Performance-based Fire Safety Design for Existing Small-scale Hospitals

AbstractThe new era of National Health Insurance in 2000 has had a significant impacted on the management and operation of smallscale hospitals. In response to social needs, and in order to survive under the new insurance system, some small-scale hospitals have transformed or established new Respiratory Care Wards by using existing hospital space. According to the 2009 statistics released by Department of Health, Executive Yuan, there are a total of 307 small-scale medical institutes which provide servicesunder 99 beds. Compared with other large-scale medical centers and general hospitals, small-scale hospitals cannot properly deal with safety management and response to emergency evacuation due to lack of facilities, equipment and human resources. Therefore, small-scale hospitals face a major challenge in emergency response once a fire has occurred. As a result of such a situation, this study has focused mainly on Respiratory Care Wards (RCW) where patients are unable to evacuate. It hopes to analyse the safety management, and emergency response in small-scale hospitals by means of understanding the space characteristics and fire risk. Through on-site surveys, we can understand the fire risk, space features, patient characteristics, facilities and equipment. With reference to the related regulations of hospital emergency management and response, we will propose some fire safety engineering approaches, such as refuge areas in horizontal evacuation and so-called “besieged zones” for “defense-in-place”, etc., to provide some alternative measures to improve fire safety for those small-scale hospitals

C-reactive Protein Positively Correlates With Metabolic Syndrome in Kidney Transplantation Patients

ObjectiveC-reactive protein (CRP) is an independent risk factor for renal allograft loss and predicts all-cause mortality in kidney transplantation patients. Metabolic syndrome has also been associated with increased mortality in kidney transplantation patients. The aim of this study was to investigate the relationship between CRP and metabolic syndrome in kidney transplantation patients.Materials and MethodsFasting blood samples were obtained from 55 kidney transplantation patients. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.ResultsIn total, 13 kidney transplantation patients (23.6%) had metabolic syndrome. Fasting CRP levels positively correlated with metabolic syndrome (p = 0.001). Univariate linear regression analysis indicated that fasting serum CRP values were positively correlated with body weight (p = 0.001), waist circumference (p = 0.008), body mass index (p < 0.001), and body fat mass (p = 0.042). Multivariate forward stepwise linear regression analysis of the significant variables showed that body mass index (β = 0.455, R2 = 0.207, p < 0.001) was an independent predictor of serum CRP levels in kidney transplantation patients.ConclusionCRP level positively correlated with metabolic syndrome in kidney transplantation patients. Body mass index was an independent predictor of serum CRP levels in kidney transplantation patients

Common-mode noise reduction schemes for weakly coupled differential serpentine delay microstrip lines

This paper proposes design schemes to reduce the common mode noise from weakly coupled differential serpentine delay microstrip lines (DSDMLs). The proposed approach is twofold: we leverage strongly coupled vertical-turn-coupled traces (VTCTs) instead of weakly coupled VTCTs (conventional pattern) and add guard traces. Time- and frequency-domain analyses of the proposed schemes for reducing the common-mode noise are performed by studying the transmission waveform and the differential-to-common mode conversion using the circuit solver HSPICE and the 3-D full-wave simulator HFSS, respectively. Compared to the conventional design of the weakly coupled DSDMLs, the proposed solutions yield a reduction of about 54% of the peak-to-peak amplitude of the common-mode noise, while the differential impedance remains matched along the complete length of the DSDML. Moreover, the range of frequencies, over which the magnitude of the differential-to-common mode conversion is now significantly reduced, is very wide, i.e. about 0.3-10 GHz. Furthermore, the differential insertion and reflection loss introduced by the newly proposed designs are almost the same as the ones achieved by using the conventional design. Finally, a favorable comparison between simulated and measured results confirms the excellent common-mode noise reduction performance of the proposed schemes

Insights into Hypoxic Systemic Responses Based on Analyses of Transcriptional Regulation in Arabidopsis

We have adopted a hypoxic treatment system in which only roots were under hypoxic conditions. Through analyzing global transcriptional changes in both shoots and roots, we found that systemic signals may be transduced from roots to trigger responses in tissues not directly subjected to hypoxia. The molecular mechanisms of such systemic responses under flooding are currently largely unknown. Using ontological categorization for regulated genes, a systemic managing program of carbohydrate metabolism was observed, providing an example of how systemic responses might facilitate the survival of plants under flooding. Moreover, a proportion of gene expressions that regulated in shoots by flooding was affected in an ethylene signaling mutation, ein2-5. Many systemic-responsive genes involved in the systemic carbohydrate managing program, hormone responses and metabolism, ubiquitin-dependent protein degradation were also affected in ein2-5. These results suggested an important role of ethylene in mediation of hypoxic systemic responses. Genes associated with abscisic acid (ABA) biosynthesis are upregulated in shoots and down regulated in roots. An ABA signaling mutation, abi4-1, affects expression of several systemic responsive genes. These results suggested that regulation of ABA biosynthesis could be required for systemic responses. The implications of these results for the systemic responses of root-flooded Arabidopsis are discussed

Teaching topographic map skills and geomorphology concepts with Google Earth in a one-computer classroom

