[Meningitis (II)--acute bacterial meningitis]

Acute meningitis is a medical emergency, particularly in patients with rapidly progressing disease, mental status changes or neurological deficits. The majority of cases of bacterial meningitis are caused by a limited number of species, i.e. Streptococcus pneumoniae, Neisseria meningitis, Listeria monocytogenes, group B Streptococci (Streptococcus agalactiae), Haemophilus influenzae and Enterobacteriaceae. Many other pathogens can occasionally cause bacterial meningitis, often under special clinical circumstances. Treatment of meningitis includes two main goals: Eradication of the infecting organism, and management of CNS and systemic complications. Empiric therapy should be initiated without delay, as the prognosis of the disease depends on the time when therapy is started. One or two blood cultures should be obtained before administering the first antibiotic. Empiric therapy is primarily based on the age of the patient, with modifications if there are positive findings on CSF gram stain or if the patient presents with special risk factors. It is safer to choose regimens with broad coverage, as they can usually be modified within 24-48 hours, when antibiotic sensitivities of the infecting organism become available. Adjunctive therapy with dexamethasone is also administered in severely ill patients concomitantly with the first antibiotic dose. In patients who are clinically stable and are unlikely to be adversely affected if antibiotics are not administered immediately, including those with suspected viral or chronic meningitis, a lumbar puncture represents the first step, unless there is clinical suspicion of an intracerebral mass lesion. Findings in the CSF and on CT scan, if performed, will guide the further diagnostic work-up and therapy in all patients.

Open Data and Earth Observations The Case of Opening Up Access to and Use of Earth Observation Data Through the Global Earth Observation System of Systems

Earth observations (EO) represent a growing and valuable resource for many scientific, research and practical applications carried out by users around the world. Access to EO data for some applications or activities, like climate change research or emergency response activities, becomes indispensable for their success. However, often EO data or products made of them are (or are claimed to be) subject to intellectual property law protection and are licensed under specific conditions regarding access and use. Restrictive conditions on data use can be prohibitive for further work with the data. Global Earth Observation System of Systems (GEOSS) is an initiative led by the Group on Earth Observations (GEO) with the aim to provide coordinated, comprehensive, and sustained EO and information for making informed decisions in various areas beneficial to societies, their functioning and development. It seeks to share data with users world-wide with the fewest possible restrictions on their use by implementing GEOSS Data Sharing Principles adopted by GEO. The Principles proclaim full and open exchange of data shared within GEOSS, while recognising relevant international instruments and national policies and legislation through which restrictions on the use of data may be imposed.The paper focuses on the issue of the legal interoperability of data that are shared with varying restrictions on use with the aim to explore the options of making data interoperable. The main question it addresses is whether the public domain or its equivalents represent the best mechanism to ensure legal interoperability of data. To this end, the paper analyses legal protection regimes and their norms applicable to EO data. Based on the findings, it highlights the existing public law statutory, regulatory, and policy approaches, as well as private law instruments, such as waivers, licenses and contracts, that may be used to place the datasets in the public domain, or otherwise make them publicly available for use and re-use without restrictions. It uses GEOSS and the particular characteristics of it as a system to identify the ways to reconcile the vast possibilities it provides through sharing of data from various sources and jurisdictions on the one hand, and the restrictions on the use of the shared resources on the other. On a more general level the paper seeks to draw attention to the obstacles and potential regulatory solutions for sharing factual or research data for the purposes that go beyond research and education.

A Link Quality and Geographical-aware Routing Protocol for Video Transmission in Mobile IoT

Wireless mobile sensor networks are enlarging the Internet of Things (IoT) portfolio with a huge number of multimedia services for smart cities. Safety and environmental monitoring multimedia applications will be part of the Smart IoT systems, which aim to reduce emergency response time, while also predicting hazardous events. In these mobile and dynamic (possible disaster) scenarios, opportunistic routing allows routing decisions in a completely distributed manner, by using a hop- by-hop route decision based on protocol-specific characteristics, and a predefined end-to-end path is not a reliable solution. This enables the transmission of video flows of a monitored area/object with Quality of Experience (QoE) support to users, headquarters or IoT platforms. However, existing approaches rely on a single metric to make the candidate selection rule, including link quality or geographic information, which causes a high packet loss rate, and reduces the video perception from the human standpoint. This article proposes a cross-layer Link quality and Geographical-aware Opportunistic routing protocol (LinGO), which is designed for video dissemination in mobile multimedia IoT environments. LinGO improves routing decisions using multiple metrics, including link quality, geographic loca- tion, and energy. The simulation results show the benefits of LinGO compared with well-known routing solutions for video transmission with QoE support in mobile scenarios.

