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1
Cui, Wei, Bao Gang Zhao, Yang Liu, Si Yu Qian, Jia Ye, Hai Feng Yang, and Ya Jun Li. "A Research of CIM Model in Education Fields." Advanced Materials Research 267 (June 2011): 64–69. http://dx.doi.org/10.4028/www.scientific.net/amr.267.64.
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This article has been supported by Chinese National Natural Science Fund in 2010, “Strategy research of using supply chain partner’s knowledge in enterprise knowledge creation process”, Project approving code: 71072124. It was also supported by Fund of Liaoning Province reform of higher education "Research of service outsourcing personnel training mode" in 2007, Fund of Dalian Science and Technology Plan "Research of ways expanding Dalian outsourcing service industry market" in 2008, Fund of Dalian Science and Technology Plan "Research of Dalian comprehensive prediction system of electric power and energy" in 2009, Fund of Chongqing Electric Power Corporation "Research of Chongqing comprehensive prediction system of electric power and energy" in 2008 and Project of Dalian Maritime University reform of graduate education and teaching “Construction of teaching content system of Management Science and Engineering based on the platform of motion and internet of things ” in 2010.
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Peppercorn, Jeffrey M., Stephanie B. Wheeler, Kevin Houck, Bercedis Peterson, Victor Villagra, James Antetomaso, Adane Fekadu Wogu, and Gary H. Lyman. "Impact of copayment elimination on annual and biennial screening mammography utilization among rural U.S. women." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 6503. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.6503.
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6503 Background: Early detection of breast cancer through mammography screening leads to earlier stage at diagnosis and improved survival. Previous research has shown that rural American women are less likely to receive screening mammography compared to their urban counterparts. Copayments for mammography are a potential barrier to screening, and elimination of copayments may improve screening rates. We examined annual (aSMU) and biennial (bSMU) screening mammography utilization and the impact of copayment elimination among rural U.S. women. Methods: Using the insurance claims database of the National Rural Electric Cooperative Association (NRECA), which insures over 100,000 electrical workers and their families nationally, we identified all women ages 40 to 64 with no prior history of invasive breast cancer or DCIS (based on ICD-9 codes) and captured claims for aSMU and bSMU between 1999 and 2009. Changes in screening over time were assessed for the periods before and after NRECA elimination of copayments for screening mammography in January, 2006. Chi-squared tests were used to compare aSMU and bSMU rates by age group. All p-values are two-sided. Results: During this time period, over 20,000 women ages 40 to 64 received health insurance through NRECA each year. From 1999 to 2009, aSMU increased from 38.1% to 49.5%, while bSMU increased from 57.2% to 68.1%. Screening increased significantly following elimination of copayments in 2006 (p = 0.0004). Specifically, for the period 2006-2007 compared to 2004-2005, the percentage of women undergoing at least biennial screening increased from 60.9 to 68.8% (p < 0.0001), with absolute differences in screening by age ranging from an increase of 5.3% among women 40-45, to 10% among women 60 – 64. Conclusions: Evaluation of insurance claims data from rural US populations reveals that a large percentage of rural women ages 40 to 64 do not undergo even biennial breast cancer screening. Elimination of copayments improves both annual and biennial screening rates in all age groups, but does not eliminate all barriers. Further investigation is ongoing to understand financial and non-financial barriers to screening and attitudes towards current screening recommendations.
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Perrault, David, Danielle Rochlin, Christopher Pham, Arash Momeni, Yvonne Karanas, and Clifford C. Sheckter. "Timing of Flap Surgery in Acute Burn Patients Does Not Affect Complications." Journal of Burn Care & Research 41, no. 5 (June 25, 2020): 967–70. http://dx.doi.org/10.1093/jbcr/iraa096.
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Abstract Pedicled and free flaps are occasionally necessary to reconstruct complex wounds in acute burn patients. Flap coverage has classically been delayed for concern of progressive tissue necrosis and flap failure. We aim to investigate flap complications in primary burn care leveraging national U.S. data. Acute burn patients with known % total body surface area(TBSA) were extracted from the Nationwide/National Inpatient Sample from 2002 to 2014 based on the International Classification of Disease (ICD) codes, ninth edition. Variables included age, sex, race, Elixhauser index, %TBSA, mechanism, inhalation injury, and location of burn. Flap complication was defined by ICD-9 procedure code 86.75, return to the operating room for flap revision. Multivariable analysis evaluated predictors of flap compromise using stepwise logistic regression with backward elimination. The weighted sample included 306,924 encounters of which 526 received a flap (0.17%). About 7.8% of flap encounters sustained electric injury compared to 2.7% of non-flap encounters (odds ratio [OR] 3.76, 95% confidence interval [CI] 1.95–7.24, P < .001). The mean hospital day of the flap procedure was 10.1 (SD 10.7) days. Flap complications occurred in 6.4% of cases. The timing of flap coverage was not associated with complications. The only independent predictor of flap complication was electrical injury (OR 40.49, 95% CI 2.98–550.64, P = .005). Electrical injury was an independent predictor of flap complications compared to other mechanisms. Flap timing was not associated with return to surgery for complications. This suggests that the use of flaps is safe in acute burn care to achieve burn wound closure with an understanding that electrical injuries may warrant particular consideration to avoid failure.
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Pandey, M. D., V. Ho, S. Bedi, and S. B. Woodward. "Development of a condition assessment model for transmission line in-service wood crossarms." Canadian Journal of Civil Engineering 32, no. 3 (June 1, 2005): 480–89. http://dx.doi.org/10.1139/l04-114.
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Wood transmission structures, such as H frames, have been extensively used to support electrical transmission lines throughout Canada. The transmission infrastructure is in general aging, and fungal decay of wood crossarms poses a significant risk of failure under adverse weather conditions. A crossarm failure in the transmission system can result in forced outages and customer disruptions that lead to significant economic losses. This paper presents a condition assessment model to prioritize the replacement of transmission crossarms that are near the end of their service life. The proposed standard involves a visual condition rating system, which is validated by results of full-scale testing of a sample of in-service crossarms. Aerial inspection of transmission lines using the proposed visual rating system is a simple, economical, fast, and effective method of assessment. The proposed approach would ensure a more consistent compliance with the condition-based replacement standard specified in the Canadian (Canadian Standards Association Standard CSA 22.3 No. 1-01) and North American (US National Electric Safety Code 2002 edition) standards.Key words: transmission structure, wood crossarms, decay, condition assessment, full-scale testing, visual rating system, statistical data analysis, bending strength.
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Sheckter, Clifford C., David Perrault, Danielle H. Rochlin, Christopher H. Pham, and Yvonne L. Karanas. "105 The Impact of Flap Timing and Mechanism of Injury on Flap Complications in Acute Burn Patients." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S69—S70. http://dx.doi.org/10.1093/jbcr/iraa024.108.
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Abstract Introduction Burn wounds are often amenable to excision and grafting, but pedicled and free flaps are sometimes necessary to achieve closure of complex wounds. Flap coverage of exposed bone, tendons and cartilage has classicaly been delayed in acute burn patients due to concern of progressive tissue necrosis, microvascular thrombosis and percieved high failure rates. More recently, a number of reports have demonstrated that the use of flaps is safe earlier in acute burn care. We aim to elucidate the role of flaps in primary burn woud coverage leveraging national US data. Methods Acute burn patients with known % total body surface area were extracted from the Nationwide/National Inpatient Sample from 2002–2014 based on International Classification of Disease (ICD) Codes 9th edition. Flap procedures were identified based on ICD-9 procedure codes. Flap and non-flapped patients were compared using multivariable analysis. Variables included age, gender, race, Elixhauser comorbidity index, %TBSA, burn mechanism, inhalation injury, and location of burn. Flap complication was defined by ICD-9 procedure code 8675, return to OR for revision of flap. Multivariable analysis evaluated predictors of flap compromise based on stepwise logistic regression with backwards elimination. Results The weighted sample included 306,924 encounters of which 526 received a flap (0.17%). The mean age of encounters receiving a flap was 45.0 (SD 21.2) years versus 35.5 (SD 24.2) years in the non flap group (p=0.023). 7.8% of patients who received a flap suffered electric injury compared to 2.7% of non-free flap encounters (OR 3.76, 95% CI 1.95–7.24, p< 0.001). Patients who underwent flap wound coverage were more likely to have a lower extremity burn; 55.3% of encounters versus 43.1% in non- flap patients (OR 2.26, 95% CI 1.05–2.15, p=0.024). There were no significant differences in gender, race, Elixhauser comorbidity index, %TBSA, or inhalation injury. The mean hospital day of the flap procedure was 10.1 (SD 10.7) days. Flap complications occurred in 6.4% of flap encounters. The only independent predictor of flap complication was electrical injury (OR 40.49, 95% OR 2.98–550.64, p=0.005). The time to flap coverage and location were not associated with complications. Conclusions Electrical injury was an independent predictor of flap complications compared to other mechanisms. Flap timing was not associated with return to surgery for complications. This suggests that the use of flaps is safe in acute burn care to achieve burn wound closure with an understanding that electrical injuries may deserve particular consideration to avoid failure. Applicability of Research to Practice Inform surgeon decision making when deciding candidacy for flap surgery in acute burn patients.
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Gallucci, Raymond HV. "Risk-Reduction Credit for Very Early Warning Fire Detection at Nuclear Power Plants: From FAQ to Fiction." Civil Engineering Journal 5, no. 2 (February 27, 2019): 309. http://dx.doi.org/10.28991/cej-2019-03091246.
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In 2004, the U.S. Nuclear Regulatory Commission (NRC), with support from the commercial nuclear power industry, adopted the 2001 Edition of National Fire Protection Association (NFPA) Standard 805, “Performance-Based Standard for Fire Protection for Light Water Reactor Electric Generating Plants,” as the means by which commercial nuclear power licensees could comply with Title 10 of the Code of Federal Regulations, Part 50.48(c), to replace deterministic fire protection licensing bases with ones that are risk-informed and performance-based. To facilitate licensee “transitions” to the new licensing bases via NFPA 805, a “Frequently Asked Questions” (FAQs) program, established early during the pilot-plant phase, was expanded to enable use of consensus technical “short-cuts” for fire probabilistic risk assessment (PRA) methods. These “Fire PRA FAQs” enabled licensees, with NRC approval, to bypass more traditional means of establishing acceptable PRA method enhancements on an interim basis, pending eventual confirmation by test programs and/or more detailed analyses. The NRC approved several, of which perhaps the most substantial in providing risk reduction benefits was FAQ 08-0046 on “Incipient Fire Detection Systems,” more accurately characterized as “Very Early Warning Fire Detection Systems” (VEWFDSs). Controversial from the start, the hidden story behind this FAQ’s initial adoption is relevant to examination of the NRC NUREG report that later replaced it and remains in effect today. This article examines this backstory, tracing recommendations that were proposed and bypassed, then examines alternatives to the current guidance. These alternatives, which maximize possible risk reduction credit for VEWFDSs at nuclear power plants, remain at least a factor of two less than the current peak NUREG-2180 risk-reduction factor even before the latter accounts for the possibility of fire pre-emption altogether.
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Yousuf, Md, and Ashutosh Bagchi. "Seismic design and performance evaluation of steel-frame buildings designed using the 2005 National building code of Canada." Canadian Journal of Civil Engineering 36, no. 2 (February 2009): 280–94. http://dx.doi.org/10.1139/l08-122.
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The seismic design provisions in the current edition of the National building code of Canada significantly differ from those in the earlier version of the code . Although the code has moved from the earlier prescriptive provisions towards a more performance-based design, such design principles have not yet been fully implemented. In the present work, four ductile steel moment-resisting frame buildings with heights of 5, 10, 15, and 20 storeys, were designed for Vancouver using the newer code, and their performances were studied to determine the level of seismic protection implied in the code. Synthesized and scaled real ground motion records were used to evaluate the nonlinear dynamic response of these structures. Although the buildings achieved the collapse prevention performance objective of the code, variations in evaluated performance parameters for the different buildings were observed. Also, building performance was found to be affected by the presence of infill walls, as well as by the nature of selected ground motion records and the methods used to scale them to Vancouver uniform hazard spectra.
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Atkinson, Gail M. "Earthquake time histories compatible with the 2005 National building code of Canada uniform hazard spectrum." Canadian Journal of Civil Engineering 36, no. 6 (June 2009): 991–1000. http://dx.doi.org/10.1139/l09-044.
