Nighttime Construction Issues

This report addresses several issues to consider when considering performing highway construction work in Kentucky at night. Surveys of other state departments of transportation and Kentucky highway contractors were made to identify best practices and concerns. An advisory committee of experienced KyTC engineers plus contractor representatives met extensively to identify successful approaches for handling key issues which arise on night-time construction projects. Seventeen specific recommendations have been proposed to enhance the Cabinet\u27s use of night-time construction for its projects. These cover several issues related to night-time work, including contract requirements, traffic control, law enforcement, personnel issues, lighting and public awareness. A method (the Night-Time Project Evaluation Form) was also developed for evaluating a proposed construction project as a candidate for night-time work. If properly implemented, night-time construction can greatly decrease the duration of highway construction projects, greatly reduce road user delays and associated costs, while providing a safe environment for both workers and the traveling public

Uranium recovery from ore by a Higgins ion-exchange contactor at Grand Junction pilot plant /

"Date issued: Jul 1, 1957."At head of title: Chemical Technology Division.Bibliography: p. 8.Operated by Union Carbide Nuclear CompanyMode of access: Internet

State Supremacy in Decline

This paper discusses the dynamics of the international pharmaceutical industry, and how these are creating problems for the Australian government in its efforts to manage change within the regulated domestic industry. The paper argues that regulatory reform and industry development policy have eroded the capacity of the federal government to maintain the pricing regime associated with the Pharmaceutical Benefits Scheme (PBS) since 1950. The bargaining strength of the transnational firms which dominate the pharmaceutical industry in Australia is increasing; current global rationalisation of manufacturing and of R&D make threats to relocate more credible than in the past.

Liraglutide and Renal Outcomes in Type 2 Diabetes.

BACKGROUND: In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. METHODS: We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. RESULTS: A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). CONCLUSIONS: This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo. (Funded by Novo Nordisk and the National Institutes of Health; LEADER ClinicalTrials.gov number, NCT01179048 .)