Mesoscale acid deposition modeling studies

The work performed in support of the EPA/DOE MADS (Mesoscale Acid Deposition) Project included the development of meteorological data bases for the initialization of chemistry models, the testing and implementation of new planetary boundary layer parameterization schemes in the MASS model, the simulation of transport and precipitation for MADS case studies employing the MASS model, and the use of the TASS model in the simulation of cloud statistics and the complex transport of conservative tracers within simulated cumuloform clouds. The work performed in support of the NASA/FAA Wind Shear Program included the use of the TASS model in the simulation of the dynamical processes within convective cloud systems, the analyses of the sensitivity of microburst intensity and general characteristics as a function of the atmospheric environment within which they are formed, comparisons of TASS model microburst simulation results to observed data sets, and the generation of simulated wind shear data bases for use by the aviation meteorological community in the evaluation of flight hazards caused by microbursts

Seismic Safety Study

During the past three decades, the Laboratory has been proactive in providing a seismically safe working environment for its employees and the general public. Completed seismic upgrades during this period have exceeded $30M with over 24 buildings structurally upgraded. Nevertheless, seismic questions still frequently arise regarding the safety of existing buildings. To address these issues, a comprehensive study was undertaken to develop an improved understanding of the seismic integrity of the Laboratory's entire building inventory at the Livermore Main Site and Site 300. The completed study of February 2005 extended the results from the 1998 seismic safety study per Presidential Executive Order 12941, which required each federal agency to develop an inventory of its buildings and to estimate the cost of mitigating unacceptable seismic risks. Degenkolb Engineers, who performed the first study, was recontracted to perform structural evaluations, rank order the buildings based on their level of seismic deficiencies, and to develop conceptual rehabilitation schemes for the most seriously deficient buildings. Their evaluation is based on screening procedures and guidelines as established by the Interagency Committee on Seismic Safety in Construction (ICSSC). Currently, there is an inventory of 635 buildings in the Laboratory's Facility Information Management System's (FIMS's) database, out of which 58 buildings were identified by Degenkolb Engineers that require seismic rehabilitation. The remaining 577 buildings were judged to be adequate from a seismic safety viewpoint. The basis for these evaluations followed the seismic safety performance objectives of DOE standard (DOE STD 1020) Performance Category 1 (PC1). The 58 buildings were ranked according to three risk-based priority classifications (A, B, and C) as shown in Figure 1-1 (all 58 buildings have structural deficiencies). Table 1-1 provides a brief description of their expected performance and damage state following a major earthquake, rating the seismic vulnerability (1-10) where the number 10 represents the highest and worst. Buildings in classifications A and B were judged to require the Laboratory's highest attention towards rehabilitation, classification C buildings could defer rehabilitation until a major remodel is undertaken. Strengthening schemes were developed by Degenkolb Engineers for the most seriously deficient A and B classifications (15 total), which the Laboratory's Plant Engineering Department used as its basis for rehabilitation construction cost estimates. A detailed evaluation of Building 2580, a strengthening scheme, and a construction cost estimate are pending. Specific details of the total estimated rehabilitation costs, a proposed 10-year seismic rehabilitation plan, exemption categories by building, DOE performance guidelines, cost comparisons for rehabilitation, and LLNL reports by Degenkolb Engineers are provided in Appendix A. Based on the results of Degenkolb Engineers evaluations, along with the prevailing practice for the disposition of seismically deficient buildings and risk-based evaluations, it is concluded that there is no need to evacuate occupants from these 58 buildings prior to their rehabilitation

Bypassing nearest hospital for more distant neuroscience care in head-injured adults with suspected traumatic brain injury: findings of the head injury transportation straight to neurosurgery (HITS-NS) pilot cluster randomised trial

OBJECTIVE: Reconfiguration of trauma services, with direct transport of patients with traumatic brain injury (TBI) to specialist neuroscience centres (SNCs)-bypassing non-specialist acute hospitals (NSAHs), could improve outcomes. However, delays in stabilisation of airway, breathing and circulation (ABC) may worsen outcomes when compared with selective secondary transfer from nearest NSAH to SNC. We conducted a pilot cluster randomised controlled trial to determine the feasibility and plausibility of bypassing suspected patients with TBI -directly into SNCs-producing a measurable effect. SETTING: Two English Ambulance Services. PARTICIPANTS: 74 clusters (ambulance stations) were randomised within pairs after matching for important characteristics. Clusters enrolled head-injured adults-injured nearest to an NSAH-with internationally accepted TBI risk factors and stable ABC. We excluded participants attended by Helicopter Emergency Medical Services or who were injured more than 1 hour by road from nearest SNC. INTERVENTIONS: Intervention cluster participants were transported directly to an SNC bypassing nearest NSAH; control cluster participants were transported to nearest NSAH with selective secondary transfer to SNC. OUTCOMES: Trial recruitment rate (target n=700 per annum) and percentage with TBI on CT scan (target 80%) were the primary feasibility outcomes. 30-day mortality, 6-month Extended Glasgow Outcome Scale and quality of life were secondary outcomes. RESULTS: 56 ambulance station clusters recruited 293 patients in 12 months. The trial arms were similar in terms of age, conscious level and injury severity. Less than 25% of recruited patients had TBI on CT (n=70) with 7% (n=20) requiring neurosurgery. Complete case analysis showed similar 30-day mortality in the two trial arms (control=8.8 (2.7-14.0)% vs intervention=9.4(2.3-14.0)%). CONCLUSION: Bypassing patients with suspected TBI to SNCs gives an overtriage (false positive) ratio of 13:1 for neurosurgical intervention and 4:1 for TBI. A measurable effect from a full trial of early neuroscience care following bypass is therefore unlikely. TRIAL REGISTRATION NUMBER: ISRCTN68087745

