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

Giant lipoma arising from deep lobe of the parotid gland

BACKGROUND: Lipomas are common benign soft tissue neoplasms but they are found very rarely in the deep lobe of parotid gland. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus knowledge of the anatomy and meticulous surgical technique are essential. CASE PRESENTATION: A 71-year-old female presented with a large asymptomatic mass, which had occupied the left facial area for over the past fifteen years, and she requested surgical excision for a cosmetically better facial appearance. The computed tomography (CT) scan showed a well-defined giant lipoma arising from the left deep parotid gland. The lipoma was successfully enucleated after full exposure and mobilization of the overlying facial nerve branches. The surgical specimen measured 9 × 6 cm in size, and histopathology revealed fibrolipoma. The patient experienced an uneventful recovery, with a satisfying facial contour and intact facial nerve function. CONCLUSION: Giant lipomas involving the deep parotid lobe are extremely rare. The high-resolution CT scan provides an accurate and cost-effective preoperative investigative method. Surgical management of deep lobe lipoma should be performed by experienced surgeons due to the need for meticulous dissection of the facial nerve branches. Superficial parotidectomy before deep lobe lipoma removal may be unnecessary in selected cases because preservation of the superficial lobe may contribute to a better aesthetic and functional result

Reduction in magnetic coercivity of Co nanomagnets by Fe alloying

We measured the magnetic hysteresis and coercivity of individual Co and Co$_{0.8}$Fe$_{0.2}$ bilayer nano-sized island structures formed on Cu (111) substrate using spin-polarized scanning tunneling microscopy. From the hysteresis taken on various sizes of islands, we found that the alloyed islands are ferromagnetic with out-of-plane magnetic anisotropy, same as the pure islands. Coercivity of the alloy islands, which is dependent on their size, was significantly reduced to ≈40% of that of the pure islands. Based on the Stoner–Wohlfarth model, we evaluated the amount of magnetic anisotropic energy and anisotropy constant for both pure and alloy islands. Since tunneling spectra taken on the alloy islands show upward shifts of the valence electronic states as compared to the pure ones, fewer electrons populated in the valence band of the alloy islands are presumably responsible for the reduction in the magnetic anisotropic energy

Demethoxycurcumin Retards Cell Growth and Induces Apoptosis in Human Brain Malignant Glioma GBM 8401 Cells

Demethoxycurcumin (DMC; a curcumin-related demethoxy compound) has been recently shown to display antioxidant and antitumor activities. It has also produced a potent chemopreventive action against cancer. In the present study, the antiproliferation (using the MTT assay, DMC was found to have cytotoxic activities against GBM 8401 cell with IC50 values at 22.71 μM) and induced apoptosis effects of DMC have been investigated in human brain malignant glioma GBM 8401 cells. We have studied the mitochondrial membrane potential (MMP), DNA fragmentation, caspase activation, and NF-κB transcriptional factor activity. By these approaches, our results indicated that DMC has produced an inhibition of cell proliferation as well as the activation of apoptosis in GBM 8401 cells. Both effects were observed to increase in proportion with the dosage of DMC treatment, and the apoptosis was induced by DMC in human brain malignant glioma GBM 8401 cells via mitochondria- and caspase-dependent pathways

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

Cerebral Radionecrosis with Cystic Degeneration Following Radiotherapy for Nasal Cavity Squamous Cell Carcinoma: A Case Report

A 31-year-old man with nasal cavity squamous cell carcinoma was treated in our hospital with two courses of radiotherapy (120 Gy total dose) followed by surgical tumor resection. Three years after the last irradiation, he developed seizures as well as changes in behavior and consciousness. Medical therapy with diphenylhydantoin (Dilantin(r)) terminated the seizures. Dysphagia, unsteady gait, and right-side limb weakness developed 37 months after the onset of seizures. Magnetic resonance imaging showed a large, cystic mass in the left temporal lobe with left to right midline shift. Following craniotomy with decompression of the cystic mass, the patient improved clinically. No malignant cells were found in the specimen. No further progression of neurologic symptoms was noted after a 1-year follow-up. Cerebral radionecrosis is an uncommon late complication of radiotherapy and needs to be differentiated from tumor recurrence or metastasis if the irradiation field covers the cerebral region in patients with head and neck malignancies

