality in treating refractory B-cell malignancies including acute and chronic lymphatic leukemia, Hodjkin's and non-Hodjkin's lymphoma. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
47 CFR 87.29 - Partial grant of application.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 5 2011-10-01 2011-10-01 false Partial grant of application. 87.29 Section 87.29 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES Applications and Licenses § 87.29 Partial grant of application. Whenever the Commission...
47 CFR 87.29 - Partial grant of application.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Partial grant of application. 87.29 Section 87.29 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES Applications and Licenses § 87.29 Partial grant of application. Whenever the Commission...
75 FR 13433 - Safety Zone; Invista Inc Facility Docks, Victoria Barge Canal, Victoria, TX
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-22
...-AA00 Safety Zone; Invista Inc Facility Docks, Victoria Barge Canal, Victoria, TX AGENCY: Coast Guard... safety zone for a partial blockage of the Victoria Barge Canal when the Invista Inc facility is... channel will be substantially reduced. The safety zone is necessary to help ensure the safety of the...
Diao, Jiayin; Xu, Can; Zheng, Huiting; He, Siyi; Wang, Shumei
2018-06-21
Viticis Fructus is a traditional Chinese herbal drug processed by various methods to achieve different clinical purposes. Thermal treatment potentially alters chemical composition, which may impact on effectiveness and toxicity. In order to interpret the constituent discrepancies of raw versus processed (stir-fried) Viticis Fructus, a multivariate detection method (NIR, HPLC, and UPLC-MS) based on metabonomics and chemometrics was developed. Firstly, synergy interval partial least squares and partial least squares-discriminant analysis were employed to screen the distinctive wavebands (4319 - 5459 cm -1 ) based on preprocessed near-infrared spectra. Then, HPLC with principal component analysis was performed to characterize the distinction. Subsequently, a total of 49 compounds were identified by UPLC-MS, among which 42 compounds were eventually characterized as having a significant change during processing via the semiquantitative volcano plot analysis. Moreover, based on the partial least squares-discriminant analysis, 16 compounds were chosen as characteristic markers that could be in close correlation with the discriminatory near-infrared wavebands. Together, all of these characterization techniques effectively discriminated raw and processed products of Viticis Fructus. In general, our work provides an integrated way of classifying Viticis Fructus, and a strategy to explore discriminatory chemical markers for other traditional Chinese herbs, thus ensuring safety and efficacy for consumers. Georg Thieme Verlag KG Stuttgart · New York.
Chang, Wei-Ju; Bennell, Kim L.; Hodges, Paul W.; Hinman, Rana S.; Young, Carolyn L.; Buscemi, Valentina; Liston, Matthew B.
2017-01-01
A randomised, assessor- and participant-blind, sham-controlled trial was conducted to assess the safety and feasibility of adding transcranial direct current stimulation (tDCS) to quadriceps strengthening exercise in knee osteoarthritis (OA), and provide data to inform a fully powered trial. Participants were randomised to receive active tDCS+exercise (AT+EX) or sham tDCS+exercise (ST+EX) twice weekly for 8 weeks whilst completing home exercises twice per week. Feasibility, safety, patient-perceived response, pain, function, pressure pain thresholds (PPTs) and conditioned pain modulation (CPM) were assessed before and after treatment. Fifty-seven people were screened for eligibility. Thirty (52%) entered randomisation and 25 (84%) completed the trial. One episode of headache in the AT+EX group was reported. Pain reduced in both groups following treatment (AT+EX: p<0.001, partial η2 = 0.55; ST+EX: p = 0.026, partial η2 = 0.18) but no between-group differences were observed (p = 0.18, partial η2 = 0.08). Function improved in the AT+EX (p = 0.01, partial η2 = 0.22), but not the ST+EX (p = 0.16, partial η2 = 0.08) group, between-group differences did not reach significance (p = 0.28, partial η2 = 0.052). AT+EX produced greater improvements in PPTs than ST+EX (p<0.05) (superolateral knee: partial η2 = 0.17; superior knee: partial η2 = 0.3; superomedial knee: partial η2 = 0.26). CPM only improved in the AT+EX group but no between-group difference was observed (p = 0.054, partial η2 = 0.158). This study provides the first feasibility and safety data for the addition of tDCS to quadriceps strengthening exercise in knee OA. Our data suggest AT+EX may improve pain, function and pain mechanisms beyond that of ST+EX, and provides support for progression to a fully powered randomised controlled trial. PMID:28665989
Gibbs, L; Waters, E; Sherrard, J; Ozanne-Smith, J; Robinson, J; Young, S; Hutchinson, A
2005-12-01
To develop an understanding of factors acting as barriers and motivators to parental uptake of child poison safety strategies. A qualitative study involving semistructured interviews and focus groups. A grounded theory approach was used for the collection and analysis of data. Sixty five parents of children under 5 years of age, some of whom had experienced an unintentional child poisoning incident. A range of knowledge based, environmental, and behavioral barriers to comprehensive parental uptake of poison safety practices were identified. As a result there tended to be only partial implementation of safety initiatives in the home. Selection of safety practices was often guided by the interests and behaviors of the child. This made the child vulnerable to changes in the home environment, inadequate supervision, and/or shifts in their own behavior and developmental ability. Personal or vicarious exposure of a parent to a child poisoning incident was a significant motivator for parental review of safety practices. Environmental measures targeting child resistant containers, warning labels, and lockable poisons cupboards will support parents' efforts to maintain poison safety. Additional education campaigns using stories of actual poisoning incidents may help to increase awareness of risk and encourage increased uptake.
Huang, Baqun; Liu, Yuelong; Tang, Yan; Li, Qing; Zhu, Yihui
2017-01-01
Background and purpose Accelerated partial breast irradiation (APBI) technology has theoretical advantages in comparison with traditional adjuvant radiation therapy (whole-breast irradiation; WBI) after breast-conserving surgery. However, published randomized controlled trials have shown inconsistent outcomes. Therefore, a comprehensive assessment of the effectiveness and safety of APBI technology is needed. Results A total of 7 studies of 7452 patients were included in this analysis. All 7 studies reported local recurrence as an outcome. Meta-analysis of 5 trials that included 6486 patients showed significantly different 5-year local recurrence rates for APBI and WBI groups (hazard ratio = 4.54, 95% confidence interval: 1.78–11.61, p = 0.002). Further analysis showed that this difference may be related to the choice of treatment methods. Benefit was conferred to the APBI group for the outcome of non-breast cancer deaths. There was no significant difference between the two groups in terms of nodal recurrence, systemic recurrence, overall survival, or mortality rates. Toxicity side effects and cosmetic effects were similar in both groups, but intraoperative radiotherapy seemed to have a greater acute response. Material and methods Searches for relevant randomized controlled trials of APBI versus WBI were performed using the following sources: PubMed, EMBASE, Cochrane Library, Web of Science. Two independent observers evaluated the identified studies. The meta-analysis was conducted using RevMan 5.2 software. Conclusions Although the analysis showed that patients receiving APBI had a higher local recurrence rate, subgroup analyses suggested that this might be related to treatment options. Patients who receive accurate radiotherapy may have greater benefits. APBI is a promising treatment technology and more phase III clinical trials are expected based on new treatments. PMID:28938661
Villanueva, Vicente; Holtkamp, Martin; Delanty, Norman; Rodriguez-Uranga, Juan; McMurray, Rob; Santagueda, Patricia
2017-11-01
The Euro-Esli study was an exploratory pooled analysis of data from 14 European clinical practice studies, which was conducted to audit the real-world effectiveness, safety, and tolerability of eslicarbazepine acetate (ESL) as an adjunctive treatment for partial-onset seizures. Retention and effectiveness were assessed after 3, 6, and 12 months of ESL treatment, and at the final visit. Safety and tolerability were assessed throughout ESL treatment by evaluating adverse events (AEs) and ESL discontinuation due to AEs. Data from 2058 patients (52.1% male; mean age 44.0 years) were included. All 2058 patients were assessed for safety and 1975 (96.0%) patients were assessed for effectiveness. After 12 months, retention, responder (≥50% seizure frequency reduction), and seizure freedom rates were 73.4, 75.6, and 41.3%, respectively. AEs were reported for 34.0% of patients and led to discontinuation in 13.6% of patients. The most frequently reported AEs were dizziness (6.7% of patients), fatigue (5.4%), and somnolence (5.1%). No unexpected safety signals emerged over a median duration of follow-up of >5 years. Subgroup analyses revealed that ESL was significantly more effective in patients aged ≥65 versus <65 years, in patients who were not receiving treatment with other sodium channel blockers versus those who were receiving treatment with other sodium channel blockers, and in patients who were receiving <2 versus ≥2 concomitant antiepileptic drugs at baseline. Euro-Esli is the largest ESL clinical practice study conducted to date. This study provides strong and reassuring evidence of ESL's safety profile, and complements the data from clinical trials.
Toh, Sengwee; García Rodríguez, Luis A; Hernán, Miguel A
2012-05-01
Electronic healthcare databases are commonly used in comparative effectiveness and safety research of therapeutics. Many databases now include additional confounder information in a subset of the study population through data linkage or data collection. We described and compared existing methods for analyzing such datasets. Using data from The Health Improvement Network and the relation between non-steroidal anti-inflammatory drugs and upper gastrointestinal bleeding as an example, we employed several methods to handle partially missing confounder information. The crude odds ratio (OR) of upper gastrointestinal bleeding was 1.50 (95% confidence interval: 0.98, 2.28) among selective cyclo-oxygenase-2 inhibitor initiators (n = 43 569) compared with traditional non-steroidal anti-inflammatory drug initiators (n = 411 616). The OR dropped to 0.81 (0.52, 1.27) upon adjustment for confounders recorded for all patients. When further considering three additional variables missing in 22% of the study population (smoking, alcohol consumption, body mass index), the OR was between 0.80 and 0.83 for the missing-category approach, the missing-indicator approach, single imputation by the most common category, multiple imputation by chained equations, and propensity score calibration. The OR was 0.65 (0.39, 1.09) and 0.67 (0.38, 1.16) for the unweighted and the inverse probability weighted complete-case analysis, respectively. Existing methods for handling partially missing confounder data require different assumptions and may produce different results. The unweighted complete-case analysis, the missing-category/indicator approach, and single imputation require often unrealistic assumptions and should be avoided. In this study, differences across methods were not substantial, likely due to relatively low proportion of missingness and weak confounding effect by the three additional variables upon adjustment for other variables. Copyright © 2012 John Wiley & Sons, Ltd.
The Role of Safety Culture in Influencing Provider Perceptions of Patient Safety.
Bishop, Andrea C; Boyle, Todd A
2016-12-01
To determine how provider perceptions of safety culture influence their involvement in patient safety practices. Health-care providers were surveyed in 2 tertiary hospitals located in Atlantic Canada, composed of 4 units in total. The partial least squares (PLS) approach to structural equation modeling was used to analyze the data. Latent variables provider PLS model encompassed the hypothesized relationships between provider characteristics, safety culture, perceptions of patient safety practices, and actual performance of patient safety practices, using the Health Belief Model (HBM) as a guide. Data analysis was conducted using SmartPLS. A total of 113 health-care providers completed a survey out of an eligible 318, representing a response rate of 35.5%. The final PLS model showed acceptable internal consistency with all four latent variables having a composite reliability score above the recommended 0.70 cutoff value (safety culture = 0.86, threat = 0.76, expectations = 0.83, PS practices = 0.75). Discriminant validity was established, and all path coefficients were found to be significant at the α = 0.05 level using nonparametric bootstrapping. The survey results show that safety culture accounted for 34% of the variance in perceptions of threat and 42% of the variance in expectations. This research supports the role that safety culture plays in the promotion and maintenance of patient safety activities for health-care providers. As such, it is recommended that the introduction of new patient safety strategies follow a thorough exploration of an organization's safety culture.
Sekulic, Aleksandar; Migden, Michael R; Lewis, Karl; Hainsworth, John D; Solomon, James A; Yoo, Simon; Arron, Sarah T; Friedlander, Philip A; Marmur, Ellen; Rudin, Charles M; Chang, Anne Lynn S; Dirix, Luc; Hou, Jeannie; Yue, Huibin; Hauschild, Axel
2015-06-01
Primary analysis from the pivotal ERIVANCE BCC study resulted in approval of vismodegib, a Hedgehog pathway inhibitor indicated for treatment of adults with metastatic or locally advanced basal cell carcinoma (BCC) that has recurred after surgery or for patients who are not candidates for surgery or radiation. An efficacy and safety analysis was conducted 12 months after primary analysis. This was a multinational, multicenter, nonrandomized, 2-cohort study in patients with measurable and histologically confirmed locally advanced or metastatic BCC taking oral vismodegib (150 mg/d). Primary outcome measure was objective response rate (complete and partial responses) assessed by independent review facility. After 12 months of additional follow-up, median duration of exposure to vismodegib was 12.9 months. Objective response rate increased from 30.3% to 33.3% in patients with metastatic disease, and from 42.9% to 47.6% in patients with the locally advanced form. Median duration of response in patients with locally advanced BCC increased from 7.6 to 9.5 months. No new safety signals emerged with extended treatment duration. Limitations include low prevalence of advanced BCC and challenges of designing a study with heterogenous manifestations. The 12-month update of the study confirms the efficacy and safety of vismodegib in management of advanced BCC. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
The adaptive safety analysis and monitoring system
NASA Astrophysics Data System (ADS)
Tu, Haiying; Allanach, Jeffrey; Singh, Satnam; Pattipati, Krishna R.; Willett, Peter
2004-09-01
The Adaptive Safety Analysis and Monitoring (ASAM) system is a hybrid model-based software tool for assisting intelligence analysts to identify terrorist threats, to predict possible evolution of the terrorist activities, and to suggest strategies for countering terrorism. The ASAM system provides a distributed processing structure for gathering, sharing, understanding, and using information to assess and predict terrorist network states. In combination with counter-terrorist network models, it can also suggest feasible actions to inhibit potential terrorist threats. In this paper, we will introduce the architecture of the ASAM system, and discuss the hybrid modeling approach embedded in it, viz., Hidden Markov Models (HMMs) to detect and provide soft evidence on the states of terrorist network nodes based on partial and imperfect observations, and Bayesian networks (BNs) to integrate soft evidence from multiple HMMs. The functionality of the ASAM system is illustrated by way of application to the Indian Airlines Hijacking, as modeled from open sources.
Probiotics and the Microbiome in Celiac Disease: A Randomised Controlled Trial
Myers, Stephen P.; Rolfe, Margaret
2016-01-01
Background. There is limited research investigating the composition of the gastrointestinal microbiota in individuals with celiac disease (CoeD) reporting only partial symptom improvement despite adherence to a strict gluten-free diet (GFD). The aim of this research was to determine if the gastrointestinal microbiota could be altered by probiotic bacteria and provide a potential new therapy for this subgroup. Methods. A multicentre RCT was conducted between January and August 2011 in Australia. Participants included 45 people with CoeD reporting only partial symptom improvement despite adherence to a strict GFD for a minimum of 12 months. Participants took 5 g of VSL#™ probiotic formulation (n = 23) or 5 g placebo (n = 22) orally twice daily for 12 weeks. The main outcome measured was the efficacy of the probiotic formula in altering faecal microbiota counts between baseline and week 12. Safety was determined by safety blood and monitoring adverse events. Results. SPSS™ multivariate repeated measures analysis (95th confidence level) revealed no statistically significant changes between the groups in the faecal microbiota counts or blood safety measures over the course of the study. Conclusion. The probiotic formula when taken orally over the 12-week period did not significantly alter the microbiota measured in this population. The trial was registered with Australian and New Zealand Clinical Trials Register ACTRN12610000630011. PMID:27525027
16 CFR Figure 1 to Subpart A of... - Partial Insulation Preparation Apparatus
Code of Federal Regulations, 2010 CFR
2010-01-01
... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Partial Insulation Preparation Apparatus 1 Figure 1 to Subpart A of Part 1209 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER..., Subpt. A, Fig. 1 Figure 1 to Subpart A of Part 1209—Partial Insulation Preparation Apparatus EC03OC91...
16 CFR Figure 1 to Subpart A of... - Partial Insulation Preparation Apparatus
Code of Federal Regulations, 2011 CFR
2011-01-01
... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Partial Insulation Preparation Apparatus 1 Figure 1 to Subpart A of Part 1209 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER..., Subpt. A, Fig. 1 Figure 1 to Subpart A of Part 1209—Partial Insulation Preparation Apparatus EC03OC91...
49 CFR Appendix A to Part 222 - Approved Supplementary Safety Measures
Code of Federal Regulations, 2010 CFR
2010-10-01
... crossings located within New Partial Quiet Zones shall be closed from 10 p.m. until 7 a.m. every day. Public... apply only to New Quiet Zones or New Partial Quiet Zones. Constant warning time devices and power-out...-Rule Partial Quiet Zones are renewed, or new automatic warning device systems are installed, power-out...
Conversion to eslicarbazepine acetate monotherapy
French, Jacqueline; Jacobson, Mercedes P.; Pazdera, Ladislav; Gough, Mallory; Cheng, Hailong; Grinnell, Todd; Blum, David
2016-01-01
Objective: To assess the efficacy and safety of eslicarbazepine acetate (ESL) monotherapy. Methods: This post hoc pooled analysis of 2 randomized double-blind studies (093-045 and -046) included adults with partial-onset seizures medically uncontrolled by 1 or 2 antiepileptic drugs (AEDs). Following the baseline period (8 weeks), eligible patients were randomized 2:1 to receive ESL 1,600 mg or 1,200 mg once daily for 18 weeks; the primary endpoint was study exit by meeting predefined exit criteria (signifying worsening seizure control). In each study, treatment was considered effective if the upper 95% confidence limit for exit rate was lower than the historical control threshold (65.3%). Results: Pooled exit rates were as follows: ESL 1,600 mg = 20.6% (95% confidence interval: 15.6%–26.8%); ESL 1,200 mg = 30.8% (23.0%–40.5%). Use of 2 baseline AEDs or rescue medication, US location, epilepsy duration ≥20 years, and higher maximum baseline seizure frequency were associated with higher exit risks. Median percent reductions in standardized seizure frequency between baseline and the 18-week double-blind period were as follows: ESL 1,600 mg = 43.2%; ESL 1,200 mg = 35.7%; baseline carbamazepine use was associated with smaller reductions. Safety profiles were similar between ESL doses. Conclusions: Exit rates for ESL monotherapy (1,600 mg and 1,200 mg once daily) were lower than the historical control threshold, irrespective of baseline AED use and region, with no additional safety concerns identified. Clinical factors and location clearly influence treatment responses in conversion-to-monotherapy trials. Classification of evidence: This pooled analysis provides Class IV evidence that for adults with medically uncontrolled partial-onset seizures, ESL monotherapy is well tolerated and effective. PMID:26911639
Zhang, Xinghui; Xuan, Xin; Chen, Fumei; Zhang, Cai; Luo, Yuhan; Wang, Yun
2016-03-01
Perceptions of school safety have an important effect on students' development. Based on the model of "context-process-outcomes," we examined school safety as a context variable to explore how school safety at the school level affected students' self-esteem. We used hierarchical linear modeling to examine the link between school safety at the school level and students' self-esteem, including school liking as a mediator. The data were from the National Children's Study of China (NCSC), in which 6618 fourth- to fifth-grade students in 79 schools were recruited from 100 counties in 31 provinces in China. Multilevel mediation analyses showed that the positive relationship between school safety at the school level and self-esteem was partially mediated by school liking, controlling for demographics at both student and school levels. Furthermore, a sex difference existed in the multilevel mediation model. For boys, school liking fully mediated the relationship between school safety at the school level and self-esteem. However, school liking partially mediated the relationship between school safety at the school level and self-esteem among girls. School safety should receive increasing attention from policymakers because of its impact on students' self-esteem. © 2016, American School Health Association.
Police accident report forms: safety device coding and enacted laws.
Brock, K; Lapidus, G
2008-12-01
Safety device coding on state police accident report (PAR) forms was compared with provisions in state traffic safety laws. PAR forms were obtained from all 50 states and the District of Columbia (states/DC). For seat belts, 22 states/DC had a primary seat belt enforcement law vs 50 with a PAR code. For car seats, all 51 states/DC had a law and a PAR code. For booster seats, 39 states/DC had a law vs nine with a PAR code. For motorcycle helmets, 21 states/DC had an all-age rider helmet law and another 26 a partial-age law vs 50 with a PAR code. For bicycle helmets, 21 states/DC had a partial-age rider helmet law vs 48 with a PAR code. Therefore gaps in the ability of states to fully record accident data reflective of existing state traffic safety laws are revealed. Revising the PAR forms in all states to include complete variables for safety devices should be an important priority, independent of the laws.
Code of Federal Regulations, 2010 CFR
2010-10-01
... MOTOR CARRIER SAFETY REGULATIONS TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Delivery of Shipments § 375.707 If a shipment is partially lost or destroyed, what...
49 CFR 234.106 - Partial activation.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 4 2010-10-01 2010-10-01 false Partial activation. 234.106 Section 234.106 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GRADE CROSSING SIGNAL SYSTEM SAFETY AND STATE ACTION PLANS Response to Reports...
49 CFR 234.106 - Partial activation.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 4 2011-10-01 2011-10-01 false Partial activation. 234.106 Section 234.106 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GRADE CROSSING SIGNAL SYSTEM SAFETY AND STATE ACTION PLANS Response to Reports...
Autoclave decomposition method for metals in soils and sediments.
Navarrete-López, M; Jonathan, M P; Rodríguez-Espinosa, P F; Salgado-Galeana, J A
2012-04-01
Leaching of partially leached metals (Fe, Mn, Cd, Co, Cu, Ni, Pb, and Zn) was done using autoclave technique which was modified based on EPA 3051A digestion technique. The autoclave method was developed as an alternative to the regular digestion procedure passed the safety norms for partial extraction of metals in polytetrafluoroethylene (PFA vessel) with a low constant temperature (119.5° ± 1.5°C) and the recovery of elements were also precise. The autoclave method was also validated using two Standard Reference Materials (SRMs: Loam Soil B and Loam Soil D) and the recoveries were equally superior to the traditionally established digestion methods. Application of the autoclave was samples from different natural environments (beach, mangrove, river, and city soil) to reproduce the recovery of elements during subsequent analysis.
Al Yami, Majed S; Kurdi, Sawsan; Abraham, Ivo
2018-01-01
Standard-duration (7-10 days) thromboprophylaxis with low molecular weight heparin, low dose unfractionated heparin, or fondaparinux in hospitalized medically ill patients is associated with ~50% reduction in venous thromboembolism (VTE) risk. However, these patients remain at high risk for VTE post-discharge. The direct oral anticoagulants (DOACs) apixaban, rivaroxaban and betrixaban have been evaluated for extended-duration (30-42 days) thromboprophylaxis in this population. We review the efficacy and safety results from the 3 pivotal trials of extended-duration DOAC thromboprophylaxis in medically ill patients. We performed a meta-analysis of these pivotal trials focusing on 6 VTE (efficacy) and three bleeding outcomes (safety). These results were integrated into a quantitative risk/benefit assessment. The trials evaluating extended-duration DOAC thromboprophylaxis in medically ill patients failed to establish clear efficacy and/or safety signals for each agent. Our meta-analysis shows that, as a class, DOACs have selective and partial extended-duration prophylactic activity in preventing VTE events. However, this is associated with a marked increase in the risk of various bleeding events. The risk/benefit analyses fail to show a consistent net clinical benefit of extended-duration DOAC prophylaxis in medically ill patients. At this time, the evidence of safe and effective extended-duration thromboprophylaxis with DOACs in this population is inconclusive.
Gama, Helena; Vieira, Mariana; Costa, Raquel; Graça, Joana; Magalhães, Luís M; Soares-da-Silva, Patrício
2017-12-01
Eslicarbazepine acetate was first approved in the European Union in 2009 as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization. The objective of this study was to review the safety profile of eslicarbazepine acetate analyzing the data from several clinical studies to 6 years of post-marketing surveillance. We used a post-hoc pooled safety analysis of four phase III, double-blind, randomized, placebo-controlled studies (BIA-2093-301, -302, -303, -304) of eslicarbazepine acetate as add-on therapy in adults. Safety data of eslicarbazepine acetate in special populations of patients aged ≥65 years with partial-onset seizures (BIA-2093-401) and subjects with moderate hepatic impairment (BIA-2093-111) and renal impairment (BIA-2093-112) are also considered. The incidences of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and serious adverse events were analyzed. The global safety database of eslicarbazepine acetate was analyzed for all cases from post-marketing surveillance from 1 October, 2009 to 21 October, 2015. From a pooled analysis of four phase III studies, it was concluded that the incidence of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and adverse drug reactions were dose dependent. Dizziness, somnolence, headache, and nausea were the most common treatment-emergent adverse events (≥10% of patients) and the majority were of mild-to-moderate intensity. No dose-dependent trend was observed for serious adverse events and individual serious adverse events were reported in less than 1% of patients. Hyponatremia was classified as a possibly related treatment-emergent adverse event in phase III studies (1.2%); however, after 6 years of post-marketing surveillance it represents the most frequently (10.2%) reported adverse drug reaction, with more than half of these cases occurring with eslicarbazepine acetate at daily doses of 1200 mg. Other adverse drug reactions reported in post-marketing surveillance are seizure (5.8%), dizziness (4.1%), rash (2.6%), and fatigue (2.1%). The safety profile of eslicarbazepine acetate in renal and hepatic impairment subjects (phase I studies) and in elderly patients (phase III study) did not raise any specific concern. After 6 years of post-marketing surveillance, eslicarbazepine acetate maintains a similar safety profile to that observed in pivotal clinical studies.
Driving behaviours, traffic risk and road safety: comparative study between Malaysia and Singapore.
Khan, Saif ur Rehman; Khalifah, Zainab Binti; Munir, Yasin; Islam, Talat; Nazir, Tahira; Khan, Hashim
2015-01-01
The present study aims to investigate differences in road safety attitude, driver behaviour and traffic risk perception between Malaysia and Singapore. A questionnaire-based survey was conducted among a sample of Singaporean (n = 187) and Malaysian (n = 313) road users. The data was analysed using confirmatory factor analysis and structural equation modelling applied to measure comparative fit indices of Malaysian and Singaporean respondents. The results show that the perceived traffic risk of Malaysian respondents is higher than Singaporean counterparts. Moreover, the structural equation modelling has confirmed perceived traffic risk performing the role of full mediation between perceived driving skills and perceived road safety for both the countries, while perceived traffic skills was found to perform the role of partial mediation between aggression and anxiety, on one hand, and road safety, on the other hand, in Malaysia and Singapore. In addition, in both countries, a weak correlation between perceived driving skills, aggression and anxiety with perceived road safety was found, while a strong correlation exists with traffic risk perception. The findings of this study have been discussed in terms of theoretical, practical and conceptual implications for both scholars and policy-makers to better understand the young drivers' attitude and behaviour relationship towards road safety measures with a view to future research.
Validation of the French version of the Hospital Survey on Patient Safety Culture questionnaire.
Occelli, P; Quenon, J-L; Kret, M; Domecq, S; Delaperche, F; Claverie, O; Castets-Fontaine, B; Amalberti, R; Auroy, Y; Parneix, P; Michel, P
2013-09-01
To assess the psychometric properties of the French version of the Hospital Survey on Patient Safety Culture questionnaire (HSOPSC) and study the hierarchical structure of the measured dimensions. Cross-sectional survey of the safety culture. 18 acute care units of seven hospitals in South-western France. Full- and part-time healthcare providers who worked in the units. None. Item responses measured with 5-point agreement or frequency scales. Data analyses A principal component analysis was used to identify the emerging components. Two structural equation modeling methods [LInear Structural RELations (LISREL) and Partial Least Square (PLS)] were used to verify the model and to study the relative importance of the dimensions. Internal consistency of the retained dimensions was studied. A test-retest was performed to assess reproducibility of the items. Overall response rate was 77% (n = 401). A structure in 40 items grouped in 10 dimensions was proposed. The LISREL approach showed acceptable data fit of the proposed structure. The PLS approach indicated that three dimensions had the most impact on the safety culture: 'Supervisor/manager expectations & actions promoting safety' 'Organizational learning-continuous improvement' and 'Overall perceptions of safety'. Internal consistency was above 0.70 for six dimensions. Reproducibility was considered good for four items. The French HSOPSC questionnaire showed acceptable psychometric properties. Classification of the dimensions should guide future development of safety culture improving action plans.
A Simplified Approach to Risk Assessment Based on System Dynamics: An Industrial Case Study.
Garbolino, Emmanuel; Chery, Jean-Pierre; Guarnieri, Franck
2016-01-01
Seveso plants are complex sociotechnical systems, which makes it appropriate to support any risk assessment with a model of the system. However, more often than not, this step is only partially addressed, simplified, or avoided in safety reports. At the same time, investigations have shown that the complexity of industrial systems is frequently a factor in accidents, due to interactions between their technical, human, and organizational dimensions. In order to handle both this complexity and changes in the system over time, this article proposes an original and simplified qualitative risk evaluation method based on the system dynamics theory developed by Forrester in the early 1960s. The methodology supports the development of a dynamic risk assessment framework dedicated to industrial activities. It consists of 10 complementary steps grouped into two main activities: system dynamics modeling of the sociotechnical system and risk analysis. This system dynamics risk analysis is applied to a case study of a chemical plant and provides a way to assess the technological and organizational components of safety. © 2016 Society for Risk Analysis.
NASA Astrophysics Data System (ADS)
Mavkov, B.; Witrant, E.; Prieur, C.; Maljaars, E.; Felici, F.; Sauter, O.; the TCV-Team
2018-05-01
In this paper, model-based closed-loop algorithms are derived for distributed control of the inverse of the safety factor profile and the plasma pressure parameter β of the TCV tokamak. The simultaneous control of the two plasma quantities is performed by combining two different control methods. The control design of the plasma safety factor is based on an infinite-dimensional setting using Lyapunov analysis for partial differential equations, while the control of the plasma pressure parameter is designed using control techniques for single-input and single-output systems. The performance and robustness of the proposed controller is analyzed in simulations using the fast plasma transport simulator RAPTOR. The control is then implemented and tested in experiments in TCV L-mode discharges using the RAPTOR model predicted estimates for the q-profile. The distributed control in TCV is performed using one co-current and one counter-current electron cyclotron heating actuation.
Trepka, Mary Jo; Newman, Frederick L; Davila, Evelyn P; Matthew, Karen J; Dixon, Zisca; Huffman, Fatma G
2008-06-01
Pregnant women and the very young are among those most susceptible to foodborne infections and at high risk of a severe outcome from foodborne infections. To determine if interactive multimedia is a more effective method than pamphlets for delivering food safety education to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clients. A randomized controlled trial of WIC clients was conducted. Self-reported food safety practices were compared between pre- and postintervention questionnaires completed >or=2 months after the intervention. Pregnant WIC clients or female caregivers (usually mothers) of WIC clients who were 18 years of age or older and able to speak and read English were recruited from an inner-city WIC clinic. Participants were randomized to receive food safety pamphlets or complete an interactive multimedia food safety education program on a computer kiosk. Change from pre- to postintervention food safety scores. A mean food safety score was determined for each participant for the pre- and postintervention questionnaires. The scores were used in a two-group repeated measures analysis of variance. Of the 394 participants, 255 (64.7%) completed the postintervention questionnaire. Satisfaction with the program was high especially among those with no education beyond high school. When considering a repeated measures analysis of variance model with the two fixed between-subject effects of group and age, a larger improvement in score in the interactive multimedia group than in the pamphlet group (P=0.005) was found, but the size of the group effect was small (partial eta(2)=0.033). Women aged 35 years or older in the interactive multimedia group had the largest increase in score. The interactive multimedia was well-accepted and resulted in improved self-reported food safety practices, suggesting that interactive multimedia is an effective option for food safety education in WIC clinics.
Abou, Seraphin C
2012-03-01
In this paper, a new interpretation of intuitionistic fuzzy sets in the advanced framework of the Dempster-Shafer theory of evidence is extended to monitor safety-critical systems' performance. Not only is the proposed approach more effective, but it also takes into account the fuzzy rules that deal with imperfect knowledge/information and, therefore, is different from the classical Takagi-Sugeno fuzzy system, which assumes that the rule (the knowledge) is perfect. We provide an analytical solution to the practical and important problem of the conceptual probabilistic approach for formal ship safety assessment using the fuzzy set theory that involves uncertainties associated with the reliability input data. Thus, the overall safety of the ship engine is investigated as an object of risk analysis using the fuzzy mapping structure, which considers uncertainty and partial truth in the input-output mapping. The proposed method integrates direct evidence of the frame of discernment and is demonstrated through references to examples where fuzzy set models are informative. These simple applications illustrate how to assess the conflict of sensor information fusion for a sufficient cooling power system of vessels under extreme operation conditions. It was found that propulsion engine safety systems are not only a function of many environmental and operation profiles but are also dynamic and complex. Copyright © 2011 Elsevier Ltd. All rights reserved.
9 CFR 319.29 - Miscellaneous pork products.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Miscellaneous pork products. 319.29 Section 319.29 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Miscellaneous pork products. (a) Partially defatted pork fatty tissue. “Partially Defatted Pork Fatty Tissue” is...
9 CFR 319.29 - Miscellaneous pork products.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Miscellaneous pork products. 319.29 Section 319.29 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Miscellaneous pork products. (a) Partially defatted pork fatty tissue. “Partially Defatted Pork Fatty Tissue” is...
9 CFR 319.29 - Miscellaneous pork products.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Miscellaneous pork products. 319.29 Section 319.29 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Miscellaneous pork products. (a) Partially defatted pork fatty tissue. “Partially Defatted Pork Fatty Tissue” is...
9 CFR 319.29 - Miscellaneous pork products.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Miscellaneous pork products. 319.29 Section 319.29 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Miscellaneous pork products. (a) Partially defatted pork fatty tissue. “Partially Defatted Pork Fatty Tissue” is...
9 CFR 319.29 - Miscellaneous pork products.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Miscellaneous pork products. 319.29 Section 319.29 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Miscellaneous pork products. (a) Partially defatted pork fatty tissue. “Partially Defatted Pork Fatty Tissue” is...
Safety profile of levetiracetam.
Arroyo, Santiago; Crawford, Pamela
2003-05-01
A good balance between safety and tolerability is necessary for an antiepileptic drug (AED) to be successful in the management of patients with epilepsy. Levetiracetam is one of the new generation of AEDs licensed as an add-on therapy for the treatment of patients with partial-onset seizures. Leveti-racetam's mechanisms of action are not fully understood. Controlled clinical trials, open-label studies, and postmarketing surveillance indicate that leveti-racetam has a favorable safety profile characterized by little effect on vital signs or clinical laboratory values, reported adverse events that are mild to moderate, and no known drug-drug interactions. The tolerability of levetiracetam may extend to both pediatric and elderly patients based on analyses of small numbers of patients. Tolerability is maintained over the long term. Levetirac-etam does not appear to have a different safety profile in learning-disabled patients. Levetiracetam appears to have a good balance between tolerability and efficacy in the treatment of a wide variety of patients with partial epilepsy.
75 FR 3372 - Safety Zone: Congress Street Bridge, Pequonnock River, Bridgeport, CT
Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-21
...-AA00 Safety Zone: Congress Street Bridge, Pequonnock River, Bridgeport, CT AGENCY: Coast Guard, DHS... waters surrounding the Congress Street Bridge over the Pequonnock River in Bridgeport, Connecticut. This... and equipment that are being utilized for partial demolition of the Congress Street Bridge. Entry into...
Biton, Victor; Gil-Nagel, Antonio; Brodie, Martin J; Derossett, Sarah E; Nohria, Virinder
2013-11-01
Retigabine (RTG; international nonproprietary name)/ezogabine (EZG; US adopted name) is an antiepileptic drug (AED) that prolongs neuronal voltage-gated potassium-channel KCNQ2-5 (Kv 7.2-7.5) opening. This double-blind study evaluated different RTG/EZG dose-titration rates. Patients (N=73) with partial-onset seizures receiving concomitant AEDs were randomized to one of three titration groups, all of which were initiated at RTG/EZG 300mg/day divided into three equal doses. Fast-, medium-, and slow-titration groups received dose increments of 150mg/day every 2, 4, and 7 days, respectively, achieving the target dose of 1200mg/day after 13, 25, and 43 days, respectively. Safety assessments were performed throughout. Discontinuation rates due to treatment-emergent adverse events (TEAEs) were numerically higher in the fast- (10/23) and medium- (7/22) titration groups than in the slow-titration group (3/23) but statistical significance was achieved only for the high-titration group compared with the low-titration group (p=0.024). Stratified analysis, with concomitant AEDs divided into enzyme inducers (carbamazepine, phenytoin, oxcarbazepine) or noninducers, showed that the risk of discontinuation due primarily to TEAEs was significantly higher in the fast- (p=0.010) but not in the medium-titration group (p=0.078) when compared with the slow-titration group. Overall, the slow-titration rate appeared to be best tolerated and was used in further efficacy and safety studies with RTG/EZG. Copyright © 2013 Elsevier B.V. All rights reserved.
Negative pressure wound therapy for partial-thickness burns.
Dumville, Jo C; Munson, Christopher; Christie, Janice
2014-12-15
A burn wound is a complex and evolving injury, with both local and systemic consequences. Burn treatments include a variety of dressings, as well as newer strategies, such as negative pressure wound therapy (NPWT), which, by means of a suction force that drains excess fluids from the burn, tries to promote the wound healing process and minimise progression of the burn wound. To assess the effectiveness of NPWT for people with partial-thickness burns. We searched the Cochrane Wounds Group Specialised Register (searched 04 September 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8). All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated the safety and effectiveness of NPWT for partial-thickness burns. Two review authors used standardised forms, and extracted the data independently. We assessed each trial for risk of bias, and resolved differences by discussion. One RCT, that was an interim report, satisfied the inclusion criteria. We undertook a narrative synthesis of results, as the absence of data and poor reporting precluded us from carrying out any formal statistical analysis. The trial was at high risk of bias. There was not enough evidence available to permit any conclusions to be drawn regarding the use of NPWT for treatment of partial-thickness burn wounds.
Yokoyama, Daiichiro; Shinya, Akikazu; Gomi, Harunori; Vallittu, Pekka K; Shinya, Akiyoshi
2012-01-01
Using finite element analysis (FEA), this study investigated the effects of the mechanical properties of adhesive resin cements on stress distributions in fiber-reinforced resin composite (FRC) adhesive fixed partial dentures (AFPDs). Two adhesive resin cements were compared: Super-Bond C&B and Panavia Fluoro Cement. The AFPD consisted of a pontic to replace a maxillary right lateral incisor and retainers on a maxillary central incisor and canine. FRC framework was made of isotropic, continuous, unidirectional E-glass fibers. Maximum principal stresses were calculated using finite element method (FEM). Test results revealed that differences in the mechanical properties of adhesive resin cements led to different stress distributions at the cement interfaces between AFPD and abutment teeth. Clinical implication of these findings suggested that the safety and longevity of an AFPD depended on choosing an adhesive resin cement with the appropriate mechanical properties.
Experience with rufinamide in a pediatric population: a single center's experience.
Vendrame, Martina; Loddenkemper, Tobias; Gooty, Vasu D; Takeoka, Masanori; Rotenberg, Alexander; Bergin, Ann M; Eksioglu, Yaman Z; Poduri, Annapurna; Duffy, Frank H; Libenson, Mark; Bourgeois, Blaise F; Kothare, Sanjeev V
2010-09-01
Rufinamide is a new antiepileptic drug recently approved as adjunctive treatment for generalized seizures in Lennox-Gastaut syndrome. We undertook a retrospective analysis of 77 patients with refractory epilepsy and receiving rufinamide to evaluate the drug's efficacy, tolerability, safety, and dosing schedules. It appeared efficacious in diverse epilepsy syndromes, with the highest responder rate in focal cryptogenic epilepsies (81.1% of patients with >50% response rate), and in diverse seizure types, with the highest responder rate in tonic/atonic and partial seizures (48.6% and 46.7% of patients with >50% response rate, respectively). Rufinamide was well tolerated: only 13% of patients developed side effects necessitating drug withdrawal. These findings suggest that rufinamide may possess good efficacy and tolerability, and that its efficacy may extend to epilepsy syndromes beyond Lennox-Gastaut, including both partial and generalized epilepsy syndromes. Copyright 2010 Elsevier Inc. All rights reserved.
Lacosamide adjunctive therapy for partial-onset seizures: a meta-analysis
Newman, Jennifer J.; Deshpande, Santosh; Jones, Philip M.
2013-01-01
Background. The relative efficacy and safety of lacosamide as adjunctive therapy compared to other antiepileptic drugs has not been well established. Objective. To determine if lacosamide provides improved efficacy and safety, reduced length of hospital stay and improved quality of life compared with other anti-epileptic therapies for adults with partial-onset seizures. Data Sources. A systematic review of the medical literature using Medline (1946–Week 4, 2012), EMBASE (1980–Week 3, 2012), Cochrane Central Register of Controlled Trials (Issue 1 of 12, January 2012). Additional studies were identified (through to February 7, 2012) by searching bibliographies, the FDA drug approval files, clinical trial registries and major national and international neurology meeting abstracts. No restrictions on publication status or language were applied. Study Selection. Randomized controlled trials of lacosamide in adults with partial-onset seizures were included. Data Extraction. Study selection, extraction and risk of bias assessment were performed independently by two authors. Authors of studies were contacted for missing data. Data Synthesis. All pooled analyses used the random effects model. Results. Three trials (1311 patients) met inclusion criteria. Lacosamide increased the 50% responder rate compared to placebo (RR 1.68 [95% CI 1.36 to 2.08]; I2 = 0%). Discontinuation due to adverse events was statistically significantly higher in the lacosamide arm (RR3.13 [95% CI 1.94 to 5.06]; I2 = 0%). Individual adverse events (ataxia, dizziness, fatigue, and nausea) were also significantly higher in the lacosamide group. Limitations. All dosage arms from the included studies were pooled to make a single pair-wise comparison to placebo. Selective reporting of outcomes was found in all of the included RCTs. Conclusions. Lacosamide as adjunctive therapy in patients with partial-onset seizures increases the 50% responder rate but with significantly more adverse events compared to the placebo. PMID:23940830
Eslicarbazepine acetate: an update on efficacy and safety in epilepsy.
Verrotti, Alberto; Loiacono, Giulia; Rossi, Alessandra; Zaccara, Gaetano
2014-01-01
Epilepsy is a common neurological disorder. Despite a broad range of commonly used antiepileptic drugs, approximately 30% of patients with epilepsy have drug resistance or encounter significant adverse effects. Eslicarbazepine acetate is a new central nervous system-active compound with anticonvulsant activity whose mechanism of action is by blocking the voltage-gated sodium channel. Eslicarbazepine acetate was approved by the European Medicines Agency and launched onto the European market in 2009 for adjunctive treatment in adult subjects of partial-onset seizures, with or without secondary generalization. This article provides an overview on the recent studies on eslicarbazepine acetate in the treatment of drug-resistant partial epilepsy. Efficacy and safety of this drug for partial-onset seizures were assessed in four randomized clinical trials with responder rates ranged between 17% and 43%. Adverse events were usually mild to moderate in intensity and the most common were dizziness, somnolence, nausea, diplopia, headache, vomiting, abnormal coordination, blurred vision, vertigo and fatigue. Eslicarbazepine acetate is not recommended below 18 years, but a published phase II trial had the main goal to evaluate the pharmacokinetics, efficacy and safety of this drug in pediatric population. Eslicarbazepine acetate appears to be a safe and effective drug with a linear pharmacokinetics, very low potential for drug-drug interactions and therefore it can offer a valid alternative to current antiepileptic drugs. Additionally, it is undergoing investigation for monotherapy in subjects with partial epilepsy, and other neurological and psychiatric disorders. Copyright © 2013 Elsevier B.V. All rights reserved.
Meijerink, Martijn R; Puijk, Robbert S; van Tilborg, Aukje A J M; Henningsen, Kirsten Holdt; Fernandez, Llenalia Garcia; Neyt, Mattias; Heymans, Juanita; Frankema, Jacqueline S; de Jong, Koert P; Richel, Dick J; Prevoo, Warner; Vlayen, Joan
2018-04-17
To assess safety and outcome of radiofrequency ablation (RFA) and microwave ablation (MWA) as compared to systemic chemotherapy and partial hepatectomy (PH) in the treatment of colorectal liver metastases (CRLM). MEDLINE, Embase and the Cochrane Library were searched. Randomized trials and comparative observational studies with multivariate analysis and/or matching were included. Guidelines from National Guideline Clearinghouse and Guidelines International Network were assessed using the AGREE II instrument. The search revealed 3530 records; 328 were selected for full-text review; 48 were included: 8 systematic reviews, 2 randomized studies, 26 comparative observational studies, 2 guideline-articles and 10 case series; in addition 13 guidelines were evaluated. Literature to assess the effectiveness of ablation was limited. RFA + systemic chemotherapy was superior to chemotherapy alone. PH was superior to RFA alone but not to RFA + PH or to MWA. Compared to PH, RFA showed fewer complications, MWA did not. Outcomes were subject to residual confounding since ablation was only employed for unresectable disease. The results from the EORTC-CLOCC trial, the comparable survival for ablation + PH versus PH alone, the potential to induce long-term disease control and the low complication rate argue in favour of ablation over chemotherapy alone. Further randomized comparisons of ablation to current-day chemotherapy alone should therefore be considered unethical. Hence, the highest achievable level of evidence for unresectable CRLM seems reached. The apparent selection bias from previous studies and the superior safety profile mandate the setup of randomized controlled trials comparing ablation to surgery.
ERIC Educational Resources Information Center
French, Brian F.; Breidenbach, Daniel H.; Field, William E.; Tormoehlen, Roger
2007-01-01
The written certification exam that accompanies the Gearing Up for Safety-Agricultural Production Safety Training for Youth curriculum was designed to partially meet the testing requirements of the Agricultural Hazardous Occupations Order (AgHOs) Certification Training Program. This curriculum and accompanying assessment tools are available for…
Diaz Beveridge, Robert; Alcolea, Vicent; Aparicio, Jorge; Segura, Ángel; García, Jose; Corbellas, Miguel; Fonfría, María; Giménez, Alejandra; Montalar, Joaquin
2014-01-10
The combination of gemcitabine and erlotinib is a standard first-line treatment for unresectable, locally advanced or metastatic pancreatic cancer. We reviewed our single centre experience to assess its efficacy and toxicity in clinical practice. Clinical records of patients with unresectable, locally advanced or metastatic pancreatic cancer who were treated with the combination of gemcitabine and erlotinib were reviewed. Univariate survival analysis and multivariate analysis were carried out to indentify independent predictors factors of overall survival. Our series included 55 patients. Overall disease control rate was 47%: 5% of patients presented complete response, 20% partial response and 22% stable disease. Median overall survival was 8.3 months). Cox regression analysis indicated that performance status and locally advanced versus metastatic disease were independent factors of overall survival. Patients who developed acne-like rash toxicity, related to erlotinib administration, presented a higher survival than those patients who did not develop this toxicity. Gemcitabine plus erlotinib doublet is active in our series of patients with advanced pancreatic cancer. This study provides efficacy and safety results similar to those of the pivotal phase III clinical trial that tested the same combination.
Pharmacotherapy of focal epilepsy in children: a systematic review of approved agents.
Arya, Ravindra; Glauser, Tracy A
2013-04-01
Partial-onset seizures contribute the bulk of seizure burden in childhood epilepsy. The therapeutic decision making involves consideration of factors specific to drug, patient and socioeconomic situation. This paper systematically reviews the available efficacy/effectiveness evidence for various anti-epileptic drugs (AED) as monotherapy and adjunctive therapy for partial-onset seizures in children. Relevant randomized clinical trials (RCTs) were identified by a structured PubMed search, supplemented by an additional hand search of reference lists and authors' files. Eligible studies were reviewed and data extracted into tables. Included RCTs were classified based on accepted published criteria. Only efficacy and effectiveness outcome measures were evaluated since there is little scientifically rigorous comprehensive AED adverse effects data. Oxcarbazepine is the only AED with Class I evidence for efficacy/effectiveness as initial monotherapy for partial-onset seizures in children. Carbamazepine, clobazam, lamotrigine, phenobarbital, phenytoin, topiramate, valproate, vigabatrin and zonisamide have, at best, Class III efficacy/effectiveness evidence for monotherapy of partial-onset seizures in children. For adjunctive therapy, gabapentin, lamotrigine, levetiracetam, oxcarbazepine and topiramate have Class I efficacy/effectiveness evidence for treatment of pediatric partial-onset seizures. This efficacy/effectiveness analysis must not be used in isolation when selecting therapy. AED selection for a specific child needs to integrate a drug's efficacy/effectiveness data with its safety and tolerability profile, pharmacokinetic properties, available formulations, and patient specific characteristics. It is critical that physicians and patients incorporate all these relevant variables when choosing AED therapy.
Numerical Computation of Homogeneous Slope Stability
Xiao, Shuangshuang; Li, Kemin; Ding, Xiaohua; Liu, Tong
2015-01-01
To simplify the computational process of homogeneous slope stability, improve computational accuracy, and find multiple potential slip surfaces of a complex geometric slope, this study utilized the limit equilibrium method to derive expression equations of overall and partial factors of safety. This study transformed the solution of the minimum factor of safety (FOS) to solving of a constrained nonlinear programming problem and applied an exhaustive method (EM) and particle swarm optimization algorithm (PSO) to this problem. In simple slope examples, the computational results using an EM and PSO were close to those obtained using other methods. Compared to the EM, the PSO had a small computation error and a significantly shorter computation time. As a result, the PSO could precisely calculate the slope FOS with high efficiency. The example of the multistage slope analysis indicated that this slope had two potential slip surfaces. The factors of safety were 1.1182 and 1.1560, respectively. The differences between these and the minimum FOS (1.0759) were small, but the positions of the slip surfaces were completely different than the critical slip surface (CSS). PMID:25784927
Numerical computation of homogeneous slope stability.
Xiao, Shuangshuang; Li, Kemin; Ding, Xiaohua; Liu, Tong
2015-01-01
To simplify the computational process of homogeneous slope stability, improve computational accuracy, and find multiple potential slip surfaces of a complex geometric slope, this study utilized the limit equilibrium method to derive expression equations of overall and partial factors of safety. This study transformed the solution of the minimum factor of safety (FOS) to solving of a constrained nonlinear programming problem and applied an exhaustive method (EM) and particle swarm optimization algorithm (PSO) to this problem. In simple slope examples, the computational results using an EM and PSO were close to those obtained using other methods. Compared to the EM, the PSO had a small computation error and a significantly shorter computation time. As a result, the PSO could precisely calculate the slope FOS with high efficiency. The example of the multistage slope analysis indicated that this slope had two potential slip surfaces. The factors of safety were 1.1182 and 1.1560, respectively. The differences between these and the minimum FOS (1.0759) were small, but the positions of the slip surfaces were completely different than the critical slip surface (CSS).
Gkorezis, Panagiotis; Panagiotou, Maria; Theodorou, Mamas
2016-10-01
The aim of this study was to examine the direct and indirect effect, through organizational identification, of workplace ostracism on nurses' silence towards patient safety. Employee silence in nursing has recently received attention in relation to its antecedents. Yet, very little is known about the role of workplace ostracism in generating nurses' silence. A cross-sectional survey was conducted in a public hospital in Cyprus. Data were collected from 157 nurses employed in a public hospital of Cyprus between November 2014-January 2015. To examine the present hypotheses bootstrapping analysis and Sobel test were conducted. Results demonstrated that workplace ostracism has an effect on nurses' silence towards patient safety. Moreover, this effect was partially mediated through organizational identification. Workplace ostracism among nurses significantly affects both nurses' attitude and behaviour namely organizational identification and employee silence. © 2016 John Wiley & Sons Ltd.
Sekulic, Aleksandar; Migden, Michael R; Basset-Seguin, Nicole; Garbe, Claus; Gesierich, Anja; Lao, Christopher D; Miller, Chris; Mortier, Laurent; Murrell, Dedee F; Hamid, Omid; Quevedo, Jorge F; Hou, Jeannie; McKenna, Edward; Dimier, Natalie; Williams, Sarah; Schadendorf, Dirk; Hauschild, Axel
2017-05-16
In the primary analysis of the ERIVANCE BCC trial, vismodegib, the first US Food and Drug Administration-approved Hedgehog pathway inhibitor, showed objective response rates (ORRs) by independent review facility (IRF) of 30% and 43% in metastatic basal cell carcinoma (mBCC) and locally advanced BCC (laBCC), respectively. ORRs by investigator review were 45% (mBCC) and 60% (laBCC). Herein, we present long-term safety and final investigator-assessed efficacy results in patients with mBCC or laBCC. One hundred four patients with measurable advanced BCC received oral vismodegib 150 mg once daily until disease progression or intolerable toxicity. The primary end point was IRF-assessed ORR. Secondary end points included ORR, duration of response (DOR), progression-free survival, overall survival (OS), and safety. At data cutoff (39 months after completion of accrual), 8 patients were receiving the study drug (69 patients in survival follow-up). Investigator-assessed ORR was 48.5% in the mBCC group (all partial responses) and 60.3% in the laBCC group (20 patients had complete response and 18 patients had partial response). ORRs were comparable across patient subgroups, including aggressive histologic subtypes (eg, infiltrative BCC). Median DOR was 14.8 months (mBCC) and 26.2 months (laBCC). Median OS was 33.4 months in the mBCC cohort and not estimable in the laBCC cohort. Adverse events remained consistent with clinical experience. Thirty-three deaths (31.7%) were reported; none were related to vismodegib. This long-term update of the ERIVANCE BCC trial demonstrated durability of response, efficacy across patient subgroups, and manageable long-term safety of vismodegib in patients with advanced BCC. This study was registered prospectively with Clinicaltrials.gov , number NCT00833417 on January 30, 2009.
Fully vs. Sequentially Coupled Loads Analysis of Offshore Wind Turbines
DOE Office of Scientific and Technical Information (OSTI.GOV)
Damiani, Rick; Wendt, Fabian; Musial, Walter
The design and analysis methods for offshore wind turbines must consider the aerodynamic and hydrodynamic loads and response of the entire system (turbine, tower, substructure, and foundation) coupled to the turbine control system dynamics. Whereas a fully coupled (turbine and support structure) modeling approach is more rigorous, intellectual property concerns can preclude this approach. In fact, turbine control system algorithms and turbine properties are strictly guarded and often not shared. In many cases, a partially coupled analysis using separate tools and an exchange of reduced sets of data via sequential coupling may be necessary. In the sequentially coupled approach, themore » turbine and substructure designers will independently determine and exchange an abridged model of their respective subsystems to be used in their partners' dynamic simulations. Although the ability to achieve design optimization is sacrificed to some degree with a sequentially coupled analysis method, the central question here is whether this approach can deliver the required safety and how the differences in the results from the fully coupled method could affect the design. This work summarizes the scope and preliminary results of a study conducted for the Bureau of Safety and Environmental Enforcement aimed at quantifying differences between these approaches through aero-hydro-servo-elastic simulations of two offshore wind turbines on a monopile and jacket substructure.« less
Ghazizadeh, Mahtab; McDonald, Anthony D; Lee, John D
2014-09-01
This study applies text mining to extract clusters of vehicle problems and associated trends from free-response data in the National Highway Traffic Safety Administration's vehicle owner's complaint database. As the automotive industry adopts new technologies, it is important to systematically assess the effect of these changes on traffic safety. Driving simulators, naturalistic driving data, and crash databases all contribute to a better understanding of how drivers respond to changing vehicle technology, but other approaches, such as automated analysis of incident reports, are needed. Free-response data from incidents representing two severity levels (fatal incidents and incidents involving injury) were analyzed using a text mining approach: latent semantic analysis (LSA). LSA and hierarchical clustering identified clusters of complaints for each severity level, which were compared and analyzed across time. Cluster analysis identified eight clusters of fatal incidents and six clusters of incidents involving injury. Comparisons showed that although the airbag clusters across the two severity levels have the same most frequent terms, the circumstances around the incidents differ. The time trends show clear increases in complaints surrounding the Ford/Firestone tire recall and the Toyota unintended acceleration recall. Increases in complaints may be partially driven by these recall announcements and the associated media attention. Text mining can reveal useful information from free-response databases that would otherwise be prohibitively time-consuming and difficult to summarize manually. Text mining can extend human analysis capabilities for large free-response databases to support earlier detection of problems and more timely safety interventions.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-24
... (TIN)/partial TIN required by paragraph S5.5.1 on one of the tire sidewalls. YTC indicates that the noncompliant tires do however include the full TIN on the intended outboard sidewall. YTC argues that the TIN and the partial TIN are used to properly identify tires that are involved in a safety campaign. YTC...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-17
... Partial Change of Use of Public Lands in Clark County, NV AGENCY: Bureau of Land Management, Interior.... The city proposes to change the use of 10 acres from a public park and police substation to a safety village. DATES: Interested parties may submit written comments regarding the proposed change of use of the...
Brivaracetam: An Adjunctive Treatment for Partial-Onset Seizures.
Kappes, John A; Hayes, William J; Strain, Joe D; Farver, Debra K
2017-07-01
Brivaracetam is an analogue of levetiracetam that is Food and Drug Administration-approved for adjunctive treatment of partial-onset seizures in patients 16 years and older. In placebo-controlled trials adjunct brivaracetam demonstrated efficacy in reducing the frequency of seizures. The most commonly reported adverse effects are somnolence, dizziness, and fatigue. Clinical trials have evaluated brivaracetam for safety and efficacy in adjunctive treatment of partial-onset seizures in patients 16 years and older for up to 16 weeks. Brivaracetam's mechanism is similar to that of levetiracetam but with greater receptor binding affinity on synaptic vesicle protein 2A and inhibitory effects on sodium channels. Clinically significant differences between these agents are undetermined. Brivaracetam is available as oral tablets, oral solution, and intravenous solution. The Food and Drug Administration-approved dose is 50 mg twice daily, and titration is not required. Brivaracetam does not need dose adjustment for renal impairment and has minimal drug-drug interactions. Current limitations of brivaracetam include lack of head-to-head trials, limited long-term safety and efficacy data, and cost. Overall, brivaracetam is a viable adjunct therapeutic option for refractory partial-onset seizures in those who have failed conventional therapies. © 2017, The American College of Clinical Pharmacology.
Leucoreduction of blood components: an effective way to increase blood safety?
Bianchi, Maria; Vaglio, Stefania; Pupella, Simonetta; Marano, Giuseppe; Facco, Giuseppina; Liumbruno, Giancarlo M.; Grazzini, Giuliano
2016-01-01
Over the past 30 years, it has been demonstrated that removal of white blood cells from blood components is effective in preventing some adverse reactions such as febrile non-haemolytic transfusion reactions, immunisation against human leucocyte antigens and human platelet antigens, and transmission of cytomegalovirus. In this review we discuss indications for leucoreduction and classify them into three categories: evidence-based indications for which the clinical efficacy is proven, indications based on the analysis of observational clinical studies with very consistent results and indications for which the clinical efficacy is partial or unproven. PMID:26710353
Lacosamide cardiac safety: clinical trials in patients with partial-onset seizures.
