Quantitative risk analysis for road tunnels complying with EU regulations

Tunnels have improved the connection of regions within the European Commission (EC) and have been used lately as a catalyst for economic development of previously isolated regions. However, the increasing number of these important infrastructures is raising upfront an endogenous problem, which is the severity of accidents that may occur. These risks have much greater impact when heavy goods vehicles (HGVs) or dangerous goods (DGs) are involved in the accident. As a result, the EC launched the EC Directive 2004/54/EC. In order to achieve a minimum acceptable level of safety, the EC Directive 2004/54/EC suggests, apart from the measures imposed based on tunnel characteristics, the implementation of a risk analysis in cases such as the opening of the road tunnel to DGs. The most widely accepted method for such quantitative risk analysis (QRA) is the OECD/PIARC QRA Model. This research exploits the QRA Model to perform a QRA for five illustrative cases in order to explore the sufficiency of the minimum tunnel safety measures imposed by the Directive when transportation of HGVs and DGs is allowed through the tunnel. The research concludes that, at least for tunnels with marginal values of the EC Directive classes for length and traffic, the risk exposure (F/N curves) lays over the acceptable safety limits of ALARP (as low as reasonably practicable) models. Thus, the manager of the tunnel should take seriously into account the provision of the Directive for further risk analysis and consider more safety measures as well as take into account the risk associated with the alternative routes

Total Score of Athleticism Profiling Strength and Power Characteristics in Professional Soccer Players After Anterior Cruciate Ligament Reconstruction to Assess Readiness to Return to Sport

Background: There is no consensus on the optimal testing procedure to determine return-to-sport (RTS) readiness after anterior cruciate ligament (ACL) reconstruction. Current approaches use limb symmetry across a range of tests, but this does not consider a patient’s level of athleticism or benchmarks relative to his or her noninjured counterparts. Purpose: To examine the utility of the Total Score of Athleticism (TSA), a composite scale including strength, power, and reactive strength assessments, to aid RTS decision-making. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 95 professional soccer players (60 who underwent ACL reconstruction [mean age, 25.1 6 12.6 years] and 35 who were uninjured [mean age, 23.8 6 2.8 years]) completed a battery of tests including isokinetic knee extension and flexion torque, bilateral and unilateral countermovement jump height, relative peak power, and reactive strength index–modified. The TSA score (derived from Z scores) was calculated, and we (1) examined differences between the ACL-reconstructed and unin�jured groups at the time of RTS, (2) assessed the predictive ability of the TSA to identify the player’s status (ACL reconstruction vs uninjured control), and (3) included a case series to discuss the characteristics of players who sustained a subsequent injury within 4 months after RTS. Results: A large difference between the ACL-reconstructed and uninjured groups in the TSA score (d = 0.84; P \ .0001) was evident. For every additional increase of 1 unit in the TSA score, the odds of belonging to the ACL-reconstructed group decreased by 74% (95% CI, 0.19-0.56). By visual inspection, the frequency of reinjured players was higher in the low (4/7) TSA tertile com�pared with the medium (2/7) and high (1/7) TSA tertiles. Conclusion: Preliminary evidence indicates that the TSA may be a useful RTS readiness tool, as the composite score derived from strength and power measures was different in soccer players at the time of RTS after ACL reconstruction compared with healthy matched controls. There was also a higher frequency of low TSA scores in players who sustained a second injury after RTS. Therefore, it is recommended to routinely administer RTS tests encompassing strength, power, and reactive strength qual�ities each season across the largest possible number of players (ideally teammates)

Influence of the magnetic sublattices in the double perovskite LaCaNiReO6

The magnetism of double perovskites is a complex phenomenon, determined from intra- or interatomic magnetic moment interactions, and strongly influenced by geometry. We take advantage of the complementary length and timescales of the muon spin rotation, relaxation, and resonance (μ+SR) microscopic technique and bulk ac/dc magnetic susceptibility measurements to study the magnetic phases of the LaCaNiReO6 double perovskite. As a result, we are able to discern and report ferrimagnetic ordering below TC=102K and the formation of different magnetic domains above TC. Between TC<T<270K, the following two magnetic environments appear, a dense spin region and a static-dilute spin region. The paramagnetic state is obtained only above T>270K. An evolution of the interaction between Ni and Re magnetic sublattices, in this geometrically frustrated fcc perovskite structure, is revealed as a function of temperature through the critical behavior and thermal evolution of microscopic and macroscopic physical quantities

Derivation of flow related risk indices for stenosed left anterior descending coronary arteries with the use of computer simulations

The geometry of the coronary vessel network is believed to play a decisive role in the initiation, progression and outcome of coronary artery disease (CAD) and the occurrence of acute coronary syndromes (ACS). It also determines the flow field in the coronary artery which can be linked to CAD evolution. In this work geometric 3D models of left anterior descending (LAD) coronary arteries associated with either myocardial infarction (MI) or stable (STA) CAD were constructed. Transient numerical simulations of the flow for each model showed that specific flow patterns develop in different extent in the different groups examined. Recirculation zones, present distal the stenosis in all models, had larger extent and duration in MI cases. For mild stenosis (up to 50%) areas with low time averaged wall shear stress TAWSS (3 Pa) appeared only in MI models; in moderate and severe stenosis (>50%) these areas were present in all models but were significantly larger for MI than STA models. These differentiations were expressed via numerical indices based on TAWSS, oscillating shear index (OSI) and relative residence time (RRT). Additionally we introduced the coagulation activation index (CAI), based on the threshold behaviour of coagulation initiation, which exceeded the suggested threshold only for MI models with intermediate stenosis (up to 50%). These results show that numerical simulations of flow can produce arithmetic indices linked with the risk of CAD complications

Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization: a case report

<p>Abstract</p> <p>Introduction</p> <p>Splenic vein thrombosis results in localized portal hypertension called sinistral portal hypertension, which may also lead to massive upper gastrointestinal bleeding. Symptomatic sinistral portal hypertension is usually best treated by splenectomy, but interventional radiological techniques are safe and effective alternatives in the management of a massive hemorrhage, particularly in cases that have a high surgical risk.</p> <p>Case presentation</p> <p>We describe a 23-year-old Greek man with acute massive gastric variceal bleeding caused by splenic vein thrombosis due to a missing von Leiden factor, which was successfully managed with splenic arterial embolization.</p> <p>Conclusions</p> <p>Interventional radiological techniques are attractive alternatives for patients with a high surgical risk or in cases when the immediate surgical excision of the spleen is technically difficult. Additionally, surgery is not always successful because of the presence of numerous portal collaterals and adhesion. Splenic artery embolization is now emerging as a safe and effective alternative to surgery in the management of massive hemorrhage from gastric varices due to splenic vein thrombosis, which often occurs in patients with hypercoagulability.</p

Effects of dietary substitution of fishmeal by black soldier fly (Hermetia illucens) meal on growth performance, whole-body chemical composition, and fatty acid profile of Pontastacus leptodactylus juveniles

Freshwater crayfish are considered as aquatic products of high quality and high nutritional value. The increasing demand has led to populations reduction in several locations throughout their range. Thus, the development of appropriate rearing conditions is considered necessary, among which, optimization of their diet is a basic part. Towards this direction, in the present study, a 98-day feeding trial was carried out to evaluate the impact of dietary fishmeal substitution by Hermetia illucens meal on Pontastacus leptodactylus juveniles kept under laboratory conditions. Insect meals represent an environmentally friendly alternative solution, considered as a high-value feed source, rich in nutrients such as protein and fat. Three dietary regimens were utilized with a fishmeal-based without Hermetia meal (HM) defined as the control diet (HM0), and two diets, the first with 50% (HM50) and the second with 100% (HM100) of fishmeal substitution by HM, respectively. Growth performance, whole-body composition, and fatty acid profiles of individuals were studied in the different treatments. At the end of the feeding trial, statistically significant differences were observed in the mean survival rate (SR), specific growth rate (SGR), feed conversion ratio (FCR) and weight gain (WG) values. More specifically, animals fed with HM-based diets had higher mean SR, while the control group performed better regarding FCR and SGR. The HM inclusion in the diet significantly altered the whole-body chemical composition of the crayfish signifying a different metabolic utilization compared to fishmeal (FM). The fatty acid analysis revealed that 16:0 (palmitic acid) was the predominant saturated fatty acid (SFA), 18:1ω9 (oleic acid) was found to be the main monounsaturated fatty acid (MUFA), while 18:2ω6 (linoleic acid) represented the major polyunsaturated fatty acid (PUFA) followed by C20:3 cis ω3 (cis-11-14-17-eicosatrienoate) and C22:6 cis ω3 (cis-4,7,10,13,16,19-Docosahexaenoic) fatty acids. The inclusion of dietary HM significantly reduced the contents of ∑SFAs, ∑PUFAs and ∑ω6 fatty acids, as well as those of C22:6 cis ω3 and increased the ω6/ω3 and hypocholesterolemic to hypercholesterolemic ratios in the body. In parallel with improvements in balanced diets and in culture conditions that need to be optimised for rearing of freshwater crayfish, our study provides new data that enlighten the suitability of insect meals in the nutrition of P. leptodactylus

Colorectal cancer screening awareness among physicians in Greece

BACKGROUND: Data comparison between SEER and EUROCARE database provided evidence that colorectal cancer survival in USA is higher than in European countries. Since adjustment for stage at diagnosis markedly reduces the survival differences, a screening bias was hypothesized. Considering the important role of primary care in screening activities, the purpose of the study was to investigate the colorectal cancer screening awareness among Hellenic physicians. METHODS: 211 primary care physicians were surveyed by mean of a self-reported prescription-habits questionnaire. Both physicians' colorectal cancer screening behaviors and colorectal cancer screening recommendations during usual check-up visits were analyzed. RESULTS: Only 50% of physicians were found to recommend screening for colorectal cancer during usual check-up visits, and only 25% prescribed cost-effective procedures. The percentage of physicians recommending stool occult blood test and sigmoidoscopy was 24% and 4% respectively. Only 48% and 23% of physicians recognized a cancer screening value for stool occult blood test and sigmoidoscopy. Colorectal screening recommendations were statistically lower among physicians aged 30 or less (p = 0.012). No differences were found when gender, level and type of specialization were analyzed, even though specialists in general practice showed a trend for better prescription (p = 0.054). CONCLUSION: Contemporary recommendations for colorectal cancer screening are not followed by implementation in primary care setting. Education on presymptomatic control and screening practice monitoring are required if primary care is to make a major impact on colorectal cancer mortality

Heterogeneity, high performance computing, self-organization and the Cloud

This open access book addresses the most recent developments in cloud computing such as HPC in the Cloud, heterogeneous cloud, self-organising and self-management, and discusses the business implications of cloud computing adoption. Establishing the need for a new architecture for cloud computing, it discusses a novel cloud management and delivery architecture based on the principles of self-organisation and self-management. This focus shifts the deployment and optimisation effort from the consumer to the software stack running on the cloud infrastructure. It also outlines validation challenges and introduces a novel generalised extensible simulation framework to illustrate the effectiveness, performance and scalability of self-organising and self-managing delivery models on hyperscale cloud infrastructures. It concludes with a number of potential use cases for self-organising, self-managing clouds and the impact on those businesses