Preferences for the organization of long-term follow-up in adolescent and young adult cancer survivors.

PURPOSE As survival rates of adolescent and young adult (AYA) cancer patients increase, a growing number of AYA cancer survivors need follow-up care. However, there is little research on their preferences for follow-up care. We aimed to (1) describe AYA cancer survivors' preferences for the organization and content of follow-up care, (2) describe their preferences for different models of follow-up, and (3) investigate clinical and sociodemographic characteristics associated with preferences for the different models. METHODS AYA cancer survivors (diagnosed with cancer at age 16-25 years; ≥5 years after diagnosis) were identified through the Cancer Registry Zurich and Zug. Survivors completed a questionnaire on follow-up attendance, preferences for organizational aspects of follow-up care (what is important during follow-up, what should be included during appointments, what specialists should be involved, location), models of follow-up (telephone/questionnaire, general practitioner (GP), pediatric oncologist, medical oncologist, multidisciplinary team), and sociodemographic characteristics. Information on tumor and treatment was available through the Cancer Registry Zurich and Zug. RESULTS Of 389 contacted survivors, 160 (41.1 %) participated and 92 (57.5 %) reported still attending follow-up. Medical aspects of follow-up care were more important than general aspects (p < 0.001). Among different organizational models, follow-up by a medical oncologist was rated higher than all other models (p = 0.002). Non-attenders of follow-up rated GP-led follow-up significantly higher than attenders (p = 0.001). CONCLUSION Swiss AYA cancer survivors valued medical content of follow-up and showed a preference for medical oncologist-led follow-up. Implementation of different models of follow-up care might improve accessibility and attendance among AYA cancer survivors.

An ITS architecture specification - The FOTsis project experience

The recent continuous development of Cooperative ITS has resulted in several initiatives which focus on different parts of the Cooperative environment landscape. The FOTsis project focuses on the infrastructure side of the Cooperative environment and will deploy and test 7 services designed to maximise the benefits of the integration of the road operator and infrastructure-based information providers into the ITS environment. This integration can take place in any of the stages of data collection, processing and actuations of the services, but also support and trigger external tasks such as operations of the emergency response entities, etc. This paper describes the current status of the project and focuses on the specification of the supporting architecture to the services tested: references, a brief outline of the requirements’ definition, and the FOTsis architecture proposal, with some conclusions about the architecture tests conducted. The outlook on the project’s next steps is given in the last section of the paper.

Flooding through the lens of mobile phone activity

Natural disasters affect hundreds of millions of people worldwide every year. Emergency response efforts depend upon the availability of timely information, such as information concerning the movements of affected populations. The analysis of aggregated and anonymized Call Detail Records (CDR) captured from the mobile phone infrastructure provides new possibilities to characterize human behavior during critical events. In this work, we investigate the viability of using CDR data combined with other sources of information to characterize the floods that occurred in Tabasco, Mexico in 2009. An impact map has been reconstructed using Landsat-7 images to identify the floods. Within this frame, the underlying communication activity signals in the CDR data have been analyzed and compared against rainfall levels extracted from data of the NASA-TRMM project. The variations in the number of active phones connected to each cell tower reveal abnormal activity patterns in the most affected locations during and after the floods that could be used as signatures of the floods - both in terms of infrastructure impact assessment and population information awareness. The epresentativeness of the analysis has been assessed using census data and civil protection records. While a more extensive validation is required, these early results suggest high potential in using cell tower activity information to improve early warning and emergency management mechanisms.

