Results of 1/4-Scale Experiments. Vapor Simulant And Liquid Jet A Tests

A quarter-scale engineering model of the center wing tank (CWT) of a 747-100 was constructed. This engineering model replicated the compartmentalization, passageways, and venting to the atmosphere. The model was designed to scale the fluid dynamical and combustion aspects of the explosion, not the structural failure of the beams or spars. The effect of structural failure on combustion was examined by using model beams and spars with deliberately engineered weak connections to the main tank structure. The model was filled with a simulant fuel (a mixture of propane and hydrogen) and ignited with a hot wire. The simulant fuel was chosen on the basis of laboratory testing to model the combustion characteristics (pressure rise and flame speed) of Jet A vapor created by a Jet A liquid layer at 50C at an altitude of 13.8 kft. A series of experiments was carried out in this model in order to: (a) investigate combustion in a CWT geometry; and (b) provide guidance to the TWA 800 crash investigation. The results of the experiments were observed with high-speed film, video, and still cameras, fast and slow pressure sensors, thermocouples, photodetectors, and motion sensors. A special pseudo-schlieren system was used to visualize flame propagation within the tank. This report describes the test program, facility, instrumentation, the first 30 experiments, comparisons between experiments, and performance of the instrumentation; then examines the significance of these results to the TWA 800 crash investigation. The key results of this study are: Flame Motion: The motion of flame was dominated by the effects of turbulence created by jetting through the passageways and vent stringers. A very rapid combustion event (lasting 10 to 20 ms) occurred once the flame traveled outside of the ignition bay and interacted with the turbulent flow. Most of the gas within the tank was burned during this rapid event. Compartments: The combustion time decreased with an increasing number of compartments (bays) within the tank. With six bays, combustion took only 100 to 150 ms to be completed from the time of ignition until the end of the rapid combustion phase. The total combustion event was three to four times shorter with compartments than without. Venting: Venting to the outside of the tank through the model vent stringers had a negligible effect on the combustion progress or on the peak pressure reached at the end of the burn. Ignition Location: Variation of the ignition location produced distinctive pressure loads on the structural components. Liquid Fuel: Lofting of a cold liquid fuel layer was produced by the combustion-induced gas motion. Although this spray of liquid eventually ignited and burned, it did not contribute to the pressure loading. Structural Failure: Structural failure resulted in flame acceleration, decreasing the overall combustion time. TWA 800 Investigation: The pressure loads were sufficiently high, up to 4 bar, and the combustion events were sufficiently short, that the forward portion (spanwise beam 3, front spar) of the CWT structure would fail as a direct consequence of the explosion. A combination of pressure loads was produced in some tests consistent with the TWA 800 wreckage. Replica tests, structural modeling, and sensitivity studies on fuel concentration are needed before any conclusions can be drawn about probable ignition locations. Cargo Bay: Tests with a simplified model of a half-full cargo bay indicated that repeated pressure waves with an amplitude of 1 bar or less are produced when an explosion scenario similar to TWA 800 is tested. Future Testing: Future studies should include replica tests, tests with Jet A vapor and warm liquid Jet A layers, and sensitivity tests to examine ignition location, fuel concentration, and vent area perturbations. Summary: Explosion tests in a 747-100 CWT model reveal that a very complex pattern of combustion occurs due the interaction of the flame and the flow-generated turbulence. A wide range of structural load patterns occur, depending on the location of the ignition source. Some of these load patterns are consistent with damage believed to be associated with the initial explosion event in TWA 800. Sensitivity of the loading to the ignition location indicates that narrowing down the ignition location in TWA 800 may be possible. However, the complexity of the combustion and structural failure processes in the actual center wing tank mandates extremely careful consideration of the uncertainties that enter into this process

The Minimum Important Difference for the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form in Women with Stress Urinary Incontinence

