Evacuation Hazards in Crowded Subway Stations

Underground subway system is the key transportation means in dense urban areas such as Hong Kong. Subway stations are crowded with passengers on the platforms and they are observed to squeeze into the train carriages during rush hours. Putting in platform screen doors made the situation even worse. As reported in the local news, subway management claims that after following the change in maximum capacity from six passengers per meter square to four passengers per meter square, the capacity is only 70% full at rush hours. However, the capacity can be over 90% of full loading under the new calculation. Subway stations become more crowded with an average weekday patronage of nearly 5.3 million passengers.  Subway stations are mostly located in the basement or ground levels connecting the shopping mall, commercial or residential building in downtown areas. The occupancy density of passengers can be much higher than expected during festivals with fireworks show and during large-scale movements such as Occupy Central. Therefore, evacuation time in emergency situation will be prolonged. To have a better understanding of the safety issue in subway stations, evacuation time in emergency situations will be studied in this paper.  Two subway stations, Station A and Station B are selected in this paper to study the evacuation hazard of crowded stations when a fire occurs. Station A is an interchange station between two railway lines, being one of the most crowded stations with high occupancy density. Station B is the first station in the local rail network to feature a special design - “Lift-only Entrancesâ€. This is a deep underground station which lies under 70 m of ground level, the passengers have to be evacuated by lift. The occupancy density in Station B is relatively much lower than Station A under normal conditions at the moment, though the station can be very crowded if there are train delays due to signal failure or other reasons.  In this paper, the evacuation effectiveness of Station A and Station B are estimated in terms of evacuation time in different scenarios by using Hydraulic Model Calculation. Moreover, the special evacuation feature of “Lift-only Entrances†in Station B and the fire safety management strategies for emergency evacuation will be discussed.  Three scenarios will be studied in each station:  Scenario A: Assume that the passengers are evenly distributed in different exits in emergency situation. All the possible factors such as passenger behaviors and conditions are eliminated.  Scenario B: Passengers have a higher tendency to evacuate at the larger exit, this is one of the passenger behaviors in emergency situation. Therefore, the passenger distribution which depends on the exit width will be studied.  Scenario C: Assume that some of the exit routes are blocked.  The most important factor for the above study is the passenger behaviors. As in scenario B, passenger behaviors would affect the evacuation time. Therefore, fire safety management is identified to be a key part in keeping efficient evacuation. For example, a good fire action plan on crowd control is needed

Sexual Functioning of Gynecological Cancer Patients: A Literature Review

Background: According to the World Health Organization, cervical, uterine and ovarian cancers were the third, sixth and eighth most common cancers in women worldwide. Unlike other physiological side effects of cancer treatment, sexual problems in gynecological cancer survivors do not tend to resolve after first few years of cancer treatment. However, women who experience sexual dysfunction do not discuss the problem openly with their healthcare professionals.Objective: The objectives of this literature review are to identify, summarize and critically appraise current literatures investigating the sexual functioning and sexual health needs of gynecological cancer patients, as well as to identify the communication between gynecological cancer patients and healthcare professionals.Design: A thorough analysis of the literatures on the topic of sexual functioning of gynecological cancer patients.Data sources: EBSCO host (Medline, CINAL Plus and Academic Search Alumni Edition) and Ovid Technology (British Nursing Index).Review methods: A comprehensive search was conducted in the named data sources from 2003 to 2014 to identify English articles with the keywords “ovarian cancerâ€, “uterine cancerâ€, “cervical cancerâ€, “gynecological cancerâ€, “sexual functioningâ€, “sexuality†and “sexual health needsâ€. Two authors assessed all identified articles independently for inclusion in the review.Results: A total of eight studies were included in the review. All studies focused on the sexual functioning of gynecological cancer patients. Four of them assessed their sexual health needs and one evaluated the communication between the patients and healthcare professionals. The findings indicated that gynecological cancer patients experienced sexual dysfunction after the diagnosis and treatment of the disease. Uncertainty of the side-effects of cancer treatment on bodily functions led to misunderstanding and misconceptions on sexual functioning. Communication, in general, was found to be insufficient between gynecological cancer patients and healthcare professionals.Conclusion: Sexual functioning after the diagnosis and treatment of gynecological cancer requires special attention and care. Appropriate interventions should be developed to meet the patients’ needs. As most of the studies investigating the sexual functioning of gynecological cancer patients were carried out in Western countries, implications for research on this issue in different cultural background is suggested