Flooding through the lens of mobile phone activity

Natural disasters affect hundreds of millions of people worldwide every year. Emergency response efforts depend upon the availability of timely information, such as information concerning the movements of affected populations. The analysis of aggregated and anonymized Call Detail Records (CDR) captured from the mobile phone infrastructure provides new possibilities to characterize human behavior during critical events. In this work, we investigate the viability of using CDR data combined with other sources of information to characterize the floods that occurred in Tabasco, Mexico in 2009. An impact map has been reconstructed using Landsat-7 images to identify the floods. Within this frame, the underlying communication activity signals in the CDR data have been analyzed and compared against rainfall levels extracted from data of the NASA-TRMM project. The variations in the number of active phones connected to each cell tower reveal abnormal activity patterns in the most affected locations during and after the floods that could be used as signatures of the floods - both in terms of infrastructure impact assessment and population information awareness. The representativeness of the analysis has been assessed using census data and civil protection records. While a more extensive validation is required, these early results suggest high potential in using cell tower activity information to improve early warning and emergency management mechanisms.

La protección civil municipal: análisis de los distintos tipos de gestión y propuesta metodológica de planificación

Mediante la elaboración de esta tesis doctoral se pretende diseñar un sistema para la realización del plan de autoprotección en industrias con riesgo de incendio dentro de un polígono industrial. Para desarrollar esta línea de investigación se realizará una investigación cartográfica así como un reconocimiento visual de las distintas empresas industriales, de actividades heterogéneas, seleccionadas por su emplazamiento y condiciones. Este tipo de industria es esencial en el sistema económico nacional, ya que dota de recursos y servicios al tejido social, además de tener una relación directa con la generación de riqueza y por tanto incide de forma positiva en el empleo de cualquier región. Estas razones y otras son determinantes para fomentar el progreso, si bien nunca a expensas de la seguridad de los empleados que hacen posible la línea de producción así como de los posibles viandantes que transcurran por la zona de impacto en caso de incidentes como por ejemplo un incendio que afecte a cualquiera de los locales y/o empresas que se emplazen en los denominados polígonos industriales. La tesis incluye trabajos experimentales de los que se extraen recomendaciones y conclusiones encaminadas a la optimización de la instrumentalización utilizada, las técnicas de observación, diseño y cálculo necesarias que determinarán el acercamiento al método propuesto para nuestra valoración del riesgo por incendio. Las posibles emergencias que pueden darse a nivel de industrias localizadas en polígonos industriales son diversas y numerosas. De todas ellas se elige abordar el caso de “incendio” por su casuística más numerosa. No obstante, la planificación orientada desde el prisma de la investigación de esta tesis puede estenderse a cualquier otro riesgo, lo que se aportará como líneas futuras de investigación. Las aproximaciones y etapas de los trabajos que forman parte de esta investigación se han integrado en cada capítulo y son las siguientes: En primer lugar un capítulo de Introducción, en el que se realiza una reflexión justificada de la elección del tema tratado, se formula la hipótesis de partida y se enumeran los distintos objetivos que se pretenden alcanzar. En el segundo capítulo, titulado Aspectos de la Protección Civil en la Constitución Española de 1978, se ha realizado un estudio exhaustivo de la Constitución en todo lo relacionado con el ámbito de la protección, haciendo especial énfasis en las distintas competencias según el tipo de administración que corresponda en cada caso, así como las obligaciones y deberes que corresponden a los ciudadanos en caso de catástrofe. Así mismo se analizan especialmente los casos de Guerra y el estado de Alarma. En el tercer capítulo, titulado Repuesta de las administraciones públicas ante emergencias colectivas, se trata de formular el adecuado sistema de repuesta que sería preciso para tratar de mitigar desastres y catástrofes. Se analizan los distintos sistemas de gestión de emergencias constatando en cada caso los pros y los contras de cada uno. Se pretende con ello servir de ayuda en la toma de decisiones de manera coherente y racional. El capítulo cuarto, denominado Planes Locales de emergencia. Estudio en las distintas administraciones, se ha pormenorizado en la presentación