Teaching high-school geomorphological concepts and topographic map reading entails many challenges. This research reports the applicability and effectiveness of Google Earth in teaching topographic map skills and geomorphological concepts, by a single teacher, in a one-computer classroom. Compared to learning via a conventional instructional method, students learning with Google Earth do not have different geomorphological concepts development because both settings enable students to learn with similar static representation. However, students learning with Google Earth improve topographic map skills significantly compared to the conventional instructional method. This is because of the 3D landscape visualization and prior knowledge connections available with Google Earth

Entanglement detection via condition of quantum correlation

We develop a novel necessary condition of quantum correlation. It is utilized to construct $d$-level bipartite Bell-type inequality which is strongly resistant to noise and requires only analyses of $O(d)$ measurement outcomes compared to the previous result $O(d^{2})$. Remarkably, a connection between the arbitrary high-dimensional bipartite Bell-type inequality and entanglement witnesses is found. Through the necessary condition of quantum correlation, we propose that the witness operators to detect truly multipartite entanglement for a generalized Greenberger-Horne-Zeilinger (GHZ) state with two local measurement settings and a four-qubit singlet state with three settings. Moreover, we also propose the first robust entanglement witness to detect four-level tripartite GHZ state with only two local measurement settings

Dose pre-hospital laryngeal mask airway use has a survival benefit in non-shockable cardiac arrest?

Background. Whether pre-hospital laryngeal mask airway (LMA) use poses a survival benefit and should be approved as routine airway management in non-shockable cardiac arrest is of major concern. The present study examined the effectiveness of LMA, in comparison to other pre-hospital airway management on individuals who have experienced non-shockable cardiac arrest. Methods. Adult patients who experienced non-shockable cardiac arrest with activation of the emergency medical service (EMS) made up our study cohort in Taoyuan, Taiwan. The data were abstracted from EMS records and cardiac arrest registration protocols. Results. Among the 1912 enrolled patients, most received LMA insertion (72.4%), 108 (5.6%) bag-valve-mask (BVM) ventilation, 376 (19.7%) high-flow oxygen non-rebreather facemask, and only 44 (2.3%) received endotracheal tube intubation (ETI). With regard to survival to discharge, no significant differences in prevalence were evident among the groups: 2.8% of oxygen facial mask, 1.1% of BVM, 2.1% of LMA, and 4.5% of the ETI group survived to discharge (p = 0.314). In comparison to oxygen facial mask use, different types of airway management remained unassociated with survival to discharge after adjusting for variables by logistic regression analysis (BVM: 95% confidence interval [CI], 0.079 – 1.639 [p = 0.186]; LMA: 95% CI, 0.220–2.487 [p = 0.627]; ETI: 95% CI, 0.325–17.820 [p = 0.390]). The results of Hosmer-Lemeshow goodness-of-fit test of logistic regression model revealed good calibration. Conclusions. Pre-hospital LMA use was not associated with additional survival to discharge compared with facial oxygen mask, BVM, or ETI following non-shockable cardiac arrest

Quantum correlation generation capability of experimental processes

Einstein-Podolsky-Rosen (EPR) steering and Bell nonlocality illustrate two different kinds of correlations predicted by quantum mechanics. They not only motivate the exploration of the foundation of quantum mechanics, but also serve as important resources for quantum-information processing in the presence of untrusted measurement apparatuses. Herein, we introduce a method for characterizing the creation of EPR steering and Bell nonlocality for dynamical processes in experiments. We show that the capability of an experimental process to create quantum correlations can be quantified and identified simply by preparing separable states as test inputs of the process and then performing local measurements on single qubits of the corresponding outputs. This finding enables the construction of objective benchmarks for the two-qubit controlled operations used to perform universal quantum computation. We demonstrate this utility by examining the experimental capability of creating quantum correlations with the controlled-phase operations on the IBM Quantum Experience and Amazon Braket Rigetti superconducting quantum computers. The results show that our method provides a useful diagnostic tool for evaluating the primitive operations of nonclassical correlation creation in noisy intermediate scale quantum devices.Comment: 5 figures, 3 appendice

Apoptosis Induction in Primary Human Colorectal Cancer Cell Lines and Retarded Tumor Growth in SCID Mice by Sulforaphane

We have investigated the anticancer effects of the dietary isothiocyanate sulforaphane (SFN) on colorectal cancer (CRC), using primary cancer cells lines isolated from five Taiwanese colorectal cancer patients as the model for colorectal cancer. SFN-treated cells accumulated in metaphase (SFN 6.25 μM) and subG1 (SFN 12.5 and 25 μM) as determined by flow cytometry. In addition, treated cells showed nuclear apoptotic morphology that coincided with an activation of caspase-3, and loss of mitochondrial membrane potential (ΔΨm). Incubations at higher SFN doses (12.5 and 25 μM) resulted in cleavage of procaspase-3 and elevated caspase-2, -3, -8, and -9 activity, suggesting that the induction of apoptosis and the sulforaphane-induced mitosis delay at the lower dose are independently regulated. Daily SFN s.c. injections (400 micromol/kg/d for 3 weeks) in severe combined immunodeficient mice with primary human CRC (CP1 to CP5) s.c. tumors resulted in a decrease of mean tumor weight by 70% compared with vehicle-treated controls. Our findings suggest that, in addition to the known effects on cancer prevention, sulforaphane may have antitumor activity in established colorectal cancer