Occupant tenability in large-scale residential fires: an analysis of heat exposure, toxic gases, water application, and fire-service ventilation

The fire dynamics of residential fires has been drastically changing in the past 50 years. Modern fires burn faster and produce more toxic gases due to the increased presence of synthetic materials and plastics in the fire environment. In order to gain a better understanding of the risks present in modern residential fires and the effect of modern firefighting tactics on the fire environment, several large scale experimental studies were undertaken. These studies aimed to analyze the threat of heat (radiative and convective) and toxic gases (carbon monoxide, carbon dioxide, and hydrogen cyanide) on occupants in the fire environments. The large-scale experiments also studied the influence of different firefighting ventilation and water application techniques. The first large-scale study aimed to study vertical ventilation and transitional water application tactics. This study also allowed for quantification of the heat and toxic gases threat based on the ISO 13571 methodology. Seventeen experiments were performed at Underwriters Laboratories in Northbrook, IL, with nine experiments in a one-story structure and eight experiments in a two-story structure. Different types of fires were studied in both structure types, including living room fires, bedroom fires, and kitchen fires. Some of the major findings of the study were that toxic gases pose a much more significant threat in the one-story structure than does heat exposure. However, the threat from heat and toxic gases is similar in the two-story structure fires. Additionally, it was observed that ventilation actually resulted in rapidly deteriorating conditions and, if possible, firefighting crews should aim to get access to the fire environment with as little ventilation as possible. The second large-scale study looked to study the impact of exterior and interior water applications on the fire environment. This study implemented an experimental setup involving pig skin as a surrogate for human skin. The pig skin specimens were used to analyze the impact of water application on possible steam burns for trapped occupants. Additionally, a tunable diode laser absorption spectroscopic technique was employed to measure water vapor in the fire environment. Twenty-four experiments were performed in identical one-story structures with ignition occurring in the bedroom(s) at Underwriters Laboratories in Northbrook, IL. It was observed that water application resulted in spikes in skin surface temperatures. However, there was no significant difference observed in temperature spikes between interior and exterior applications. And the impact of delayed intervention resulted in much larger skin temperatures than the spikes observed from water application, suggesting it is best to get water on the fire as soon as possible. The laser diagnostic technique was successfully implemented, although the amount of obscuration was so large that at times signal was lost. Therefore, a three-tier sensitivity scheme was developed and tested at the Illinois Fire Service Institute that could measure water vapor over transmission ranges from 0.01-100% transmission. Finally, a laser diagnostic technique was developed and tested at the Illinois Fire Service Institute that could measure Hydrogen Cyanide in the fire environment. The measurement scheme extracted gas samples from the fire environment and passed the sample through two filters to filter out the soot. Hydrogen cyanide absorption was measured using a tunable laser near 3001.5 nm, and the scheme could measure HCN at a rate of 10 Hz with a detection limit of 3.6 ppm-m. The measurements showed that the threat from hydrogen cyanide can be equal to or greater than the threat of carbon monoxide poisoning, especially at greater heights in the fire environment where more than 1000 ppm HCN was measured during one experiment at 1.2 m above the floor

Occupant Tenability in Single Family Homes: Part II: Impact of Door Control, Vertical Ventilation and Water Application

This paper describes experimental investigations of fire service ventilation and suppression practices in full-scale residential structures, including a one-story, 112 m2, 3 bedroom, 1 bathroom house with 8 total rooms and a two-story 297 m2, 4 bedroom, 2.5 bathroom house with 12 total rooms. The two-story house featured a modern open floor plan, two-story great room and open foyer. Seventeen experiments were conducted varying fire location, ventilation locations, the size of ventilation openings and suppression techniques. The experimental series was designed to examine the impact of several different tactics on tenability: door control, vertical ventilation size, and exterior suppression. The results of these experiments examine potential occupant and firefighter tenability and provide knowledge the fire service can use to examine their vertical ventilation and exterior suppression standard operating procedures and training content. It was observed that door control performed better at controlling the thermal exposure to occupants than did fully opening the door. Additionally, the impact of increased vertical ventilation area was minimal, and only slightly reduced the thermal exposure to occupants in a few non-fire rooms. In the two-story structure, the non-fire rooms on the second floor consistently had larger thermal fractional effective rate (FER) values (approximately 2.59 the thermal risk to oocupants) than did the non-fire rooms on the first floor. Water application was also shown to reduce the thermal risk to occupants 60 s after water application 1/3rd the original values on second floor rooms of the two-story structure and by at least 1/5th of the original values on the first floor rooms of both structures. Data also showed that the impact of front door ventilation on the toxic gases exposure was minimal, as the toxic gases FER actually increased after front door ventilation for several experiments. However, after vertical ventilation there was a 30% reduction in the toxic gases exposure rate in two of the one-story structure experiments.Funding was provided by the Department of Homeland Security (Grant No. EMW-2010-FP-00661).Ope

Occupant Tenability in Single Family Homes: Part I—Impact of Structure Type, Fire Location and Interior Doors Prior to Fire Department Arrival