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The seismic design provisions of the 2005 National building code of Canada (NBCC) (NRC 2005) describe earthquake ground motions for which structures are to be designed in terms of a uniform hazard spectrum (UHS) having a 2% chance of being exceeded in 50 years. The “target” UHS depends on location and site condition, where site condition is described by a classification scheme based on the time-averaged shear-wave velocity in the top 30 m of the deposit. For some applications, such as dynamic analysis by time history methods, it is useful to have time histories that represent the types of earthquake motions expected and match the target UHS from the NBCC over some prescribed period range. In this study, the stochastic finite-fault method is used to generate earthquake time histories that may be used to match the 2005 NBCC UHS for a range of Canadian sites. Records are provided for site classes A, C, D, and E. They are freely available at www.seismotoolbox.ca .
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Saatcioglu, M., M. Shooshtari, and S. Foo. "Seismic screening of buildings based on the 2010 National Building Code of Canada." Canadian Journal of Civil Engineering 40, no. 5 (May 2013): 483–98. http://dx.doi.org/10.1139/cjce-2012-0055.
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Seismic screening software is developed for existing buildings in Canada on the basis of the requirements of 2010 National Building Code of Canada. The software is based on the “Manual for Screening of Buildings for Seismic Investigation,” published by the National Research Council of Canada in 1992. The new software incorporates updated seismicity and soil classifications used in the National Building Code of Canada (NBCC) since 2005, as well as the new ductility and over-strength factors specified in the 2010 NBCC. The uniform hazard spectrum values of the current Canadian seismicity, defined for each municipality in Canada with a 2500 year earthquake return period, are used as reference hazard values. Seismic risk associated with the use of older seismic hazard values specified in older editions of the NBCC is identified relative to the current reference seismicity. The new site classifications are incorporated, while establishing relative soil amplification values between the new acceleration-based and velocity-based soil amplification factors and the foundation factors used in older codes. The new ductility and over-strength factors used in recent editions of the code are introduced in identifying different structural types with different toughness and energy dissipation capacities. The software can be used to conduct seismic screening of buildings located in different municipalities in Canada relative to the seismic requirements of NBCC-2010. It can also be used to generate tables for different locations in the country for manual screening of buildings.
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Bartlett, F. M., H. P. Hong, and W. Zhou. "Load factor calibration for the proposed 2005 edition of the National Building Code of Canada: Statistics of loads and load effects." Canadian Journal of Civil Engineering 30, no. 2 (April 1, 2003): 429–39. http://dx.doi.org/10.1139/l02-087.
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The 2005 edition of the National Building Code of Canada (NBCC) will adopt a companion-action format for load combinations and specify wind and snow loads based on their 50 year return period values. This paper summarizes statistics for dead load, live load due to use and occupancy, snow load, and wind load that have been adopted for calibration, and a companion paper presents the calibration itself. A new survey of typical construction tolerances indicates that statistics for dead load widely adopted for building code calibration are adequate unless the dead load is dominated by thin, cast-in-place concrete toppings. Unique statistics for live load due to use and occupancy are derived that pertain specifically to the live load reduction factor equation used in the NBCC. Statistics for snow and wind loads are normalized using the 50 year values that will be specified in the 2005 NBCC. New statistics are determined for the factors that transform wind speeds and ground snow depths into wind and snow loads on structures.Key words: buildings, code calibration, companion action, dead loads, live loads, load combinations, load factors, reliability, safety, snow loads, wind loads.
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Panneton, M., P. Léger, and R. Tremblay. "Inelastic analysis of a reinforced concrete shear wall building according to the National Building Code of Canada 2005." Canadian Journal of Civil Engineering 33, no. 7 (July 1, 2006): 854–71. http://dx.doi.org/10.1139/l06-026.
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An eight-storey reinforced concrete shear wall building located in Montréal and designed according to the 1995 National Building Code of Canada (NBCC) and the Canadian Standards Association standard CSA-A23.3-94 is studied to evaluate the impact of new requirements for inclusion in new editions of the NBCC and CSA-A23.3. Static and modal analyses were conducted according to the 2005 NBCC (draft 2003) and CSA-A23.3-04 (draft 4) procedures, and three-dimensional dynamic inelastic time history analysis was performed using three earthquake records. The building is braced by four flat shear walls and three cores. Various estimates of the fundamental period of vibration based on empirical expressions presented in the literature or structural models with different stiffness assumptions were examined. The analysis also permitted the study of the displacement and force demand on the lateral load resisting system. It was found that the base shear from the 2005 NBCC is 29% higher than the 1995 NBCC value when code empirical formulae are used for the fundamental period of vibration.Key words: building, shear wall, inelastic seismic response, NBCC, CSA-A23.3 design of concrete structures.
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Bartlett, F. M., H. P. Hong, and W. Zhou. "Load factor calibration for the proposed 2005 edition of the National Building Code of Canada: Companion-action load combinations." Canadian Journal of Civil Engineering 30, no. 2 (April 1, 2003): 440–48. http://dx.doi.org/10.1139/l02-086.
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The 2005 edition of the National Building Code of Canada (NBCC) will adopt a companion-action format for load combinations and specify wind and snow loads based on their 50 year return period values. This paper presents the calibration of these factors, based on statistics for dead load, live load due to use and occupancy, snow load, and wind load, which are summarized in a companion paper. A target reliability index of approximately 3 for a design life of 50 years was adopted for consistency with the 1995 NBCC. The load combinations and load factors for strength and stability checks recommended for the 2005 NBCC were based on preliminary values from reliability analysis that were subsequently revised slightly to address major inconsistencies with past practice. The recommended load combinations and factors generally give factored load effects similar to those in the 1995 NBCC, but are up to 10% more severe for the combination of dead load plus snow load and are generally less severe for the combination of dead load, snow load, and live load due to use and occupancy. Load factors less than one are recommended for checking serviceability limit states involving specified snow and wind loads. Importance factors for various classifications of structure are also presented. Revisions to the commentaries of the NBCC are recommended that will provide guidance on dead load allowances for architectural and mechanical superimposed dead loads and cast-in-place cover slabs and toppings.Key words: buildings, code calibration, companion action, dead loads, live loads, load combinations, load factors, reliability, safety, snow loads, wind loads.
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Wiegner, Dirk, Gerhard Luz, Patrick Jüschke, Robin Machinal, Thomas Merk, Ulrich Seyfried, Wolfgang Templ, Andreas Pascht, Rüdiger Quay, and Friedbert Van Raay. "AlGaN/GaN-based power amplifiers for mobile radio applications: a review from the system supplier's perspective." International Journal of Microwave and Wireless Technologies 2, no. 1 (February 2010): 95–104. http://dx.doi.org/10.1017/s175907871000022x.
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This paper gives a summarized overview on the progress and achievements on AlGaN/GaN high electron mobility transistors (HEMT)-based power amplifiers (PAs) for mobile radio applications which have been achieved within two national funded German projects during a period of six years. Starting with a first 34 dBm (2.5 W, peak) amplifier in 2003 the impressive progress toward highly efficient S-band mobile radio PAs with up to >50 dBm (100 W) peak output power is described by means of some selected single- and multiband amplifier demonstrators. This progress has been mainly enabled by clear progress on GaN technology, device packaging, and PA design. Targeting at highly efficient single-band amplifier applications, a 2.7 GHz symmetrical Doherty amplifier with up to 45% drain efficiency at close to 45 dBm average output power under single-carrier W-CDMA (Wideband Code Division Multiple Access) operation using digital predistortion can be highlighted. In case of multiband capable amplifiers addressing software-defined radio applications, a class-AB-based demonstrator covering a frequency range from 1.8 to 2.7 GHz was realized. The amplifier showed >30% drain efficiency up to 2.5 GHz as well as up to 40 dBm average output power under single-carrier W-CDMA operation using proprietary digital predistortion. Finally, Alcatel-Lucent's activities on envelope tracking for future efficiency improved GaN-based amplifiers are described.
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Hsieh, Chen-Hsi, Shiang-Jiun Tsai, Wen-Yen Chiou, Moon-Sing Lee, Hon-Yi Lin, and Shih-Kai Hung. "Better Survival with Three-Dimensional Conformal Radiotherapy Than with Conventional Radiotherapy for Cervical Cancer: A Population-Based Study." ISRN Oncology 2013 (October 2, 2013): 1–7. http://dx.doi.org/10.1155/2013/729819.
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Three-dimensional conformal radiation therapy (3DCRT) has emerged as a preferred treatment for gynecologic malignancies. Yet its superiority to conventional radiotherapy (2-dimensional radiotherapy (2DRT)) for gynecologic malignancies has not been well established. Data from the 2005 to 2010 National Health Insurance Research Database (NHIRD) provided by the National Research Institutes in Taiwan were analyzed to address this issue. Patients were initially diagnosed as having cervical cancer according to the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) code 180, and this clinical diagnosis was confirmed histopathologically or cytologically. Kaplan-Meier method and Cox proportional hazards regression were used to analyze the reported data. Between January 2005 and December 2010, there were 776 patients with newly diagnosed cervical cancer without metastasis, local recurrence, or surgical treatment before RT and 132 and 644 patients, respectively, who received 2DRT and 3DCRT. After adjustment for age, diabetes mellitus, hypertension, coronary heart disease, hyperlipidemia, side effects, urbanization level, geographic region, and enrollee category in the 5-year follow-up period, the HR was 1.82 (95% CI, 1.16–2.85, P=0.009). The 5-year survival rate in the 2DRT and 3DCRT groups was 73.0% and 82.3%, P=0.007, respectively. Cervical cancer patients treated with 3DCRT had better overall survival.
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Humar, JagMohan, and Mohamed A. Mahgoub. "Determination of seismic design forces by equivalent static load method." Canadian Journal of Civil Engineering 30, no. 2 (April 1, 2003): 287–307. http://dx.doi.org/10.1139/l02-067.
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In the proposed 2005 edition of the National Building Code of Canada (NBCC), the seismic hazard will be represented by uniform hazard spectra corresponding to a 2% probability of being exceeded in 50 years. The seismic design base shear for use in an equivalent static load method of design will be obtained from the uniform hazard spectrum for the site corresponding to the first mode period of the building. Because this procedure ignores the effect of higher modes, the base shear so derived must be suitably adjusted. A procedure for deriving the base shear adjustment factors for different types of structural systems is described and the adjustment factor values proposed for the 2005 NBCC are presented. The adjusted base shear will be distributed across the height of the building in accordance with the provisions in the current version of the code. Since the code-specified distribution is primarily based on the first mode vibration shape, it leads to an overestimation of the overturning moments, which should therefore be suitably adjusted. Adjustment factors that must be applied to the overturning moments at the base and across the height are derived for different structural shapes, and the empirical values for use in the 2005 NBCC are presented.Key words: uniform hazard spectrum, seismic design base shear, equivalent static load procedure, higher mode effects, base shear adjustment factors, distribution of base shear, overturning moment adjustment factors.
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Tremblay, Robert. "Fundamental Periods of Vibration of Braced Steel Frames for Seismic Design." Earthquake Spectra 21, no. 3 (August 2005): 833–60. http://dx.doi.org/10.1193/1.1989358.
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An analytical study is performed to propose a simple expression for the fundamental period of vibration of concentrically braced steel frames. This work was carried out in the context of the development of the 2005 National Building Code of Canada (NBCC) and is mainly applicable to structures located in moderate and low seismic regions. Available field and test measurements of building periods are compared to analytical predictions. An empirical period formula is developed based on a survey of analytically computed building periods published in the literature. The influence of the 2005 NBCC design provisions on braced steel-frame periods is examined through a closed-form period solution and an extensive parametric study. Building periods are found to vary significantly with seismic hazard levels and soil conditions. An expression is tentatively proposed that provides reasonable lower-bound period estimates for most situations in Canada.
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Osaulenko, O. H. "Experience of Introduction of National Principles Governing the Activity of the State Statistics Bodies of Ukraine." Statistics of Ukraine, no. 1(76) (March 20, 2017): 56–60. http://dx.doi.org/10.31767/su.1(76).2017.01.08.
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The paper analyzes the role of the Fundamental Principles of Official Statistics in the development of the Ukrainian statistical system and its adaptation to international standards.
The adoption and implementation of the Fundamental Principles, their subsequent development in the European Statistics Code of Practice (2005) and explanation in the National Principles Governing the Activity of the State Statistics Bodies of Ukraine (2010) served as a clear benchmark for setting priorities in the state statistical activity. It should be noted that not all of the principles could be equally easy implemented in the existing statistical practice. Even today two decades after the adoption of the Fundamental Principles of Official Statistics, there is still a number of debating points in their practical implementation.
