Healthcare human reliability analysis - By heart

As part of the investigations into a surgical incident involving the accidental retention inside a patient's venous system of a guide wire for central venous catheterisation (CVC), the Human Error Assessment and Reduction Technique (HEART) was used to examine the potential for further occurrences. It was found to be time-efficient and to yield plausible probabilities of human error, although its use in healthcare has challenges, suggesting adaptation would be beneficial.

The potential use of 241Am as proliferation resistant burnable poison in PWRs

This paper discusses the use of 241Am as proliferation resistant burnable poison for light water reactors. Homogeneous addition of small (as little as 0.12%) amounts of 241Am to the conventional light water reactor fuel results in significant increase in 238Pu/Pu ratio in the discharged fuel improving its proliferation resistance. Moreover, 241Am, admixed to the fuel, acts as burnable absorber allowing for substantial reduction in conventional reactivity control means without a notable fuel cycle length penalty. This is possible due to favorable characteristics of 241Am transmutation chain. The fuel cycle length penalty of introducing 241Am into the core is evaluated and discussed, as well as the impact of He production in the fuel pins and degradation of reactivity feedback coefficients. Proliferation resistance and reactivity control features related to the use of 241Am are compared to those of using 237Np, which has also been suggested as an additive to the conventional fuel in order to improve its proliferation resistance. It was found that 241Am admixture is more favorable than 237Np admixture because of the smaller fuel cycle length penalty and higher burnable poison savings. Addition of either 237Np or 241Am would provide substantial but not ultimate protection from misuse of Pu originating in the spent fuel from the commercial power reactors. Therefore, the benefits from application of the concept would have to be carefully evaluated against the additional costs and proliferation risks associated with manufacturing of 237Np or 241Am doped fuel. Although this work concerns specifically with PWRs, the conclusions could also be applied to BWRs and, to some extent, to other thermal spectrum reactor types. © 2009 Elsevier Ltd. All rights reserved.

The potential use of 241Am as proliferation resistant burnable poison

This paper discusses the use of 141Am as proliferation resistant burnable poison for light water reactors. Homogeneous addition of small (less than 1 %) amounts of 241Am to the conventional LWR fuel results in significant increase in 238Pu/Pu ratio in the discharged fuel improving its proliferation resistance. Moreover, 241Am, admixed to the fuel, acts as burnable absorber allowing for substantial reduction in conventional reactivity control means without notable fuel cycle length penalty. This is possible due to favourable characteristics of 241Am transmutation chain. The fuel cycle length penalty of introducing 241Am into the core is evaluated and discussed, as well as the impact of He production in the fuel pins and degradation of reactivity feedback coefficients. Proliferation resistance and reactivity control features related to the use of 241Am are compared to those of using 237Np, which has also been suggested as an additive to the conventional fuel in order to improve its proliferation resistance. It was found that 241Am admixture is more favourable than 237Np admixture because of the smaller fuel cycle length penalty and higher burnable poison savings.

Room-temperature spin-oriented photocurrent under near-infrared irradiation and comparison of optical means with Shubnikov de-Haas measurements in AlXGa1-XN/GaN heterostructures

The admixture of linear and circular photogalvanic effects and (CPGEs) in AlxGa1-xN/GaN heterostructures has been investigated quantitatively by near-infrared irradiation at room temperature. The spin-based photocurrent that the authors have observed solidly indicates the sizable spin-orbital interaction of the two-dimensional electron gas in the heterostructures. Further analysis shows consistency between studies by optical and magnetic (Shubnikov de-Haas) measurements on the spin-orbital coupling effects among different AlxGa1-xN/GaN heterostructures, indicating that the CPGE measurement is a good way to investigate the spin splitting and the spin polarization in semiconductors. (C) 2007 American Institute of Physics.

Energy level analyses of even-parity J=1 and 2 Rydberg states of Sn I by multichannel quantum defect theory

This paper analyzes the energy levels along the even-parity J=1 and 2 Rydberg series of Sn I by multichannel quantum defect theory. A good agreement between theoretical and experimental energy levels was achieved. Below 59198 cm~(-1), a total of 85 and 23 new energy levels, respectively, in the J=1 and J=2 series, which cannot be measured previously by experiments, are predicted in this work. Based on the calculated admixture coefficients of each channel, interchannel interactions were discussed in detail. The results are helpful to understand the characteristics of configuration interaction among even-parity levels in Sn I.

Role of five-quark components in radiative and strong decays of the Lambda(1405) resonance

Within an extended chiral constituent quark model, the three- and five-quark structure of the S-01 resonance Lambda(1405) is investigated. Helicity amplitudes for electromagnetic decays [Lambda(1405)->Lambda(1116)gamma, Sigma(1194)gamma] and transition amplitudes for strong decays [Lambda(1405)->Sigma(1194)pi, K- p] are derived, as well as the relevant decay widths. The experimental value for the strong decay width, Gamma(Lambda(1405)->(Sigma pi)degrees) = 50 +/- 2MeV, is well reproduced with about 50% of a five-quark admixture in the Lambda(1405). Important effects owing to the configuration mixing among Lambda P-2(1)A, Lambda P-2(8)M, and Lambda P-4(8)M are found. In addition, transitions between the three- and the five-quark components in the baryons turn out to be significant in both radiative and strong decays of the Lambda(1405) resonance.

