Atmospheric fluidized bed combustor development program. Final report

The objective of this project was to demonstrate and promote the commercialization of a coal-fired atmospheric fluidized bed combustion (AFBC) system, with limestone addition for SO{sub 2} emissions control and a baghouse for particulate emissions control. This AFBC system was targeted for small scale industrial-commercial-institutional space and process heat applications in the 1 x 10{sup 6} to 10 x 10{sup 6} Btu/hr capacity range. A cost effective and environmentally acceptable AFBC technology in this size range would displace a considerable amount of gas/oil with coal while resulting in significant total cost savings to the owner/operators. The project itself was separated into three levels: (1) feasibility, (2--3) subsystem development and integration, and (4) proof-of-concept. In Level (1), the technical and economic feasibility of a 1 million Btu/hr coal-fired AFBC air heater was evaluated. In Level (2--3), the complete EER fluidized bed combustor (1.5 million Btu/hr) system was developed and tested. The goal or reducing SO{sub 2} emissions to 1.2 lb/10{sup 6} Btu, from high sulfur Ohio coal, was achieved by adding limestone with a Ca/S (coal) ratio of {approximately} 3.0. Finally, in Level (4), the proof-of-concept system, a 2.2 million Btu/hr unit was installed and successfully operated at Cedar Lane Farms, a commercial nursery in Ohio

Temporal causality and the dynamics of crime in Turkey

This study is concerned with understanding of the factors of aggregate, nonviolent and violent crime categories in Turkey for the period 1965-2009. The determinants of all crime categories are related to selected socio-economic factors. Bounds testing approach to cointegration is employed to test the existence of long-run relationship amongst the variables. Cointegration analysis yields the major contributors of crime are income and unemployment. The direction of causalities between the variables are established using within and out of sample causality tests. The findings from this study present the dynamics of aggregate, violent and non-violent crimes to design and implement any relevant policy measures to combat them

Active surveillance in renal transplant patients with prostate cancer: a multicentre analysis

Introduction: Due to medical improvements leading to increased life expectancy after renal transplantation and widened eligibility criteria allowing older patients to be transplanted, incidence of (low-risk) prostate cancer (PCa) is increasing among renal transplant recipients (RTR). It remains to be established whether active surveillance (AS) for PCa represents a safe treatment option in this setting. Therefore, we aim to compare AS discontinuation and oncological outcomes of AS for PCa of RTR vs. non-transplant patients. Methods: Multicentre study including RTR diagnosed with PCa between 2008 and 2018 in whom AS was initiated. A subgroup of non-RTR from the St. Antonius hospital AS cohort was used as a control group. Comparison of RTR vs. non-RTR was performed by 2:1 propensity score matched survival analysis. Outcome measures included tumour progression-free survival, treatment-free survival, metastasis rates, biochemical recurrence rates and overall survival. Patients were matched based on age, year of diagnosis, PSA, biopsy ISUP grade group, relative number of positive biopsy cores and clinical stage. Results: A total of 628 patients under AS were evaluated, including 17 RTRs and 611 non-RTRs. A total of 13 RTR cases were matched with 24 non-RTR cases. Median overall follow-up for the RTR and non-RTR matched cases was, respectively, 5.1 (IQR 3.2–8.7) years and 5.7 (IQR 4.8–8.1) years. There were no events of metastasis and biochemical recurrence among matched cases. The matched-pair analysis results in a 1-year and 5-year survival of the RTR and non-RTR patients were, respectively, 100 vs. 92%, and 39 vs. 76% for tumour progression, 100 vs. 91% and 59 vs. 76% for treatment-free survival and, respectively, 100 vs. 100% and 88 vs. 100% for overall survival. No significant differences in tumour progression-free survival (p = 0.07) and treatment-free survival were observed (p = 0.3). However, there was a significant difference in overall survival comparing both groups (p = 0.046). Conclusions: AS may be carefully considered in RTR with low-risk PCa. In our preliminary analysis, no major differences were present in AS outcomes between RTR and non-RTR. Overall mortality was significantly higher in the RTR subgroup

Patient-Reported Outcome questionnaires for hip arthroscopy: a systematic review of the psychometric evidence

