Applying new uncertainty related theories and multicriteria decision analysis methods to snow avalanche risk management

International audienceMaking the best decision in the event of a snow avalanche encounters problems in the assessment and management process because of the lack of information and knowledge on natural phenomena and the heterogeneity and reliability of the information sources available (historical data, field measurements, and expert assessments). One major goal today is therefore to aid decision making by improving the quality, quantity, and reliability of the available information. This article presents a new method called evidential reasoning and multicriteria decision analysis (ER-MCDA) to help decision making by considering information imperfections arising from several more or less reliable and possibly conflicting sources of information. First, the principles of the existing methods are reviewed. Classical methods of multicriteria decision making and existing theories attempting to represent and propagate information imperfections are described. In a second point, we describe the principle of the ER-MCDA method combining multicriteria decision analysis (MCDA) to model the decision-making process and fuzzy sets theory, possibility theory, and evidence theory to represent, fuse and propagate information imperfections. Experts, considered more or less reliable, provide imprecise and uncertain evaluations of quantitative and qualitative criteria that are combined through information fusion. The method is applied to a simplified version of an existing system aiming to evaluate the sensitivity of avalanche sites. This new method makes it possible to consider both the importance of the information available and reliability in the decision process. It also contributes to improving traceability. Other developments designed to handle other assessment problems such as avalanche triggering conditions or data quality are in progress

Evaluation of Efficiency of Torrential Protective Structures With New BF-TOPSIS Methods

Decision-Aid Methods (DAMs) such as the CostBenefit Analysis (CBA) and the Analytical Hierarchy Process (AHP) help decision-makers to rank alternatives or to choose the best one among several potential ones

Using Composite Materials in a Cryogenic Pump

Several modifications have been made to the design and operation of an extended-shaft cryogenic pump to increase the efficiency of pumping. In general, the efficiency of pumping a cryogenic fluid is limited by thermal losses which is itself caused by pump inefficiency and leakage of heat through the pump structure. A typical cryogenic pump includes a drive shaft and two main concentric static components (an outer pressure containment tube and an intermediate static support tube) made from stainless steel. The modifications made include replacement of the stainless-steel drive shaft and the concentric static stainless-steel components with components made of a glass/epoxy composite. The leakage of heat is thus reduced because the thermal conductivity of the composite is an order of magnitude below that of stainless steel. Taking advantage of the margin afforded by the decrease in thermal conductivity, the drive shaft could be shortened to increase its effective stiffness, thereby increasing the rotordynamic critical speeds, thereby further making it possible to operate the pump at a higher speed to increase pumping efficiency. During the modification effort, an analysis revealed that substitution of the shorter glass/epoxy shaft for the longer stainless-steel shaft was not, by itself, sufficient to satisfy the rotordynamic requirements at the desired increased speed. Hence, it became necessary to increase the stiffness of the composite shaft. This stiffening was accomplished by means of a carbon-fiber-composite overwrap along most of the length of the shaft. Concomitantly with the modifications described thus far, it was necessary to provide for joining the composite-material components with metallic components required by different aspects of the pump design. An adhesive material formulated specially to bond the composite and metal components was chosen as a means to satisfy these requirements

Early blood pressure, antihypotensive therapy and outcomes at 18–22 months’ corrected age in extremely preterm infants

Investigate relationships between early blood pressure (BP) changes, receipt of anti-hypotensive therapy, and 18 – 22 month corrected age (CA) outcomes for extremely preterm infants

Stronger and More Vulnerable: A Balanced View of the Impacts of the NICU Experience on Parents

For parents, the experience of having an infant in the NICU is often psychologically traumatic. No parent can be fully prepared for the extreme stress and range of emotions of caring for a critically ill newborn. As health care providers familiar with the NICU, we thought that we understood the impact of the NICU on parents. But we were not prepared to see the children in our own families as NICU patients. Here are some of the lessons our NICU experience has taught us. We offer these lessons in the hope of helping health professionals consider a balanced view of the NICU's impact on families

Early postnatal hypotension and developmental delay at 24 months of age among extremely low gestational age newborns

To evaluate, in extremely low gestational age newborns (ELGANs), relationships between indicators of hypotension during the first 24 postnatal hours and developmental delay at 24 months of age

Early Blood Gas Predictors of Bronchopulmonary Dysplasia in Extremely Low Gestational Age Newborns

Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods. We studied the association of extreme quartiles of blood gas measurements (hypoxemia, hyperoxemia, hypocapnea, and hypercapnea) in the first three postnatal days, with bronchopulmonary dysplasia, among 906 newborns, using multivariable models adjusting for potential confounders. We approximated NIH criteria by classifying severity of BPD on the basis of the receipt of any O 2 on postnatal day 28 and at 36 weeks PMA and assisted ventilation. Results. In models that did not adjust for ventilation, hypoxemia was associated with increased risk of severe BPD and very severe BPD, while infants who had hypercapnea were at increased risk of very severe BPD only. In contrast, infants who had hypocapnea were at reduced risk of severe BPD. Including ventilation for 14 or more days eliminated the associations with hypoxemia and with hypercapnea and made the decreased risk of very severe BPD statistically significant. Conclusions. Among ELGANs, recurrent/persistent blood gas abnormalities in the first three postnatal days convey information about the risk of severe and very severe BPD

Early postnatal hypotension is not associated with indicators of white matter damage or cerebral palsy in extremely low gestational age newborns

ObjectivesTo evaluate, in extremely low gestational age newborns (ELGANs), relationships between indicators of early postnatal hypotension and cranial ultrasound indicators of cerebral white matter damage imaged in the nursery and cerebral palsy diagnoses at 24 month follow-up.MethodsThe 1041 infants in this prospective study were born at < 28 weeks gestation, were assessed for 3 indicators of hypotension in the first 24 postnatal hours, had at least one set of protocol cranial ultrasound scans, and were evaluated with a structured neurologic exam at 24 months corrected age. Indicators of hypotension included: 1) lowest mean arterial pressure (MAP) in the lowest quartile for gestational age; 2) treatment with a vasopressor; and 3) blood pressure lability, defined as the upper quartile of the difference between each infant’s lowest and highest MAP. Outcomes included indicators of cerebral white matter damage, i.e. moderate/severe ventriculomegaly or an echolucent lesion on cranial ultrasound, and cerebral palsy diagnoses at 24 months gestation. Logistic regression was used to evaluate relationships among hypotension indicators and outcomes, adjusting for potential confounders.ResultsTwenty-one percent of surviving infants had a lowest blood pressure in the lowest quartile for gestational age, 24% were treated with vasopressors, and 24% had labile blood pressure. Among infants with these hypotension indicators, 10% percent developed ventriculomegaly and 7% developed an echolucent lesion. At 24-months follow-up, 6% had developed quadriparesis, 4% diparesis, and 2% hemiparesis. After adjusting for confounders, we found no association between indicators of hypotension, and indicators of cerebral white matter damage or a cerebral palsy diagnosis.ConclusionsThe absence of an association between indicators of hypotension and cerebral white matter damage and or cerebral palsy suggests that early hypotension may not be important in the pathogenesis of brain injury in ELGANs

Chiral Heterocyclic Ligands. XI. Self-assembly and X-Ray Crystal Structures of Chiral Silver Coordination Polymers of (S)-(-)-Nicotine

Three chiral coordination polymers have been prepared by reaction of (S)-(-)-nicotine with silver(I) salts. X-Ray crystal structure determinations revealed that these all contain polymer chains in which the nicotine molecule acts as a bridging ligand between four-coordinate silver atoms. In one case additional bridging by nitrate anions leads to a three-dimensional network structure

Evolving blood pressure dynamics for extremely preterm infants

ObjectiveTo examine changes in arterial blood pressure (ABP) after birth in extremely preterm infants.Study DesignProspective observational study of infants 230/7 – 266/7 weeks gestational age (GA). Antihypotensive therapy use and ABP measurements were recorded for the first 24 hours.ResultsA cohort of 367 infants had 18,709 ABP measurements recorded. ABP decreased for the first three hours, reached a nadir at 4 – 5 hours, then increased at an average rate of 0.2 mmHg / hour. The rise in ABP from hour 4 – 24 was similar for untreated infants (n=164) and infants given any antihypotensive therapy (n=203), a fluid bolus (n=135), or dopamine (n=92). GA specific trends were similar. ABP tended to be lower as GA decreased, but varied widely at each GA.ConclusionArterial blood pressure increased spontaneously over the first 24 postnatal hours for extremely preterm infants. The rate of rise in ABP did not change with antihypotensive therapy