Blood-gas properties of plateau zokor (Myospalax baileyi)

Plateau zokor (Myospalax baileyi) is one of the blind subterranean mole rats that spend their life solely underground in scaled burrows. It is one of the special species of the Qinghai-Tibet plateau. In their burrows, oxygen is low and carbon dioxide is high and their contents fluctuate with the change of seasons, soil types, rain and depth of burrows. However, plateau zokors show successful adaptation to that extreme environment. In this study, their adapting mechanisms to the hypoxic hypercapnic environment were analyzed through the comparison of their blood-gas properties with that of pikas (Ochotona curzniae) and Sprague-Dawley rats. The results indicated that plateau zokors had higher red blood corpuscle counts (8.11 +/- 0.59 (10(12)/L)) and hemoglobin concentrations (147 +/- 9.85 g/L), but hematocrit (45.9 +/- 3.29%) and mean corpuscular volume (56.67 +/- 2.57 fL) were lower than the other rodents. Their arterial blood and venous blood pH were 7.46 +/- 0.07 and 7.27 +/- 0.07. Oxygen pressure in arterial blood of plateau zokors was about 1.5 times higher than that of pikas and rats, and it was 0.36 and 0.26 times in their venous blood. Partial pressure for carbon dioxide in arterial and venous blood of plateau zokors was 1.5-fold and 2.0-fold higher, respectively, than in rats and pikas. Oxygen saturation of plateau zokors was 5.7 and 9.3 times lower in venous blood than that of pikas and rats, respectively. As result, the difference of oxygen saturation in arterial blood to venous blood was 2- and 4.5-fold higher in plateau zokors as that of pikas and rats, respectively. In conclusion, plateau zokors had a high tolerance to pH changes in tissues, together with strong capabilities to obtain oxygen from their hypoxic-hypercapnic environment. (c) 2006 Published by Elsevier Inc.

Quantitative Analysis of Single Nucleotide Polymorphisms within Copy Number Variation

Background Single nucleotide polymorphisms (SNPs) have been used extensively in genetics and epidemiology studies. Traditionally, SNPs that did not pass the Hardy-Weinberg equilibrium (HWE) test were excluded from these analyses. Many investigators have addressed possible causes for departure from HWE, including genotyping errors, population admixture and segmental duplication. Recent large-scale surveys have revealed abundant structural variations in the human genome, including copy number variations (CNVs). This suggests that a significant number of SNPs must be within these regions, which may cause deviation from HWE. Results We performed a Bayesian analysis on the potential effect of copy number variation, segmental duplication and genotyping errors on the behavior of SNPs. Our results suggest that copy number variation is a major factor of HWE violation for SNPs with a small minor allele frequency, when the sample size is large and the genotyping error rate is 0~1%. Conclusions Our study provides the posterior probability that a SNP falls in a CNV or a segmental duplication, given the observed allele frequency of the SNP, sample size and the significance level of HWE testing.

An EORTC phase I study of capecitabine (Xeloda) in combination with fixed doses of cyclophosphamide and epirubicin (cex) as primary treatment for large operable or locally advanced/inflammatory breast cancer.

In breast cancer, chemotherapy regimens that include infusional 5-fluorouracil (5-FU) lead to high response rates, but require central venous access and pumps. To avoid these inconveniences, we substituted infusional 5-FU with capecitabine. The main objective of this study was to determine the maximum tolerated dose (MTD) of capecitabine when given in combination with fixed doses of epirubicin and cyclophosphamide (100 and 600 mg/m(2) day 1 every (q) 3 weeks) as primary treatment for large operable or locally advanced/inflammatory breast cancer without distant metastasis. Capecitabine was escalated from 750 mg/m(2) twice a day (bid) to 1250 mg/m(2) bid from day 1 to day 14 in four dose levels. Dose escalation was permitted if 0/3 or 1/6 patients experienced dose-limiting toxicity (DLT). A total of 23 patients were included and 117 courses were administered. At dose level 4, 2 of 2 patients presented DLTs defining the MTD. A high rate of capecitabine treatment modification was required with capecitabine 1050 mg/m(2) bid (dose level 3). 19 patients achieved an objective response (83%). In conclusion, we believe that capecitabine 900 mg/m(2) bid (dose level 2) is the recommended dose in combination with epirubicin 100 mg/m(2) and cyclophosphamide 600 mg/m(2). The acceptable toxicity profile and encouraging activity of this regimen warrant further evaluation.

Thromboembolism and bleeding in bladder cancer.

