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

Design of cross-coupled CMAC for contour-following – a reinforcement-based ILC approach

One of the most popular applications of a bi-axial motion stage is precision motion control. The reduction of tracking error and contour error is one of the most coveted goals in precision motion control systems. The accuracy of a motion control system is often affected by external disturbances. In addition, system non-linearity such as friction also represents a major hurdle to motion precision. In order to deal with the aforementioned problem, this paper proposes a fuzzy logic-based Reinforcement Iterative Learning Control (RILC) and a Cross-Coupled Cerebellar Model Articulation Controller (CCCMAC). In particular, the proposed fuzzy logicbased RILC and a LuGre friction model-based compensation approach are exploited to improve motion accuracy. The fuzzy logic-based RILC aims at reducing tracking error and compensating for external disturbance, while the LuGre friction model is responsible for friction compensation. In addition, the CCCMAC consisting of a cerebellar model articulation controller and a cross-coupled controller aims at reducing contour error and dealing with the problem of dynamics mismatch between different axes. Performance comparisons between the proposed fuzzy logic-based Reinforcement Iterative Learning Cross-Coupled Cerebellar Model Articulation Controller (RIL–CCCMAC) and several existing control schemes are conducted on a bi-axial motion stage. Experimental results verify the effectiveness of the proposed RIL–CCCMAC

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

Efficient Prodrug Activator Gene Therapy by Retroviral Replicating Vectors Prolongs Survival in an Immune-Competent Intracerebral Glioma Model.

Prodrug activator gene therapy mediated by murine leukemia virus (MLV)-based retroviral replicating vectors (RRV) was previously shown to be highly effective in killing glioma cells both in culture and in vivo. To avoid receptor interference and enable dual vector co-infection with MLV-RRV, we have developed another RRV based on gibbon ape leukemia virus (GALV) that also shows robust replicative spread in a wide variety of tumor cells. We evaluated the potential of GALV-based RRV as a cancer therapeutic agent by incorporating yeast cytosine deaminase (CD) and E. coli nitroreductase (NTR) prodrug activator genes into the vector. The expression of CD and NTR genes from GALV-RRV achieved highly efficient delivery of these prodrug activator genes to RG-2 glioma cells, resulting in enhanced cytotoxicity after administering their respective prodrugs 5-fluorocytosine and CB1954 in vitro. In an immune-competent intracerebral RG-2 glioma model, GALV-mediated CD and NTR gene therapy both significantly suppressed tumor growth with CB1954 administration after a single injection of vector supernatant. However, NTR showed greater potency than CD, with control animals receiving GALV-NTR vector alone (i.e., without CB1954 prodrug) showing extensive tumor growth with a median survival time of 17.5 days, while animals receiving GALV-NTR and CB1954 showed significantly prolonged survival with a median survival time of 30 days. In conclusion, GALV-RRV enabled high-efficiency gene transfer and persistent expression of NTR, resulting in efficient cell killing, suppression of tumor growth, and prolonged survival upon CB1954 administration. This validates the use of therapeutic strategies employing this prodrug activator gene to arm GALV-RRV, and opens the door to the possibility of future combination gene therapy with CD-armed MLV-RRV, as the latter vector is currently being evaluated in clinical trials

A General Phase Matching Condition for Quantum Searching Algorithm

A general consideration on the phase rotations in quantum searching algorithm is taken in this work. As four phase rotations on the initial state, the marked states, and the states orthogonal to them are taken account, we deduce a phase matching condition for a successful search. The optimal options for these phase are obtained consequently.Comment: 3 pages, 3 figure

Site classification and Vs30 estimation of free-field TSMIP stations using the logging data of EGDT

The Engineering Geological Database for TSMIP (EGDT), the Taiwan Strong Motion Instrumentation Program, has been under construction by the National Center for Research on Earthquake Engineering and the Central Weather Bureau in Taiwan since 2000. Site characterization, comprising surface investigations and logging measurements, was carried out throughout the project. We provide a set of specifications and a description to help users understand the subject matter of the database. EGDT contains 469 surveyed stations, 439 of which were drilled and the logging measurements completed. Of these, 385 had logging data reaching at least 30 m, and we used these to examine and determine the most accurate extrapolation of Vs30 (the average S-wave velocity of the top 30 m of strata) for the other 54 stations with velocity profiles less than 30 m. The chosen method assumed that the bottom velocity is identical from the actual depth of the hole to a distance of 30 m, that is, the Bottom Constant Velocity (BCV) method. In order to utilize other existing boreholes which have only N values but no velocities in the future, the empirical S-wave velocity equations for seven different regions and the whole of Taiwan were evaluated by a multivariable analysis. Henceforth, for those existing boreholes which have an N profile less than 30 m, the S-wave velocity profile can first be calculated by empirical S-wave velocity equations, and then Vs30 can be estimated by reliable extrapolation. Some other studies of site classifications of TSMIP stations were compared with our results to demonstrate the necessity of reclassification. Ultimately, the Vs30 values of the 439 drilled free-field TSMIP stations were derived and the new site classification was achieved according to the Vs30-based provisions of the National Earthquake Hazards Reduction Program

Mechanical Buckling of Multi-Walled Carbon Nanotubes: The Effects of Slenderness Ratio

Abstract Buckling strengths, in terms of compressive strain, of single-, double-and triple-walled carbon nanotubes (CNTs) are investigated to study the effects of slenderness ratio (S R ) via the molecular dynamics (MD) simulations with the Tersoff potential. Under constant ratio of slenderness, the CNTs with small S R behave like a continuum shell object. For large S R 's, multi-walled CNTs exhibit the characteristics of the Euler columns. In addition, smaller nanotubes possess higher buckling-resistance. The buckling strength of multiwalled nanotubes is controlled by the size of their outermost shell.