North Carolina Stormwater Compliance Evaluation for the 20 Coastal Counties

Stormwater is one of the largest sources of pollutants in the United States and contributes sediment, heavy metals, oil, pesticides, fertilizers, bacteria, and other contaminants to coastal waters. Water quality is critical to coastal areas for commercial fishery health and recreational activities. To minimize the introduction of water quality pollutants, North Carolina implemented the State Stormwater Program (SSP) for post construction stormwater management. A study in 2005 identified low compliance rates with the SSP (30.7%) and a follow-up in 2009 found that only 20% of noncompliant sites had rectified their violations. There are currently no studies documenting recent compliance rates with the SSP. This study addressed three objectives: (1) Update the compliance study to include recent trends in compliance and reasons for violations (2) Determine the perceptions of the strengths and opportunities for improvement, and (3) Conduct a program analysis of the SSP. These objectives were achieved by analyzing compliance data from the Division of Energy, Mineral, and Land Resources, conducting interviews with a small sample of entities that interact with the SSP, and reviewing applicable compliance literature. The results of our study show potential areas for improvement and were used to make policy recommendations for North Carolina to increase compliance with these regulations. Our results indicate that compared to the 2005 estimate, compliance in 2012 increased to 50%, and was lower in coastal counties than noncoastal counties. In total there were 2,838 compliance inspections between 2008 and 2012. Yearly inspections increased between 2008 and 2010, but decreased sharply in 2011 and remained low in 2012. The majority of violations were due to reporting and maintenance issues. Interview respondents indicated that the main impediments to compliance are maintenance and education, and that compliance could be improved through increased maintenance checks and public outreach efforts. The program analysis showed that while the stormwater program generally has clear regulations, it could benefit from increased visibility of the regulating agency, engagement, as well as education. Potential avenues for improvement are discussed, and are considered within the context of our findings

The diverse magneto-optical selection rules in bilayer black phosphorus

The magneto-optical properties of bilayer phosphorene is investigated by the generalized tight-binding model and the gradient approximation. The vertical inter-Landau-level transitions, being sensitive to the polarization directions, are mainly determined by the spatial symmetries of sub-envelope functions on the distinct sublattices. The anisotropic excitations strongly depend on the electric and magnetic fields. A perpendicular uniform electric field could greatly diversify the selection rule, frequency, intensity, number and form of symmetric absorption peaks. Specifically, the unusual magneto-optical properties appear beyond the critical field as a result of two subgroups of Landau levels with the main and side modes. The rich and unique magneto-absorption spectra arise from the very close relations among the geometric structures, multiple intralayer and interlayer hopping integrals, and composite external fields

Using Type-2 Fuzzy Models to Detect Fall Incidents and Abnormal Gaits Among Elderly

— June 2012, 11% of the overall population in Taiwan was over the age of 65. This ratio is higher than the average figure for the United Nations (8%) . Critical issues concerning elderly in healthcare include fall detection, loneliness prevention and retard of obliviousness. In this study we design type-2 fuzzy models that utilize smart phone tri-axial accelerometer signals to detect fall incidents and identify abnormal gaits among elderly. Once a fall incident is detected an alarm is sent to notify the medical staff for taking any necessary treatment. When the proposed system is used as a pedometer, all the tri-axial accelerometer signals are used to identify the gaits during walking. Based on the proposed type-2 fuzzy models, the walking gaits can be identified as normal, left-tilted, and right-tilted. Experimental results from type-2 fuzzy models reveal that the accuracy rates in identifying normal walking and fall over are 92.3% and 100%, respectively, exceeding what are obtained using type-1 fuzzy models

Spleen artery embolization increases the success of nonoperative management following blunt splenic injury

AbstractBackgroundSpleen artery embolization (SAE) may increase the success rate of nonoperative management (NOM). The present study investigated the clinical outcome after the installation of SAE in the management of blunt splenic injury.MethodsA retrospective review of hospital records was performed to enroll patients with blunt injury of the spleen. Demographic data and information about the injury severity score, organ injury scale, hospitalization days, management and final outcomes were evaluated. Patients were separated into early and late groups according to the year that SAE was selectively used (2003–2004 and 2005–2008).ResultsSix of eleven (55%) patients in the early group were successfully managed without surgery for blunt splenic injury, whereas all of the 38 patients (100%) in the late group were successfully managed without surgery. Eleven patients (11 of 38; 28.9%) received SAE in the late group. The rate of NOM increased from 55% in the early group to 100% in the late group (p < 0.001). Both early and late groups had similar injury severity score, length of hospitalization, blood transfusion, and complications, and there was no mortality.ConclusionPerformance of SAE for the patients with blunt splenic injury could increase the successful rate of NOM significantly and safely. An algorithm including the angioembolization might be beneficial in the management of patients with blunt spleen trauma

Effects of virtual reality training on decreasing the rates of needlestick or sharp injury in new-coming medical and nursing interns in Taiwan

Purpose Senior nursing and medical interns’ lack of familiarity and confidence with respect to practicing universal precaution for the prevention of occupational needlestick or sharp injuries may harm themselves. Trainees’ self-reported needlestick or sharp injury rate was known to be especially high during the first 2 months of internship in Taiwan. This prospective cohort study aimed to assess the effect of newly developed virtual reality (VR) game, which uses Gagne’s learning model to improve universal precaution for needlestick or sharp injury prevention and decrease the rates of needle stick or sharp injuries in new-coming medical and nursing interns in Taiwan. Methods From 2017 to 2019, the VR system was developed and applied in training of 59 new-coming nursing and 50 medical interns. Occupational needlestick or sharp injury prevention was sought to be achieved through a game of right and wrong choices for safe or unsafe universal precaution behaviors. Results In comparison with medical interns, a higher proportion of nursing interns had past experiences of deep occupational needlestick or sharp injury. Before VR training, the familiarity and confidence for needlestick or sharp injury prevention were higher among nursing interns than medical interns. Trainees with past experiences of deep needlestick or sharp injury exhibited better performance on the accuracy rate and time needed to complete 20 decisions than those without past experiences in VR practice. All trainees showed an improved performance after VR training. A high proportion of trainees reported that the VR-based training significantly decreased their anxiety about needlestick or sharp injury prevention. Conclusion This self-developed VR game system using Gagne’s flow improved universal precaution for needlestick or sharp injury prevention and reduced the needlestick or sharp injury rates in the first 2 months of nursing and medical internship