Abstract Background Hip arthroscopies are often used in the treatment of intra-articular hip injuries. Patient-reported outcomes (PRO) are an important parameter in evaluating treatment. It is unclear which PRO questionnaires are specifically available for hip arthroscopy patients. The aim of this systematic review was to investigate which PRO questionnaires are valid and reliable in the evaluation of patients undergoing hip arthroscopy. Methods A search was conducted in Pubmed, Medline, CINAHL, the Cochrane Library, Pedro, EMBASE and Web of Science from 1931 to October 2010. Studies assessing the quality of PRO questionnaires in the evaluation of patients undergoing hip arthroscopy were included. The quality of the questionnaires was evaluated by the psychometric properties of the outcome measures. The quality of the articles investigating the questionnaires was assessed by the COSMIN list. Results Five articles identified three questionnaires; the Modified Harris Hip Score (MHHS), the Nonarthritic Hip Score (NAHS) and the Hip Outcome Score (HOS). The NAHS scored best on the content validity, whereas the HOS scored best on agreement, internal consistency, reliability and responsiveness. The quality of the articles describing the HOS scored highest. The NAHS is the best quality questionnaire. The articles describing the HOS are the best quality articles. Conclusions This systematic review shows that there is no conclusive evidence for the use of a single patient-reported outcome questionnaire in the evaluation of patients undergoing hip arthroscopy. Based on available psychometric evidence we recommend using a combination of the NAHS and the HOS for patients undergoing hip arthroscopy.</p

THE COMMUNITY LEVERAGED UNIFIED ENSEMBLE (CLUE) IN THE 2016 NOAA/HAZARDOUS WEATHER TESTBED SPRING FORECASTING EXPERIMENT

One primary goal of annual Spring Forecasting Experiments (SFEs), which are coorganized by NOAA’s National Severe Storms Laboratory and Storm Prediction Center and conducted in the National Oceanic and Atmospheric Administration’s (NOAA) Hazardous Weather Testbed, is documenting performance characteristics of experimental, convection-allowing modeling systems (CAMs). Since 2007, the number of CAMs (including CAM ensembles) examined in the SFEs has increased dramatically, peaking at six different CAM ensembles in 2015. Meanwhile, major advances have been made in creating, importing, processing, verifying, and developing tools for analyzing and visualizing these large and complex datasets. However, progress toward identifying optimal CAM ensemble configurations has been inhibited because the different CAM systems have been independently designed, making it difficult to attribute differences in performance characteristics. Thus, for the 2016 SFE, a much more coordinated effort among many collaborators was made by agreeing on a set of model specifications (e.g., model version, grid spacing, domain size, and physics) so that the simulations contributed by each collaborator could be combined to form one large, carefully designed ensemble known as the Community Leveraged Unified Ensemble (CLUE). The 2016 CLUE was composed of 65 members contributed by five research institutions and represents an unprecedented effort to enable an evidence-driven decision process to help guide NOAA’s operational modeling efforts. Eight unique experiments were designed within the CLUE framework to examine issues directly relevant to the design of NOAA’s future operational CAM-based ensembles. This article will highlight the CLUE design and present results from one of the experiments examining the impact of single versus multicore CAM ensemble configurations

THE COMMUNITY LEVERAGED UNIFIED ENSEMBLE (CLUE) IN THE 2016 NOAA/HAZARDOUS WEATHER TESTBED SPRING FORECASTING EXPERIMENT

One primary goal of annual Spring Forecasting Experiments (SFEs), which are coorganized by NOAA’s National Severe Storms Laboratory and Storm Prediction Center and conducted in the National Oceanic and Atmospheric Administration’s (NOAA) Hazardous Weather Testbed, is documenting performance characteristics of experimental, convection-allowing modeling systems (CAMs). Since 2007, the number of CAMs (including CAM ensembles) examined in the SFEs has increased dramatically, peaking at six different CAM ensembles in 2015. Meanwhile, major advances have been made in creating, importing, processing, verifying, and developing tools for analyzing and visualizing these large and complex datasets. However, progress toward identifying optimal CAM ensemble configurations has been inhibited because the different CAM systems have been independently designed, making it difficult to attribute differences in performance characteristics. Thus, for the 2016 SFE, a much more coordinated effort among many collaborators was made by agreeing on a set of model specifications (e.g., model version, grid spacing, domain size, and physics) so that the simulations contributed by each collaborator could be combined to form one large, carefully designed ensemble known as the Community Leveraged Unified Ensemble (CLUE). The 2016 CLUE was composed of 65 members contributed by five research institutions and represents an unprecedented effort to enable an evidence-driven decision process to help guide NOAA’s operational modeling efforts. Eight unique experiments were designed within the CLUE framework to examine issues directly relevant to the design of NOAA’s future operational CAM-based ensembles. This article will highlight the CLUE design and present results from one of the experiments examining the impact of single versus multicore CAM ensemble configurations