INTRODUCTION: Minimum important difference (MID) estimates the minimum degree of change in an instrument\u27s score that correlates with a patient\u27s subjective sense of improvement. We aimed to determine the MID for the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) using both anchor based and distribution based methods derived using data from the Trial of Midurethral Slings (TOMUS). MATERIALS AND METHODS: Instruments for the anchor-based analyses included the urogenital distress inventory (UDI), incontinence impact questionnaire (IIQ), patient global impression of improvement (PGI-I), incontinence episodes (IE) on 7-day bladder diary, and satisfaction with surgical results. After confirming moderate correlation (r ≥ 0.3) of ICIQ-UI SF and each anchor, MIDs were determined by calculating the difference between the mean instrument scores for individuals with the smallest amount of improvement and with no change. The distribution-based method of MID assessment was applied using effect sizes of 0.2 and 0.5 SD (small to medium effects). Triangulation was used to examine these multiple MID values in order to converge on a small range of values. RESULTS: Anchor-based MIDs range from -4.5 to -5.7 at 12 months and from -3.1 to 4.3 at 24 months. Distribution-based MID values were lower. Triangulation analysis supports a MID of -5 at 12 months and -4 at 24 months. CONCLUSION: The recommended MIDs for ICIQ-UI SF are -5 at 12 months and -4 at 24 months. In surgical patients, ICIQ-UI SF score changes that meet these thresholds can be considered clinically meaningful

A regional informatics platform for coordinated antibiotic resistant infection tracking, alerting and prevention

Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region. Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010. Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%–23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems. Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission

Randomized Trial of Letrozole Following Tamoxifen as Extended Adjuvant Therapy in Receptor-Positive Breast Cancer: Updated Findings from NCIC CTG MA.17

Background: Most recurrences in women with breast cancer receiving 5 years of adjuvant tamoxifen occur after 5 years. The MA.17 trial, which was designed to determine whether extended adjuvant therapy with the aromatase inhibitor letrozole after tamoxifen reduces the risk of such late recurrences, was stopped early after an interim analysis showed that letrozole improved disease-free survival. This report presents updated findings from the trial. Methods: Postmenopausal women completing 5 years of tamoxifen treatment were randomly assigned to a planned 5 years of letrozole (n = 2593) or placebo (n = 2594). The primary endpoint was disease-free survival (DFS); secondary endpoints included distant disease-free survival, overall survival, incidence of contralateral tumors, and toxic effects. Survival was examined using Kaplan-Meier analysis and log-rank tests. Planned subgroup analyses included those by axillary lymph node status. All statistical tests were two-sided. Results: After a median follow-up of 30 months (range = 1.5-61.4 months), women in the letrozole arm had statistically significantly better DFS and distant DFS than women in the placebo arm (DFS: hazard ratio [HR] for recurrence or contralateral breast cancer = 0.58, 95% confidence interval [CI] = 0.45 to 0.76; P<.001; distant DFS: HR = 0.60, 95% CI = 0.43 to 0.84; P = .002). Overall survival was the same in both arms (HR for death from any cause = 0.82, 95% CI = 0.57 to 1.19; P = .3). However, among lymph node-positive patients, overall survival was statistically significantly improved with letrozole (HR = 0.61, 95% CI = 0.38 to 0.98; P = .04). The incidence of contralateral breast cancer was lower in women receiving letrozole, but the difference was not statistically significant. Women receiving letrozole experienced more hormonally related side effects than those receiving placebo, but the incidences of bone fractures and cardiovascular events were the same. Conclusion: Letrozole after tamoxifen is well-tolerated and improves both disease-free and distant disease-free survival but not overall survival, except in node-positive patient

An unusual SAR arc observed during ring current development, 4 August 1972

Measurements made from the ISIS-II spacecraft at 1400 km and ground-based measurements from New Zealand provide a detailed description of an unusual SAR arc observed at dusk on 4 August 1972, during the growth phase of the ring current. Proton precipitation was observed over a latitude range of a few degrees, with electron temperature enhancements throughout the region but espeically at its boundaries, and an F-region trough was present at the equatorward boundary. SAR arcs usually occur at equatorward proton boundaries but this one appeared at the poleward boundary, which seems to have given rise to a number of unusual features. Characteristics unique to this event are a high flux of low energy electrons at the SAR arc location, associated with an upward field-aligned current there, and a "slot" in the ambient electron density, which falls to 5% of the background density over a region of 1.5 km half-width. Immediately poleward of the low energy electron flux, intense whistler mode noise (0.1-0.4 MHz) is evident. The 6300 A emission, which has a total intensity of 10.6 kR, appears divided into two components, one at 285 km excited by the low energy electrons, and the other at 400 km, excited thermally by the electron gas. Comparisons are made with S3-A spacecraft observations made in the equatorial region at the same time, with ISIS-II observations of a more normal SAR arc, and with other observations reported in the literature. The kinetic Alfven wave process described by Hasegawa and Mima (1978) seems a candidate for the acceleration of these low energy electrons, but it is not possible to entirely exclude the alternative of an auroral-type acceleration process.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23358/1/0000302.pd