Special attention is given to the compilation of the National Principles Governing the Activity of the State Statistics Bodies of Ukraine that are based on the European Statistics Code of Practice and incorporate PARIS21 system of indicators. The principles have been developed and implemented with the goal to create the basis for further strengthening of the institutional capacity of national statistical office, to implement the best practices of the European statistics, and on this basis to enhance user confidence in the official statistics and ensure high-quality statistical information.
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Goda, K., H. P. Hong, and G. M. Atkinson. "Impact of using updated seismic information on seismic hazard in western Canada." Canadian Journal of Civil Engineering 37, no. 4 (April 2010): 562–75. http://dx.doi.org/10.1139/l09-170.
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This study provides a preliminary assessment of the impact of new seismological information on the existing seismic hazard model, as implemented in the 2005 National building code of Canada (NBCC); this seismic hazard model was actually developed in the early 1990s, and thus there is significant new information available in the literature since then. A reassessment of seismic hazard is carried out by updating magnitude-recurrence relations based on the earthquake catalog up to the end of 2006, including conversion of all earthquake magnitudes to a homogenous moment magnitude scale. The recent ground-motion prediction equations, which update the knowledge base used in the 2005 NBCC, are also used. Focusing on Vancouver and Victoria, sensitivity analyses are carried out to investigate both individual and combined impacts of these updates on the uniform hazard spectra. The proposed model can be used as a guide to the direction in which future seismic hazard models for western Canada may move.
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Boudreault, F. A., C. Blais, and C. A. Rogers. "Seismic force modification factors for light-gauge steel-frame - wood structural panel shear walls." Canadian Journal of Civil Engineering 34, no. 1 (January 1, 2007): 56–65. http://dx.doi.org/10.1139/l06-097.
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Design guidelines for laterally loaded light-gauge steel-frame – wood structural panel shear walls are not available in Canadian codes. A design method for the calculation of shear stiffness and strength has been developed for use with the 2005 National Building Code of Canada (NBCC), however. This method was based on the analysis, using an equivalent energy elastic–plastic (EEEP) approach, of over 180 single-storey shear wall tests of various configurations. Ductility-related (Rd) and overstrength-related (Ro) force modification factors also need to be defined to calculate equivalent static seismic forces following the 2005 NBCC. This paper describes the development of these two factors based on the EEEP analysis of the shear wall test results. To verify the "test-based" Rdand Rovalues, nonlinear time-history dynamic analyses of two representative buildings were carried out using a suite of 10 earthquake records scaled to the 2% in 50 year uniform hazard spectrum (UHS) for Vancouver, British Columbia. Preliminary values have been determined for the force modification factors, namely Rd= 2.5 and Ro= 1.7.Key words: shear wall, light-gauge steel, wood structural panel, seismic, R value.
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Grin, O. S. "TRANSFORMATION OF CONTRACT FORM REQUIREMENTS BASED ON THE DEVELOPMENT OF DIGITAL TECHNOLOGIES." Actual Problems of Russian Law, no. 6 (July 18, 2019): 49–57. http://dx.doi.org/10.17803/1994-1471.2019.103.6.049-057.
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The article deals with the main issues of improving the Russian civil laws concerning the form of transaction the majority of which are associated with the adoption of the Federal Law of March 18, 2019, No. 34-FZ «On Amendments to Parts I, II and Article 1124 of Part III of the Civil Code of the Russian Federation.» The adoption of amendments mentioned above was preconditioned by the implementation of the federal project «Normative Regulation of the Digital Environment» within the framework of the National Program «Digital Economy of the Russian Federation.» The author highlights similarity of approaches perceived by the Russian law-maker with the provisions of international instruments, in particular the UNCITRAL Model Law on Electronic Commerce of 1996 and the UN Convention on «The Use of Electronic Communications in International Contracts» 2005. It is concluded that, as a result of transformation of requirements for the form of contracts, 2 main variations of written form (a single document signed by the parties, and exchange of documents) and 2 basic fictions of this form (accepting by conduct of a written offer and making a transaction by electronic or other technical means) have been approved.
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Roy, Nathalie, Patrick Paultre, and Jean Proulx. "Performance-based seismic retrofit of a bridge bent: Design and experimental validation." Canadian Journal of Civil Engineering 37, no. 3 (March 2010): 367–79. http://dx.doi.org/10.1139/l09-138.
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Changes in the 2005 edition of the National building code of Canada resulted in an increase in earthquake hazard for some regions in Canada. This project studied the impact of this increase on a selected highway bridge. A seismic retrofit scheme, using carbon-fiber-reinforced polymers (CFRPs), was developed and applied to the selected highway bridge bent. The retrofitting technique is based on specific performance criteria under which the retrofitted structure must meet prescribed ductility levels corresponding to selected seismic events, and its design includes a new confinement model for reinforced-concrete columns wrapped with CFRP. Using this performance-based approach, the amount of required composite materials to achieve the specified criteria was found to be much more economical when compared with the ductility requirements in the 2000 edition of the Canadian highway bridge design code. The performance of the retrofitting technique was evaluated by pseudo-dynamic tests carried out on a 1:3 scale model of one of the bridge bents. Using the substructuring approach, the remainder of the structure was modeled, and the bridge bent was subjected to increasing levels of seismic loading, corresponding to various limit states of the bridge. The measured response of the test specimen compared well with the predictions of a three-dimensional (3D) nonlinear finite-element model calibrated with dynamic properties obtained from on-site ambient vibration tests. During the highest intensity test corresponding to a return period of 2500 years for a region of high seismicity, the CFRP retrofit showed no sign of distress, and the strain values measured on the fibers were very low, indicating that the performance-based design procedure is conservative.
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Branston, A. E., F. A. Boudreault, C. Y. Chen, and C. A. Rogers. "Light-gauge steel-frame wood structural panel shear wall design method." Canadian Journal of Civil Engineering 33, no. 7 (July 1, 2006): 872–89. http://dx.doi.org/10.1139/l06-036.
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Design guidelines for laterally loaded (wind and seismic) light-gauge steel-frame wood structural panel shear walls are currently unavailable in Canadian standards and codes. A research project was initiated at McGill University in 2001 with the objective of developing a shear wall design method that could be used in conjunction with the 2005 National Building Code of Canada (NBCC). An extensive program of tests was first carried out to establish a database of shear wall information. The equivalent energy elasticplastic (EEEP) analysis approach was then chosen to derive key design parameters for the shear walls, including nominal shear strength, elastic stiffness, overstrength, and ductility. This paper presents the development of the proposed design method, the resulting nominal strength and unit elastic stiffness values according to typical perimeter fastener schedules and sheathing type, and the calibration of a resistance factor to the 2005 NBCC wind loads. Overstrength values used for a capacity-based seismic design approach and factors of safety for wind loading are also provided.Key words: shear wall, light-gauge steel, wood structural panel, earthquake, wind, design.
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Karbassi, Amin, and Marie-José Nollet. "Development of an index assignment procedure compatible with the regional seismicity in the province of Quebec for the rapid visual screening of existing buildings." Canadian Journal of Civil Engineering 35, no. 9 (September 2008): 925–37. http://dx.doi.org/10.1139/l08-041.
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In the context of the seismic vulnerability evaluation of buildings, the score assignment method can be used as the first step of a multiphase procedure aimed at identifying hazardous buildings that must then be analysed in greater detail. Because the existing Canadian rapid visual screening procedure has not been updated since 1992, a new procedure is proposed based on a set of vulnerability indices for different cities in the province of Quebec. A seismicity level (low, moderate, or high) is attributed to each city using the spectral acceleration response values included in the 2005 edition of National building code of Canada (NBCC) and the criteria proposed in FEMA 310 Handbook for the seismic evaluation of buildings - a prestandard. The structural vulnerability indices (SVIs) are calculated using the recently improved nonlinear static analysis procedure in FEMA 440, Improvement of nonlinear static seismic analysis procedures for each seismicity level. The NBCC 2005 reference soil class C is considered in the calculation of the SVIs, and index modifiers for the building height, irregularities, and design and construction year. The application of these indices to the estimation of the probable damage distribution in building inventories is discussed at the end.
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Oka, Simeon, Aleksandar Sedmak, and Maja Djurovic-Petrovic. "Energy efficiency in Serbia national energy efficiency program: Strategy and priorities for the future." Thermal Science 10, no. 4 (2006): 7–16. http://dx.doi.org/10.2298/tsci0604007o.
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Energy system in Serbia, in the whole energy chain, from exploitation of primary energy sources, transformations in electric power plants and district heating plants, energy (electric and heat) transmission and distribution to final users, and up to final energy consumption, is faced with a number of irrational and inefficient behavior and processes. In order to fight with such situation National Energy Efficiency Program, financed by the Ministry of Science and Environmental Protection has been founded in 2001. Basic facts about status of energy sector in Serbia, with special emphasis on the energy efficiency and use of renewable energy sources have been given in the review paper published in the issue No. 2, 2006 of this journal. In present paper new strategy and priorities of the National Energy Efficiency Program for the future period from 2006 to 2008, and beyond, is presented. This strategy and priorities are mainly based on the same concept and principles as previous, but new reality and new and more simulative economic and financial environment in energy sector made by the Energy low (accepted by Parliament in 2004) and Strategy of Development of Energy Sector in Republic Serbia up to 2015 (accepted by the Parliament in May 2005), have been taken into account. Also, responsibilities that are formulated in the Energy Community Treaty signed by the South-East European countries, and also coming from documents and directives of the European Community and Kyoto Protocol are included in new strategy. Once again necessity of legislative framework and influence of regulations and standards, as well as of the governmental support, has been pointed out if increased energy efficiency and increased use of renewable energy sources are expected. .
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Bhatt, Neel S., Parth Bhatt, Keyur Donda, Fredrick Dapaah-Siakwan, Sunil Kumar Batalahally, Vijay Linga, Anusha Lekshminarayan, Riddhi Chaudhari, Samer Zaid Kalyani, and Smita Bhaskaran. "Trends of Splenectomy in Pediatric Patients with Immune Thrombocytopenia before and after the ASH 2011 Evidence-Based Practice Guidelines." Blood 130, Suppl_1 (December 7, 2017): 676. http://dx.doi.org/10.1182/blood.v130.suppl_1.676.676.
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Abstract Background: Immune thrombocytopenia (ITP) is an autoimmune disorder which affects 1 in 10,000 children. Thrombocytopenia occurs largely due to rapid destruction of antibody sensitized platelets in the reticuloendothelial system. While spontaneous resolution is commonly seen in acute ITP, treatment of chronic or persistent ITP is controversial and could pose as management challenges for clinicians. Splenectomy increases platelet survival by removing a common site of platelet destruction and has a 70-80% response rate, however, published literature is conflicting regarding its ideal timing. Furthermore, it is an invasive procedure with significant risk of infections, venous thromboembolism. In 2011, the American Society of Hematology (ASH) published revised clinical practice guidelines for the management of ITP (Neunert C et al. Blood 2011). Splenectomy was recommended in patients with severe symptomatic ITP with significant or persistent bleeding refractory to intravenous immunoglobulin (IVIG), corticosteroids, and anti-D therapy. It is unclear if the rates of splenectomy have changed since the publication of these guidelines. Using a large population-based estimate, we aimed to study the trends of splenectomy in pediatric patients with ITP, and the factors predicting the procedure in this population. Methods: We used discharge data from the National (Nationwide) Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ). Pediatric patients (age ≤ 18 years) hospitalized with ITP from 2005-2014 were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9-CM) code 287.31. Cases of total splenectomy were identified using ICD9-CM procedure code '41.50'. To calculate estimated trends of splenectomy, Cochran-Armitage trend test was used. Chi-square test, Mann-Whitney U test, survey logistic regression and hierarchal regression were used for analyses. Weights provided by NIS were used to calculate national estimates. A p-value < 0.05 was considered significant. All analyses were performed using SAS 9.4 (SAS Institute Inc., Cary, NC, USA). Results: The NIS data included 62 million weighted pediatric hospitalizations between 2005 and 2014 (unweighted admissions n=13 million). After excluding patient transfers, a total of 40,998 weighted hospitalizations with ITP occurred during this time-period. Total splenectomy was performed in 1,009 patients. Splenectomy rate showed a decline prior to revised guidelines: 3.3% (2005-06) to 2.3% (2011-12). It continued to decline further after the publication: 1.6% (2013-14), p <0.0001. Similar trend was noted for patients < 5 years of age: 10.6% (2005-06), 5.2% (2011-12), and 3.5% (2013-14), p <0.001. None of the other patient ages (5-10, 11-15, and 16-18), gender, or hospital regions showed consistent splenectomy trend in either direction. Multivariable analysis showed one year increase in patient age significantly increased adjusted odds of having splenectomy (odds ratio, OR 1.18, 95% confidence interval, CI 1.14-1.22, p <0.0001). Having an intracranial bleed also significantly predicted splenectomy (OR 5.16, 95% CI 1.96- 13.61, p=0.0009). Splenectomy was more commonly done in patients from Midwest (OR 2.83, 95% CI 1.19-6.74, p= 0.02) and South region (OR 1.89, 95% CI 1.02-3.51, p=0.04) compared to Northeast region. Mortality rate was similar between patients who received splenectomy and who did not. Conclusion: Overall, splenectomy rates showed consistently downward trend in pediatric patients with ITP between 2005 and 2014. Reduction in splenectomy rates in children <5 years of age could be due to increasing awareness for sepsis secondary to asplenia. Presence of severe bleeding (e.g. intracranial bleeding) in patients with ITP predicted splenectomy, which is consistent with ASH recommendations. Declining splenectomy rates in last 3 years since ASH guidelines release could mean that more patients receive medical management initially as recommended by ASH. However, due to possible under-coding for IVIG, corticosteroids, and anti-D and lack of longitudinal data, we were unable to study the association between prior treatment and splenectomy. Future studies should revisit the role of splenectomy in ITP with advent of novel therapeutic options such as thrombopoietin receptor agonists. Disclosures No relevant conflicts of interest to declare.