Co-firing of biomass with coals Part 1. Thermogravimetric kinetic analysis of combustion of fir (abies bornmulleriana) wood

The chemical composition and reactivity of fir (Abies bornmulleriana) wood under non-isothermal thermogravimetric (TG) conditions were studied. Oxidation of the wood sample at temperatures near 600 A degrees C caused the loss of aliphatics from the structure of the wood and created a char heavily containing C-O functionalities and of highly aromatic character. On-line FTIR recordings of the combustion of wood indicated the oxidation of carbonaceous and hydrogen content of the wood and release of some hydrocarbons due to pyrolysis reactions that occurred during combustion of the wood. TG analysis was used to study combustion of fir wood. Non-isothermal TG data were used to evaluate the kinetics of the combustion of this carbonaceous material. The article reports application of Ozawa-Flynn-Wall model to deal with non-isothermal TG data for the evaluation of the activation energy corresponding to the combustion of the fir wood. The average activation energy related to fir wood combustion was 128.9 kJ/mol, and the average reaction order for the combustion of wood was calculated as 0.30

An operational analysis of Lake Surface Water Temperature

Operational analyses of Lake Surface Water Temperature (LSWT) have many potential uses including improvement of numerical weather prediction (NWP) models on regional scales. In November 2011, LSWT was included in the Met Office Operational Sea Surface Temperature and Ice Analysis (OSTIA) product, for 248 lakes globally. The OSTIA analysis procedure, which has been optimised for oceans, has also been used for the lakes in this first version of the product. Infra-red satellite observations of lakes and in situ measurements are assimilated. The satellite observations are based on retrievals optimised for Sea Surface Temperature (SST) which, although they may introduce inaccuracies into the LSWT data, are currently the only near-real-time information available. The LSWT analysis has a global root mean square difference of 1.31 K and a mean difference of 0.65 K (including a cool skin effect of 0.2 K) compared to independent data from the ESA ARC-Lake project for a 3-month period (June to August 2009). It is demonstrated that the OSTIA LSWT is an improvement over the use of climatology to capture the day-to-day variation in global lake surface temperatures

Vestibular Perception following Acute Unilateral Vestibular Lesions.

Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and after compensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2) and velocity steps of 90°/s (acceleration 180°/s(2)). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of perceptual processes (ultimately cortical) participating in vestibular compensation, suppressing asymmetry acutely in unilateral vestibular lesions

The effectiveness of dietary approaches to stop hypertension (DASH) counselling on estimated 10-year cardiovascular risk among patients with newly diagnosed grade 1 hypertension : a randomised clinical trial

The Dietary Approaches to Stop Hypertension (DASH) has been shown to lower blood pressure in the West. However, the real-life impact of DASH on reducing cardiovascular (CV) risk in routine clinical setting has not been studied. Methods A parallel-group, open-labelled, physician-blinded, randomised controlled trial was conducted in January–June 2013 and followed up for 6- and 12-months in primary care settings in Hong Kong. Patients newly diagnosed with grade 1 hypertension (aged 40–70 years) who had no concomitant medical conditions requiring dietary modifications were consecutively recruited. Subjects were randomised to standard education (usual care) (n = 275), or usual care plus dietitian-delivered DASH-based dietary counselling in a single one-to-one session (intervention) (n = 281). Primary outcomes were the changes in estimated 10-year CV risk. Results Outcome data were available for 504 (90.6%) and 485 (87.2%) patients at 6 and 12 months, respectively. There was no difference in the reduction of 10-year CV risk between the two groups at 6 months (−0.13%, 95% confidence interval [95% CI] −0.50% to 0.23%, p = 0.477) and 12 months (−0.08%, 95% CI −0.33% to 0.18%, p = 0.568). Multivariate regression analyses showed that male subjects, younger patients, current smokers, subjects with lower educational level, and those who dined out for main meals for ≥4 times in a typical week were significantly associated with no improvements in CV risk. Conclusions The findings may not support automatic referral of newly diagnosed grade 1 hypertensive patients for further one-to-one dietitian counselling on top of primary care physician's usual care. Patients with those risk factors identified should receive more clinical attention to reduce their CV risk

Towards a conceptual framework demonstrating the effectiveness of audiovisual patient descriptions (patient video cases): a review of the current literature

Background: Technological advances have enabled the widespread use of video cases via web-streaming and online download as an educational medium. The use of real subjects to demonstrate acute pathology should aid the education of health care professionals. However, the methodology by which this effect may be tested is not clear. Methods: We undertook a literature review of major databases, found relevant articles relevant to using patient video cases as educational interventions, extracted the methodologies used and assessed these methods for internal and construct validity. Results: A review of 2532 abstracts revealed 23 studies meeting the inclusion criteria and a final review of 18 of relevance. Medical students were the most commonly studied group (10 articles) with a spread of learner satisfaction, knowledge and behaviour tested. Only two of the studies fulfilled defined criteria on achieving internal and construct validity. The heterogeneity of articles meant it was not possible to perform any meta-analysis. Conclusions: Previous studies have not well classified which facet of training or educational outcome the study is aiming to explore and had poor internal and construct validity. Future research should aim to validate a particular outcome measure, preferably by reproducing previous work rather than adopting new methods. In particular cognitive processing enhancement, demonstrated in a number of the medical student studies, should be tested at a postgraduate level