así como puesta en funcionamiento de los planes, comparando los datos obtenidos entre ellos para concluir en un punto informativo que nos lleva a la realidad de la planificación. Para la realización y desarrollo de los capítulos 5 y 6, llamados Análisis de la Norma Básica de Autoprotección y Métodos de evaluación del riesgo de Incendio, se estudia la normativa actual en autoprotección prestando atención a los antecedentes históricos así como a todas las figuras que intervienen en la misma. Se analizan los distintos métodos actuales para la valoración del riesgo por incendio en industrias. Este aspecto es de carácter imprescindible en la protección civil de los ciudadanos pero también es de especial importancia en las compañías aseguradoras. En el capítulo 7, Propuesta metodológica, se propone y justifica la necesidad de establecer una metodología de estudio para estos casos de riesgo por incendio en industrias para así, acortar el tiempo de respuesta de los servicios de emergencia hasta la zona, así como dotar de información imprescindible sobre el riesgo a trabajadores y transeúntes. El último capítulo se refiere a las Conclusiones, donde se establecen y enuncian una serie de conclusiones y resultados como consecuencia de la investigación desarrollada, para finalizar esta tesis doctoral enunciando posibles desarrollos y líneas de investigación futuros. ABSTRACT The development of this thesis is to design a system for the implementation of the plan of self-protection in industries with risk of fire in an industrial park. To develop this line of research will be done cartographic research as well as visual recognition of the distinct and heterogeneous industrial companies selected by its location and conditions. This type of industry is an essential part in the economic national system providing economic resources to society as well as with a direct relationship in unemployment. For this reason it is crucial to promote their progress, but never at the expense of the security of the employees that make the line of production as well as possible walkers that pass by the area of impact in the event of a fire affecting the company. The thesis includes experimental works which are extracted recommendations and conclusions aimed at optimization of used exploit, techniques of observation, design and calculation needed to determine the approach to the method proposed for our assessment of the risk from fire. The approaches and stages of works that are part of this research have been integrated into each chapter and are as follows: In the first chapter, holder introduction, perform a supporting reflection of the choice of the subject matter, is formulated the hypothesis of departure and listed the different objectives that are intended to achieve. In the second chapter, holder aspects of Civil Protection in the Spanish Constitution of 1978, examines an exhaustive study of the Constitution in everything related to the scope of protection. With an emphasis on individual skills according to the type of management with corresponding in each case, as well as the obligations and duties which correspond to citizens in the event of a catastrophe. Also analyzes the particular cases of war and the State of alarm. In the third chapter, holder public administrations collective emergency response, discussed trafficking in defining the proper system response that would be precise to address disasters and catastrophes. We discusses the different systems of emergency management in each case, we pretend the pros and cons of each. We tried that this serve as decision-making aid coherent and rational way. The fourth chapter is holder Local Emergency Plans (LEP). Study on the different administrations, has detailed in the presentation as well as operation of the LEP, comparing the data between them to conclude in an information point that leads us to the reality of planning. For the realization and development of chapters 5 and 6, holder Analysis of the basic rule of self-protection and fire risk assessment methods, paying attention to the historical background as well as all the figures involved in the same studies with the current rules of self-protection. The current methods for the estimation of the risk are analyzed by fire in industries. This aspect is essential in the civil protection of the citizens, but it is also of special importance for insurance companies. The seventh chapter, holder Methodological proposal, we propose and justifies the need to establish a methodology for these cases of risk by fire in industries. That shorts the response time of emergency services to the area, and provides essential information about the risk to workers and walkers. The last chapter refers to the Conclusions, laying down a series of results as a consequence of the previous chapters to complete billing possible developments and research future.