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Yen, Y. N., C. F. Cheng, and H. M. Cheng. "Disaster Risk Management and Measurement Indicators for Cultural Heritage in Taiwan." ISPRS Annals of Photogrammetry, Remote Sensing and Spatial Information Sciences II-5/W3 (August 12, 2015): 383–88. http://dx.doi.org/10.5194/isprsannals-ii-5-w3-383-2015.
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Under the influence of global climate change, the risk preparedness has become a universal issue in different research fields. In the conservation of cultural heritage, disaster risk management is becoming one of the major research topics. Besides researches on the theory and mechanism of disaster risk management, the tools for the performance of site managers to protect cultural heritage is another important issue that needs development. <br><br> UNESCO and ICOMOS have released some important documents on disaster risk management including its concept, identification, evaluation, mitigation, monitoring and resilience, etc. However, there is a big gap between concept and implementation in Taiwan. Presently there are 2000 monuments in Taiwan that hardly meet the modern code. First, based on international documents released, this research presents 13 disaster indicators on monuments and their environments. Next, 345 monuments in northern Taiwan are taken as examples to evaluate their risk situations with indicators designed in 2011. Some positive recommendations were given at the same time. As a result, a comparative evaluation was completed in 2012 and some key issues are found, such as too many electrical facilities, lack of efficient firefighting equipment, and a shortage of management mechanism, just to name a few. Through the improvement of the management, some major risk can be mitigated. <br><br> In 2013~14, this research took 23 national monuments from the 345 monuments to evaluate their risk situations and compare the differences between national and local monuments. Results show that almost all management mechanisms in the national monuments have been established and are running well. However, problems like inappropriate electrical facilities and insufficient monitoring equipment remain. In addition, the performance of private monuments is not as good as public ones. Based on the collected information and evaluation, this research develops safety measures of heritage conservation in two aspects. One is for researchers to measure the risk of the heritage; the other is for site managers to manage the risk of their monument with ease. In conclusion, intendants of monuments in Taiwan have to develop more disaster risk management ideas to mitigate and prevent risks. In the meantime, the management and monitoring mechanisms available are helpful tools for risk mitigation. The awareness and training of the site managers are important issues for the implementation of risk prevention.
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Menes, Tehillah S., Tal Sella, and Gabriel Chodick. "Time to cancer diagnosis in young women presenting to surgeons with breast-related symptoms: A population-based cohort study." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e13099-e13099. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e13099.
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e13099 Background: Reports on delay to diagnosis of cancer in young women are based on retrospective studies and conflicting. The purpose of this study was to investigate time to cancer diagnosis in women presenting to a surgeon with breast-related complaints; and particularly, the role of age. Methods: A population-based cohort study including all women aged 18 to 44 presenting to a surgeon with a breast-related complaint between 2005 and 2015 in a large Israeli healthcare plan (N = 157,264). We collected data including demographics, diagnosis codes, breast imaging and biopsies. Breast cancer diagnosis within one year of the visit was ascertained from the national cancer registry. Time to breast imaging and biopsy was compared between the different age groups. Logistic regression analysis was used to determine the association between age and delay to biopsy while adjusting for possible confounders. Results: During the first year after the visit, 45,434 (29%) women had a breast imaging study; 5,767 (3.7%) women had a breast biopsy; and 676 (0.43%) were diagnosed with breast cancer. Overall, time to first breast imaging (mean, 53 days) and biopsy (mean, 68 days) did not differ significantly between the age groups. Non-specific visit codes (other than breast mass) were associated with delays to imaging and biopsy. This was more pronounced in the women ultimately diagnosed with breast cancer. Among women diagnosed with breast cancer, age under 40 (OR 2.3, 95% CI 1.4; 3.9), being post-partum (OR 2.6, 95% CI 1.1; 5.9) and a non-specific visit code (OR-8.3, 95% CI 4.9; 14.2) were associated with delay to biopsy. Conclusions: Symptomatic women with lower a-priori likelihood of breast malignancy (younger age, post-partum, or non-specific visit code) are at a significantly greater risk of delayed diagnosis of cancer. Physicians should be aware of the challenging diagnosis in young women with non-specific symptoms.
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Dehal, Ahmed, Ali Abbas, and Samir Johna. "Comorbidity and outcomes after surgery among women with breast cancer: Analysis of national in-patient sample database." Journal of Clinical Oncology 30, no. 27_suppl (September 20, 2012): 83. http://dx.doi.org/10.1200/jco.2012.30.27_suppl.83.
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83 Background: Evidence is scarce about the influence of comorbidity on short-term outcomes of patients with breast cancer after surgery. The objective of this study was to examine the effect of comorbidity on risk of postoperative complications, prolonged hospitalization (defined as above median length of stay), and in-patient death among women with breast cancer. Methods: National inpatient sample is a nationwide clinical and administrative database. Patient discharges with primary diagnosis code of breast cancer and coincident procedure code for breast surgery from 2005 to 2009 were identified using International Disease Codes 9th edition (ICD-9). Information about demographics, hospital characteristics, comorbidities, stage, surgical treatment, postoperative complications, length of hospital stay, and in-patient deaths was obtained. Comorbidities were identified using ICD-9 codes and used to calculate modified Charlson comorbidity index (CCI) score. We divided patients based on these scores into 4 groups: 0, 1, 2, and 3 or more. Multivariate logistic regression analyses were used to examine risk adjusted association between CCI score and the aforementioned outcomes. Results: We identified 75,100 patient discharges with a mean age of 61 years. Compared to patients with a CCI score of 0, as a reference group, CCI scores of 1, 2, and 3 or more increased the risk of post-operative complications by 1.7 fold, 2.6 fold, and 4.6 fold, respectively (p <0.001). Compared to patients with a CCI score of 0, CCI scores of 1, 2, and 3 or more increased the risk of prolonged hospitalization by 1.2 fold, 1.6 fold, and 2.3 fold, respectively (p <0.001). Similarly, Compared to patients with a CCI score of 0, CCI scores of 1, 2, and 3 or more increased the risk of in-patient death by 3.1 fold, 5.4 fold, and 15.8 fold, respectively (p <0.001). Conclusions: After controlling for potential confounders, we found a strong and statistically significant association between comorbidity and outcomes of patients with breast cancer after surgery. Effective control of comorbidity in breast cancer patients may reduce post-operative morbidity and mortality.
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Vasko, P. F., and M. R. Ibragimova. "SMALL HYDROPOWER PLANTS AS A PART OF ELECTRIC POWER INDUSTRY AND ENERGY MARKET OF UKRAINE." Alternative Energy and Ecology (ISJAEE), no. 25-30 (December 7, 2018): 73–85. http://dx.doi.org/10.15518/isjaee.2018.25-30.073-085.
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Globalization and sustainable development necessitate joint analysis of technological and environmental trends in energy development taking into account current economic and legal provisions. Based on synthesis of the current state of Ukrainian electric power system in general and hydropower in particular, there have been underscored the importance of comprehensive approach in identifying the key tasks of building the pathway of further electric power industry development. The authors provide the characteristics of today’s organizational and technological structure of the electric power system, including the legal provisions regulating its activity. As currently there are significant legislative changes, particular attention was paid to the review of electricity market. Features of the new liberalized electricity market have been determined in comparison with the current market, and also in connection with renewable energy characteristics. Thus, amendments introduced by the new Law “On electricity market” to the green tariff policy have been detailed with the regard to incentive mechanism for development of renewable energy and liability of electricity producers operating under Green Tariff for imbalances. The article focuses on the analysis of the state and growth potential of small hydropower. Еconomic incentives are systematized according to the current legislation. Also, here is presented the potential for possible growth of small hydropower, namely, quantitative result of the exploration of the technical potential of hydropower resources of small rivers. There have been identified a number of barriers and impediments to the construction of small HPPs. Environmental restrictions to the construction of small hydropower stations have been formulated according to the accurate analysis of various branches of national legislation such as the Land Code, the Water Code, the Law “On the Nature Reserve Fund of Ukraine”, etc., as well as valid ratified documents and other key soft-low instruments at the international level. Additionally, provisions of Сustoms and Tax legislation on small hydropower regarding to incentives for technology development have been defined. Consideration of small hydropower projects successfully implemented on the territory of the country confirms the possibility of the future development of small hydropower.
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Porwollik, Vera, Susanne Rolinski, Jens Heinke, and Christoph Müller. "Generating a rule-based global gridded tillage dataset." Earth System Science Data 11, no. 2 (June 12, 2019): 823–43. http://dx.doi.org/10.5194/essd-11-823-2019.
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Abstract. Tillage is a central element in agricultural soil management and has direct and indirect effects on processes in the biosphere. Effects of agricultural soil management can be assessed by soil, crop, and ecosystem models, but global assessments are hampered by lack of information on the type of tillage and their spatial distribution. This study describes the generation of a classification of tillage practices and presents the spatially explicit mapping of these crop-specific tillage systems for around the year 2005. Tillage practices differ by the kind of equipment used, soil surface and depth affected, timing, and their purpose within the cropping systems. We classified the broad variety of globally relevant tillage practices into six categories: no-tillage in the context of Conservation Agriculture, traditional annual, traditional rotational, rotational, reduced, and conventional annual tillage. The identified tillage systems were allocated to gridded crop-specific cropland areas with a resolution of 5 arcmin. Allocation rules were based on literature findings and combine area information on crop type, water management regime, field size, water erosion, income, and aridity. We scaled reported national Conservation Agriculture areas down to grid cells via a probability-based approach for 54 countries. We provide area estimates of the six tillage systems aggregated to global and country scale. We found that 8.67 Mkm2 of global cropland area was tilled intensively at least once a year, whereas the remaining 2.65 Mkm2 was tilled less intensely. Further, we identified 4.67 Mkm2 of cropland as an area where Conservation Agriculture could be expanded to under current conditions. The tillage classification enables the parameterization of different soil management practices in various kinds of model simulations. The crop-specific tillage dataset indicates the spatial distribution of soil management practices, which is a prerequisite to assess erosion, carbon sequestration potential, as well as water, and nutrient dynamics of cropland soils. The dynamic definition of the allocation rules and accounting for national statistics, such as the share of Conservation Agriculture per country, also allow for derivation of datasets for historical and future global soil management scenarios. The resulting tillage system dataset and source code are accessible via an open-data repository (DOIs: https://doi.org/10.5880/PIK.2019.009 and https://doi.org/10.5880/PIK.2019.010, Porwollik et al., 2019a, b).
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Leyden, J., L. Fung, and S. Frick. "Autism and toe-walking: are they related? Trends and treatment patterns between 2005 and 2016." Journal of Children's Orthopaedics 13, no. 4 (August 2019): 340–45. http://dx.doi.org/10.1302/1863-2548.13.180160.