Rudd, G D; Haverkamp, W; Mason, J W; Wenger, T; Jay, G; Hebert, D; Doty, P; Horstmann, R
2015-11-01
To evaluate the cardiac safety of adjunctive lacosamide in a large pool of adults with partial-onset seizures (POS). Post-randomization changes from baseline for electrocardiographic (ECG) measurements, diagnostic findings, and relevant adverse events (AEs) were compared for pooled data from three randomized, placebo-controlled trials of adjunctive lacosamide for the treatment of POS. Lacosamide did not prolong the QTc interval or affect heart rate as determined by an analysis of data from patients randomized to lacosamide 200, 400, or 600 mg/day (n = 944) compared with placebo (n = 364). After 12-week maintenance treatment, mean changes from baseline for QRS duration were similar between the placebo and lacosamide 200 and 400 mg/day groups (0.0, -0.2, and 0.4 ms), but slightly increased for lacosamide 600 mg/day (2.3 ms). A small, dose-related mean increase in PR interval was observed (-0.3, 1.4, 4.4, and 6.6 ms for the placebo and lacosamide 200, 400, and 600 mg/day groups, respectively). First-degree atrioventricular (AV) block was reported as a non-serious AE in 0.0%, 0.7%, 0.2%, and 0.5% of patients in the same respective groups. Second- or higher degree AV block was not observed. There was no evidence of a PR-interval-related pharmacodynamic interaction of lacosamide with either carbamazepine or lamotrigine. Evaluation of the pooled cardiac safety data from patients with POS showed that adjunctive lacosamide at the maximum recommended dose (400 mg/day) was not clearly associated with any cardiac effect other than a small, dose-related increase in PR interval that had no evident symptomatic consequence. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Factors influencing Australian agricultural workers' self-efficacy using chemicals in the workplace.
Blackman, Ian R
2012-11-01
A hypothetical model was formulated to explore which factors can simultaneously influence the self-reported ability of agricultural employees to embrace chemical safety practices. Eight variables were considered in the study, including the employees' gender, age, duration of current employment status, and whether they were employed full-time or part-time. The self-efficacy measures of 169 participants were then estimated by measuring their self-rated ability to understand and perform different chemical safety practices. Models identifying employee self-efficacy pathways leading to worker readiness to engage in chemical safety were then tested using Partial Least Squares Path Analysis. Study results suggest that employees' self-efficacy to successfully engage in safe chemical practices in their workplace can be directly predicted by four variables, with additional indirect effects offered by one other variable, which cumulatively account for 41% of the variance of employees' chemical safety self-efficacy scores. The most significant predictor variables that directly influenced employees' self-efficacy in adopting chemical safety practices in the workplace were worker age, gender, years of employment, and concurrent confidence (self-efficacy) arising from prior experience using chemicals in the workplace. The variables of employees' prior knowledge and understanding about the use of administrative controls and personal protective equipment to protect workers from chemical exposure had no direct influence on self-efficacy to handle chemical emergencies. Employees' unfamiliarity with risk control strategies and reliance on material safety data sheets for information suggest that ongoing and targeted training are necessary if chemical safety issues are to be addressed.
Job hindrances, job resources, and safety performance: The mediating role of job engagement.
Yuan, Zhenyu; Li, Yongjuan; Tetrick, Lois E
2015-11-01
Job engagement has received widespread attention in organizational research but has rarely been empirically investigated in the context of safety. In the present study, we examined the mediating role of job engagement in the relationships between job characteristics and safety performance using self-reported data collected at a coal mining company in China. Most of our study hypotheses were supported. Job engagement partially mediated the relationships between job resources and safety performance dimensions. Theoretical and practical implications and directions for future research are also discussed. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Chughtai, Aamir Ali
2016-10-02
This study investigated the mediating role of organizational identification and psychological safety in the relationship between servant leadership and two employee outcomes: employee voice and negative feedback seeking behavior. The sample for this study comprised of 174 full-time employees drawn from a large food company based in Pakistan. Results showed that organizational identification and psychological safety partially mediated the effects of servant leadership on voice and negative feedback seeking behavior. The theoretical and practical implications of this research are discussed.
Facilities Maintenance in the U.S. Navy
1986-01-01
Row’a9IVI s..Nl,I I~de 14. 11111116104 It. safeI MeAI. 5,124 AN (:lgnd) JOHN SMITH I765 IIf Figure 111-1 Work Request is EMIROENCY/SERVICE WORK...Eliminate fire, health and active life of less than 3 years safety hazards o Infrequently or only partially o Patch and reinforce instead used of...safety or health hazards and to permit reactivation within the period prescribed under mobili- zation plans o Surplus facilities a Fliminate fire, safety
Miner, Philip B; Silberg, Debra G; Ruth, Magnus; Miller, Frank; Pandolfino, John
2014-11-18
The γ-aminobutyric acid type B-receptor agonist lesogaberan (AZD3355) has been developed for use in patients with gastroesophageal reflux disease (GERD) symptoms despite proton pump inhibitor (PPI) therapy (partial responders). This study aimed to explore the dose-response effect of lesogaberan on reflux episodes in partial responders. In this randomized, single-centre, double-blind, crossover, placebo-controlled study, partial responders taking optimised PPI therapy were given 30, 90, 120 and 240 mg doses of lesogaberan. Each dose was given twice (12 h apart) during a 24-h period, during which impedance-pH measurements were taken. Twenty-five patients were included in the efficacy analysis and 27 in the safety analysis. The effect of lesogaberan on the mean number of reflux episodes was dose-dependent, and all doses significantly reduced the mean number of reflux episodes relative to placebo. Lesogaberan also dose-dependently reduced the mean number of acid reflux episodes (except the 30 mg dose) and weakly acid reflux episodes (all doses) significantly, relative to placebo. Regardless of dose, lesogaberan had a similar effect on the percentage of time with esophageal pH < 4 [mean reduction: 68.5% (30 mg), 54.2% (90 mg), 65.9% (120 mg), 72.1% (240 mg); p < 0.05 except 90 mg dose]. No adverse events led to discontinuation and no serious adverse events occurred during active treatment. Lesogaberan inhibited reflux in a dose-dependent manner in partial responders taking optimised PPI therapy, and these effects were significant versus placebo. All lesogaberan doses were well tolerated and were not associated with clinically relevant adverse events. ClinicalTrials.gov identifier: NCT01043185.
Kahlert, Daniela; Schlicht, Wolfgang
2015-08-21
Traffic safety and pedestrian friendliness are considered to be important conditions for older people's motivation to walk through their environment. This study uses an experimental study design with computer-simulated living environments to investigate the effect of micro-scale environmental factors (parking spaces and green verges with trees) on older people's perceptions of both motivational antecedents (dependent variables). Seventy-four consecutively recruited older people were randomly assigned watching one of two scenarios (independent variable) on a computer screen. The scenarios simulated a stroll on a sidewalk, as it is 'typical' for a German city. In version 'A,' the subjects take a fictive walk on a sidewalk where a number of cars are parked partially on it. In version 'B', cars are in parking spaces separated from the sidewalk by grass verges and trees. Subjects assessed their impressions of both dependent variables. A multivariate analysis of covariance showed that subjects' ratings on perceived traffic safety and pedestrian friendliness were higher for Version 'B' compared to version 'A'. Cohen's d indicates medium (d = 0.73) and large (d = 1.23) effect sizes for traffic safety and pedestrian friendliness, respectively. The study suggests that elements of the built environment might affect motivational antecedents of older people's walking behavior.
Kim, Myoung Soo
2012-08-01
The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use. The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis. Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed. The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.
ERIC Educational Resources Information Center
Gilbert, George L., Ed.
1986-01-01
Background information, list of materials needed, and procedures used are provided for a demonstration involving the transformation of a hydrophobic liquid to a partially hydrophobic semisolid. Safety considerations are noted. (JN)
Martínez-Córcoles, Mario; Schöbel, Markus; Gracia, Francisco J; Tomás, Inés; Peiró, José M
2012-07-01
Safety participation is of paramount importance in guaranteeing the safe running of nuclear power plants. The present study examined the effects of empowering leadership on safety participation. Based on a sample of 495 employees from two Spanish nuclear power plants, structural equation modeling showed that empowering leadership has a significant relationship with safety participation, which is mediated by collaborative team learning. In addition, the results revealed that the relationship between empowering leadership and collaborative learning is partially mediated by the promotion of dialogue and open communication. The implications of these findings for safety research and their practical applications are outlined. An empowering leadership style enhances workers' safety performance, particularly safety participation behaviors. Safety participation is recommended to detect possible rule inconsistencies or misunderstood procedures and make workers aware of critical safety information and issues. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
Dunbar, Geoffrey C; Inglis, Fraser; Kuchibhatla, Ramana; Sharma, Tonmoy; Tomlinson, Mark; Wamsley, James
2007-03-01
Cognitive decline seen in the normal elderly is associated with selective loss of neuronal nicotinic acetylcholine receptors (nAChRs). Nicotine given either by inhalation or transdermally helps cognition, but unacceptable side effects limit its utility. The present study assessed the safety, tolerability and effect on cognition of ispronicline, a highly selective partial agonist at the 4beta2 nAChR, in elderly subjects (n =76) with age associated memory impairment (AAMI). This double-blind, placebo-controlled cross-over study explored ascending oral doses of ispronicline in the range 50-150 mg given as a single morning dose for a period of 3 weeks. Pharmacokinetics (PK) were assessed, as well as cognitive function measured by means of the Cognitive Drug Research (CDR) computerized test battery. Ispronicline had a favourable safety profile and was well tolerated at doses below 150 mg. No effect of clinical importance was seen on biochemistry, haematology, urine analysis, vital signs, electrocardiogram (ECG) or Holter monitoring. The most frequent drug induced adverse event was light-headedness (dizziness). A beneficial effect was seen on cognition across the dose range. This was most marked at 50 mg on factors measuring attention and episodic memory. PK analysis indicated a plasma Cmax range of 5-25/35 ng/ml ispronicline was associated with the most beneficial effect. These early results demonstrate ispronicline was well tolerated and did not display the side effects typical of nicotine. Ispronicline also had a beneficial effect on cognition in subjects with AAMI. This was seen most strongly in a Cmax range that had been predicted from pre-clinical animal studies.
ERIC Educational Resources Information Center
Wilens, Timothy E.; Gault, Laura M.; Childress, Ann; Kratochvil, Christopher J.; Bensman, Lindsey; Hall, Coleen M.; Olson, Evelyn; Robieson, Weining Z.; Garimella, Tushar S.; Abi-Saab, Walid M.; Apostol, George; Saltarelli, Mario D.
2011-01-01
Objective: To assess the safety and efficacy of ABT-089, a novel alpha[subscript 4]beta[subscript 2] neuronal nicotinic receptor partial agonist, vs. placebo in children with attention-deficit/hyperactivity disorder (ADHD). Method: Two multicenter, randomized, double-blind, placebo-controlled, parallel-group studies of children 6 through 12 years…
Vilazodone for the Treatment of Depression: An Update
Wang, Sheng-Min; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A.; Masand, Prakash S
2016-01-01
Vilazodone is a novel antidepressant having a selective serotonin (5-HT) reuptake inhibitor and 5-HT1A receptor partial agonist profile, so it has been regarded as a serotonin partial agonist-reuptake inhibitor (SPARI). We aimed to provide Vilazodone's clinical implications mainly by reviewing published clinical trials. Vilazodone has been speculated to have three potential benefits including faster onset of action, greater efficacy, and better tolerability owning to its SPARI properties. However, no studies conducted so far have directly proven the above speculations. Five initial phase II trials failed to distinguish vilazodone from placebo in the treatment of MDD, but 4 randomized clinical trials (RCT), 3 post-hoc or pooled analysis, 1 long-term open label study, and a meta-analysis showed vilazodone's superior efficacy over placebo. The studies also showed vilazodone is generally safe and tolerable. However, diarrhea, nausea, headache, dizziness, dry mouth, and insomnia warrant close attention in clinical practice because they have been constantly noted throughout the clinical studies. 2 RCTs recently documented the efficacy and safety of vilazodone in patients with generalized anxiety disorder, which could be a start of broadening vilazodone's usage or FDA approval in diverse anxiety disorders. PMID:27231672
Jamal, Nausheen; Erman, Andrew; Chhetri, Dinesh K.
2013-01-01
Objectives To determine symptoms and findings in patients with dysphagia related to epiglottic dysfunction. To analyze outcomes in patients who underwent partial epiglottidectomy due to dysphagia related to epiglottic dysfunction Study Design Review and analysis of clinical data obtained as part of the diagnosis and treatment of patients with dysphagia related to epiglottic dysfunction. Methods A retrospective review was performed of all post-treatment head and neck cancer patients who underwent epiglottidectomy at a single tertiary care referral center. Objective pre- and post-procedure swallow findings, endoscopic evaluation, and subjective improvement based on patient self-report were reviewed. Results Seven patients were identified based on endoscopic evaluation and modified barium swallow study (MBSS) as having epiglottic pathology leading to dysphagia. Specific anatomic and functional findings included thickening of the epiglottis, absence of epiglottic deflection, vallecular bolus retention during and after the swallow, and bolus backflow from the pharynx to the oral or nasal cavity. Partial epiglottidectomy was performed in these patients. Post-operative MBSS was analyzed for changes in swallow efficiency and safety. Nearly all patients demonstrated improved pharyngeal bolus passage with little to no added swallowing morbidity. Conclusions Preliminary findings suggest a role for partial epiglottidectomy in post-treatment head and neck cancer patients with swallowing disorders. Ideal candidates have intact tongue base contraction and poor retroflexion of the epiglottis, which result in bolus obstruction at the level of the valleculae. Partial epiglottic resection enables improved bolus passage in the pharyngeal phase. Minimal post-operative morbidity occurs in the appropriately selected patient. PMID:23794244
Formal Methods for Verification and Validation of Partial Specifications: A Case Study
NASA Technical Reports Server (NTRS)
Easterbrook, Steve; Callahan, John
1997-01-01
This paper describes our work exploring the suitability of formal specification methods for independent verification and validation (IV&V) of software specifications for large, safety critical systems. An IV&V contractor often has to perform rapid analysis on incomplete specifications, with no control over how those specifications are represented. Lightweight formal methods show significant promise in this context, as they offer a way of uncovering major errors, without the burden of full proofs of correctness. We describe a case study of the use of partial formal models for V&V of the requirements for Fault Detection Isolation and Recovery on the space station. We conclude that the insights gained from formalizing a specification are valuable, and it is the process of formalization, rather than the end product that is important. It was only necessary to build enough of the formal model to test the properties in which we were interested. Maintenance of fidelity between multiple representations of the same requirements (as they evolve) is still a problem, and deserves further study.
Farina, Elena; Bena, Antonella; Fedeli, Ugo; Mastrangelo, Giuseppe; Veronese, Michela; Agnesi, Roberto
2016-04-01
Literature suggests that more research is needed to clarify the effect of workplace inspections by governmental officers on injury rates. This paper aims to compare comprehensive and partial inspections in Italian manufacturing companies. Survival analysis was applied to the period free from injuries following inspection by means of the Kaplan-Meier method and of Cox models. Kaplan-Meier curves show that, compared to companies with a partial inspection, companies which had a comprehensive inspection had a higher survival through the entire period. Adjusting for confounders, the Cox model confirms a significant preventive effect of comprehensive inspection for companies with 10-30 employees, but not for those with >30 employees. The results suggest that the effect on injuries is greater if all aspects of safety are addressed during the inspection instead of focusing on a single aspect. These findings are interesting because they can help in planning effective prevention activities. © 2016 Wiley Periodicals, Inc.
Matias-Guiu, Pau; Rodríguez-Bencomo, Juan José; Pérez-Correa, José R; López, Francisco
2018-04-15
Developing new distillation strategies can help the spirits industry to improve quality, safety and process efficiency. Batch stills equipped with a packed column and an internal partial condenser are an innovative experimental system, allowing a fast and flexible management of the rectification. In this study, the impact of four factors (heart-cut volume, head-cut volume, pH and cooling flow rate of the internal partial condenser during the head-cut fraction) on 18 major volatile compounds of Muscat spirits was optimized using response surface methodology and desirability function approaches. Results have shown that high rectification at the beginning of the heart-cut enhances the overall positive aroma compounds of the product, reducing off-flavor compounds. In contrast, optimum levels of heart-cut volume, head-cut volume and pH factors varied depending on the process goal. Finally, three optimal operational conditions (head off-flavors reduction, flowery terpenic enhancement and fruity ester enhancement) were evaluated by chemical and sensory analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.
Making work safer: testing a model of social exchange and safety management.
DeJoy, David M; Della, Lindsay J; Vandenberg, Robert J; Wilson, Mark G
2010-04-01
This study tests a conceptual model that focuses on social exchange in the context of safety management. The model hypothesizes that supportive safety policies and programs should impact both safety climate and organizational commitment. Further, perceived organizational support is predicted to partially mediate both of these relationships. Study outcomes included traditional outcomes for both organizational commitment (e.g., withdrawal behaviors) as well as safety climate (e.g., self-reported work accidents). Questionnaire responses were obtained from 1,723 employees of a large national retailer. Using structural equation modeling (SEM) techniques, all of the model's hypothesized relationships were statistically significant and in the expected directions. The results are discussed in terms of social exchange in organizations and research on safety climate. Maximizing safety is a social-technical enterprise. Expectations related to social exchange and reciprocity figure prominently in creating a positive climate for safety within the organization. Copyright 2010 Elsevier Ltd. All rights reserved.
Report on the formal specification and partial verification of the VIPER microprocessor
NASA Technical Reports Server (NTRS)
Brock, Bishop; Hunt, Warren A., Jr.
1991-01-01
The formal specification and partial verification of the VIPER microprocessor is reviewed. The VIPER microprocessor was designed by RSRE, Malvern, England, for safety critical computing applications (e.g., aircraft, reactor control, medical instruments, armaments). The VIPER was carefully specified and partially verified in an attempt to provide a microprocessor with completely predictable operating characteristics. The specification of VIPER is divided into several levels of abstraction, from a gate-level description up to an instruction execution model. Although the consistency between certain levels was demonstrated with mechanically-assisted mathematical proof, the formal verification of VIPER was never completed.
Development of a simulation model for dynamic derailment analysis of high-speed trains
NASA Astrophysics Data System (ADS)
Ling, Liang; Xiao, Xin-Biao; Jin, Xue-Song
2014-12-01
The running safety of high-speed trains has become a major concern of the current railway research with the rapid development of high-speed railways around the world. The basic safety requirement is to prevent the derailment. The root causes of the dynamic derailment of high-speed trains operating in severe environments are not easy to identify using the field tests or laboratory experiments. Numerical simulation using an advanced train-track interaction model is a highly efficient and low-cost approach to investigate the dynamic derailment behavior and mechanism of high-speed trains. This paper presents a three-dimensional dynamic model of a high-speed train coupled with a ballast track for dynamic derailment analysis. The model considers a train composed of multiple vehicles and the nonlinear inter-vehicle connections. The ballast track model consists of rails, fastenings, sleepers, ballasts, and roadbed, which are modeled by Euler beams, nonlinear spring-damper elements, equivalent ballast bodies, and continuous viscoelastic elements, in which the modal superposition method was used to reduce the order of the partial differential equations of Euler beams. The commonly used derailment safety assessment criteria around the world are embedded in the simulation model. The train-track model was then used to investigate the dynamic derailment responses of a high-speed train passing over a buckled track, in which the derailment mechanism and train running posture during the dynamic derailment process were analyzed in detail. The effects of train and track modelling on dynamic derailment analysis were also discussed. The numerical results indicate that the train and track modelling options have a significant effect on the dynamic derailment analysis. The inter-vehicle impacts and the track flexibility and nonlinearity should be considered in the dynamic derailment simulations.
Fast-acting nuclear reactor control device
Kotlyar, Oleg M.; West, Phillip B.
1993-01-01
A fast-acting nuclear reactor control device for moving and positioning a fety control rod to desired positions within the core of the reactor between a run position in which the safety control rod is outside the reactor core, and a shutdown position in which the rod is fully inserted in the reactor core. The device employs a hydraulic pump/motor, an electric gear motor, and solenoid valve to drive the safety control rod into the reactor core through the entire stroke of the safety control rod. An overrunning clutch allows the safety control rod to freely travel toward a safe position in the event of a partial drive system failure.
Glucose determination in human aqueous humor with Raman spectroscopy
NASA Technical Reports Server (NTRS)
Lambert, James L.; Pelletier, Christine C.; Borchert, Mark
2005-01-01
It has been suggested that spectroscopic analysis of the aqueous humor of the eye could be used to indirectly predict blood glucose levels in diabetics noninvasively. We have been investigating this potential using Raman spectroscopy in combination with partial least squares (PLS) analysis. We have determined that glucose at clinically relevant concentrations can be accurately predicted in human aqueous humor in vitro using a PLS model based on artificial aqueous humor. We have further determined that with proper instrument design, the light energy necessary to achieve clinically acceptable prediction of glucose does not damage the retinas of rabbits and can be delivered at powers below internationally acceptable safety limits. Herein we summarize our current results and address our strategies to improve instrument design. 2005 Society of Photo-Optical Instrumentation Engineers.
Impact of Lead Time and Safety Factor in Mixed Inventory Models with Backorder Discounts
NASA Astrophysics Data System (ADS)
Lo, Ming-Cheng; Chao-Hsien Pan, Jason; Lin, Kai-Cing; Hsu, Jia-Wei
This study investigates the impact of safety factor on the continuous review inventory model involving controllable lead time with mixture of backorder discount and partial lost sales. The objective is to minimize the expected total annual cost with respect to order quantity, backorder price discount, safety factor and lead time. A model with normal demand is also discussed. Numerical examples are presented to illustrate the procedures of the algorithms and the effects of parameters on the result of the proposed models are analyzed.
21 CFR 601.27 - Pediatric studies.
Code of Federal Regulations, 2010 CFR
2010-04-01
... action on waiver. FDA shall grant a full or partial waiver, as appropriate, if the agency finds that... treatment-limiting drug reaction; documented enhancement of compliance; or evidence of safety and...
Negative pressure wound therapy for partial-thickness burns.
Dumville, Jo C; Munson, Christopher
2012-12-12
A burn wound is a complex and evolving injury, with both local and systemic consequences. Burn treatments include a variety of dressings, as well as newer strategies, such as negative pressure wound therapy (NPWT), which, by means of a suction force that drains excess fluids from the burn, tries to promote the wound healing process and minimise progression of the burn wound. To assess the effectiveness of NPWT for people with partial-thickness burns. For this third update we searched the Cochrane Wounds Group Specialised Register (searched 18 May 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 5); Ovid MEDLINE (2010 to May Week 2 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations 17 May 2012); Ovid EMBASE (2010 to 2012 Week 19); and EBSCO CINAHL (2010 to 16 May 2012). All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated the safety and effectiveness of NPWT for partial-thickness burns. Two review authors used standardised forms, and extracted the data independently. We assessed each trial for risk of bias, and resolved differences by discussion. One RCT, that was an interim report, satisfied the inclusion criteria. We undertook a narrative synthesis of results, as the absence of data and poor reporting precluded us from carrying out any formal statistical analysis. The trial was at high risk of bias. There was not enough evidence available to permit any conclusions to be drawn regarding the use of NPWT for treatment of partial-thickness burn wounds.
A preliminary validation of a new measure of occupational health and safety.
Cadieux, Jean; Roy, Mario; Desmarais, Lise
2006-01-01
This article describes the validation of an instrument designed to conduct an Occupational Health and Safety (OHS) self-diagnosis using workers observations of tangible facts and actions in the workplace. The instrument puts the emphasis on observable factors that make it possible to act proactively before accidents actually occur. Three companies were recruited from the printing sector in Québec based on their OHS performance (low, medium, and high), their interest in the project, and their availability. The master sample was composed of 269 people. Partial least squares (PLS) and vanishing tetrad analyses were used to study the behavior of the formative scales developed. The results indicate that partial revision of the instrument will be necessary to reach a fully satisfying level of validity. With regards to the statistical approach adopted, the use of a macro called CTA-SAS 2.0 developed by Bollen and Ting [Bollen, K.A., & Ting, K.-F. (1993). Confirmatory tetrad analysis. In P.V. Marsden (Ed.), Social methodology.Vol.23 (pp.147-176). Cambridge, MA: Blackwell, 23] has proven to be effective in providing a suitable statistical treatment of the latent formative variables on which our instrument's development is based. The results suggest that the instrument appears to be relatively robust and appropriate to diagnose OHS leading measures. In the long run, this instrument will make it possible for companies to draw a more refined picture of OHS evolution, even in the absence of occupational injuries.
Social capital and knowledge sharing: effects on patient safety.
Chang, Chia-Wen; Huang, Heng-Chiang; Chiang, Chi-Yun; Hsu, Chiu-Ping; Chang, Chia-Chen
2012-08-01
This article is a report on a study that empirically examines the influence of social capital on knowledge sharing and the impact of knowledge sharing on patient safety. Knowledge sharing is linked to many desirable managerial outcomes, including learning and problem-solving, which are essential for patient safety. Rather than studying the tangible effects of rewards, this study examines whether social capital (including social interaction, trust and shared vision) directly supports individual knowledge sharing in an organization. This cross-sectional study analysed data collected through a questionnaire survey of nurses from a major medical centre in northern Taiwan. The data were collected over a 9-month period from 2008 to 2009. The data analysis was conducted using the Partial Least Squares Graph v3.0 program to evaluate the measurement properties and the structural relationships specified in the research model. Based on a large-scale survey, empirical results indicate that Registered Nurses' perceptions of trust and shared vision have statistically significant and direct effects on knowledge sharing. In addition, knowledge sharing is significantly and positively associated with patient safety. The findings suggest that hospital administrators should foster group trust and initiate a common vision among Registered Nurses. In addition, administrators and chief knowledge officers of hospitals should encourage positive intentions towards knowledge sharing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Kahlert, Daniela; Schlicht, Wolfgang
2015-01-01
Traffic safety and pedestrian friendliness are considered to be important conditions for older people’s motivation to walk through their environment. This study uses an experimental study design with computer-simulated living environments to investigate the effect of micro-scale environmental factors (parking spaces and green verges with trees) on older people’s perceptions of both motivational antecedents (dependent variables). Seventy-four consecutively recruited older people were randomly assigned watching one of two scenarios (independent variable) on a computer screen. The scenarios simulated a stroll on a sidewalk, as it is ‘typical’ for a German city. In version ‘A,’ the subjects take a fictive walk on a sidewalk where a number of cars are parked partially on it. In version ‘B’, cars are in parking spaces separated from the sidewalk by grass verges and trees. Subjects assessed their impressions of both dependent variables. A multivariate analysis of covariance showed that subjects’ ratings on perceived traffic safety and pedestrian friendliness were higher for Version ‘B’ compared to version ‘A’. Cohen’s d indicates medium (d = 0.73) and large (d = 1.23) effect sizes for traffic safety and pedestrian friendliness, respectively. The study suggests that elements of the built environment might affect motivational antecedents of older people’s walking behavior. PMID:26308026
Schnitzer, Thomas J; Torbey, Souraya; Herrmann, Kristi; Kaushal, Gagan; Yeasted, Renita; Vania Apkarian, A
2016-01-01
Few effective pharmacological treatment options exist for chronic back pain, the leading cause of disability in the US, and all are associated with significant adverse effects. To determine the efficacy and safety of D-cycloserine, a partial agonist to the N-methyl-D-aspartate receptor, in the treatment of chronic low back pain. A total of 41 participants with chronic back pain who met all inclusion and exclusion criteria were enrolled in a double-blind, placebo-controlled randomized pilot trial of D-cycloserine. Treatment was administered orally for six weeks at escalating daily doses of 100 mg, 200 mg, and 400 mg, each for two weeks. The primary outcome measure was back pain intensity using the Numeric Rating Scale (0-10). Secondary measures were back pain-related questionnaires: McGill Pain Questionnaire short form, painDETECT, PANAS, and BDI. The pre-specified analysis was a two-way repeated measures analysis of variance. A treatment difference was observed between groups treated with D-cycloserine and placebo at six weeks of 1.05 ± 3.1 units on the Numeric Rating Scale, with an effect size of 0.4 and p = 0.14. This trend of better chronic back pain relief with D-cycloserine was also observed in the secondary measures. No safety issues were seen. The difference in mean pain between the D-cycloserine and placebo groups did not reach statistical significance. However, a clinically meaningful effect size in the magnitude of pain relief was observed with a consistent pattern across multiple outcome measures with good safety, supporting further research into the effectiveness of D-cycloserine for chronic back pain. © The Author(s) 2016.
Scagliotti, Giorgio; Kang, Jin Hyoung; Smith, David; Rosenberg, Richard; Park, Keunchil; Kim, Sang-We; Su, Wu-Chou; Boyd, Thomas E; Richards, Donald A; Novello, Silvia; Hynes, Scott M; Myrand, Scott P; Lin, Ji; Smyth, Emily Nash; Wijayawardana, Sameera; Lin, Aimee Bence; Pinder-Schenck, Mary
2016-10-01
Introduction LY2603618 is a selective inhibitor of checkpoint kinase 1 (CHK1) protein kinase, a key regulator of the DNA damage checkpoint, and is predicted to enhance the effects of antimetabolites, such as pemetrexed. This phase II trial assessed the overall response rate, safety, and pharmacokinetics (PK) of LY2603618 and pemetrexed in patients with non-small cell lung cancer (NSCLC). Methods In this open-label, single-arm trial, patients with advanced or metastatic NSCLC progressing after a prior first-line treatment regimen (not containing pemetrexed) and Eastern Cooperative Oncology Group performance status ≤2 received pemetrexed (500 mg/m(2), day 1) and LY2603618 (150 mg/m(2), day 2) every 21 days until disease progression. Safety was assessed using Common Terminology Criteria for Adverse Events v3.0. Serial blood samples were collected for PK analysis after LY2603618 and pemetrexed administration. Expression of p53, as measured by immunohistochemistry and genetic variant analysis, was assessed as a predictive biomarker of response. Results Fifty-five patients were enrolled in the study. No patients experienced a complete response; a partial response was observed in 5 patients (9.1 %; 90 % CI, 3.7-18.2) and stable disease in 20 patients (36.4 %). The median progression-free survival was 2.3 months (range, 0-27.1). Safety and PK of LY2603618 in combination with pemetrexed were favorable. No association between p53 status and response was observed. Conclusions There was no significant clinical activity of LY2603618 and pemetrexed combination therapy in patients with advanced NSCLC. The results were comparable with historical pemetrexed single-agent data, with similar safety and PK profiles being observed.
Submerged flow bridge scour under clear water conditions
DOT National Transportation Integrated Search
2012-09-01
Prediction of pressure flow (vertical contraction) scour underneath a partially or fully submerged bridge superstructure : in an extreme flood event is crucial for bridge safety. An experimentally and numerically calibrated formulation is : developed...
Kim, Sung-Hoon; Jin, Seok-Joon; Karm, Myong-Hwan; Moon, Young-Jin; Jeong, Hye-Won; Kim, Jae-Won; Ha, Seung-Il; Kim, Joung-Uk
2016-08-01
Although the elicited responses of motor evoked potential (MEP) monitoring are very sensitive to suppression by anesthetic agents and muscle relaxants, the use of neuromuscular blockade (NMB) during MEP monitoring is still controversial because of serious safety concerns and diagnostic accuracy. Here, we evaluated the incidence of unacceptable movement and compared false-negative MEP results between no and partial NMB during cerebral aneurysm clipping surgery. We reviewed patient medical records for demographic data, anesthesia regimen, neurophysiology event logs, MEP results, and clinical outcomes. Patients were divided into 2 groups according to the intraoperative use of NMB: no NMB group (n = 276) and partial NMB group (n = 409). We compared the diagnostic accuracy of MEP results to predict postoperative outcomes between both groups. Additionally, we evaluated unwanted patient movement during MEP monitoring in both groups. Of the 685 patients, 622 (90.8%) manifested no intraoperative changes in MEP and no postoperative motor deficits. Twenty patients showed postoperative neurologic deficits despite preserved intraoperative MEP. False-positive MEP results were 3.6% in the no NMB group and 3.9% in the partial NMB group (P = 1.00). False-negative MEP results were 1.1% in the no NMB group and 4.2% in the partial NMB group (P = 0.02). No spontaneous movement or spontaneous respiration was observed in either group. Propofol/remifentanil-based anesthesia without NMB decreases the stimulation intensity of MEPs, which may reduce the false-negative ratio of MEP monitoring during cerebral aneurysm surgery. Our anesthetic protocol enabled reliable intraoperative MEP recording and patient immobilization during cerebral aneurysm clipping surgery.
Pregabalin monotherapy in patients with partial-onset seizures
Kwan, Patrick; Fakhoury, Toufic; Pitman, Verne; DuBrava, Sarah; Knapp, Lloyd; Yurkewicz, Lorraine
2014-01-01
Objective: To assess pregabalin monotherapy for partial-onset seizures using a historical-controlled conversion-to-monotherapy design. Methods: Adults with inadequately controlled partial-onset seizures while receiving 1 or 2 antiepileptic drugs during an 8-week prospective baseline were randomized to double-blind monotherapy with pregabalin 600 or 150 mg/d (4:1) for 20 weeks (8-week conversion and 12-week monotherapy period). The primary endpoint was the seizure-related exit rate for pregabalin 600 mg/d, based on discontinuations due to predefined criteria. Efficacy was declared if the upper limit of the 95% confidence interval for the exit rate was below a historical-control threshold of 74%, with stepwise evaluation using a threshold of 68%. Results: The trial was stopped early for positive efficacy after an interim analysis in 125 patients. The full study population included 161 patients, with 148 evaluable for efficacy. The mean time since epilepsy diagnosis was 14 years. Overall, 54.3% (600 mg/d) and 46.9% (150 mg/d) of patients completed 20 weeks of double-blind treatment. Seizure-related exit rate in the 600 mg/d group (27.5%; 95% confidence interval, 17.8%–37.2%) was significantly below the 74% and 68% thresholds (p < 0.001 for both). Eight patients on 600 mg/d and 2 on 150 mg/d were seizure-free throughout pregabalin monotherapy. Pregabalin's overall safety profile was consistent with prior trials. Conclusions: Pregabalin monotherapy was safe and efficacious for patients with inadequately controlled partial-onset seizures. Classification of evidence: This study provides Class III evidence that patients with inadequately controlled partial-onset seizures switched to pregabalin monotherapy have fewer seizure-related exit events compared with historical controls switched to pseudo-placebo monotherapy. PMID:24415567
Hensley, Martee L; Patel, Shreyaskumar R; von Mehren, Margaret; Ganjoo, Kristen; Jones, Robin L; Staddon, Arthur; Rushing, Daniel; Milhem, Mohammed; Monk, Bradley; Wang, George; McCarthy, Sharon; Knoblauch, Roland E; Parekh, Trilok V; Maki, Robert G; Demetri, George D
2017-09-01
Trabectedin demonstrated significantly improved disease control in leiomyosarcoma and liposarcoma patients in a global phase 3 trial (NCT01343277). A post hoc analysis was conducted to assess the efficacy and safety of trabectedin or dacarbazine in women with uterine leiomyosarcoma (uLMS), the largest subgroup of enrolled patients (40%). Of 577 patients randomized 2:1 to receive trabectedin 1.5mg/m 2 by 24-hour IV infusion or dacarbazine 1g/m 2 by 20-120-minute IV infusion once every three weeks, 232 had uLMS (trabectedin: 144; dacarbazine: 88). The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS), objective response rate (ORR), clinical benefit rate (CBR: complete responses+partial responses+stable disease [SD] for at least 18weeks), duration of response (DOR), and safety. PFS for trabectedin was 4.0months compared with 1.5months for dacarbazine (hazard ratio [HR]=0.57; 95% CI 0.41-0.81; P=0.0012). OS was similar (trabectedin 13.4months vs. dacarbazine 12.9months, HR=0.89; 95% CI 0.65-1.24; P=0.51) between groups. ORR was 11% with trabectedin vs. 9% with dacarbazine (P=0.82). CBR for trabectedin was 31% vs. 18% with dacarbazine (P=0.05); median DOR was 6.5months for trabectedin vs. 4.1months for dacarbazine (P=0.32). Grade 3/4 treatment-emergent adverse events observed in ≥10% of patients in the trabectedin group included transient aminotransferase (aspartate/alanine) elevations, anemia, leukopenia, and thrombocytopenia. In this post hoc subset analysis of patients with uLMS who had received prior anthracycline therapy, trabectedin treatment resulted in significantly longer PFS versus dacarbazine, with an acceptable safety profile. There was no difference in OS. Copyright © 2017. Published by Elsevier Inc.
Wei, James C-C; Baeten, Dominique; Sieper, Joachim; Deodhar, Atul; Bhosekar, Vaishali; Martin, Ruvie; Porter, Brian
2017-05-01
To evaluate efficacy and safety of secukinumab in Asian patients with active ankylosing spondylitis (AS) via a pooled subgroup analysis from two phase 3 studies, MEASURE 1 (NCT01358175) and MEASURE 2 (NCT01649375). In MEASURE 1, patients were randomized to intravenous secukinumab 10 mg/kg or placebo at baseline, Weeks 2 and 4, followed by subcutaneous (s.c.) secukinumab 150 mg, 75 mg or placebo every 4 weeks (q4w) at Week 8. In MEASURE 2, patients were randomized to s.c. secukinumab 150 mg, 75 mg or placebo at baseline, Weeks 1, 2 and 3, and q4w starting at Week 4. Efficacy outcomes were SpondyloArthritis International Society (ASAS) 20/40, high-sensitivity C-reactive protein (hsCRP), ASAS5/6, Bath Ankylosing Spondylitis Disease Activity Index, Short Form-36 physical component summary, AS quality of life (QoL), ASAS partial remission, and Ankylosing Spondylitis Disease Activity Score - CRP at Weeks 16 and 52. Due to lack of efficacy, the secukinumab 75 mg dose in MEASURE 2 was excluded from this pooled Asian subgroup analysis. Safety analysis included patients who received ≥ 1 dose of study treatment. Of 517 patients enrolled into the MEASURE studies, 69 (13.3%) were Asians: 46 in pooled secukinumab and 23 in placebo. At Week 16, ASAS20/40 responses in Asian patients were 69.6%/43.5% with pooled secukinumab versus 26.1%/17.4% with placebo, which were comparable with rates reported in the overall study population. Secukinumab improved predefined efficacy endpoints at Week 16, with responses sustained through Week 52. Secukinumab was well tolerated in Asian patients, with a safety profile consistent with that reported in the overall study population. Secukinumab improved signs and symptoms, physical function, and disease-specific QoL in Asian patients with active AS. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Wei, Wei; Guo, Ming; Ye, Long; Liao, Ganli; Yang, Zhehan
2016-10-01
Despite the large body of work on the work-family interface, hardly any literature has addressed the work-family interface in safety-critical settings. This study draws from social exchange theory to examine the effect of employees' strain-based work-to-family conflict on their supervisors' rating of their safety participation through job satisfaction. The sample consisted of 494 drivers from a major railway company in China. The results of a structural equation model revealed that drivers' strain-based work-to-family conflict negatively influences safety participation, and the relationship was partially mediated by job satisfaction. These findings highlight the importance of reducing employees' work-to-family conflict in safety-critical organizations. Copyright © 2016 Elsevier Ltd. All rights reserved.
A partial pressure monitor and controller for stable ozone flow from a silica gel trap
NASA Astrophysics Data System (ADS)
Stevens, R. E.; Hsiao, C.-W.; Le, Linh; Curro, N. J.; Monton, B. J.; Chang, B.-Y.; Kung, C.-Y.; Kittrell, C.; Kinsey, J. L.
1998-06-01
A new ozone trapping system designed for safe and consistent delivery to a reaction vessel is described. Silica gel is used to trap the ozone because of its known safety advantages over traps that store ozone in liquid form. The new design is free of any liquid baths, such as freon or flammable solvents. A circuit design for monitoring and controlling the ozone partial pressure of 6-25 Torr is also described.
Efficacy of Pregabalin in Childhood Refractory Partial Seizure
Zamani, Gholamreza; Tavasoli, Alireza; Zare-Shahabadi, Ameneh; Rezaei, Nima; Ahmadvand, Alireza
2014-01-01
Objective: About one third of partial seizures are refractory to treatment. Several anticonvulsant drugs have entered the market in recent decades but concerns about intolerance, drug interactions, and the safety of the drug are notable. One of these new anticonvulsants is pregabalin, a safe drug with almost no interaction with other antiepileptic drugs. Methods: In this open label clinical trial study, pregabalin was used for evaluation of its efficacy on reducing seizure frequency in 29 children suffering from refractory partial seizures. Average daily and weekly seizure frequency of the patients was recorded during a 6-week period (baseline period). Then, during a period of 2 weeks (titration period), pregabalin was started with a dose of 25-75 mg/d, using method of flexible dose, and was brought to maximum dose of drug that was intended in this study (450 mg/d) based on clinical response of the patients and seizure frequency. Then the patients were given the drug for 12 weeks and the average frequency of daily and weekly seizures were recorded again (treatment period). Findings : Reduction in seizure frequency in this study was 36% and the responder rate or number of patients who gained more than 50% reduction in seizure frequency was 51.7%. Conclusion: This study showed that pregabalin can be used with safety and an acceptable efficacy in treatment of childhood refractory partial seizures. PMID:25793053
Oza, Amit M; Tinker, Anna V; Oaknin, Ana; Shapira-Frommer, Ronnie; McNeish, Iain A; Swisher, Elizabeth M; Ray-Coquard, Isabelle; Bell-McGuinn, Katherine; Coleman, Robert L; O'Malley, David M; Leary, Alexandra; Chen, Lee-May; Provencher, Diane; Ma, Ling; Brenton, James D; Konecny, Gottfried E; Castro, Cesar M; Giordano, Heidi; Maloney, Lara; Goble, Sandra; Lin, Kevin K; Sun, James; Raponi, Mitch; Rolfe, Lindsey; Kristeleit, Rebecca S
2017-11-01
An integrated analysis was undertaken to characterize the antitumor activity and safety profile of the oral poly(ADP-ribose) polymerase inhibitor rucaparib in patients with relapsed high-grade ovarian carcinoma (HGOC). Eligible patients from Study 10 (NCT01482715) and ARIEL2 (NCT01891344) who received a starting dose of oral rucaparib 600mg twice daily (BID) with or without food were included in these analyses. The integrated efficacy population included patients with HGOC and a deleterious germline or somatic BRCA1 or BRCA2 (BRCA1/2) mutation who received at least two prior chemotherapies and were sensitive, resistant, or refractory to platinum-based chemotherapy. The primary endpoint was investigator-assessed confirmed objective response rate (ORR). Secondary endpoints included duration of response (DOR) and progression-free survival (PFS). The integrated safety population included patients with HGOC who received at least one dose of rucaparib 600mg BID, irrespective of BRCA1/2 mutation status and prior treatments. In the efficacy population (n=106), ORR was 53.8% (95% confidence interval [CI], 43.8-63.5); 8.5% and 45.3% of patients achieved complete and partial responses, respectively. Median DOR was 9.2months (95% CI, 6.6-11.6). In the safety population (n=377), the most frequent treatment-emergent adverse events (AEs) were nausea, asthenia/fatigue, vomiting, and anemia/hemoglobin decreased. The most common grade ≥3 treatment-emergent AE was anemia/hemoglobin decreased. Treatment-emergent AEs led to treatment interruption, dose reduction, and treatment discontinuation in 58.6%, 45.9%, and 9.8% of patients, respectively. No treatment-related deaths occurred. Rucaparib has antitumor activity in advanced BRCA1/2-mutated HGOC and a manageable safety profile. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
49 CFR 234.106 - Partial activation.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GRADE CROSSING SAFETY, INCLUDING SIGNAL SYSTEMS, STATE ACTION PLANS, AND EMERGENCY NOTIFICATION SYSTEMS Response to Credible Reports of Warning System Malfunction at Highway-Rail...
49 CFR 234.106 - Partial activation.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GRADE CROSSING SAFETY, INCLUDING SIGNAL SYSTEMS, STATE ACTION PLANS, AND EMERGENCY NOTIFICATION SYSTEMS Response to Credible Reports of Warning System Malfunction at Highway-Rail...
49 CFR 234.106 - Partial activation.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GRADE CROSSING SAFETY, INCLUDING SIGNAL SYSTEMS, STATE ACTION PLANS, AND EMERGENCY NOTIFICATION SYSTEMS Response to Credible Reports of Warning System Malfunction at Highway-Rail...
Schiffinger, Michael; Latzke, Markus; Steyrer, Johannes
2016-01-01
Safety climate (SC) and more recently patient engagement (PE) have been identified as potential determinants of patient safety, but conceptual and empirical studies combining both are lacking. On the basis of extant theories and concepts in safety research, this study investigates the effect of PE in conjunction with SC on perceived error occurrence (pEO) in hospitals, controlling for various staff-, patient-, and hospital-related variables as well as the amount of stress and (lack of) organizational support experienced by staff. Besides the main effects of PE and SC on error occurrence, their interaction is examined, too. In 66 hospital units, 4,345 patients assessed the degree of PE, and 811 staff assessed SC and pEO. PE was measured with a new instrument, capturing its core elements according to a recent literature review: Information Provision (both active and passive) and Activation and Collaboration. SC and pEO were measured with validated German-language questionnaires. Besides standard regression and correlational analyses, partial least squares analysis was employed to model the main and interaction effects of PE and SC on pEO, also controlling for stress and (lack of) support perceived by staff, various staff and patient attributes, and potential single-source bias. Both PE and SC are associated with lower pEO, to a similar extent. The joint effect of these predictors suggests a substitution rather than mutually reinforcing interaction. Accounting for control variables and/or potential single-source bias slightly attenuates some effects without altering the results. Ignoring PE potentially amounts to forgoing a potential source of additional safety. On the other hand, despite the abovementioned substitution effect and conjectures of SC being inert, PE should not be considered as a replacement for SC.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Liao, J.; Kucukboyaci, V. N.; Nguyen, L.
2012-07-01
The Westinghouse Small Modular Reactor (SMR) is an 800 MWt (> 225 MWe) integral pressurized water reactor (iPWR) with all primary components, including the steam generator and the pressurizer located inside the reactor vessel. The reactor core is based on a partial-height 17x17 fuel assembly design used in the AP1000{sup R} reactor core. The Westinghouse SMR utilizes passive safety systems and proven components from the AP1000 plant design with a compact containment that houses the integral reactor vessel and the passive safety systems. A preliminary loss of coolant accident (LOCA) analysis of the Westinghouse SMR has been performed using themore » WCOBRA/TRAC-TF2 code, simulating a transient caused by a double ended guillotine (DEG) break in the direct vessel injection (DVI) line. WCOBRA/TRAC-TF2 is a new generation Westinghouse LOCA thermal-hydraulics code evolving from the US NRC licensed WCOBRA/TRAC code. It is designed to simulate PWR LOCA events from the smallest break size to the largest break size (DEG cold leg). A significant number of fluid dynamics models and heat transfer models were developed or improved in WCOBRA/TRAC-TF2. A large number of separate effects and integral effects tests were performed for a rigorous code assessment and validation. WCOBRA/TRAC-TF2 was introduced into the Westinghouse SMR design phase to assist a quick and robust passive cooling system design and to identify thermal-hydraulic phenomena for the development of the SMR Phenomena Identification Ranking Table (PIRT). The LOCA analysis of the Westinghouse SMR demonstrates that the DEG DVI break LOCA is mitigated by the injection and venting from the Westinghouse SMR passive safety systems without core heat up, achieving long term core cooling. (authors)« less
1980-11-01
the rapid, partial removal or covering of contamination to reduce the radiation exposure rate as quickly as practicable to a point where priority work ...should be responsible for planning and implementing all decontamination activities. He could be a city en- gineer, public works engineer, industrial safety...responsibility for a local civil defense or emergency preparedness program. DisaterAnalysis - A review and determination of the extent of damage sufere bya
Haschke, Ferdinand; Klassen-Wigger, Petra
2010-01-01
Marketing-driven innovation in the field of pediatric nutrition, in particular in the infant formula segment is not sustainable. New benefits of products must be scientifically proven and safety and efficacy of new formulae established in clinical trials. The scientific innovation process of three infant formulae is described. Improvement in protein quality allowed to reduce the protein concentration in whey-based infant formula. Weight gain and BMI of infants fed those formulae corresponds to breastfed infants and is lower than in infants fed traditional formulae with higher protein concentration. A meta-analysis indicates associations between rapid weight gain in infancy and obesity later in life. If infants cannot be exclusively breastfed until 4-6 months of age, feeding low-protein formulae may contribute to positive long-term health outcome with potentially important health economic effects. A partially hydrolyzed whey based formula for prevention of allergic symptoms in children with hereditary risk for allergic diseases was developed more than 25 years ago. The most recent meta-analysis which included 15 randomized clinical trials indicates that the risk of all allergic diseases and atopic dermatitis/eczema is significantly reduced in infants at risk when the partially hydrolyzed formula is fed. The partially hydrolyzed formula had the same protective effect as casein-based high-degree extensively hydrolyzed formula. Because of substantial price differences between the two formulae, feeding the partially hydrolyzed whey formula is cost saving. Hypoallergenic claims can be made in many countries, and international nutrition committees have positively commented the preventive effect of those formulae. Acidified formulae have been widely used during the last decade in replacement feeding programs for infants whose mothers are HIV positive. The formula was innovated by improving whey protein quality and lowering protein concentration. The bacteriostatic properties of the new formula were proven in in vitro tests. Meta-analysis indicated that feeding the formula to immunocompromised infants resulted in growth similar to breastfeeding. The bacteriostatic effects of the acidified formula need to be communicated to health care professionals, but also the risks if replacement feeding is not acceptable, feasible, affordable, sustainable, and safe for mother and infant. Copyright © 2010 S. Karger AG, Basel.
Bi, Sheng; Xia, Ming
2015-08-11
To compare the validity and safety between holmium: YAG laser and traditional surgery in partial nephrectomy. A total of 28 patients were divided into two groups (holmium: YAG laser group without renal artery clamping and traditional surgery group with renal artery clamping). The intraoperative blood loss, total operative time, renal artery clamping time, postoperative hospital stay, separated renal function, postoperative complications and depth of tissue injury were recorded. The intraoperative blood loss, total operative time, renal artery clamping time, postoperative hospital stay, separated renal function, postoperative complications and depth of tissue injury were 80 ml, 77 min, 0 min, 7.4 days, 35 ml/min, 0, 0.9 cm, respectively, in holmium: YAG laser group. And in traditional surgery group were 69 ml, 111 min, 25.5 min, 7.3 days, 34 ml/min, 0, 2.0 cm, respectively. The differences of total operative time, renal artery clamping time and depth of tissue injury between two groups were statistically significant. The others were not statistically significant. Holmium: YAG laser is effective and safe in partial nephrectomy. It can decrease the total operative time, minimize the warm ischemia time and enlarge the extent of surgical excision.
Uncertainty quantification and sensitivity analysis with CASL Core Simulator VERA-CS
Brown, C. S.; Zhang, Hongbin
2016-05-24
Uncertainty quantification and sensitivity analysis are important for nuclear reactor safety design and analysis. A 2x2 fuel assembly core design was developed and simulated by the Virtual Environment for Reactor Applications, Core Simulator (VERA-CS) coupled neutronics and thermal-hydraulics code under development by the Consortium for Advanced Simulation of Light Water Reactors (CASL). An approach to uncertainty quantification and sensitivity analysis with VERA-CS was developed and a new toolkit was created to perform uncertainty quantification and sensitivity analysis with fourteen uncertain input parameters. Furthermore, the minimum departure from nucleate boiling ratio (MDNBR), maximum fuel center-line temperature, and maximum outer clad surfacemore » temperature were chosen as the selected figures of merit. Pearson, Spearman, and partial correlation coefficients were considered for all of the figures of merit in sensitivity analysis and coolant inlet temperature was consistently the most influential parameter. We used parameters as inputs to the critical heat flux calculation with the W-3 correlation were shown to be the most influential on the MDNBR, maximum fuel center-line temperature, and maximum outer clad surface temperature.« less
Response Time Analysis and Test of Protection System Instrument Channels for APR1400 and OPR1000
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lee, Chang Jae; Han, Seung; Yun, Jae Hee
2015-07-01
Safety limits are required to maintain the integrity of physical barriers designed to prevent the uncontrolled release of radioactive materials in nuclear power plants. The safety analysis establishes two critical constraints that include an analytical limit in terms of a measured or calculated variable, and a specific time after the analytical limit is reached to begin protective action. Keeping with the nuclear regulations and industry standards, satisfying these two requirements will ensure that the safety limit will not be exceeded during the design basis event, either an anticipated operational occurrence or a postulated accident. Various studies on the setpoint determinationmore » methodology for the safety-related instrumentation have been actively performed to ensure that the requirement of the analytical limit is satisfied. In particular, the protection setpoint methodology for the advanced power reactor 1400 (APP1400) and the optimized power reactor 1000 (OPR1000) has been recently developed to cover both the design basis event and the beyond design basis event. The developed setpoint methodology has also been quantitatively validated using specific computer programs and setpoint calculations. However, the safety of nuclear power plants cannot be fully guaranteed by satisfying the requirement of the analytical limit. In spite of the response time verification requirements of nuclear regulations and industry standards, it is hard to find the studies on the systematically integrated methodology regarding the response time evaluation. In cases of APR1400 and OPR1000, the response time analysis for the plant protection system is partially included in the setpoint calculation and the response time test is separately performed via the specific plant procedure. The test technique has a drawback which is the difficulty to demonstrate completeness of timing test. The analysis technique has also a demerit of resulting in extreme times that not actually possible. Thus, the establishment of the systematic response time evaluation methodology is needed to justify the conformance to the response time requirement used in the safety analysis. This paper proposes the response time evaluation methodology for APR1400 and OPR1000 using the combined analysis and test technique to confirm that the plant protection system can meet the analytical response time assumed in the safety analysis. In addition, the results of the quantitative evaluation performed for APR1400 and OPR1000 are presented in this paper. The proposed response time analysis technique consists of defining the response time requirement, determining the critical signal path for the trip parameter, allocating individual response time to each component on the signal path, and analyzing the total response time for the trip parameter, and demonstrates that the total analyzed response time does not exceed the response time requirement. The proposed response time test technique is composed of defining the response time requirement, determining the critical signal path for the trip parameter, determining the test method for each component on the signal path, performing the response time test, and demonstrates that the total test result does not exceed the response time requirement. The total response time should be tested in a single test that covers from the sensor to the final actuation device on the instrument channel. When the total channel is not tested in a single test, separate tests on groups of components or single components including the total instrument channel shall be combined to verify the total channel response. For APR1400 and OPR1000, the ramp test technique is used for the pressure and differential pressure transmitters and the step function testing technique is applied to the signal processing equipment and final actuation device. As a result, it can be demonstrated that the response time requirement is satisfied by the combined analysis and test technique. Therefore, the proposed methodology in this paper plays a crucial role in guaranteeing the safety of the nuclear power plants systematically satisfying one of two critical requirements from the safety analysis. (authors)« less
20 CFR 410.635 - Disqualification of Administrative Law Judge.
Code of Federal Regulations, 2011 CFR
2011-04-01
... AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Determinations of Disability, Other... which he is prejudiced or partial with respect to any party, or where he has any interest in the matter...
20 CFR 410.635 - Disqualification of Administrative Law Judge.
Code of Federal Regulations, 2010 CFR
2010-04-01
... AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Determinations of Disability, Other... which he is prejudiced or partial with respect to any party, or where he has any interest in the matter...
Evaluation of 1983 selective speed enforcement projects in Virginia.
DOT National Transportation Integrated Search
1985-01-01
This report describes and evaluates Virginia's 1983 selective speed enforcement projects. These projects are one of the various types of highway safety programs, classified as selective traffic enforcement projects (STEPs) partially funded by the fed...
Fear patterns: a new approach to designing road safety advertisements.
Algie, Jennifer; Rossiter, John R
2010-01-01
This research studies fear patterns within fear appeal anti-speeding television commercials. A pattern of fear is the sequence of fear arousal and fear reduction, if any, that is felt by the viewing audience when exposed to a fear appeal advertisement. Many road safety advertisers use fear appeals, such as "shock" advertising, that result in fear arousal, leaving the viewer feeling extremely tense. The moment-to-moment reactions of young drivers to 12 road safety commercials are gauged using a dynamic, temporal measure of fear. The fear patterns generated from each ad are analyzed and a new perspective on creating fear appeal road safety advertisements, with an emphasis on fear-relief, fear-partial relief, and fear-only patterns, is discussed.
Steinhoff, Bernhard J; Somerville, Ernest R; Van Paesschen, Wim; Ryvlin, Philippe; Schelstraete, Isabelle
2007-08-01
The Safety of Keppra as Adjunctive Therapy in Epilepsy (SKATE) study aimed to evaluate the safety and efficacy of levetiracetam (Keppra, LEV) as add-on therapy for refractory partial seizures in clinical practice. This Phase IV, 16-week, open-label study recruited patients > or =16-year old with treatment-resistant partial seizures. LEV (1000 mg/day) was added to a stable concomitant antiepileptic drug regimen. LEV dosage was adjusted based on seizure control and tolerability to a maximum of 3000 mg/day. 1541 patients (intent-to-treat population) were recruited including 1346 (87.3%) who completed the study and 77.0% who declared further continuing on LEV after the trial. Overall, 50.5% of patients reported at least one adverse event that was considered related to LEV treatment. The most frequently reported drug-related adverse events were mild-to-moderate somnolence, fatigue, dizziness and headache. Serious adverse events considered related to LEV occurred in 1.0% of patients. 7.5% of patients reported adverse events as the most important reason for study drug discontinuation. The median reduction from baseline in the frequency of all seizures was 50.2%; 15.8% of patients were seizure free; 50.1% had seizure frequency reduction of > or =50%. At the end of the study, 60.4% of patients were considered by the investigator to show marked or moderate improvement. There was a significant improvement in health-related quality of life as assessed with the QOLIE-10-P (total score increasing from 55.6 to 61.6; p<0.001). This community-based study suggests that LEV is well tolerated and effective as add-on therapy for refractory partial seizures in adults. These data provide supportive evidence for the safety and efficacy of LEV demonstrated in the pivotal Phase III placebo-controlled studies.