This paper describes an experimental investigation of the impact of structure geometry, fire location, and closed interior doors on occupant tenability in typical single family house geometries using common fuels from twenty-first century fires. Two houses were constructed inside a large fire facility; a one-story, 112 m2, 3-bedroom, 1-bathroom house with 8 total rooms, and a two-story 297 m2, 4-bedroom, 2.5-bathroom house with 12 total rooms. Seventeen experiments were conducted with varying fire locations. In all scenarios, two bedrooms had doors remaining open while the door remained closed in a third bedroom immediately adjacent to the open door bedrooms. Temperature and gas measurement at the approximate location of a crawling or crouching trapped occupant (0.9 m from the floor) were utilized with the ISO 13571 fractional effective dose (FED) methodology to characterize occupant tenability up to the point of firefighter intervention. The FED values for the fire room were higher for heat exposure than for toxic gases, while target rooms reached highest FED due to CO/CO2 exposure. The closed interior door decreased FED significantly, with the worst case scenario resulting in a 2% probability of receiving an incapacitating dose compared to the worst case scenario for an open bedroom of 93% probability of receiving an incapacitating dose. In fact, in 7 of the 17 experiments, the closed interior door resulted in a less than 0.1% chance of an occupant receiving an incapacitating dose prior to firefighter ‘intervention.’Funding was provided by U.S. Department of Homeland Security (Grant No. EMW-2010-FP-00661).Ope

Recycling oriented vertical vibratory separation of copper and polypropylene particles

Vibration has been employed in various engineering processes for material handling. The famous Brazil nut effect, large particles tend to rise to the top under vibration, initiates various research about vibration induced particle segregation. Particle size and density are two determining factors for their behaviour under vibration. Previous research in University of Nottingham proves vertical vibratory separation to be a promising environmental friendly mechanical separation method for recycling metallic fraction from shredded Waste Electric and Electronic Equipment (WEEE) stream. A pilot scale thin cell vibratory separator has been developed to investigate the potential for WEEE recycling applications. Shredded copper and polypropylene particles have been chosen to mimic metallic and non-metallic fractions in WEEE. Vibratory separation experiment with controlled environment and addition of solid lubricant are presented in this paper. The result demonstrates the effect of relative humidity and solid lubricant on improving flowability of granular system hence successful vibratory separation. The proposed mechanisms for the presence of moisture and solid lubricant are lubricant effect and elimination of static electricity

Adjuvant enzalutamide for the treatment of early-stage androgen-receptor positive, triple-negative breast cancer: a feasibility study.

PURPOSE: Chemotherapy with or without immunotherapy remains the mainstay of treatment for triple-negative breast cancer (TNBC). A subset of TNBCs express the androgen receptor (AR), representing a potential new therapeutic target. This study assessed the feasibility of adjuvant enzalutamide, an AR antagonist, in early-stage, AR-positive (AR +) TNBC. METHODS: This study was a single-arm, open-label, multicenter trial in which patients with stage I-III, AR ≥ 1% TNBC who had completed standard-of-care therapy were treated with enzalutamide 160 mg/day orally for 1 year. The primary objective of this study was to evaluate the feasibility of 1 year of adjuvant enzalutamide, defined as the treatment discontinuation rate of enzalutamide due to toxicity, withdrawal of consent, or other events related to tolerability. Secondary endpoints included disease-free survival (DFS), overall survival (OS), safety, and genomic features of recurrent tumors. RESULTS: Fifty patients were enrolled in this study. Thirty-five patients completed 1 year of therapy, thereby meeting the prespecified trial endpoint for feasibility. Thirty-two patients elected to continue with an optional second year of treatment. Grade ≥ 3 treatment-related adverse events were uncommon. The 1-year, 2-year, and 3-year DFS were 94%, 92% , and 80%, respectively. Median OS has not been reached. CONCLUSION: This clinical trial demonstrates that adjuvant enzalutamide is a feasible and well-tolerated regimen in patients with an early-stage AR + TNBC. Randomized trials in the metastatic setting may inform patient selection through biomarker development; longer follow-up is needed to determine the effect of anti-androgens on DFS and OS in this patient population

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys

PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets

Long-term cellular immunity of vaccines for Zaire Ebola Virus Diseases

Recent Ebola outbreaks underscore the importance of continuous prevention and disease control efforts. Authorized vaccines include Merck’s Ervebo (rVSV-ZEBOV) and Johnson & Johnson’s two-dose combination (Ad26.ZEBOV/MVA-BN-Filo). Here, in a five-year follow-up of the PREVAC randomized trial (NCT02876328), we report the results of the immunology ancillary study of the trial. The primary endpoint is to evaluate long-term memory T-cell responses induced by three vaccine regimens: Ad26–MVA, rVSV, and rVSV–booster. Polyfunctional EBOV-specific CD4+ T-cell responses increase after Ad26 priming and are further boosted by MVA, whereas minimal responses are observed in the rVSV groups, declining after one year. In-vitro expansion for eight days show sustained EBOV-specific T-cell responses for up to 60 months post-prime vaccination with both Ad26-MVA and rVSV, with no decline. Cytokine production analysis identify shared biomarkers between the Ad26-MVA and rVSV groups. In secondary endpoint, we observed an elevation of pro-inflammatory cytokines at Day 7 in the rVSV group. Finally, we establish a correlation between EBOV-specific T-cell responses and anti-EBOV IgG responses. Our findings can guide booster vaccination recommendations and help identify populations likely to benefit from revaccination