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Purpose This study quantified toe-walking trends and treatment decisions in patients with autism spectrum disorder (ASD) in the United States between 2005 and 2016 using a large national private-payer database. Methods A retrospective database review was performed on paediatric patients with ASD, and for International Classification of Diseases-9/10 diagnosis codes for toe-walking. Patients were filtered based on treatment type by Current Procedural Terminology (CPT) code. Continued toe-walking rates were assessed for each patient population and treatment group. A Pearson’s chi-squared test was used to evaluate differences in group characteristics. Results Of 2 221 009 paediatric patients in the database, 5739 patients had a diagnosis of ASD, and 8.4% of patients with ASD also had a diagnosis of toe-walking (n = 484). For typically developing children in the database, 0.47% of patients had a diagnosis of persistent toe-walking. In all, 59.3% of ASD patients underwent physical therapy, 7.4% serial casting and 3.3% surgical correction, compared with 38.1%, 3.6% and 1.2% of normally developing children, respectively (chi-square 6.4031; p < 0.040699). Without intervention, 63.6% of patients with ASD continued to toe-walk within ten years of their diagnosis, with 19.3% of patients without ASD (chi-square 82.9762; p < 0.0001). Conclusion This study supports the association between a greater prevalence of toe-walking in children with ASD. We showed that patients with ASD and toe-walking receive surgical correction at nearly triple the rate of children without ASD who toe-walk. The continued rate of toe-walking is comparable between treatment groups as well as between ASD and typically developing children. Typically developing children have higher rates of toe-walking resolution without intervention than children with ASD. Level of evidence Level II
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Hong, H. P., T. G. Mara, R. Morris, S. H. Li, and W. Ye. "Basis for recommending an update of wind velocity pressures in Canadian design codes." Canadian Journal of Civil Engineering 41, no. 3 (March 2014): 206–21. http://dx.doi.org/10.1139/cjce-2013-0287.
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Reference wind velocity pressures corresponding to specified return period wind speeds are provided in several Canadian design codes. A review of the two most recent editions of the National Building Code of Canada (NBCC) indicates that significant changes in some 50-year return period wind speeds, vAH-50, were introduced in the 2010 version of the NBCC-2010 compared to the previous NBCC-2005. The changes are due to analysis approaches, available wind records, and a re-examination of anemometer histories. To potentially improve the estimates of vAH-50, wind records in the Environment Canada HLY01 digital archive were processed. Two hundred and thirty-five meteorological stations are considered in the analysis, and height and exposure corrected annual maximum hourly-mean wind speed, VAH, are extracted. Statistical analysis and distribution fitting were carried out using the Gumbel distribution and generalized extreme value distribution and several fitting methods were employed. The results indicate that it is preferable to treat VAH as a Gumbel variate, and to carry out the fit using the generalized least-squares method. Wind speed contour maps for Canada are developed based on the estimated vAH-T for T equal to 50, 500, and 1000 years. A comparison of the maps of vAH-50 to those inferred from NBCC-2005 and NBCC-2010 shows that the developed map retains some of the smoothness of the wind speeds exhibited in NBCC-2010, while maintains the localized wind speed features presented in NBCC-2005. Results also show that the wind speed corresponding to the factored design wind load in NBCC-2010 is associated with a return period ranging from 200 to 5000 years, but for 90% of stations considered, the range narrows to 300 to 900 years.
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Akintoye, Emmanuel, William R. Miranda, Gruschen R. Veldtman, Heidi M. Connolly, and Alexander C. Egbe. "National trends in Fontan operation and in-hospital outcomes in the USA." Heart 105, no. 9 (October 30, 2018): 708–14. http://dx.doi.org/10.1136/heartjnl-2018-313680.
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BackgroundNational prevalence and outcomes of Fontan operation in the USA is unknown. Study objective was to determine trends (temporal change) in the annual volume of Fontan operations, in-hospital mortality, postoperative complications and type of hospital discharge.MethodsReview of the Nationwide Inpatient Sample for patients that underwent Fontan operation from 2001 to 2014 using the International Classification of Diseases-Ninth Revision, Clinical Modification procedure code for Fontan operation, that is, 35.94. To evaluate for change in patients’ demographics over the years, we divided the patient population into four groups based on procedure year (2001–2004, 2005–2008, 2009–2011 and 2012–2014).ResultsAn estimated 15 934 Fontan operations were performed in the USA from 2001 to 2014. Median (Q1–Q3) age was 3 (2–4) years and 39.8% were female. Hypoplastic left heart syndrome was the most common (29%) congenital heart disease diagnosis. An estimated 1175 procedures were performed in 2001 and 1340 in 2014, but there was no significant change in the number of procedures per year (p=0.47). There was significant decline in in-hospital mortality from 4.5% (53/1175) in 2001 to 1.1% (15/1340) in 2014 (p=0.009). When we compared event rates between 2001–2004 and 2012–2014 periods, there was significant decline in postoperative cardiac complications (12.6% (459/3640) to 8% (378/4706), p=0.007) and respiratory complications (17.1% (623/3640) to 10.2% (481/4706), p<0.001). However, there was increase in the number of patients discharged to home with healthcare assistance or transferred to another acute care facility (5.8% (211/3640) to 9.4% (443/4706), p=0.01) and inflation-adjusted hospitalisation cost (US$46 978 to US$60 383, p<0.001), but no significant change in length of stay (p=0.73).ConclusionOn the average, 1062 Fontan operations are performed annually in the USA with no change in volume of procedures but a decrease in in-hospital mortality and postoperative complications over a 15-year period.
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Karadayı, Yıldız, Mehmet N. Aydin, and A. Selçuk Öğrenci. "A Hybrid Deep Learning Framework for Unsupervised Anomaly Detection in Multivariate Spatio-Temporal Data." Applied Sciences 10, no. 15 (July 28, 2020): 5191. http://dx.doi.org/10.3390/app10155191.
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Multivariate time-series data with a contextual spatial attribute have extensive use for finding anomalous patterns in a wide variety of application domains such as earth science, hurricane tracking, fraud, and disease outbreak detection. In most settings, spatial context is often expressed in terms of ZIP code or region coordinates such as latitude and longitude. However, traditional anomaly detection techniques cannot handle more than one contextual attribute in a unified way. In this paper, a new hybrid approach based on deep learning is proposed to solve the anomaly detection problem in multivariate spatio-temporal dataset. It works under the assumption that no prior knowledge about the dataset and anomalies are available. The architecture of the proposed hybrid framework is based on an autoencoder scheme, and it is more efficient in extracting features from the spatio-temporal multivariate datasets compared to the traditional spatio-temporal anomaly detection techniques. We conducted extensive experiments using buoy data of 2005 from National Data Buoy Center and Hurricane Katrina as ground truth. Experiments demonstrate that the proposed model achieves more than 10% improvement in accuracy over the methods used in the comparison where our model jointly processes the spatial and temporal dimensions of the contextual data to extract features for anomaly detection.
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Meirelles, Lyghia Maria Araújo, and Fernanda Nervo Raffin. "Clay and Polymer-Based Composites Applied to Drug Release: A Scientific and Technological Prospection." Journal of Pharmacy & Pharmaceutical Sciences 20 (May 19, 2017): 115. http://dx.doi.org/10.18433/j3r617.
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There has been a growing trend in recent years for the development of hybrid materials, called composites, based on clay and polymers, whose innovative properties render them attractive for drug release. The objective of this manuscript was to conduct a review of original articles on this topic published over the last decade and of the body of patents related to these carriers. A scientific prospection was carried out spanning the period from 2005 to 2015 on the Web of Science database. The technological prospection encompassed the United States Patent and Trademark Office, the European Patent Office, the World International Patent Office and the National Institute of Industrial Property databases, filtering patents with the code A61K. The survey revealed a rise in the number of publications over the past decade, confirming the potential of these hybrids for use in pharmaceutical technology. Through interaction between polymer and clay, the mechanical and thermal properties of composites are enhanced, promoting stable, controlled drugs release in biological media. The most cited clays analyzed in the articles was montmorillonite, owing to its high surface area and capacity for ion exchange. The polymeric part is commonly obtained by copolymerization, particularly using acrylate derivatives. The hybrid materials are obtained mainly in particulate form on a nanometric scale, attaining a modified release profile often sensitive to stimuli in the media. A low number of patents related to the topic were found. The World International Patent Office had the highest number of lodged patents, while Japan was the country which published the most patents. A need to broaden the application of this technology to include more therapeutic classes was identified. Moreover, the absence of regulation of nanomaterials might explain the disparity between scientific and technological output. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.
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Hikmawan, Ari. "HAK DAN KEWAJIBAN PARA PIHAK DALAM PERJANJIAN JUAL BELI TENAGA LISTRIK (SPJBTL) ANTARA PT PLN (PERSERO) UNIT PELAKSANA PELAYANAN PELANGGAN TANJUNGPINANG DENGAN PELANGGAN." Jurnal Panji Keadilan : Jurnal Ilmiah Nasional Mahasiswa Hukum 3, no. 1 (November 28, 2020): 1–24. http://dx.doi.org/10.36085/jpk.v3i1.1178.