Circulating Levels of Adipocyte and Epidermal Fatty Acid–Binding Proteins in Relation to Nephropathy Staging and Macrovascular Complications in Type 2 Diabetic Patients

OBJECTIVE—To investigate the relationships of serum adipocyte fatty acid–binding protein (A-FABP) and epidermal fatty acid–binding protein (E-FABP) with renal dysfunction and macrovascular complications in type 2 diabetic patients

The voltage-gated sodium channel NaV1.7 underlies endometriosis-associated chronic pelvic pain

OnlinePublChronic pelvic pain (CPP) is the primary symptom of endometriosis patients, but adequate treatments are lacking. Modulation of ion channels expressed by sensory nerves innervating the viscera has shown promise for the treatment of irritable bowel syndrome and overactive bladder. However, similar approaches for endometriosis-associated CPP remain underdeveloped. Here, we examined the role of the voltage-gated sodium (NaV) channel NaV1.7 in (i) the sensitivity of vagina-innervating sensory afferents and investigated whether (ii) NaV1.7 inhibition reduces nociceptive signals from the vagina and (iii) ameliorates endometriosis-associated CPP. The mechanical responsiveness of vagina-innervating sensory afferents was assessed with ex vivo single-unit recording preparations. Pain evoked by vaginal distension (VD) was quantified by the visceromotor response (VMR) in vivo. In control mice, pharmacological activation of NaV1.7 with OD1 sensitised vagina-innervating pelvic afferents to mechanical stimuli. Using a syngeneic mouse model of endometriosis, we established that endometriosis sensitised vagina-innervating pelvic afferents to mechanical stimuli. The highly selective NaV1.7 inhibitor Tsp1a revealed that this afferent hypersensitivity occurred in a NaV1.7-dependent manner. Moreover, in vivo intra-vaginal treatment with Tsp1a reduced the exaggerated VMRs to VD which is characteristic of mice with endometriosis. Conversely, Tsp1a did not alter ex vivo afferent mechano-sensitivity nor in vivo VMRs to VD in Sham control mice. Collectively, these findings suggest that NaV1.7 plays a crucial role in endometriosis-induced vaginal hyperalgesia. Importantly, NaV1.7 inhibition selectively alleviated endometriosis-associated CPP without the loss of normal sensation, suggesting that selective targeting of NaV1.7 could improve the quality of life of women with endometriosis.Joel Castro, Jessica Maddern, Chun Yuen Chow, Poanna Tran, Irina Vetter, Glenn F. King, Stuart M. Brierle

Disrupted murine gut-to-human liver signaling alters bile acid homeostasis in humanized mouse liver models

The humanized liver mouse model is being exploited increasingly for human drug metabolism studies. However, its model stability, intercommunication between human hepatocytes and mouse nonparenchymal cells in liver and murine intestine, and changes in extrahepatic transporter and enzyme expressions have not been investigated. We examined these issues in FRGN [fumarylacetoacetate hydrolase (Fah2/2), recombination activating gene 2 (Rag22/2), and interleukin 2 receptor subunit gamma (IL-2rg 2/2) triple knockout] on nonobese diabetic (NOD) background] and chimeric mice: mFRGN and hFRGN (repopulated withmouse or human hepatocytes, respectively). hFRGN mice showed markedly higher levels of liver cholesterol, biliary bilirubin, and bile acids (liver, bile, and plasma; mainly human forms, but also murine bile acids) but lower transforming growth factor beta receptor 2 (TGFBR2) mRNA expression levels (10%) in human hepatocytes and other proliferative markers in mouse nonparenchymal cells (Tgf-1) and cholangiocytes [plasma membrane-bound, G protein-coupled receptor for bile acids (Tgr5)], suggestive of irregular regeneration processes in hFRGN livers. Changes in gene expression in murine intestine, kidney, and brain of hFRGN mice, in particular, induction of intestinal farnesoid X receptor (Fxr) genes: fibroblast growth factor 15 (Fgf15), mouse ileal bile acid binding protein (Ibabp), small heterodimer partner (Shp), and the organic solute transporter alpha (Osta), were observed. Proteomics revealed persistence of remnant murine proteins (cyotchrome P450 7α-hydroxylase (Cyp7a1) and other enzymes and transporters) in hFRGN livers and suggest the likelihood ofmouse activity.When comparedwith normal human liver tissue, hFRGN livers showed lower SHP mRNA and higher CYP7A1 (300%) protein expression, consequences of tb- and ta-muricholic acid-mediated inhibition of the FXR-SHP cascade and miscommunication between intestinal Fgf15 and human liver fibroblast growth factor receptor 4 (FGFR4), as confirmed by the unchanged hepatic pERK/total ERK ratio. Dysregulation of hepatocyte proliferation and bile acid homeostasis in hFRGN livers led to hepatotoxicity, gallbladder distension, liver deformity, and other extrahepatic changes, making questionable the use of the preparation for drug metabolism studies