Initiation process of earthquakes and its implications for seismic hazard reduction strategy.

For the average citizen and the public, "earthquake prediction" means "short-term prediction," a prediction of a specific earthquake on a relatively short time scale. Such prediction must specify the time, place, and magnitude of the earthquake in question with sufficiently high reliability. For this type of prediction, one must rely on some short-term precursors. Examinations of strain changes just before large earthquakes suggest that consistent detection of such precursory strain changes cannot be expected. Other precursory phenomena such as foreshocks and nonseismological anomalies do not occur consistently either. Thus, reliable short-term prediction would be very difficult. Although short-term predictions with large uncertainties could be useful for some areas if their social and economic environments can tolerate false alarms, such predictions would be impractical for most modern industrialized cities. A strategy for effective seismic hazard reduction is to take full advantage of the recent technical advancements in seismology, computers, and communication. In highly industrialized communities, rapid earthquake information is critically important for emergency services agencies, utilities, communications, financial companies, and media to make quick reports and damage estimates and to determine where emergency response is most needed. Long-term forecast, or prognosis, of earthquakes is important for development of realistic building codes, retrofitting existing structures, and land-use planning, but the distinction between short-term and long-term predictions needs to be clearly communicated to the public to avoid misunderstanding.

Boston, Massachusetts Region LIDAR First Return Elevation Data, 2002

LIDAR (LIght Detection And Ranging) first return elevation data of the Boston, Massachusetts region from MassGIS at 1-meter resolution. This LIDAR data was captured in Spring 2002. LIDAR first return data (which shows the highest ground features, e.g. tree canopy, buildings etc.) can be used to produce a digital terrain model of the Earth's surface. This dataset consists of 74 First Return DEM tiles. The tiles are 4km by 4km areas corresponding with the MassGIS orthoimage index. This data set was collected using 3Di's Digital Airborne Topographic Imaging System II (DATIS II). The area of coverage corresponds to the following MassGIS orthophoto quads covering the Boston region (MassGIS orthophoto quad ID: 229890, 229894, 229898, 229902, 233886, 233890, 233894, 233898, 233902, 233906, 233910, 237890, 237894, 237898, 237902, 237906, 237910, 241890, 241894, 241898, 241902, 245898, 245902). The geographic extent of this dataset is the same as that of the MassGIS dataset: Boston, Massachusetts Region 1:5,000 Color Ortho Imagery (1/2-meter Resolution), 2001 and was used to produce the MassGIS dataset: Boston, Massachusetts, 2-Dimensional Building Footprints with Roof Height Data (from LIDAR data), 2002 [see cross references].

Boston, Massachusetts, 2-Dimensional Building Footprints with Height Data (from LIDAR data), 2002

This dataset consists of 2D footprints of the buildings in the metropolitan Boston area, based on tiles in the orthoimage index (orthophoto quad ID: 229890, 229894, 229898, 229902, 233886, 233890, 233894, 233898, 233902, 237890, 237894, 237898, 237902, 241890, 241894, 241898, 241902, 245898, 245902). This data set was collected using 3Di's Digital Airborne Topographic Imaging System II (DATIS II). Roof height and footprint elevation attributes (derived from 1-meter resolution LIDAR (LIght Detection And Ranging) data) are included as part of each building feature. This data can be combined with other datasets to create 3D representations of buildings and the surrounding environment.

The Social Pillar already exists… but more effort is needed to strengthen it. CEPS Commentary, 9 March 2016 Wednesday, 9 March 2016

There is an unmet demand for a more social Europe in the EU. Asked what would strengthen the feeling of being a European citizen, 32% of the respondents replied: “a European social welfare system harmonised between the Member States”. This answer ranked higher than any other possible response, such as being able to use your mobile phone in all EU countries at the same price (23%), a European emergency response service to fight international natural disasters (22%) and having a European ID card in addition to national ID cards (20%) (Eurobarometer, 2014).

Energy Signaling in the Regulation of Gene Expression during Stress

Maintenance of homeostasis is pivotal to all forms of life. In the case of plants, homeostasis is constantly threatened by the inability to escape environmental fluctuations, and therefore sensitive mechanisms must have evolved to allow rapid perception of environmental cues and concomitant modification of growth and developmental patterns for adaptation and survival. Re-establishment of homeostasis in response to environmental perturbations requires reprogramming of metabolism and gene expression to shunt energy sources from growth-related biosynthetic processes to defense, acclimation, and, ultimately, adaptation. Failure to mount an initial 'emergency' response may result in nutrient deprivation and irreversible senescence and cell death. Early signaling events largely determine the capacity of plants to orchestrate a successful adaptive response. Early events, on the other hand, are likely to be shared by different conditions through the generation of similar signals and before more specific responses are elaborated. Recent studies lend credence to this hypothesis, underpinning the importance of a shared energy signal in the transcriptional response to various types of stress. Energy deficiency is associated with most environmental perturbations due to their direct or indirect deleterious impact on photosynthesis and/or respiration. Several systems are known to have evolved for monitoring the available resources and triggering metabolic, growth, and developmental decisions accordingly. In doing so, energy-sensing systems regulate gene expression at multiple levels to allow flexibility in the diversity and the kinetics of the stress response.

National survey of hazardous waste generators and treatment, storage, and disposal facilities regulated under RCRA in 1981.

Mode of access: Internet.

Abstract proceedings : Second Forum on Innovative Hazardous Waste Treatment Technologies, Domestic and International : Philadelphia, PA, May 15-17, 1990.

Mode of access: Internet.