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ABSTRAKPasal 1 angka 1 Undang-Undang Nomor 30 Tahun 2009 tentang Ketenagalistrikan dapat dikatakan bahwa, ketenagalistrikan adalah segala sesuatu yang menyangkut penyediaan dan pemanfaatan tenaga listrik serta usaha penunjang tenaga listrik. Tenaga Listrik mempunyai peran yang sangat penting dan strategis dalam mewujudkan tujuan pembangunan nasional, maka usaha penyediaan tenaga listrik perlu terus ditingkatkan sejalan dengan perkembangan pembangunan agar tersedia tenaga listrik dalam jumlah yang cukup, merata, dan bermutu. Usaha penyediaan tenaga listrik merupakan pengadaan tenaga listrik meliputi pembangkitan, transmisi, dan penjualan tenaga listrik. Dalam penjualan tenaga listrik terjadi transaksi jual beli tenaga listrik antara pelanggan dengan PT. PLN (Persero). Berdasarkan Pasal 1457 KUHPerdata, jual beli adalah suatu perjanjian dengan mana pihak yang satu mengikat dirinya untuk menyerahkan hak milik atas suatu barang dan pihak yang lain untuk membayar harga yang telah dijanjikan. Oleh karena itu dalam pelaksanaannya perlu diadakan suatu perjanjian antara pelanggan dengan PT. PLN (Persero) yang disebut dengan “Surat Perjanjian Jual Beli Tenaga Listrik (SPJBTL)”. Penelitian ini membahas mengenai hak dan kewajiban para pihak dalam Perjanjian Jual Beli Tenaga Listrik (SPJBTL) antara PT PLN (Persero) Unit Pelaksana Pelayanan Pelanggan Tanjungpinang dengan Pelanggan dan Perjanjian Jual Beli Tenaga Listrik (SPJBTL) antara PT PLN (Persero) Unit Pelaksana Pelayanan Pelanggan Tanjungpinang dengan Pelanggan jika dilihat dari asas itikad baik.Metode Penelitian adalah penelitian hukum normatif, yang disebut juga dengan penelitian hukum doktrinal. Dalam penelitian hukum normatif ini, penulis tertarik untuk melakukan penelitian dengan menggunakan asas hukum. Penelitian yang membahas tentang asas hukum ini penulis gunakan dikarenakan berkaitan dengan asas hukum itikad baik (Good Faith) terhadap mengenai hak dan kewajiban para pihak dalam Perjanjian Jual Beli Tenaga Listrik (SPJBTL) antara PT PLN (Persero) Unit Pelaksana Pelayanan Pelanggan Tanjungpinang dengan Pelanggan serta mengenai upaya penyelesaian perselisihan yang terjadi antara PT PLN (Persero) Unit Pelaksana Pelayanan Pelanggan Tanjungpinang dengan Pelanggan. Penulis menggunakan metode kajian kepustakaan yaitu peneliti menganalisa berdasarkan buku-buku, peraturan perundang-undangan maupun literatur-literatur lainnya yang terkait dengan permasalahan yang diteliti. Analisis data dilakukan secara kualitatif yaitu data yang diperoleh tidak dengan menggunakan statistik atau matematika ataupun yang sejenisnya. Dalam menarik kesimpulan penulis menggunakan metode berfikir deduktif yaitu cara berfikir yang menarik kesimpulan dari suatu pernyataan atau dalil yang bersifat umum menjadi suatu pernyataan atau kasus yang bersifat khusus.Kesimpulan penelitian ini adalah para pihak harus memenuhi hak dan kewajibannya sebagai pelanggan dan tidak melakukan pelanggaran dalam menggunakan tenaga listrik, antara lain: tidak menunggak atau tidak membayar rekening tagihan tenaga listrik, tidak melakukan pencurian tenaga listrik, tidak menyalurkan tenaga listrik pada pihak lain, menggunakan tenaga listrik sesuai peruntukan dalam SPJBTL serta tidak merubah atau merusak peralatan listrik dan tidak melakukan perbuatan lainnya yang merugikan PT. PLN (Persero). Akan tetapi hak dan kewajiban para pihak dalam Surat Perjanjian Jual Beli Tenaga Listrik (SPJBTL) antara PT PLN (Persero) Unit Pelaksana Pelayanan Pelanggan Tanjungpinang tidak diatur secara jelas dan tegas. Sehingga apabila terdapat wanprestasi yang dilakukan oleh para pihak, maka pihak yang dirugikan tidak mendapatkan ganti kerugian sebagaimana mestinya. Sehingga untuk menghindari terjadinya wanprestasi yang dapat merugikan para pihak maka perjanjian jual beli tenaga listrik (SPJBTL) antara PT. PLN (Persero) dengan konsumen harus didasarkan dengan itikad baik. Untuk kedepannya dalam membuat surat perjanjian jual beli tenaga listrik pihak PLN harus meninjau ulang mengenai klausula dalam SPJBTL, karena beberapa pasal dalam SPJBTL masih mengandung klausula yang melanggar hak-hak konsumen. Sehingga tujuan Negara untuk mencapai kemakmuran dan kesejahteran rakyat dalam energi listrik di Indonesia dan misi PLN tentang kepuasan pelanggan dapat tercapai. Untuk konsumen kedepannya harus lebih bertanggungjawab dalam menunaikan kewajibannya, agar hak-hak juga bisa diperoleh dengan baik. Sehingga tidak ada pihak yang dirugikan.Kata kunci: hak dan kewajiban; SPJBTL; PLN unit pelaksana pelayanan pelanggan TanjungpinangABSTRACTArticle 1 number 1 of Law Number 30 Year 2009 concerning Electricity can be said that, electricity is everything related to the supply and use of electricity as well as electricity supporting businesses. Electric Power has a very important and strategic role in realizing national development goals, so the business of supplying electricity needs to be continuously increased in line with the development development so that there is sufficient, equitable and quality electricity. Electricity supply business is the supply of electricity including the generation, transmission and sale of electricity. In the sale of electricity there is a power purchase transaction between the customer and PT. PLN (Persero). Based on Article 1457 of the Civil Code, buying and selling is an agreement with which one party binds himself to surrender ownership rights to an item and the other party to pay the price promised. Therefore in its implementation it is necessary to hold an agreement between the customer and PT. PLN (Persero), called the "Electricity Purchase Agreement (SPJBTL)". This study discusses the rights and obligations of the parties in the Electricity Sale and Purchase Agreement (SPJBTL) between PT PLN (Persero) Tanjungpinang Customer Service Implementing Unit with Customers and the Electricity Sale and Purchase Agreement (SPJBTL) between PT PLN (Persero) Customer Service Implementation Unit Tanjungpinang with customers when viewed from the principle of good faith.The research method is normative legal research, also called doctrinal law research. In this normative legal research, the author is interested in conducting research using the principle of law. This research discusses the legal principle I use because it relates to the legal principle of good faith (Good Faith) regarding the rights and obligations of the parties in the Power Purchase Agreement (SPJBTL) between PT PLN (Persero) Tanjungpinang Customer Service Implementation Unit with Customers and regarding efforts to resolve disputes that occur between PT PLN (Persero) Tanjungpinang Customer Service Implementation Unit and Customers. The author uses the method of literature study in which the researcher analyzes based on books, laws and regulations and other literatures related to the problem under study. Data analysis was carried out qualitatively, that is, the data obtained were not using statistics or mathematics or the like.The conclusion of this research is that the parties must fulfill their rights and obligations as customers and do not violate the use of electricity, including: not arrears or not paying electricity bill, not stealing electricity, not delivering electricity to other parties, using electricity in accordance with the designation in the SPJBTL and does not change or damage the electrical equipment and does not do other actions that harm PT. PLN (Persero). However, the rights and obligations of the parties in the Power Purchase Agreement (SPJBTL) between PT PLN (Persero) Tanjungpinang Customer Service Implementation Unit are not clearly and clearly regulated. So if there is a default done by the parties, the injured party does not get compensation as they should. So as to avoid the occurrence of default that can be detrimental to the parties, the power purchase agreement (SPJBTL) between PT. PLN (Persero) with consumers must be based on good faith. In the future, in making a power purchase agreement, the PLN must review the clause in the SPJBTL, because some articles in the SPJBTL still contain clauses that violate consumer rights. So that the State's goal of achieving prosperity and prosperity of the people in electrical energy in Indonesia and PLN's mission of customer satisfaction can be achieved. For consumers in the future must be more responsible in fulfilling their obligations, so that rights can also be obtained properly. So that no party is harmed.Keywords: rights and obligations; SPJBTL; PLN Tanjungpinang customer service implementation unit.
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Akhras, G., and W. Li. "Seismic evaluation of concrete moment frames in existing government buildings." Canadian Journal of Civil Engineering 36, no. 5 (May 2009): 813–25. http://dx.doi.org/10.1139/l09-035.
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Many government departments have hundreds of buildings located in active seismic regions. Most of these buildings were built decades ago according to old design codes, and could be vulnerable to strong or even moderate earthquakes. To evaluate the seismic performance of concrete moment frames or moment frames with shear walls in these buildings, the static, vibration and modal response spectrum analyses are carried out according to the 2005 National building code of Canda NBCC. The analysis uses 2-D finite element models consisting of frame elements and inplane elements. The frame element has a built-in rigid linear segment at each end for modeling the portion within the beam–column joint, whereas the inplane element may have openings for modeling doors and windows in shear walls. The stiffness of both elements is adjusted to include effects of shear deformation in beams and bending deformation in wall piers. The results are further adjusted to incorporate effects of torsion and accidental torsion. Then, CSA-A23.3-04 is followed for detailed evaluation on safety in limit states, “strong column – weak beam” concept and shear strength requirements. Based on this approach, a new computer program is developed to perform this evaluation with minimum input data. Important issues in each step are discussed in detail. Examples are presented, and results are compared with available existing data.
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Khanam, Shamsunnahar, M. J. M. M. Noor, Zamri Mohamed, and Yuzuru Miyata. "Economic Impacts of Introducing a New Low Carbon City in Johor Bahru, Malaysia - A CGE Modelling Approach." Applied Mechanics and Materials 735 (February 2015): 238–42. http://dx.doi.org/10.4028/www.scientific.net/amm.735.238.
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The Johor Bahru metropolitan area is an industrial and commercial hotspot in the region and almost any significant industrial brand has a branch here. However, the effectiveness of good and effective industrial policy has never been quantified to integrate economy and environment. Taking into account the idea ‘think globally, act locally’, with an emphasis on economy, environment integration, and introducing a Low Carbon City, by building a computable general equilibrium (CGE) model, this study successfully examined the economic impacts of new production and the usefulness of economic measure based on the simulated macroeconomic and sectoral factors. An input-output (I-O) table and social accounting matrix (SAM) is the cornerstone in designing a CGE model. Lack of input-output table has badly hampered any effects in the arena of CGE modelling in Johor Bahru City. This study, therefore, attempted to utilize the most updated 2005 input-output table of Malaysia to prepare an input-output table of Johor Bahru City along with using several statistics, including the national population census, manufacturing census and commerce census for developing an input-output table for economic analysis. Modelling results showed that the total industrial output including city GDP has increased 0.07% and 0.08% respectively in 2005. Additionally, the decreasing trends of the prices of major commodity products such as solar power( -1.53 %), electric vehicle ( -0.77%) and in cogeneration (-0.32 % ) were observed significant. Thus, new industrial formation and subsidy plan have proven as the most significant contributors. Therefore, the present research suggests to apply this model into Johor Bahru City’s economy to integrate economy and environment in a city named ‘Low Carbon City-JB’.
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Tiffin, Paul A., Jose L. Mediavilla, Helen Close, Adetayo S. Kasim, Patrick Welsh, Lewis W. Paton, and James M. Mason. "What were the impacts of the Committee on Safety of Medicines warning and publication of the NICE guidelines on trends in child and adolescent antidepressant prescribing in primary care? A population based study." BMJ Open 9, no. 8 (August 2019): e028201. http://dx.doi.org/10.1136/bmjopen-2018-028201.
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ObjectivesTo assess the impact of both the Committee on Safety of Medicines (CSM) warning (December 2003) and the National Institute for Health and Care Excellence (NICE) guidance (September 2005) on antidepressant prescription rates in children and adolescents within the UK primary care service.SettingPopulation based study of primary care antidepressant prescribing using the Clinical Practice Research Datalink (CPRD).ParticipantsUnder-18s presenting to primary care with a depressive disorder or related diagnostic code recorded in the CPRD.Primary outcome measureAntidepressant prescription rates per month per 100 000 depressed 4–17 year olds.ResultsFollowing the CSM warning, the prior trend towards increased prescribing rates for selective serotonin reuptake inhibitors (SSRIs) in children was significantly reversed (β for change in trend −12.34 (95% CI −18.67 to −6.00, p<0.001)). However, after the publication of the NICE guidelines the prior trend towards increased prescribing resumed for those SSRIs mentioned as potential treatments in the guidance (fluoxetine, citalopram and sertraline) (β for change in trend 11.52 (95% CI 5.32 to 17.73, p<0.001)). Prescribing of other SSRIs and tricyclics remained low.ConclusionsDespite a strong emphasis on psychosocial interventions for child and adolescent depression, it may be that the NICE guidelines inadvertently encouraged further antidepressant prescribing, at least for those SSRIs cited. Although the guidelines gave cautions and caveats for the use of antidepressants, practitioners may have interpreted these recommendations as endorsing their use in young people with depression and related conditions. However, more accurate prevalence trend estimates for depression in this age group, and information on the use of psychosocial interventions would be needed to rule out other reasons underlying this increase in prescribing.
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Maxwell, Bryan G., Jim K. Wong, and Robert L. Lobato. "Perioperative Morbidity and Mortality after Noncardiac Surgery in Young Adults with Congenital or Early Acquired Heart Disease: A Retrospective Cohort Analysis of the National Surgical Quality Improvement Program Database." American Surgeon 80, no. 4 (April 2014): 321–26. http://dx.doi.org/10.1177/000313481408000411.
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An increasing number of patients with congenital heart disease survive to adulthood. Expert opinion suggests that noncardiac surgery is a high-risk event, but few data describe perioperative outcomes in this population. Using the National Surgical Quality Improvement Program database, we identified a cohort of patients aged 18 to 39 years with prior heart surgery who underwent noncardiac surgery between 2005 and 2010. A comparison cohort with no prior cardiovascular surgery was matched on age, sex, race/ethnicity, operation year, American Society of Anesthesiologists physical status, and Current Procedural Terminology code. A study cohort consisting of 1191 patients was compared with a cohort of 5127 patients. Baseline dyspnea, inpatient status at the time of surgery, and a prior operation within 30 days were more common in the study cohort. Postoperative outcomes were less favorable in the study cohort. Observed rates of death, peri-operative cardiac arrest, myocardial infarction, stroke, respiratory complications, renal failure, sepsis, venous thromboembolism, perioperative transfusion, and reoperation were significantly higher in the study cohort ( P < 0.01 for all). Mean postoperative length of stay was greater in the study cohort (5.8 vs 3.6 days, P < 0.01). Compared with a matched control cohort, young adult patients with a history of prior cardiac surgery experienced significantly greater perioperative morbidity and mortality after noncardiac surgery. A history of prior cardiac surgery represents a marker of substantial perioperative risk in this young population that is not accounted for by the matched variables. These results suggest that adult patients with congenital heart disease are at risk for adverse outcomes and support the need for further registry-based investigations.
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Kong, Jee Hyun, Tae-Hwa Go, Jung Yeon Lee, Jieun Uhm, and Shin Young Hyun. "Clinical Characteristics of Elderly Chronic Myeloid Leukemia Patients in Korea; Based on the National Health Information Database." Blood 132, Supplement 1 (November 29, 2018): 4262. http://dx.doi.org/10.1182/blood-2018-99-116158.