Yan, Lufeng; Li, Junhui; Wang, Danli; Ding, Tian; Hu, Yaqin; Ye, Xingqian; Linhardt, Robert J; Chen, Shiguo
2017-12-15
Fucosylated chondroitin sulfate from sea cucumber Isostichopus badionotus (FCS-Ib) showed potent anticoagulant activities without selectivity. The present study focused on developing safe FCS-Ib oligomers showing selective inhibition of intrinsic factor Xase (anti-FXase) prepared through partial N-deacetylation-deaminative cleavage. The N-deacetylation degree was regulated by reaction time, controlling the resulting oligomer distribution. Structure analysis confirmed the selectivity of degradation, and 12 high purity fractions with trisaccharide-repeating units were separated. In vitro anticoagulant assays indicated a decrease in molecular weight (Mw) dramatically reduced activated partial thromboplastin time (APTT), thrombin time (TT), AT-dependent anti-FIIa and anti-FXa activities, while the oligomers retained potent anti-FXase activity until they fell below 3kDa. Meanwhile, human FXII activation and platelet aggregation were markedly reduced with decreasing Mw and were moderate when under 12.0kDa. Thus, fragments of 3-12.0kDa should be safe and effective as selective inhibitors of intrinsic tenase complex for application as clinical anticoagulants. Copyright © 2017 Elsevier Ltd. All rights reserved.
Formal Methods of V&V of Partial Specifications: An Experience Report
NASA Technical Reports Server (NTRS)
Easterbrook, Steve; Callahan, John
1997-01-01
This paper describes our work exploring the suitability of formal specification methods for independent verification and validation (IV&V) of software specifications for large, safety critical systems. An IV&V contractor often has to perform rapid analysis on incomplete specifications, with no control over how those specifications are represented. Lightweight formal methods show significant promise in this context, as they offer a way of uncovering major errors, without the burden of full proofs of correctness. We describe an experiment in the application of the method SCR. to testing for consistency properties of a partial model of requirements for Fault Detection Isolation and Recovery on the space station. We conclude that the insights gained from formalizing a specification is valuable, and it is the process of formalization, rather than the end product that is important. It was only necessary to build enough of the formal model to test the properties in which we were interested. Maintenance of fidelity between multiple representations of the same requirements (as they evolve) is still a problem, and deserves further study.
NASA Astrophysics Data System (ADS)
Latief, Yusuf; Machfudiyanto, Rossy A.; Arifuddin, Rosmariani; Yogiswara, Yoko
2017-03-01
Based on the data, 32% of accidental cases in Indonesia occurs on constructional sectors. It is supported by the data from Public Work and Housing Department that 27.43% of the implementation level of Safety Management System policy at construction companies in Indonesia remains unsafe categories. Moreover, there are dimensions of occupational safety culture formed including leadership, behavior, strategy, policy, process, people, safety cost, value and contract system. The aim of this study is to determine the model of an effective safety culture and know the relationship between dimensions in construction industry. The method used in this research was questionnaire survey which was distributed to the sample of construction companies either in a national private one in Indonesia. The result of this research is supposed to be able to illustrate the development of the relationship among occupational safety culture dimensions which have influences to the performances of constructional companies in Indonesia.
Baum, Rex L.; Savage, William Z.; Godt, Jonathan W.
2008-01-01
The Transient Rainfall Infiltration and Grid-Based Regional Slope-Stability Model (TRIGRS) is a Fortran program designed for modeling the timing and distribution of shallow, rainfall-induced landslides. The program computes transient pore-pressure changes, and attendant changes in the factor of safety, due to rainfall infiltration. The program models rainfall infiltration, resulting from storms that have durations ranging from hours to a few days, using analytical solutions for partial differential equations that represent one-dimensional, vertical flow in isotropic, homogeneous materials for either saturated or unsaturated conditions. Use of step-function series allows the program to represent variable rainfall input, and a simple runoff routing model allows the user to divert excess water from impervious areas onto more permeable downslope areas. The TRIGRS program uses a simple infinite-slope model to compute factor of safety on a cell-by-cell basis. An approximate formula for effective stress in unsaturated materials aids computation of the factor of safety in unsaturated soils. Horizontal heterogeneity is accounted for by allowing material properties, rainfall, and other input values to vary from cell to cell. This command-line program is used in conjunction with geographic information system (GIS) software to prepare input grids and visualize model results.
Objective responses in relapsed T-cell lymphomas with single-agent brentuximab vedotin
Advani, Ranjana H.; Bartlett, Nancy L.; Jacobsen, Eric D.; Sharman, Jeff P.; O’Connor, Owen A.; Siddiqi, Tanya; Kennedy, Dana A.; Oki, Yasuhiro
2014-01-01
This phase 2, open-label, multicenter study evaluated the efficacy and safety of brentuximab vedotin, a CD30-directed antibody-drug conjugate, in relapsed/refractory CD30+ non-Hodgkin lymphomas. The primary end point was objective response rate (ORR). Key secondary end points included safety, correlation of CD30 expression with response, response duration, and progression-free survival (PFS). Brentuximab vedotin 1.8 mg/kg was administered every 3 weeks until progression or unacceptable toxicity. This planned subset analysis included patients with peripheral T-cell lymphomas (PTCLs; n = 35), specifically angioimmunoblastic T-cell lymphoma (AITL; n = 13) and PTCL not otherwise specified (n = 22). Median age was 64 years; 63% were refractory to most recent therapy. Of 34 evaluable patients, ORR was 41% (8 complete remissions [CRs], 6 partial remissions [PRs]), and ORR was 54% in AITL (5 CRs, 2 PRs) with median PFS of 6.7 months thus far. No correlation between CD30 expression per central review and response was observed. Safety data were consistent with the known profile of brentuximab vedotin, and included at least grade 3 events of neutropenia (14%), peripheral sensory neuropathy, and hyperkalemia (9% each). In summary, brentuximab vedotin showed antitumor activity in patients with relapsed PTCL particularly AITL. This trial was registered at www.clinicaltrials.gov as #NCT01421667. PMID:24652992
Two low-dose levonorgestrel intrauterine contraceptive systems: a randomized controlled trial.
Nelson, Anita; Apter, Dan; Hauck, Brian; Schmelter, Thomas; Rybowski, Sarah; Rosen, Kimberly; Gemzell-Danielsson, Kristina
2013-12-01
To evaluate the efficacy and safety of two low-dose levonorgestrel intrauterine contraceptive systems. Nulliparous and parous women aged 18-35 years with regular menstrual cycles (21-35 days) requesting contraception were randomized to 3 years of treatment with one of two levonorgestrel intrauterine contraceptive systems: 13.5 mg total content or 19.5 mg total content. The primary outcome was the pregnancy rate, calculated as the Pearl Index. Overall, 1,432 and 1,452 women in the 13.5 mg intrauterine contraceptive system and 19.5 mg intrauterine contraceptive system groups, respectively, had a placement attempted and were included in the full analysis set to evaluate efficacy and safety. Mean (standard deviation) age was 27.1 (4.8) years; 39.2% were nulliparous. Over the 3-year study period, 0.33 pregnancies per 100 women-years (95% confidence interval [CI] 0.16-0.60) were observed with the 13.5 mg intrauterine contraceptive system compared with 0.31 per 100 women-years (95% CI 0.15-0.57) with the 19.5 mg intrauterine contraceptive system. Kaplan-Meier estimates for that period were 0.009 and 0.010, respectively. At least partial expulsions occurred in 4.56% and 3.58% and discontinuation rates resulting from a reported adverse event occurred in 21.9% and 19.1%, respectively. Ten of the 20 pregnancies were ectopic. Serious adverse events included six cases of pelvic inflammatory disease and one partial uterine perforation. Both lower-dose levonorgestrel intrauterine contraceptive systems were highly effective for 3 years of use and generally well tolerated. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00528112. : I.
Responsive cortical stimulation for the treatment of medically intractable partial epilepsy.
Morrell, Martha J
2011-09-27
This multicenter, double-blind, randomized controlled trial assessed the safety and effectiveness of responsive cortical stimulation as an adjunctive therapy for partial onset seizures in adults with medically refractory epilepsy. A total of 191 adults with medically intractable partial epilepsy were implanted with a responsive neurostimulator connected to depth or subdural leads placed at 1 or 2 predetermined seizure foci. The neurostimulator was programmed to detect abnormal electrocorticographic activity. One month after implantation, subjects were randomized 1:1 to receive stimulation in response to detections (treatment) or to receive no stimulation (sham). Efficacy and safety were assessed over a 12-week blinded period and a subsequent 84-week open-label period during which all subjects received responsive stimulation. Seizures were significantly reduced in the treatment (-37.9%, n = 97) compared to the sham group (-17.3%, n = 94; p = 0.012) during the blinded period and there was no difference between the treatment and sham groups in adverse events. During the open-label period, the seizure reduction was sustained in the treatment group and seizures were significantly reduced in the sham group when stimulation began. There were significant improvements in overall quality of life (p < 0.02) and no deterioration in mood or neuropsychological function. Responsive cortical stimulation reduces the frequency of disabling partial seizures, is associated with improvements in quality of life, and is well-tolerated with no mood or cognitive effects. Responsive stimulation may provide another adjunctive treatment option for adults with medically intractable partial seizures. This study provides Class I evidence that responsive cortical stimulation is effective in significantly reducing seizure frequency for 12 weeks in adults who have failed 2 or more antiepileptic medication trials, 3 or more seizures per month, and 1 or 2 seizure foci.
The development of fire evaluation system for detention and correctional occupancies
NASA Astrophysics Data System (ADS)
Nelson, H. E.; Shibe, A. J.
1984-12-01
A fire safety evaluation system for detention and correctional occupancies was developed. It can be used for determining if a facility has fire safety equivalent to that obtained by meeting the requirement of a given code. The system was calibrated for use with proposed chapters for detention and correctional occupancies of the Life Safety Code (1985). There are separate sets of requirements for each of four use conditions: one for zoned egress, one for zoned impeded egress, one for impeded egress, and one for contained. Within each set, there are two levels of evaluation: one for partially sprinklered and nonsprinklered buildings, and one for totally sprinklered buildings.
Mirheydar, Hossein S; Parsons, J Kellogg
2013-06-01
Robotic technology disseminated into urological practice without robust comparative effectiveness data. To review the diffusion of robotic surgery into urological practice. We performed a comprehensive literature review focusing on diffusion patterns, patient safety, learning curves, and comparative costs for robotic radical prostatectomy, partial nephrectomy, and radical cystectomy. Robotic urologic surgery diffused in patterns typical of novel technology spreading among practicing surgeons. Robust evidence-based data comparing outcomes of robotic to open surgery were sparse. Although initial Level 3 evidence for robotic prostatectomy observed complication outcomes similar to open prostatectomy, subsequent population-based Level 2 evidence noted an increased prevalence of adverse patient safety events and genitourinary complications among robotic patients during the early years of diffusion. Level 2 evidence indicated comparable to improved patient safety outcomes for robotic compared to open partial nephrectomy and cystectomy. Learning curve recommendations for robotic urologic surgery have drawn exclusively on Level 4 evidence and subjective, non-validated metrics. The minimum number of cases required to achieve competency for robotic prostatectomy has increased to unrealistically high levels. Most comparative cost-analyses have demonstrated that robotic surgery is significantly more expensive than open or laparoscopic surgery. Evidence-based data are limited but suggest an increased prevalence of adverse patient safety events for robotic prostatectomy early in the national diffusion period. Learning curves for robotic urologic surgery are subjective and based on non-validated metrics. The urological community should develop rigorous, evidence-based processes by which future technological innovations may diffuse in an organized and safe manner.
NASA Astrophysics Data System (ADS)
Kurdhi, N. A.; Jamaluddin, A.; Jauhari, W. A.; Saputro, D. R. S.
2017-06-01
In this study, we consider a stochastic integrated manufacturer-retailer inventory model with service level constraint. The model analyzed in this article considers the situation in which the vendor and the buyer establish a long-term contract and strategic partnership to jointly determine the best strategy. The lead time and setup cost are assumed can be controlled by an additional crashing cost and an investment, respectively. It is assumed that shortages are allowed and partially backlogged on the buyer’s side, and that the protection interval (i.e., review period plus lead time) demand distribution is unknown but has given finite first and second moments. The objective is to apply the minmax distribution free approach to simultaneously optimize the review period, the lead time, the setup cost, the safety factor, and the number of deliveries in order to minimize the joint total expected annual cost. The service level constraint guarantees that the service level requirement can be satisfied at the worst case. By constructing Lagrange function, the analysis regarding the solution procedure is conducted, and a solution algorithm is then developed. Moreover, a numerical example and sensitivity analysis are given to illustrate the proposed model and to provide some observations and managerial implications.
NASA Astrophysics Data System (ADS)
Li, Yanran; Chen, Duo; Li, Li; Zhang, Jiwei; Li, Guang; Liu, Hongxia
2017-11-01
GIS (gas insulated switchgear), is an important equipment in power system. Partial discharge plays an important role in detecting the insulation performance of GIS. UHF method and ultrasonic method frequently used in partial discharge (PD) detection for GIS. However, few studies have been conducted on comparison of this two methods. From the view point of safety, it is necessary to investigate UHF method and ultrasonic method for partial discharge in GIS. This paper presents study aimed at clarifying the effect of UHF method and ultrasonic method for partial discharge caused by free metal particles in GIS. Partial discharge tests were performed in laboratory simulated environment. Obtained results show the ability of anti-interference of signal detection and the accuracy of fault localization for UHF method and ultrasonic method. A new method based on UHF method and ultrasonic method of PD detection for GIS is proposed in order to greatly enhance the ability of anti-interference of signal detection and the accuracy of detection localization.
NASA Astrophysics Data System (ADS)
Wu, L. Z.; Selvadurai, A. P. S.; Zhang, L. M.; Huang, R. Q.; Huang, Jinsong
2016-12-01
Rainfall-induced landslides are a common occurrence in terrain with steep topography and soils that have degradable strength. Rainfall infiltration into a partially saturated slope of infinite extent can lead to either a decrease or complete elimination of soil suction, compromising the slopes' stability. In this research the rainfall infiltration coupled with deformation of a partially saturated soil slope during rainfall infiltration is analyzed. The limit equilibrium conditions and the shear strength relationship of a partially saturated soil are employed to develop an analytical solution for calculating the stability of an infinite partially saturated slope due to rainfall infiltration. The analytical solutions are able to consider the influence of the coupled effects on the stability of the slope. The factors that affect the safety of a partially saturated slope of infinite extent are discussed. The results indicate that the poro-mechanical coupling of water infiltration and deformation has an important effect on the stability of the infinite unsaturated slope.
Once-daily USL255 as adjunctive treatment of partial-onset seizures: Randomized phase III study
Chung, Steve S; Fakhoury, Toufic A; Hogan, R Edward; Nagaraddi, Venkatesh N; Blatt, Ilan; Lawson, Balduin; Arnold, Stephan; Anders, Bob; Clark, Annie M; Laine, Dawn; Meadows, R Shawn; Halvorsen, Mark B
2014-01-01
Objective To evaluate the efficacy and safety of USL255, Qudexy™ XR (topiramate) extended-release capsules, as an adjunctive treatment for refractory partial-onset seizures (POS) in adults taking one to three concomitant antiepileptic drugs. Methods In this global phase III study (PREVAIL; NCT01142193), 249 adults with POS were randomized 1:1 to once-daily USL255 (200 mg/day) or placebo. The primary and key secondary efficacy endpoints were median percent reduction in weekly POS frequency and responder rate (proportion of patients with ≥50% reduction in seizure frequency). Seizure freedom was also assessed. Safety (adverse events, clinical and laboratory findings), as well as treatment effects on quality of life (QOLIE-31-P) and clinical global impression of change (CGI-C), were evaluated. Results Across the entire 11-week treatment phase, USL255 significantly reduced the median percent seizure frequency and significantly improved responder rate compared with placebo. Efficacy over placebo was observed early in treatment, in patients with highly refractory POS, and in those with the most debilitating seizure types (i.e., complex partial, partial secondarily generalized). USL255 was safe and generally well tolerated with a low incidence of neurocognitive adverse events. USL255 was associated with significant clinical improvement without adversely affecting quality of life. Significance The PREVAIL phase III clinical study demonstrated that once-daily USL255 (200 mg/day) significantly improved seizure control and was safe and generally well tolerated with few neurocognitive side effects. PMID:24902983
Human Biomechanical and Cardiopulmonary Responses to Partial Gravity - A Systematic Review.
Richter, Charlotte; Braunstein, Bjoern; Winnard, Andrew; Nasser, Mona; Weber, Tobias
2017-01-01
The European Space Agency has recently announced to progress from low Earth orbit missions on the International Space Station to other mission scenarios such as exploration of the Moon or Mars. Therefore, the Moon is considered to be the next likely target for European human space explorations. Compared to microgravity (μg), only very little is known about the physiological effects of exposure to partial gravity (μg < partial gravity <1 g). However, previous research studies and experiences made during the Apollo missions comprise a valuable source of information that should be taken into account when planning human space explorations to reduced gravity environments. This systematic review summarizes the different effects of partial gravity (0.1-0.4 g) on the human musculoskeletal, cardiovascular and respiratory systems using data collected during the Apollo missions as well as outcomes from terrestrial models of reduced gravity with either 1 g or microgravity as a control. The evidence-based findings seek to facilitate decision making concerning the best medical and exercise support to maintain astronauts' health during future missions in partial gravity. The initial search generated 1,323 publication hits. Out of these 1,323 publications, 43 studies were included into the present analysis and relevant data were extracted. None of the 43 included studies investigated long-term effects. Studies investigating the immediate effects of partial gravity exposure reveal that cardiopulmonary parameters such as heart rate, oxygen consumption, metabolic rate, and cost of transport are reduced compared to 1 g, whereas stroke volume seems to increase with decreasing gravity levels. Biomechanical studies reveal that ground reaction forces, mechanical work, stance phase duration, stride frequency, duty factor and preferred walk-to-run transition speed are reduced compared to 1 g. Partial gravity exposure below 0.4 g seems to be insufficient to maintain musculoskeletal and cardiopulmonary properties in the long-term. To compensate for the anticipated lack of mechanical and metabolic stimuli some form of exercise countermeasure appears to be necessary in order to maintain reasonable astronauts' health, and thus ensure both sufficient work performance and mission safety.
Human Biomechanical and Cardiopulmonary Responses to Partial Gravity – A Systematic Review
Richter, Charlotte; Braunstein, Bjoern; Winnard, Andrew; Nasser, Mona; Weber, Tobias
2017-01-01
The European Space Agency has recently announced to progress from low Earth orbit missions on the International Space Station to other mission scenarios such as exploration of the Moon or Mars. Therefore, the Moon is considered to be the next likely target for European human space explorations. Compared to microgravity (μg), only very little is known about the physiological effects of exposure to partial gravity (μg < partial gravity <1 g). However, previous research studies and experiences made during the Apollo missions comprise a valuable source of information that should be taken into account when planning human space explorations to reduced gravity environments. This systematic review summarizes the different effects of partial gravity (0.1–0.4 g) on the human musculoskeletal, cardiovascular and respiratory systems using data collected during the Apollo missions as well as outcomes from terrestrial models of reduced gravity with either 1 g or microgravity as a control. The evidence-based findings seek to facilitate decision making concerning the best medical and exercise support to maintain astronauts' health during future missions in partial gravity. The initial search generated 1,323 publication hits. Out of these 1,323 publications, 43 studies were included into the present analysis and relevant data were extracted. None of the 43 included studies investigated long-term effects. Studies investigating the immediate effects of partial gravity exposure reveal that cardiopulmonary parameters such as heart rate, oxygen consumption, metabolic rate, and cost of transport are reduced compared to 1 g, whereas stroke volume seems to increase with decreasing gravity levels. Biomechanical studies reveal that ground reaction forces, mechanical work, stance phase duration, stride frequency, duty factor and preferred walk-to-run transition speed are reduced compared to 1 g. Partial gravity exposure below 0.4 g seems to be insufficient to maintain musculoskeletal and cardiopulmonary properties in the long-term. To compensate for the anticipated lack of mechanical and metabolic stimuli some form of exercise countermeasure appears to be necessary in order to maintain reasonable astronauts' health, and thus ensure both sufficient work performance and mission safety. PMID:28860998
AHRQ's hospital survey on patient safety culture: psychometric analyses.
Blegen, Mary A; Gearhart, Susan; O'Brien, Roxanne; Sehgal, Niraj L; Alldredge, Brian K
2009-09-01
This project analyzed the psychometric properties of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPSC) including factor structure, interitem reliability and intraclass correlations, usefulness for assessment, predictive validity, and sensitivity. The survey was administered to 454 health care staff in 3 hospitals before and after a series of multidisciplinary interventions designed to improve safety culture. Respondents (before, 434; after, 368) included nurses, physicians, pharmacists, and other hospital staff members. Factor analysis partially confirmed the validity of the HSOPSC subscales. Interitem consistency reliability was above 0.7 for 5 subscales; the staffing subscale had the lowest reliability coefficients. The intraclass correlation coefficients, agreement among the members of each unit, were within recommended ranges. The pattern of high and low scores across the subscales of the HSOPSC in the study hospitals were similar to the sample of Pacific region hospitals reported by the Agency for Healthcare Research and Quality and corresponded to the proportion of items in each subscale that are worded negatively (reverse scored). Most of the unit and hospital dimensions were correlated with the Safety Grade outcome measure in the tool. Overall, the tool was shown to have moderate-to-strong validity and reliability, with the exception of the staffing subscale. The usefulness in assessing areas of strength and weakness for hospitals or units among the culture subscales is questionable. The culture subscales were shown to correlate with the perceived outcomes, but further study is needed to determine true predictive validity.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Brown, C. S.; Zhang, Hongbin
Uncertainty quantification and sensitivity analysis are important for nuclear reactor safety design and analysis. A 2x2 fuel assembly core design was developed and simulated by the Virtual Environment for Reactor Applications, Core Simulator (VERA-CS) coupled neutronics and thermal-hydraulics code under development by the Consortium for Advanced Simulation of Light Water Reactors (CASL). An approach to uncertainty quantification and sensitivity analysis with VERA-CS was developed and a new toolkit was created to perform uncertainty quantification and sensitivity analysis with fourteen uncertain input parameters. Furthermore, the minimum departure from nucleate boiling ratio (MDNBR), maximum fuel center-line temperature, and maximum outer clad surfacemore » temperature were chosen as the selected figures of merit. Pearson, Spearman, and partial correlation coefficients were considered for all of the figures of merit in sensitivity analysis and coolant inlet temperature was consistently the most influential parameter. We used parameters as inputs to the critical heat flux calculation with the W-3 correlation were shown to be the most influential on the MDNBR, maximum fuel center-line temperature, and maximum outer clad surface temperature.« less
Zheng, Yi; Han, Jia-Gang; Wang, Zhen-Jun; Gao, Zhi-Gang; Wei, Guang-Hui; Zhai, Zhi-Wei; Zhao, Bao-Cheng
2018-06-05
The introduction of individualized abdominoperineal excision (APE) may minimize operative trauma and reduce the rate of complications. The purpose of this study was to evaluate the safety and efficacy of individualized APE for low rectal cancer. Fifty-six patients who underwent individualized APE from June 2011 to June 2015 were evaluated retrospectively in Beijing Chaoyang Hospital, Capital Medical University. The main outcome measures were circumferential resection margin (CRM) involvement, intraoperative perforation, postoperative complications, and local recurrence. Statistical analysis was performed using SPSS version 16.0. Fifty (89%) patients received preoperative chemoradiotherapy: 51 (91%) patients were treated with the sacrococcyx preserved; 27 (48%) patients with the levator ani muscle partially preserved bilaterally; 20 (36%) patients with the levator ani muscle partially preserved unilaterally and the muscle on the opposite side totally preserved; 7 (13%) patients with intact levator ani muscle and part of the ischioanal fat bilaterally dissected; and 2 (4%) patients with part of the ischioanal fat and intact lavator ani muscle dissected unilaterally and the muscle on the opposite side partially preserved. The most common complications included sexual dysfunction (12%), perineal wound complications (13%), urinary retention (7%), and chronic perineal pain (5%). A positive CRM was demonstrated in 3 (5%) patients, and intraoperative perforations occurred in 2 (4%) patients. On multiple logistic regression analysis, longer operative time (P = 0.032) and more intraoperative blood loss (P = 0.006) were significantly associated with perineal procedure-related complications. The local recurrence was 4% at a median follow-up of 53 months (range: 30-74 months). With preoperative chemoradiotherapy, individualized APE may be a relatively safe and feasible approach for low rectal cancer with acceptable oncological outcomes.
Koopmann, Jaclyn; Lanaj, Klodiana; Wang, Mo; Zhou, Le; Shi, Junqi
2016-07-01
The teams literature suggests that team tenure improves team psychological safety climate and climate strength in a linear fashion, but the empirical findings to date have been mixed. Alternatively, theories of group formation suggest that new and longer tenured teams experience greater team psychological safety climate than moderately tenured teams. Adopting this second perspective, we used a sample of 115 research and development teams and found that team tenure had a curvilinear relationship with team psychological safety climate and climate strength. Supporting group formation theories, team psychological safety climate and climate strength were higher in new and longer tenured teams compared with moderately tenured teams. Moreover, we found a curvilinear relationship between team tenure and average team member creative performance as partially mediated by team psychological safety climate. Team psychological safety climate improved average team member task performance only when team psychological safety climate was strong. Likewise, team tenure influenced average team member task performance in a curvilinear manner via team psychological safety climate only when team psychological safety climate was strong. We discuss theoretical and practical implications and offer several directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
The Driver Behaviour Questionnaire as accident predictor; A methodological re-meta-analysis.
Af Wåhlberg, A E; Barraclough, P; Freeman, J
2015-12-01
The Manchester Driver Behaviour Questionnaire (DBQ) is the most commonly used self-report tool in traffic safety research and applied settings. It has been claimed that the violation factor of this instrument predicts accident involvement, which was supported by a previous meta-analysis. However, that analysis did not test for methodological effects, or include unpublished results. The present study re-analysed studies on prediction of accident involvement from DBQ factors, including lapses, and many unpublished effects. Tests of various types of dissemination bias and common method variance were undertaken. Outlier analysis showed that some effects were probably not reliable data, but excluding them did not change the results. For correlations between violations and crashes, tendencies for published effects to be larger than unpublished ones and for effects to decrease over time were observed, but were not significant. Also, using the mean of accidents as proxy for effect indicated that studies where effects for violations are not reported have smaller effect sizes. These differences indicate dissemination bias. Studies using self-reported accidents as dependent variables had much larger effects than those using recorded accident data. Also, zero-order correlations were larger than partial correlations controlled for exposure. Similarly, violations/accidents effects were strong only when there was also a strong correlation between accidents and exposure. Overall, the true effect is probably very close to zero (r<.07) for violations versus traffic accident involvement, depending upon which tendencies are controlled for. Methodological factors and dissemination bias have inflated the published effect sizes of the DBQ. Strong evidence of various artefactual effects is apparent. A greater level of care should be taken if the DBQ continues to be used in traffic safety research. Also, validation of self-reports should be more comprehensive in the future, taking into account the possibility of common method variance. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.
Traceability of 'Limone di Siracusa PGI' by a multidisciplinary analytical and chemometric approach.
Amenta, M; Fabroni, S; Costa, C; Rapisarda, P
2016-11-15
Food traceability is increasingly relevant with respect to safety, quality and typicality issues. Lemon fruits grown in a typical lemon-growing area of southern Italy (Siracusa), have been awarded the PGI (Protected Geographical Indication) recognition as 'Limone di Siracusa'. Due to its peculiarity, consumers have an increasing interest about this product. The detection of potential fraud could be improved by using the tools linking the composition of this production to its typical features. This study used a wide range of analytical techniques, including conventional techniques and analytical approaches, such as spectral (NIR spectra), multi-elemental (Fe, Zn, Mn, Cu, Li, Sr) and isotopic ((13)C/(12)C, (18)O/(16)O) marker investigations, joined with multivariate statistical analysis, such as PLS-DA (Partial Least Squares Discriminant Analysis) and LDA (Linear Discriminant Analysis), to implement a traceability system to verify the authenticity of 'Limone di Siracusa' production. The results demonstrated a very good geographical discrimination rate. Copyright © 2016 Elsevier Ltd. All rights reserved.
Effects of sleep schedules on commercial motor vehicle driver performance : part 1
DOT National Transportation Integrated Search
2000-09-01
The Federal Motor Carrier Safety Administration sponsored a study to gather and analyze data on commercial motor vehicle (CMV) driver rest and recovery cycles, effects of partial sleep deprivation, and prediction of subsequent performance. The study ...
Effects of sleep schedules on commercial motor vehicle driver performance : part 2
DOT National Transportation Integrated Search
2000-09-01
The Federal Motor Carrier Safety Administration sponsored a study to gather and analyze data on commercial motor vehicle driver rest and recovery cycles, effects of partial sleep deprivation, and prediction of subsequent performance. The study began ...
McDiarmid, Melissa A; Condon, Marian
2005-07-01
The health risks posed to health care workers (HCW) handling antineoplastic and other hazardous drugs (HDs) are well established. However, despite nearly 20 years of professional practice standards, compliance with safe handling procedures is poor. We present documentation of undercompliance with recommended safety procedures for HDs. Then, we examine a similar problem, HCW compliance with blood-borne pathogen universal precautions (UP) and its partial solution tied to the strength of a facility's safety culture. Lessons learned here may be applicable to the HD issue. It is proposed that analyzing a facility's safety culture may enlarge our understanding of the barriers contributing to HD under-compliance and suggest strategies to improve it. The Safety Culture paradigm offers many targets for intervention to enhance and promote worker compliance with safe HD handling practices thus mitigating internal exposure.
Lilly, Michelle M
2011-01-01
This study examines the relationship between world assumptions and trauma history in predicting symptoms of dissociation. It was proposed that cognitions related to the safety and benevolence of the world, as well as self-worth, would be related to the presence of dissociative symptoms, the latter of which were theorized to defend against threats to one's sense of safety, meaningfulness, and self-worth. Undergraduates from a midwestern university completed the Multiscale Dissociation Inventory, World Assumptions Scale, and Traumatic Life Events Questionnaire. Consistent with the hypotheses, world assumptions were related to the extent of trauma exposure and interpersonal trauma exposure in the sample but were not significantly related to non-interpersonal trauma exposure. World assumptions acted as a significant partial mediator of the relationship between trauma exposure and dissociation, and this relationship held when interpersonal trauma exposure specifically was considered. The factor structures of dissociation and world assumptions were also examined using principal component analysis, with the benevolence and self-worth factors of the World Assumptions Scale showing the strongest relationships with trauma exposure and dissociation. Clinical implications are discussed.
Efficacy and Safety of Frozen Blood for Transfusion in Trauma Patients
2012-11-01
ELIZABETH E. HEYD DR. RODGER D. VANDERBEEK Chief, Airmen Integration Research Support Chair...blood mixed with citrate-phosphate-dextrose-adenine (CPDA) is centrifuged, the plasma is partially removed, and it is stored at 2-8 o C. The US
Isotani, Shuji; Shimoyama, Hirofumi; Yokota, Isao; China, Toshiyuki; Hisasue, Shin-ichi; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Ukimura, Osamu; Horie, Shigeo
2015-05-01
To evaluate the feasibility and accuracy of virtual partial nephrectomy analysis, including a color-coded three-dimensional virtual surgical planning and a quantitative functional analysis, in predicting the surgical outcomes of robot-assisted partial nephrectomy. Between 2012 and 2014, 20 patients underwent virtual partial nephrectomy analysis before undergoing robot-assisted partial nephrectomy. Virtual partial nephrectomy analysis was carried out with the following steps: (i) evaluation of the arterial branch for selective clamping by showing the vascular-supplied area; (ii) simulation of the optimal surgical margin in precise segmented three-dimensional model for prediction of collecting system opening; and (iii) detailed volumetric analyses and estimates of postoperative renal function based on volumetric change. At operation, the surgeon identified the targeted artery and determined the surgical margin according to the virtual partial nephrectomy analysis. The surgical outcomes between the virtual partial nephrectomy analysis and the actual robot-assisted partial nephrectomy were compared. All 20 patients had negative cancer surgical margins and no urological complications. The tumor-specific renal arterial supply areas were shown in color-coded three-dimensional model visualization in all cases. The prediction value of collecting system opening was 85.7% for sensitivity and 100% for specificity. The predicted renal resection volume was significantly correlated with actual resected specimen volume (r(2) = 0.745, P < 0.001). The predicted estimated glomerular filtration rate was significantly correlated with actual postoperative estimated glomerular filtration rate (r(2) = 0.736, P < 0.001). Virtual partial nephrectomy analysis is able to provide the identification of tumor-specific renal arterial supply, prediction of collecting system opening and prediction of postoperative renal function. This technique might allow urologists to compare various arterial clamping methods and resection margins with surgical outcomes in a non-invasive manner. © 2015 The Japanese Urological Association.
Profitability and occupational injuries in U.S. underground coal mines☆
Asfaw, Abay; Mark, Christopher; Pana-Cryan, Regina
2015-01-01
Background Coal plays a crucial role in the U.S. economy yet underground coal mining continues to be one of the most dangerous occupations in the country. In addition, there are large variations in both profitability and the incidence of occupational injuries across mines. Objective The objective of this study was to examine the association between profitability and the incidence rate of occupational injuries in U.S. underground coal mines between 1992 and 2008. Data and method We used mine-specific data on annual hours worked, geographic location, and the number of occupational injuries suffered annually from the employment and accident/injury databases of the Mine Safety and Health Administration, and mine-specific data on annual revenue from coal sales, mine age, workforce union status, and mining method from the U.S. Energy Information Administration. A total of 5669 mine-year observations (number of mines × number of years) were included in our analysis. We used a negative binomial random effects model that was appropriate for analyzing panel (combined time-series and cross-sectional) injury data that were non-negative and discrete. The dependent variable, occupational injury, was measured in three different and non-mutually exclusive ways: all reported fatal and nonfatal injuries, reported nonfatal injuries with lost workdays, and the ‘most serious’ (i.e. sum of fatal and serious nonfatal) injuries reported. The total number of hours worked in each mine and year examined was used as an exposure variable. Profitability, the main explanatory variable, was approximated by revenue per hour worked. Our model included mine age, workforce union status, mining method, and geographic location as additional control variables. Results After controlling for other variables, a 10% increase in real total revenue per hour worked was associated with 0.9%, 1.1%, and 1.6% decrease, respectively, in the incidence rates of all reported injuries, reported injuries with lost workdays, and the most serious injuries reported. Conclusion We found an inverse relationship between profitability and each of the three indicators of occupational injuries we used. These results might be partially due to factors that affect both profitability and safety, such as management or engineering practices, and partially due to lower investments in safety by less profitable mines, which could imply that some financially stressed mines might be so focused on survival that they forgo investing in safety. PMID:22884379
Profitability and occupational injuries in U.S. underground coal mines.
Asfaw, Abay; Mark, Christopher; Pana-Cryan, Regina
2013-01-01
Coal plays a crucial role in the U.S. economy yet underground coal mining continues to be one of the most dangerous occupations in the country. In addition, there are large variations in both profitability and the incidence of occupational injuries across mines. The objective of this study was to examine the association between profitability and the incidence rate of occupational injuries in U.S. underground coal mines between 1992 and 2008. We used mine-specific data on annual hours worked, geographic location, and the number of occupational injuries suffered annually from the employment and accident/injury databases of the Mine Safety and Health Administration, and mine-specific data on annual revenue from coal sales, mine age, workforce union status, and mining method from the U.S. Energy Information Administration. A total of 5669 mine-year observations (number of mines×number of years) were included in our analysis. We used a negative binomial random effects model that was appropriate for analyzing panel (combined time-series and cross-sectional) injury data that were non-negative and discrete. The dependent variable, occupational injury, was measured in three different and non-mutually exclusive ways: all reported fatal and nonfatal injuries, reported nonfatal injuries with lost workdays, and the 'most serious' (i.e. sum of fatal and serious nonfatal) injuries reported. The total number of hours worked in each mine and year examined was used as an exposure variable. Profitability, the main explanatory variable, was approximated by revenue per hour worked. Our model included mine age, workforce union status, mining method, and geographic location as additional control variables. After controlling for other variables, a 10% increase in real total revenue per hour worked was associated with 0.9%, 1.1%, and 1.6% decrease, respectively, in the incidence rates of all reported injuries, reported injuries with lost workdays, and the most serious injuries reported. We found an inverse relationship between profitability and each of the three indicators of occupational injuries we used. These results might be partially due to factors that affect both profitability and safety, such as management or engineering practices, and partially due to lower investments in safety by less profitable mines, which could imply that some financially stressed mines might be so focused on survival that they forgo investing in safety. Published by Elsevier Ltd.
Losigamone add-on therapy for partial epilepsy.
Xiao, Yousheng; Luo, Man; Wang, Jin; Luo, Hongye
2012-06-13
Epilepsy is a common neurologic disorder, affecting approximately 50 million people worldwide; nearly a third of these people are not well controlled by a single antiepileptic drug and usually require treatment with a combination of two or more antiepileptic drugs. In recent years, many newer antiepileptic drugs have been investigated as add-on therapy for partial epilepsy; losigamone is one of these drugs and is the focus of this systematic review. To investigate the efficacy and safety of losigamone when used as an add-on therapy for partial epilepsy. We searched the Cochrane Epilepsy Group Specialized Register (1 May 2012), the Cochrane Central Register of Controlled Trials (CENTRAL Issue 4 of 12, The Cochrane Library, 2012) and MEDLINE (1 May 2012). We searched trials registers and contacted the manufacturer of losigamone and authors of included studies for additional information. There were no language restrictions. Randomized controlled add-on trials comparing losigamone with placebo for partial epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcomes were 50% or greater reduction in seizure frequency and seizure freedom; the secondary outcomes were treatment withdrawal and adverse events. Results are presented as risk ratios (RR) with 95% confidence intervals (CIs) or 99% CIs (for the individual listed adverse events to make an allowance for multiple testing). Two trials involving a total of 467 patients were eligible for inclusion. Both trials assessed losigamone 1200 or 1500 mg/d as an add-on therapy for partial epilepsy. One trial was assessed as being of good methodologic quality while the other was of uncertain quality. For the efficacy outcomes, results did show patients taking losigamone were significantly more likely to achieve a 50% or greater reduction in seizure frequency (RR 1.75; 95% CI 1.14 to 2.72), but associated with a significant increase of treatment withdrawal when compared with those taking placebo (RR 2.16; 95% CI 1.28 to 3.67). For the safety outcomes, results indicated the proportion of patients who experienced adverse events in the losigamone group was higher than the placebo group (RR 1.34; 95% CI 1.00 to 1.80), dizziness was the only adverse event significantly in relation to losigamone (RR 3.82; 99% CI 1.69 to 8.64). The proportion of patients achieving seizure freedom was not reported in either trial report. A subgroup analysis according to different doses of losigamone showed that a higher dose of losigamone (1500 mg/d) is associated with a greater reduction in seizure frequency than lower doses, but is also associated with more dropouts due to adverse events. The results of this review showed losigamone can reduce seizure frequency but was associated with more treatment withdrawals when used as an add-on therapy for people with partial epilepsy. However, trials included were of short-term duration and uncertain quality. Future well-designed randomized, double-blind, placebo-controlled trials with a longer-term duration are needed.
Zhu, Jundong; Jiang, Fan; Li, Pu; Shao, Pengfei; Liang, Chao; Xu, Aiming; Miao, Chenkui; Qin, Chao; Wang, Zengjun; Yin, Changjun
2017-09-11
To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping for the patients with multiple renal tumor of who have solitary kidney or contralateral kidney insufficiency. Nine patients who have undergone retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping between October 2010 and January 2017 were retrospectively analyzed. Clinical materials and parameters during and after the operation were summarized. Nineteen tumors were resected in nine patients and the operations were all successful. The operation time ranged from 100 to 180 min (125 min); clamping time of segmental renal artery was 10 ~ 30 min (23 min); the amount of blood loss during the operation was 120 ~ 330 ml (190 ml); hospital stay after the operation is 3 ~ 6d (5d). There was no complication during the perioperative period, and the pathology diagnosis after the surgery showed that there were 13 renal clear cell carcinomas, two papillary carcinoma and four perivascular epithelioid cell tumors with negative margins from the 19 tumors. All patients were followed up for 3 ~ 60 months, and no local recurrence or metastasis was detected. At 3-month post-operation follow-up, the mean serum creatinine was 148.6 ± 28.1 μmol/L (p = 0.107), an increase of 3.0 μmol/L from preoperative baseline. For the patients with multiple renal tumors and solitary kidney or contralateral kidney insufficiency, retroperitoneal laparoscopic partial nephrectomy with sequential segmental renal artery clamping was feasible and safe, which minimized the warm ischemia injury to the kidney and preserved the renal function effectively.
Complex conductivity response to silver nanoparticles in partially saturated sand columns
The increase in the use of nanoscale materials in consumer products has resulted in a growing concern of their potential hazard to ecosystems and public health from their accidental or intentional introduction to the environment. Key environmental, health, and safety research nee...
Novel Percutaneous Radiofrequency Ablation of Portal Vein Tumor Thrombus: Safety and Feasibility
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mizandari, Malkhaz; Ao, Guokun; Zhang Yaojun
2013-02-15
We report our experience of the safety of partial recanalization of the portal vein using a novel endovascular radiofrequency (RF) catheter for portal vein tumor thrombosis. Six patients with liver cancer and tumor thrombus in the portal vein underwent percutaneous intravascular radiofrequency ablation (RFA) using an endovascular bipolar RF device. A 0.035-inch guidewire was introduced into a tributary of the portal vein and through which a 5G guide catheter was introduced into the main portal vein. After manipulation of the guide catheter over the thrombus under digital subtraction angiography, the endovascular RF device was inserted and activated around the thrombus.more » There were no observed technique specific complications, such as hemorrhage, vessel perforation, or infection. Post-RFA portography showed partial recanalization of portal vein. RFA of portal vein tumor thrombus in patients with hepatocellular carcinoma is technically feasible and warrants further investigation to assess efficacy compared with current recanalization techniques.« less
Safety and Efficacy of PD-1 Inhibitors Among HIV-Positive Patients With Non-Small Cell Lung Cancer.
Ostios-Garcia, Lorena; Faig, Jennifer; Leonardi, Giulia C; Adeni, Anika E; Subegdjo, Safiya J; Lydon, Christine A; Rangachari, Deepa; Huberman, Mark S; Sehgal, Kartik; Shea, Meghan; VanderLaan, Paul A; Cheng, Matthew P; Marty, Francisco M; Hammond, Sarah P; Costa, Daniel B; Awad, Mark M
2018-04-06
Despite widespread administration of programmed death receptor 1 (PD-1) pathway inhibitors among individuals with NSCLC, little is known about the safety and activity of these agents among human immunodeficiency virus (HIV) - infected patients since this population has largely been excluded from immunotherapy clinical trials. Here, we describe seven patients with metastatic NSCLC and HIV infection who were treated with PD-1 inhibitors nivolumab (two cases) or pembrolizumab (five cases with three in the first-line setting). Partial responses to immune checkpoint inhibitors were observed in three of seven cases. Among four patients with a programmed death ligand-1 tumor proportion score ≥50%, three partial responses were observed. All patients received antiretroviral therapy while on anti-PD-1 treatment. None of the patients experienced grade 3 or 4 immune-related adverse events or immune reconstitution inflammatory syndrome, and none required PD-1 inhibitor dose interruption or discontinuation due to toxicity. Nivolumab and pembrolizumab can be safe and effective among patients with NSCLC and HIV. Larger studies will be needed to determine the overall safety and efficacy of immune checkpoint inhibitors among cancer patients with HIV. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
Brexpiprazole: A Partial Dopamine Agonist for the Treatment of Schizophrenia.
Ekinci, Asli; Ekinci, Okan
2018-01-31
Schizophrenia is a chronic and debilitating mental disorder that affects the patient's and their family's life. The disease remains a complicated disorder that is challenging to treat, despite there being a large antipsychotic armamentarium. Brexpiprazole acts both as a partial agonist at the serotonin 5-HT1A and dopamine D2 receptors and as an antagonist at the serotonin 5- HT2A and noradrenaline alpha1B and alpha2C receptors, all with similar potency. This balanced receptor profile may produce promising antipsychotic effects on positive, negative and cognitive symptoms in schizophrenia with minimal adverse effects. This review summarizes the pharmacodynamics and pharmacokinetic profile of brexpiprazole and the clinical trial information pertaining to its effectiveness and safety and tolerability, discusses its best clinical use, and compares its clinical profile to those of other widely used antipsychotic agents. Brexpiprazole demonstrated significant clinical efficacy and had good safety and tolerability in well-designed trials with patients with schizophrenia. This agent may be a useful treatment alternative. However, it will be valuable to consider a long-term observational study that includes an active comparator, especially other second-generation antipsychotics (SGAs), to further evaluate the efficacy and safety of brexpiprazole in the treatment of schizophrenia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Nonyelum, Stanley Catherine; Nkem, Nwachukwu; Ifeyinwa, Chijoke-Nwauche; Orisakwe, Orish Ebere
2010-10-01
To investigate the adequacy of safety warnings and first aid instructions on the labels of pharmaceutical and consumer products in Nigeria. A market basket method (total collection of all available samples) was used to investigate the adequacy of safety warnings and first aid instructions on the labels of 600 pharmaceutical and consumer products in Nigeria. The results showed that 69.8% of the products had adequate warnings whereas 385 (64.1%) of the products screened had legible product warnings. Only 52 (8.7%) of the total number of products had appropriate first aid instructions while only 25 (4.12%) of the products described symptoms and full treatment of poisoning by the product and 319 (53.2%) products surveyed recommended calling a health professional. A total of 31 (5.2%) products had labels that were considered too technical (non English). Of the 600 products, 386 (64.3%) had dosage instructions that were considered adequate while 538 (89.6%) had adequate storage instructions. About 68% of the products had partially correct warnings while 44 or 7.3% had partially correct first aid instructions. Some products had neither warnings nor first aid instructions. This study suggests a not too impressive improvement in the correctness and appropriateness of label information.
Dean, Emma; Banerji, Udai; Schellens, Jan H M; Krebs, Matthew G; Jimenez, Begona; van Brummelen, Emilie; Bailey, Chris; Casson, Ed; Cripps, Diana; Cullberg, Marie; Evans, Stephen; Foxley, Andrew; Lindemann, Justin; Rugman, Paul; Taylor, Nigel; Turner, Guy; Yates, James; Lawrence, Peter
2018-05-01
AZD5363 is a potent pan-AKT inhibitor originally formulated as a capsule; a tablet was developed for patient convenience and manufacturing ease. This study assessed the PK comparability of both formulations (Part A) and the effect of food (Part B) on the PK/safety of the tablet. Adults with advanced solid tumours received AZD5363 480 mg bid in a partially fasted state by tablet (Week 1) and capsule (Week 2) in a '4-days-on/3-days-off' schedule (Part A). PK parameters were evaluated using pre-defined 90% CIs for AUCτ and C max ratios of 0.75-1.33 to assess comparability. In Part B, AZD5363 tablet was given to a new cohort of patients under the same conditions as Part A, except on the morning of PK assessment days, when it was administered after an overnight fast (Week 1) and standard meal (Week 2). In evaluable patients (N = 11), the geometric least-squares mean ratios (tablet:capsule) for AUCτ and C max were 0.90 (0.77-1.06) and 1.02 (0.86-1.20), respectively, demonstrating comparable PK in the partially fasted state. Tablet and capsule safety data were also comparable. Tablet PK profiles indicated later t max and lower C max after food versus overnight fast. Fed and fasted AUCτ and C max ratios were 0.89 (0.76-1.05) and 0.67 (0.55-0.82), respectively (N = 9). The safety/tolerability profile of the tablet was comparable between fed and fasted states. PK and safety/tolerability of AZD5363 tablet and capsule were comparable. Food did not affect the bioavailability of AZD5363, but reduced the absorption rate without discernibly affecting safety/tolerability.
Shaheen, Nicholas J; Denison, Hans; Björck, Karin; Karlsson, Maria; Silberg, Debra G
2013-09-01
Lesogaberan (AZD3355) is a novel γ-aminobutyric acid B-type receptor agonist designed to treat gastro-oesophageal reflux disease (GERD) by inhibiting transient lower oesophageal sphincter relaxations. A randomised, double-blind, placebo-controlled, multi-centre phase IIb study was performed to assess the efficacy and safety of lesogaberan as an add-on to proton pump inhibitor (PPI) therapy in patients with GERD who are partially responsive to PPI therapy (ClinicalTrials.gov reference: NCT01005251). In total, 661 patients were randomised to receive 4 weeks of placebo or 60, 120, 180 or 240 mg of lesogaberan twice daily, in addition to ongoing PPI therapy. Symptoms were measured using the Reflux Symptom Questionnaire electronic Diary. Response to treatment was defined as having an average of ≥ 3 additional days per week of not more than mild GERD symptoms during treatment compared with baseline. In the primary analysis, 20.9%, 25.6%, 23.5% and 26.2% of patients responded to the 60, 120, 180 and 240 mg twice daily lesogaberan doses, respectively, and 17.9% responded to placebo. The response to the 240 mg twice daily dose was statistically significantly greater than the response to placebo using a one-sided test at the predefined significance level of p < 0.1. However, the absolute increases in the proportions of patients who responded to lesogaberan compared with placebo were low. Lesogaberan was generally well tolerated, although six patients receiving lesogaberan developed reversible elevated alanine transaminase levels. In patients with GERD symptoms partially responsive to PPI therapy, lesogaberan was only marginally superior to placebo in achieving an improvement in symptoms.
Gerber, Bernhard; Alberio, Lorenzo; Rochat, Sophie; Stenner, Frank; Manz, Markus G; Buser, Andy; Schanz, Urs; Stussi, Georg
2016-10-01
Curative chemotherapy approaches in patients with malignancies and platelet (PLT) transfusion refractoriness due to alloimmunization may be hampered by the lack of suitable PLT donors. For these patients, transfusion of cryopreserved autologous PLTs is an option, but is time- and resource-consuming. We aimed at further simplifying this process. A retrospective single-center analysis was conducted on the transfusion of cryopreserved autologous PLTs in nine female alloimmunized, PLT transfusion-refractory patients treated for acute leukemia (n = 8) and non-Hodgkin's lymphoma (n = 1). No additional processing was used before transfusion, and most notably, washing and centrifugation steps were omitted. Clinical efficacy and safety, as well as a flow cytometric assessment of structural and functional PLT changes, were analyzed. A total of 40 autologous PLT concentrates were thawed at bedside and transfused a median of 32 (range, 9 to 994) days after cryopreservation. No major bleeds and no severe dimethyl sulfoxide toxicity were observed. The median PLT count increments did not differ 1 and 18 to 24 hours after transfusion and reached 6 × 10 9 /L (interquartile range [IQR], 3 × 10 9 -7.5 × 10 9 /L) and 6 × 10 9 /L (IQR, 2.5 × 10 9 -9.5 × 10 9 /L), respectively. Cryopreservation resulted in partial activation of one-third of the PLTs. In vitro stimulation with strong agonists induced additional full activation of cryopreserved PLTs: median, 55% (IQR, 42%-60%) after thrombin and 39% (IQR, 36%-39%) after convulxin. The transfusion of cryopreserved autologous PLTs is feasible and safe. Despite the cryopreservation process, PLT functionality is partially maintained. © 2016 AABB.
Partially Premixed Flame (PPF) Research for Fire Safety
NASA Technical Reports Server (NTRS)
Puri, Ishwar K.; Aggarwal, Suresh K.; Lock, Andrew J.; Hegde, Uday
2004-01-01
Incipient fires typically occur after the partial premixing of fuel and oxidizer. The mixing of product species into the fuel/oxidizer mixture influences flame stabilization and fire spread. Therefore, it is important to characterize the impact of different levels of fuel/oxidizer/product mixing on flame stabilization, liftoff and extinguishment under different gravity conditions. With regard to fire protection, the agent concentration required to achieve flame suppression is an important consideration. The initial stage of an unwanted fire in a microgravity environment will depend on the level of partial premixing and the local conditions such as air currents generated by the fire itself and any forced ventilation (that influence agent and product mixing into the fire). The motivation of our investigation is to characterize these impacts in a systematic and fundamental manner.
Allergoids for allergy treatment.
Carnes, Jeronimo; Gallego, Maria T; Moya, Raquel; Iraola, Victor
2018-02-21
Background Chemically modified allergen extracts, known as allergoids, are commonly used for treating allergic patients. In general terms, the concept of allergoids implies allergen extracts with a reduction of their allergenicity maintaining their immunogenicity. Different methods to obtain allergoids have been developed in the past years, opening attractive lines of research. Objective To review the different approaches to allergoid development as well as their characterization, mechanism of action and efficacy and safety issues. Methods A revision and analysis of the different types of allergoids has been performed, with special attention to patents submitted and granted in the last years. Additionally, updated information about the mechanism of action and clinical evidence and safety of allergoids has been discussed. Results Principally, allergoids are obtained by the polymerization of native allergen extracts with aldehydes, including formaldehyde or glutaraldehyde. However, recent patents and publications about different chemical modifications have been presented, as well as about the use of new adjuvants with allergoids. Regarding the characterization, allergoids require more sophisticated analytical methods than native extracts, as a consequence of their properties and characteristics. Conclusion In the last years, the partial understanding of the mechanism of action and the generation of clinical evidence of different types of allergoids, linked to their excellent safety profile and their convenience for a quick build up phase, have made of allergoids an excellent product for allergy treatment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
ACOG committee opinion number 398, February 2008: fatigue and patient safety.
2008-02-01
It has long been recognized that fatigue can affect human cognitive and physical function. Although there are limited published data on the effects of fatigue on health care providers, including full-time practicing physicians, there is increasing awareness within the patient safety movement that fatigue, even partial sleep deprivation, impairs performance. Most of the current literature reviews resident function after recent work reform changes. However, the information available from many studies in health care and other occupations can be applied to the work habits of practicing obstetrician-gynecologists.
10 CFR 830.204 - Documented safety analysis.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Documented safety analysis. 830.204 Section 830.204 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT Safety Basis Requirements § 830.204 Documented safety analysis... approval from DOE for the methodology used to prepare the documented safety analysis for the facility...
Occupational injuries in the Finnish furniture industry.
Aaltonen, M V
1996-06-01
The purpose of the study was to determine the types of occupational injuries that occur in the Finnish furniture industry and to see whether they differ as regards production type and company size. During a one-year registration period accident events, the actual and potential severity of the injuries, the causes of the accidents, and the measures needed to prevent such accidents were examined in 18 Finnish furniture factories of different types. An analysis of covariance determined the variables affecting the actual and potential severity of the injuries. The 214 accidents registered were lost-time injuries; two of them resulted in slight partial loss of fingertips. The disabling injury rate was 14.4 per 100 workers per year. Wooden furniture production and kitchen cupboard production in large companies had the highest rate. Accidents involving machines comprised half of the material. Saws were the most common machine type. Forty-two percent of the injuries could have been more severe; one injury could have been fatal. The injured persons and their foremen identified the causal factors of the accidents and the needed safety countermeasures well. Sixty-six percent of the causes and 65% of the safety countermeasures were associated with the actions of the workers and the workplace procedures. Nevertheless, only 6% of the identified safety countermeasures were put into force. It was estimated that, in 1987, 2000 on-site accidents leading to at least first-aid at some health care center occurred in the Finnish furniture industry. Special efforts should be taken to improve safety in furniture production in Finland.
Yao, N; Zeng, Q; Zhong, N X; Li, D X; Huang, L A; Shao, M Y; Ruan, H Y
2015-09-01
To investigate the willingness of Chinese female sex workers (FSWs) to participate (WTP) in a clinical trial of microbicides; to explore the potential hindrances and facilitating factors; and to provide support for future microbicide clinical trials by tailoring their design to better meet the specific needs of FSWs. Cross-sectional study. In total, 404 FSWs were investigated using structured questionnaires. Exploratory factor analysis and partial least squares path modelling were used to explore the correlations between several influencing factors and WTP. The WTP of FSWs enrolled in this study was high (53.47%, 216/404). Possible benefits from enrolment in the trial were positively associated with WTP, while concern about a hypothetical microbicide, potential physical harm, economic loss from participation, and fear of family or social isolation were negatively associated with WTP. FSWs are appropriate participants in microbicide clinical trials, and are likely to benefit from effective microbicides. In a microbicide clinical trial, it is imperative to ensure protection of the rights, dignity, safety, confidentiality and welfare of FSW participants. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
A decision framework for managing risk to airports from terrorist attack.
Shafieezadeh, Abdollah; Cha, Eun J; Ellingwood, Bruce R
2015-02-01
This article presents an asset-level security risk management framework to assist stakeholders of critical assets with allocating limited budgets for enhancing their safety and security against terrorist attack. The proposed framework models the security system of an asset, considers various threat scenarios, and models the sequential decision framework of attackers during the attack. Its novel contributions are the introduction of the notion of partial neutralization of attackers by defenders, estimation of total loss from successful, partially successful, and unsuccessful actions of attackers at various stages of an attack, and inclusion of the effects of these losses on the choices made by terrorists at various stages of the attack. The application of the proposed method is demonstrated in an example dealing with security risk management of a U.S. commercial airport, in which a set of plausible threat scenarios and risk mitigation options are considered. It is found that a combination of providing blast-resistant cargo containers and a video surveillance system on the airport perimeter fence is the best option based on minimum expected life-cycle cost considering a 10-year service period. © 2014 Society for Risk Analysis.
Code of Federal Regulations, 2010 CFR
2010-10-01
..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS FOR SELF... that: (1) Hold and interbarrier spaces on a vessel with full secondary barriers are inerted so that the... interbarrier spaces contain only dry air or inert gas on: (i) A vessel with partial secondary barriers; (ii) A...
2016-06-01
HELICOPTER FLEET Hasnan bin Mohamad Rais Major, Malaysian Army B.S., University Technology of Malaysia , 2000 Submitted in partial...HELICOPTER MAINTENANCE POLICY B. The objective of MAA helicopter maintenance activities is to preserve helicopter safety and mission reliability to
Sheard, Laura; Marsh, Claire; O’Hara, Jane; Armitage, Gerry; Wright, John; Lawton, Rebecca
2017-01-01
Objectives A patient safety intervention was tested in a 33-ward randomised controlled trial. No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards. Design Large qualitative process evaluation of the implementation of a patient safety intervention. Setting and participants National Health Service staff based on 17 acute hospital wards located at five hospital sites in the North of England. Data We concentrate on three sources here: (1) analysis of taped discussion between ward staff during action planning meetings; (2) facilitators’ field notes and (3) follow-up telephone interviews with staff focusing on whether action plans had been achieved. The analysis involved the use of pen portraits and adaptive theory. Findings First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff. Conclusions A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components. PMID:28710206
Safety hazards in bacteriocinogenic Staphylococcus strains isolated from goat and sheep milk.