ACTH-Bestimmungen im Plasma aus dem Bulbus cranialis venae jugularis

Der Anstieg der Corticosteroninkretion in das Nebennierenvenenblut frisch hypophysektomierter Ratten diente zur Bestimmung von ACTH-Spiegeln in 1 ml nativen, menschlichen Plasma. Normale ACTH-Plasmaspiegel sind sowohl bei Punktion der Vena cubitalis als auch des Bulbus cranialis venae jugularis durch diese Methode nicht oder nur ungenau zu erfassen. Bei Patienten mit pathologisch erhöhten ACTH-Spiegeln in der Vena cubitalis sind die ACTH-Spiegel im Bulbus cranialis venae jugularis signifikant höher. Es ließ sich eine Beziehung zwischen ACTH-Spiegel in der Peripherie (Vena cubitalis), Differenz der ACTH-Spiegel zwischen Bulbus cranialis venae jugularis und Vena cubitalis und biologischer Halbwertszeit von endogenem ACTH aufstellen. Nach den Ergebnissen der Bestimmung von ACTH-Spiegeln bei Nebennierengesunden läßt sich folgern, daß die biologische Halbwertszeit von endogenem ACTH größer als 4 min sein muß. Bei Patienten mit erhöhten ACTH-Spiegeln ließ sich die biologische Halbwertszeit von endogenem ACTH größenordnungsmäßig mit ca. 40 min berechnen. Bei diesen Patienten betrug die mittlere tägliche ACTH-Inkretion ca. 100 E.ACTH-contents of 1 ml specimens of human plasma were assayed by measurement of increases of corticosterone output in the adrenal vein of acutely hypophysectomized rats. This procedure is not sensitive enough to measure normal ACTH-levels acurately, neither when blood was drawn from the bulbus cranialis venae jugularis, nor from the vena cubitalis. In patients having pathologically elevated ACTH-levels, the ACTH-content of plasma is significantly higher in the bulbus cranialis venae jugularis than in peripheral venous blood. An equation is presented formulating the relation of peripheral ACTH-levels, differences of ACTH-levels between bulbus cranialis venae jugularis and vena cubitalis, and of the biological halflife of endogenous ACTH. On the basis of the results of the determinations of socalled normal ACTH-levels it can be concluded, that the biological halflife of endogenous ACTH is longer than 4 min. From the data of patients with elevated ACTH-levels a halflife of approximately 40 min and a mean ACTH-secretion of approx. 100 units per day could be calculated

Multiple factors influence compliance with colorectal cancer staging recommendations: an exploratory study

<p>Abstract</p> <p>Background</p> <p>For patients with colorectal cancer (CRC) retrieval by surgeons, and assessment by pathologists of at least 12 lymph nodes (LNs) predicts the need for adjuvant treatment and improved survival. Different interventions (educational presentation, engaging clinical opinion leaders, performance data sent to hospital executives) to improve compliance with this practice had variable results. This exploratory study examined factors hypothesized to have influenced the outcome of those interventions.</p> <p>Methods</p> <p>Semi-structured interviews were conducted with 26 surgeons and pathologists at eleven hospitals. Clinicians were identified by intervention organizers, public licensing body database, and referral from interviewees. An interview guide incorporating open-ended questions was pilot-tested on one surgeon and pathologist. A single investigator conducted all interviews by phone. Transcripts were analyzed independently by two investigators using a grounded approach,ho then compared findings to resolve differences.</p> <p>Results</p> <p>Improvements in LN staging practice may have occurred largely due to educational presentations that created awareness, and self-initiated changes undertaken by pathologists. Executives that received performance data may not have shared this with staff, and opinion leaders engaged to promote compliance may not have fulfilled their roles. Barriers to change that are potentially amenable to quality improvement included perceptions about the practice (perceived lack of evidence for the need to examine at least 12 LNs) and associated responsibilities (blaming other profession), technical issues (need for pathology assistants, better clearing solutions and laboratory facilities), and a lack of organizational support for multidisciplinary interaction (little communication between surgeons and pathologists) or quality improvement (no change leaders or capacity for monitoring).</p> <p>Conclusion</p> <p>Use of an exploratory approach provided an in-depth view of the way that numerous factors amenable to quality improvement influenced the adoption of new CRC LN staging recommendations. Continued interventions targeting physicians and executives, in the absence of a receptive organizational infrastructure, may be fruitless. Individualized rather than regional or punitive performance data, coupled with increased organizational capacity for change may stimulate greater surgical and organizational response to quality improvement. Descriptive or experimental studies are needed to test these hypotheses.</p