The abilities of improved schizophrenia patients to work and live independently in the community: a 10-year long-term outcome study from Mumbai, India

Background: The outcome of schizophrenia has several determinants. Socioecological factors, particularly living conditions, migration, community and culture, not only affect the level of risk but also the outcome. Mega cities around the world show a unique socioecological condition that has several challenges for mental health. The present study reports on the long-term status of patients with schizophrenia in such a mega city: Mumbai, India. Aim This study aims to reveal the long-term outcome of patients suffering from schizophrenia with special reference to clinical symptoms and social functioning. Methods: The cohort for this study was drawn from a 10-year follow-up of first episode schizophrenia. Patients having completed 10 years of consistent treatment after first hospitalisation were assessed on psychopathological and recovery criteria. Clinical as well as social parameters of recovery were evaluated. Descriptive statistics with 95% confidence intervals are provided. Results: Of 200 patients recruited at the beginning of this study, 122 patients (61%) were present in the city of Mumbai at the end of 10-year follow-up study period. Among 122 available patients, 101 patients (50.5%) were included in the assessment at the end of 10-year follow-up study period, 6 patients (3.0%) were excluded from the study due to changed diagnosis, and 15 patients (7.5%) were excluded due to admission into long-term care facilities. This indicates that 107 out of 122 available patients (87.7%) were living in the community with their families. Out of 101 (50.5%) patients assessed at the end of 10 years, 61 patients (30.5%) showed improved recovery on the Clinical Global Impression Scale, 40 patients (20%) revealed no improvement in the recovery, 43 patients (72.9%) were able to live independently, and 24 patients (40%) were able to find employment. Conclusions: With 10 years of treatment, the recovery rate among schizophrenia patients in Mumbai was 30.5%. Among the patients, 87.7% of patients lived in the community, 72.9% of patients lived independently, and 40% of patients obtained employment. However, 60% of patients were unable to return to work, which highlights the need for continued monitoring and support to prevent the deterioration of health in these patients. It is likely that socioecological factors have played a role in this outcome

Power-Law Scaling in the Brain Surface Electric Potential

Recent studies have identified broadband phenomena in the electric potentials produced by the brain. We report the finding of power-law scaling in these signals using subdural electrocorticographic recordings from the surface of human cortex. The power spectral density (PSD) of the electric potential has the power-law form from 80 to 500 Hz. This scaling index, , is conserved across subjects, area in the cortex, and local neural activity levels. The shape of the PSD does not change with increases in local cortical activity, but the amplitude, , increases. We observe a “knee” in the spectra at , implying the existence of a characteristic time scale . Below , we explore two-power-law forms of the PSD, and demonstrate that there are activity-related fluctuations in the amplitude of a power-law process lying beneath the rhythms. Finally, we illustrate through simulation how, small-scale, simplified neuronal models could lead to these power-law observations. This suggests a new paradigm of non-oscillatory “asynchronous,” scale-free, changes in cortical potentials, corresponding to changes in mean population-averaged firing rate, to complement the prevalent “synchronous” rhythm-based paradigm

Tourism economics research: A review and assessment

This paper aims to provide the most up-to-date survey of tourism economics research and to summarise the key trends in its recent development. Particular attention is paid to the research progress made over the last decade in respect of approaches, methodological innovations, emerging topics, research gaps, and directions for future research. Remarkable but unbalanced developments have been observed across different sub-research areas in tourism economics. While neoclassical economics has contributed the most to the development of tourism economics, alternative schools of thought in economics have also emerged in advancing our understanding of tourism from different perspectives. As tourism studies are multi- and inter-disciplinary, integrating economics with other social science disciplines will further contribute to knowledge creation in tourism studies