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Abstract Objectives Aging involves progressive impairments in the functional reserve of multiple organs, which might also affect drug metabolism and pharmacokinetics. Elderly might experience more drug adverse events than younger patients. Thus, we evaluated clinical characteristics and tyrosine kinase inhibitor (TKI) prescription pattern in Korean elderly chronic myeloid leukemia (CML) patients, using National Health Information Database "NHID". Methods This study included patients 70 and older who were diagnosed with Philadelphia chromosome positive CML (ICD code C92.1) from 2005 to 2013 and prescribed TKIs (which included imatinib, dasatinib, nilotinib and radotinib which were covered by the National Health Insurance Service (NHIS), currently). We excluded following cases; ①TKI was prescribed just once ② TKI was started with a higher dose than the recommended for chronic phase (imatinib, 400mg QD; dasatinib, 100mg QD; nilotinib, 300mg BID; radotinib 300mg BID). ③ interferon was treated prior to TKI ④ TKI dosage data was missing. We extracted age, sex, medical insurance premium (which is imposed by proportionate to income), prescribed medication list, and date of death from NHID. Medication possession ratio (MPR) was used for adherence. Each patients' laboratory result, disease phase (chronic phase, accelerate phase, or blastic crisis), or the reasons for TKI change or dose reduction were not available. Overall survival (OS) was calculated by Kaplan-Meier methods. Additionally, Univariate and multivariate analysis were done with Cox proportional hazard regression, with following variables using SAS; sex (male vs female), age (70 ≤age<75, 75≤age<80, age≥80) medical insurance premium (high vs low), frontline TKI (imatinib vs other TKIs), and MPR (≥0.9 vs <0.9). Result A total of 385 patients were followed up median 52 (1-133) months until the end of 2016. The patients consisted of 54% male (n=208), median age of 75 (70-95), and 64 patients (16.6%) who were diagnosed after the age of 80. About 85% of the patients experienced imatinib. Dasatinib was prescribed to 107 patients (27.8%), nilotinib to 71 (18.4%), and radotinib to 16 (4.2%). Frontline TKI was maintained in 279 (72.5%) patients, and the others were treated with more than one TKI; 2TKIs, n=80 (20.8%); 3TKIs, n=22 (5.7%); 4TKIs n=4 (1%). Imatinib was selected as frontline TKI in 318 patients (81.8%). Median MPR to TKI was 0.89 (0.00-1.84), and 51% of patients' MPR was less than 0.9. Patients were treated median 42 (0-146) months, and 186 (48.3%) were expired during the follow up period. Among 327 patients, 42 (12.8%) started with reduced dose of imatinib, and 285 (87.2%) started with imatinib 400mg QD. After median 2 (0-118) months, full dose imatinib reduced to mean 263mg±63 in 165 patients. Only 111 patients (34%) maintained imatinib. Dasatinib 100 mg was initiated in 89.9% (n=94) of 107 patients. Thirty patients (28%) did not change dasatinib dose. Others, reduced dose to mean 57±13mg after median 3 (0-33) months. Patients who were taking nilotinib or radotinib, full dose without dose reduction, were 31 (43%) and 7 (43%) respectively. Nilotinib was reduced to mean 325±62 after median 2(0-29) months, and radotinib to mean 357±162mg after median 4 (0-43) months. The estimated OS at 5-year was 60.3% and 10-year was 24.6%. For both univariate and multivariate analysis, age and MPR associated OS significantly; Patients aged 80 and older and from 75 to 80 showed poor OS than those aged from 70 to 75 through adjusted HR 2.67[95% CI.I, 1.81-3.93] (p<0.0001) and 1.81[95% C.I., 1.29-2.53] (p=0.0006), respectively. Patients with high MPR (≥0.9) survived longer than those with low MPR (<0.9), and its adjusted HR was 2.34 [95% C.I. 1.70-3.23] (p<0.0001). Conclusion Based on NHID, 10-50% of TKIs were initiated with reduced dose in age 70 and older CML patients. Full dose was maintained only 28-43% of prescribed TKIs. Despite of this, the outcome was favorable showing that because the estimated OS at 5-year was 60.3%. Age and adherence to TKI were associated with OS in elderly CML patients. Disclosures No relevant conflicts of interest to declare.
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Uprety, Dipesh, Yazhini Vallatharasu, and Benjamin Parsons. "Survival Trends Among Patients with High Risk Myelodysplastic Syndrome in Pre- and Post-Hypomethylating Era: A SEER Population Based Study." Blood 128, no. 22 (December 2, 2016): 5523. http://dx.doi.org/10.1182/blood.v128.22.5523.5523.
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Abstract Background: The myelodysplastic syndrome (MDS) includes a diverse group of clonal hematopoietic stem cell malignancies primarily affecting older individuals. It is characterized by bone marrow failure, peripheral blood cytopenias, and reduced survival. Treatment is based on prognostic scoring system and the pathology. Higher-risk disease carries a significant risk of progression to Acute Myelogenous Leukemia (AML). In these patients, treatment includes either an allogeneic stem cell transplantation (SCT) or a hypo-methylatingagent. Elderly patients with MDS usually are not a suitable candidate for allogeneic stem cell transplant given their age and other associated comorbidities. In this subset of patients, hypomethylatingagents, namely azacitidineor decitabineare the preferred treatment options. The effect of the introduction of therapeutic advances has not been well understood at the population level.We conducted this study to compare relative survival rates of elderly patients (≥65 years) with MDS in pre- and post- hypomethylatingagent era. Methodology: We utilized the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER-18) database to identify patients diagnosed with MDS. MDS subtype, namely Refractory anemia with excess blasts [Code: 9983/3] and Refractory anemia with excess blasts in transformation [Code: 9984/3] have the highest risk rate of transformation to AML. We opted to focus on these high risk MDS subtype. We limited our analysis to patients who are ≥ 65 years of age. On May 19, 2004, the U.S. Food and Drug Administration approvedazacitidinefor MDS. We defined our timeframes as follows: pre-hypomethylatingera (from 1994 to 2003) and post-hypomethylatingera (from 2005 to 2011). We analyzed one- and two-year relative survival rates (RS) of MDS patients. Several cohorts categorized by race (Caucasians and African Americans), gender and age (65-80, ≥ 80) were compared to assess the survival differences across our two defined eras. Z-test was used to compare the survival rates. Results: The database comprised of 2,665 patients (691 in pre and 1,974 in post). Overall there was an improved survival in post-hypomethylatingera (1-year: 43.8±2.0% vs. 50.2±1.2, Z-score= 2.993, p-value=0.0028; 2-year: 22.3±1.7 vs. 26.9±1.1, Z score= 3.202, p value=0.0014). There was a significant improvement in 1-year RS for males and 2-year RS for females. Elderly Caucasians also had survival benefit in post-hypomethylatingera. There was no survival benefit observed for African Americans however this did not reach statistical significance. A survival benefit was observed for elderly (65-79 years) and very elderly (≥ 80 years, only 2-year RS) population. Conclusion: The survival of myelodysplastic syndrome has improved significantly in post-hypomethylatingera. Improvements in supportive care, utilization of allogeneic stem cell transplant, andhypomethylatingagetnsmay all have contributed to this observation. Disclosures No relevant conflicts of interest to declare.
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Orbán, Anna, and Annamária Beláz. "eIdentification - Renewable regulated electronic administration services." Central and Eastern European eDem and eGov Days 325 (February 14, 2018): 463–76. http://dx.doi.org/10.24989/ocg.v325.38.
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Since 2005, Hungary has a comprehensive central identification solution. The Client Gate is capable of identifying citizens for any public authority that connects to it. The Client Gate is very popular and useful tool for identification among citizens for electronic transaction. Today approximately 2.4 million clients have a Client Gate account. However, many have an aversion towards the online administration. They can choose the personal administration or they can use their mobile phone for administration.
Since the beginning of 2016, the new electronic ID card integrates personal identification, social security and tax identification information which is also suitable for providing an electronic signature. These two new identification options are available to citizens, including the newly introduced national eID card, as well as the Partial Code Telephone Authentication. A half years about a million new eID card has been claimed for the citizens. However, the telephone authentication is less popular.
In Hungary, the new electronic administration is based on the "Regulated Electronic Administrative Services” (Hungarian short name SZEÜSZ) since 2012. The new central identification solution, the Central Authentication Agent as one of the Regulated Electronic Administrative Service has been launched that supports the use of different electronic identification and authentication services. Now the usual Client Gate has been changed to the Central Authentication Agent in Web Assistant application to implement full electronic administration procedures.
The aim of the study is to present the experience of the various methods of identification by comparative analysis.
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Kong, Jee Hyun, Tae-Hwa Go, Jung Yeon Lee, Hye Bin Song, Hohyung Nam, Jieun Uhm, and Shin Young Hyun. "Adherence to Tyrosine Kinase Inhibitor Affects Overall Survival in Adult Korean Chronic Myeloid Leukemia Patients; Based on the National Health Information Database." Blood 132, Supplement 1 (November 29, 2018): 1745. http://dx.doi.org/10.1182/blood-2018-99-111645.
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Abstract Objectives We evaluated clinical characteristics including adherence and its effects on overall survival (OS) in Korean patients diagnosed with chronic myeloid leukemia (CML) using National Health Information Database "NHID". Methods This study included patients 15 and older who were diagnosed with Philadelphia chromosome positive CML (ICD code C921) from 2005 to 2013 and prescribed with tyrosine kinase inhibitors (TKIs). TKIs included imatinib, dasatinib, nilotinib and radotinib which were covered by the National Health Insurance Service (NHIS) currently.Patients who were received interferon, prescribed TKI only once, or prescribed TKI 6 months after diagnosis were excluded. We extracted age, sex, medical institution, medical insurance premium (which is imposed by proportionate to income), medication list, date of hematopoietic stem cell transplantation (HSCT), and date of death from NHID. Each patients' laboratory result or disease phase (chronic phase, accelerate phase, or blastic crisis) were not available. Medication possession ratio (MPR) was used for adherence. Overall Survival (OS) was calculated by Kaplan-Meier methods. As well as, univariate and multivariate analysis were done with Cox proportional hazard regression using SAS with following variables: Sex, age (≤50 years vs 50> years), income (high (upper 50%), low (lower 50%)), frontline TKI (imatinib vs others), and adherence (high (MPR ≥0.90), low (MPR<0.9)). Results A total of 3146 were followed up with a median of 69 (1-147) months until the end of 2016. Male was 60.2% (n=1899). Median age was 50 (16-92). More patients (n=1991, 62.9%) payed higher insurance premium. Imatinib was most frequently prescribed TKI (n=2764, 87.4%), then dasatinib (n=904, 28.6%), nilotinib (n=760, 24.0%), and radotinib (n=145, 4.6%) followed in orders. About two-thirds (n=2055, 65%) maintained frontline TKI until the end of follow up. Imatinib was selected as frontline TKI in 86.2% (n=3310), and 13.8% of patients chose newer generation TKIs. After TKI treatment, 7.7% of the patients received cytotoxic chemotherapy, and 19 patients underwent HSCT. Median MPR was 0.975 (0.003-2.035). A total 62% of patients (n=1966) showed high adherence. Male (p=0.036), young age (p<0.0001), high income (p=0.0002), using newer generation TKIs in the frontline (p<0.0001), and longer TKI treatment duration (p<0.0001) were associated with better adherence. Patients with low MPR performed chemotherapy (p<0.0001) or HSCT(p<0.0001) and expired (p<0.001) more than those with high MPR. Estimated OS at 5-year and 10-year were 84.7% and 75.3%, respectively. In univariate analysis, patients older than 50-years (HR 2.11 [95% C.I. 1.81-2.47] (Figure 1A) and low MPR (HR 6.34[95% CI 5.22-7.70] (Figure 1B) showed poor OS. In multivariate analysis, male, age >50, low MPR patients associated with poor OS showing HR 1.29 [95% C.I., 1.09-1.52], 2.98 [95% C.I., 2.49-3.58], and 6.13 [95% C.I., 5.04-7.45], respectively. Conclusion Based on NHID, estimated OS of 3146 Korean CML patients at 10-year was 75.3%, and female, age ≤50, and high MPR associated with better OS. Disclosures No relevant conflicts of interest to declare.