Rahmdel, Samane; Hosseinzadeh, Saeid; Shekarforoush, Seyed Shahram; Torriani, Sandra; Gatto, Veronica; Pashangeh, Safoora
2018-03-01
In this study, 28 bacteriocinogenic Staphylococcus strains isolated from goat and sheep milk were subjected to the PCR detection of enterotoxin genes (sea-see), enterotoxin-like toxin Q gene (selq), toxic shock syndrome toxin gene (tst1), and antibiotic resistance genes. They were also evaluated for phenotypic resistance against 10 antibiotics and hemolytic activity. The tyramine and histamine production was investigated using the agar plate assay and capillary zone electrophoretic analysis (CZE). Twenty-five isolates harbored at least one enterotoxin gene. The gene sec was the most frequent (89%). The gene tst1 was found in 84% of sec-positive isolates. The occurrence of antibiotic resistance genes was in the order of blaZ/tetK (100%), mecA/ermB (86%), ermC (50%), and tetM (18%). The genes ermA, aac(6')Ie-aph(2″)Ia, vanA, and vanB were absent in all the isolates. Nineteen isolates were phenotypically susceptible to all the antibiotics. The only isolate with phenotypic resistance to penicillin G and oxacillin was S. epidermidis 4S93 which had a different SmaI-PFGE profile from those of the other S. epidermidis strains. All the S. haemolyticus and S. pseudintermedius isolates were not susceptible to trimethoprim. Twenty-five isolates showed complete or partial hemolytic activity. None of the isolates was able to decarboxylate tyrosine, while CZE analysis revealed histamine formation activity in S. haemolyticus 4S12. The occurrence of safety risks in the isolates reinforces the need for regular monitoring of food-producing animals to mitigate the risks of multidrug resistant and zoonotic pathogens. Moreover, none of the isolates fulfilled the safety criteria to be used as starter cultures or biopreservatives. Copyright © 2018. Published by Elsevier Ltd.
Molecular biological researches of Kuro-Koji molds, their classification and safety.
Yamada, Osamu; Takara, Ryo; Hamada, Ryoko; Hayashi, Risa; Tsukahara, Masatoshi; Mikami, Shigeaki
2011-09-01
To assess the position of Kuro-Koji molds in black Aspergillus, we performed sequence analysis of approximately 2500 nucleotides of partial gene fragments, such as histone 3, on a total of 57 Aspergillus strains, including Aspergillus kawachii NBRC 4308, 12 Kuro-Koji molds isolated from awamori breweries in Japan, Aspergillus niger ATCC 1015, and A. tubingensis ATCC10550. Sequence results showed that all black Aspergillus strains could be classified into 3 types, type N which includes A. niger ATCC 1015, type T which includes A. tubingensis ATCC 10550, and type L which includes A. kawachii NBRC 4308. Phylogenetic analysis showed these three types belong to different clusters. All 12 Kuro-Koji molds isolated from awamori breweries were classified as type L, thus we concluded type L represents the industrial Kuro-Koji molds. We found all type L strains lack the An15g07920 gene which is required for ochratoxin A biosynthesis in black Aspergillus. This sequence is present in the genome of A. niger CBS 513.88 and has homology to the polyketide synthase fragment of A. ochraceus which is involved in ochratoxin A biosynthesis. Based on the industrial importance and the safety of Kuro-Koji molds, we propose to classify the type L strains as Aspergillus luchuensis, as initially reported by Dr. Inui. Copyright © 2011 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.
Park, Kyong-Hwa; Choi, Yoon Ji; Kim, Kwan-Woo; Ro, Kyung-Han; Kang, Chang Ho; Song, Sang-Heon; Park, Jong Hoon
2016-09-01
To elucidate the clinical benefit and safety of low-dose chemotherapy using methotrexate and vinblastine in patients (mostly adults) with progressive and/or symptomatic fibromatosis. Patients were enrolled if they were treated with methotrexate and vinblastine chemotherapy for recurrences after surgical excision or newly diagnosed aggressive fibromatosis that was not amenable to surgical resection at the Korea University Medical Center from May 2008 to February 2016. Twenty-two patients were treated with this regimen, and 21 were eligible for safety and efficacy analysis. Eleven (52%) of 21 patients showed a documented partial response (PR), and 11 showed stable disease (SD) by the end of treatment. All the patients who achieved PR reported a significant reduction in pain and improvement in the function of the affected lesions. Median progression-free survival was not reached at the time of analysis. The most common adverse event was abnormalities of the liver transaminases (overall 84.2%). The most common grade 3 or higher toxicity was neutropenia (36.8%), but no febrile neutropenic event was observed. The elevated levels of transaminases were normalized by reducing the dose of methotrexate or delaying treatment. Low-dose chemotherapy with methotrexate and vinblastine for 1 year was effective and well tolerated by adult patients with aggressive, recurrent fibromatosis. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Arthur, Douglas W; Winter, Kathryn A; Kuerer, Henry M; Haffty, Bruce G; Cuttino, Laurie W; Todor, Dorin A; Simone, Nicole L; Hayes, Shelly B; Woodward, Wendy A; McCormick, Beryl; Cohen, Randi J; Sahijdak, Walter M; Canaday, Daniel J; Brown, Doris R; Currey, Adam D; Fisher, Christine M; Jagsi, Reshma; White, Julia
2017-08-01
To determine the associated toxicity, tolerance, and safety of partial-breast reirradiation. Eligibility criteria included in-breast recurrence occurring >1 year after whole-breast irradiation, <3 cm, unifocal, and resected with negative margins. Partial-breast reirradiation was targeted to the surgical cavity plus 1.5 cm; a prescription dose of 45 Gy in 1.5 Gy twice daily for 30 treatments was used. The primary objective was to evaluate the rate of grade ≥3 treatment-related skin, fibrosis, and/or breast pain adverse events (AEs), occurring ≤1 year from re-treatment completion. A rate of ≥13% for these AEs in a cohort of 55 patients was determined to be unacceptable (86% power, 1-sided α = 0.07). Between 2010 and 2013, 65 patients were accrued, and the first 55 eligible and with 1 year follow-up were analyzed. Median age was 68 years. Twenty-two patients had ductal carcinoma in situ, and 33 had invasive disease: 19 ≤1 cm, 13 >1 to ≤2 cm, and 1 >2 cm. All patients were clinically node negative. Systemic therapy was delivered in 51%. All treatment plans underwent quality review for contouring accuracy and dosimetric compliance. All treatment plans scored acceptable for tumor volume contouring and tumor volume dose-volume analysis. Only 4 (7%) scored unacceptable for organs at risk contouring and organs at risk dose-volume analysis. Treatment-related skin, fibrosis, and/or breast pain AEs were recorded as grade 1 in 64% and grade 2 in 7%, with only 1 (<2%) grade ≥3 and identified as grade 3 fibrosis of deep connective tissue. Partial-breast reirradiation with 3-dimensional conformal radiation therapy after second lumpectomy for patients experiencing in-breast failures after whole-breast irradiation is safe and feasible, with acceptable treatment quality achieved. Skin, fibrosis, and breast pain toxicity was acceptable, and grade 3 toxicity was rare. Copyright © 2017 Elsevier Inc. All rights reserved.
14 CFR Appendix B to Part 415 - Safety Review Document Outline
Code of Federal Regulations, 2013 CFR
2013-01-01
....0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and... Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety Plan 4.3.1Flight Safety Personnel 4... Safety (§ 415.117) 5.1Ground Safety Analysis Report 5.2Ground Safety Plan 6.0Launch Plans (§ 415.119 and...
14 CFR Appendix B to Part 415 - Safety Review Document Outline
Code of Federal Regulations, 2014 CFR
2014-01-01
....0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and... Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety Plan 4.3.1Flight Safety Personnel 4... Safety (§ 415.117) 5.1Ground Safety Analysis Report 5.2Ground Safety Plan 6.0Launch Plans (§ 415.119 and...
Certifying Domain-Specific Policies
NASA Technical Reports Server (NTRS)
Lowry, Michael; Pressburger, Thomas; Rosu, Grigore; Koga, Dennis (Technical Monitor)
2001-01-01
Proof-checking code for compliance to safety policies potentially enables a product-oriented approach to certain aspects of software certification. To date, previous research has focused on generic, low-level programming-language properties such as memory type safety. In this paper we consider proof-checking higher-level domain -specific properties for compliance to safety policies. The paper first describes a framework related to abstract interpretation in which compliance to a class of certification policies can be efficiently calculated Membership equational logic is shown to provide a rich logic for carrying out such calculations, including partiality, for certification. The architecture for a domain-specific certifier is described, followed by an implemented case study. The case study considers consistency of abstract variable attributes in code that performs geometric calculations in Aerospace systems.
Zohar, Dov; Lee, Jin
2016-10-01
The study was designed to test a multilevel path model whose variables exert opposing effects on school bus drivers' performance. Whereas departmental safety climate was expected to improve driving safety, the opposite was true for in-vehicle disruptive children behavior. The driving safety path in this model consists of increasing risk-taking practices starting with safety shortcuts leading to rule violations and to near-miss events. The study used a sample of 474 school bus drivers in rural areas, driving children to school and school-related activities. Newly developed scales for measuring predictor, mediator and outcome variables were validated with video data taken from inner and outer cameras, which were installed in 29 buses. Results partially supported the model by indicating that group-level safety climate and individual-level children distraction exerted opposite effects on the driving safety path. Furthermore, as hypothesized, children disruption moderated the strength of the safety rule violation-near miss relationship, resulting in greater strength under high disruptiveness. At the same time, the hypothesized interaction between the two predictor variables was not supported. Theoretical and practical implications for studying safety climate in general and distracted driving in particular for professional drivers are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.
Efficacy and safety of brivaracetam for partial-onset seizures in 3 pooled clinical studies
Mameniškienė, Rūta; Quarato, Pier Paolo; Klein, Pavel; Gamage, Jessica; Schiemann, Jimmy; Johnson, Martin E.; Whitesides, John; McDonough, Belinda; Eckhardt, Klaus
2016-01-01
Objective: To assess the efficacy, safety, and tolerability of adjunctive brivaracetam (BRV), a selective, high-affinity ligand for SV2A, for treatment of partial-onset (focal) seizures (POS) in adults. Methods: Data were pooled from patients (aged 16–80 years) with POS uncontrolled by 1 to 2 antiepileptic drugs receiving BRV 50, 100, or 200 mg/d or placebo, without titration, in 3 phase III studies of BRV (NCT00490035, NCT00464269, and NCT01261325, ClinicalTrials.gov, funded by UCB Pharma). The studies had an 8-week baseline and a 12-week treatment period. Patients receiving concomitant levetiracetam were excluded from the efficacy pool. Results: In the efficacy population (n = 1,160), reduction over placebo (95% confidence interval) in baseline-adjusted POS frequency/28 days was 19.5% (8.0%–29.6%) for 50 mg/d (p = 0.0015), 24.4% (16.8%–31.2%) for 100 mg/d (p < 0.00001), and 24.0% (15.3%–31.8%) for 200 mg/d (p < 0.00001). The ≥50% responder rate was 34.2% (50 mg/d, p = 0.0015), 39.5% (100 mg/d, p < 0.00001), and 37.8% (200 mg/d, p = 0.00003) vs 20.3% for placebo (p < 0.01). Across the safety population groups (n = 1,262), 90.0% to 93.9% completed the studies. Treatment-emergent adverse events (TEAEs) were reported by 68.0% BRV overall (n = 803) and 62.1% placebo (n = 459). Serious TEAEs were reported by 3.0% (BRV) and 2.8% (placebo); 3 patients receiving BRV and one patient receiving placebo died. TEAEs in ≥5% patients taking BRV (vs placebo) were somnolence (15.2% vs 8.5%), dizziness (11.2% vs 7.2%), headache (9.6% vs 10.2%), and fatigue (8.7% vs 3.7%). Conclusions: Adjunctive BRV was effective and generally well tolerated in adults with POS. Classification of evidence: This analysis provides Class I evidence that adjunctive BRV is effective in reducing POS frequency in adults with epilepsy and uncontrolled seizures. PMID:27335114
Ebert, Andreas D; Dong, Liying; Merz, Martin; Kirsch, Bodo; Francuski, Maja; Böttcher, Bettina; Roman, Horace; Suvitie, Pia; Hlavackova, Olga; Gude, Kerstin; Seitz, Christian
2017-10-01
To study the safety and efficacy of dienogest 2 mg in adolescents with suspected endometriosis. A 52-week, open-label, single-arm study. In 21 study centers, in 6 European countries. Adolescents aged 12 to younger than 18 years with clinically suspected or laparoscopically confirmed endometriosis. Dienogest 2 mg once daily. The primary end point was relative change in lumbar spine (L2-L4) bone mineral density (BMD) measured using dual-energy x-ray absorptiometry. A key secondary end point was change in endometriosis-associated pain assessed using a visual analogue scale. Of 120 patients screened, 111 comprised the full-analysis set (ie, patients who took ≥1 dose of study drug and had ≥1 post-treatment observation) and 97 (87.4%) completed the study. Mean lumbar BMD at baseline was 1.1046 (SD, 0.1550) g/cm 2 . At the end of dienogest treatment (EOT; defined as at 52 weeks or premature study discontinuation), mean relative change in BMD from baseline was -1.2% (SD, 2.3%; n = 103). Follow-up measurement 6 months after EOT in the subgroup with decreased BMD at EOT (n = 60) showed partial recovery in lumbar BMD (mean change from baseline: -2.3% at EOT, -0.6% 6 months after EOT). Mean endometriosis-associated pain score was 64.3 (SD, 19.1) mm at baseline and decreased to 9.0 (SD, 13.9) mm by week 48. In adolescents with suspected endometriosis, dienogest 2 mg for 52 weeks was associated with a decrease in lumbar BMD, followed by partial recovery after treatment discontinuation. Endometriosis-associated pain was substantially reduced during treatment. Because bone accretion is critical during adolescence, results of the VISanne study to assess safety in ADOlescents (VISADO) study highlights the need for tailored treatment in this population, taking into account the expected efficacy on endometriosis-associated pain and an individual's risk factors for osteoporosis. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Li, Yanran; Chen, Duo; Zhang, Jiwei; Chen, Ning; Li, Xiaoqi; Gong, Xiaojing
2017-09-01
GIS (gas insulated switchgear), is an important equipment in power system. Partial discharge plays an important role in detecting the insulation performance of GIS. UHF method and ultrasonic method frequently used in partial discharge (PD) detection for GIS. It is necessary to investigate UHF method and ultrasonic method for partial discharge in GIS. However, very few studies have been conducted on the method combined this two methods. From the view point of safety, a new method based on UHF method and ultrasonic method of PD detection for GIS is proposed in order to greatly enhance the ability of anti-interference of signal detection and the accuracy of fault localization. This paper presents study aimed at clarifying the effect of the new method combined UHF method and ultrasonic method. Partial discharge tests were performed in laboratory simulated environment. Obtained results show the ability of anti-interference of signal detection and the accuracy of fault localization for this new method combined UHF method and ultrasonic method.
EMR continuance usage intention of healthcare professionals.
Sayyah Gilani, Mina; Iranmanesh, Mohammad; Nikbin, Davoud; Zailani, Suhaiza
2017-03-01
Electronic medical records (EMRs) have been proven to be effective tools for improving the safety and quality of healthcare despite their relatively low usage rate in hospitals. The long-term development by EMRs depends on the continued use of healthcare professionals. In this study, technology continuance theory (TCT) was used to evaluate the short-term and long-term continuance acceptance of EMRs among healthcare professionals. Data were gathered by surveying 195 medical professionals in Iran. The data were analyzed using the partial least squares (PLS) technique. The analysis showed that the TCT provided a deep understanding of user continuance intention toward EMRs. In addition, the findings illustrated that the determinants of continuance intention vary between short-term and long-term users. The theoretical and practical implications of the study are discussed.
Liu, Fei; Ye, Lanhan; Peng, Jiyu; Song, Kunlin; Shen, Tingting; Zhang, Chu; He, Yong
2018-02-27
Fast detection of heavy metals is very important for ensuring the quality and safety of crops. Laser-induced breakdown spectroscopy (LIBS), coupled with uni- and multivariate analysis, was applied for quantitative analysis of copper in three kinds of rice (Jiangsu rice, regular rice, and Simiao rice). For univariate analysis, three pre-processing methods were applied to reduce fluctuations, including background normalization, the internal standard method, and the standard normal variate (SNV). Linear regression models showed a strong correlation between spectral intensity and Cu content, with an R 2 more than 0.97. The limit of detection (LOD) was around 5 ppm, lower than the tolerance limit of copper in foods. For multivariate analysis, partial least squares regression (PLSR) showed its advantage in extracting effective information for prediction, and its sensitivity reached 1.95 ppm, while support vector machine regression (SVMR) performed better in both calibration and prediction sets, where R c 2 and R p 2 reached 0.9979 and 0.9879, respectively. This study showed that LIBS could be considered as a constructive tool for the quantification of copper contamination in rice.
Ye, Lanhan; Song, Kunlin; Shen, Tingting
2018-01-01
Fast detection of heavy metals is very important for ensuring the quality and safety of crops. Laser-induced breakdown spectroscopy (LIBS), coupled with uni- and multivariate analysis, was applied for quantitative analysis of copper in three kinds of rice (Jiangsu rice, regular rice, and Simiao rice). For univariate analysis, three pre-processing methods were applied to reduce fluctuations, including background normalization, the internal standard method, and the standard normal variate (SNV). Linear regression models showed a strong correlation between spectral intensity and Cu content, with an R2 more than 0.97. The limit of detection (LOD) was around 5 ppm, lower than the tolerance limit of copper in foods. For multivariate analysis, partial least squares regression (PLSR) showed its advantage in extracting effective information for prediction, and its sensitivity reached 1.95 ppm, while support vector machine regression (SVMR) performed better in both calibration and prediction sets, where Rc2 and Rp2 reached 0.9979 and 0.9879, respectively. This study showed that LIBS could be considered as a constructive tool for the quantification of copper contamination in rice. PMID:29495445
[B-BS and occupational health and safety management systems: the SGSL certification].
Calabrese, G; Candura, G
2010-01-01
The social costs deriving from the lack of occupational safety, which nowadays constitute approximately 2.8% of the GDP, tend not to come down despite the regulations, the inspections and the sanctions. The problems may be ascribed both to a shortage of systemic actions and to inappropriate training of the workers. Possible solutions are represented by the adoption of organizational models (D. Lgs. 81 art. 30) and by the implementation of protocols such as the Behavior-Based Safety (B-BS). Organisational and Management Models have been introduced with art. 30 D.Lgs. 81/2008 and with art. 6 D.Lgs. 231/2001. The comparison between their requisites and the ones specified by the OHSAS 18001 standards, confirms the partial overlapping of the Organizational Models with the Occupational Health & Safety Management Systems. Nevertheless such Systems are rarely adopted by Italian companies and their implementation still doesn't grant complete effectiveness. The B-BS protocol is proving to be a tool of extraordinary value to increase the level of safety, especially when used along with the known Health & Safety Management Systems.
29 CFR 1918.31 - Hatch coverings.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 29 Labor 7 2011-07-01 2011-07-01 false Hatch coverings. 1918.31 Section 1918.31 Labor Regulations...) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Working Surfaces § 1918.31 Hatch coverings. (a) No cargo... partially opened intermediate deck unless either the hatch at that deck is sufficiently covered or an...
29 CFR 1918.31 - Hatch coverings.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 29 Labor 7 2010-07-01 2010-07-01 false Hatch coverings. 1918.31 Section 1918.31 Labor Regulations...) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Working Surfaces § 1918.31 Hatch coverings. (a) No cargo... partially opened intermediate deck unless either the hatch at that deck is sufficiently covered or an...
29 CFR 1918.31 - Hatch coverings.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 29 Labor 7 2013-07-01 2013-07-01 false Hatch coverings. 1918.31 Section 1918.31 Labor Regulations...) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Working Surfaces § 1918.31 Hatch coverings. (a) No cargo... partially opened intermediate deck unless either the hatch at that deck is sufficiently covered or an...
29 CFR 1918.31 - Hatch coverings.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 29 Labor 7 2014-07-01 2014-07-01 false Hatch coverings. 1918.31 Section 1918.31 Labor Regulations...) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Working Surfaces § 1918.31 Hatch coverings. (a) No cargo... partially opened intermediate deck unless either the hatch at that deck is sufficiently covered or an...
29 CFR 1918.31 - Hatch coverings.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 29 Labor 7 2012-07-01 2012-07-01 false Hatch coverings. 1918.31 Section 1918.31 Labor Regulations...) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Working Surfaces § 1918.31 Hatch coverings. (a) No cargo... partially opened intermediate deck unless either the hatch at that deck is sufficiently covered or an...
Effect of stirring on the safety of flammable liquid mixtures.
Liaw, Horng-Jang; Gerbaud, Vincent; Chen, Chan-Cheng; Shu, Chi-Min
2010-05-15
Flash point is the most important variable employed to characterize fire and explosion hazard of liquids. The models developed for predicting the flash point of partially miscible mixtures in the literature to date are all based on the assumption of liquid-liquid equilibrium. In real-world environments, however, the liquid-liquid equilibrium assumption does not always hold, such as the collection or accumulation of waste solvents without stirring, where complete stirring for a period of time is usually used to ensure the liquid phases being in equilibrium. This study investigated the effect of stirring on the flash-point behavior of binary partially miscible mixtures. Two series of partially miscible binary mixtures were employed to elucidate the effect of stirring. The first series was aqueous-organic mixtures, including water+1-butanol, water+2-butanol, water+isobutanol, water+1-pentanol, and water+octane; the second series was the mixtures of two flammable solvents, which included methanol+decane, methanol+2,2,4-trimethylpentane, and methanol+octane. Results reveal that for binary aqueous-organic solutions the flash-point values of unstirred mixtures were located between those of the completely stirred mixtures and those of the flammable component. Therefore, risk assessment could be done based on the flammable component flash-point value. However, for the assurance of safety, it is suggested to completely stir those mixtures before handling to reduce the risk. Copyright (c) 2010 Elsevier B.V. All rights reserved.
Lacosamide monotherapy for partial onset seizures.
Lattanzi, Simona; Cagnetti, Claudia; Foschi, Nicoletta; Provinciali, Leandro; Silvestrini, Mauro
2015-04-01
To evaluate the 1-year efficacy and safety of oral lacosamide as conversion monotherapy in adult patients with partial onset seizures with or without generalization. We prospectively followed-up consecutive patients converted to lacosamide monotherapy after 1-year seizure freedom on lacosamide add-on therapy and withdrawal of the concurrent antiepileptic drug (AED). Seizure occurrence, treatment compliance and drug toxicity were assessed every 3 months up to 1 year. The study outcomes were the retention rate of lacosamide as single AED and the seizure freedom under lacosamide monotherapy at 1 year from withdrawal of background AED. The safety variable was the prevalence of lacosamide related adverse events (AEs). Among the 58 included patients, at 1 year from withdrawal of background medication, 37 (63.8%) retained lacosamide as single AED and 32 (55.2%) were free from seizure occurrence under lacosamide monotherapy throughout the entire follow-up. The history of less than three lifetime AEDs turned out to be significant predictor of seizure freedom (adjusted OR = 6.38, 95% CI 1.85-21.98, p = 0.003). Twelve (20.8%) subjects reported mild to moderate AEs, with the commonest being drowsiness, dizziness, and headache. Conversion to lacosamide monotherapy could be effective and well tolerated in selected adults patients with partial onset seizures who had achieved seizure freedom during lacosamide add-on therapy. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
75 FR 17604 - Federal Motor Vehicle Safety Standards; Roof Crush Resistance
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-07
... Safety Analysis & Forensic Engineering, LLC (SAFE) brought to our attention errors in the preamble that incorrectly attributed to it the comments of another organization, Safety Analysis, Inc. Both of these... Safety Analysis, Inc. SAFE noted that there is no affiliation between SAFE and Safety Analysis, Inc. and...
Ibrahim, Nafisa B; Anandan, Srividya; Hartman, Audrey L; McSweeney, Michelle; Chun, Jeanette; McKee, Andrea; Yang, Rebecca; Kim, Cathleen
2015-01-01
The use of accelerated partial breast irradiation (APBI) following breast-conserving surgery is rapidly gaining popularity as an alternative to whole-breast irradiation (WBI) in selected patients with early-stage breast cancer. Although data on the long-term effectiveness and safety of APBI accelerated partial breast irradiation are still being gathered, the shorter treatment course and narrowed radiation target of APBI accelerated partial breast irradiation provide an attractive alternative for carefully selected patients. These patients include those with relatively small tumors (≤3 cm), negative or close margins, and negative sentinel lymph nodes. Possible long-term complications include telangiectasia and the development of a palpable mass at the lumpectomy site. Mammographic findings in patients who have undergone APBI accelerated partial breast irradiation are distinct from those in patients who have undergone conventional WBI whole-breast irradiation . The most common post-APBI accelerated partial breast irradiation radiographic findings include formation of seromas at the lumpectomy site, focal parenchymal changes such as increased trabeculation and parenchymal distortion, fat necrosis, and skin changes such as thickening or retraction. Given the continued evolution of breast cancer treatment, it is important that radiologists have a comprehensive understanding of APBI accelerated partial breast irradiation in terms of rationale, patient selection criteria, common postprocedural radiographic findings (and how they differ from post-WBI whole-breast irradiation findings), and advantages and potential complications. RSNA, 2015
Randomized, multicenter, dose-ranging trial of retigabine for partial-onset seizures.
Porter, R J; Partiot, A; Sachdeo, R; Nohria, V; Alves, W M
2007-04-10
To evaluate the efficacy and safety of retigabine 600, 900, and 1,200 mg/day administered three times daily as adjunctive therapy in patients with partial-onset seizures. A multicenter, randomized, double-blind, placebo-controlled trial was performed. After an 8-week baseline phase, patients were randomized to a 16-week double-blind treatment period (8-week forced titration and 8-week maintenance) followed by either tapering or entry into an open-label extension study. Primary efficacy was the percentage change from baseline in monthly seizure frequency and compared across treatment arms. Secondary efficacy comparisons included the proportion of patients experiencing >/=50% reduction in seizure frequency (responder rate), emergence of new seizure types, and physician assessment of global clinical improvement. Safety/tolerability assessments included adverse events (AEs), physical and neurologic examinations, and clinical laboratory evaluations. Efficacy analyses were performed on the intent-to-treat population. Of the 399 randomized patients, 279 (69.9%) completed the double-blind treatment period. The median percent change in monthly total partial seizure frequency from baseline was -23% for 600 mg/day, -29% for 900 mg/day, and -35% for 1,200 mg/day vs -13% for placebo (p < 0.001 for overall difference across all treatment arms). Responder rates for retigabine were 23% for 600 mg/day, 32% for 900 mg/day (p = 0.021), and 33% for 1,200 mg/day (p = 0.016), vs 16% for placebo. The most common treatment-emergent AEs were somnolence, dizziness, confusion, speech disorder, vertigo, tremor, amnesia, abnormal thinking, abnormal gait, paresthesia, and diplopia. Adjunctive therapy with retigabine is well tolerated and reduces the frequency of partial-onset seizures in a dose-dependent manner.
Comparison of universal approximators incorporating partial monotonicity by structure.
Minin, Alexey; Velikova, Marina; Lang, Bernhard; Daniels, Hennie
2010-05-01
Neural networks applied in control loops and safety-critical domains have to meet more requirements than just the overall best function approximation. On the one hand, a small approximation error is required; on the other hand, the smoothness and the monotonicity of selected input-output relations have to be guaranteed. Otherwise, the stability of most of the control laws is lost. In this article we compare two neural network-based approaches incorporating partial monotonicity by structure, namely the Monotonic Multi-Layer Perceptron (MONMLP) network and the Monotonic MIN-MAX (MONMM) network. We show the universal approximation capabilities of both types of network for partially monotone functions. On a number of datasets, we investigate the advantages and disadvantages of these approaches related to approximation performance, training of the model and convergence. 2009 Elsevier Ltd. All rights reserved.
14 CFR 415.115 - Flight safety.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Flight safety. 415.115 Section 415.115... From a Non-Federal Launch Site § 415.115 Flight safety. (a) Flight safety analysis. An applicant's safety review document must describe each analysis method employed to meet the flight safety analysis...
14 CFR 415.115 - Flight safety.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Flight safety. 415.115 Section 415.115... From a Non-Federal Launch Site § 415.115 Flight safety. (a) Flight safety analysis. An applicant's safety review document must describe each analysis method employed to meet the flight safety analysis...
14 CFR 415.115 - Flight safety.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Flight safety. 415.115 Section 415.115... From a Non-Federal Launch Site § 415.115 Flight safety. (a) Flight safety analysis. An applicant's safety review document must describe each analysis method employed to meet the flight safety analysis...
14 CFR 415.115 - Flight safety.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Flight safety. 415.115 Section 415.115... From a Non-Federal Launch Site § 415.115 Flight safety. (a) Flight safety analysis. An applicant's safety review document must describe each analysis method employed to meet the flight safety analysis...
14 CFR 415.115 - Flight safety.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Flight safety. 415.115 Section 415.115... From a Non-Federal Launch Site § 415.115 Flight safety. (a) Flight safety analysis. An applicant's safety review document must describe each analysis method employed to meet the flight safety analysis...
High-intensity focused ultrasound (HIFU) treatment for uterine fibroids: a meta-analysis.
Ji, Yongshuo; Hu, Kaimeng; Zhang, Yu; Gu, Lijun; Zhu, Junqiu; Zhu, Linglin; Zhu, Yanfei; Zhao, Hong
2017-12-01
High-intensity focused ultrasound (HIFU) is a non-invasive uterine-preserving treatment alternative to hysterectomy for women with fibroids. We performed this meta-analysis to evaluate the efficacy of HIFU in the treatment of women with symptomatic fibroids comparing it to other approaches including medical treatment with mifepristone (Mife), traditional surgery with myomectomy or hysterectomy (MYC/HRM), and radiofrequency ablation (RF). 16 studies with 1725 women were included. The pooled data of HIFU comparing it to other methods in terms of complete or partial response rate (CR/PR) was not significantly better, but in subgroup analysis, the response rate was significantly higher than Mife, significantly lower than RF and comparable to MYC/HRM, respectively. For the endpoints of safety, the superiority of HIFU compared to MYC/HMR or Mife was found to be significant in terms of pain/discomfort, fever, transfusion, genital tract, gastrointestinal tract, and anesthesia-related complications, while no superiority was identified for skin burn, urinary tract, and nervous system complications. These results suggest that HIFU treatment of uterine leiomyomas leads to clinical improvement with few significant clinical complications and adverse events.
Lipid reducing activity and toxicity profiles of a library of polyphenol derivatives.
Urbatzka, Ralph; Freitas, Sara; Palmeira, Andreia; Almeida, Tiago; Moreira, João; Azevedo, Carlos; Afonso, Carlos; Correia-da-Silva, Marta; Sousa, Emilia; Pinto, Madalena; Vasconcelos, Vitor
2018-05-10
Obesity is an increasing epidemic worldwide and novel treatments are urgently needed. Polyphenols are natural compounds derived from plants, which are known in particular for their antioxidant properties. However, some polyphenols were described to possess anti-obesity activities in vitro and in vivo. In this study, we aimed to screen a library of 85 polyphenol derivatives for their lipid reducing activity and toxicity. Compounds were analyzed at 5 μM with the zebrafish Nile red fluorescence fat metabolism assay and for general toxicity in vivo. To improve the safety profile, compounds were screened at 50 μM in murine preadipocytes in vitro for cytotoxicity. Obtained activity data were used to create a 2D-QSAR (quantitative structure activity relationship) model. 38 polyphenols showed strong lipid reducing activity. Toxicity analysis revealed that 18 of them did not show any toxicity in vitro or in vivo. QSAR analysis revealed the importance of the number of rings, fractional partial positively charged surface area, relative positive charge, relative number of oxygen atoms, and partial negative surface area for lipid-reducing activity. The five most potent compounds with EC 50 values in the nanomolar range for lipid reducing activity and without any toxic effects are strong candidates for future research and development into anti-obesity drugs. Molecular profiling for fasn, sirt1, mtp and ppary revealed one compound that reduced significantly fasn mRNA expression. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Sensitivity Analysis of Digital I&C Modules in Protection and Safety Systems
NASA Astrophysics Data System (ADS)
Khalil Ur, Rahman; Zubair, M.; Heo, G.
2013-12-01
This research is performed to examine the sensitivity of digital Instrumentation and Control (I&C) components and modules used in regulating and protection systems architectures of nuclear industry. Fault Tree Analysis (FTA) was performed for four configurations of RPS channel architecture. The channel unavailability has been calculated by using AIMS-PSA, which comes out 4.517E-03, 2.551E-03, 2.246E-03 and 2.7613-04 for architecture configuration I, II, III and IV respectively. It is observed that unavailability decreases by 43.5 % & 50.4% by inserting partial redundancy whereas maximum reduction of 93.9 % in unavailability happens when double redundancy is inserted in architecture. Coincidence module output failure and bi-stable output failures are identified as sensitive failures by Risk Reduction Worth (RRW) and Fussell-Vesely (FV) importance. RRW highlights that risk from coincidence processor output failure can reduced by 48.83 folds and FV indicates that BP output is sensitive by 0.9796 (on a scale of 1).
Liu, Jinxia; Cao, Yue; Wang, Qiu; Pan, Wenjuan; Ma, Fei; Liu, Changhong; Chen, Wei; Yang, Jianbo; Zheng, Lei
2016-01-01
Water-injected beef has aroused public concern as a major food-safety issue in meat products. In the study, the potential of multispectral imaging analysis in the visible and near-infrared (405-970 nm) regions was evaluated for identifying water-injected beef. A multispectral vision system was used to acquire images of beef injected with up to 21% content of water, and partial least squares regression (PLSR) algorithm was employed to establish prediction model, leading to quantitative estimations of actual water increase with a correlation coefficient (r) of 0.923. Subsequently, an optimized model was achieved by integrating spectral data with feature information extracted from ordinary RGB data, yielding better predictions (r = 0.946). Moreover, the prediction equation was transferred to each pixel within the images for visualizing the distribution of actual water increase. These results demonstrate the capability of multispectral imaging technology as a rapid and non-destructive tool for the identification of water-injected beef. Copyright © 2015 Elsevier Ltd. All rights reserved.
Species-specific detection of processed animal proteins in feed by Raman spectroscopy.
Mandrile, Luisa; Amato, Giuseppina; Marchis, Daniela; Martra, Gianmario; Rossi, Andrea Mario
2017-08-15
The existing European Regulation (EC n° 51/2013) prohibits the use of animals meals in feedstuffs in order to prevent Bovine Spongiform Encephalopathy infection and diffusion, however the legislation is rapidly moving towards a partial lifting of the "feed ban" and the competent control organisms are urged to develop suitable analytical methods able to avoid food safety incidents related to animal origin products. The limitations of the official methods (i.e. light microscopy and Polymerase Chain Reaction) suggest exploring new analytic ways to get reliable results in a short time. The combination of spectroscopic techniques with optical microscopy allows the development of an individual particle method able to meet both selectivity and sensitivity requirements (0.1%w/w). A spectroscopic method based on Fourier Transform micro-Raman spectroscopy coupled with Discriminant Analysis is here presented. This approach could be very useful for in-situ applications, such as customs inspections, since it drastically reduces time and costs of analysis. Copyright © 2017. Published by Elsevier Ltd.
Attitudes to teamwork and safety among Italian surgeons and operating room nurses.
Prati, Gabriele; Pietrantoni, Luca
2014-01-01
Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.
Efficacy, safety, and cost of pomalidomide in relapsed and refractory multiple myeloma.
Gueneau, Pauline; Chretien, Marie-Lorraine; Cransac-Miet, Amelie; Aho, Ludwig Serge; Lafon, Ingrid; Favennec, Camille; Guy, Julien; Caillot, Denis; Boulin, Mathieu
2018-05-01
To investigate the efficacy, safety, and cost of a pomalidomide-dexamethasone regimen in patients with relapsed and refractory multiple myeloma (RRMM). All patients (n = 63) treated with pomalidomide-dexamethasone for RRMM in our university hospital between August 2013 and October 2015 were included. Pomalidomide was discontinued early due to progression (before the 4th cycle) in 17 (27%) patients. No case was discontinued for intolerance. The only independent factor that predicted early pomalidomide discontinuation was time from diagnosis to pomalidomide initiation <3 years. Overall response rate was 51% including complete response in 8%, very good partial response in 25%, and partial response in 19% patients. Thirteen (33%) patients showed stable disease. Median overall survival was 6.4 months in the 17 patients who discontinued pomalidomide early vs 26.8 months in the 14 patients with stable disease vs not achieved in the 32 responders (log-rank; P < 10 -3 ). The most common grade ≥3 adverse events were neutropenia (14%) and infections (25%). The incremental cost-effectiveness ratio of pomalidomide-dexamethasone compared with dexamethasone alone was estimated at €39 911 per life-year gained. The study demonstrated that pomalidomide-dexamethasone regimen has a long-term favorable safety-efficacy profile in RRMM patients. The survival benefit is substantial even in patients with stable disease. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Rosenfeld, William; Fountain, Nathan B; Kaubrys, Gintaras; Ben-Menachem, Elinor; McShea, Cindy; Isojarvi, Jouko; Doty, Pamela
2014-12-01
Long-term (up to 8 years of exposure) safety and efficacy of the antiepileptic drug lacosamide was evaluated in this open-label extension trial (SP615 [ClinicalTrials.gov identifier: NCT00552305]). Patients were enrolled following participation in a double-blind trial or one of two open-label trials of adjunctive lacosamide for partial-onset seizures. Dosage adjustments of lacosamide (100-800 mg/day) and/or concomitant antiepileptic drugs were allowed to optimize tolerability and seizure reduction. Of the 370 enrolled patients, 77%, 51%, and 39% had >1, >3, or >5 years of lacosamide exposure, respectively. Median lacosamide modal dose was 400mg/day. Common treatment-emergent adverse events (TEAEs) were dizziness (39.7%), headache (20.8%), nausea (17.3%), diplopia (17.0%), fatigue (16.5%), upper respiratory tract infection (16.5%), nasopharyngitis (16.2%), and contusion (15.4%). Dizziness (2.2%) was the only TEAE that led to discontinuation in >2% of patients. Ranges for median percent reductions in seizure frequency were 47-65%, and those for ≥ 50% responder rates were 49-63% for 1-, 3-, and 5-year completer cohorts. Exposure to lacosamide for up to 8 years was generally well tolerated, with a safety profile similar to previous double-blind trials, and efficacy was maintained. Copyright © 2014 Elsevier Inc. All rights reserved.
Radioembolization for Neuroendocrine Liver Metastases: Safety, Imaging, and Long-Term Outcomes
DOE Office of Scientific and Technical Information (OSTI.GOV)
Memon, Khairuddin; Lewandowski, Robert J.; Mulcahy, Mary F.
2012-07-01
Purpose: To present long-term outcomes on the safety and efficacy of Yttrium-90 radioembolization in the treatment of unresectable hepatic neuroendocrine metastases refractory to standard-of-care therapy. Methods and Materials: This study was approved by our institutional review board and was compliant with the Health Insurance Portability and Accountability Act. Forty patients with hepatic neuroendocrine metastases were treated with {sup 90}Y radioembolization at a single center. Toxicity was assessed using National Cancer Institute Common Terminology Criteria v3.0. Response to therapy was assessed by World Health Organization (WHO) guidelines for size and European Association for the Study of the Liver disease (EASL) guidelinesmore » for necrosis. Time to response and overall survival were calculated using the Kaplan-Meier method. Univariate and multivariate analyses were performed. Results: The median dose was 113 Gy (29-299 Gy). Clinical toxicities included fatigue (63%), nausea/vomiting (40%), abdominal pain (18%), fever (8%), diarrhea and weight loss (5%); Grade 3 and 4 bilirubin toxicities were experienced by 2 patients and 1 patient, respectively. Different responses were noted by WHO (complete response, 1.2%; partial response, 62.7%) and EASL (complete response, 20.5%; partial response, 43.4%). Median time to response was 4 and 4.9 months by lesion and patient, respectively. The 1-, 2-, and 3-year overall survival rates were 72.5%, 62.5%, and 45%, respectively. Eastern Cooperative Oncology Group (ECOG) performance score 0 (p < 0.0001), tumor burden {<=}25% (p = 0.0019), albumin {>=}3.5 g/dL (p = 0.017), and bilirubin {<=}1.2 mg/dL (p = 0.002) prognosticated survival on univariate analysis; only ECOG performance score 0 and bilirubin {<=}1.2 mg/dL prognosticated better survival outcome on multivariate analysis (p = 0.0001 and p = 0.02). Conclusion: Yttrium-90 therapy for hepatic neuroendocrine metastases leads to satisfactory tumor response and patient survival with low toxicity, in line with published national guidelines recommending radioembolization as a potential option for unresectable hepatic neuroendocrine metastases.« less
Coagulopathy induced by saw palmetto: a case report.
Villanueva, Salvador; González, Jenniffer
2009-01-01
Saw palmetto is the most popular herbal supplement used to treat symptoms of benign prostatic hyperplasia (BPH). The safety and efficacy of saw palmetto has been established in the literature. While the majority of studies document the efficacy and safety of saw palmetto, some studies document the adverse side effects, including increased risk of bleeding. There are no reports in the literature about increased prothombin time (PT), partial thromboplastin time (PTT) or international normalized ratio (INR) while using saw palmetto. We present a case of hematuria and coagulopathy in a patient who was using saw palmetto.
14 CFR 417.221 - Time delay analysis.
Code of Federal Regulations, 2010 CFR
2010-01-01
... OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.221 Time delay analysis. (a) General. A flight safety analysis must include a time delay analysis that establishes the mean elapsed time between the violation of a flight termination rule and the time when the flight safety system is...
14 CFR 417.221 - Time delay analysis.
Code of Federal Regulations, 2011 CFR
2011-01-01
... OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.221 Time delay analysis. (a) General. A flight safety analysis must include a time delay analysis that establishes the mean elapsed time between the violation of a flight termination rule and the time when the flight safety system is...
Code of Federal Regulations, 2010 CFR
2010-07-01
... come within the exemption as a partial-duty loader. (Levinson v. Spector Motor Service, 330 U.S. 649... limited handling of them, that his activities will not come within the kind of “loading” which directly... it is light in weight, probably could not be loaded in a manner which would adversely affect “safety...
Code of Federal Regulations, 2011 CFR
2011-07-01
... come within the exemption as a partial-duty loader. (Levinson v. Spector Motor Service, 330 U.S. 649... limited handling of them, that his activities will not come within the kind of “loading” which directly... it is light in weight, probably could not be loaded in a manner which would adversely affect “safety...
77 FR 51649 - Federal Motor Vehicle Safety Standards; Motorcycle Brake Systems
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-24
... S7 include pre- and post-burnishment effectiveness tests, a fade and recovery test, a partial failure... visually inspected without removing the pads. Pre- and post-burnish tests. The service brake system and... to 8 mph less than the maximum motorcycle speed. The post-burnish tests are conducted in the same way...
29 CFR 1904.1 - Partial exemption for employers with 10 or fewer employees.
Code of Federal Regulations, 2011 CFR
2011-07-01
.... 1904.1 Section 1904.1 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Scope § 1904.1... ten (10) or fewer employees at all times during the last calendar year, you do not need to keep OSHA...
29 CFR 1904.2 - Partial exemption for establishments in certain industries.
Code of Federal Regulations, 2011 CFR
2011-07-01
.... 1904.2 Section 1904.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Scope § 1904.2... listed in appendix A to this subpart B, you do not need to keep OSHA injury and illness records unless...
29 CFR 1904.2 - Partial exemption for establishments in certain industries.
Code of Federal Regulations, 2010 CFR
2010-07-01
.... 1904.2 Section 1904.2 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Scope § 1904.2... listed in Appendix A to this Subpart B, you do not need to keep OSHA injury and illness records unless...
29 CFR 1904.1 - Partial exemption for employers with 10 or fewer employees.
Code of Federal Regulations, 2010 CFR
2010-07-01
.... 1904.1 Section 1904.1 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Scope § 1904.1... ten (10) or fewer employees at all times during the last calendar year, you do not need to keep OSHA...
Schuh, Elizabeth M; Portela, Roberta; Gardner, Heather L; Schoen, Christian; London, Cheryl A
2017-10-02
Hyperthermia is an established anti-cancer treatment but is limited by tolerance of adjacent normal tissues. Parenteral administration of gold nanorods (NRs) as a photosensitizer amplifies the effects of hyperthermia treatment while sparing normal tissues. This therapy is well tolerated and has demonstrated anti-tumor effects in mouse models. The purpose of this phase 1 study was to establish the safety and observe the anti-tumor impact of gold NR enhanced (plasmonic) photothermal therapy (PPTT) in client owned canine patients diagnosed with spontaneous neoplasia. Seven dogs underwent gold NR administration and subsequent NIR PPTT. Side effects were mild and limited to local reactions to NIR laser. All of the dogs enrolled in the study experienced stable disease, partial remission or complete remission. The overall response rate (ORR) was 28.6% with partial or complete remission of tumors at study end. PPTT utilizing gold nanorod therapy can be safely administered to canine patients. Further studies are needed to determine the true efficacy in a larger population of canine cancer patients and to and identify those patients most likely to benefit from this therapy.
Transportation systems safety hazard analysis tool (SafetyHAT) user guide (version 1.0)
DOT National Transportation Integrated Search
2014-03-24
This is a user guide for the transportation system Safety Hazard Analysis Tool (SafetyHAT) Version 1.0. SafetyHAT is a software tool that facilitates System Theoretic Process Analysis (STPA.) This user guide provides instructions on how to download, ...
10 CFR 830.206 - Preliminary documented safety analysis.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Preliminary documented safety analysis. 830.206 Section 830.206 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT Safety Basis Requirements § 830.206 Preliminary documented safety analysis. If construction begins after December 11, 2000, the contractor...
Nadler, Jeffrey P; Berger, Daniel S; Blick, Gary; Cimoch, Paul J; Cohen, Calvin J; Greenberg, Richard N; Hicks, Charles B; Hoetelmans, Richard M W; Iveson, Kathy J; Jayaweera, Dushyantha S; Mills, Anthony M; Peeters, Monika P; Ruane, Peter J; Shalit, Peter; Schrader, Shannon R; Smith, Stephen M; Steinhart, Corklin R; Thompson, Melanie; Vingerhoets, Johan H; Voorspoels, Ellen; Ward, Douglas; Woodfall, Brian
2007-03-30
TMC125-C223 is an open-label, partially blinded, randomized clinical trial to evaluate the efficacy and safety of two dosages of etravirine (TMC125), a non-nucleoside reverse transcriptase inhibitor (NNRTI) with activity against wild-type and NNRTI-resistant HIV-1. A total of 199 patients were randomly assigned 2: 2: 1 to twice-daily etravirine 400 mg, 800 mg and control groups, respectively. The primary endpoint was a change in viral load from baseline at week 24 in the intention-to-treat population. Patients had HIV-1 with genotypic resistance to approved NNRTIs and at least three primary protease inhibitor (PI) mutations. Etravirine groups received an optimized background of at least two approved antiretroviral agents [nucleoside reverse transcriptase inhibitors (NRTI) and/or lopinavir/ritonavir and/or enfuvirtide]. Control patients received optimized regimens of at least three antiretroviral agents (NRTIs or PIs and/or enfuvirtide). The mean change from baseline in HIV-1 RNA at week 24 was -1.04, -1.18 and -0.19 log10 copies/ml for etravirine 400 mg twice a day, 800 mg twice a day and the control group, respectively (P < 0.05 for both etravirine groups versus control). Etravirine showed no dose-related effects on safety and tolerability. No consistent pattern of neuropsychiatric symptoms was observed. There were few hepatic adverse events, and rashes were predominantly early onset and mild to moderate in severity. Etravirine plus an optimized background significantly reduced HIV-1-RNA levels from baseline after 24 weeks in patients with substantial NNRTI and PI resistance, and demonstrated a favorable safety profile compared with control.
Subcutaneous ofatumumab in patients with relapsing-remitting multiple sclerosis: The MIRROR study.
Bar-Or, Amit; Grove, Richard A; Austin, Daren J; Tolson, Jerry M; VanMeter, Susan A; Lewis, Eric W; Derosier, Frederick J; Lopez, Monica C; Kavanagh, Sarah T; Miller, Aaron E; Sorensen, Per S
2018-05-15
To assess dose-response effects of the anti-CD20 monoclonal antibody ofatumumab on efficacy and safety outcomes in a phase 2b double-blind study of relapsing forms of multiple sclerosis (RMS). Patients (n = 232) were randomized to ofatumumab 3, 30, or 60 mg every 12 weeks, ofatumumab 60 mg every 4 weeks, or placebo for a 24-week treatment period, with a primary endpoint of cumulative number of new gadolinium-enhancing lesions (per brain MRI) at week 12. Relapses and safety/tolerability were assessed, and CD19+ peripheral blood B-lymphocyte counts measured. Safety monitoring continued weeks 24 to 48 with subsequent individualized follow-up evaluating B-cell repletion. The cumulative number of new lesions was reduced by 65% for all ofatumumab dose groups vs placebo ( p < 0.001). Post hoc analysis (excluding weeks 1-4) estimated a ≥90% lesion reduction vs placebo (week 12) for all cumulative ofatumumab doses ≥30 mg/12 wk. Dose-dependent CD19 B-cell depletion was observed. Notably, complete depletion was not necessary for a robust treatment effect. The most common adverse event was injection-related reactions (52% ofatumumab, 15% placebo), mild to moderate severity in 97%, most commonly associated with the first dose and diminishing on subsequent dosing. Imaging showed that all subcutaneous ofatumumab doses demonstrated efficacy (most robust: cumulative doses ≥30 mg/12 wk), with a safety profile consistent with existing ofatumumab data. This treatment effect also occurred with dosage regimens that only partially depleted circulating B cells. This study provides Class I evidence that for patients with RMS, ofatumumab decreases the number of new MRI gadolinium-enhancing lesions 12 weeks after treatment initiation. © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
Subcutaneous ofatumumab in patients with relapsing-remitting multiple sclerosis
Grove, Richard A.; Austin, Daren J.; Tolson, Jerry M.; VanMeter, Susan A.; Lewis, Eric W.; Derosier, Frederick J.; Lopez, Monica C.; Kavanagh, Sarah T.; Miller, Aaron E.; Sorensen, Per S.
2018-01-01
Objective To assess dose-response effects of the anti-CD20 monoclonal antibody ofatumumab on efficacy and safety outcomes in a phase 2b double-blind study of relapsing forms of multiple sclerosis (RMS). Methods Patients (n = 232) were randomized to ofatumumab 3, 30, or 60 mg every 12 weeks, ofatumumab 60 mg every 4 weeks, or placebo for a 24-week treatment period, with a primary endpoint of cumulative number of new gadolinium-enhancing lesions (per brain MRI) at week 12. Relapses and safety/tolerability were assessed, and CD19+ peripheral blood B-lymphocyte counts measured. Safety monitoring continued weeks 24 to 48 with subsequent individualized follow-up evaluating B-cell repletion. Results The cumulative number of new lesions was reduced by 65% for all ofatumumab dose groups vs placebo (p < 0.001). Post hoc analysis (excluding weeks 1–4) estimated a ≥90% lesion reduction vs placebo (week 12) for all cumulative ofatumumab doses ≥30 mg/12 wk. Dose-dependent CD19 B-cell depletion was observed. Notably, complete depletion was not necessary for a robust treatment effect. The most common adverse event was injection-related reactions (52% ofatumumab, 15% placebo), mild to moderate severity in 97%, most commonly associated with the first dose and diminishing on subsequent dosing. Conclusion Imaging showed that all subcutaneous ofatumumab doses demonstrated efficacy (most robust: cumulative doses ≥30 mg/12 wk), with a safety profile consistent with existing ofatumumab data. This treatment effect also occurred with dosage regimens that only partially depleted circulating B cells. Classification of evidence This study provides Class I evidence that for patients with RMS, ofatumumab decreases the number of new MRI gadolinium-enhancing lesions 12 weeks after treatment initiation. PMID:29695594
Poe, Dennis S; Hanna, Bassem Matta Nashed
2011-01-01
Balloon catheter dilation of diseased sinus ostia has recently demonstrated efficacy and safety in the treatment of chronic sinus disease with 2 years of follow-up. Similar to sinus surgery, initial studies of partial resection of inflamed mucosa from within the cartilaginous eustachian tube (ET) have demonstrated efficacy and safety in the treatment of medically refractory otitis media with effusion. Therefore, balloon dilation of the cartilaginous ET was investigated as a possible treatment modality for otitis media. A protocol for sinus balloon catheter dilation was evaluated in each of the cartilaginous ETs in 8 fresh human cadaver heads. Computed tomographic scans and detailed endoscopic inspections with video or photographic documentation were performed pre- and posttreatment, and gross anatomical dissections were done to analyze the effects of treatment and to look for evidence of undesired injury. Catheters successfully dilated all cartilaginous ETs without any significant injuries. There were no bony or cartilaginous fractures, and 3 specimens showed minor mucosal tears in the anterolateral or inferior walls. Volumetric measurements of the cartilaginous ET lumens showed a change from an average of 0.16 to 0.49 cm(3) (SD, 0.12), representing an average increase of 357% (range, 20-965%). Balloon catheter dilation of the nasopharyngeal orifice of the ET was shown to be feasible and without evidence of untoward injury. A significant increase in volume of the cartilaginous ET was achieved. A clinical study is now indicated to determine whether balloon dilation will demonstrate lasting benefits and safety in the treatment of otitis media. Copyright © 2011 Elsevier Inc. All rights reserved.
2012-01-01
Background Bleeding severity, anatomic location, tissue characteristics, and visibility are common challenges encountered while managing intraoperative bleeding, and conventional hemostatic measures (suture, ligature, and cautery) may sometimes be ineffective or impractical. While topical absorbable hemostats (TAH) are useful hemostatic adjuvants, each TAH has associated disadvantages. Methods We evaluated the safety and hemostatic efficacy of a new advanced biologic combination product―fibrin pad―to potentially address some gaps associated with TAHs. Fibrin pad was assessed as adjunctive hemostat in open partial nephrectomy in single-center, open-label, Phase I study (N = 10), and as primary hemostat in multicenter, single-blind, randomized, standard-of-care (SOC)-controlled Phase I/II study (N = 7) in Israel. It was used to control mild-to-moderate bleeding in Phase I and also spurting arterial bleeding in Phase I/II study. Phase I study assessed safety and Phase I/II study, proportion of successes at 10 min following randomization, analyzed by Fisher exact tests at 5% significance level. Results Phase I (N = 10): All patients completed the study. Hemostasis was achieved within 3–4 min (average = 3.1 min) of a single application in all patients. Fibrin pad was found to be safe for human use, with no product-related adverse events reported. Phase I/II (N = 7): Hemostatic success at 10 min (primary endpoint) was achieved in 3/4 patients treated with fibrin pad versus 0/3 patients treated with SOC. No clinically significant change in laboratory or coagulation parameters was recorded, except a case of post-procedural hemorrhage with fibrin pad, which was considered serious and related to the fibrin pad treatment, and required re-operation. Although Data Safety Monitoring Board authorized trial continuation, the sponsor decided against proceeding toward an indication for primary treatment of severe arterial hemorrhage as a replacement for sutures. The study was suspended after 7/30 planned subjects were enrolled. Conclusions The first-in-man trial of fibrin pad demonstrated its safety and efficacy as an adjunctive hemostatic technique for mild-to-moderate bleeding in partial nephrectomy. The study also suggested that the product should not replace sutures or meticulous surgical techniques for the treatment of severe arterial hemorrhage. Trial registration Phase I/II trial, NCT00598130 PMID:23137020
NASA Technical Reports Server (NTRS)
Joshi, Anjali; Heimdahl, Mats P. E.; Miller, Steven P.; Whalen, Mike W.
2006-01-01
System safety analysis techniques are well established and are used extensively during the design of safety-critical systems. Despite this, most of the techniques are highly subjective and dependent on the skill of the practitioner. Since these analyses are usually based on an informal system model, it is unlikely that they will be complete, consistent, and error free. In fact, the lack of precise models of the system architecture and its failure modes often forces the safety analysts to devote much of their effort to gathering architectural details about the system behavior from several sources and embedding this information in the safety artifacts such as the fault trees. This report describes Model-Based Safety Analysis, an approach in which the system and safety engineers share a common system model created using a model-based development process. By extending the system model with a fault model as well as relevant portions of the physical system to be controlled, automated support can be provided for much of the safety analysis. We believe that by using a common model for both system and safety engineering and automating parts of the safety analysis, we can both reduce the cost and improve the quality of the safety analysis. Here we present our vision of model-based safety analysis and discuss the advantages and challenges in making this approach practical.
Shaheen, Nicholas J; Denison, Hans; Björck, Karin; Silberg, Debra G
2013-04-01
Approximately 20-30% of patients with gastroesophageal reflux disease (GERD) do not experience complete symptom resolution during proton pump inhibitor (PPI) therapy. The aim of this study was to determine the prevalence of esophageal mucosal breaks among patients who have a partial response to PPI therapy. This was an analysis of data from a phase 2b clinical trial carried out to assess the efficacy and safety of a reflux inhibitor, lesogaberan (AZD3355), as an add-on to PPI therapy in this patient population (clinicaltrials.gov reference: NCT01005251). A total of 661 patients with persistent GERD symptoms who had received a minimum of 4 weeks of PPI therapy were included in the study. The prevalence of esophageal mucosal breaks was assessed according to (i) the most recent endoscopy results from within the previous 24 months, if available ("historical" endoscopies), and (ii) the results of endoscopies performed at study baseline ("baseline" endoscopies). Baseline endoscopies were not carried out in patients who had a historical endoscopy showing an absence of esophageal mucosal breaks. Historical endoscopy results were available for 244 patients, of whom 48 (19.7%) had esophageal mucosal breaks. Baseline endoscopies were carried out in 465 patients, of whom 146 (31.4%) had esophageal mucosal breaks. Sensitivity analyses showed a prevalence of esophageal mucosal breaks of 20-30%. In both the historical and baseline endoscopies, most esophageal mucosal breaks were Los Angeles grades A or B. In patients with GERD symptoms partially responsive to PPI therapy, mild-to-moderate severity esophageal mucosal breaks are common (prevalence 20-30%), and may contribute to symptom etiology.