Bladder cancer is a unique disease process in that clinically significant hemorrhage can occur simultaneously with equally significant aberrant clotting. With hematuria the key presenting symptom of bladder cancer, hemorrhage is generally thought to be a component of the natural history of the disease, and to commonly occur during its treatment. However, as those who regularly treat bladder cancer know, the need to address a predisposition to clotting is also very much part of the treatment paradigm. Physicians must be cognizant of the biochemical changes that confer a propensity for both significant bleeding and clotting occurring simultaneously in their patients. Both of these entities remain important issues, and further study is needed to find ways to mitigate and balance the associated risks. Here, we performed a review of the literature, focusing on the concomitant issues of bleeding and venous thromboembolism in both the pre- and post-operative periods in patients with bladder cancer. We formulated a general management approach with respect to these two processes, and we provide direction for further investigation.

Genetic and migratory evidence for sympatric spawning of tropical Pacific eels from Vanuatu

The spawning areas of tropical anguillid eels in the South Pacific are poorly known, and more information about their life histories is needed to facilitate conservation. We genetically characterized 83 out of 84 eels caught on Gaua Island (Vanuatu) and tagged 8 eels with pop-up satellite transmitters. Based on morphological evidence, 32 eels were identified as Anguilla marmorata, 45 as A. megastoma and 7 as A. obscura. Thirteen of these eels possessed a mitochondrial DNA sequence (control region, 527 bp) or nuclear haplotype (GTH2b, 268 bp) conflicting with their species designation. These individuals also had multi-locus genotypes (6 microsatellite loci) intermediate between the species, and 9 of these eels further possessed heterozygote genotypes at species-diagnostic nuclear single nucleotide polymorphisms (SNPs). We classified these individuals as possibly admixed between A. marmorata and A. megastoma. One A. marmorata and 1 A. megastoma migrated 634 and 874 km, respectively, towards the border between the South Equatorial Current and the South Equatorial Counter Current. Both species descended from around 200 m depth at night to 750 m during the day. Lunar cycle affected the upper limit of migration depths of both species. The tags remained attached for 3 and 5 mo and surfaced <300 km from the pop-up location of a previously tagged A. marmorata pop-up location. A salinity maximum at the pop-up locations corresponding to the upper nighttime eel migration depths may serve as a seamark of the spawning area. The similar pop-up locations of both species and the evidence for admixture suggest that these tropical eels share a sympatric spawning area.

No evidence of endothelial dysfunction in patients with Alzheimer's disease

In view of accumulating evidence of vascular pathology in Alzheimer's disease (AD), we tested the hypothesis that AD patients have impaired endothelial function. This was assessed using the technique of strain-gauge venous occlusion plethysmography, which measures forearm blood flow (FBF). Intra-arterial (brachial) infusion of acetylcholine (ACh) and sodium nitroprusside (SNP) was used to assess local endothelial dependent and independent responses, respectively. There was no difference in the basal FBF of patients and controls. ACh and SNP caused dose-related increases in FBF from baseline, but no difference was recorded between the AD and control group. This study provides no evidence of endothelial dysfunction in the systemic circulation of patients with AD.

State-selective one-electron capture by slow state-prepared N2+(P-2) ground-state ions in collisions with hydrogen atoms

The technique of double translational energy spectroscopy.(DTES), recently successfully developed in this laboratory for use with targets of atomic hydrogen, has been used to study one-electron capture by ground-state N2+(2s22p)(2)p(0) ions in collisions with hydrogen atoms at energies within the range 0.8-6.0 keV. Cross sections for the formation of the main excited product channels have been determined. The measurements allow a re-evaluation of our previous TES measurements carried out with N2+ primary beams containing an admixture of metastable N2+(2s2p2)(4)p ions. The main findings of these earlier measurements are confirmed and the DTES measurements now remove any ambiguity in interpretation of the experimental data. While recent theoretical studies correctly predict the two main N+ D-3(0) and P-3(0) product channels, the quantitative agreement with experiment is only partially satisfactory.

Filling Ability and Passing Ability of Self-Consolidating Concrete

This paper reviews statistical models obtained from a composite factorial design study, which was carried out to determine the influence of three key parameters of mixture composition on filling ability and passing ability of self-consolidating concrete (SCC). This study was a part of the European project “Testing SCC”- GRD2-2000-30024. The parameters considered in this study were the dosages of water and high-range water-reducing admixture (HRWRA), and the volume of coarse aggregates. The responses of the derived statistical models were slump flow, T50 , T60, V-funnel flow time, Orimet flow time, and blocking ratio (L-box). The retention of these tests was also measured at 30 and 60 minutes after adding the first water. The models are valid for mixtures made with 188 to 208 L/m3 (317 to 350 lb/yd3) of water, 3.8 to 5.8 kg/m3 (570 to 970 mL/100 kg of binder) of HRWRA, and 220 to 360 L/m3 (5.97 to 9.76 ft3/yd3) of coarse aggregates. The utility of such models to optimize concrete mixtures and to achieve a good balance between filling ability and passing ability is discussed. Examples highlighting the usefulness of the models are presented using isoresponse surfaces to demonstrate single and coupled effects of mixture parameters on slump flow, T50 , T60 , V-funnel flow time, Orimet flow time, and blocking ratio. The paper also illustrates the various trade-offs between the mixture parameters on the derived responses that affected the filling and the passing ability.