Nautical Depth Sounding- The Rheocable Survey Method

Since 1984, research and development activities have been undertaken in Belgium comprising in situ measurements and sea trials with TSHD ‘Vlaanderen 18’ in Zeebrugge. Towing tank experiments and sludge test tank experiments have also been performed in the laboratories of the Flanders Hydraulic Research. This work has enabled the authors to conclude that mud on the seabed consists of two different physical states occurring in the same configuration - fluid mud on top of solid (consolidating) mud. Fluid mud is navigable, solid mud is not. The interface between both is characterized by a drastic increase of rheological parameters, in particular, the yield stress. However, for the time being, this phenomenon cannot be fully interpreted scientifically. The Rheocable sounding method is designed to detect the interface between fluid and solid mud. A towed object, when kept in a velocity window, is always positioned at this interface between fluid and solid mud. This method makes it possible to develop a new maintenance dredging strategy - leave/ignore the fluid mud and remove only the solid mud. The dredging of fluid mud is therefore unnecessary – it is navigable (!) – and extremely uneconomical. Solid mud on the other hand is not navigable, is immobile and will absolutely maintain its position on the seabed unless removed by dredging action. Furthermore, the deployment of the Rheocable implies many operational and contractual advantages, including transparency of dredged quantities etc. The Rehocable cable sounding method allows for a considerably improved focus, smaller quantities and easier planning of the maintenance dredging activities, resulting in lower budgets and improved safety for shipping traffic.Desde 1984, se han emprendido en Bélgica actividades relacionadas con la investigación y el desarrollo, comprendiendo medidas in situ y pruebas en el mar con el TSHD ‘Vlaanderen 18’, en Zeebrugge. Se han llevado a cabo también experimentos en canale de pruebas hidrodinámicas y experimentos de canales de prueba para sedimentos en los laboratorios de Investigación Hidráulica de Flandes. Este trabajo ha permitido a los autores concluir que el lodo del fondo marino consta de dos estados físicos diferentes en la misma configuración - el lodo fluido en la parte superior del lodo sólido (que se consolida). El lodo fluido es navegable, el lodo sólido no lo es. La interfaz entre ambos está caracteri-zada por un aumento drástico de los parámetros reológicos, en particular la elasticidad. Sin embargo, por el momento, este fenómeno no puede ser interpretado del todo científica-mente. El sondaje empleando el método de flujo ha sido diseñado para detectar la interfaz entre el lodo fluido y el sólido. Un objeto remolcado, cuando se mantiene en una ventana de velocidad, está siempre posicionado en esta interfaz entre el lodo fluido y el sólido. Este método hace que sea posible desarrollar una nueva estrategia de mantenimiento del dragado - dejar/ignorar el lodo fluido y retirar sólo el lodo sólido. El dragado del lodo fluido es pues innecesario - es navegable (¡!) – y extremadamente costoso. Por otra parte, el lodo sólido no es navegable, es inmóvil y mantendrá absoluta-mente su posición en el fondo marino a menos que sea retirado mediante el dragado. Además, el despliegue del método flujo dependiente implica muchas ventajas operaciona-les y transaccionales, incluyendo la transparencia de las cantidades dragadas etc. El sondaje empleando el método de flujo permite un enfoque considerablemente mejorado, cantidades inferiores y una planificación más sencilla de las actividades de mantenimiento del dragado, dando como resultado presupuestos inferiores y una mejora en la seguridad del tráfico marítimo.Depuis 1984, des activités de recherche et de développement . entreprises en Belgique, qui comprennent des mesures in situ et des essais à la mer sur le TSHD ‘Vlaanderen 18’ à Zeebrugge. Des expériences dans des bassins d’essais de carène et des expériences dans des bassins de boue ont également été réalisées dans les laboratoires de la Flanders Hydraulic Research. Ces travaux ont permis aux auteurs de conclure que la boue du fond marin consiste en deux différentes compositions physiques qui se présentent sous la mê-me configuration – boue fluide sur un sommet de boue solide (en consolidation). La boue fluide est navigable, la boue solide ne l’est pas L’interface entre les deux est caractérisée par un accroissement drastique des paramètres rhéologiques, en particulier le seuil d’écoulement. Toutefois, pour le moment, ce phénomène ne peut pas être entière-ment interprété au niveau scientifique. La méthode Rheocable de sondes est destinée à détecter l’interface entre la boue solide et la boue fluide. Un objet tracté lorsqu’il est maintenu dans une fenêtre de vélocité est tou-jours positionné à l’interface entre la boue fluide et la boue solide. Cette méthode rend pos-sible le développement d’une nouvelle stratégie de dragage d’entretien. – de laisser/ignorer la boue fluide et d’enlever seulement la boue solide. Le dragage de boue fluide n’est donc pas nécessaire – c’est navigable – et extrêmement peu économique. D’un autre côté, la boue solide n’est pas navigable, est immobile et dragage. En outre, le déploiement du Rheocable implique des avantages opérationnels et contractuels incluant la transparence sur les quantités draguées, etc. La méthode de levés Rheocable permet une mise au point considérablement améliorée, de plus petites quantités et une planification plus aisée des activités de dragage d’entretien, ce qui a pour résultat une réduction des budgets et l’amélioration de la sécurité du trafic maritime