Hogendoorn, S; Duijnisveld, B J; van Duinen, S G; Stoel, B C; van Dijk, J G; Fibbe, W E; Nelissen, R G H H
2014-01-01
Traumatic brachial plexus injury causes severe functional impairment of the arm. Elbow flexion is often affected. Nerve surgery or tendon transfers provide the only means to obtain improved elbow flexion. Unfortunately, the functionality of the arm often remains insufficient. Stem cell therapy could potentially improve muscle strength and avoid muscle-tendon transfer. This pilot study assesses the safety and regenerative potential of autologous bone marrow-derived mononuclear cell injection in partially denervated biceps. Nine brachial plexus patients with insufficient elbow flexion (i.e., partial denervation) received intramuscular escalating doses of autologous bone marrow-derived mononuclear cells, combined with tendon transfers. Effect parameters included biceps biopsies, motor unit analysis on needle electromyography and computerised muscle tomography, before and after cell therapy. No adverse effects in vital signs, bone marrow aspiration sites, injection sites, or surgical wound were seen. After cell therapy there was a 52% decrease in muscle fibrosis (p = 0.01), an 80% increase in myofibre diameter (p = 0.007), a 50% increase in satellite cells (p = 0.045) and an 83% increase in capillary-to-myofibre ratio (p < 0.001) was shown. CT analysis demonstrated a 48% decrease in mean muscle density (p = 0.009). Motor unit analysis showed a mean increase of 36% in motor unit amplitude (p = 0.045), 22% increase in duration (p = 0.005) and 29% increase in number of phases (p = 0.002). Mononuclear cell injection in partly denervated muscle of brachial plexus patients is safe. The results suggest enhanced muscle reinnervation and regeneration. Cite this article: Bone Joint Res 2014;3:38-47.
Predictors of radiation exposure to providers during percutaneous nephrolithotomy
Wenzler, David L.; Abbott, Joel E.; Su, Jeannie J.; Shi, William; Slater, Richard; Miller, Daniel; Siemens, Michelle J.; Sur, Roger L.
2017-01-01
Background: Limited studies have reported on radiation risks of increased ionizing radiation exposure to medical personnel in the urologic community. Fluoroscopy is readily used in many urologic surgical procedures. The aim of this study was to determine radiation exposure to all operating room personnel during percutaneous nephrolithotomy (PNL), commonly performed for large renal or complex stones. Materials and Methods: We prospectively collected personnel exposure data for all PNL cases at two academic institutions. This was collected using the Instadose™ dosimeter and reported both continuously and categorically as high and low dose using a 10 mrem dose threshold, the approximate amount of radiation received from one single chest X-ray. Predictors of increased radiation exposure were determined using multivariate analysis. Results: A total of 91 PNL cases in 66 patients were reviewed. Median surgery duration and fluoroscopy time were 142 (38–368) min and 263 (19–1809) sec, respectively. Median attending urologist, urology resident, anesthesia, and nurse radiation exposure per case was 4 (0–111), 4 (0–21), 0 (0–5), and 0 (0–5) mrem, respectively. On univariate analysis, stone area, partial or staghorn calculi, surgery duration, and fluoroscopy time were associated with high attending urologist and resident radiation exposure. Preexisting access that was utilized was negatively associated with resident radiation exposure. However, on multivariate analysis, only fluoroscopy duration remained significant for attending urologist radiation exposure. Conclusion: Increased stone burden, partial or staghorn calculi, surgery and fluoroscopy duration, and absence of preexisting access were associated with high provider radiation exposure. Radiation safety awareness is essential to minimize exposure and to protect the patient and all providers from potential radiation injury. PMID:28216931
Making the Hubble Space Telescope servicing mission safe
NASA Technical Reports Server (NTRS)
Bahr, N. J.; Depalo, S. V.
1992-01-01
The implementation of the HST system safety program is detailed. Numerous safety analyses are conducted through various phases of design, test, and fabrication, and results are presented to NASA management for discussion during dedicated safety reviews. Attention is given to the system safety assessment and risk analysis methodologies used, i.e., hazard analysis, fault tree analysis, and failure modes and effects analysis, and to how they are coupled with engineering and test analysis for a 'synergistic picture' of the system. Some preliminary safety analysis results, showing the relationship between hazard identification, control or abatement, and finally control verification, are presented as examples of this safety process.
Psychosocial work characteristics predicting daytime sleepiness in day and shift workers.
Takahashi, Masaya; Nakata, Akinori; Haratani, Takashi; Otsuka, Yasumasa; Kaida, Kosuke; Fukasawa, Kenji
2006-01-01
Characteristics of work organization other than working time arrangements may contribute importantly to daytime sleepiness. The present study was designed to identify the psychosocial factors at work that predict daytime sleepiness in a sample of day and shift workers. Participants working at a pulp and chemical factory completed an annual questionnaire regarding psychosocial factors at work using the U.S. National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (i.e., quantitative workload, variance in workload, job control, support from supervisor, coworkers, or family/friends, job satisfaction, and depressive symptoms), as well as daytime sleepiness (through the Epworth Sleepiness Scale [ESS]) and sleep disturbances for three years starting in 2002 (response rates, 94.6-99.0%). The present analysis included 55 day workers (11 women) and 57 shift workers (all men) who participated in all three years of the study, worked under the same work schedule throughout the study period, and had no missing data on any of the daytime sleep items. A repeated-measures analysis of covariance (ANCOVA) was used to test the effects of work schedule (day vs. shift work) and psychosocial factors at work in 2002 on the ESS scores in subsequent years, with sleep duration, insomnia symptoms, chronic diseases, and sleepiness levels at baseline as covariates. Given significant and near-significant interactions of work schedules with psychosocial factor or study year, the ANCOVA, with the factors of psychosocial work characteristics and study year, was performed by type of work schedule. The results indicated a significant main effect of psychosocial work characteristics (p = 0.010, partial eng2 = 0.14) and an almost significant main effect of study year (p = 0.067, partial eng2 = 0.06) and interaction between psychosocial work characteristics and study year (p = 0.085, partial eng2 = 0.06) for variance in workload among the day work group. The day workers reporting high variance in workload in 2002 exhibited significantly higher ESS scores in 2003 and 2004 than did those reporting low variance in workload. The ANCOVA for the shift work group showed a main effect of psychosocial work characteristics for job satisfaction (p = 0.026, partial eng2 = 0.10) and depressive symptoms (p = 0.094, partial eng2 = 0.06) with the interaction between psychosocial work characteristics and study year for job satisfaction (p = 0.172, partial eng2 = 0.04) and depressive symptoms (p = 0.035, partial eng2 = 0.07). The shift workers with low job satisfaction and high symptoms of depression in 2002 showed significantly greater ESS scores in 2003 and/or 2004 than did those with opposite characteristics. These results may suggest a potential predictive value of variance in workload for day workers as well as job satisfaction and depressive symptoms for shift workers with respect to daytime sleepiness. The present findings may imply that redesigning these aspects of work environment would be of help in managing daytime sleepiness.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bolton, P.
The purpose of this task was to support ESH-3 in providing Airborne Release Fraction and Respirable Fraction training to safety analysts at LANL who perform accident analysis, hazard analysis, safety analysis, and/or risk assessments at nuclear facilities. The task included preparation of materials for and the conduct of two 3-day training courses covering the following topics: safety analysis process; calculation model; aerosol physic concepts for safety analysis; and overview of empirically derived airborne release fractions and respirable fractions.
A Generalized Partial Credit Model: Application of an EM Algorithm.
ERIC Educational Resources Information Center
Muraki, Eiji
1992-01-01
The partial credit model with a varying slope parameter is developed and called the generalized partial credit model (GPCM). Analysis results for simulated data by this and other polytomous item-response models demonstrate that the rating formulation of the GPCM is adaptable to the analysis of polytomous item responses. (SLD)
Wang, Gaoqi; Zhang, Song; Bian, Cuirong; Kong, Hui
2016-01-01
The purpose of the study was to verify the finite element analysis model of three-unite fixed partial denture with in vitro electronic strain analysis and analyze clinical situation with the verified model. First, strain gauges were attached to the critical areas of a three-unit fixed partial denture. Strain values were measured under 300 N load perpendicular to the occlusal plane. Secondly, a three-dimensional finite element model in accordance with the electronic strain analysis experiment was constructed from the scanning data. And the strain values obtained by finite element analysis and in vitro measurements were compared. Finally, the clinical destruction of the fixed partial denture was evaluated with the verified finite element analysis model. There was a mutual agreement and consistency between the finite element analysis results and experimental data. The finite element analysis revealed that failure will occur in the veneer layer on buccal surface of the connector under occlusal force of 570 N. The results indicate that the electronic strain analysis is an appropriate and cost saving method to verify the finite element model. The veneer layer on buccal surface of the connector is the weakest area in the fixed partial denture. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
DOT National Transportation Integrated Search
2014-03-01
Recent research in highway safety has focused on the more advanced and statistically proven techniques of highway : safety analysis. This project focuses on the two most recent safety analysis tools, the Highway Safety Manual (HSM) : and SafetyAnalys...
Eslicarbazepine acetate for the treatment of partial epilepsy.
Zelano, Johan; Ben-Menachem, Elinor
2016-06-01
Eslicarbazepine acetate (ESL) is a third generation AED structurally related to carbamazepine and oxcarbazepine, but without several of the drawbacks associated with these compounds. ESL is completely metabolized to its eslicarbazpine, which selectively binds inactivated voltage-gated sodium channels and thus selectively reduces the activity of rapidly firing (epileptic) neurons. In addition, ESL has pharmacokinetic properties allowing once daily dosing. This review summarizes data from the initial phase I to III studies, which demonstrated efficacy of ESL as add-on treatment in partial onset epilepsy, and more recent studies that demonstrate efficacy of ESL as monotherapy. Real-life observational studies are also reviewed, and seem to confirm the notion of ESL as a well-tolerated AED. As a new AED, ESL needs to be subject to close monitoring regarding long-term adverse events. Future independent studies will most likely clarify the role of ESL in the management of partial onset seizures. The role of ESL in management of partial onset seizures is discussed, as is the need for close monitoring and evaluation for broad-spectrum pharmacodynamics properties. The characteristics of the molecule and efficacy and safety profiles seem, however, very promising.
Analysis of passenger-car crash injury severity in different work zone configurations.
Osman, Mohamed; Paleti, Rajesh; Mishra, Sabyasachee
2018-02-01
Work zone safety remains a priority to the Federal Highway Administration, State Highway Departments, highway engineers, and the traveling public. Work zones create a hospitable environment for crashes; an issue that gained tremendous share of attention in recent years. Therefore, every effort should be sought out to reduce the injury severity of crashes in work zones. In this paper we attempt to investigate factors contributing to the injury severity of passenger-car crashes in different work zone configurations. Considering the discrete ordinal nature of injury severity categories, a Mixed Generalized Ordered Response Probit (MGORP) modeling framework was developed. The model estimation was undertaken by compiling a database consisting of 10 years of crashes that involved at least one passenger car, and occurred in a work zone. Revealing the underlying factors contributing to injury severity levels for different work zone configurations will allow for distinguishing mitigation methods for higher severity outcomes that best suit each of the depicted work zone layouts. This can be accomplished through the implementation of specific safety measures based on the specific configuration of a work zone as a potential crash location. Elasticity analysis suggests that partial control of access, roadways classified as rural, crashes during evening times, crashes during weekends, and curved roadways are key factors that increase the likelihood of severe outcomes. Also, the effects of several covariates were found to vary across the different work zone configurations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Coles, Claire D; Strickland, Dorothy C; Padgett, Lynne; Bellmoff, Lynnae
2007-01-01
Unintentional injuries are a leading cause of death and disability for children. Those with developmental disabilities, including children affected by prenatal alcohol exposure, are at highest risk for injuries. Although teaching safety skills is recommended to prevent injury, cognitive limitations and behavioral problems characteristic of children with fetal alcohol spectrum disorder make teaching these skills challenging for parents and teachers. In the current study, 32 children, ages 4-10, diagnosed with fetal alcohol syndrome (FAS) and partial FAS, learned fire and street safety through computer games that employed "virtual worlds" to teach recommended safety skills. Children were pretested on verbal knowledge of four safety elements for both fire and street safety conditions and then randomly assigned to one condition. After playing the game until mastery, children were retested verbally and asked to "generalize" their newly acquired skills in a behavioral context. They were retested after 1 week follow-up. Children showed significantly better knowledge of the game to which they were exposed, immediately and at follow-up, and the majority (72%) was able to generalize all four steps within a behavioral setting. Results suggested that this is a highly effective method for teaching safety skills to high-risk children who have learning difficulties.
Tadori, Yoshihiro; Forbes, Robert A; McQuade, Robert D; Kikuchi, Tetsuro
2011-10-15
Aripiprazole is the first dopamine D(2)/D(3) receptor partial agonist successfully developed and ultimately approved for treatment of a broad spectrum of psychiatric and neurological disorders. Aripiprazole's dopamine D(2) and serotonin 5-HT(1A) receptor partial agonist activities have been postulated to confer clinical efficacy without marked sedation, and a relatively favorable overall side-effect profile. Using aripiprazole's unique profile as a benchmark for new dopamine partial agonist development may facilitate discovery of new antipsychotics. We conducted an in vitro comparative analysis between aripiprazole, and its human metabolite OPC-14857 (7-(4-[4-(2,3-dichlorophenyl)-1-piperazinyl)butoxy)-2(1H)-quinolinone)); RGH-188 (trans-1-[4-[2-[4-(2,3-dichlorophenyl)piperazine-1-yl]ethyl]cyclohexyl]-3,3-dimethylurea), and its metabolite didesmethyl-RGH-188 (DDM-RGH-188); as well as bifeprunox, sarizotan, N-desmethylclozapine (NDMC; clozapine metabolite), and SDZ 208-912 (N-[(8α)-2-chloro-6-methylergolin-8-yl]-2,2-dimethylpropanamide). In vitro pharmacological assessment included inhibition of forskolin-stimulated cAMP accumulation and the reversal of dopamine-induced inhibition in clonal Chinese hamster ovary cell lines expressing D(2S), D(2L), D(3) Ser-9 and D(3) Gly-9 for human dopamine receptors. All test compounds behaved as dopamine D(2)/D(3) receptor partial agonists. Aripiprazole's intrinsic activity at dopamine D(2S) and D(2L) receptors was similar to that of OPC-14857 and RGH-188; lower than that of dopamine and bifeprunox; and higher than that of DDM-RGH-188, SDZ 208-912, sarizotan, and NDMC. Aripiprazole's intrinsic activity at dopamine D(3) Ser-9 and D(3) Gly-9 receptors was similar to that of OPC-14857 and sarizotan; lower than that of dopamine, bifeprunox, RGH-188 and DDM-RGH-188; and higher than that of SDZ 208-912 and NDMC. A consolidated assessment of these findings may help defining the most appropriate magnitude of intrinsic activity at dopamine D(2)/D(3) receptors for clinical efficacy and safety. Copyright © 2011 Elsevier B.V. All rights reserved.
ERIC Educational Resources Information Center
Fulco, Charles
2017-01-01
The 2017 Total Solar Eclipse (TSE2017) will occur on August 21 in the continental United States, bringing totality to this area for the first time since 1979. The Moon's umbra will traverse from Oregon to South Carolina in about 90 minutes, bringing an eerie darkness to 14 states coast-to-coast and a partial eclipse to every part of the country…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-20
... tires include the full Tire Identification Number (TIN) on one sidewall but omits the partial serial... failure incidents. The TIN becomes important in the event of a safety campaign and enables the owners to... with the current FMVSS No. 139 sidewall marking regulation that requires a full TIN on the sidewall and...
ERIC Educational Resources Information Center
Wilens, Timothy E.; Bukstein, Oscar; Brams, Matthew; Cutler, Andrew J.; Childress, Ann; Rugino, Thomas; Lyne, Andrew; Grannis, Kara; Youcha, Sharon
2012-01-01
Objective: To examine efficacy, tolerability, and safety of guanfacine extended release (GXR; less than or equal to 4 mg/d) adjunctive to a long-acting psychostimulant for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents 6 to 17 years of age with suboptimal, but partial, response to psychostimulant…
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 4 2013-01-01 2013-01-01 false Exemptions. 1705.11 Section 1705.11 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.11 Exemptions. Pursuant to 5 U.S.C. 552a(k), the Board has determined that system of records DNFSB-3, “Drug Testing Program Records,” is partially exempt from 5 U.S.C...
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 4 2012-01-01 2012-01-01 false Exemptions. 1705.11 Section 1705.11 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.11 Exemptions. Pursuant to 5 U.S.C. 552a(k), the Board has determined that system of records DNFSB-3, “Drug Testing Program Records,” is partially exempt from 5 U.S.C...
ERIC Educational Resources Information Center
Mellin, Elizabeth A.; Fang, Hong-Ning
2010-01-01
This study found that lack of involvement in prosocial institutions, affiliation with other troubled youth, and indifference regarding personal safety partially mediate the relationship between depression and delinquency among justice-involved female adolescents. The results suggest that depression may not be the primary conduit to delinquency.…
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Exemptions. 1705.11 Section 1705.11 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.11 Exemptions. Pursuant to 5 U.S.C. 552a(k), the Board has determined that system of records DNFSB-3, “Drug Testing Program Records,” is partially exempt from 5 U.S.C...
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 4 2011-01-01 2011-01-01 false Exemptions. 1705.11 Section 1705.11 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.11 Exemptions. Pursuant to 5 U.S.C. 552a(k), the Board has determined that system of records DNFSB-3, “Drug Testing Program Records,” is partially exempt from 5 U.S.C...
Addressing safety liabilities of TfR bispecific antibodies that cross the blood-brain barrier.
Couch, Jessica A; Yu, Y Joy; Zhang, Yin; Tarrant, Jacqueline M; Fuji, Reina N; Meilandt, William J; Solanoy, Hilda; Tong, Raymond K; Hoyte, Kwame; Luk, Wilman; Lu, Yanmei; Gadkar, Kapil; Prabhu, Saileta; Ordonia, Benjamin A; Nguyen, Quyen; Lin, Yuwen; Lin, Zhonghua; Balazs, Mercedesz; Scearce-Levie, Kimberly; Ernst, James A; Dennis, Mark S; Watts, Ryan J
2013-05-01
Bispecific antibodies using the transferrin receptor (TfR) have shown promise for boosting antibody uptake in brain. Nevertheless, there are limited data on the therapeutic properties including safety liabilities that will enable successful development of TfR-based therapeutics. We evaluate TfR/BACE1 bispecific antibody variants in mouse and show that reducing TfR binding affinity improves not only brain uptake but also peripheral exposure and the safety profile of these antibodies. We identify and seek to address liabilities of targeting TfR with antibodies, namely, acute clinical signs and decreased circulating reticulocytes observed after dosing. By eliminating Fc effector function, we ameliorated the acute clinical signs and partially rescued a reduction in reticulocytes. Furthermore, we show that complement mediates a residual decrease in reticulocytes observed after Fc effector function is eliminated. These data raise important safety concerns and potential mitigation strategies for the development of TfR-based therapies that are designed to cross the blood-brain barrier.
Sliwinski-Korell, A; Lutz, F
1998-05-01
In the last years the standards for professional handling of hazardous material as well as health and safety in the veterinary practice became considerably more stringent. This is expressed in various safety regulations, particularly the decree of hazardous material and the legislative directives concerning health and safety at work. In part 1, a definition based on the law for hazardous material was given and the potential risks were mentioned. The correct documentation regarding the protection of personal and the purchase, storage, working conditions and removal of hazardous material was explained. General rules for the handling of hazardous material were described. In part 2, partial emphasis is put on the handling of flammable liquids, disinfectants, cytostatica, pressurised gases, liquid nitrogen, narcotics, mailing of potentially infectious material and safe disposal of hazardous waste. Advice about possible unrecognized hazards and references are also given.
Stepwise Analysis of Differential Item Functioning Based on Multiple-Group Partial Credit Model.
ERIC Educational Resources Information Center
Muraki, Eiji
1999-01-01
Extended an Item Response Theory (IRT) method for detection of differential item functioning to the partial credit model and applied the method to simulated data using a stepwise procedure. Then applied the stepwise DIF analysis based on the multiple-group partial credit model to writing trend data from the National Assessment of Educational…
Automatisms in EMIR instrument to improve operation, safety and maintenance
NASA Astrophysics Data System (ADS)
Fernández Izquierdo, Patricia; Núñez Cagigal, Miguel; Barreto Rodríguez, Roberto; Martínez Rey, Noelia; Santana Tschudi, Samuel; Barreto Cabrera, Maria; Patrón Recio, Jesús; Garzón López, Francisco
2014-08-01
EMIR is the NIR imager and multiobject spectrograph being built as a common user instrument for the 10-m class GTC. Big cryogenic instruments demand a reliable design and a specific hardware and software to increase its safety and productivity. EMIR vacuum, cooling and heating systems are monitored and partially controlled by a Programmable Logic Controller (PLC) in industrial format with a touch screen. The PLC aids the instrument operator in the maintenance tasks recovering autonomously vacuum if required or proposing preventive maintenance actions. The PLC and its associated hardware improve EMIR safety having immediate reactions against eventual failure modes in the instrument or in external supplies, including hardware failures during the heating procedure or failure in the PLC itself. EMIR PLC provides detailed information periodically about status and alarms of vacuum and cooling components or external supplies.
Institutional Oversight of Occupational Health and Safety for Research Programs Involving Biohazards
Dyson, Melissa C; Carpenter, Calvin B; Colby, Lesley A
2017-01-01
Research with hazardous biologic materials (biohazards) is essential to the progress of medicine and science. The field of microbiology has rapidly advanced over the years, partially due to the development of new scientific methods such as recombinant DNA technology, synthetic biology, viral vectors, and the use of genetically modified animals. This research poses a potential risk to personnel as well as the public and the environment. Institutions must have appropriate oversight and take appropriate steps to mitigate the risks of working with these biologic hazards. This article will review responsibilities for institutional oversight of occupational health and safety for research involving biologic hazards. PMID:28662748
Dyson, Melissa C; Carpenter, Calvin B; Colby, Lesley A
2017-06-01
Research with hazardous biologic materials (biohazards) is essential to the progress of medicine and science. The field of microbiology has rapidly advanced over the years, partially due to the development of new scientific methods such as recombinant DNA technology, synthetic biology, viral vectors, and the use of genetically modified animals. This research poses a potential risk to personnel as well as the public and the environment. Institutions must have appropriate oversight and take appropriate steps to mitigate the risks of working with these biologic hazards. This article will review responsibilities for institutional oversight of occupational health and safety for research involving biologic hazards.
Zhu, Junya
2018-06-11
Self-report instruments have been widely used to better understand variations in patient safety climate between physicians and nurses. Research is needed to determine whether differences in patient safety climate reflect true differences in the underlying concepts. This is known as measurement equivalence, which is a prerequisite for meaningful group comparisons. This study aims to examine the degree of measurement equivalence of the responses to a patient safety climate survey of Chinese hospitals and to demonstrate how the measurement equivalence method can be applied to self-report climate surveys for patient safety research. Using data from the Chinese Hospital Survey of Patient Safety Climate from six Chinese hospitals in 2011, we constructed two groups: physicians and nurses (346 per group). We used multiple-group confirmatory factor analyses to examine progressively more stringent restrictions for measurement equivalence. We identified weak factorial equivalence across the two groups. Strong factorial equivalence was found for Organizational Learning, Unit Management Support for Safety, Adequacy of Safety Arrangements, Institutional Commitment to Safety, Error Reporting and Teamwork. Strong factorial equivalence, however, was not found for Safety System, Communication and Peer Support and Staffing. Nevertheless, further analyses suggested that nonequivalence did not meaningfully affect the conclusions regarding physician-nurse differences in patient safety climate. Our results provide evidence of at least partial equivalence of the survey responses between nurses and physicians, supporting mean comparisons of its constructs between the two groups. The measurement equivalence approach is essential to ensure that conclusions about group differences are valid.
NASA Astrophysics Data System (ADS)
Dinç, Erdal; Ertekin, Zehra Ceren; Büker, Eda
2017-09-01
In this study, excitation-emission matrix datasets, which have strong overlapping bands, were processed by using four different chemometric calibration algorithms consisting of parallel factor analysis, Tucker3, three-way partial least squares and unfolded partial least squares for the simultaneous quantitative estimation of valsartan and amlodipine besylate in tablets. In analyses, preliminary separation step was not used before the application of parallel factor analysis Tucker3, three-way partial least squares and unfolded partial least squares approaches for the analysis of the related drug substances in samples. Three-way excitation-emission matrix data array was obtained by concatenating excitation-emission matrices of the calibration set, validation set, and commercial tablet samples. The excitation-emission matrix data array was used to get parallel factor analysis, Tucker3, three-way partial least squares and unfolded partial least squares calibrations and to predict the amounts of valsartan and amlodipine besylate in samples. For all the methods, calibration and prediction of valsartan and amlodipine besylate were performed in the working concentration ranges of 0.25-4.50 μg/mL. The validity and the performance of all the proposed methods were checked by using the validation parameters. From the analysis results, it was concluded that the described two-way and three-way algorithmic methods were very useful for the simultaneous quantitative resolution and routine analysis of the related drug substances in marketed samples.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Santhanam, A; Min, Y; Beron, P
Purpose: Patient safety hazards such as a wrong patient/site getting treated can lead to catastrophic results. The purpose of this project is to automatically detect potential patient safety hazards during the radiotherapy setup and alert the therapist before the treatment is initiated. Methods: We employed a set of co-located and co-registered 3D cameras placed inside the treatment room. Each camera provided a point-cloud of fraxels (fragment pixels with 3D depth information). Each of the cameras were calibrated using a custom-built calibration target to provide 3D information with less than 2 mm error in the 500 mm neighborhood around the isocenter.more » To identify potential patient safety hazards, the treatment room components and the patient’s body needed to be identified and tracked in real-time. For feature recognition purposes, we used a graph-cut based feature recognition with principal component analysis (PCA) based feature-to-object correlation to segment the objects in real-time. Changes in the object’s position were tracked using the CamShift algorithm. The 3D object information was then stored for each classified object (e.g. gantry, couch). A deep learning framework was then used to analyze all the classified objects in both 2D and 3D and was then used to fine-tune a convolutional network for object recognition. The number of network layers were optimized to identify the tracked objects with >95% accuracy. Results: Our systematic analyses showed that, the system was effectively able to recognize wrong patient setups and wrong patient accessories. The combined usage of 2D camera information (color + depth) enabled a topology-preserving approach to verify patient safety hazards in an automatic manner and even in scenarios where the depth information is partially available. Conclusion: By utilizing the 3D cameras inside the treatment room and a deep learning based image classification, potential patient safety hazards can be effectively avoided.« less
14 CFR 417.231 - Collision avoidance analysis.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Collision avoidance analysis. 417.231..., DEPARTMENT OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.231 Collision avoidance analysis. (a) General. A flight safety analysis must include a collision avoidance analysis that...
Determination of mango fruit from binary image using randomized Hough transform
NASA Astrophysics Data System (ADS)
Rizon, Mohamed; Najihah Yusri, Nurul Ain; Abdul Kadir, Mohd Fadzil; bin Mamat, Abd. Rasid; Abd Aziz, Azim Zaliha; Nanaa, Kutiba
2015-12-01
A method of detecting mango fruit from RGB input image is proposed in this research. From the input image, the image is processed to obtain the binary image using the texture analysis and morphological operations (dilation and erosion). Later, the Randomized Hough Transform (RHT) method is used to find the best ellipse fits to each binary region. By using the texture analysis, the system can detect the mango fruit that is partially overlapped with each other and mango fruit that is partially occluded by the leaves. The combination of texture analysis and morphological operator can isolate the partially overlapped fruit and fruit that are partially occluded by leaves. The parameters derived from RHT method was used to calculate the center of the ellipse. The center of the ellipse acts as the gripping point for the fruit picking robot. As the results, the rate of detection was up to 95% for fruit that is partially overlapped and partially covered by leaves.
Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy
Witt, Thomas; Worth, Robert; Henry, Thomas R.; Gross, Robert E.; Nazzaro, Jules M.; Labar, Douglas; Sperling, Michael R.; Sharan, Ashwini; Sandok, Evan; Handforth, Adrian; Stern, John M.; Chung, Steve; Henderson, Jaimie M.; French, Jacqueline; Baltuch, Gordon; Rosenfeld, William E.; Garcia, Paul; Barbaro, Nicholas M.; Fountain, Nathan B.; Elias, W. Jeffrey; Goodman, Robert R.; Pollard, John R.; Tröster, Alexander I.; Irwin, Christopher P.; Lambrecht, Kristin; Graves, Nina; Fisher, Robert
2015-01-01
Objective: To report long-term efficacy and safety results of the SANTE trial investigating deep brain stimulation of the anterior nucleus of the thalamus (ANT) for treatment of localization-related epilepsy. Methods: This long-term follow-up is a continuation of a previously reported trial of 5- vs 0-V ANT stimulation. Long-term follow-up began 13 months after device implantation with stimulation parameters adjusted at the investigators' discretion. Seizure frequency was determined using daily seizure diaries. Results: The median percent seizure reduction from baseline at 1 year was 41%, and 69% at 5 years. The responder rate (≥50% reduction in seizure frequency) at 1 year was 43%, and 68% at 5 years. In the 5 years of follow-up, 16% of subjects were seizure-free for at least 6 months. There were no reported unanticipated adverse device effects or symptomatic intracranial hemorrhages. The Liverpool Seizure Severity Scale and 31-item Quality of Life in Epilepsy measure showed statistically significant improvement over baseline by 1 year and at 5 years (p < 0.001). Conclusion: Long-term follow-up of ANT deep brain stimulation showed sustained efficacy and safety in a treatment-resistant population. Classification of evidence: This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy, anterior thalamic stimulation is associated with a 69% reduction in seizure frequency and a 34% serious device-related adverse event rate at 5 years. PMID:25663221
Patel, Manish R; Ellerton, John; Infante, Jeffrey R; Agrawal, Manish; Gordon, Michael; Aljumaily, Raid; Britten, Carolyn D; Dirix, Luc; Lee, Keun-Wook; Taylor, Mathew; Schöffski, Patrick; Wang, Ding; Ravaud, Alain; Gelb, Arnold B; Xiong, Junyuan; Rosen, Galit; Gulley, James L; Apolo, Andrea B
2018-01-01
The approval of anti-programmed death ligand 1 (PD-L1) and anti-programmed death 1 agents has expanded treatment options for patients with locally advanced or metastatic urothelial carcinoma. Avelumab, a human monoclonal anti-PD-L1 antibody, has shown promising antitumour activity and safety in this disease. We aimed to assess the safety profile in patients (both post-platinum therapy and cisplatin-naive) treated with avelumab and to assess antitumour activity of this drug in post-platinum patients. In this pooled analysis of two cohorts from the phase 1 dose-expansion JAVELIN Solid Tumor study, patients aged 18 years and older with histologically or cytologically confirmed locally advanced or metastatic urothelial carcinoma that had progressed after at least one previous platinum-based chemotherapy were enrolled from 80 cancer treatment centres or hospitals in the USA, Europe, and Asia. Eligible patients had adequate end-organ function, an Eastern Cooperative Oncology Group performance status of 0 or 1, life expectancy of at least 3 months, and at least one measurable lesion. Cisplatin-ineligible patients who might have been previously treated in the perioperative setting, including platinum-naive patients, were also eligible. Patients unselected for PD-L1 expression received avelumab (10 mg/kg, 1 h intravenous infusion) every 2 weeks until confirmed disease progression, unacceptable toxicity, or other criterion for withdrawal. The primary endpoint for this efficacy expansion cohort was confirmed best overall response (according to RECIST version 1.1), adjudicated by independent review. Safety analysis was done in all patients who received at least one dose of avelumab. Antitumour activity was assessed in post-platinum patients who received at least one dose of avelumab. This trial is registered with ClinicalTrials.gov, number NCT01772004; enrolment in this cohort of patients with metastatic urothelial carcinoma is closed and the trial is ongoing. Between Sept 3, 2014, and March 15, 2016, 329 patients with advanced metastatic urothelial carcinoma were screened for enrolment into this study; 249 patients were eligible and received treatment with avelumab for a median of 12 weeks (IQR 6·0-19·7) and followed up for a median of 9·9 months (4·3-12·1). Safety and antitumour activity were evaluated at data cutoff on June 9, 2016. In 161 post-platinum patients with at least 6 months of follow-up, a best overall response of complete or partial response was recorded in 27 patients (17%; 95% CI 11-24), including nine (6%) complete responses and 18 (11%) partial responses. The most frequent treatment-related adverse events (any grade in ≥10% patients) were infusion-related reaction (73 [29%]; all grade 1-2) and fatigue (40 [16%]). Grade 3 or worse treatment-related adverse events occurred in 21 (8%) of 249 patients, the most common of which were fatigue (four [2%]), and asthenia, elevated lipase, hypophosphataemia, and pneumonitis in two (1%) patients each. 19 (8%) of 249 patients had a serious adverse event related to treatment with avelumab, and one treatment-related death occurred (pneumonitis). Avelumab showed antitumour activity in the treatment of patients with platinum-refractory metastatic urothelial carcinoma; a manageable safety profile was reported in all avelumab-treated patients. These data provide the rationale for therapeutic use of avelumab in metastatic urothelial carcinoma and it has received accelerated US FDA approval in this setting on this basis. Merck KGaA, and Pfizer Inc. Copyright © 2018 Elsevier Ltd. All rights reserved.
Gług, Maciej; Brela, Mateusz Z; Boczar, Marek; Turek, Andrzej M; Boda, Łukasz; Wójcik, Marek J; Nakajima, Takahito; Ozaki, Yukihiro
2017-01-26
In this study we present complementary computational and experimental studies of hydrogen bond interaction in crystalline benzoic acid and its deuterated and partially deuterated derivatives. The experimental part of the presented work includes preparation of partially deuterated samples and measurement of attenuated total reflection (ATR)-FTIR spectra. Analysis of the geometrical parameters and time course of dipole moment of crystalline benzoic acid and its deuterated and partially deuterated derivatives by Born-Oppenheimer molecular dynamics (BOMD) enabled us to deeply analyze the IR spectra. Presented simulations based on BOMD gave us opportunity to investigate individual motion and its contribution to the IR spectra. The band contours calculated using Fourier transform of autocorrelation function are in quantitative agreement with the experimental spectra. Characterization of single bands was carried out by "normal coordinate analysis". The salient point of our study is a comparison of the spectra of the deuterated and partially deuterated crystalline benzoic acid with that of the nondeuterated one. Furthermore, we have applied the principal component analysis for analysis of the number of components in partially deuterated systems. In this study, we reveal that the arrangements of hydrogen and deuterium atoms in partially deuterated samples are random.
Xin, Yong; Huang, Qian; Zhang, Pei; Yang, Ming; Hou, Xiao-Yang; Tang, Jian-Qin; Zhang, Long Zhen; Jiang, Guan
2016-04-01
The aim of this study was to compare the efficacy and safety of interferon (IFN) combined with dacarbazine (DTIC) (experimental group) versus DTIC alone (control group) in cutaneous malignant melanoma. After searching all available databases, eligible articles were identified and subjected to quality assessment. Meta-analysis was performed using RevMan 5.3; combined relative risk (RR) and 95% confidence intervals (95% CIs) were calculated for survival rates, response rates, and adverse events. Eight randomized controlled trials published between 1990 and 2014 involving 795 patients were included in the meta-analysis. Compared with DTIC alone, IFN combined with DTIC significantly increased the overall response rate (RR = 1.59, 95% CI 1.21-2.08, P = 0.0008),the complete response rate (RR = 3.30, 95% CI 1.89-5.76, P < 0.0001), 2-year survival (RR = 1.59, 95% CI 0.99-2.54, P = 0.050) grade ≥3 hematologic toxicity (RR = 2.30, 95% CI 1.32-4.02, P = 0.003), neurotoxicity (RR = 18.15, 95% CI 5.34-61.74, P < 0.00001), and flu-like symptoms (RR = 6.31, 95% CI 1.95-20.39, P = 0.002). The partial response rate, grade ≥3 nausea and vomiting, treatment-related, and 1- and 3-year survival were not significantly different between IFN combined with DTIC and DTIC alone. IFN combined with DTIC may moderately improve the complete response rate, but increases the incidence of adverse events and has no significant effect on 1- and 3-year survival in cutaneous malignant melanoma.
Xin, Yong; Huang, Qian; Zhang, Pei; Yang, Ming; Hou, Xiao-Yang; Tang, Jian-Qin; Zhang, Long Zhen; Jiang, Guan
2016-01-01
Abstract The aim of this study was to compare the efficacy and safety of interferon (IFN) combined with dacarbazine (DTIC) (experimental group) versus DTIC alone (control group) in cutaneous malignant melanoma. After searching all available databases, eligible articles were identified and subjected to quality assessment. Meta-analysis was performed using RevMan 5.3; combined relative risk (RR) and 95% confidence intervals (95% CIs) were calculated for survival rates, response rates, and adverse events. Eight randomized controlled trials published between 1990 and 2014 involving 795 patients were included in the meta-analysis. Compared with DTIC alone, IFN combined with DTIC significantly increased the overall response rate (RR = 1.59, 95% CI 1.21–2.08, P = 0.0008),the complete response rate (RR = 3.30, 95% CI 1.89–5.76, P < 0.0001), 2-year survival (RR = 1.59, 95% CI 0.99–2.54, P = 0.050) grade ≥3 hematologic toxicity (RR = 2.30, 95% CI 1.32–4.02, P = 0.003), neurotoxicity (RR = 18.15, 95% CI 5.34–61.74, P < 0.00001), and flu-like symptoms (RR = 6.31, 95% CI 1.95–20.39, P = 0.002). The partial response rate, grade ≥3 nausea and vomiting, treatment-related, and 1- and 3-year survival were not significantly different between IFN combined with DTIC and DTIC alone. IFN combined with DTIC may moderately improve the complete response rate, but increases the incidence of adverse events and has no significant effect on 1- and 3-year survival in cutaneous malignant melanoma. PMID:27100429
Rapid determination of sugar level in snack products using infrared spectroscopy.
Wang, Ting; Rodriguez-Saona, Luis E
2012-08-01
Real-time spectroscopic methods can provide a valuable window into food manufacturing to permit optimization of production rate, quality and safety. There is a need for cutting edge sensor technology directed at improving efficiency, throughput and reliability of critical processes. The aim of the research was to evaluate the feasibility of infrared systems combined with chemometric analysis to develop rapid methods for determination of sugars in cereal products. Samples were ground and spectra were collected using a mid-infrared (MIR) spectrometer equipped with a triple-bounce ZnSe MIRacle attenuated total reflectance accessory or Fourier transform near infrared (NIR) system equipped with a diffuse reflection-integrating sphere. Sugar contents were determined using a reference HPLC method. Partial least squares regression (PLSR) was used to create cross-validated calibration models. The predictability of the models was evaluated on an independent set of samples and compared with reference techniques. MIR and NIR spectra showed characteristic absorption bands for sugars, and generated excellent PLSR models (sucrose: SEP < 1.7% and r > 0.96). Multivariate models accurately and precisely predicted sugar level in snacks allowing for rapid analysis. This simple technique allows for reliable prediction of quality parameters, and automation enabling food manufacturers for early corrective actions that will ultimately save time and money while establishing a uniform quality. The U.S. snack food industry generates billions of dollars in revenue each year and vibrational spectroscopic methods combined with pattern recognition analysis could permit optimization of production rate, quality, and safety of many food products. This research showed that infrared spectroscopy is a powerful technique for near real-time (approximately 1 min) assessment of sugar content in various cereal products. © 2012 Institute of Food Technologists®
Treatment of Early-Age Mania: Outcomes for Partial and Nonresponders to Initial Treatment.
Walkup, John T; Wagner, Karen Dineen; Miller, Leslie; Yenokyan, Gayane; Luby, Joan L; Joshi, Paramjit T; Axelson, David A; Robb, Adelaide; Salpekar, Jay A; Wolf, Dwight; Sanyal, Abanti; Birmaher, Boris; Vitiello, Benedetto; Riddle, Mark A
2015-12-01
The Treatment of Early Age Mania (TEAM) study evaluated lithium, risperidone, and divalproex sodium (divalproex) in children with bipolar I disorder who were naive to antimanic medication, or were partial or nonresponders to 1 of 3 study medications. This report evaluates the benefit of either an add-on or a switch of antimanic medications for an 8-week trial period in partial responders and nonresponders, respectively. TEAM is a randomized, controlled trial of individuals (N = 379) aged 6 to 15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (mixed or manic phase). Participants (n = 154) in this report were either nonresponders or partial responders to 1 of the 3 study medications. Nonresponders (n = 89) were randomly assigned to 1 of the other 2 antimanic medications and cross-tapered. Partial responders (n = 65) were randomly assigned to 1 of 2 other antimanic medications as an add-on to their initial medication. Adverse event (AE) rates are reported only for the add-on group. Response rate for children switched to risperidone (47.6%) was higher than for those switched to either lithium (12.8%; p = .005; number needed to treat [NNT] = 3; 95% CI = 1.71-9.09) or divalproex (17.2%; p = .03; NNT = 3; 95% CI = 1.79-20.10); response rate for partial responders who added risperidone (53.3%) was higher than for those who added divalproex (0%; p = .0002; NNT = 2; 95% CI = 1.27-3.56) and trended higher for lithium (26.7%; p = .07; NNT = 4). Reported AEs in the add-on group were largely consistent with the known AE profile for the second medication. Weight gain (kg) was observed for all add-on medications: lithium add-on (n = 29 of 30) = 1.66 ± 1.97; risperidone add-on (n = 15 of 15) = 2.8 ± 1.34; divalproex add-on (n = 19 of 20) = 1.42 ± 1.96. There was no evidence at the 5% significance level that the average weight gain was different by study medication for partial responders (p = .07, 1-way analysis of variance). Risperidone appears to be more useful than lithium or divalproex for children with bipolar I disorder and other comorbid conditions who are nonresponders or partial responders to an initial antimanic medication trial. Clinical trial registration information-Study of Outcome and Safety of Lithium, Divalproex and Risperidone for Mania in Children and Adolescents (TEAM); http://clinicaltrials.gov/; NCT00057681. Copyright © 2015. Published by Elsevier Inc.
Conditions for a partial summation of SO2 and NO2 hazardous effect in gas emission regulations
NASA Astrophysics Data System (ADS)
Sokolov, A. K.
2017-12-01
In order to provide environmental safety, the concentrations of SO2 and SO2 in the surface layer of atmospheric air should not exceed corresponding one-time values accepted for maximum permissible concentrations (MPCs). The only document that provides a normative calculation of hazardous substance dispersion in the atmospheric air up to the present time is presented by regulations OND-86. It has established that, in taking into account the summation (unidirectionality) of hazardous action of substances (including SO2 and NO2 gases), the sum of their relative concentrations should not exceed unity. A novel standard GN 2.1.6.2326-08 stipulates that "nitrogen dioxide and sulfur dioxide have a partial summation of action; therefore the sum of their relative concentrations should not exceed 1.6." This paper is devoted to analyzing the calculation of the summation of action for SO2 and NO2 gases and proving that the condition established in GN 2.1.6.2326-08 is not quite correct. According to the condition required by standard GN 2.1.6.2326-08, it turns out that, for some combinations of concentrations, the hazardous effect of gases is not added together, but one gas compensates an effect of the other, which contradicts the points of OND-86. For example, at SO2 and NO2 concentrations amounting to 0.6 and 0.04, respectively, the condition required by standard GN 2.1.6.2326-08 is satisfied, although the concentration of SO2 exceeds a normatively fixed value of MPC = 0.5. The graphical analysis of a concentration region for SO2 and NO2 gases clearly shows the areas where the condition required by standard GN 2.1.6.2326-08 is satisfied, but the environmental safety according to OND-86 is not provided. Recommendations are proposed for the correction of requirements established by standard GN 2.1.6.2326-08.
Li, Xuan; Dong, Hao; Zhang, Yifeng; Zhang, Guoxin
2017-01-01
Carbon dioxide (CO2) insufflation is increasingly used for endoscopic submucosal dissection (ESD) owing to the faster absorption of CO2 as compared to that of air. Studies comparing CO2 insufflation and air insufflation have reported conflicting results. This meta-analysis is aimed to assess the efficacy and safety of use of CO2 insufflation for ESD. Clinical trials of CO2 insufflation versus air insufflation for ESD were searched in PubMed, Embase, the Cochrane Library and Chinese Biomedical Literature Database. We performed a meta-analysis of all randomized controlled trials (RCTs). Eleven studies which compared the use of CO2 insufflation and air insufflation, with a combined study population of 1026 patients, were included in the meta-analysis (n = 506 for CO2 insufflation; n = 522 for air insufflation). Abdominal pain and VAS scores at 6h and 24h post-procedure in the CO2 insufflation group were significantly lower than those in the air insufflation group, but not at 1h and 3h after ESD. The percentage of patients who experienced pain 1h and 24h post-procedure was obviously decreased. Use of CO2 insufflation was associated with lower VAS scores for abdominal distention at 1h after ESD, but not at 24h after ESD. However, no significant differences were observed with respect to postoperative transcutaneous partial pressure carbon dioxide (PtcCO2), arterial blood carbon dioxide partial pressure (PaCO2), oxygen saturation (SpO2%), abdominal circumference, hospital stay, white blood cell (WBC) counts, C-Reactive protein (CRP) level, dosage of sedatives used, incidence of dysphagia and other complications. Use of CO2 insufflation for ESD was safe and effective with regard to abdominal discomfort, procedure time, and the residual gas volume. However, there appeared no significant differences with respect to other parameters namely, PtcCO2, PaCO2, SpO2%, abdominal circumference, hospital stay, sedation dosage, complications, WBC, CRP, and dysphagia.
Runge, Uwe; Arnold, Stephan; Brandt, Christian; Reinhardt, Fritjof; Kühn, Frank; Isensee, Kathleen; Ramirez, Francisco; Dedeken, Peter; Lauterbach, Thomas; Noack-Rink, Matthias; Mayer, Thomas
2015-12-01
Evidence for the efficacy and safety of adjunctive lacosamide in the treatment of partial-onset seizures (POS) was gained during placebo-controlled clinical trials in patients with treatment-resistant seizures who were taking one to three concomitant antiepileptic drugs (AEDs). The VITOBA study (NCT01098162) evaluated the effectiveness and tolerability of adjunctive lacosamide added to one baseline AED in real-world clinical practice. We conducted a 6-month observational study at 112 sites across Germany. Adult patients (≥ 16 years) with POS received lacosamide adjunctive to only one baseline AED. Seizure frequency reduction at the end of the observation period was compared with a 3-month retrospective baseline period. Five hundred seventy-one patients received lacosamide at least once (Safety Set [SS]); 520 provided evaluable seizure records (Full Analysis Set [FAS]); and 499 took in-label dosages of lacosamide (up to 400 mg) and were evaluated for effectiveness (modified FAS). Median baseline seizure frequency was 2.0 per 28 days: 47.1% of patients (235/499, mFAS) took a concomitant sodium channel-blocking (SCB) AED; 38.1% (190/499) had only one lifetime AED; and 18.4% (92/499) were aged ≥ 65 years (mFAS). At the final visit, 72.5% (358/494) of patients showed a ≥ 50% reduction in seizure frequency from baseline, 63.8% (315/494) showed a ≥ 75% reduction, and 45.5% (225/494) were seizure-free. Seizure freedom rates were higher in patients aged ≥ 65 years (56.7%) compared with patients aged <65 years (43.1%), in patients with ≤ 5 years epilepsy duration (52.5%) versus >5 years duration (41.0%), and when added to first monotherapy (60.5%) rather than as a later therapy option. Treatment-emergent adverse events (TEAEs) were reported by 48.5% (277/571) of patients (SS), with a profile similar to that observed in pivotal trials; 466 of patients (81.6%, SS) continued lacosamide therapy after the trial. These results suggest that lacosamide use, added to one concomitant AED, was effective at improving seizure control and was well tolerated in patients treated in routine clinical practice. © 2015 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.
Losigamone add-on therapy for partial epilepsy.
Xiao, Yousheng; Luo, Man; Wang, Jin; Luo, Hongye
2015-12-10
Epilepsy is a common neurologic disorder, affecting approximately 50 million people worldwide; nearly a third of these people are not well controlled by a single antiepileptic drug (AED) and usually require treatment with a combination of two or more AEDs. In recent years, many newer AEDs have been investigated as add-on therapy for partial epilepsy; losigamone is one of these drugs and is the focus of this systematic review. This is an update of a Cochrane review first published in 2012 (Cochrane Database of Systematic Reviews 2012, Issue 6). To investigate the efficacy and safety of losigamone when used as an add-on therapy for partial epilepsy. We searched the Cochrane Epilepsy Group Specialized Register (16 February 2015), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 16 February 2015) and MEDLINE (Ovid, 1946 to 16 February 2015). We searched trials registers and contacted the manufacturer of losigamone and authors of included studies for additional information. We did not impose any language restrictions. Randomized controlled, add-on trials comparing losigamone with placebo for partial epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcomes were 50% or greater reduction in seizure frequency and seizure freedom; the secondary outcomes were treatment withdrawal and adverse events. Results are presented as risk ratios (RRs) with 95% confidence intervals (CIs) or 99% CIs (for the individual listed adverse events to make an allowance for multiple testing). Two trials involving a total of 467 patients, aged over 18 years, were eligible for inclusion. Both trials assessed losigamone 1200 mg/day or 1500 mg/day as an add-on therapy for partial epilepsy. One trial was assessed as being of good methodological quality while the other was of uncertain quality. For the efficacy outcomes, results did show patients taking losigamone were significantly more likely to achieve a 50% or greater reduction in seizure frequency (RR 1.76; 95% CI 1.14 to 2.72), but associated with a significant increase of treatment withdrawal when compared with those taking placebo (RR 2.16; 95% CI 1.28 to 3.67). For the safety outcomes, results indicated the proportion of patients who experienced adverse events in the losigamone group was higher than the placebo group (RR 1.34; 95% CI 1.00 to 1.80), dizziness was the only adverse event significantly reported in relation to losigamone (RR 3.82; 99% CI 1.69 to 8.64). The proportion of patients achieving seizure freedom was not reported in either trial report. A subgroup analysis according to different doses of losigamone showed that a higher dose of losigamone (1500 mg/day) was associated with a greater reduction in seizure frequency than lower doses, but was also associated with more dropouts due to adverse events. The results of this review showed losigamone did reduce seizure frequency but was associated with more treatment withdrawals when used as an add-on therapy for people with partial epilepsy. However, trials included were of short-term duration and uncertain quality. Future well-designed randomized, double-blind, placebo-controlled trials with a longer-term duration are needed. No new studies have been found since the last version of this review.
Clustering stocks using partial correlation coefficients
NASA Astrophysics Data System (ADS)
Jung, Sean S.; Chang, Woojin
2016-11-01
A partial correlation analysis is performed on the Korean stock market (KOSPI). The difference between Pearson correlation and the partial correlation is analyzed and it is found that when conditioned on the market return, Pearson correlation coefficients are generally greater than those of the partial correlation, which implies that the market return tends to drive up the correlation between stock returns. A clustering analysis is then performed to study the market structure given by the partial correlation analysis and the members of the clusters are compared with the Global Industry Classification Standard (GICS). The initial hypothesis is that the firms in the same GICS sector are clustered together since they are in a similar business and environment. However, the result is inconsistent with the hypothesis and most clusters are a mix of multiple sectors suggesting that the traditional approach of using sectors to determine the proximity between stocks may not be sufficient enough to diversify a portfolio.
Quillivan, Rebecca R; Burlison, Jonathan D; Browne, Emily K; Scott, Susan D; Hoffman, James M
2016-08-01
Second victim experiences can affect the wellbeing of health care providers and compromise patient safety. Many factors associated with improved coping after patient safety event involvement are also components of a strong patient safety culture, so that supportive patient safety cultures may reduce second victim-related trauma. A cross-sectional survey study was conducted to assess the influence of patient safety culture on second victim-related distress. The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC) and the Second Victim Experience and Support Tool (SVEST), which was developed to assess organizational support and personal and professional distress after involvement in a patient safety event, were administered to nurses involved in direct patient care. Of 358 nurses at a specialized pediatric hospital, 169 (47.2%) completed both surveys. Hierarchical linear regres sion demonstrated that the patient safety culture survey dimension nonpunitive response to error was significantly associated with reductions in the second victim survey dimensions psychological, physical, and professional distress (p < 0.001). As a mediator, organizational support fully explained the nonpunitive response to error-physical distress and nonpunitive response to error-professional distress relationships and partially explained the nonpunitive response to error-psychological distress relationship. The results suggest that punitive safety cultures may contribute to self-reported perceptions of second victim-related psychological, physical, and professional distress, which could reflect a lack of organizational support. Reducing punitive response to error and encouraging supportive coworker, supervisor, and institutional interactions may be useful strategies to manage the severity of second victim experiences.
Quality of traffic flow on urban arterial streets and its relationship with safety.
Dixit, Vinayak V; Pande, Anurag; Abdel-Aty, Mohamed; Das, Abhishek; Radwan, Essam
2011-09-01
The two-fluid model for vehicular traffic flow explains the traffic on arterials as a mix of stopped and running vehicles. It describes the relationship between the vehicles' running speed and the fraction of running vehicles. The two parameters of the model essentially represent 'free flow' travel time and level of interaction among vehicles, and may be used to evaluate urban roadway networks and urban corridors with partially limited access. These parameters are influenced by not only the roadway characteristics but also by behavioral aspects of driver population, e.g., aggressiveness. Two-fluid models are estimated for eight arterial corridors in Orlando, FL for this study. The parameters of the two-fluid model were used to evaluate corridor level operations and the correlations of these parameters' with rates of crashes having different types/severity. Significant correlations were found between two-fluid parameters and rear-end and angle crash rates. Rate of severe crashes was also found to be significantly correlated with the model parameter signifying inter-vehicle interactions. While there is need for further analysis, the findings suggest that the two-fluid model parameters may have potential as surrogate measures for traffic safety on urban arterial streets. Copyright © 2011 Elsevier Ltd. All rights reserved.
Christodoulou-Fella, Maria; Papathanassoglou, Elizabeth D. E.
2017-01-01
Work-related moral distress (MD) and secondary traumatic stress syndrome (STSS) may be associated with compromised health status among health professionals, reduced productivity, and inadequate safety of care. We explored the association of MD with the severity of STSS symptoms, along with the mediating role of mental distress symptoms. Associations with emotional exhaustion and professional satisfaction were also assessed. This cross-sectional survey conducted in 206 mental health nurses (MHNs) was employed across public sector community and hospital settings in Cyprus. The analysis revealed that MD (measured by the modified Moral Distress Scale) was positively associated with both STSS (measured by the Secondary Traumatic Stress Scale) and mental distress symptoms (assessed by the General Health Questionnaire-28). The association of MD with STSS symptoms was partially mediated by mental distress symptoms. This association remained largely unchanged after adjusting for gender, age, education, rank, and intention to quit the job. Our findings provide preliminary evidence on the association between MD and STSS symptomatology in MHNs. Situations that may lead health professionals to be in moral distress seem to be mainly related to the work environment; thus interventions related to organizational empowerment of MHNs need to be developed. PMID:29209622
Zhang, Jie; Ren, Lixin; Huo, Jirong; Zhu, Zhiyuan; Liu, Deliang
2013-11-01
This study analyzes the efficacy and safety of a retrievable, fully covered self-expanding metal stent (cSEMS) in the treatment of refractory benign esophageal restenosis in children. This is a retrospective analysis of the application of a newly designed cSEMS in treating refractory benign postoperative restenosis in five children with ages ranging from 16 months to 8 years. Efficacy and safety were evaluated during the follow-up period. cSEMS with or without an antireflux valve at the distal end were successfully placed and removed in five children. These five patients were followed up for 4-12 months after stent removal. Among the five patients, ulcerative stricture was observed in two patients because of reflux esophagitis, while three patients showed no signs of stricture recurrence. Stent migration was observed in three patients, two of which required the stent to be reset. The narrow esophagus was successfully expended to a diameter of 12-13 mm. Besides the observation of mild granulation tissue growth in one case, no severe complications were observed during surgery and after stent placement. Our study suggests that a retrievable, fully covered SEMS is safe and partially effective for treating refractory benign postoperative esophageal restenosis in children during short-term observation. © 2013.
ERIC Educational Resources Information Center
And Others; Werts, Charles E.
1979-01-01
It is shown how partial covariance, part and partial correlation, and regression weights can be estimated and tested for significance by means of a factor analytic model. Comparable partial covariance, correlations, and regression weights have identical significance tests. (Author)
Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Skevas, Christos; Druchkiv, Vasyl; Katz, Toam; Linke, Stephan J
2015-01-01
In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral.
Cai, Rui; Wang, Shisheng; Tang, Bo; Li, Yueqing; Zhao, Weijie
2018-01-01
Sea cucumber is the major tonic seafood worldwide, and geographical origin traceability is an important part of its quality and safety control. In this work, a non-destructive method for origin traceability of sea cucumber (Apostichopus japonicus) from northern China Sea and East China Sea using near infrared spectroscopy (NIRS) and multivariate analysis methods was proposed. Total fat contents of 189 fresh sea cucumber samples were determined and partial least-squares (PLS) regression was used to establish the quantitative NIRS model. The ordered predictor selection algorithm was performed to select feasible wavelength regions for the construction of PLS and identification models. The identification model was developed by principal component analysis combined with Mahalanobis distance and scaling to the first range algorithms. In the test set of the optimum PLS models, the root mean square error of prediction was 0.45, and correlation coefficient was 0.90. The correct classification rates of 100% were obtained in both identification calibration model and test model. The overall results indicated that NIRS method combined with chemometric analysis was a suitable tool for origin traceability and identification of fresh sea cucumber samples from nine origins in China. PMID:29410795
Guo, Xiuhan; Cai, Rui; Wang, Shisheng; Tang, Bo; Li, Yueqing; Zhao, Weijie
2018-01-01
Sea cucumber is the major tonic seafood worldwide, and geographical origin traceability is an important part of its quality and safety control. In this work, a non-destructive method for origin traceability of sea cucumber ( Apostichopus japonicus ) from northern China Sea and East China Sea using near infrared spectroscopy (NIRS) and multivariate analysis methods was proposed. Total fat contents of 189 fresh sea cucumber samples were determined and partial least-squares (PLS) regression was used to establish the quantitative NIRS model. The ordered predictor selection algorithm was performed to select feasible wavelength regions for the construction of PLS and identification models. The identification model was developed by principal component analysis combined with Mahalanobis distance and scaling to the first range algorithms. In the test set of the optimum PLS models, the root mean square error of prediction was 0.45, and correlation coefficient was 0.90. The correct classification rates of 100% were obtained in both identification calibration model and test model. The overall results indicated that NIRS method combined with chemometric analysis was a suitable tool for origin traceability and identification of fresh sea cucumber samples from nine origins in China.
DOT National Transportation Integrated Search
2010-12-01
This report documents the Safety Measurement System (SMS) methodology developed to support the Comprehensive Safety Analysis 2010 (CSA 2010) Initiative for the Federal Motor Carrier Safety Administration (FMCSA). The SMS is one of the major tools for...
Overview of Energy Systems` safety analysis report programs. Safety Analysis Report Update Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-03-01
The primary purpose of an Safety Analysis Report (SAR) is to provide a basis for judging the adequacy of a facility`s safety. The SAR documents the safety analyses that systematically identify the hazards posed by the facility, analyze the consequences and risk of potential accidents, and describe hazard control measures that protect the health and safety of the public and employees. In addition, some SARs document, as Technical Safety Requirements (TSRs, which include Technical Specifications and Operational Safety Requirements), technical and administrative requirements that ensure the facility is operated within prescribed safety limits. SARs also provide conveniently summarized information thatmore » may be used to support procedure development, training, inspections, and other activities necessary to facility operation. This ``Overview of Energy Systems Safety Analysis Report Programs`` Provides an introduction to the programs and processes used in the development and maintenance of the SARs. It also summarizes some of the uses of the SARs within Energy Systems and DOE.« less
Software Safety Progress in NASA
NASA Technical Reports Server (NTRS)
Radley, Charles F.