Sustainabilitas Arsitektur Masjid: Evaluasi Konsep “Simple Architecture” sebagai Implementasi Desain Arsitektur Berkelanjutan suatu Kawasan

Makalah ini membahas aspek-aspek “kesederhanaan” (simplicity) sebagai konsep desain bangunan masjid secara berkelanjutan (sustainable) sesuai konteks dengan mengambil studi kasus masjid kawasan Al-Irsyad Satya Kota Baru Parahyangan, Bandung. Masjid sebagai subyek arsitektur dan pusat ibadah menjadi ruang publik yang didesain dari elemen-elemen yang secara ideal mengandung nilai-nilai Islam dan bertujuan mendukung fungsinya. Desain masjid berkonsep simple atau “sederhana” digunakan sebagai alternatif kontemporer untuk mengoptimalisasi fungsi tersebut, meliputi struktur bangunan hingga biaya pemeliharaan (maintenance) sesuai prinsip keberlanjutan. Keterkaitan erat bangunan masjid dengan aktivitas masyarakat berpotensi melibatkan partisipasi masyarakat dan pengelola dalam menerapkan program sustainabilitas sesuai konteks lingkungannya. Metode yang digunakan dalam penelitian ini berbasis pendekatan Grounded Theory secara kualitatif melalui pengumpulan data dari kegiatan observasi, interview dan analisis program keberlanjutan kawasan. Penelitian menemukan keterkaitan konsep “sederhana” yang mendukung sustainabilitas desain sekaligus menggarisbawahi evaluasi konsep desain “sederhana” yang hadir serta faktor pemeliharaan/pengembangan masjid dan kawasan

Functional Effects of let-7g Expression in Colon Cancer Metastasis.

MicroRNA regulation is crucial for gene expression and cell functions. It has been linked to tumorigenesis, development and metastasis in colorectal cancer (CRC). Recently, the let-7 family has been identified as a tumor suppressor in different types of cancers. However, the function of the let-7 family in CRC metastasis has not been fully investigated. Here, we focused on analyzing the role of let-7g in CRC. The Cancer Genome Atlas (TCGA) genomic datasets of CRC and detailed data from a Taiwanese CRC cohort were applied to study the expression pattern of let-7g. In addition, in vitro as well as in vivo studies have been performed to uncover the effects of let-7g on CRC. We found that the expression of let-7g was significantly lower in CRC specimens. Our results further supported the inhibitory effects of let-7g on CRC cell migration, invasion and extracellular calcium influx through store-operated calcium channels. We report a critical role for let-7g in the pathogenesis of CRC and suggest let-7g as a potential therapeutic target for CRC treatment

Structural and cognitive deficits in chronic carbon monoxide intoxication: a voxel-based morphometry study

BACKGROUND: Patients with carbon monoxide (CO) intoxication may develop ongoing neurological and psychiatric symptoms that ebb and flow, a condition often called delayed encephalopathy (DE). The association between morphologic changes in the brain and neuropsychological deficits in DE is poorly understood. METHODS: Magnetic resonance imaging and neuropsychological tests were conducted on 11 CO patients with DE, 11 patients without DE, and 15 age-, sex-, and education-matched healthy subjects. Differences in gray matter volume (GMV) between the subgroups were assessed and further correlated with diminished cognitive functioning. RESULTS: As a group, the patients had lower regional GMV compared to controls in the following regions: basal ganglia, left claustrum, right amygdala, left hippocampus, parietal lobes, and left frontal lobe. The reduced GMV in the bilateral basal ganglia, left post-central gyrus, and left hippocampus correlated with decreased perceptual organization and processing speed function. Those CO patients characterized by DE patients had a lower GMV in the left anterior cingulate and right amygdala, as well as lower levels of cognitive function, than the non-DE patients. CONCLUSIONS: Patients with CO intoxication in the chronic stage showed a worse cognitive and morphologic outcome, especially those with DE. This study provides additional evidence of gray matter structural abnormalities in the pathophysiology of DE in chronic CO intoxicated patients