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Canestrari, Niccolo, Oleg Chubar, and Ruben Reininger. "Partially coherent X-ray wavefront propagation simulations including grazing-incidence focusing optics." Journal of Synchrotron Radiation 21, no. 5 (August 6, 2014): 1110–21. http://dx.doi.org/10.1107/s1600577514013058.
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X-ray beamlines in modern synchrotron radiation sources make extensive use of grazing-incidence reflective optics, in particular Kirkpatrick–Baez elliptical mirror systems. These systems can focus the incoming X-rays down to nanometer-scale spot sizes while maintaining relatively large acceptance apertures and high flux in the focused radiation spots. In low-emittance storage rings and in free-electron lasers such systems are used with partially or even nearly fully coherent X-ray beams and often target diffraction-limited resolution. Therefore, their accurate simulation and modeling has to be performed within the framework of wave optics. Here the implementation and benchmarking of a wave-optics method for the simulation of grazing-incidence mirrors based on the local stationary-phase approximation or, in other words, the local propagation of the radiation electric field along geometrical rays, is described. The proposed method is CPU-efficient and fully compatible with the numerical methods of Fourier optics. It has been implemented in theSynchrotron Radiation Workshop(SRW) computer code and extensively tested against the geometrical ray-tracing codeSHADOW. The test simulations have been performed for cases without and with diffraction at mirror apertures, including cases where the grazing-incidence mirrors can be hardly approximated by ideal lenses. Good agreement between theSRWandSHADOWsimulation results is observed in the cases without diffraction. The differences between the simulation results obtained by the two codes in diffraction-dominated cases for illumination with fully or partially coherent radiation are analyzed and interpreted. The application of the new method for the simulation of wavefront propagation through a high-resolution X-ray microspectroscopy beamline at the National Synchrotron Light Source II (Brookhaven National Laboratory, USA) is demonstrated.
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Pai, Menaka, Faith Sealey, Rita Selby, William Geerts, and Michael Schull. "A Pilot Study of the Accuracy of Diagnostic Coding for Venous Thromboembolism within an Administrative Dataset of Emergency Department Visits." Blood 110, no. 11 (November 16, 2007): 969. http://dx.doi.org/10.1182/blood.v110.11.969.969.
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Abstract Introduction: With the advent of low molecular weight heparins, venous thromboembolism (VTE) management has largely shifted from the inpatient to the outpatient setting. Yet there is a paucity of data addressing the incidence of outpatient VTE and the process and cost of care related to its management. Large administrative databases are often a good source of data for population-based research. However, concerns about their accuracy necessitate that they be validated first. The National Ambulatory Care Reporting System (NACRS) is an administrative database launched by the Canadian Institutes of Health Information (CIHI) in 2001. Hospitals submit abstracted information on all emergency department (ED) visits to CIHI. If the accuracy of VTE diagnosis codes within NACRS is known, this database could be used to address the above issues on a population level. Methods: Prior to a large-scale validation of VTE codes within NACRS, we conducted a pilot study at our large, tertiary care hospital - Sunnybrook Health Sciences Centre in Toronto, Canada. Our goal was to determine the accuracy of NACRS coding for VTE. To define a cohort of patients with suspected VTE who presented to our ED between January 1 and December 31, 2005 we generated a list of all visits with a procedure code of either duplex ultrasound, contrast enhanced chest CT or VQ scan. We also generated a list of all visits with a NACRS diagnosis code of VTE (ICD-10-CA codes for phlebitis and thrombophlebitis - I80.1, I80.2, I80.3, 180.8, 180.9 and pulmonary embolism - I26.0 and I26.9). The latter list captured patients who had imaging done at an outside facility. The lists were merged and duplicate entries removed. Electronic and/or paper chart review was carried out to confirm the diagnosis of VTE for all visits, based on positive diagnostic imaging results. Discrepancies were resolved by consensus between two physicians. Results: During the study period, there were over 40,000 visits to our ED. Using the above algorithm, 1149 patient visits were generated with either a procedure code for the above radiological tests or a diagnosis code for VTE. 348 visits had imaging done for reasons other than VTE (ie. trauma or malignancy), and 17 visits had no recorded diagnostic imaging. These visits were excluded. Of the remaining 784 visits, 121 had a diagnosis code of VTE and a confirmed diagnosis of VTE on chart review (true positives). 10 visits were coded as VTE but a diagnosis of VTE could not be confirmed on chart review (false positives). 30 visits were not coded as VTE but had a confirmed diagnosis of VTE (false negatives). 623 visits were neither coded as VTE nor had a confirmed diagnosis of VTE (true negatives). The prevalence of VTE in our sample was therefore 19.3%. The sensitivity of NACRS coding was 80.1% (95% CI 72.7% to 86.0%), while the specificity was 98.4% (95% CI 97.0% to 99.2%). Conclusion: NACRS coding for VTE is highly specific, but less sensitive. This suggests NACRS may be useful for studying outpatient VTE at a population level, though a multi-site validation is required. Using a search algorithm to identify patients with suspected VTE based on procedure and diagnosis codes is feasible, given the non-specific nature of the presenting symptoms of VTE. This algorithm can be used for similar validation studies.
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Dalton, Jarrod E., Andrea Kurz, Alparslan Turan, Edward J. Mascha, Daniel I. Sessler, and Leif Saager. "Development and Validation of a Risk Quantification Index for 30-Day Postoperative Mortality and Morbidity in Noncardiac Surgical Patients." Anesthesiology 114, no. 6 (June 1, 2011): 1336–44. http://dx.doi.org/10.1097/aln.0b013e318219d5f9.
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Background Optimal risk adjustment is a requisite precondition for monitoring quality of care and interpreting public reports of hospital outcomes. Current risk-adjustment measures have been criticized for including baseline variables that are difficult to obtain and inadequately adjusting for high-risk patients. The authors sought to develop highly predictive risk-adjustment models for 30-day mortality and morbidity based only on a small number of preoperative baseline characteristics. They included the Current Procedural Terminology code corresponding to the patient's primary procedure (American Medical Association), American Society of Anesthesiologists Physical Status, and age (for mortality) or hospitalization (inpatient vs. outpatient, for morbidity). Methods Data from 635,265 noncardiac surgical patients participating in the American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2008 were analyzed. The authors developed a novel algorithm to aggregate sparsely represented Current Procedural Terminology codes into logical groups and estimated univariable Procedural Severity Scores-one for mortality and morbidity, respectively-for each aggregated group. These scores were then used as predictors in developing respective risk quantification models. Models were validated with c-statistics, and calibration was assessed using observed-to-expected ratios of event frequencies for clinically relevant strata of risk. Results The risk quantification models demonstrated excellent predictive accuracy for 30-day postoperative mortality (c-statistic [95% CI] 0.915 [0.906-0.924]) and morbidity (0.867 [0.858-0.876]). Even in high-risk patients, observed rates calibrated well with estimated probabilities for mortality (observed-to-expected ratio: 0.93 [0.81-1.06]) and morbidity (0.99 [0.93-1.05]). Conclusion The authors developed simple risk-adjustment models, each based on three easily obtained variables, that allow for objective quality-of-care monitoring among hospitals.
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Joedo, Lolita Adhyana. "Peningkatan Batas Aman Induksi Elektromagnetik Saluran Udara Tegangan Ekstra Tinggi (SUTET) 500 kV Bagi Kesehatan Manusia Berdasarkan Peraturan Menteri ESDM No. 18 Tahun 2015 Juncto No. 2 Tahun 2019." KILAT 9, no. 1 (April 25, 2020): 49–56. http://dx.doi.org/10.33322/kilat.v9i1.780.
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The Development of Extra High Voltage (EHV) overhead power lines ( SUTET 500 kV) has become a national issue because based on several studies worldwide that shown residents who living next to power lines could increase the risk of their health problems. Therefore, there were huge protests from residents in Singosari and Gresik in 1991. The protest also happened in 2004, in which residents from Sumedang, Bogor, Cianjur, and Majalengka marching to Presidential Palace in Jakarta altogether. As a consequence, PLN and Faculty of Engineering of Gajah Mada University in 2005 developed collaborative research to identify HV and EHV required clearance of distance. This research refers to the WHO standard which determines the maximum of magnetic and electric field allowed, also refers to the Ministry of Mineral and Energy Resources Regulation No.01.P/47/M.PE/1992 which determines the minimum clearance distance between HV/ EVH bottom conductor with the ground as the safety levels concerning human exposure to electromagnetic fields.
As the enactment regulation of the Ministry of Mineral and Energy Resources No. 18 of 2018 and its amendment No.2 of 2019, the regulation of HV, EHV, and also HVDC (High Voltage – Direct Current) free space and required clearance distance is determined. This research describes the comparison between PLN-UGM collaborative research with both Ministry regulation mentioned above.
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Moon, Jung Min, Jin Yong Lee, Seong-Joon Koh, Hyunsun Park, Sungchan Kang, Hosim Soh, Hyun Jung Lee, Jong Pil Im, and Joo Sung Kim. "Incidence of Psoriasis in Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Matched Cohort Study." Dermatology 237, no. 3 (2021): 330–37. http://dx.doi.org/10.1159/000514030.
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<b><i>Background:</i></b> Emerging data suggest that inflammatory bowel disease (IBD) and psoriasis are associated, sharing common genetic predispositions and immunological mechanisms. However, concrete data on psoriasis risk in IBD patients compared to the general population are limited. <b><i>Objective:</i></b> We investigated the risk of developing psoriasis in IBD patients compared to controls without IBD. <b><i>Methods:</i></b> Using the Korean National Health Insurance Database, patients diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC) between 2005 and 2008 were age- and sex-matched 1:4 to non-IBD subjects from 2003 to 2018. IBD patients were defined by combining the International Classification of Diseases 10th revision code and at least one prescription of IBD-specific medications. Disease phenotypes, including psoriasis severity and psoriatic arthritis, were also identified. We investigated newly diagnosed psoriasis from 2009 to 2018. Incidence rates and risk of psoriasis were assessed with multivariate Cox regression models. Subgroup analyses for age and sex, and sensitivity analysis involving tumor necrosis factor (TNF) inhibitor-naïve patients were performed. <b><i>Results:</i></b> During nearly a decade of follow-up, 20,152 IBD patients were identified (14,619 [72.54%] UC and 5,533 [27.46%] CD). Among them, 439 patients were newly diagnosed with psoriasis (incidence rate of 217.68 per 100,000 person-years and 228.62 per 100,000 person-years for UC and CD, respectively). The psoriasis risk was higher in IBD patients than in the matched controls (adjusted hazard ratio, aHR, 2.95, 95% confidence interval, CI, 2.60–3.33). Moreover, IBD patients aged <30 years were at an increased risk (aHR 3.35, 95% CI 2.58–4.35), a trend that was unchanged across all psoriasis phenotypes. Sensitivity analysis of TNF inhibitor-naïve patients revealed consistent results. <b><i>Conclusions:</i></b> IBD patients were more likely to develop psoriasis compared to non-IBD subjects, including younger patients at an elevated risk regardless of TNF inhibitor use. This advocates the interplay between IBD and psoriasis; thus, inspection of cutaneous manifestation and dermatological consultation may be helpful in IBD patients at risk.
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Burnham, Kenneth, and Gareth Pierce. "Acoustic Techniques for Wind Turbine Blade Monitoring." Key Engineering Materials 347 (September 2007): 639–44. http://dx.doi.org/10.4028/www.scientific.net/kem.347.639.
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The total electrical generation capacity from wind sources in the International Energy Agency (IEA) Wind Member Countries has increased from 4 GW in 1995 to more than 51 GW in 2005 thus underlining the strategic importance of the resource. In the last year alone the UK increased its wind generation by 447 MW, an increase of 85% over that for the previous year. In 2004, wind generation formed just 0.5% of the national electric demand; this contribution is set to rise over the next few years with some predictions that wind energy will rise to 8% of the total UK demand by 2010. The rotor blades of a wind turbine system are a significant structural component of the overall system, and typically account for 30% of lifecycle costs, and contribute 34% to overall system downtime. Despite their importance, there is currently very little monitoring of the structural integrity of rotor components, and what does exist is limited. We perceive that especially with the current political and technological emphasis on offshore installations, there will be an increase in the perceived need for remote structural monitoring, and there is indeed currently great interest in this area from the wind turbine industry. This work focuses on the applications of acoustic techniques to assess the integrity of typical rotor blade structures. Preliminary results discuss the limiting aspects of acoustic based techniques based on the physics of acoustic wave propagation in typical structural components. Comparisons between acoustic emission approaches and conventional active ultrasound will be considered.