1995-01-01
NASA has developed guidelines for development and analysis of safety-critical software. These guidelines have been documented in a Guidebook for Safety Critical Software Development and Analysis. The guidelines represent a practical 'how to' approach, to assist software developers and safety analysts in cost effective methods for software safety. They provide guidance in the implementation of the recent NASA Software Safety Standard NSS-1740.13 which was released as 'Interim' version in June 1994, scheduled for formal adoption late 1995. This paper is a survey of the methods in general use, resulting in the NASA guidelines for safety critical software development and analysis.
NASA Technical Reports Server (NTRS)
Zelkin, Natalie; Henriksen, Stephen
2011-01-01
This document is being provided as part of ITT's NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract: "New ATM Requirements--Future Communications, C-Band and L-Band Communications Standard Development." ITT has completed a safety hazard analysis providing a preliminary safety assessment for the proposed C-band (5091- to 5150-MHz) airport surface communication system. The assessment was performed following the guidelines outlined in the Federal Aviation Administration Safety Risk Management Guidance for System Acquisitions document. The safety analysis did not identify any hazards with an unacceptable risk, though a number of hazards with a medium risk were documented. This effort represents an initial high-level safety hazard analysis and notes the triggers for risk reassessment. A detailed safety hazards analysis is recommended as a follow-on activity to assess particular components of the C-band communication system after the profile is finalized and system rollout timing is determined. A security risk assessment has been performed by NASA as a parallel activity. While safety analysis is concerned with a prevention of accidental errors and failures, the security threat analysis focuses on deliberate attacks. Both processes identify the events that affect operation of the system; and from a safety perspective the security threats may present safety risks.
NASA Astrophysics Data System (ADS)
Workman, R. L.; Tiator, L.; Wunderlich, Y.; Döring, M.; Haberzettl, H.
2017-01-01
We compare the methods of amplitude reconstruction, for a complete experiment and a truncated partial-wave analysis, applied to the photoproduction of pseudoscalar mesons. The approach is pedagogical, showing in detail how the amplitude reconstruction (observables measured at a single energy and angle) is related to a truncated partial-wave analysis (observables measured at a single energy and a number of angles).
Workman, R. L.; Tiator, L.; Wunderlich, Y.; ...
2017-01-19
Here, we compare the methods of amplitude reconstruction, for a complete experiment and a truncated partial-wave analysis, applied to the photoproduction of pseudoscalar mesons. The approach is pedagogical, showing in detail how the amplitude reconstruction (observables measured at a single energy and angle) is related to a truncated partial-wave analysis (observables measured at a single energy and a number of angles).
Sheard, Laura; Marsh, Claire; O'Hara, Jane; Armitage, Gerry; Wright, John; Lawton, Rebecca
2017-07-13
A patient safety intervention was tested in a 33-ward randomised controlled trial. No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards. Large qualitative process evaluation of the implementation of a patient safety intervention. National Health Service staff based on 17 acute hospital wards located at five hospital sites in the North of England. We concentrate on three sources here: (1) analysis of taped discussion between ward staff during action planning meetings; (2) facilitators' field notes and (3) follow-up telephone interviews with staff focusing on whether action plans had been achieved. The analysis involved the use of pen portraits and adaptive theory. First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff. A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Hernández-Ávila, Mauricio; Lazcano-Ponce, Eduardo; Hernández-Ávila, Juan Eugenio; Alpuche-Aranda, Celia M; Rodríguez-López, Mario Henry; García-García, Lourdes; Madrid-Marina, Vicente; López Gatell-Ramírez, Hugo; Lanz-Mendoza, Humberto; Martínez-Barnetche, Jesús; Díaz-Ortega, José Luis; Ángeles-Llerenas, Angélica; Barrientos-Gutiérrez, Tonatiuh; Bautista-Arredondo, Sergio; Santos-Preciado, José Ignacio
2016-01-01
Dengue is a major global public health problem affecting Latin America and Mexico Prevention and control measures, focusing on epidemiological surveillance and vector control, have been partially effective and costly, thus, the development of a vaccine against dengue has created great expectations among health authorities and scientific communities worldwide. The CYD-TDV dengue vaccine produced by Sanofi-Pasteur is the only dengue vaccine evaluated in phase 3 controlled clinical trials. Notwithstanding the significant contribution to the development of a vaccine against dengue, the three phase 3 clinical studies of CYD-TDV and the meta-analysis of the long-term follow up of those studies, have provided evidence that this vaccine exhibited partial vaccine efficacy to protect against virologically confirmed dengue and lead to four considerations: a) adequate vaccine efficacy against dengue virus (DENV) infections 3 and 4, less vaccine efficacy against DENV 1 and no protection against infection by DENV 2; b) decreased vaccine efficacy in dengue seronegative individuals at the beginning of the vaccination; c) 83% and 90% protection against hospitalizations and severe forms of dengue, respectively, at 25 months follow-up; and d) increased hospitalization for dengue in the vaccinated group, in children under nine years of age at the time of vaccination, detected since the third year of follow-up. The benefit of the CYD-TDV vaccine can be summarized in the protection against infection by DENV 3 and 4, as well as protection for hospitalizations and severe cases in people over nine years, who have had previous dengue infection, working mainly as a booster. In this review we identified elements on efficacy and safety of this vaccine that must be taken into account in the licensing process and potential inclusion in the national vaccination program of Mexico. The available scientific evidence on the CYD-TDV vaccine shows merits, but also leads to relevant questions that should be answered to properly assess the safety profile of the product and the target populations of potential benefit. In this regard we consider it would be informative to complete the 6-year follow-up after starting vaccination, according to the company's own study protocol recommended by the World Health Organization. As with any new vaccine, the potential licensing and implementation of the CYD-TDV as part of Mexico's vaccination program, requires a clear definition of the balance between the expected benefits and risks. Particularly with a vaccine with variable efficacy and some signs of risk, in the probable case of licensing, the post-licensed period must involve the development of detailed protocols to immediately identify risks or any health event associated with vaccination.
Transformational leadership and group interaction as climate antecedents: a social network analysis.
Zohar, Dov; Tenne-Gazit, Orly
2008-07-01
In order to test the social mechanisms through which organizational climate emerges, this article introduces a model that combines transformational leadership and social interaction as antecedents of climate strength (i.e., the degree of within-unit agreement about climate perceptions). Despite their longstanding status as primary variables, both antecedents have received limited empirical research. The sample consisted of 45 platoons of infantry soldiers from 5 different brigades, using safety climate as the exemplar. Results indicate a partially mediated model between transformational leadership and climate strength, with density of group communication network as the mediating variable. In addition, the results showed independent effects for group centralization of the communication and friendship networks, which exerted incremental effects on climate strength over transformational leadership. Whereas centralization of the communication network was found to be negatively related to climate strength, centralization of the friendship network was positively related to it. Theoretical and practical implications are discussed.
Development and analysis of the Software Implemented Fault-Tolerance (SIFT) computer
NASA Technical Reports Server (NTRS)
Goldberg, J.; Kautz, W. H.; Melliar-Smith, P. M.; Green, M. W.; Levitt, K. N.; Schwartz, R. L.; Weinstock, C. B.
1984-01-01
SIFT (Software Implemented Fault Tolerance) is an experimental, fault-tolerant computer system designed to meet the extreme reliability requirements for safety-critical functions in advanced aircraft. Errors are masked by performing a majority voting operation over the results of identical computations, and faulty processors are removed from service by reassigning computations to the nonfaulty processors. This scheme has been implemented in a special architecture using a set of standard Bendix BDX930 processors, augmented by a special asynchronous-broadcast communication interface that provides direct, processor to processor communication among all processors. Fault isolation is accomplished in hardware; all other fault-tolerance functions, together with scheduling and synchronization are implemented exclusively by executive system software. The system reliability is predicted by a Markov model. Mathematical consistency of the system software with respect to the reliability model has been partially verified, using recently developed tools for machine-aided proof of program correctness.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schultz, R.R.; Wagoner, S.R.
1983-01-01
As a part of the charter of the Severe Accident Sequence Analysis (SASA) Program, station blackout transients have been analyzed using a RELAP5 model of the Browns Ferry Unit 1 Plant. The task was conducted as a partial fulfillment of the needs of the US Nuclear Regulatory Commission in examining the Unresolved Safety Issue A-44: Station Blackout (1) the station blackout transients were examined (a) to define the equipment needed to maintain a well cooled core, (b) to determine when core uncovery would occur given equipment failure, and (c) to characterize the behavior of the vessel thermal-hydraulics during the stationmore » blackout transients (in part as the plant operator would see it). These items are discussed in the paper. Conclusions and observations specific to the station blackout are presented.« less
Safety System Design for Technology Education. A Safety Guide for Technology Education Courses K-12.
ERIC Educational Resources Information Center
North Carolina State Dept. of Public Instruction, Raleigh. Div. of Vocational Education.
This manual is designed to involve both teachers and students in planning and controlling a safety system for technology education classrooms. The safety program involves students in the design and maintenance of the system by including them in the analysis of the classroom environment, job safety analysis, safety inspection, and machine safety…
14 CFR Appendix B of Part 415 - Safety Review Document Outline
Code of Federal Regulations, 2010 CFR
2010-01-01
... Performed by Certified Personnel 4.0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and Assumptions 4.1.2Sample Calculation and Products 4.1.3 Launch Specific Updates and Final Flight Safety Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety...
14 CFR Appendix B of Part 415 - Safety Review Document Outline
Code of Federal Regulations, 2012 CFR
2012-01-01
... Performed by Certified Personnel 4.0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and Assumptions 4.1.2Sample Calculation and Products 4.1.3 Launch Specific Updates and Final Flight Safety Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety...
14 CFR Appendix B of Part 415 - Safety Review Document Outline
Code of Federal Regulations, 2011 CFR
2011-01-01
... Performed by Certified Personnel 4.0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and Assumptions 4.1.2Sample Calculation and Products 4.1.3 Launch Specific Updates and Final Flight Safety Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety...
Saito, Tsuyoshi; Hoshi, Toshiro; Ikeda, Hiroyasu; Okabe, Kohei
2015-01-01
In December 2013, the Japanese Ministry of Health, Labour and Welfare (MHLW) partially amended the safety regulations for use of industrial robots so that "collaborative operation" could be performed at Japanese worksites as allowed in the ISO standard for industrial robots. In order to show global harmonization of Japanese legislation on machinery safety and problems with applying ISO safety standards to Japanese worksites, this paper reports the progress of a research study which have been conducted in National Institute of Occupational Safety and Health, Japan from 2011 to the present at the request of MHLW to examine the necessity and effect of the amendment. In the first phase of this study, a questionnaire survey was conducted among domestic robot manufacturers and users. The obtained results revealed their potential demand for the collaborative operation and problems concerning their risk assessment and rule-based risk reduction. To solve the problems, we propose a method based on an investigation result of the regulatory framework for safety of machinery in the European Union. Furthermore, a model of robot system capable of demonstrating the collaborative operation and risk reduction measures which is being developed to support appropriate implementation of the amendment is also described.
14 CFR 417.227 - Toxic release hazard analysis.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Toxic release hazard analysis. 417.227..., DEPARTMENT OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.227 Toxic release hazard analysis. A flight safety analysis must establish flight commit criteria that protect the public from any...
41 CFR 102-80.130 - Who must perform the equivalent level of safety analysis?
Code of Federal Regulations, 2010 CFR
2010-07-01
...-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety Analysis... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who must perform the equivalent level of safety analysis? 102-80.130 Section 102-80.130 Public Contracts and Property Management...
A Synthetic Vision Preliminary Integrated Safety Analysis
NASA Technical Reports Server (NTRS)
Hemm, Robert; Houser, Scott
2001-01-01
This report documents efforts to analyze a sample of aviation safety programs, using the LMI-developed integrated safety analysis tool to determine the change in system risk resulting from Aviation Safety Program (AvSP) technology implementation. Specifically, we have worked to modify existing system safety tools to address the safety impact of synthetic vision (SV) technology. Safety metrics include reliability, availability, and resultant hazard. This analysis of SV technology is intended to be part of a larger effort to develop a model that is capable of "providing further support to the product design and development team as additional information becomes available". The reliability analysis portion of the effort is complete and is fully documented in this report. The simulation analysis is still underway; it will be documented in a subsequent report. The specific goal of this effort is to apply the integrated safety analysis to SV technology. This report also contains a brief discussion of data necessary to expand the human performance capability of the model, as well as a discussion of human behavior and its implications for system risk assessment in this modeling environment.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Smith, Benjamin D.; Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX; Arthur, Douglas W.
2009-07-15
Purpose: To present guidance for patients and physicians regarding the use of accelerated partial-breast irradiation (APBI), based on current published evidence complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database yielded 645 candidate original research articles potentially applicable to APBI. Of these, 4 randomized trials and 38 prospective single-arm studies were identified. A Task Force composed of all authors synthesized the published evidence and, through a series of meetings, reached consensus regarding the recommendations contained herein. Results: The Task Force proposed three patient groups: (1) a 'suitable' group, for whom APBImore » outside of a clinical trial is acceptable, (2) a 'cautionary' group, for whom caution and concern should be applied when considering APBI outside of a clinical trial, and (3) an 'unsuitable' group, for whom APBI outside of a clinical trial is not generally considered warranted. Patients who choose treatment with APBI should be informed that whole-breast irradiation (WBI) is an established treatment with a much longer track record that has documented long-term effectiveness and safety. Conclusion: Accelerated partial-breast irradiation is a new technology that may ultimately demonstrate long-term effectiveness and safety comparable to that of WBI for selected patients with early breast cancer. This consensus statement is intended to provide guidance regarding the use of APBI outside of a clinical trial and to serve as a framework to promote additional clinical investigations into the optimal role of APBI in the treatment of breast cancer.« less
SLSF in-reactor local fault safety experiment P4. Final report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Thompson, D. H.; Holland, J. W.; Braid, T. H.
The Sodium Loop Safety Facility (SLSF), a major facility in the US fast-reactor safety program, has been used to simulate a variety of sodium-cooled fast reactor accidents. SLSF experiment P4 was conducted to investigate the behavior of a "worse-than-case" local fault configuration. Objectives of this experiment were to eject molten fuel into a 37-pin bundle of full-length Fast-Test-Reactor-type fuel pins form heat-generating fuel canisters, to characterize the severity of any molten fuel-coolant interaction, and to demonstrate that any resulting blockage could either be tolerated during continued power operation or detected by global monitors to prevent fuel failure propagation. The designmore » goal for molten fuel release was 10 to 30 g. Explusion of molten fuel from fuel canisters caused failure of adjacent pins and a partial flow channel blockage in the fuel bundle during full-power operation. Molten fuel and fuel debris also lodged against the inner surface of the test subassembly hex-can wall. The total fuel disruption of 310 g evaluated from posttest examination data was in excellent agreement with results from the SLSF delayed neutron detection system, but exceeded the target molten fuel release by an order of magnitude. This report contains a summary description of the SLSF in-reactor loop and support systems and the experiment operations. results of the detailed macro- and microexamination of disrupted fuel and metal and results from the analysis of the on-line experimental data are described, as are the interpretations and conclusions drawn from the posttest evaluations. 60 refs., 74 figs.« less
Recognising and responding to 'cutting corners' when providing nursing care: a qualitative study.
Jones, Angela; Johnstone, Megan-Jane; Duke, Maxine
2016-08-01
The aim of this study is to report on a key finding of a larger study investigating the 'gaps' in patient care that registered nurses encounter during the course of their practice. A key finding of this larger study was that 'cutting corners' was a gap discerned by nurses. 'Cutting corners' has been characterised as a 'violation' and threat to patient safety, although there is a paucity of research on this issue. Naturalistic inquiry using a qualitative exploratory descriptive approach. Data were collected from a purposeful sample of 71 registered nurses from emergency department, critical care, perioperative, rehabilitation and transitional care and neurosciences settings in Australia and analysed using content and thematic analysis strategies. Cutting corners was a common practice that encompassed (1) the partial or complete omission of patient care, (2) delays in providing care and (3) the failure to do things correctly. Corners were cut in patient assessment, essential nursing care, the care of central venous catheters and medication administration. The practice of cutting corners was perceived as contributing to preventable adverse events. The study found that cutting corners created gaps that contributed to unfinished nursing care and preventable adverse events. The findings of the study raise the possibility that cutting corners is a salient but underinvestigated characteristic of nursing practice. Further research and inquiry are needed to deepen understanding of cutting corners and its impact on patient safety. Identifying the nature and implications of cutting corners when providing nursing care is an important contributing factor to improving patient safety and quality care. © 2016 John Wiley & Sons Ltd.
Apatinib for advanced nonsmall-cell lung cancer: A retrospective case series analysis.
Yang, Chengxi; Feng, Wen; Wu, Di
2018-01-01
Apatinib, a tyrosine kinase inhibitor which selectively inhibits vascular endothelial growth factor receptor-2, has been shown to be beneficial to patients with a variety of cancers, including advanced nonsmall-cell lung cancer (NSCLC). Thus, this study was aimed to retrospectively assess the efficacy and safety of apatinib in patients with advanced/metastatic NSCLC who failed more than two lines of treatment. Twenty-three NSCLC patients were involved in this study, who received oral apatinib at a daily dose of 250/500/750 mg, with the progression after the failure of second-line therapy. Treatment was continued until disease progression. The tumor assessments were determined according to the Response Evaluation Criteria in Solid Tumors (version 1.1). Safety was evaluated with adverse reactions and toxicities based on the Common Terminology Criteria for Adverse Events (version 4.0). Response and safety for the included patients were evaluated every 8 weeks. In this study, 23 NSCLC patients were followed from January 2015 to December 2016. Available image efficacy was obtained in 22 patients, including 4 identified as partial responses, 17 stable disease, and 1 progressive disease; no complete responses was observed. The objective response rate was 18.2%, and the disease control rate was 95.5%. Median progression free survival and overall survival for apatinib were 203 days (95% CI, 120-269) and 227 days (95% CI, 146-294), respectively. The most frequent treatment-related adverse events were hypertension, gastrointestinal reactions, and hand-foot skin reaction. Apatinib exhibited modest activity and acceptable toxicity for advanced NSCLC after the failure of chemotherapy or other targeted therapy.
A Study on Urban Road Traffic Safety Based on Matter Element Analysis
Hu, Qizhou; Zhou, Zhuping; Sun, Xu
2014-01-01
This paper examines a new evaluation of urban road traffic safety based on a matter element analysis, avoiding the difficulties found in other traffic safety evaluations. The issue of urban road traffic safety has been investigated through the matter element analysis theory. The chief aim of the present work is to investigate the features of urban road traffic safety. Emphasis was placed on the construction of a criterion function by which traffic safety achieved a hierarchical system of objectives to be evaluated. The matter element analysis theory was used to create the comprehensive appraisal model of urban road traffic safety. The technique was used to employ a newly developed and versatile matter element analysis algorithm. The matter element matrix solves the uncertainty and incompatibility of the evaluated factors used to assess urban road traffic safety. The application results showed the superiority of the evaluation model and a didactic example was included to illustrate the computational procedure. PMID:25587267
Nissen, Alexander; Heir, Trond
2016-12-01
We aimed to explore how perceived safety after terrorism is connected to views on security measures and emergency preparedness in a workplace setting. Using a questionnaire-based, cross-sectional study of ministerial employees in Norway who were targeted in a terrorist attack in 2011 (n=3344), we investigated how employees' perceived safety at work 9 to 10 months after the attack was associated with their perceptions of whether security measures were sufficiently prioritized at work, whether there had been sufficient escape and evacuation training, and whether they were confident with evacuation procedures. We found strong evidence of increasing perceived safety at work the more employees believed security measures were sufficiently prioritized at work (partially confounded by post-traumatic stress disorder), and the better their knowledge of evacuation procedures (modified by gender and education). The present study suggests that employers may enhance perceived safety at work for terror-exposed employees by showing a commitment to security measures and by ensuring employees know evacuation procedures well. More research is needed to investigate causality patterns behind the associations found in this cross-sectional study. (Disaster Med Public Health Preparedness. 2016;10:805-811).
Czerniecki, Stefan M; Cruz, Nelly M; Harder, Jennifer L; Menon, Rajasree; Annis, James; Otto, Edgar A; Gulieva, Ramila E; Islas, Laura V; Kim, Yong Kyun; Tran, Linh M; Martins, Timothy J; Pippin, Jeffrey W; Fu, Hongxia; Kretzler, Matthias; Shankland, Stuart J; Himmelfarb, Jonathan; Moon, Randall T; Paragas, Neal; Freedman, Benjamin S
2018-05-15
Organoids derived from human pluripotent stem cells are a potentially powerful tool for high-throughput screening (HTS), but the complexity of organoid cultures poses a significant challenge for miniaturization and automation. Here, we present a fully automated, HTS-compatible platform for enhanced differentiation and phenotyping of human kidney organoids. The entire 21-day protocol, from plating to differentiation to analysis, can be performed automatically by liquid-handling robots, or alternatively by manual pipetting. High-content imaging analysis reveals both dose-dependent and threshold effects during organoid differentiation. Immunofluorescence and single-cell RNA sequencing identify previously undetected parietal, interstitial, and partially differentiated compartments within organoids and define conditions that greatly expand the vascular endothelium. Chemical modulation of toxicity and disease phenotypes can be quantified for safety and efficacy prediction. Screening in gene-edited organoids in this system reveals an unexpected role for myosin in polycystic kidney disease. Organoids in HTS formats thus establish an attractive platform for multidimensional phenotypic screening. Copyright © 2018 Elsevier Inc. All rights reserved.
Boundary condition identification for a grid model by experimental and numerical dynamic analysis
NASA Astrophysics Data System (ADS)
Mao, Qiang; Devitis, John; Mazzotti, Matteo; Bartoli, Ivan; Moon, Franklin; Sjoblom, Kurt; Aktan, Emin
2015-04-01
There is a growing need to characterize unknown foundations and assess substructures in existing bridges. It is becoming an important issue for the serviceability and safety of bridges as well as for the possibility of partial reuse of existing infrastructures. Within this broader contest, this paper investigates the possibility of identifying, locating and quantifying changes of boundary conditions, by leveraging a simply supported grid structure with a composite deck. Multi-reference impact tests are operated for the grid model and modification of one supporting bearing is done by replacing a steel cylindrical roller with a roller of compliant material. Impact based modal analysis provide global modal parameters such as damped natural frequencies, mode shapes and flexibility matrix that are used as indicators of boundary condition changes. An updating process combining a hybrid optimization algorithm and the finite element software suit ABAQUS is presented in this paper. The updated ABAQUS model of the grid that simulates the supporting bearing with springs is used to detect and quantify the change of the boundary conditions.
Wang, Mei; Avula, Bharathi; Wang, Yan-Hong; Zhao, Jianping; Avonto, Cristina; Parcher, Jon F; Raman, Vijayasankar; Zweigenbaum, Jerry A; Wylie, Philip L; Khan, Ikhlas A
2014-01-01
As part of an ongoing research program on authentication, safety and biological evaluation of phytochemicals and dietary supplements, an in-depth chemical investigation of different types of chamomile was performed. A collection of chamomile samples including authenticated plants, commercial products and essential oils was analysed by GC/MS. Twenty-seven authenticated plant samples representing three types of chamomile, viz. German chamomile, Roman chamomile and Juhua were analysed. This set of data was employed to construct a sample class prediction (SCP) model based on stepwise reduction of data dimensionality followed by principle component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). The model was cross-validated with samples including authenticated plants and commercial products. The model demonstrated 100.0% accuracy for both recognition and prediction abilities. In addition, 35 commercial products and 11 essential oils purported to contain chamomile were subsequently predicted by the validated PLS-DA model. Furthermore, tentative identification of the marker compounds correlated with different types of chamomile was explored. Copyright © 2013 Elsevier Ltd. All rights reserved.
Quillivan, Rebecca R.; Burlison, Jonathan D.; Browne, Emily K.; Scott, Susan D.; Hoffman, James M.
2017-01-01
Background Second victim experiences can affect the well-being of healthcare providers and compromise patient safety. Many factors associated with improved coping afer patient safety event involvement are also components of a strong patient safety culture, so that supportive patient safety cultures may reduce second victim–related trauma. A cross-sectional survey study was conducted to assess the influence of patient safety culture on second victim–related distress, in which associations among patient safety culture dimensions, organizational support, and second victim distress were investigated. Methods The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC) and the Second Victim Experience and Support Tool (SVEST), which was developed to assess organizational support and personal and professional distress after involvement in a patient safety event, were administered to nurses involved in direct patient care. Results Of 358 nurses, 155 (41%) responded, of whom 144 completed both surveys. Hierarchical linear regression demonstrated that the patient safety culture survey dimension nonpunitive response to errors was significantly associated with reductions in the second victim survey dimensions psychological, physical, and professional distress (p <.001). As a mediator, organizational support fully explained the nonpunitive response to errors–physical distress and nonpunitive response to errors–professional distress relationships and partially explained the nonpunitive response to error–psychological distress relationship. Conclusions A nonpunitive response to errors may mitigate the negative effects of involvement in a patient safety event by encouraging supportive interactions. Also, perceptions of second victim–related distress may be less severe when hospital cultures are characterized by nonpunitive response to errors. Reducing punitive response to error and encouraging supportive coworker, supervisor, and institutional interactions may be useful strategies to manage the severity of second victim experiences. PMID:27456420
Casey, Tristan W; Riseborough, Karli M; Krauss, Autumn D
2015-05-01
Growing international trade and globalization are increasing the cultural diversity of the modern workforce, which often results in migrants working under the management of foreign leadership. This change in work arrangements has important implications for occupational health and safety, as migrant workers have been found to be at an increased risk of injuries compared to their domestic counterparts. While some explanations for this discrepancy have been proposed (e.g., job differences, safety knowledge, and communication difficulties), differences in injury involvement have been found to persist even when these contextual factors are controlled for. We argue that employees' national culture may explain further variance in their safety-related perceptions and safety compliance, and investigate this through comparing the survey responses of 562 Anglo and Southern Asian workers at a multinational oil and gas company. Using structural equation modeling, we firstly established partial measurement invariance of our measures across cultural groups. Estimation of the combined sample structural model revealed that supervisor production pressure was negatively related to willingness to report errors and supervisor support, but did not predict safety compliance behavior. Supervisor safety support was positively related to both willingness to report errors and safety compliance. Next, we uncovered evidence of cultural differences in the relationships between supervisor production pressure, supervisor safety support, and willingness to report errors; of note, among Southern Asian employees the negative relationship between supervisor production pressure and willingness to report errors was stronger, and for supervisor safety support, weaker as compared to the model estimated with Anglo employees. Implications of these findings for safety management in multicultural teams within the oil and gas industry are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-30
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD [Recommendation 2010-1] Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers AGENCY: Defense Nuclear Facilities Safety Board... Nuclear Facilities Safety Board has made a recommendation to the Secretary of Energy requesting an...
Canister Storage Building (CSB) Design Basis Accident Analysis Documentation
DOE Office of Scientific and Technical Information (OSTI.GOV)
CROWE, R.D.; PIEPHO, M.G.
2000-03-23
This document provided the detailed accident analysis to support HNF-3553, Spent Nuclear Fuel Project Final Safety Analysis Report, Annex A, ''Canister Storage Building Final Safety Analysis Report''. All assumptions, parameters, and models used to provide the analysis of the design basis accidents are documented to support the conclusions in the Canister Storage Building Final Safety Analysis Report.
NASA Technical Reports Server (NTRS)
Cooper, L. P.
1981-01-01
An analysis was conducted of the effect of flameholding devices on the precombustion fuel-air characteristics and on oxides of nitrogen (NOx) emissions for combustion of premixed partially vaporized mixtures. The analysis includes the interrelationships of flameholder droplet collection efficiency, reatomization efficiency and blockage, and the initial droplet size distribution and accounts for the contribution of droplet combustion in partially vaporized mixtures to NOx emissions. Application of the analytical procedures is illustrated and parametric predictions of NOx emissions are presented.
NASA Technical Reports Server (NTRS)
Ni, Jianjun (David)
2012-01-01
This presentation discusses an analysis approach to evaluate the interuser interference for Direct-Sequence Spread-Spectrum (DSSS) Systems for Space Network (SN) Users. Part I of this analysis shows that the correlation property of pseudo noise (PN) sequences is the critical factor which determines the interuser interference performance of the DSSS system. For non-standard DSSS systems in which PN sequence s period is much larger than one data symbol duration, it is the partial-period cross-correlation that determines the system performance. This study reveals through an example that a well-designed PN sequence set (e.g. Gold Sequence, in which the cross-correlation for a whole-period is well controlled) may have non-controlled partial-period cross-correlation which could cause severe interuser interference for a DSSS system. Since the analytical derivation of performance metric (bit error rate or signal-to-noise ratio) based on partial-period cross-correlation is prohibitive, the performance degradation due to partial-period cross-correlation will be evaluated using simulation in Part II of this analysis in the future.
Combining Static Analysis and Model Checking for Software Analysis
NASA Technical Reports Server (NTRS)
Brat, Guillaume; Visser, Willem; Clancy, Daniel (Technical Monitor)
2003-01-01
We present an iterative technique in which model checking and static analysis are combined to verify large software systems. The role of the static analysis is to compute partial order information which the model checker uses to reduce the state space. During exploration, the model checker also computes aliasing information that it gives to the static analyzer which can then refine its analysis. The result of this refined analysis is then fed back to the model checker which updates its partial order reduction. At each step of this iterative process, the static analysis computes optimistic information which results in an unsafe reduction of the state space. However we show that the process converges to a fired point at which time the partial order information is safe and the whole state space is explored.
Concept analysis of safety climate in healthcare providers.
Lin, Ying-Siou; Lin, Yen-Chun; Lou, Meei-Fang
2017-06-01
To report an analysis of the concept of safety climate in healthcare providers. Compliance with safe work practices is essential to patient safety and care outcomes. Analysing the concept of safety climate from the perspective of healthcare providers could improve understanding of the correlations between safety climate and healthcare provider compliance with safe work practices, thus enhancing quality of patient care. Concept analysis. The electronic databases of CINAHL, MEDLINE, PubMed and Web of Science were searched for literature published between 1995-2015. Searches used the keywords 'safety climate' or 'safety culture' with 'hospital' or 'healthcare'. The concept analysis method of Walker and Avant analysed safety climate from the perspective of healthcare providers. Three attributes defined how healthcare providers define safety climate: (1) creation of safe working environment by senior management in healthcare organisations; (2) shared perception of healthcare providers about safety of their work environment; and (3) the effective dissemination of safety information. Antecedents included the characteristics of healthcare providers and healthcare organisations as a whole, and the types of work in which they are engaged. Consequences consisted of safety performance and safety outcomes. Most studies developed and assessed the survey tools of safety climate or safety culture, with a minority consisting of interventional measures for improving safety climate. More prospective studies are needed to create interventional measures for improving safety climate of healthcare providers. This study is provided as a reference for use in developing multidimensional safety climate assessment tools and interventional measures. The values healthcare teams emphasise with regard to safety can serve to improve safety performance. Having an understanding of the concept of and interventional measures for safety climate allows healthcare providers to ensure the safety of their operations and their patients. © 2016 John Wiley & Sons Ltd.
Clinical use of a 15-W diode laser in small animal surgery: results in 30 varied procedures
NASA Astrophysics Data System (ADS)
Crowe, Dennis T.; Swalander, David; Hittenmiller, Donald; Newton, Jenifer
1999-06-01
The use of a 15-watt diode laser (CeramOptec)in 30 surgical procedures in dogs and cats was reviewed. Ease of use, operator safety, hemostasis control, wound healing, surgical time, complication rate, and pain control were observed and recorded. Procedures performed were partial pancreatectomy, nasal carcinoma ablation, medial meniscus channeling, perianal and anorectal mass removal (5), hemangioma and hemangiopericytoma removal from two legs, benign skin mass removal (7), liver lobectomy, partial prostatectomy, soft palate resection, partial arytenoidectomy, partial ablation of a thyroid carcinoma, photo-vaporization of the tumor bed following malignant tumor resection (4), neurosheath tumor removal from the tongue, tail sebaceous cyst resection, malignant mammary tumor and mast cell tumor removal. The laser was found to be very simple and safe to use. Hemostasis was excellent in all but the liver and prostate surgeries. The laser was particularly effective in preventing hemorrhage during perianal, anal, and tongue mass removal. It is estimated that a time and blood loss savings of 50% over that of conventional surgery occurred with the use of the laser. All external wounds made by laser appeared to heal faster and with less inflammation than those made with a conventional or electrosurgical scalpel.
Interchange Safety Analysis Tool (ISAT) : user manual
DOT National Transportation Integrated Search
2007-06-01
This User Manual describes the usage and operation of the spreadsheet-based Interchange Safety Analysis Tool (ISAT). ISAT provides design and safety engineers with an automated tool for assessing the safety effects of geometric design and traffic con...
NASA Astrophysics Data System (ADS)
Arfawi Kurdhi, Nughthoh; Adi Diwiryo, Toray; Sutanto
2016-02-01
This paper presents an integrated single-vendor two-buyer production-inventory model with stochastic demand and service level constraints. Shortage is permitted in the model, and partial backordered partial lost sale. The lead time demand is assumed follows a normal distribution and the lead time can be reduced by adding crashing cost. The lead time and ordering cost reductions are interdependent with logaritmic function relationship. A service level constraint policy corresponding to each buyer is considered in the model in order to limit the level of inventory shortages. The purpose of this research is to minimize joint total cost inventory model by finding the optimal order quantity, safety stock, lead time, and the number of lots delivered in one production run. The optimal production-inventory policy gained by the Lagrange method is shaped to account for the service level restrictions. Finally, a numerical example and effects of the key parameters are performed to illustrate the results of the proposed model.
Safety culture assessment in petrochemical industry: a comparative study of two algerian plants.
Boughaba, Assia; Hassane, Chabane; Roukia, Ouddai
2014-06-01
To elucidate the relationship between safety culture maturity and safety performance of a particular company. To identify the factors that contribute to a safety culture, a survey questionnaire was created based mainly on the studies of Fernández-Muñiz et al. The survey was randomly distributed to 1000 employees of two oil companies and realized a rate of valid answer of 51%. Minitab 16 software was used and diverse tests, including the descriptive statistical analysis, factor analysis, reliability analysis, mean analysis, and correlation, were used for the analysis of data. Ten factors were extracted using the analysis of factor to represent safety culture and safety performance. The results of this study showed that the managers' commitment, training, incentives, communication, and employee involvement are the priority domains on which it is necessary to stress the effort of improvement, where they had all the descriptive average values lower than 3.0 at the level of Company B. Furthermore, the results also showed that the safety culture influences the safety performance of the company. Therefore, Company A with a good safety culture (the descriptive average values more than 4.0), is more successful than Company B in terms of accident rates. The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance.
Safety Culture Assessment in Petrochemical Industry: A Comparative Study of Two Algerian Plants
Boughaba, Assia; Hassane, Chabane; Roukia, Ouddai
2014-01-01
Background To elucidate the relationship between safety culture maturity and safety performance of a particular company. Methods To identify the factors that contribute to a safety culture, a survey questionnaire was created based mainly on the studies of Fernández-Muñiz et al. The survey was randomly distributed to 1000 employees of two oil companies and realized a rate of valid answer of 51%. Minitab 16 software was used and diverse tests, including the descriptive statistical analysis, factor analysis, reliability analysis, mean analysis, and correlation, were used for the analysis of data. Ten factors were extracted using the analysis of factor to represent safety culture and safety performance. Results The results of this study showed that the managers' commitment, training, incentives, communication, and employee involvement are the priority domains on which it is necessary to stress the effort of improvement, where they had all the descriptive average values lower than 3.0 at the level of Company B. Furthermore, the results also showed that the safety culture influences the safety performance of the company. Therefore, Company A with a good safety culture (the descriptive average values more than 4.0), is more successful than Company B in terms of accident rates. Conclusion The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance. PMID:25180135
Mine safety assessment using gray relational analysis and bow tie model
2018-01-01
Mine safety assessment is a precondition for ensuring orderly and safety in production. The main purpose of this study was to prevent mine accidents more effectively by proposing a composite risk analysis model. First, the weights of the assessment indicators were determined by the revised integrated weight method, in which the objective weights were determined by a variation coefficient method and the subjective weights determined by the Delphi method. A new formula was then adopted to calculate the integrated weights based on the subjective and objective weights. Second, after the assessment indicator weights were determined, gray relational analysis was used to evaluate the safety of mine enterprises. Mine enterprise safety was ranked according to the gray relational degree, and weak links of mine safety practices identified based on gray relational analysis. Third, to validate the revised integrated weight method adopted in the process of gray relational analysis, the fuzzy evaluation method was used to the safety assessment of mine enterprises. Fourth, for first time, bow tie model was adopted to identify the causes and consequences of weak links and allow corresponding safety measures to be taken to guarantee the mine’s safe production. A case study of mine safety assessment was presented to demonstrate the effectiveness and rationality of the proposed composite risk analysis model, which can be applied to other related industries for safety evaluation. PMID:29561875
NASA Astrophysics Data System (ADS)
Sterpone, L.; Violante, M.
2007-08-01
Modern SRAM-based field programmable gate array (FPGA) devices offer high capability in implementing complex system. Unfortunately, SRAM-based FPGAs are extremely sensitive to single event upsets (SEUs) induced by radiation particles. In order to successfully deploy safety- or mission-critical applications, designer need to validate the correctness of the obtained designs. In this paper we describe a system based on partial-reconfiguration for running fault-injection experiments within the configuration memory of SRAM-based FPGAs. The proposed fault-injection system uses the internal configuration capabilities that modern FPGAs offer in order to inject SEU within the configuration memory. Detailed experimental results show that the technique is orders of magnitude faster than previously proposed ones.
49 CFR 229.307 - Safety analysis.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 49 Transportation 4 2014-10-01 2014-10-01 false Safety analysis. 229.307 Section 229.307 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Locomotive Electronics § 229.307 Safety...
49 CFR 229.307 - Safety analysis.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 49 Transportation 4 2013-10-01 2013-10-01 false Safety analysis. 229.307 Section 229.307 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Locomotive Electronics § 229.307 Safety...
49 CFR 229.307 - Safety analysis.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 49 Transportation 4 2012-10-01 2012-10-01 false Safety analysis. 229.307 Section 229.307 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Locomotive Electronics § 229.307 Safety...
DOE Office of Scientific and Technical Information (OSTI.GOV)
PECH, S.H.
This report describes the methodology used in conducting the K Basins Hazard Analysis, which provides the foundation for the K Basins Final Safety Analysis Report. This hazard analysis was performed in accordance with guidance provided by DOE-STD-3009-94, Preparation Guide for U. S. Department of Energy Nonreactor Nuclear Facility Safety Analysis Reports and implements the requirements of DOE Order 5480.23, Nuclear Safety Analysis Report.
Sparse partial least squares regression for simultaneous dimension reduction and variable selection
Chun, Hyonho; Keleş, Sündüz
2010-01-01
Partial least squares regression has been an alternative to ordinary least squares for handling multicollinearity in several areas of scientific research since the 1960s. It has recently gained much attention in the analysis of high dimensional genomic data. We show that known asymptotic consistency of the partial least squares estimator for a univariate response does not hold with the very large p and small n paradigm. We derive a similar result for a multivariate response regression with partial least squares. We then propose a sparse partial least squares formulation which aims simultaneously to achieve good predictive performance and variable selection by producing sparse linear combinations of the original predictors. We provide an efficient implementation of sparse partial least squares regression and compare it with well-known variable selection and dimension reduction approaches via simulation experiments. We illustrate the practical utility of sparse partial least squares regression in a joint analysis of gene expression and genomewide binding data. PMID:20107611
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-15
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD [Recommendation 2010-1] Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers AGENCY: Defense Nuclear Facilities Safety Board... Facilities Safety Board has made a recommendation to the Secretary of Energy requesting an amendment to the...
Tachibana, Hidekazu; Takagi, Toshio; Kondo, Tsunenori; Ishida, Hideki; Tanabe, Kazunari
2018-04-01
To compare surgical outcomes, including renal function and the preserved renal parenchymal volume, between robot-assisted laparoscopic partial nephrectomy and laparoscopic partial nephrectomy using propensity score-matched analyses. In total, 253 patients, with a normal contralateral kidney, who underwent laparoscopic partial nephrectomy (n = 131) or robot-assisted laparoscopic partial nephrectomy (n = 122) with renal arterial clamping between 2010 and 2015, were included. Patients' background and tumor factors were adjusted by propensity score matching. Surgical outcomes, including postoperative renal function, complications, warm ischemia time and preserved renal parenchymal volume, evaluated by volumetric analysis, were compared between the surgical procedures. After matching, 64 patients were assigned to each group. The mean age was 56-57 years, and the mean tumor size was 22 mm. Approximately 50% of patients had low complexity tumors (RENAL nephrometry score 4-7). The incidence rate of acute kidney failure was significantly lower in the robot-assisted laparoscopic partial nephrectomy (11%) than laparoscopic partial nephrectomy (23%) group (P = 0.049), and warm ischemia time shorter in the robot-assisted laparoscopic partial nephrectomy (17 min) than laparoscopic partial nephrectomy (25 min) group (P < 0.0001). The preservation rate of renal function, measured by the estimated glomerular filtration rate, at 6 months post-surgery was 96% for robot-assisted laparoscopic partial nephrectomy and 90% for laparoscopic partial nephrectomy (P < 0.0001). The preserved renal parenchymal volume was higher for robot-assisted laparoscopic partial nephrectomy (89%) than laparoscopic partial nephrectomy (77%; P < 0.0001). The rate of perioperative complications, surgical margin status and length of hospital stay were equivalent for both techniques. Robot-assisted laparoscopic partial nephrectomy allows to achieve better preservation of renal function and parenchymal volume than laparoscopic partial nephrectomy. © 2018 The Japanese Urological Association.
Motives for consumer choice of traditional food and European food in mainland China.
Wang, Ou; De Steur, Hans; Gellynck, Xavier; Verbeke, Wim
2015-04-01
The demand for European (-style) foods in mainland China has been increasing dramatically during the last decade. Nevertheless, European food producers often appear to be not capable to fully exploit this huge market potential, partially due to the competition with traditional (Chinese) foods. This study examines the determinants of mainland Chinese consumers' choice of traditional food and European food. A web-based survey was administered with 541 consumers from two cities: Shanghai and Xi'an. Thereby, the Food Choice Motives model, predominantly used thus far in a European or developed context, is applied to mainland China in order to address the lack of knowledge on food motives of its consumer market and to detect associations between these motives, attitudes, and purchase intentions. Factor analysis resulted in a new Food Choice Motive construct that is considered more appropriate within the context of mainland Chinese consumers, encompassing six dimensions: Health concern, Time or money saving, Sensory appeal, Availability and familiarity, Mood and Food safety concern. Path analysis demonstrated that Time or money saving was negatively associated with attitude toward traditional food on the one hand and purchase intentions toward European food on the other hand. Availability and familiarity had a positive association with attitude toward traditional food. Mood was a positive factor driving attitude toward European food. For both food types, Sensory appeal and Attitude were positively linked to purchase intentions. Furthermore, Mood was negatively linked to the purchase intention toward traditional food in Shanghai. Food safety concern was positively associated with attitudes toward traditional food in Xi'an. Copyright © 2014 Elsevier Ltd. All rights reserved.
Yang, Nan; Chen, Jinqiu; Zhang, Hui; Dai, Zhiming; Yao, Huan; Ma, Xiaorong; Bai, Ju; Zhang, Yilin; Zhang, Wanggang
2017-12-01
The first-line formulation of antithymocyte globulin (ATG) remains unknown. We aimed to systematically review evidence to compare the efficacy and safety profiles of different ATGs. We did a systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort controlled studies comparing horse and rabbit ATG in immunosuppressive therapy of treatment-naïve aplastic anemia. We searched The Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov , and conference proceedings of American Society of Hematology and European Society for Blood and Marrow Transplantation annual meetings. The outcomes were 3-, 6-, and 12-month response; early mortality; relapse; and evolution. We pooled hazard ratios for relapse and odds ratios (ORs) for other outcomes using fixed-effect or random-effect models based on the heterogeneity. This study was registered with PROSPERO, number CRD42016036945. We included 1636 participants from three RCTs and 11 cohort controlled studies. Allocation to horse ATG increased 6-month response events by 86% compared with rabbit ATG. The benefit of horse ATG was mainly driven by increase in studies with non-Asian (OR 95% CI = 2.39 (1.54-3.69), p < 0.0001) and good partial response criterion (OR 95% CI = 2.73 (1.53-4.89), p = 0.0007). The early mortality and evolution were similar between groups. Compared with rabbit ATG, horse ATG had superior remission by 6 months and equivalent safety profiles in patients with treatment-naïve AA. Evidence for further responses beyond 6 to 12 months was limited.
14 CFR 417.221 - Time delay analysis.
Code of Federal Regulations, 2012 CFR
2012-01-01
... occurs; (2) A flight safety official's decision and reaction time, including variation in human response... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Time delay analysis. 417.221 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.221 Time delay analysis. (a...
14 CFR 417.221 - Time delay analysis.
Code of Federal Regulations, 2014 CFR
2014-01-01
... occurs; (2) A flight safety official's decision and reaction time, including variation in human response... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Time delay analysis. 417.221 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.221 Time delay analysis. (a...
14 CFR 417.221 - Time delay analysis.
Code of Federal Regulations, 2013 CFR
2013-01-01
... occurs; (2) A flight safety official's decision and reaction time, including variation in human response... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Time delay analysis. 417.221 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.221 Time delay analysis. (a...
14 CFR 417.217 - Overflight gate analysis.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Overflight gate analysis. 417.217 Section..., DEPARTMENT OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.217 Overflight gate analysis. For a launch that involves flight over a populated or other protected area, the flight safety...
10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.
Code of Federal Regulations, 2013 CFR
2013-01-01
...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2013-01-01 2013-01-01 false Contents of applications; technical information in final...
10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.
Code of Federal Regulations, 2012 CFR
2012-01-01
...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2012-01-01 2012-01-01 false Contents of applications; technical information in final...
14 CFR Appendix J to Part 417 - Ground Safety Analysis Report
Code of Federal Regulations, 2014 CFR
2014-01-01
... information required by this appendix. J417.3Ground safety analysis report chapters (a) Introduction. A ground... analysis report must include a chapter that provides detailed safety information about each launch vehicle... data. A hazard analysis form must contain or reference all information necessary to understand the...
10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.
Code of Federal Regulations, 2014 CFR
2014-01-01
...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2014-01-01 2014-01-01 false Contents of applications; technical information in final...
14 CFR Appendix J to Part 417 - Ground Safety Analysis Report
Code of Federal Regulations, 2013 CFR
2013-01-01
... information required by this appendix. J417.3Ground safety analysis report chapters (a) Introduction. A ground... analysis report must include a chapter that provides detailed safety information about each launch vehicle... data. A hazard analysis form must contain or reference all information necessary to understand the...
14 CFR Appendix J to Part 417 - Ground Safety Analysis Report
Code of Federal Regulations, 2010 CFR
2010-01-01
... information required by this appendix. J417.3Ground safety analysis report chapters (a) Introduction. A ground... analysis report must include a chapter that provides detailed safety information about each launch vehicle... data. A hazard analysis form must contain or reference all information necessary to understand the...
14 CFR Appendix J to Part 417 - Ground Safety Analysis Report
Code of Federal Regulations, 2011 CFR
2011-01-01
... information required by this appendix. J417.3Ground safety analysis report chapters (a) Introduction. A ground... analysis report must include a chapter that provides detailed safety information about each launch vehicle... data. A hazard analysis form must contain or reference all information necessary to understand the...
10 CFR 52.157 - Contents of applications; technical information in final safety analysis report.
Code of Federal Regulations, 2011 CFR
2011-01-01
...; technical information in final safety analysis report. The application must contain a final safety analysis...) Information sufficient to demonstrate compliance with the applicable requirements regarding testing, analysis... 10 Energy 2 2011-01-01 2011-01-01 false Contents of applications; technical information in final...
14 CFR Appendix J to Part 417 - Ground Safety Analysis Report
Code of Federal Regulations, 2012 CFR
2012-01-01
... information required by this appendix. J417.3Ground safety analysis report chapters (a) Introduction. A ground... analysis report must include a chapter that provides detailed safety information about each launch vehicle... data. A hazard analysis form must contain or reference all information necessary to understand the...
Information Services at the Nuclear Safety Analysis Center.
ERIC Educational Resources Information Center
Simard, Ronald
This paper describes the operations of the Nuclear Safety Analysis Center. Established soon after an accident at the Three Mile Island nuclear power plant near Harrisburg, Pennsylvania, its efforts were initially directed towards a detailed analysis of the accident. Continuing functions include: (1) the analysis of generic nuclear safety issues,…
USDA-ARS?s Scientific Manuscript database
Illegal use of nitrogen-rich melamine (C3H6N6) to boost perceived protein content of food products such as milk, infant formula, frozen yogurt, pet food, biscuits, and coffee drinks has caused serious food safety problems. Conventional methods to detect melamine in foods, such as Enzyme-linked immun...
Life in extreme environments: how will humans perform on Mars?
NASA Technical Reports Server (NTRS)
Newman, D. J.
2000-01-01
This review of astronaut extravehicular activity (EVA) and the details of American and Soviet/Russian spacesuit design focuses on design recommendations to enhance astronaut safety and effectiveness. Innovative spacesuit design is essential, given the challenges of future exploration-class missions in which astronauts will be called upon to perform increasingly complex and physically demanding tasks in the extreme environments of microgravity and partial gravity.
41 CFR 102-80.105 - What information must be included in an equivalent level of safety analysis?
Code of Federal Regulations, 2011 CFR
2011-01-01
... of Safety Analysis § 102-80.105 What information must be included in an equivalent level of safety... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What information must be included in an equivalent level of safety analysis? 102-80.105 Section 102-80.105 Public Contracts and...
41 CFR 102-80.105 - What information must be included in an equivalent level of safety analysis?
Code of Federal Regulations, 2014 CFR
2014-01-01
... of Safety Analysis § 102-80.105 What information must be included in an equivalent level of safety... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What information must be included in an equivalent level of safety analysis? 102-80.105 Section 102-80.105 Public Contracts and...
41 CFR 102-80.105 - What information must be included in an equivalent level of safety analysis?
Code of Federal Regulations, 2013 CFR
2013-07-01
... of Safety Analysis § 102-80.105 What information must be included in an equivalent level of safety... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What information must be included in an equivalent level of safety analysis? 102-80.105 Section 102-80.105 Public Contracts and...
41 CFR 102-80.105 - What information must be included in an equivalent level of safety analysis?
Code of Federal Regulations, 2012 CFR
2012-01-01
... of Safety Analysis § 102-80.105 What information must be included in an equivalent level of safety... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What information must be included in an equivalent level of safety analysis? 102-80.105 Section 102-80.105 Public Contracts and...
Saikali, Melody; Tanios, Alain; Saab, Antoine
2017-11-21
The aim of the study was to evaluate the sensitivity and resource efficiency of a partially automated adverse event (AE) surveillance system for routine patient safety efforts in hospitals with limited resources. Twenty-eight automated triggers from the hospital information system's clinical and administrative databases identified cases that were then filtered by exclusion criteria per trigger and then reviewed by an interdisciplinary team. The system, developed and implemented using in-house resources, was applied for 45 days of surveillance, for all hospital inpatient admissions (N = 1107). Each trigger was evaluated for its positive predictive value (PPV). Furthermore, the sensitivity of the surveillance system (overall and by AE category) was estimated relative to incidence ranges in the literature. The surveillance system identified a total of 123 AEs among 283 reviewed medical records, yielding an overall PPV of 52%. The tool showed variable levels of sensitivity across and within AE categories when compared with the literature, with a relatively low overall sensitivity estimated between 21% and 44%. Adverse events were detected in 23 of the 36 AE categories defined by an established harm classification system. Furthermore, none of the detected AEs were voluntarily reported. The surveillance system showed variable sensitivity levels across a broad range of AE categories with an acceptable PPV, overcoming certain limitations associated with other harm detection methods. The number of cases captured was substantial, and none had been previously detected or voluntarily reported. For hospitals with limited resources, this methodology provides valuable safety information from which interventions for quality improvement can be formulated.
Food insecurity and glycemic control among low-income patients with type 2 diabetes.
Seligman, Hilary K; Jacobs, Elizabeth A; López, Andrea; Tschann, Jeanne; Fernandez, Alicia
2012-02-01
To determine whether food insecurity--the inability to reliably afford safe and nutritious food--is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes. We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of 711 patients with diabetes in safety net health clinics. We then examined whether difficulty following a diabetic diet, self-efficacy, or emotional distress related to diabetes mediated the relationship between food insecurity and glycemic control. The food insecurity prevalence in our sample was 46%. Food-insecure participants were significantly more likely than food-secure participants to have poor glycemic control, as defined by hemoglobin A(1c) ≥8.5% (42 vs. 33%; adjusted odds ratio 1.48 [95% CI 1.07-2.04]). Food-insecure participants were more likely to report difficulty affording a diabetic diet (64 vs. 49%, P < 0.001). They also reported lower diabetes-specific self-efficacy (P < 0.001) and higher emotional distress related to diabetes (P < 0.001). Difficulty following a healthy diet and emotional distress partially mediated the association between food insecurity and glycemic control. Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. This risk may be partially attributable to increased difficulty following a diabetes-appropriate diet and increased emotional distress regarding capacity for successful diabetes self-management. Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting.
Crouch, Edmund A; Labarre, David; Golden, Neal J; Kause, Janell R; Dearfield, Kerry L
2009-10-01
The U.S. Department of Agriculture, Food Safety and Inspection Service is exploring quantitative risk assessment methodologies to incorporate the use of the Codex Alimentarius' newly adopted risk management metrics (e.g., food safety objectives and performance objectives). It is suggested that use of these metrics would more closely tie the results of quantitative microbial risk assessments (QMRAs) to public health outcomes. By estimating the food safety objective (the maximum frequency and/or concentration of a hazard in a food at the time of consumption) and the performance objective (the maximum frequency and/or concentration of a hazard in a food at a specified step in the food chain before the time of consumption), risk managers will have a better understanding of the appropriate level of protection (ALOP) from microbial hazards for public health protection. We here demonstrate a general methodology that allows identification of an ALOP and evaluation of corresponding metrics at appropriate points in the food chain. It requires a two-dimensional probabilistic risk assessment, the example used being the Monte Carlo QMRA for Clostridium perfringens in ready-to eat and partially cooked meat and poultry products, with minor modifications to evaluate and abstract required measures. For demonstration purposes, the QMRA model was applied specifically to hot dogs produced and consumed in the United States. Evaluation of the cumulative uncertainty distribution for illness rate allows a specification of an ALOP that, with defined confidence, corresponds to current industry practices.
Vangsness, C Thomas; Farr, Jack; Boyd, Joel; Dellaero, David T; Mills, C Randal; LeRoux-Williams, Michelle
2014-01-15
There are limited treatment options for tissue restoration and the prevention of degenerative changes in the knee. Stem cells have been a focus of intense preclinical research into tissue regeneration but limited clinical investigation. In a randomized, double-blind, controlled study, the safety of the intra-articular injection of human mesenchymal stem cells into the knee, the ability of mesenchymal stem cells to promote meniscus regeneration following partial meniscectomy, and the effects of mesenchymal stem cells on osteoarthritic changes in the knee were investigated. A total of fifty-five patients at seven institutions underwent a partial medial meniscectomy. A single superolateral knee injection was given within seven to ten days after the meniscectomy. Patients were randomized to one of three treatment groups: Group A, in which patients received an injection of 50 × 10⁶ allogeneic mesenchymal stem cells; Group B, 150 × 10⁶ allogeneic mesenchymal stem cells; and the control group, a sodium hyaluronate (hyaluronic acid/hyaluronan) vehicle control. Patients were followed to evaluate safety, meniscus regeneration, the overall condition of the knee joint, and clinical outcomes at intervals through two years. Evaluations included sequential magnetic resonance imaging (MRI). No ectopic tissue formation or clinically important safety issues were identified. There was significantly increased meniscal volume (defined a priori as a 15% threshold) determined by quantitative MRI in 24% of patients in Group A and 6% in Group B at twelve months post meniscectomy (p = 0.022). No patients in the control group met the 15% threshold for increased meniscal volume. Patients with osteoarthritic changes who received mesenchymal stem cells experienced a significant reduction in pain compared with those who received the control, on the basis of visual analog scale assessments. There was evidence of meniscus regeneration and improvement in knee pain following treatment with allogeneic human mesenchymal stem cells. These results support the study of human mesenchymal stem cells for the apparent knee-tissue regeneration and protective effects.
Systems Analysis of NASA Aviation Safety Program: Final Report
NASA Technical Reports Server (NTRS)
Jones, Sharon M.; Reveley, Mary S.; Withrow, Colleen A.; Evans, Joni K.; Barr, Lawrence; Leone, Karen
2013-01-01
A three-month study (February to April 2010) of the NASA Aviation Safety (AvSafe) program was conducted. This study comprised three components: (1) a statistical analysis of currently available civilian subsonic aircraft data from the National Transportation Safety Board (NTSB), the Federal Aviation Administration (FAA), and the Aviation Safety Information Analysis and Sharing (ASIAS) system to identify any significant or overlooked aviation safety issues; (2) a high-level qualitative identification of future safety risks, with an assessment of the potential impact of the NASA AvSafe research on the National Airspace System (NAS) based on these risks; and (3) a detailed, top-down analysis of the NASA AvSafe program using an established and peer-reviewed systems analysis methodology. The statistical analysis identified the top aviation "tall poles" based on NTSB accident and FAA incident data from 1997 to 2006. A separate examination of medical helicopter accidents in the United States was also conducted. Multiple external sources were used to develop a compilation of ten "tall poles" in future safety issues/risks. The top-down analysis of the AvSafe was conducted by using a modification of the Gibson methodology. Of the 17 challenging safety issues that were identified, 11 were directly addressed by the AvSafe program research portfolio.
Sources of Safety Data and Statistical Strategies for Design and Analysis: Clinical Trials.