Adverse events associated with individual statin treatments for cardiovascular disease: an indirect comparison meta-analysis

Background: Statins are the most widely prescribed drug available. Due to this reason, it is important to understand the risks involved with the drug class and individual statins. Aim: We conducted a meta-analysis and employed indirect comparisons to identify differing risk effects across statins. Design: We included any randomized clinical trial (RCT) of atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin and simvastatin used for cardiovascular disease event prevention. The main outcome was adverse events [all-cause mortality, cancers, rhabdomylosis, diabetes, aspartate and alanine aminotransferase (AST/ALT), and creatinine kinase (CK) increases beyond the upper limit of normal]. In order to evaluate the relative effects of each drug on adverse events, we calculated adjusted indirect comparisons of the adverse-event outcomes. Results: Seventy-two trials involving 159 458 patients met our inclusion criteria. Overall, statin treatments significantly increased the rate of diabetes when compared to controls (OR: 1.09; 95% CI: 1.02-1.16) and elevated AST (OR: 1.31; 95% CI: 1.04-1.66) and ALT (OR: 1.28; 95% CI: 1.11-1.48) levels when compared to controls. Using indirect comparisons, we also found that atorvastatin significantly elevated AST levels compared to pravastatin (OR: 2.21; 95% CI: 1.13-4.29) and simvastatin significantly increased CK levels when compared to rosuvastatin (OR: 4.39; 95% CI: 1.01-19.07). Higher dose studies had increased risk of AST elevations. Discussion: Although statins are generally well tolerated, there are risks associated with almost all drugs. With few exceptions, statins appear to exert a similar risk across individual drug

Years of life lost to prison: racial and gender gradients in the United States of America

© 2008 Hogg et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

The Impact of Digital Therapeutics on Current Health Technology Assessment Frameworks

Historically healthcare has been delivered offline (e.g., physician consultations, mental health counseling services). It is widely understood that healthcare lags behind other industries (e.g., financial, transportation) whom have already incorporated digital technologies in their workflow. However, this is changing with the recent emergence of digital therapeutics (DTx) helping to bring healthcare services online. To promote adoption, healthcare providers need to be educated regarding the digital therapy to allow for proper prescribing. But of equal importance is affordability and many countries rely on reimbursement support from the government and insurance agencies. Here we briefly explore how national reimbursement agencies or non-profits across six countries (Canada, United States of America, United Kingdom, Germany, France, Australia) handle DTx submissions and describe the potential impact of digital therapeutics on current health technology assessment (HTA) frameworks. A targeted review to identify HTA submissions and guidelines from national reimbursement agencies or non-profits was conducted. We reviewed guidelines from the Institute for Clinical and Economic Review (ICER) in the USA, the Canadian Agency for Drugs and Technologies in Health (CADTH) in Canada, the National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK), the Institute for Quality and Efficiency in Health Care (IQWIG) in Germany, Haute Autorité de Santé (HAS) in France, and the Pharmaceutical Benefits Advisory Committee (PBAC) in Australia. Our review identified one set of guidelines developed by NICE in the UK. The guidelines by NICE outlined an evidence standards framework for digital health technologies (DHT). Depending on the organizational impact, financial commitment, and economic risk for the payer, different economic analyses are required. Economic analyses levels are separated into 3 categories, basic, low financial commitment, and high financial commitment. All economic analyses levels require a budget impact analysis. A cost-utility analysis is recommended for DHTs categorized in the high financial commitment category. Whereas, for DHTs that are in the low financial commitment category, a cost-consequence analysis is typically recommended. No HTA guidelines for DTx submissions were identified for the remaining countries (Canada, USA, Germany, France, and Australia