Spatial Cloaking Revisited: Distinguishing Information Leakage from Anonymity

Abstract. Location-based services (LBS) are receiving increasing popularity as they provide convenience to mobile users with on-demand information. The use of these services, however, poses privacy issues as the user locations and queries are exposed to untrusted LBSs. Spatial cloaking techniques provide privacy in the form of k-anonymity; i.e., they guarantee that the (location of the) querying user u is indistinguishable from at least k-1 others, where k is a parameter specified by u at query time. To achieve this, they form a group of k users, including u, and forward their minimum bounding rectangle (termed anonymizing spatial region, ASR) to the LBS. The rationale behind sending an ASR instead of the distinct k locations is that exact user positions (querying or not) should not be disclosed to the LBS. This results in large ASRs with considerable dead-space, and leads to unnecessary performance degradation. Additionally, there is no guarantee regarding the amount of location information that is actually revealed to the LBS. In this paper, we introduce the concept of information leakage in spatial cloaking. We provide measures of this leakage, and show how we can trade it for better performance in a tunable manner. The proposed methodology directly applies to centralized and decentralized cloaking models, and is readily deployable on existing systems.

The Ricci flow on noncommutative two-tori

In this paper we construct a version of Ricci flow for noncommutative 2-tori, based on a spectral formulation in terms of the eigenvalues and eigenfunction of the Laplacian and recent results on the Gauss-Bonnet theorem for noncommutative tori.Comment: 18 pages, LaTe

Case studies of interprofessional education initiatives from five countries

Background Although teamwork and interprofessional collaboration are critical to patient safety, healthcare graduates frequently report that they often feel ill-prepared to confidently communicate and collaborate with other team members. While interprofessional education has been advocated as a way of addressing this issue, there are multiple barriers to its systematic and sustained integration in undergraduate healthcare programs. Despite these challenges, examples of effective IPE initiatives have emerged. Purpose This paper profiles seven case studies of innovative interprofessional education activities that have been successfully implemented across five countries, for a variety of learners and using different delivery modalities. The evaluation results from these interprofessional education activities attest to their impact and positive outcomes. Conclusion These case studies demonstrate that the barriers to interprofessional education can be overcome when creative and targeted approaches are used. This paper provides a wealth of ideas for the successful design and implementation of interprofessional education initiatives and will be of benefit to educators wishing to expand their repertoire of teaching approaches. Clinical Relevance: A body of research attests to the relationship between interprofessional communication, teamwork and patient outcomes. Interprofessional education is imperative for facilitating the development of graduates’ communication and teamwork skills, however, innovative approaches are needed to overcome the perceived and actual impediments to its implementation

The amyloid precursor protein controls PIKfyve function

While the Amyloid Precursor Protein (APP) plays a central role in Alzheimer's disease, its cellular function still remains largely unclear. It was our goal to establish APP function which will provide insights into APP's implication in Alzheimer's disease. Using our recently developed proteo-liposome assay we established the interactome of APP's intracellular domain (known as AICD), thereby identifying novel APP interactors that provide mechanistic insights into APP function. By combining biochemical, cell biological and genetic approaches we validated the functional significance of one of these novel interactors. Here we show that APP binds the PIKfyve complex, an essential kinase for the synthesis of the endosomal phosphoinositide phosphatidylinositol-3,5-bisphosphate. This signalling lipid plays a crucial role in endosomal homeostasis and receptor sorting. Loss of PIKfyve function by mutation causes profound neurodegeneration in mammals. Using C. elegans genetics we demonstrate that APP functionally cooperates with PIKfyve in vivo. This regulation is required for maintaining endosomal and neuronal function. Our findings establish an unexpected role for APP in the regulation of endosomal phosphoinositide metabolism with dramatic consequences for endosomal biology and important implications for our understanding of Alzheimer's disease

Additive Interaction of Hyperglycemia and Albuminuria on Risk of Ischemic Stroke in Type 2 Diabetes: Hong Kong Diabetes Registry

OBJECTIVE—The study aims to test whether biological interaction between hyperglycemia and albuminuria can explain the inconsistent findings from epidemiological studies and clinical trials about effects of hyperglycemia on stroke in type 2 diabetes