Zink, Richard C; Marchenko, Olga; Sanchez-Kam, Matilde; Ma, Haijun; Jiang, Qi
2018-03-01
There has been an increased emphasis on the proactive and comprehensive evaluation of safety endpoints to ensure patient well-being throughout the medical product life cycle. In fact, depending on the severity of the underlying disease, it is important to plan for a comprehensive safety evaluation at the start of any development program. Statisticians should be intimately involved in this process and contribute their expertise to study design, safety data collection, analysis, reporting (including data visualization), and interpretation. In this manuscript, we review the challenges associated with the analysis of safety endpoints and describe the safety data that are available to influence the design and analysis of premarket clinical trials. We share our recommendations for the statistical and graphical methodologies necessary to appropriately analyze, report, and interpret safety outcomes, and we discuss the advantages and disadvantages of safety data obtained from clinical trials compared to other sources. Clinical trials are an important source of safety data that contribute to the totality of safety information available to generate evidence for regulators, sponsors, payers, physicians, and patients. This work is a result of the efforts of the American Statistical Association Biopharmaceutical Section Safety Working Group.
Limited-scope probabilistic safety analysis for the Los Alamos Meson Physics Facility (LAMPF)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sharirli, M.; Rand, J.L.; Sasser, M.K.
1992-01-01
The reliability of instrumentation and safety systems is a major issue in the operation of accelerator facilities. A probabilistic safety analysis was performed or the key safety and instrumentation systems at the Los Alamos Meson Physics Facility (LAMPF). in Phase I of this unique study, the Personnel Safety System (PSS) and the Current Limiters (XLs) were analyzed through the use of the fault tree analyses, failure modes and effects analysis, and criticality analysis. Phase II of the program was done to update and reevaluate the safety systems after the Phase I recommendations were implemented. This paper provides a brief reviewmore » of the studies involved in Phases I and II of the program.« less
Limited-scope probabilistic safety analysis for the Los Alamos Meson Physics Facility (LAMPF)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sharirli, M.; Rand, J.L.; Sasser, M.K.
1992-12-01
The reliability of instrumentation and safety systems is a major issue in the operation of accelerator facilities. A probabilistic safety analysis was performed or the key safety and instrumentation systems at the Los Alamos Meson Physics Facility (LAMPF). in Phase I of this unique study, the Personnel Safety System (PSS) and the Current Limiters (XLs) were analyzed through the use of the fault tree analyses, failure modes and effects analysis, and criticality analysis. Phase II of the program was done to update and reevaluate the safety systems after the Phase I recommendations were implemented. This paper provides a brief reviewmore » of the studies involved in Phases I and II of the program.« less
Frenel, Jean-Sebastien; Le Tourneau, Christophe; O'Neil, Bert; Ott, Patrick A; Piha-Paul, Sarina A; Gomez-Roca, Carlos; van Brummelen, Emilie M J; Rugo, Hope S; Thomas, Shari; Saraf, Sanatan; Rangwala, Reshma; Varga, Andrea
2017-12-20
Purpose The KEYNOTE-028 trial ( ClinicalTrials.gov identifier: NCT02054806) was designed to assess the safety and efficacy of pembrolizumab in 20 programmed death ligand 1-positive, advanced solid tumor cohorts. Here, we present the results from the cohort of patients with advanced cervical cancer. Methods Patients were treated with pembrolizumab 10 mg/kg every 2 weeks for up to 24 months. Response was assessed every 8 weeks for the first 6 months and every 12 weeks thereafter. The primary end point was overall response rate per Response Evaluation Criteria in Solid Tumors, version 1.1, by investigator review. Safety was a secondary end point. Results Twenty-four patients were enrolled in the cervical cancer cohort. The median age was 42 years (range, 26 to 62 years), 22 patients (92%) had received prior radiation therapy, and 15 patients (63%) had received two or more lines of therapy, including bevacizumab (10 of 24 patients), for advanced disease. At the data cutoff, median follow-up duration was 11.0 months (range, 1.3 to 32.2 months). Overall response rate was 17% (95% CI, 5% to 37%); four patients (17%) achieved a confirmed partial response, and three patients (13%) had stable disease. Median duration of response for the four patients who achieved a partial response was 5.4 months (4.1 to 7.5 months). Treatment related adverse events (AEs) were experienced by 18 patients (75%); only rash (n = 5; 21%) and pyrexia (n = 4; 17%) and occurred in ≥ 10% of patients. Five patients experienced grade 3 treatment-related AEs. No grade 4 treatment-related AEs or deaths were observed. Conclusion In patients with programmed death ligand 1-positive advanced cervical cancer, pembrolizumab demonstrated antitumor activity and exhibited a safety profile consistent with that seen in other tumor types.
An analysis of commitment strategies in planning: The details
NASA Technical Reports Server (NTRS)
Minton, Steven; Bresina, John; Drummond, Mark; Philips, Andrew B.
1991-01-01
We compare the utility of different commitment strategies in planning. Under a 'least commitment strategy', plans are represented as partial orders and operators are ordered only when interactions are detected. We investigate claims of the inherent advantages of planning with partial orders, as compared to planning with total orders. By focusing our analysis on the issue of operator ordering commitment, we are able to carry out a rigorous comparative analysis of two planners. We show that partial-order planning can be more efficient than total-order planning, but we also show that this is not necessarily so.
Code of Federal Regulations, 2010 CFR
2010-07-01
... equivalent level of safety. (c) As a third option, other technical analysis procedures, as approved by the... Equivalent Level of Safety Analysis § 102-80.115 Is there more than one option for establishing that an... areas of safety. Available safe egress times would be developed based on analysis of a number of assumed...
Requirements Analysis for the Army Safety Management Information System (ASMIS)
1989-03-01
8217_>’ Telephone Number « .. PNL-6819 Limited Distribution Requirements Analysis for the Army Safety Management Information System (ASMIS) Final...PNL-6819 REQUIREMENTS ANALYSIS FOR THE ARMY SAFETY MANAGEMENT INFORMATION SYSTEM (ASMIS) FINAL REPORT J. S. Littlefield A. L. Corrigan March...accidents. This accident data is available under the Army Safety Management Information System (ASMIS) which is an umbrella for many databases
Zhang, Mengliang; Zhao, Yang; Harrington, Peter de B; Chen, Pei
2016-03-01
Two simple fingerprinting methods, flow-injection coupled to ultraviolet spectroscopy and proton nuclear magnetic resonance, were used for discriminating between Aurantii fructus immaturus and Fructus poniciri trifoliatae immaturus . Both methods were combined with partial least-squares discriminant analysis. In the flow-injection method, four data representations were evaluated: total ultraviolet absorbance chromatograms, averaged ultraviolet spectra, absorbance at 193, 205, 225, and 283 nm, and absorbance at 225 and 283 nm. Prediction rates of 100% were achieved for all data representations by partial least-squares discriminant analysis using leave-one-sample-out cross-validation. The prediction rate for the proton nuclear magnetic resonance data by partial least-squares discriminant analysis with leave-one-sample-out cross-validation was also 100%. A new validation set of data was collected by flow-injection with ultraviolet spectroscopic detection two weeks later and predicted by partial least-squares discriminant analysis models constructed by the initial data representations with no parameter changes. The classification rates were 95% with the total ultraviolet absorbance chromatograms datasets and 100% with the other three datasets. Flow-injection with ultraviolet detection and proton nuclear magnetic resonance are simple, high throughput, and low-cost methods for discrimination studies.
Prediction of Rainfall-Induced Landslides in Tegucigalpa, Honduras, Using a Hydro-Geotechnical Model
NASA Astrophysics Data System (ADS)
Garcia Urquia, Elias; Axelsson, K.
2010-05-01
Central America is constantly being affected by natural hazards. Among these events are hurricanes and earthquakes, capable of triggering landslides that can alter the natural landscape, destroy infrastructure and cause the death of people in the most important settlements of the region. Hurricane Mitch in October of 1998 was of particular interest for the region, since it provoked hundreds of rainfall-induced landslides, mainly in 4 different countries. Studies carried out after Hurricane Mitch have allowed researchers to identify the factors that contribute to slope instability in many vulnerable areas. As Tegucigalpa, Honduras was partially destroyed due to the various landslide and flooding events triggered by this devastating hurricane, various research teams have deepened in their investigations and have proposed measures to mitigate the effects of similar future incidents. A model coupling an infinite-slope analysis and a simple groundwater flow approach can serve as a basis to predict the occurrence of landslides in Tegucigalpa, Honduras as a function of topographic, hydrological and soil variables. A safety map showing the rainfall-triggered landslide risk zones for Tegucigalpa, Honduras is to be created. As opposed to previous safety maps in which only steady-state conditions are studied, this analysis is extended and different steady-state and quasi-dynamic scenarios are considered for comparison. For the purpose of the latter settings, a hydrological analysis that determines the rainfall extreme values and their return periods in Tegucigalpa will account for the influence of rainfall on the groundwater flow and strength of soils. It is known that the spatial distribution of various factors that contribute to the risk of landslides (i.e. soil thickness, conductivity and strength properties; rainfall intensity and duration; root strength; subsurface flow orientation) is hard to determine. However, an effort is done to derive correlations for these parameters based on the existing information (i.e. rainfall data, soil testing data, land-use data). In addition, the spatial data management and manipulation is done by means of a Geographic Information System (GIS). For such purpose, maps of land-use, topography and geology provided by JICA have bee manually digitized and converted into GIS raster maps. The resulting safety map is then validated by comparing it with existing slope-failure-maps that have been created to show the affected areas during Hurricane Mitch. This safety map represents a useful tool in the prevention of landslide-related disasters, as it would be able to point out which segments of the population are at risk as a consequence of the rainfall-slope interaction in Tegucigalpa.
Beaton, Derek; Dunlop, Joseph; Abdi, Hervé
2016-12-01
For nearly a century, detecting the genetic contributions to cognitive and behavioral phenomena has been a core interest for psychological research. Recently, this interest has been reinvigorated by the availability of genotyping technologies (e.g., microarrays) that provide new genetic data, such as single nucleotide polymorphisms (SNPs). These SNPs-which represent pairs of nucleotide letters (e.g., AA, AG, or GG) found at specific positions on human chromosomes-are best considered as categorical variables, but this coding scheme can make difficult the multivariate analysis of their relationships with behavioral measurements, because most multivariate techniques developed for the analysis between sets of variables are designed for quantitative variables. To palliate this problem, we present a generalization of partial least squares-a technique used to extract the information common to 2 different data tables measured on the same observations-called partial least squares correspondence analysis-that is specifically tailored for the analysis of categorical and mixed ("heterogeneous") data types. Here, we formally define and illustrate-in a tutorial format-how partial least squares correspondence analysis extends to various types of data and design problems that are particularly relevant for psychological research that include genetic data. We illustrate partial least squares correspondence analysis with genetic, behavioral, and neuroimaging data from the Alzheimer's Disease Neuroimaging Initiative. R code is available on the Comprehensive R Archive Network and via the authors' websites. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Strandroth, Johan
2015-03-01
When targeting a society free from serious and fatal road-traffic injuries, it has been a common practice in many countries and organizations to set up time-limited and quantified targets for the reduction of fatalities and injuries. In setting these targets EU and other organizations have recognized the importance to monitor and predict the development toward the target as well as the efficiency of road safety policies and interventions. This study aims to validate a method to forecast future road safety challenges by applying it to the fatal crashes in Sweden in 2000 and using the method to explain the change in fatalities based on the road safety interventions made until 2010. The estimation of the method is then compared to the true outcome in 2010. The aim of this study was to investigate if a residual of crashes produced by a partial analysis could constitute a sufficient base to describe the characteristics of future crashes. show that out of the 332 car occupants killed in 2000, 197 were estimated to constitute the residual in 2010. Consequently, 135 fatalities from 2000 were estimated by the model to be prevented by 2010. That is a predicted reduction of 41% compared to the reduction in the real outcome of 53%, from 332 in 2000 to 156 in 2010. The method was found able to generate a residual of crashes in 2010 from the crashes in 2000 that had a very similar nature, with regards to crash type, as the true outcome of 2010. It was also found suitable to handle double counting and system effects. However, future research is needed in order to investigate how external factors as well as random and systematic variation should be taken into account in a reliable manner. Copyright © 2015 Elsevier Ltd. All rights reserved.
A Note on the Factor Analysis of Partial Covariance Matrices
ERIC Educational Resources Information Center
McDonald, Roderick P.
1978-01-01
The relationship between the factor structure of a convariance matrix and the factor structure of a partial convariance matrix when one or more variables are partialled out of the original matrix is given in this brief note. (JKS)
Li, Ling; Li, Xin; Wang, Xinhua; Fu, Xiaorui; Ma, Wang; Qin, Yanru; Li, Wencai; Wu, Jingjing; Sun, Zhenchang; Zhang, Xudong; Nan, Feifei; Chang, Yu; Li, Zhaoming; Zhang, Dandan; Wang, Guannan; Yan, Jiaqin; Su, Liping; Wang, Jinghua; Xue, Hongwei; Young, Ken H.; Zhang, Mingzhi
2016-01-01
To explore a more effective treatment for newly diagnosed, advanced-stage extranodal natural killer/T-cell lymphoma, nasal type (ENKTL), we conducted a phase 4 study of the cisplatin, dexamethasone, gemcitabine, pegaspargase (DDGP) regimen. The primary end point was the 2-year progression-free survival (PFS) after the protocol treatment. Secondary endpoints included response rate (RR), overall survival (OS) and median survival time (MST). The interim analysis included data only from March 2011 to September 2013, who received six cycles of DDGP chemotherapy. A total of 25 eligible patients were enrolled. Seventeen patients (17/24, 70.83%) achieved complete response (CR) and four (4/24, 16.67%) achieved partial response (PR), three (3/24, 12.50%) had progressive disease (PD). The RR after treatment was 87.50%. After a median follow-up duration of 24.67 months (range 4-48 months). The 2-year PFS and OS rate were 61.80% (95% CI, 42.00% to 81.60%) and 68.50 % (95% CI, 48.70% to 88.30%), respectively. The MST was 36.55 months (95% CI, 29.41 months to 43.70 months). Grade 3/4 leukopenia occurred in fourteen patients (58.33%) and grade 3/4 thrombocytopenia occurred in eleven patients (45.83%). Twelve patients (50.00%) experienced Activated Partial Phromboplastin Ptime (APTT) elongation and fourteen patients (58.33%) experienced hypofibrinogenemia. In conclusion, DDGP regimen is an effective and tolerated treatment for newly diagnosed, advanced-stage ENKTL. This trial was registered at www.ClinicalTrials.gov as #NCT01501149. PMID:27384676
Li, Hongyu; Hu, Jing; Wu, Shuhong; Wang, Li; Cao, Xiaobo; Zhang, Xiaoshan; Dai, Bingbing; Cao, Mengru; Shao, Ruping; Zhang, Ran; Majidi, Mourad; Ji, Lin; Heymach, John V.; Wang, Michael; Pan, Shiyang; Minna, John; Mehran, Reza J.; Swisher, Stephen G.; Roth, Jack A.; Fang, Bingliang
2016-01-01
Auranofin, a gold complex that has been used to treat rheumatoid arthritis in clinics and has documented pharmacokinetic and safety profiles in humans, has recently been investigated for its anticancer activity in leukemia and some solid cancers. However, auranofin's single agent activity in lung cancer is not well characterized. To determine whether auranofin has single agent activity in lung cancer, we evaluated auranofin's activity in a panel of 10 non-small cell lung cancer (NSCLC) cell lines. Cell viability analysis revealed that auranofin induced growth inhibition in a subset of NSCLC cell lines with a half maximal inhibitory concentration (IC50) below 1.0 μM. Treatment with auranofin elicited apoptosis and necroptosis in auranofin-sensitive cell lines. Moreover, the susceptibility of NSCLC cells to auranofin was inversely correlated with TXNRD1 expression in the cells. Transient transfection of the TXNRD1-expressing plasmid in auranofin-sensitive Calu3 cells resulted in partial resistance, indicating that high TXNRD level is one of causal factors for resistance to auranofin. Further mechanistic characterization with proteomic analysis revealed that auranofin inhibits expression and/or phosphorylation of multiple key nodes in the PI3K/AKT/mTOR pathway, including S6, 4EBP1, Rictor, p70S6K, mTOR, TSC2, AKT and GSK3. Ectopic expression of TXNRD1 partially reversed auranofin-mediated PI3K/AKT/mTOR inhibition, suggesting that TXNRD1 may participate in the regulation of PI3K/AKT/mTOR pathway. Administration of auranofin to mice with xenograft tumors derived from NSCLC cells significantly suppressed tumor growth without inducing obvious toxic effects. Our results demonstrated feasibility of repurposing auranofin for treatment of lung cancer. PMID:26657290
Viewpoint on ISA TR84.0.02--simplified methods and fault tree analysis.
Summers, A E
2000-01-01
ANSI/ISA-S84.01-1996 and IEC 61508 require the establishment of a safety integrity level for any safety instrumented system or safety related system used to mitigate risk. Each stage of design, operation, maintenance, and testing is judged against this safety integrity level. Quantitative techniques can be used to verify whether the safety integrity level is met. ISA-dTR84.0.02 is a technical report under development by ISA, which discusses how to apply quantitative analysis techniques to safety instrumented systems. This paper discusses two of those techniques: (1) Simplified equations and (2) Fault tree analysis.
Diode laser supported partial nephrectomy in laparoscopic surgery: preliminary results
NASA Astrophysics Data System (ADS)
Sroka, Ronald; Hennig, Georg; Zillinberg, Katja; Khoder, Wael Y.
2011-07-01
Introduction: Warm ischemia and bleeding during laparoscopic partial nephrectomy place technical constraints on surgeons. Therefore it was the aim to develop a safe and effective laser assisted partial nephrectomy technique without need for ischemia. Patients and methods: A diode laser emitting light at 1318nm in cw mode was coupled into a bare fibre (core diameter 600 μm) thus able to transfer up to 100W to the tissue. After dry lab experience, a total of 8 patients suffering from kidney malformations underwent laparoscopic/retroperitoneoscopic partial nephrectomy. Clinically, postoperative renal function and serum c-reactive protein (CRP) were monitored. Laser induced coagulation depth and effects on resection margins were evaluated. Demographic, clinical and follow-up data are presented. Results: Overall interventions, the mean operative time was 116,5 minutes (range 60-175min) with mean blood loss of 238ml (range 50-600ml) while laser assisted resection of the kidney tissue took max 15min. After extirpation of the tumours all patients showed clinical favourable outcome during follow up period. The tumour size was measured to be 1.8 to 5cm. With respect to clinical safety and due to blood loos, two warm ischemia (19 and 24min) must be performed. Immediate postoperative serum creatinine and CRP were elevated within 0.1 to 0.6 mg/dl (mean 0.18 mg/dl) and 2.1-10 mg/dl (mean 6.24 mg/dl), respectively. The depth of the coagulation on the removed tissue ranged between <1 to 2mm without effect on histopathological evaluation of tumours or resection margin. As the surface of the remaining kidney surface was laser assisted coagulated after removal. The sealing of the surface was induced by a slightly larger coagulation margin, but could not measured so far. Conclusion: This prospective in-vivo feasibility study shows that 1318nm-diode laser assisted partial nephrectomy seems to be a safe and promising medical technique which could be provided either during open surgery as well as laparascopically. This application showed good haemostasis and minimal parenchymal damage. Oncological safety appears to be warranted by the use of diode laser. Further investigations and development are needed for on-line detection of the remain coagulation margin, optimisation of the treatment equipment, and finally to train the application technique.
Shared decision making in the safety net: where do we go from here?
Bouma, Angelique B; Tiedje, Kristina; Poplau, Sara; Boehm, Deborah H; Shah, Nilay D; Commers, Matthew J; Linzer, Mark; Montori, Victor M
2014-01-01
Shared decision making (SDM) is an interactive process between clinicians and patients in which both share information, deliberate together, and make clinical decisions. Clinics serving safety net patients face special challenges, including fewer resources and more challenging work environments. The use of SDM within safety net institutions has not been well studied. We recruited a convenience sample of 15 safety net primary care clinicians (13 physicians, 2 nurse practitioners). Each answered a 9-item SDM questionnaire and participated in a semistructured interview. From the transcribed interviews and questionnaire data, we identified themes and suggestions for introducing SDM into a safety net environment. Clinicians reported only partially fulfilling the central components of SDM (sharing information, deliberating, and decision making). Most clinicians expressed interest in SDM by stating that they "selected a treatment option together" with patients (8 of 15 in strong or complete agreement), but only a minority (3 of 15) "thoroughly weighed the different treatment options" together with patients. Clinicians attributed this gap to many barriers, including time pressure, overwhelming visit content, patient preferences, and lack of available resources. All clinicians believed that lack of time made it difficult to practice SDM. To increase use of SDM in the safety net, efficient SDM interventions designed for this environment, team care, and patient engagement in SDM will need further development. Future studies should focus on adapting SDM to safety net settings and determine whether SDM can reduce health care disparities.
Improving safety on rural local and tribal roads site safety analysis - user guide #1.
DOT National Transportation Integrated Search
2014-08-01
This User Guide presents an example of how rural local and Tribal practitioners can study conditions at a preselected site. It demonstrates the step-by-step safety analysis process presented in Improving Safety on Rural Local and Tribal Roads Saf...
DOT National Transportation Integrated Search
2010-12-01
This project mainly focuses on exit ramp performance analysis of safety and operations. In addition, issues of advance guide sign for exit ramp are also mentioned. : Safety analysis evaluates safety performances of different exit ramps used in Florid...
Ellison, Jonathan S; Montgomery, Jeffrey S; Wolf, J Stuart; Hafez, Khaled S; Miller, David C; Weizer, Alon Z
2012-07-01
Minimally invasive nephron sparing surgery is gaining popularity for small renal masses. Few groups have evaluated robot-assisted partial nephrectomy compared to other approaches using comparable patient populations. We present a matched pair analysis of a heterogeneous group of surgeons who performed robot-assisted partial nephrectomy and a single experienced laparoscopic surgeon who performed conventional laparoscopic partial nephrectomy. Perioperative outcomes and complications were compared. All 249 conventional laparoscopic and robot-assisted partial nephrectomy cases from January 2007 to June 2010 were reviewed from our prospectively maintained institutional database. Groups were matched 1:1 (108 matched pairs) by R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to polar lines) nephrometry score, transperitoneal vs retroperitoneal approach, patient age and hilar nature of the tumor. Statistical analysis was done to compare operative outcomes and complications. Matched analysis revealed that nephrometry score, age, gender, tumor side and American Society of Anesthesia physical status classification were similar. Operative time favored conventional laparoscopic partial nephrectomy. During the study period robot-assisted partial nephrectomy showed significant improvements in estimated blood loss and warm ischemia time compared to those of the experienced conventional laparoscopic group. Postoperative complication rates, and complication distributions by Clavien classification and type were similar for conventional laparoscopic and robot-assisted partial nephrectomy (41.7% and 35.0%, respectively). Robot-assisted partial nephrectomy has a noticeable but rapid learning curve. After it is overcome the robotic procedure results in perioperative outcomes similar to those achieved with conventional laparoscopic partial nephrectomy done by an experienced surgeon. Robot-assisted partial nephrectomy likely improves surgeon and patient accessibility to minimally invasive nephron sparing surgery. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Kane, Christopher
2013-02-01
Minimally invasive nephron sparing surgery is gaining popularity for small renal masses. Few groups have evaluated robot-assisted partial nephrectomy compared to other approaches using comparable patient populations. We present a matched pair analysis of a heterogeneous group of surgeons who performed robot-assisted partial nephrectomy and a single experienced laparoscopic surgeon who performed conventional laparoscopic partial nephrectomy. Perioperative outcomes and complications were compared. All 249 conventional laparoscopic and robot-assisted partial nephrectomy cases from January 2007 to June 2010 were reviewed from our prospectively maintained institutional database. Groups were matched 1:1 (108 matched pairs) by R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to polar lines) nephrometry score, transperitoneal vs retroperitoneal approach, patient age and hilar nature of the tumor. Statistical analysis was done to compare operative outcomes and complications. Matched analysis revealed that nephrometry score, age, gender, tumor side and American Society of Anesthesia physical status classification were similar. Operative time favored conventional laparoscopic partial nephrectomy. During the study period robot-assisted partial nephrectomy showed significant improvements in estimated blood loss and warm ischemia time compared to those of the experienced conventional laparoscopic group. Postoperative complication rates, and complication distributions by Clavien classification and type were similar for conventional laparoscopic and robot-assisted partial nephrectomy (41.7% and 35.0%, respectively). Robot-assisted partial nephrectomy has a noticeable but rapid learning curve. After it is overcome the robotic procedure results in perioperative outcomes similar to those achieved with conventional laparoscopic partial nephrectomy done by an experienced surgeon. Robot-assisted partial nephrectomy likely improves surgeon and patient accessibility to minimally invasive nephron sparing surgery. Copyright © 2013 Elsevier Inc. All rights reserved.
Infusing Reliability Techniques into Software Safety Analysis
NASA Technical Reports Server (NTRS)
Shi, Ying
2015-01-01
Software safety analysis for a large software intensive system is always a challenge. Software safety practitioners need to ensure that software related hazards are completely identified, controlled, and tracked. This paper discusses in detail how to incorporate the traditional reliability techniques into the entire software safety analysis process. In addition, this paper addresses how information can be effectively shared between the various practitioners involved in the software safety analyses. The author has successfully applied the approach to several aerospace applications. Examples are provided to illustrate the key steps of the proposed approach.
TRIAGE DOSE ASSESSMENT FOR PARTIAL-BODY EXPOSURE: DICENTRIC ANALYSIS
Moroni, Maria; Pellmar, Terry C.
2009-01-01
Partial-body biodosimetry is likely to be required after a radiological or nuclear exposure. Clinical signs and symptoms, distribution of dicentrics in circulating blood cells, organ-specific biomarkers, physical signals in teeth and nails all can provide indications of non-homogeneous exposures. Organ specific biomarkers may provide early warning regarding physiological systems at risk after radiation injury. Use of a combination of markers and symptoms will be needed for clinical insights for therapeutic approaches. Analysis of dicentrics, a marker specific for radiation injury, is the “Gold standard” of biodosimetry and can reveal partial-body exposures. Automation of sample processing for dicentric analysis can increase throughput with customization of off-the-shelf technologies for cytogenetic sample processing and information management. Automated analysis of the metaphase spreads is currently limited but improvements are in development. Our efforts bridge the technological gaps to allow the use of dicentric chromosome assay (DCA) for risk-based stratification of mass casualties. This article summarizes current knowledge on partial-body cytogenetic dose assessment synthesizing information leading to the proposal of an approach to triage dose prediction in radiation mass casualties, based on equivalent whole-body doses under partial-body exposure conditions and assesses the validity of using this model. An initial screening using only 20 metaphase spreads per subject can confirm irradiation above 2-Gy. A subsequent increase to 50 metaphases improves dose determination to allow risk stratification for clinical triage. Metaphases evaluated for inhomogeneous distribution of dicentrics can reveal partial-body exposures. We tested the validity of this approach in an in vitro model that simulates partial-body irradiation by mixing irradiated and un-irradiated lymphocytes in various proportions. Our preliminary results support the notion that this approach will be effective under a range of conditions including some partial-body exposures, but may have limitations with low doses or small proportions of irradiated body. Our studies address an important problem in the diagnosis of partial-body irradiation and dose assessment in mass casualties and propose a solution. However, additional work is needed to fully develop and validate the application of DCA to partial-body exposures. PMID:20065689
Katoulis, A C; Alevizou, A; Bozi, E; Makris, M; Zafeiraki, A; Mantas, N; Kousta, F; Mistidou, M; Kanelleas, A; Stavrianeas, N G
2010-07-01
Solar lentigines are common, benign, cosmetically disfiguring lesions. Available physical treatments are effective, but they are costly and carry risks of side-effects. To evaluate the efficacy and safety of a preparation containing undecylenoyl phenylalanine 2% in the topical treatment of solar lentigines. In total, 36 patients with solar lentigines of the hands were randomly assigned to apply the active preparation on one side and the vehicle alone on the other side, twice daily for 12 weeks. Patients were evaluated monthly for efficacy and safety. In all, 30 patients (28 women and 2 men; age range 47-75 years) completed the study. The duration of lesions ranged from 8 months to > 10 years. All patients responded partially on the side of the active treatment. Of the partial responders, 19 (63.3%) had moderate improvement and 11 (36.6%) had marked improvement. Improvement was evident from the first follow-up visit. On the side of the vehicle, 26 remained stable (86.6%) and 4 (13.3%) had partial improvement. There was a significant difference (P < 0.01) in efficacy of the active preparation vs. the vehicle. Using patient assessment ratings, 80% were 'much more satisfied/more satisfied' with the result. The reported side-effects were minor and included erythema and itching or burning on the side of active treatment. Undecylenoyl phenylalanine 2% is a novel depigmenting agent, which possibly acts as an alpha-melanocyte-stimulating hormone antagonist, thus inhibiting melaninogenesis. It achieved a significant lightening of the lesions with minimal side-effects. Most patients were satisfied with the improvement. Undecylenoyl phenylalanine 2% may represent a safe, effective and inexpensive therapeutic alternative for solar lentigines.
A New Flow-Diverter (the FloWise): In-Vivo Evaluation in an Elastase-Induced Rabbit Aneurysm Model.
Kim, Byung Moon; Kim, Dong Joon; Kim, Dong Ik
2016-01-01
We aimed to evaluate the efficacy and safety of a newly developed, partially retrievable flow-diverter (the FloWise) in an elastase-induced rabbit aneurysm model. We developed a partially retrievable flow diverter composed of 48 strands of Nitinol and platinum wire. The FloWise is compatible with any microcatheter of 0.027-inch inner diameter, and is retrievable up to 70% deployment. The efficacy and safety of the FloWise were evaluated in the elastase-induced rabbit aneurysm model. The rate of technical success (full coverage of aneurysm neck) and assessment of aneurysm occlusion and stent patency was conducted by angiograms and histologic examinations at the 1-month, 3-month, and 6-month follow-up. The patency of small arterial branches (intercostal or lumbar arteries) covered by the FloWise were also assessed in the 5 subjects. We attempted FloWise insertion in a total of 32 aneurysm models. FloWise placement was successful in 31 subjects (96.9%). Two stents (6.2%) were occluded at the 3-month follow-up, but there was no evidence of in-stent stenosis in other subjects. All stented aneurysms showed progressive occlusion: grade I (complete aneurysm occlusion) in 44.4% and grade II (aneurysm occlusion > 90%) in 55.6% at 1 month; grade I in 90% and II in 10% at 3 months; and grade I in 90% and II in 10% at 6 months. All small arterial branches covered by the FloWise remained patent. A newly developed, partially retrievable flow-diverter seems to be a safe and effective tool of aneurysm occlusion, as evaluated in the rabbit aneurysm model.
Morrow, Stephanie L; McGonagle, Alyssa K; Dove-Steinkamp, Megan L; Walker, Curtis T; Marmet, Matthew; Barnes-Farrell, Janet L
2010-09-01
The goals of this study were twofold: (1) to confirm a relationship between employee perceptions of psychological safety climate and safety behavior for a sample of workers in the rail industry and (2) to explore the relative strengths of relationships between specific facets of safety climate and safety behavior. Non-management rail maintenance workers employed by a large North American railroad completed a survey (n=421) regarding workplace safety perceptions and behaviors. Three facets of safety climate (management safety, coworker safety, and work-safety tension) were assessed as relating to individual workers' reported safety behavior. All three facets were significantly associated with safety behavior. Dominance analysis was used to assess the relative importance of each facet as related to the outcome, and work-safety tension evidenced the strongest relationship with safety behavior. Published by Elsevier Ltd.
Gambarota, Giulio; Hitti, Eric; Leporq, Benjamin; Saint-Jalmes, Hervé; Beuf, Olivier
2017-01-01
Tissue perfusion measurements using intravoxel incoherent motion (IVIM) diffusion-MRI are of interest for investigations of liver pathologies. A confounding factor in the perfusion quantification is the partial volume between liver tissue and large blood vessels. The aim of this study was to assess and correct for this partial volume effect in the estimation of the perfusion fraction. MRI experiments were performed at 3 Tesla with a diffusion-MRI sequence at 12 b-values. Diffusion signal decays in liver were analyzed using the non-negative least square (NNLS) method and the biexponential fitting approach. In some voxels, the NNLS analysis yielded a very fast-decaying component that was assigned to partial volume with the blood flowing in large vessels. Partial volume correction was performed by biexponential curve fitting, where the first data point (b = 0 s/mm 2 ) was eliminated in voxels with a very fast-decaying component. Biexponential fitting with partial volume correction yielded parametric maps with perfusion fraction values smaller than biexponential fitting without partial volume correction. The results of the current study indicate that the NNLS analysis in combination with biexponential curve fitting allows to correct for partial volume effects originating from blood flow in IVIM perfusion fraction measurements. Magn Reson Med 77:310-317, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
14 CFR 417.405 - Ground safety analysis.
Code of Federal Regulations, 2013 CFR
2013-01-01
... qualified to perform the ground safety analysis through training, education, and experience. (c) A launch... unfenced boundary of an entire industrial complex or multi-user launch site. A launch location hazard may.... (j) A launch operator must verify all information in a ground safety analysis, including design...
14 CFR 417.405 - Ground safety analysis.
Code of Federal Regulations, 2014 CFR
2014-01-01
... qualified to perform the ground safety analysis through training, education, and experience. (c) A launch... unfenced boundary of an entire industrial complex or multi-user launch site. A launch location hazard may.... (j) A launch operator must verify all information in a ground safety analysis, including design...
14 CFR 417.405 - Ground safety analysis.
Code of Federal Regulations, 2012 CFR
2012-01-01
... qualified to perform the ground safety analysis through training, education, and experience. (c) A launch... unfenced boundary of an entire industrial complex or multi-user launch site. A launch location hazard may.... (j) A launch operator must verify all information in a ground safety analysis, including design...
Code of Federal Regulations, 2010 CFR
2010-01-01
... one analysis must be compatible in form and content with the data input requirements of any other... TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.205 General. (a) Public risk management. A flight safety analysis must demonstrate that a launch operator will, for each launch, control the risk to...
Check-Cases for Verification of 6-Degree-of-Freedom Flight Vehicle Simulations. Volume 2; Appendices
NASA Technical Reports Server (NTRS)
Murri, Daniel G.; Jackson, E. Bruce; Shelton, Robert O.
2015-01-01
This NASA Engineering and Safety Center (NESC) assessment was established to develop a set of time histories for the flight behavior of increasingly complex example aerospacecraft that could be used to partially validate various simulation frameworks. The assessment was conducted by representatives from several NASA Centers and an open-source simulation project. This document contains details on models, implementation, and results.
Time-saving impact of an algorithm to identify potential surgical site infections.
Knepper, B C; Young, H; Jenkins, T C; Price, C S
2013-10-01
To develop and validate a partially automated algorithm to identify surgical site infections (SSIs) using commonly available electronic data to reduce manual chart review. Retrospective cohort study of patients undergoing specific surgical procedures over a 4-year period from 2007 through 2010 (algorithm development cohort) or over a 3-month period from January 2011 through March 2011 (algorithm validation cohort). A single academic safety-net hospital in a major metropolitan area. Patients undergoing at least 1 included surgical procedure during the study period. Procedures were identified in the National Healthcare Safety Network; SSIs were identified by manual chart review. Commonly available electronic data, including microbiologic, laboratory, and administrative data, were identified via a clinical data warehouse. Algorithms using combinations of these electronic variables were constructed and assessed for their ability to identify SSIs and reduce chart review. The most efficient algorithm identified in the development cohort combined microbiologic data with postoperative procedure and diagnosis codes. This algorithm resulted in 100% sensitivity and 85% specificity. Time savings from the algorithm was almost 600 person-hours of chart review. The algorithm demonstrated similar sensitivity on application to the validation cohort. A partially automated algorithm to identify potential SSIs was highly sensitive and dramatically reduced the amount of manual chart review required of infection control personnel during SSI surveillance.
Smith, Mark R; Eastman, Charmane I
2012-01-01
There are three mechanisms that may contribute to the health, performance, and safety problems associated with night-shift work: (1) circadian misalignment between the internal circadian clock and activities such as work, sleep, and eating, (2) chronic, partial sleep deprivation, and (3) melatonin suppression by light at night. The typical countermeasures, such as caffeine, naps, and melatonin (for its sleep-promoting effect), along with education about sleep and circadian rhythms, are the components of most fatigue risk-management plans. We contend that these, while better than nothing, are not enough because they do not address the underlying cause of the problems, which is circadian misalignment. We explain how to reset (phase-shift) the circadian clock to partially align with the night-work, day-sleep schedule, and thus reduce circadian misalignment while preserving sleep and functioning on days off. This involves controlling light and dark using outdoor light exposure, sunglasses, sleep in the dark, and a little bright light during night work. We present a diagram of a sleep-and-light schedule to reduce circadian misalignment in permanent night work, or a rotation between evenings and nights, and give practical advice on how to implement this type of plan. PMID:23620685
Ranking procedure for partial discriminant analysis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Beckman, R.J.; Johnson, M.E.
1981-09-01
A rank procedure developed by Broffitt, Randles, and Hogg (1976) is modified to control the conditional probability of misclassification given that classification has been attempted. This modification leads to a useful solution to the two-population partial discriminant analysis problem for even moderately sized training sets.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hurt, Christopher J.; Freels, James D.; Hobbs, Randy W.
There has been a considerable effort over the previous few years to demonstrate and optimize the production of plutonium-238 ( 238Pu) at the High Flux Isotope Reactor (HFIR). This effort has involved resources from multiple divisions and facilities at the Oak Ridge National Laboratory (ORNL) to demonstrate the fabrication, irradiation, and chemical processing of targets containing neptunium-237 ( 237Np) dioxide (NpO 2)/aluminum (Al) cermet pellets. A critical preliminary step to irradiation at the HFIR is to demonstrate the safety of the target under irradiation via documented experiment safety analyses. The steady-state thermal safety analyses of the target are simulated inmore » a finite element model with the COMSOL Multiphysics code that determines, among other crucial parameters, the limiting maximum temperature in the target. Safety analysis efforts for this model discussed in the present report include: (1) initial modeling of single and reduced-length pellet capsules in order to generate an experimental knowledge base that incorporate initial non-linear contact heat transfer and fission gas equations, (2) modeling efforts for prototypical designs of partially loaded and fully loaded targets using limited available knowledge of fabrication and irradiation characteristics, and (3) the most recent and comprehensive modeling effort of a fully coupled thermo-mechanical approach over the entire fully loaded target domain incorporating burn-up dependent irradiation behavior and measured target and pellet properties, hereafter referred to as the production model. These models are used to conservatively determine several important steady-state parameters including target stresses and temperatures, the limiting condition of which is the maximum temperature with respect to the melting point. The single pellet model results provide a basis for the safety of the irradiations, followed by parametric analyses in the initial prototypical designs that were necessary due to the limiting fabrication and irradiation data available. The calculated parameters in the final production target model are the most accurate and comprehensive, while still conservative. Over 210 permutations in irradiation time and position were evaluated, and are supported by the most recent inputs and highest fidelity methodology. The results of these analyses show that the models presented in this report provide a robust and reliable basis for previous, current and future experiment safety analyses. In addition, they reveal an evolving knowledge of the steady-state behavior of the NpO 2/Al pellets under irradiation for a variety of target encapsulations and potential conditions.« less
2014-01-01
Background Although abbreviated surgery with planned reoperation (damage control surgery) is now widely used to manage major trauma patients, the procedure and its component interventions have not been evaluated in randomized controlled trials (RCTs). While some have suggested the need for such trials, they are unlikely to be conducted because of patient safety concerns. As animal studies may overcome several of the limitations of existing observational damage control studies, the primary objective of this study is to evaluate the efficacy and safety of damage control versus definitive surgery in experimental animal models of injury. Methods/design We will search electronic databases (Medline, Embase, PubMed, Web of Science, Scopus, and the Cochrane Library), conference abstracts, personal files, and bibliographies of included articles. We will include RCTs and prospective cohort studies that utilized an animal model of injury and compared damage control surgery (or specific damage control interventions or adjuncts) to definitive surgery (or specific definitive surgical interventions). Two investigators will independently evaluate the internal and external/construct validity of individual studies. The primary outcome will be all-cause mortality. Secondary outcomes will include blood loss amounts; blood pressures and heart rates; urinary outputs; core body temperatures; arterial lactate, pH, and base deficit/excess values; prothrombin and partial thromboplastin times; international normalized ratios; and thromboelastography (TEG) results/activated clotting times. We will calculate summary relative risks (RRs) of mortality and mean differences (for continuous outcomes) using DerSimonian and Laird random effects models. Heterogeneity will be explored using subgroup meta-analysis and meta-regression. We will assess for publication bias using funnel plots and Begg’s and Egger’s tests. When evidence of publication bias exists, we will use the Duval and Tweedie trim and fill method to estimate the potential influence of this bias on pooled summary estimates. Discussion This study will evaluate the efficacy and safety of damage control in experimental animal models of injury. Study results will be used to guide future clinical evaluations of damage control surgery, determine which animal study outcomes may potentially be generalizable to the clinical setting, and to provide guidelines to strengthen the conduct and relevance of future pre-clinical studies. PMID:25416175
Lin, Cheng-Horng
2016-12-23
There are more than 7 million people living near the Tatun volcano group in northern Taiwan. For the safety of the Taipei metropolis, in particular, it has been debated for decades whether or not these volcanoes are active. Here I show evidence of a deep magma reservoir beneath the Taipei metropolis from both S-wave shadows and P-wave delays. The reservoir is probably composed of either a thin magma layer overlay or many molten sills within thick partially molten rocks. Assuming that 40% of the reservoir is partially molten, its total volume could be approximately 350 km 3 . The exact location and geometry of the magma reservoir will be obtained after dense seismic arrays are deployed in 2017-2020.
Yang, Haichen; Laurenza, Antonio; Williams, Betsy; Patten, Anna; Hussein, Ziad; Ferry, Jim
2015-08-01
Perampanel is a selective, noncompetitive AMPA receptor antagonist approved as adjunctive treatment for partial seizures. To assess potential for delayed cardiac repolarization, a Phase I thorough QT study was performed, supplemented by plasma concentration-QT data modeled from 3 pooled Phase III studies. The Phase I thorough QT study (double-blind, combined fixed-sequence, parallel-group) quantified the effect of perampanel (6 mg once daily for 7 days, followed by dose escalation to a single 8-mg dose, a single 10-mg dose, then 12 mg once daily for 7 days), moxifloxacin positive control (single 400-mg dose on Day 16), and placebo on QT interval duration in healthy subjects (N = 261). Electrocardiograms were recorded at baseline, Day 7 (post 6 mg dose), and Day 16 (post 12 mg dose). Statistical comparisons were between the highest approved perampanel dose (12 mg) versus placebo, a "mid-therapeutic" dose (6 mg) versus placebo, and moxifloxacin versus placebo. Acknowledging that the Phase I thorough QT study could not incorporate a true "supratherapeutic" dose due to length of titration and tolerability concerns in healthy subjects, Phase III studies of perampanel included expanded electrocardiogram safety evaluations specifically intended to support concentration-QT response modeling. The lack of effect of perampanel on the QT interval is shown from pooled analysis of 3 double-blind, placebo-controlled, 19-week, Phase III studies with perampanel doses ≤ 12 mg (N = 1038, total perampanel; and N=442, placebo) in patients with partial seizures. QT measures were corrected for heart rate using Fridericia's (QTcF; the primary endpoint) and Bazett's (QTcB) formulas. In the Phase I thorough QT study, the positive control moxifloxacin caused peak time-matched, baseline-adjusted, placebo-corrected (ΔΔ) QTcF of 12.15 ms at 4h postdose, confirming a drug effect on QTc interval and study assessment sensitivity. Mean baseline-adjusted (Δ) QTcF versus nominal time curves were comparable between perampanel 12 mg and placebo, with most ΔQTcF values being slightly negative. Healthy subjects receiving perampanel 6 and 12 mg doses for 7 days showed no evidence of effects on cardiac repolarization. Peak ΔΔQTcF was 2.34 ms at 1.5h postdose for perampanel 6 mg and 3.92 ms at 0.5h postdose for perampanel 12 mg. At every time point, the upper 95% confidence limit of ΔΔQTcF for perampanel 6 and 12 mg was <10 ms. Phase III studies revealed no clinically significant difference between patients with partial seizures treated with perampanel or placebo in QTcF and QTcB values >450 ms, with no dose-dependent increases or large incremental changes from baseline of >60 ms. Regression analysis of individual plasma perampanel concentrations versus corresponding QTc interval values in Phase I thorough QT and Phase III studies demonstrated no relationship between perampanel concentrations and QT interval duration. Treatment with perampanel 6 mg and 12 mg for 7 days did not delay cardiac repolarization in healthy volunteers. In a population analysis of 1480 patients with partial seizures treated with perampanel doses ≤ 12 mg or placebo, no clinically significant trends in QT interval data were noted. Based on the thorough QT study and evaluations from pooled Phase III studies, there is no evidence of prolonged QT interval duration with perampanel treatment. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
10 CFR 72.248 - Safety analysis report updating.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 2 2010-01-01 2010-01-01 false Safety analysis report updating. 72.248 Section 72.248 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR THE INDEPENDENT STORAGE OF... Approval of Spent Fuel Storage Casks § 72.248 Safety analysis report updating. (a) Each certificate holder...
Reliability Modeling Methodology for Independent Approaches on Parallel Runways Safety Analysis
NASA Technical Reports Server (NTRS)
Babcock, P.; Schor, A.; Rosch, G.
1998-01-01
This document is an adjunct to the final report An Integrated Safety Analysis Methodology for Emerging Air Transport Technologies. That report presents the results of our analysis of the problem of simultaneous but independent, approaches of two aircraft on parallel runways (independent approaches on parallel runways, or IAPR). This introductory chapter presents a brief overview and perspective of approaches and methodologies for performing safety analyses for complex systems. Ensuing chapter provide the technical details that underlie the approach that we have taken in performing the safety analysis for the IAPR concept.
Demonstration of a Safety Analysis on a Complex System
NASA Technical Reports Server (NTRS)
Leveson, Nancy; Alfaro, Liliana; Alvarado, Christine; Brown, Molly; Hunt, Earl B.; Jaffe, Matt; Joslyn, Susan; Pinnell, Denise; Reese, Jon; Samarziya, Jeffrey;
1997-01-01
For the past 17 years, Professor Leveson and her graduate students have been developing a theoretical foundation for safety in complex systems and building a methodology upon that foundation. The methodology includes special management structures and procedures, system hazard analyses, software hazard analysis, requirements modeling and analysis for completeness and safety, special software design techniques including the design of human-machine interaction, verification, operational feedback, and change analysis. The Safeware methodology is based on system safety techniques that are extended to deal with software and human error. Automation is used to enhance our ability to cope with complex systems. Identification, classification, and evaluation of hazards is done using modeling and analysis. To be effective, the models and analysis tools must consider the hardware, software, and human components in these systems. They also need to include a variety of analysis techniques and orthogonal approaches: There exists no single safety analysis or evaluation technique that can handle all aspects of complex systems. Applying only one or two may make us feel satisfied, but will produce limited results. We report here on a demonstration, performed as part of a contract with NASA Langley Research Center, of the Safeware methodology on the Center-TRACON Automation System (CTAS) portion of the air traffic control (ATC) system and procedures currently employed at the Dallas/Fort Worth (DFW) TRACON (Terminal Radar Approach CONtrol). CTAS is an automated system to assist controllers in handling arrival traffic in the DFW area. Safety is a system property, not a component property, so our safety analysis considers the entire system and not simply the automated components. Because safety analysis of a complex system is an interdisciplinary effort, our team included system engineers, software engineers, human factors experts, and cognitive psychologists.
NASA Technical Reports Server (NTRS)
1992-01-01
A Preliminary Safety Analysis (PSA) is being accomplished as part of the Space Station Furnace Facility (SSFF) contract. This analysis is intended to support SSFF activities by analyzing concepts and designs as they mature to develop essential safety requirements for inclusion in the appropriate specifications, and designs, as early as possible. In addition, the analysis identifies significant safety concerns that may warrant specific trade studies or design definition, etc. The analysis activity to date concentrated on hazard and hazard cause identification and requirements development with the goal of developing a baseline set of detailed requirements to support trade study, specifications development, and preliminary design activities. The analysis activity will continue as the design and concepts mature. Section 2 defines what was analyzed, but it is likely that the SSFF definitions will undergo further changes. The safety analysis activity will reflect these changes as they occur. The analysis provides the foundation for later safety activities. The hazards identified will in most cases have Preliminary Design Review (PDR) applicability. The requirements and recommendations developed for each hazard will be tracked to ensure proper and early resolution of safety concerns.
Defining attributes of patient safety through a concept analysis.
Kim, Linda; Lyder, Courtney H; McNeese-Smith, Donna; Leach, Linda Searle; Needleman, Jack
2015-11-01
The aim of this study was to report an analysis of the concept of patient safety. Despite recent increase in the number of work being done to clarify the concept and standardize measurement of patient safety, there are still huge variations in how the term is conceptualized and how to measure patient safety data across various healthcare settings and in research. Concept analysis. A literature search was conducted through PubMed and Cumulative Index to Nursing and Allied Health Literature, Plus using the terms 'patient safety' in the title and 'concept analysis,' 'attributes' or 'definition' in the title and or abstract. All English language literature published between 2002-2014 were considered for the review. Walker and Avant's method guided this analysis. The defining attributes of patient safety include prevention of medical errors and avoidable adverse events, protection of patients from harm or injury and collaborative efforts by individual healthcare providers and a strong, well-integrated healthcare system. The application of Collaborative Alliance of Nursing Outcomes indicators as empirical referents would facilitate the measurement of patient safety. With the knowledge gained from this analysis, nurses may improve patient surveillance efforts that identify potential hazards before they become adverse events and have a stronger voice in health policy decision-making that influence implementation efforts aimed at promoting patient safety, worldwide. Further studies are needed on development of a conceptual model and framework that can aid with collection and measurement of standardized patient safety data. © 2015 John Wiley & Sons Ltd.
Mahalingam, Devalingam; Mita, Monica; Sarantopoulos, John; Wood, Leslie; Amaravadi, Ravi K; Davis, Lisa E; Mita, Alain C; Curiel, Tyler J; Espitia, Claudia M; Nawrocki, Steffan T; Giles, Francis J; Carew, Jennifer S
2014-08-01
We previously reported that inhibition of autophagy significantly augmented the anticancer activity of the histone deacetylase (HDAC) inhibitor vorinostat (VOR) through a cathepsin D-mediated mechanism. We thus conducted a first-in-human study to investigate the safety, preliminary efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) of the combination of the autophagy inhibitor hydroxychloroquine (HCQ) and VOR in patients with advanced solid tumors. Of 27 patients treated in the study, 24 were considered fully evaluable for study assessments and toxicity. Patients were treated orally with escalating doses of HCQ daily (QD) (d 2 to 21 of a 21-d cycle) in combination with 400 mg VOR QD (d one to 21). Treatment-related adverse events (AE) included grade 1 to 2 nausea, diarrhea, fatigue, weight loss, anemia, and elevated creatinine. Grade 3 fatigue and/or myelosuppression were observed in a minority of patients. Fatigue and gastrointestinal AE were dose-limiting toxicities. Six-hundred milligrams HCQ and 400 mg VOR was established as the maximum tolerated dose and recommended phase II regimen. One patient with renal cell carcinoma had a confirmed durable partial response and 2 patients with colorectal cancer had prolonged stable disease. The addition of HCQ did not significantly impact the PK profile of VOR. Treatment-related increases in the expression of CDKN1A and CTSD were more pronounced in tumor biopsies than peripheral blood mononuclear cells. Based on the safety and preliminary efficacy of this combination, additional clinical studies are currently being planned to further investigate autophagy inhibition as a new approach to increase the efficacy of HDAC inhibitors.
Warad, Deepti; Rao, Amulya Nageswara; Mullikin, Trey; Graner, Kevin; Shaughnessy, William J; Pruthi, Rajiv K; Rodriguez, Vilmarie
2015-08-01
Dalteparin is a commonly used low molecular weight heparin (LMWH) with extensive safety data in adults. With distinct advantages of once daily dosing and relative safety in renal impairment, it has been used off-label in pediatric practice; however, age-based dosing guidelines, safety and efficacy data in children are evolving. To report our institutional experience with the use of dalteparin in the treatment and prophylaxis of venous thromboembolism (VTE) in pediatric patients. Retrospective chart review of all children (0-18years) that received dalteparin from December 1, 2000 through December 31, 2011. Doses per unit body weight per day (units/kg/day) were calculated for age-based group comparisons. Of 166 patients identified, 116 (70%) received prophylactic doses while 50 (30%) received therapeutic doses of dalteparin. Infants (<1year) required significantly higher weight-based dosing to achieve therapeutic anti-Xa levels compared to children (1-10years) or adolescents (>10-18years) (mean dose units/kg/day; 396.6 versus 236.7 and 178.8 respectively, p<0.0001). Overall response rate, including complete and partial thrombus resolution, was 83%. Bleeding complications were minor and the rates were similar in therapeutic and prophylaxis patients. No significant differences in dosing or bleeding events were noted based on obesity or malignancy. In our experience, dalteparin is effective for prophylaxis and therapy of VTE in pediatric patients. Dosing should be customized in an age-based manner with close monitoring of anti-Xa activity in order to achieve optimal levels, prevent bleeding complications, and to allow full benefit of prevention or therapy of thrombotic complications. Copyright © 2015 Elsevier Ltd. All rights reserved.
Masuda, Norikazu; Iwata, Hiroji; Aogi, Kenjiro; Xu, Yihuan; Ibrahim, Ayman; Gao, Ling; Dalal, Rita; Yoshikawa, Reigetsu; Sasaki, Yasutsuna
2016-12-01
The primary objective of this study was to investigate the safety and tolerability and to confirm the recommended dose of the anti-vascular endothelial growth factor receptor 2 monoclonal antibody ramucirumab in combination with docetaxel in Japanese patients with metastatic/locally advanced breast cancer. In this multicenter, single-arm, Phase Ib trial, eligibility criteria included: 20 years or older, Eastern Cooperative Oncology Group performance status of 0/1 and confirmed diagnosis of human epidermal growth factor receptor 2-negative metastatic/locally recurrent inoperable breast adenocarcinoma. Patients received docetaxel (75 mg/m 2 ) followed by ramucirumab (10 mg/kg) on Day 1 of 21-day cycles. Recommended dose was defined as <33% dose-limiting toxicities in dose-limiting toxicity-evaluable patients in Cycle 1. The safety, pharmacokinetics, immunogenicity and antitumor activity were examined. Seven patients were treated. Most adverse events were mild to moderate. Two patients during Cycle 1 experienced a dose-limiting toxicity; one patient each experienced Grade 3 febrile neutropenia and Grade 3 gingivitis. Both dose-limiting toxicities subsequently resolved. No patients discontinued study therapies during Cycle 1. Four serious adverse events were possibly related to ramucirumab in combination with docetaxel. Anti-ramucirumab antibodies were not detected. Pharmacokinetic analysis revealed low total body clearance and long apparent terminal elimination half-life (~7-12 days). Partial response was reported in four patients. The combination of ramucirumab and docetaxel was tolerable in female Japanese patients with breast cancer. Ramucirumab 10 mg/kg in combination with docetaxel (75 mg/m 2 ) was confirmed as the recommended dose among Japanese patients, supporting its use in future studies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Bainbridge, Jacquelyn; De Backer, Marc; Eckhardt, Klaus; Tennigkeit, Frank; Bongardt, Sabine; Sen, David; Werhahn, Konrad J; Shaibani, Aziz; Faught, Edward
2017-12-01
To assess the safety profile of lacosamide monotherapy in elderly (≥65 years) subjects with diabetic neuropathic pain (DNP). Of 1,863 DNP subjects in double-blind, randomized, placebo-controlled trials of lacosamide monotherapy (NCT00861445, NCT00235469, NCT00238524, NCT00135109, NCT00350103), 502 were elderly. Safety data from elderly subjects were compared with that of younger subjects (<65 years) within these DNP trials. It should be noted that lacosamide is approved for the treatment of focal (partial-onset) seizures; it is not approved/recommended for the treatment of DNP. Overall, cardiovascular diseases were prevalent in the DNP population, as was the use of cardiac, blood pressure, diabetes, and cholesterol-lowering medications among both young and elderly subjects. The most frequently reported adverse events (AEs) for lacosamide monotherapy (200, 400, and 600 mg/day combined) in elderly versus younger subjects were dizziness (16.2% vs. 13.2%), nausea (10.0% vs. 9.4%), and headache (8.0% vs. 8.7%). Incidences of cardiac disorder AEs were higher in elderly versus younger subjects receiving placebo (6.2% vs. 3.9%), lacosamide 200 (4.8% vs. 3.3%), lacosamide 400 (7.0% vs. 4.1%), and lacosamide 600 mg/day (7.7% vs. 4.0%). Discontinuation rates because of any AE in the elderly versus younger subjects were similar for placebo (8.8% vs. 7.0%) and lacosamide 200 mg/day (9.6% vs. 11.9%) and higher for lacosamide 400 (25.1% vs. 10.8%) and lacosamide 600 mg/day (52.7% vs. 28.3%). Lacosamide monotherapy was well tolerated in elderly subjects with DNP, with an overall AE profile consistent with that reported in epilepsy trials.
Barata, Pedro C; Gopalakrishnan, Dhrmesh; Koshkin, Vadim S; Mendiratta, Prateek; Karafa, Matt; Allman, Kimberly; Martin, Allison; Beach, Jennifer; Profusek, Pam; Tyler, Allison; Wood, Laura; Ornstein, Moshe; Gilligan, Timothy; Rini, Brian I; Garcia, Jorge A; Grivas, Petros
2018-04-06
Little is known about the outcomes, safety, and response to subsequent therapies of patients with metastatic urothelial carcinoma (mUC) treated with atezolizumab outside clinical trials. The objectives of the study include to report the clinical efficacy and safety of atezolizumab, and the response to future therapies in clinical practice outside clinical trials. This is a retrospective, single-center study including consecutive patients with confirmed mUC who received at least one dose of atezolizumab 1200 mg every 3 weeks between May 2016 and April 2017. Seventy-nine patients, median age 72 years (range 29-93), 71% men and 76% ECOG PS 0-1, were identified. Most patients (79%) had primary cancer in the bladder, 62% had prior surgery, and 75% received at least one prior line of treatment (34 patients had prior cisplatin-based chemotherapy). Best response included 18% partial response, 29% stable disease, and 53% progressive disease. Patients were on atezolizumab for a median of 2.7 months (95%CI, 1.8-3.6) and median PFS was 3.2 months (95%CI, 1.6-4.8). A total of 33 (42%) patients had significant (any cause) AEs, including grade 4 hyperbilirubinemia in two patients; no toxic deaths were reported. At time of data analysis, only 18% of patients received at least one subsequent line of treatment for a median of 1.8 months (95%CI, 0.0-5.0) while 42% were referred to palliative care/hospice or died. Patients with mUC who progressed on atezolizumab were unlikely to receive subsequent systemic treatments and the benefit of those treatments appeared limited in our cohort. The findings may impact timing and designs of clinical trials in mUC.
European Workshop Industrical Computer Science Systems approach to design for safety
NASA Technical Reports Server (NTRS)
Zalewski, Janusz
1992-01-01
This paper presents guidelines on designing systems for safety, developed by the Technical Committee 7 on Reliability and Safety of the European Workshop on Industrial Computer Systems. The focus is on complementing the traditional development process by adding the following four steps: (1) overall safety analysis; (2) analysis of the functional specifications; (3) designing for safety; (4) validation of design. Quantitative assessment of safety is possible by means of a modular questionnaire covering various aspects of the major stages of system development.
Lyons, Vanessa E; Popejoy, Lori L
2014-02-01
The purpose of this study is to examine the effectiveness of surgical safety checklists on teamwork, communication, morbidity, mortality, and compliance with safety measures through meta-analysis. Four meta-analyses were conducted on 19 studies that met the inclusion criteria. The effect size of checklists on teamwork and communication was 1.180 (p = .003), on morbidity and mortality was 0.123 (p = .003) and 0.088 (p = .001), respectively, and on compliance with safety measures was 0.268 (p < .001). The results indicate that surgical safety checklists improve teamwork and communication, reduce morbidity and mortality, and improve compliance with safety measures. This meta-analysis is limited in its generalizability based on the limited number of studies and the inclusion of only published research. Future research is needed to examine possible moderating variables for the effects of surgical safety checklists.
Alvarez-Puebla, M J; Olaguibel, J M; Almudevar, E; Echegoyen, A A; Vela, C; de Esteban, B
2015-08-01
Eosinophilic asthma phenotype predicts good response to corticosteroids and associates to asthmatic exacerbations. Sputum induction by hypertonic saline (HS) inhalation is technically demanding. Bronchial hyperresponsiveness (BHR) to osmotic agents indirectly mirrors active airway inflammation. We compared the safety and ability of HS and mannitol to induce sputum and measure BHR. We evaluated the stability of inflammatory phenotypes. We studied 35 non-smoking asthmatics randomized to undergo HS and mannitol challenges on 2 days 1 week apart. Sputum was sampled for cell analysis and phenotyped as eosinophilic (≥3% eosinophils) and non-eosinophilic (<3%) asthma. Nineteen subjects had BHR to mannitol and nine of them also had BHR to HS. Drops in forced expiratory volume in 1 s were higher from HS challenge than from mannitol challenge. Adequate sputum samples were obtained from 80% subjects (68% mannitol and 71% HS). Eosinophils and macrophages from both challenges correlated. Neutrophils were higher in sputum from HS. Ninety percent samples were equally phenotyped with HS and mannitol. Fractional exhaled nitric oxide, sputum eosinophils and BHR correlated in both challenges. HS and mannitol showed similar capacity to produce valuable sputum samples. BHR to both osmotic stimuli partially resembled airway eosinophilic inflammation but mannitol was more sensitive than HS to assess BHR. Eosinophilic phenotype remained stable in most patients with both stimuli. © The Author(s) 2015.
Macarulla, T; Cervantes, A; Tabernero, J; Roselló, S; Van Cutsem, E; Tejpar, S; Prenen, H; Martinelli, E; Troiani, T; Laffranchi, B; Jego, V; von Richter, O; Ciardiello, F
2015-01-01
Background: The mitogen-activated protein kinase (MAPK) pathway has been implicated in the molecular pathogenesis of human cancers, including metastatic colorectal cancer (mCRC). This provides a rationale for the development of MAPK-targeted agents such as pimasertib. Methods: Patients with KRAS mutant mCRC were treated in the second-line setting with FOLFIRI (5-fluorouracil/folinic acid/irinotecan) plus pimasertib. The primary objective of the safety run-in phase was to determine the maximum-tolerated dose (MTD) and the recommended phase II dose of pimasertib combined with FOLFIRI. Results: Sixteen patients were enrolled in the trial. Ten and six patients were treated daily with 45 and 60 mg of pimasertib plus FOLFIRI, respectively. The MTD was considered to be 45 mg per day. The most common treatment-emergent adverse events were diarrhoea, nausea, vomiting, asthenia and skin/rash event. Of the 15 patients in the efficacy analysis group, two patients had partial response, nine patients had stable disease, three patients had progressive disease as their best overall response and one patient could not be evaluated. Conclusions: Dose escalation of pimasertib in combination with FOLFIRI was limited by toxicity. At the MTD of 45 mg per day, pimasertib was adequately tolerated in patients with mCRC and no unexpected or new safety signals or concerns were identified. PMID:25989270
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-31
..., are described in the final safety analysis report (FSAR). The staff safety evaluation documents the acceptability of these analyses, and it is the combination of the FSAR analyses and the staff safety evaluation... analysis, maintain their capability to perform their safety functions. Technical Specification Operability...
Xu, Chonggang; Gertner, George
2013-01-01
Fourier Amplitude Sensitivity Test (FAST) is one of the most popular uncertainty and sensitivity analysis techniques. It uses a periodic sampling approach and a Fourier transformation to decompose the variance of a model output into partial variances contributed by different model parameters. Until now, the FAST analysis is mainly confined to the estimation of partial variances contributed by the main effects of model parameters, but does not allow for those contributed by specific interactions among parameters. In this paper, we theoretically show that FAST analysis can be used to estimate partial variances contributed by both main effects and interaction effects of model parameters using different sampling approaches (i.e., traditional search-curve based sampling, simple random sampling and random balance design sampling). We also analytically calculate the potential errors and biases in the estimation of partial variances. Hypothesis tests are constructed to reduce the effect of sampling errors on the estimation of partial variances. Our results show that compared to simple random sampling and random balance design sampling, sensitivity indices (ratios of partial variances to variance of a specific model output) estimated by search-curve based sampling generally have higher precision but larger underestimations. Compared to simple random sampling, random balance design sampling generally provides higher estimation precision for partial variances contributed by the main effects of parameters. The theoretical derivation of partial variances contributed by higher-order interactions and the calculation of their corresponding estimation errors in different sampling schemes can help us better understand the FAST method and provide a fundamental basis for FAST applications and further improvements. PMID:24143037
Xu, Chonggang; Gertner, George
2011-01-01
Fourier Amplitude Sensitivity Test (FAST) is one of the most popular uncertainty and sensitivity analysis techniques. It uses a periodic sampling approach and a Fourier transformation to decompose the variance of a model output into partial variances contributed by different model parameters. Until now, the FAST analysis is mainly confined to the estimation of partial variances contributed by the main effects of model parameters, but does not allow for those contributed by specific interactions among parameters. In this paper, we theoretically show that FAST analysis can be used to estimate partial variances contributed by both main effects and interaction effects of model parameters using different sampling approaches (i.e., traditional search-curve based sampling, simple random sampling and random balance design sampling). We also analytically calculate the potential errors and biases in the estimation of partial variances. Hypothesis tests are constructed to reduce the effect of sampling errors on the estimation of partial variances. Our results show that compared to simple random sampling and random balance design sampling, sensitivity indices (ratios of partial variances to variance of a specific model output) estimated by search-curve based sampling generally have higher precision but larger underestimations. Compared to simple random sampling, random balance design sampling generally provides higher estimation precision for partial variances contributed by the main effects of parameters. The theoretical derivation of partial variances contributed by higher-order interactions and the calculation of their corresponding estimation errors in different sampling schemes can help us better understand the FAST method and provide a fundamental basis for FAST applications and further improvements.
Comparative study of various normal mode analysis techniques based on partial Hessians.
Ghysels, An; Van Speybroeck, Veronique; Pauwels, Ewald; Catak, Saron; Brooks, Bernard R; Van Neck, Dimitri; Waroquier, Michel
2010-04-15
Standard normal mode analysis becomes problematic for complex molecular systems, as a result of both the high computational cost and the excessive amount of information when the full Hessian matrix is used. Several partial Hessian methods have been proposed in the literature, yielding approximate normal modes. These methods aim at reducing the computational load and/or calculating only the relevant normal modes of interest in a specific application. Each method has its own (dis)advantages and application field but guidelines for the most suitable choice are lacking. We have investigated several partial Hessian methods, including the Partial Hessian Vibrational Analysis (PHVA), the Mobile Block Hessian (MBH), and the Vibrational Subsystem Analysis (VSA). In this article, we focus on the benefits and drawbacks of these methods, in terms of the reproduction of localized modes, collective modes, and the performance in partially optimized structures. We find that the PHVA is suitable for describing localized modes, that the MBH not only reproduces localized and global modes but also serves as an analysis tool of the spectrum, and that the VSA is mostly useful for the reproduction of the low frequency spectrum. These guidelines are illustrated with the reproduction of the localized amine-stretch, the spectrum of quinine and a bis-cinchona derivative, and the low frequency modes of the LAO binding protein. 2009 Wiley Periodicals, Inc.
Comparative Study of Various Normal Mode Analysis Techniques Based on Partial Hessians
GHYSELS, AN; VAN SPEYBROECK, VERONIQUE; PAUWELS, EWALD; CATAK, SARON; BROOKS, BERNARD R.; VAN NECK, DIMITRI; WAROQUIER, MICHEL
2014-01-01
Standard normal mode analysis becomes problematic for complex molecular systems, as a result of both the high computational cost and the excessive amount of information when the full Hessian matrix is used. Several partial Hessian methods have been proposed in the literature, yielding approximate normal modes. These methods aim at reducing the computational load and/or calculating only the relevant normal modes of interest in a specific application. Each method has its own (dis)advantages and application field but guidelines for the most suitable choice are lacking. We have investigated several partial Hessian methods, including the Partial Hessian Vibrational Analysis (PHVA), the Mobile Block Hessian (MBH), and the Vibrational Subsystem Analysis (VSA). In this article, we focus on the benefits and drawbacks of these methods, in terms of the reproduction of localized modes, collective modes, and the performance in partially optimized structures. We find that the PHVA is suitable for describing localized modes, that the MBH not only reproduces localized and global modes but also serves as an analysis tool of the spectrum, and that the VSA is mostly useful for the reproduction of the low frequency spectrum. These guidelines are illustrated with the reproduction of the localized amine-stretch, the spectrum of quinine and a bis-cinchona derivative, and the low frequency modes of the LAO binding protein. PMID:19813181
Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Skevas, Christos; Druchkiv, Vasyl; Katz, Toam; Linke, Stephan J.
2015-01-01
Purpose In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). Methods This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Results Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. Conclusion A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral. PMID:25875476
Hsiung, Chang; Pederson, Christopher G.; Zou, Peng; Smith, Valton; von Gunten, Marc; O’Brien, Nada A.
2016-01-01
Near-infrared spectroscopy as a rapid and non-destructive analytical technique offers great advantages for pharmaceutical raw material identification (RMID) to fulfill the quality and safety requirements in pharmaceutical industry. In this study, we demonstrated the use of portable miniature near-infrared (MicroNIR) spectrometers for NIR-based pharmaceutical RMID and solved two challenges in this area, model transferability and large-scale classification, with the aid of support vector machine (SVM) modeling. We used a set of 19 pharmaceutical compounds including various active pharmaceutical ingredients (APIs) and excipients and six MicroNIR spectrometers to test model transferability. For the test of large-scale classification, we used another set of 253 pharmaceutical compounds comprised of both chemically and physically different APIs and excipients. We compared SVM with conventional chemometric modeling techniques, including soft independent modeling of class analogy, partial least squares discriminant analysis, linear discriminant analysis, and quadratic discriminant analysis. Support vector machine modeling using a linear kernel, especially when combined with a hierarchical scheme, exhibited excellent performance in both model transferability and large-scale classification. Hence, ultra-compact, portable and robust MicroNIR spectrometers coupled with SVM modeling can make on-site and in situ pharmaceutical RMID for large-volume applications highly achievable. PMID:27029624
Overview of Energy Systems' safety analysis report programs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-03-01
The primary purpose of an Safety Analysis Report (SAR) is to provide a basis for judging the adequacy of a facility's safety. The SAR documents the safety analyses that systematically identify the hazards posed by the facility, analyze the consequences and risk of potential accidents, and describe hazard control measures that protect the health and safety of the public and employees. In addition, some SARs document, as Technical Safety Requirements (TSRs, which include Technical Specifications and Operational Safety Requirements), technical and administrative requirements that ensure the facility is operated within prescribed safety limits. SARs also provide conveniently summarized information thatmore » may be used to support procedure development, training, inspections, and other activities necessary to facility operation. This Overview of Energy Systems Safety Analysis Report Programs'' Provides an introduction to the programs and processes used in the development and maintenance of the SARs. It also summarizes some of the uses of the SARs within Energy Systems and DOE.« less
Nuclear Safety Information Center, Its Products and Services
ERIC Educational Resources Information Center
Buchanan, J. R.
1970-01-01
The Nuclear Safety Information Center (NSIC) serves as a focal point for the collection, analysis and dissemination of information related to safety problems encountered in the design, analysis, and operation of nuclear facilities. (Author/AB)
Software Safety Analysis of a Flight Guidance System
NASA Technical Reports Server (NTRS)
Butler, Ricky W. (Technical Monitor); Tribble, Alan C.; Miller, Steven P.; Lempia, David L.
2004-01-01
This document summarizes the safety analysis performed on a Flight Guidance System (FGS) requirements model. In particular, the safety properties desired of the FGS model are identified and the presence of the safety properties in the model is formally verified. Chapter 1 provides an introduction to the entire project, while Chapter 2 gives a brief overview of the problem domain, the nature of accidents, model based development, and the four-variable model. Chapter 3 outlines the approach. Chapter 4 presents the results of the traditional safety analysis techniques and illustrates how the hazardous conditions associated with the system trace into specific safety properties. Chapter 5 presents the results of the formal methods analysis technique model checking that was used to verify the presence of the safety properties in the requirements model. Finally, Chapter 6 summarizes the main conclusions of the study, first and foremost that model checking is a very effective verification technique to use on discrete models with reasonable state spaces. Additional supporting details are provided in the appendices.
Tu, Yu-Kang; Krämer, Nicole; Lee, Wen-Chung
2012-07-01
In the analysis of trends in health outcomes, an ongoing issue is how to separate and estimate the effects of age, period, and cohort. As these 3 variables are perfectly collinear by definition, regression coefficients in a general linear model are not unique. In this tutorial, we review why identification is a problem, and how this problem may be tackled using partial least squares and principal components regression analyses. Both methods produce regression coefficients that fulfill the same collinearity constraint as the variables age, period, and cohort. We show that, because the constraint imposed by partial least squares and principal components regression is inherent in the mathematical relation among the 3 variables, this leads to more interpretable results. We use one dataset from a Taiwanese health-screening program to illustrate how to use partial least squares regression to analyze the trends in body heights with 3 continuous variables for age, period, and cohort. We then use another dataset of hepatocellular carcinoma mortality rates for Taiwanese men to illustrate how to use partial least squares regression to analyze tables with aggregated data. We use the second dataset to show the relation between the intrinsic estimator, a recently proposed method for the age-period-cohort analysis, and partial least squares regression. We also show that the inclusion of all indicator variables provides a more consistent approach. R code for our analyses is provided in the eAppendix.
Mosberger, Rafael; Andreasson, Henrik; Lilienthal, Achim J
2014-09-26
This article presents a novel approach for vision-based detection and tracking of humans wearing high-visibility clothing with retro-reflective markers. Addressing industrial applications where heavy vehicles operate in the vicinity of humans, we deploy a customized stereo camera setup with active illumination that allows for efficient detection of the reflective patterns created by the worker's safety garments. After segmenting reflective objects from the image background, the interest regions are described with local image feature descriptors and classified in order to discriminate safety garments from other reflective objects in the scene. In a final step, the trajectories of the detected humans are estimated in 3D space relative to the camera. We evaluate our tracking system in two industrial real-world work environments on several challenging video sequences. The experimental results indicate accurate tracking performance and good robustness towards partial occlusions, body pose variation, and a wide range of different illumination conditions.
Mosberger, Rafael; Andreasson, Henrik; Lilienthal, Achim J.
2014-01-01
This article presents a novel approach for vision-based detection and tracking of humans wearing high-visibility clothing with retro-reflective markers. Addressing industrial applications where heavy vehicles operate in the vicinity of humans, we deploy a customized stereo camera setup with active illumination that allows for efficient detection of the reflective patterns created by the worker's safety garments. After segmenting reflective objects from the image background, the interest regions are described with local image feature descriptors and classified in order to discriminate safety garments from other reflective objects in the scene. In a final step, the trajectories of the detected humans are estimated in 3D space relative to the camera. We evaluate our tracking system in two industrial real-world work environments on several challenging video sequences. The experimental results indicate accurate tracking performance and good robustness towards partial occlusions, body pose variation, and a wide range of different illumination conditions. PMID:25264956
Use of aripiprazole for delirium in the elderly: a short review.
Kirino, Eiji
2015-03-01
The effects and tolerability of antipsychotics in delirium treatment remain controversial. Compared to other antipsychotics, aripiprazole differs in pharmacological activity because it exerts its effect as a dopamine D2 partial agonist. The guidelines of the American Psychiatric Association rank aripiprazole highly among antipsychotics with regard to safety, and this drug is likely to be useful for delirium treatment. Here, we reviewed the efficacy and safety of aripiprazole for delirium. The results of our literature review on the efficacy and safety of delirium treatments suggest that aripiprazole is an effective treatment option for delirium in the elderly. Aripiprazole is as effective as other antipsychotics in improving delirium symptoms, and it is safer because it is less likely to cause extrapyramidal symptoms, excessive sedation, and weight gain. However, these findings are based on only a few clinical studies of elderly patients with delirium. Therefore, further investigations are necessary. © 2014 The Author. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.
Safety analysis and review system (SARS) assessment report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Browne, E.T.
1981-03-01
Under DOE Order 5481.1, Safety Analysis and Review System for DOE Operations, safety analyses are required for DOE projects in order to ensure that: (1) potential hazards are systematically identified; (2) potential impacts are analyzed; (3) reasonable measures have been taken to eliminate, control, or mitigate the hazards; and (4) there is documented management authorization of the DOE operation based on an objective assessment of the adequacy of the safety analysis. This report is intended to provide the DOE Office of Plans and Technology Assessment (OPTA) with an independent evaluation of the adequacy of the ongoing safety analysis effort. Asmore » part of this effort, a number of site visits and interviews were conducted, and FE SARS documents were reviewed. The latter included SARS Implementation Plans for a number of FE field offices, as well as safety analysis reports completed for certain FE operations. This report summarizes SARS related efforts at the DOE field offices visited and evaluates the extent to which they fulfill the requirements of DOE 5481.1.« less
Food Insecurity and Glycemic Control Among Low-Income Patients With Type 2 Diabetes
Seligman, Hilary K.; Jacobs, Elizabeth A.; López, Andrea; Tschann, Jeanne; Fernandez, Alicia
2012-01-01
OBJECTIVE To determine whether food insecurity—the inability to reliably afford safe and nutritious food—is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes. RESEARCH DESIGN AND METHODS We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of 711 patients with diabetes in safety net health clinics. We then examined whether difficulty following a diabetic diet, self-efficacy, or emotional distress related to diabetes mediated the relationship between food insecurity and glycemic control. RESULTS The food insecurity prevalence in our sample was 46%. Food-insecure participants were significantly more likely than food-secure participants to have poor glycemic control, as defined by hemoglobin A1c ≥8.5% (42 vs. 33%; adjusted odds ratio 1.48 [95% CI 1.07–2.04]). Food-insecure participants were more likely to report difficulty affording a diabetic diet (64 vs. 49%, P < 0.001). They also reported lower diabetes-specific self-efficacy (P < 0.001) and higher emotional distress related to diabetes (P < 0.001). Difficulty following a healthy diet and emotional distress partially mediated the association between food insecurity and glycemic control. CONCLUSIONS Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. This risk may be partially attributable to increased difficulty following a diabetes-appropriate diet and increased emotional distress regarding capacity for successful diabetes self-management. Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting. PMID:22210570
Anti-TNF therapy for paediatric IBD: the Scottish national experience.
Cameron, F L; Wilson, M L; Basheer, N; Jamison, A; McGrogan, P; Bisset, W M; Gillett, P M; Russell, R K; Wilson, D C
2015-04-01
Biological agents are being increasingly used in the UK for paediatric-onset inflammatory bowel disease (PIBD) despite limited evidence and safety concerns. We evaluated effectiveness and safety in the clinical setting, highlighting drug cost pressures, using our national Scottish PIBD biological registry. Complete usage of the biological agents, infliximab (IFX) and adalimumab (ADA) for treatment of PIBD (in those aged <18 years) from 1 January 2000 to 30 September 2010 was collated from all treatments administered within the Scottish Paediatric Gastroenterology, Hepatology and Nutrition (PGHAN) national managed service network (all regional PGHAN centres and paediatric units within their associated district general hospitals). 132 children had biological therapy; 24 required both agents; 114 had Crohn's disease (CD), 16 had ulcerative colitis (UC) and 2 had IBD Unclassified (IBDU). 127 children received IFX to induce remission; 61 entered remission, 49 had partial response and 17 had no response. 72 were given maintenance IFX and 23 required dose escalation. 18 had infusion reactions and 27 had adverse events (infections/other adverse events). 29 had ADA to induce remission (28 CD and 1 UC), 24 after IFX; 10 entered remission, 12 had partial response and 7 had no response. All had maintenance; 19 required dose escalation. 12 children overall required hospitalisation due to drug toxicity. No deaths occurred with either IFX or ADA. Complete accrual of the Scottish nationwide 'real-life' experience demonstrates moderate effectiveness of anti tumour necrosis factor agents in severe PIBD but duration of effect is limited; significant financial issues (drug cost-need for dose escalation and/or multiple biological usage) and safety issues exist. 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.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-24
... 0584-AD65 School Food Safety Program Based on Hazard Analysis and Critical Control Point Principles... Safety Program Based on Hazard Analysis and Critical Control Point Principles (HACCP) was published on... of Management and Budget (OMB) cleared the associated information collection requirements (ICR) on...
Analysis of continuous beams with joint slip
L. A. Soltis
1981-01-01
A computer analysis with user guidelines to analyze partially continuous multi-span beams is presented. Partial continuity is due to rotational slip which occurs at spliced joints at the supports of continuous beams such as floor joists. Beam properties, loads, and joint slip are input; internal forces, reactions, and deflections are output.
A Framework for Assessment of Aviation Safety Technology Portfolios
NASA Technical Reports Server (NTRS)
Jones, Sharon M.; Reveley, Mary S.
2014-01-01
The programs within NASA's Aeronautics Research Mission Directorate (ARMD) conduct research and development to improve the national air transportation system so that Americans can travel as safely as possible. NASA aviation safety systems analysis personnel support various levels of ARMD management in their fulfillment of system analysis and technology prioritization as defined in the agency's program and project requirements. This paper provides a framework for the assessment of aviation safety research and technology portfolios that includes metrics such as projected impact on current and future safety, technical development risk and implementation risk. The paper also contains methods for presenting portfolio analysis and aviation safety Bayesian Belief Network (BBN) output results to management using bubble charts and quantitative decision analysis techniques.
Integrated Safety Risk Reduction Approach to Enhancing Human-Rated Spaceflight Safety
NASA Astrophysics Data System (ADS)
Mikula, J. F. Kip
2005-12-01
This paper explores and defines the current accepted concept and philosophy of safety improvement based on a Reliability enhancement (called here Reliability Enhancement Based Safety Theory [REBST]). In this theory a Reliability calculation is used as a measure of the safety achieved on the program. This calculation may be based on a math model or a Fault Tree Analysis (FTA) of the system, or on an Event Tree Analysis (ETA) of the system's operational mission sequence. In each case, the numbers used in this calculation are hardware failure rates gleaned from past similar programs. As part of this paper, a fictional but representative case study is provided that helps to illustrate the problems and inaccuracies of this approach to safety determination. Then a safety determination and enhancement approach based on hazard, worst case analysis, and safety risk determination (called here Worst Case Based Safety Theory [WCBST]) is included. This approach is defined and detailed using the same example case study as shown in the REBST case study. In the end it is concluded that an approach combining the two theories works best to reduce Safety Risk.
Multilevel model of safety climate for furniture industries.
Rodrigues, Matilde A; Arezes, Pedro M; Leão, Celina P
2015-01-01
Furniture companies can analyze their safety status using quantitative measures. However, the data needed are not always available and the number of accidents is under-reported. Safety climate scales may be an alternative. However, there are no validated Portuguese scales that account for the specific attributes of the furniture sector. The current study aims to develop and validate an instrument that uses a multilevel structure to measure the safety climate of the Portuguese furniture industry. The Safety Climate in Wood Industries (SCWI) model was developed and applied to the safety climate analysis using three different scales: organizational, group and individual. A multilevel exploratory factor analysis was performed to analyze the factorial structure. The studied companies' safety conditions were also analyzed. Different factorial structures were found between and within levels. In general, the results show the presence of a group-level safety climate. The scores of safety climates are directly and positively related to companies' safety conditions; the organizational scale is the one that best reflects the actual safety conditions. The SCWI instrument allows for the identification of different safety climates in groups that comprise the same furniture company and it seems to reflect those groups' safety conditions. The study also demonstrates the need for a multilevel analysis of the studied instrument.
Motorcoach and school bus fire safety analysis.
DOT National Transportation Integrated Search
2016-11-01
This report documents a motorcoach and school bus fire safety analysis performed by the John A. Volpe National Transportation Systems Center (Volpe) for the Federal Motor Carrier Safety Administration. This report aims to: 1) identify the causes, fre...
Tracking the use of onboard safety technologies across the truck fleet.
DOT National Transportation Integrated Search
2009-03-01
The Transportation Safety Analysis and the Automotive Analysis Divisons at the University of Michigan Transportation Research Institute (UMTRI) initiated the Onboard Safety Technologies project in 2007, supported by FMCSA, to collect detailed informa...
Motorcoach and school bus fire safety analysis : technology brief.
DOT National Transportation Integrated Search
2016-11-01
In 2009, the Federal Motor Carrier Safety Administration (FMCSA) published findings from a study entitled Motorcoach Fire Safety Analysis. The objective of this study was to gather and analyze information regarding the causes, frequency, and se...
Two nursing mothers treated with zonisamide: Should breast-feeding be avoided?
Ando, Hitoshi; Matsubara, Shigeki; Oi, Asako; Usui, Rie; Suzuki, Mitsuaki; Fujimura, Akio
2014-01-01
Zonisamide, an antiepileptic drug, is excreted into breast milk, but information regarding the safety of breast-feeding while using this drug is limited. We present the cases of two nursing mothers, taking 300 and 100 mg/day zonisamide. At 5 days after delivery, the milk concentrations and relative infant doses of the drug were 18.0 and 5.1 μg/mL, and 44 and 36%, respectively. In the first case, the mother fed colostrum and continued partial breast-feeding thus reducing the relative infant dose to 8%. The neonatal serum concentration of zonisamide declined to below the limit of detection at day 34 after birth. In the second case, the mother breast-fed partially until 2 weeks postpartum. No adverse effect was observed in the infants. These findings suggest that mothers taking zonisamide should not breast-feed exclusively, but may not have to avoid partial breast-feeding, with significant caution regarding adverse effects in infants. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.
Partial clinical response to anakinra in severe palmoplantar pustular psoriasis.
Tauber, M; Viguier, M; Alimova, E; Petit, A; Lioté, F; Smahi, A; Bachelez, H
2014-09-01
Palmoplantar pustular psoriasis is a clinical psoriasis variant characterised by a high impact on quality of life and poor response to biologics approved for plaque type psoriasis.The recombinant interleukin-1 (IL-1) receptor antagonist anakinra has been recently used for the treatment of isolated refractory cases of generalised pustular psoriasis with contrasted results. To report the clinical response in two patients treated with anakinra as salvage therapy in two patients with severe palmoplantar pustular psoriasis refractory to currently available antipsoriatic systemic therapies. Anakinra was given subcutaneously at the daily dose of 100 mg, and clinical response was evaluated using the palmoplantar psoriasis area and severity index (PPPASI). Only partial and transient responses were observed in both patients, who had to stop anakinra due to lack of efficacy and to side effects. Anakinra appears to provide only partial clinical improvement in refractory palmoplantar pustular psoriasis. Prospective clinical studies on larger populations are warranted to investigate more accurately both efficacy and safety of IL-1-inhibiting strategies in pustular psoriasis. © 2014 British Association of Dermatologists.
NASA Astrophysics Data System (ADS)
Rusyaman, E.; Parmikanti, K.; Chaerani, D.; Asefan; Irianingsih, I.
2018-03-01
One of the application of fractional ordinary differential equation is related to the viscoelasticity, i.e., a correlation between the viscosity of fluids and the elasticity of solids. If the solution function develops into function with two or more variables, then its differential equation must be changed into fractional partial differential equation. As the preliminary study for two variables viscoelasticity problem, this paper discusses about convergence analysis of function sequence which is the solution of the homogenous fractional partial differential equation. The method used to solve the problem is Homotopy Analysis Method. The results show that if given two real number sequences (αn) and (βn) which converge to α and β respectively, then the solution function sequences of fractional partial differential equation with order (αn, βn) will also converge to the solution function of fractional partial differential equation with order (α, β).
Mixture Rasch Models with Joint Maximum Likelihood Estimation
ERIC Educational Resources Information Center
Willse, John T.
2011-01-01
This research provides a demonstration of the utility of mixture Rasch models. Specifically, a model capable of estimating a mixture partial credit model using joint maximum likelihood is presented. Like the partial credit model, the mixture partial credit model has the beneficial feature of being appropriate for analysis of assessment data…
NASA Technical Reports Server (NTRS)
Zelkin, Natalie; Henriksen, Stephen
2011-01-01
This document is being provided as part of ITT's NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: "New ATM Requirements--Future Communications, C-Band and L-Band Communications Standard Development." ITT has completed a safety hazard analysis providing a preliminary safety assessment for the proposed L-band (960 to 1164 MHz) terrestrial en route communications system. The assessment was performed following the guidelines outlined in the Federal Aviation Administration Safety Risk Management Guidance for System Acquisitions document. The safety analysis did not identify any hazards with an unacceptable risk, though a number of hazards with a medium risk were documented. This effort represents a preliminary safety hazard analysis and notes the triggers for risk reassessment. A detailed safety hazards analysis is recommended as a follow-on activity to assess particular components of the L-band communication system after the technology is chosen and system rollout timing is determined. The security risk analysis resulted in identifying main security threats to the proposed system as well as noting additional threats recommended for a future security analysis conducted at a later stage in the system development process. The document discusses various security controls, including those suggested in the COCR Version 2.0.
Chawla, Anita J; Mytelka, Daniel S; McBride, Stephan D; Nellesen, Dave; Elkins, Benjamin R; Ball, Daniel E; Kalsekar, Anupama; Towse, Adrian; Garrison, Louis P
2014-01-01
Purpose To evaluate the advantages and disadvantages of pre-approval requirements for safety data to detect cardiovascular (CV) risk contained in the December 2008 U.S. Food and Drug Administration (FDA) guidance for developing type 2 diabetes drugs compared with the February 2008 FDA draft guidance from the perspective of diabetes population health. Methods We applied the incremental net health benefit (INHB) framework to quantify the benefits and risks of investigational diabetes drugs using a common survival metric (life-years [LYs]). We constructed a decision analytic model for clinical program development consistent with the requirements of each guidance and simulated diabetes drugs, some of which had elevated CV risk. Assuming constant research budgets, we estimate the impact of increased trial size on drugs investigated. We aggregate treatment benefit and CV risks for each approved drug over a 35-year horizon under each guidance. Results The quantitative analysis suggests that the December 2008 guidance adversely impacts diabetes population health. INHB was −1.80 million LYs, attributable to delayed access to diabetes therapies (−0.18 million LYs) and fewer drugs (−1.64 million LYs), but partially offset by reduced CV risk exposure (0.02 million LYs). Results were robust in sensitivity analyses. Conclusion The health outcomes impact of all potential benefits and risks should be evaluated in a common survival measure, including health gain from avoided adverse events, lost health benefits from delayed or forgone efficacious products, and impact of alternative policy approaches. Quantitative analysis of the December 2008 FDA guidance for diabetes therapies indicates that negative impact on patient health will result. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd. PMID:24892175
Chawla, Anita J; Mytelka, Daniel S; McBride, Stephan D; Nellesen, Dave; Elkins, Benjamin R; Ball, Daniel E; Kalsekar, Anupama; Towse, Adrian; Garrison, Louis P
2014-03-01
To evaluate the advantages and disadvantages of pre-approval requirements for safety data to detect cardiovascular (CV) risk contained in the December 2008 U.S. Food and Drug Administration (FDA) guidance for developing type 2 diabetes drugs compared with the February 2008 FDA draft guidance from the perspective of diabetes population health. We applied the incremental net health benefit (INHB) framework to quantify the benefits and risks of investigational diabetes drugs using a common survival metric (life-years [LYs]). We constructed a decision analytic model for clinical program development consistent with the requirements of each guidance and simulated diabetes drugs, some of which had elevated CV risk. Assuming constant research budgets, we estimate the impact of increased trial size on drugs investigated. We aggregate treatment benefit and CV risks for each approved drug over a 35-year horizon under each guidance. The quantitative analysis suggests that the December 2008 guidance adversely impacts diabetes population health. INHB was -1.80 million LYs, attributable to delayed access to diabetes therapies (-0 .18 million LYs) and fewer drugs (-1.64 million LYs), but partially offset by reduced CV risk exposure (0.02 million LYs). Results were robust in sensitivity analyses. The health outcomes impact of all potential benefits and risks should be evaluated in a common survival measure, including health gain from avoided adverse events, lost health benefits from delayed or for gone efficacious products, and impact of alternative policy approaches. Quantitative analysis of the December 2008 FDA guidance for diabetes therapies indicates that negative impact on patient health will result. Copyright © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.
van Halsema, Emo E; Wong Kee Song, Louis M; Baron, Todd H; Siersema, Peter D; Vleggaar, Frank P; Ginsberg, Gregory G; Shah, Pari M; Fleischer, David E; Ratuapli, Shiva K; Fockens, Paul; Dijkgraaf, Marcel G W; Rando, Giacomo; Repici, Alessandro; van Hooft, Jeanin E
2013-01-01
Temporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases. To evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases. Multicenter retrospective study. Six tertiary care centers in the United States and Europe. A total of 214 patients with benign esophageal diseases undergoing endoscopic stent removal. Endoscopic stent removal. Endoscopic techniques for stent removal, time to stent removal, and adverse events related to stent removal. A total of 214 patients underwent a total of 329 stent extractions. Stents were mainly placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents, 52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic stents. A total of 35 (10.6%) procedure-related adverse events were reported, including 7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs (P < .001) was a risk factor for adverse events during stent removal. Favorable factors for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194). Retrospective analysis, only tertiary care centers. With an acceptable major adverse event rate of 2.1%, esophageal stent removal in the setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse events caused by stent removal were not time dependent. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Cañas, Fernando; Möller, Hans-Jürgen
2010-09-01
Although atypical antipsychotics have beneficial efficacy and tolerance, non-adherence and partial adherence remain in patients treated for schizophrenia. Long-acting injectable or depot atypical antipsychotics offer better medication adherence and tolerability advantages. Currently, two drugs are available for the treatment of schizophrenia, risperidone long-acting injectable (RLAI) and olanzapine pamoate (OP). Short- and long-term safety and tolerability data on RLAI and OP from January 2006 through September 2009 were reviewed by performing Medline and PubMed searches, reviewing abstracts and poster presentations, and viewing available material from the FDA and European Medicines Agency. RLAI and OP show good short- and long-term safety when treating patients with schizophrenia, with uncommon discontinuation due to adverse effects. RLAI and OP data show rare problems with injection site reactions and patients exposed to injectable treatments prefer to continue injections. Infrequent but serious post-injection delirium sedation syndrome occurred after 1% of OP injections. Weight gain was generally higher among patients treated with OP versus RLAI. Healthcare providers, patients and family members should be made aware of the safety and benefits of long-acting injectable atypical antipsychotics in order to diminish the unnecessary restrictions of these therapies for patients with schizophrenia.
Armstrong, Gail E.; Dietrich, Mary; Norman, Linda; Barnsteiner, Jane; Mion, Lorraine
2016-01-01
Health care organizations have incorporated updated safety principles in the analysis of errors and in norms and standards. Yet no research exists that assesses bedside nurses’ perceived skills or attitudes toward updated safety concepts. The aims of this study were to develop a scale assessing nurses’ perceived skills and attitudes toward updated safety concepts, determine content validity, and examine internal consistency of the scale and subscales. Understanding nurses’ perceived skills and attitudes about safety concepts can be used in targeting strategies to enhance their safety practices. PMID:27479518
Armstrong, Gail E; Dietrich, Mary; Norman, Linda; Barnsteiner, Jane; Mion, Lorraine
Health care organizations have incorporated updated safety principles in the analysis of errors and in norms and standards. Yet no research exists that assesses bedside nurses' perceived skills or attitudes toward updated safety concepts. The aims of this study were to develop a scale assessing nurses' perceived skills and attitudes toward updated safety concepts, determine content validity, and examine internal consistency of the scale and subscales. Understanding nurses' perceived skills and attitudes about safety concepts can be used in targeting strategies to enhance their safety practices.
2016-09-01
an instituted safety program that utilizes a generic risk assessment method involving the 5-M (Mission, Man, Machine , Medium and Management) factor...the Safety core value is hinged upon three key principles—(1) each soldier has a crucial part to play, by adopting safety as a core value and making...it a way of life in his unit; (2) safety is an integral part of training, operations and mission success, and (3) safety is an individual, team and
Modelling safety of multistate systems with ageing components
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kołowrocki, Krzysztof; Soszyńska-Budny, Joanna
An innovative approach to safety analysis of multistate ageing systems is presented. Basic notions of the ageing multistate systems safety analysis are introduced. The system components and the system multistate safety functions are defined. The mean values and variances of the multistate systems lifetimes in the safety state subsets and the mean values of their lifetimes in the particular safety states are defined. The multi-state system risk function and the moment of exceeding by the system the critical safety state are introduced. Applications of the proposed multistate system safety models to the evaluation and prediction of the safty characteristics ofmore » the consecutive “m out of n: F” is presented as well.« less
Statewide crash analysis and forecasting.
DOT National Transportation Integrated Search
2008-11-20
There is a need for the development of safety analysis tools to allow Penn DOT to better assess the safety performance of road : segments in the Commonwealth. The project utilized a safety management system database at Penn DOT that integrates crash,...
NASA Astrophysics Data System (ADS)
Sarathi, R.; Giridhar, A. V.; Sethupathi, K.
2010-01-01
Liquid nitrogen (LN 2) is used as an insulant as well as coolant in high temperature superconducting power equipments. Particle contamination in liquid nitrogen is one of the major cause for formation of partial discharges during operation. An attempt has been made in the present study to understand the feasibility of using Ultra High Frequency (UHF) sensors for identification of partial discharge (PD) formed due to particle movement in liquid nitrogen under AC voltages. It is observed that the partial discharge formed in LN 2 radiates UHF signal. The results of the study indicate that the conventional partial discharge measurement and UHF peak amplitude measurement have direct correlation. The Phase Resolved Partial Discharge (PRPD) analysis indicates that the partial discharge formed due to particle movement occurs in the entire phase windows of the AC voltage. The PD magnitude increases with increase in applied voltage. The frequency content of UHF signal generated due to particle movement in liquid nitrogen under AC voltages lies in the range of 0.5-1.5 GHz. The UHF sensor output signal analyzed using spectrum analyzer by operating it in zero-span mode, indicates that burst type PD occurs due to particle movement.
Initial empirical analysis of nuclear power plant organization and its effect on safety performance
DOE Office of Scientific and Technical Information (OSTI.GOV)
Olson, J.; McLaughlin, S.D.; Osborn, R.N.
This report contains an analysis of the relationship between selected aspects of organizational structure and the safety-related performance of nuclear power plants. The report starts by identifying and operationalizing certain key dimensions of organizational structure that may be expected to be related to plant safety performance. Next, indicators of plant safety performance are created by combining existing performance measures into more reliable indicators. Finally, the indicators of plant safety performance using correlational and discriminant analysis. The overall results show that plants with better developed coordination mechanisms, shorter vertical hierarchies, and a greater number of departments tend to perform more safely.
ASIL determination for motorbike's Electronics Throttle Control System (ETCS) mulfunction
NASA Astrophysics Data System (ADS)
Zaman Rokhani, Fakhrul; Rahman, Muhammad Taqiuddin Abdul; Ain Kamsani, Noor; Sidek, Roslina Mohd; Saripan, M. Iqbal; Samsudin, Khairulmizam; Khair Hassan, Mohd
2017-11-01
Electronics Throttle Control System (ETCS) is the principal electronic unit in all fuel injection engine motorbike, augmenting the engine performance efficiency in comparison to the conventional carburetor based engine. ETCS is regarded as a safety-critical component, whereby ETCS malfunction can cause unintended acceleration or deceleration event, which can be hazardous to riders. In this study, Hazard Analysis and Risk Assessment, an ISO26262 functional safety standard analysis has been applied on motorbike's ETCS to determine the required automotive safety integrity level. Based on the analysis, the established automotive safety integrity level can help to derive technical and functional safety measures for ETCS development.
Partnerships: The Path to Improving Crisis Communication
2007-03-01
News Media Perceives Relationships with Public Safety.................32 Table 4. Public Safety SWOT Analysis ...opportunities and threats ( SWOT ) of the Seattle fire and police departments. The SWOT analysis is an assessment tool common to strategic planning for...requirements for training • Lack of strategic planning experience Table 4. Public Safety SWOT Analysis 46 Table 4 compares the strengths and
NASA Technical Reports Server (NTRS)
Gregory, J. C.
1986-01-01
Instrument design and data analysis expertise was provided in support of several space radiation monitoring programs. The Verification of Flight Instrumentation (VFI) program at NASA included both the Active Radiation Detector (ARD) and the Nuclear Radiation Monitor (NRM). Design, partial fabrication, calibration and partial data analysis capability to the ARD program was provided, as well as detector head design and fabrication, software development and partial data analysis capability to the NRM program. The ARD flew on Spacelab-1 in 1983, performed flawlessly and was returned to MSFC after flight with unchanged calibration factors. The NRM, flown on Spacelab-2 in 1985, also performed without fault, not only recording the ambient gamma ray background on the Spacelab, but also recording radiation events of astrophysical significance.
Ambiguities in model-independent partial-wave analysis
NASA Astrophysics Data System (ADS)
Krinner, F.; Greenwald, D.; Ryabchikov, D.; Grube, B.; Paul, S.
2018-06-01
Partial-wave analysis is an important tool for analyzing large data sets in hadronic decays of light and heavy mesons. It commonly relies on the isobar model, which assumes multihadron final states originate from successive two-body decays of well-known undisturbed intermediate states. Recently, analyses of heavy-meson decays and diffractively produced states have attempted to overcome the strong model dependences of the isobar model. These analyses have overlooked that model-independent, or freed-isobar, partial-wave analysis can introduce mathematical ambiguities in results. We show how these ambiguities arise and present general techniques for identifying their presence and for correcting for them. We demonstrate these techniques with specific examples in both heavy-meson decay and pion-proton scattering.
Correlations of π N partial waves for multireaction analyses
Doring, M.; Revier, J.; Ronchen, D.; ...
2016-06-15
In the search for missing baryonic resonances, many analyses include data from a variety of pion- and photon-induced reactions. For elastic πN scattering, however, usually the partial waves of the SAID (Scattering Analysis Interactive Database) or other groups are fitted, instead of data. We provide the partial-wave covariance matrices needed to perform correlated χ 2 fits, in which the obtained χ 2 equals the actual χ 2 up to nonlinear and normalization corrections. For any analysis relying on partial waves extracted from elastic pion scattering, this is a prerequisite to assess the significance of resonance signals and to assign anymore » uncertainty on results. Lastly, the influence of systematic errors is also considered.« less
Public Education and Outreach for Observing Solar Eclipses and Transits
NASA Astrophysics Data System (ADS)
Pasachoff, Jay M.
2015-08-01
The general public is often very interested in observing solar eclipses, with widespread attention from newspapers and other sources often available only days before the events. Recently, the 2012 eclipse's partial phases in Australia and the 2015 eclipse's partial phases throughout Europe as well as western Asia and northern Africa, were widely viewed. The 21 August 2017 eclipse, whose totality will sweep across the Continental United States from northwest to southeast, will have partial phases visible throughout the U.S., Canada, Mexico, Central America, and into South America. The 2019 and 2020 partial phases of total eclipses will be visible throughout South America, and partial phases from annular eclipses will be visible from other parts of the world. The 9 May 2016 transit of Mercury will be best visible from the Western Hemisphere, Europe, and Africa. Many myths and misunderstandings exist about the safety of observing partial phases, and it is our responsibility as astronomers and educators to transmit accurate information and to attempt the widest possible distribution of such information. The Working Group on Public Education at Eclipses and Transits, formerly of Commission 46 on Education and Development and now of New Commission 11, tries to coordinate the distribution of information. In collaboration with the Solar Division's Working Group on Solar Eclipses, their website at http://eclipses.info is a one-stop shop for accurate information on how to observe eclipses, why it is interesting to do so, where they will be visible (with links to online maps and weather statistics), and how encouraging students to observe eclipses can be inspirational for them, perhaps even leading them to realize that the Universe can be understood and therefore renewing the strength of their studies. Links to information about transits of Mercury and Venus are also included.
Yao, Mingyin; Yang, Hui; Huang, Lin; Chen, Tianbing; Rao, Gangfu; Liu, Muhua
2017-05-10
In seeking a novel method with the ability of green analysis in monitoring toxic heavy metals residue in fresh leafy vegetables, laser-induced breakdown spectroscopy (LIBS) was applied to prove its capability in performing this work. The spectra of fresh vegetable samples polluted in the lab were collected by optimized LIBS experimental setup, and the reference concentrations of cadmium (Cd) from samples were obtained by conventional atomic absorption spectroscopy after wet digestion. The direct calibration employing intensity of single Cd line and Cd concentration exposed the weakness of this calibration method. Furthermore, the accuracy of linear calibration can be improved a little by triple Cd lines as characteristic variables, especially after the spectra were pretreated. However, it is not enough in predicting Cd in samples. Therefore, partial least-squares regression (PLSR) was utilized to enhance the robustness of quantitative analysis. The results of the PLSR model showed that the prediction accuracy of the Cd target can meet the requirement of determination in food safety. This investigation presented that LIBS is a promising and emerging method in analyzing toxic compositions in agricultural products, especially combined with suitable chemometrics.
Fear extinction in the human brain: A meta-analysis of fMRI studies in healthy participants.
Fullana, Miquel A; Albajes-Eizagirre, Anton; Soriano-Mas, Carles; Vervliet, Bram; Cardoner, Narcís; Benet, Olívia; Radua, Joaquim; Harrison, Ben J
2018-05-01
The study of fear extinction represents an important example of translational neuroscience in psychiatry and promises to improve the understanding and treatment of anxiety and fear-related disorders. We present the results of a set of meta-analyses of human fear extinction studies in healthy participants, conducted with functional magnetic resonance imaging (fMRI) and reporting whole-brain results. Meta-analyses of fear extinction learning primarily implicate consistent activation of brain regions linked to threat appraisal and experience, including the dorsal anterior cingulate and anterior insular cortices. An overlapping anatomical result was obtained from the meta-analysis of extinction recall studies, except when studies directly compared an extinguished threat stimulus to an unextinguished threat stimulus (instead of a safety stimulus). In this latter instance, more consistent activation was observed in dorsolateral and ventromedial prefrontal cortex regions, together with other areas including the hippocampus. While our results partially support the notion of a shared neuroanatomy between human and rodent models of extinction processes, they also encourage an expanded account of the neural basis of human fear extinction. Copyright © 2018 Elsevier Ltd. All rights reserved.
Can a safety-in-numbers effect and a hazard-in-numbers effect co-exist in the same data?
Elvik, Rune
2013-11-01
Safety-in-numbers denotes a non-linear relationship between exposure (traffic volume) and the number of accidents, characterised by declining risk as traffic volume increases. There is safety-in-numbers when the number of accidents increases less than proportional to traffic volume, e.g. a doubling of traffic volume is associated with less than a doubling of the number of accidents. Hazard-in-numbers, a less-used concept, refers to the opposite effect: the number of accidents increases more than in proportion to traffic volume, e.g. is more than doubled when traffic volume is doubled. This paper discusses whether a safety-in-numbers effect and a hazard-in-numbers effect can co-exist in the same data. It is concluded that both effects can exist in a given data set. The paper proposes to make a distinction between partial safety-in-numbers and complete safety-in-numbers. Another issue that has been raised in discussions about the safety-in-numbers effect is whether the effect found in some studies is an artefact created by the way exposure was measured. The paper discusses whether measuring exposure as a rate or a share, e.g. kilometres travelled per inhabitant per year, will generate a safety-in-numbers effect as a statistical artefact. It is concluded that this is the case. The preferred measure of exposure is a count of the number of road users. The count should not be converted to a rate or to the share any group of road user contribute to total traffic volume. Copyright © 2013 Elsevier Ltd. All rights reserved.
Systemic safety project selection tool.
DOT National Transportation Integrated Search
2013-07-01
"The Systemic Safety Project Selection Tool presents a process for incorporating systemic safety planning into traditional safety management processes. The Systemic Tool provides a step-by-step process for conducting systemic safety analysis; conside...
TA-55 Final Safety Analysis Report Comparison Document and DOE Safety Evaluation Report Requirements
DOE Office of Scientific and Technical Information (OSTI.GOV)
Alan Bond
2001-04-01
This document provides an overview of changes to the currently approved TA-55 Final Safety Analysis Report (FSAR) that are included in the upgraded FSAR. The DOE Safety Evaluation Report (SER) requirements that are incorporated into the upgraded FSAR are briefly discussed to provide the starting point in the FSAR with respect to the SER requirements.
Updated analysis of NN elastic scattering to 3 GeV
NASA Astrophysics Data System (ADS)
Arndt, R. A.; Briscoe, W. J.; Strakovsky, I. I.; Workman, R. L.
2007-08-01
A partial-wave analysis of NN elastic scattering data has been updated to include a number of recent measurements. Experiments carried out at the Cooler Synchrotron (COSY) by the EDDA Collaboration have had a significant impact above 1 GeV. Results are discussed in terms of the partial-wave and direct-reconstruction amplitudes.
A root cause analysis project in a medication safety course.
Schafer, Jason J
2012-08-10
To develop, implement, and evaluate team-based root cause analysis projects as part of a required medication safety course for second-year pharmacy students. Lectures, in-class activities, and out-of-class reading assignments were used to develop students' medication safety skills and introduce them to the culture of medication safety. Students applied these skills within teams by evaluating cases of medication errors using root cause analyses. Teams also developed error prevention strategies and formally presented their findings. Student performance was assessed using a medication errors evaluation rubric. Of the 211 students who completed the course, the majority performed well on root cause analysis assignments and rated them favorably on course evaluations. Medication error evaluation and prevention was successfully introduced in a medication safety course using team-based root cause analysis projects.
System safety engineering analysis handbook
NASA Technical Reports Server (NTRS)
Ijams, T. E.
1972-01-01
The basic requirements and guidelines for the preparation of System Safety Engineering Analysis are presented. The philosophy of System Safety and the various analytic methods available to the engineering profession are discussed. A text-book description of each of the methods is included.
Roadway safety analysis methodology for Utah : final report.
DOT National Transportation Integrated Search
2016-12-01
This research focuses on the creation of a three-part Roadway Safety Analysis methodology that applies and automates the cumulative work of recently-completed roadway safety research. The first part is to prepare the roadway and crash data for analys...
NASA Astrophysics Data System (ADS)
Gentine, P.; Guerin, M. F.; von Arx, G.; Martin-Benito, D.; Griffin, K. L.; McDowell, N.; Pockman, W.; Andreu-Hayles, L.
2017-12-01
Recent droughts in the Southwest US have resulted in extensive mortality in the pinion pine population (Pinus Edulis). An important factor for resiliency is the ability of a plant to maintain a functional continuum between soil and leaves, allowing water's motion to be sustained or resumed. During droughts, loss of functional tracheids happens through embolism, which can be partially mitigated by increasing the hydraulic safety of the xylem. However, higher hydraulic safety is usually achieved by building narrower tracheids with thicker walls, resulting in a reduction of the hydraulic efficiency of the xylem (conductivity per unit area). Reduced efficiency constrains water transport, limits photosynthesis and might delay recovery after the drought. Supporting existing research on safety-efficiency tradeoff, we test the hypothesis that under dry conditions, isohydric pinions grow xylem that favor efficiency over safety. Using a seven-year experiment with three watering treatments (drought, control, irrigated) in New Mexico, we investigate the effect of drought on the xylem anatomy of pinions' branches. We also compare the treatment effect with interannual variations in xylem structure. We measure anatomical variables - conductivities, cell wall thicknesses, hydraulic diameter, cell reinforcement and density - and preliminarily conclude that treatment has little effect on hydraulic efficiency while hydraulic safety is significantly reduced under dry conditions. Taking advantage of an extremely dry year occurrence during the experiment, we find a sharp increase in vulnerability for xylem tissues built the same year.
NASA Technical Reports Server (NTRS)
Lee, Yeong-Heok (Editor); Bowen, Brent D. (Editor); Tarry, Scott E. (Editor)
2001-01-01
The ATRS held its Annual conference at Jeju Island, Korea in July 2001. The conference was a success with nearly 140 participants including 70 presenters. This report contains presentations from Volume 1 on the following: Airline and Travel Agent Relationships in Asia;Benchmarking Aviation Safety in the Commercial Airline Industry;Impact of Frequent Flyer Program on the Demand for Air Travel; Application of Genetic Algorithm on Airline Schedule;The Effects of Dual Carrier Designation and Partial Liberalization: The Case of Canada;Defense of Air Carriers and Air Agencies in FAA Enforcement proceedin gs - Damage Control Before the Case Arises; Cost Incentives for Airline Mergers? - An examination on the cost impact of U.S. airline mergers and acquisitions;Airport Regulation, Airline Competition and Canada's Airport System; Airline Competition: The Case of Israel's Domestic Doupoly; Non-Financial Indicators of Airline Distress: A Conceptual Approach;and Airport Privatization: An Empirical Analysis of Financial and Operational Efficiency.
DOE standard 3009 - a reasoned, practical approach to integrating criticality safety into SARs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vessard, S.G.
1995-12-31
In the past there have been efforts by the U.S. Department of Energy (DOE) to provide guidance on those elements that should be included in a facility`s safety analysis report (SAR). In particular, there are two DOE Orders (5480.23, {open_quotes}Nuclear Safety Analysis Reports,{close_quotes} and 5480.24, {open_quotes}Nuclear Criticality Safety{close_quotes}), an interpretive guidance document (NE-70, Interpretive Guidance for DOE Order 5480.24, {open_quotes}Nuclear Criticality Safety{close_quotes}), and DOE Standard DOE-STD-3009-94 {open_quotes}Preparation Guide for U.S. Department of Energy Nonreactor Nuclear Facility Safety Analysis Reports.{close_quotes} Of these, the most practical and useful (pertaining to the application of criticality safety) is DOE-STD-3009-94. This paper is a reviewmore » of Chapters 3, 4, and 6 of this standard and how they provide very clear, helpful, and reasoned criticality safety guidance.« less
Taghavi, F; Moosavi-Movahedi, A A; Bohlooli, M; Habibi-Rezaei, M; Hadi Alijanvand, H; Amanlou, M; Sheibani, N; Saboury, A A; Ahmad, F
2014-01-01
Sodium benzoate (SB), a powerful inhibitor of microbial growth, is one of the most commonly used food preservative. Here, we determined the effects of SB on human serum albumin (HSA) structure in the presence or absence of glucose after 35 days of incubation under physiological conditions. The biochemical, biophysical, and molecular approaches including free amine content assay (TNBSA assay), fluorescence, and circular dichroism spectroscopy (CD), differential scanning calorimetry (DSC), and molecular docking and LIGPLOT studies were utilized for structural studies. The TNBSA results indicated that SB has the ability to bind Lys residues in HSA through covalent bonds. The docking and LIGPLOT studies also determined another specific site via hydrophobic interactions. The CD results showed more structural helicity for HSA incubated with SB, while HSA incubated with glucose had the least, and HSA incubated with glucose + SB had medium helicity. Fluorescence spectrophotometry results demonstrated partial unfolding of HSA incubated with SB in the presence or absence of glucose, while maximum partial unfolding was observed in HSA incubated with glucose. These results were confirmed by DSC and its deconvoluted thermograms. The DSC results also showed significant changes in HSA energetic structural domains due to HSA incubation with SB in the presence or absence of glucose. Together, our studies showed the formation of three different intermediates and indicate that biomolecular investigation are effective in providing new insight into safety determinations especially in health-related conditions including diabetes.
NASA Astrophysics Data System (ADS)
Alzbutas, Robertas
2015-04-01
In general, the Emergency Planning Zones (EPZ) are defined as well as plant site and arrangement structures are designed to minimize the potential for natural and manmade hazards external to the plant from affecting the plant safety related functions, which can affect nearby population and environment. This may include consideration of extreme winds, fires, flooding, aircraft crash, seismic activity, etc. Thus the design basis for plant and site is deeply related to the effects of any postulated external events and the limitation of the plant capability to cope with accidents i.e. perform safety functions. It has been observed that the Probabilistic Safety Assessment (PSA) methodologies to deal with EPZ and extreme external events have not reached the same level of maturity as for severe internal events. The design basis for any plant and site is deeply related to the effects of any postulated external events and the limitation of the plant capability to cope with accidents i.e. perform safety functions. As a prime example of an advanced reactor and new Nuclear Power Plant (NPP) with enhanced safety, the International Reactor Innovative and Secure (IRIS) and Site selection for New NPP in Lithuania had been considered in this work. In the used Safety-by-Design™ approach, the PSA played obviously a key role; therefore a Preliminary IRIS PSA had been developed along with the design. For the design and pre-licensing process of IRIS the external events analysis included both qualitative evaluation and quantitative assessment. As a result of preliminary qualitative analyses, the external events that were chosen for more detailed quantitative scoping evaluation were high winds and tornadoes, aircraft crash, and seismic events. For the site selection in Lithuania a detail site evaluation process was performed and related to the EPZ and risk zoning considerations. In general, applying the quantitative assessment, bounding site characteristics could be used in order to optimize potential redefinition or future restrictions on plant siting and risk zoning. It must be noticed that the use of existing regulations and installations as the basis for this redefinition will not in any way impact the high degree of conservatism inherent in current regulations. Moreover, the remapping process makes this methodology partially independent from the uncertainties still affecting probabilistic techniques. Notwithstanding these considerations, it is still expected that applying this methodology to advanced plant designs with improved safety features will allow significant changes in the emergency planning requirements, and specifically the size of the EPZ. In particular, in the case of IRIS it is expected that taking full credit of the Safety-by-Design™ approach of the IRIS reactor will allow a dramatic changes in the EPZ, while still maintaining a level of protection to the public fully consistent with existing regulations.