974 resultados para Moment Closure
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A debate is currently prevalent among the structural engineers regarding the use of cracked versus un-cracked moment of inertia of the structural elements in analyzing and designing tall concrete buildings. (The basic definition of a tall building, according to the Journal of Structural Design of Tall Buildings Vol. 13. No. 5, 2004 is a structure that is equal to or greater than 160 feet in height, or 6 stories or greater.) The controversy is the result of differing interpretations of certain ACI (American Concrete Institute) code provisions. The issue is whether designers should use cracked moment of inertia in order to estimate lateral deflection and whether the computed lateral deflection should be used to carry out subsequent second-order analysis (analysis considering the effect of first order lateral deflections on bending moment and shear stresses). On one hand, bending moments and shear forces estimated based on un-cracked moment of inertia of the sections may result in conservative designs by overestimating moments and shears. On the other hand, lateral deflections may be underestimated due to the same analyses resulting in unsafe designs.
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Subtitle D of the Resource Conservation and Recovery Act (RCRA) requires a post closure period of 30 years for non hazardous wastes in landfills. Post closure care (PCC) activities under Subtitle D include leachate collection and treatment, groundwater monitoring, inspection and maintenance of the final cover, and monitoring to ensure that landfill gas does not migrate off site or into on site buildings. The decision to reduce PCC duration requires exploration of a performance based methodology to Florida landfills. PCC should be based on whether the landfill is a threat to human health or the environment. Historically no risk based procedure has been available to establish an early end to PCC. Landfill stability depends on a number of factors that include variables that relate to operations both before and after the closure of a landfill cell. Therefore, PCC decisions should be based on location specific factors, operational factors, design factors, post closure performance, end use, and risk analysis. The question of appropriate PCC period for Florida’s landfills requires in depth case studies focusing on the analysis of the performance data from closed landfills in Florida. Based on data availability, Davie Landfill was identified as case study site for a case by case analysis of landfill stability. The performance based PCC decision system developed by Geosyntec Consultants was used for the assessment of site conditions to project PCC needs. The available data for leachate and gas quantity and quality, ground water quality, and cap conditions were evaluated. The quality and quantity data for leachate and gas were analyzed to project the levels of pollutants in leachate and groundwater in reference to maximum contaminant level (MCL). In addition, the projected amount of gas quantity was estimated. A set of contaminants (including metals and organics) were identified as contaminants detected in groundwater for health risk assessment. These contaminants were selected based on their detection frequency and levels in leachate and ground water; and their historical and projected trends. During the evaluations a range of discrepancies and problems that related to the collection and documentation were encountered and possible solutions made. Based on the results of PCC performance integrated with risk assessment, projection of future PCC monitoring needs and sustainable waste management options were identified. According to these results, landfill gas monitoring can be terminated, leachate and groundwater monitoring for parameters above MCL and surveying of the cap integrity should be continued. The parameters which cause longer monitoring periods can be eliminated for the future sustainable landfills. As a conclusion, 30 year PCC period can be reduced for some of the landfill components based on their potential impacts to human health and environment (HH&E).
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Léon Walras (1874) already had realized that his neo-classical general equilibrium model could not accommodate autonomous investment. Sen analysed the same issue in a simple, one-sector macroeconomic model of a closed economy. He showed that fixing investment in the model, built strictly on neo-classical assumptions, would make the system overdetermined, thus, one should loosen some neo-classical condition of competitive equilibrium. He analysed three not neo-classical “closure options”, which could make the model well determined in the case of fixed investment. Others later extended his list and it showed that the closure dilemma arises in the more complex computable general equilibrium (CGE) models as well, as does the choice of adjustment mechanism assumed to bring about equilibrium at the macro level. By means of numerical models, it was also illustrated that the adopted closure rule can significantly affect the results of policy simulations based on a CGE model. Despite these warnings, the issue of macro closure is often neglected in policy simulations. It is, therefore, worth revisiting the issue and demonstrating by further examples its importance, as well as pointing out that the closure problem in the CGE models extends well beyond the problem of how to incorporate autonomous investment into a CGE model. Several closure rules are discussed in this paper and their diverse outcomes are illustrated by numerical models calibrated on statistical data. First, the analyses is done in a one-sector model, similar to Sen’s, but extended into a model of an open economy. Next, the same analyses are repeated using a fully-fledged multisectoral CGE model, calibrated on the same statistical data. Comparing the results obtained by the two models it is shown that although, using the same closure option, they generate quite similar results in terms of the direction and – to a somewhat lesser extent – of the magnitude of change in the main macro variables, the predictions of the multi-sectoral CGE model are clearly more realistic and balanced.
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Peer reviewed
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Peer reviewed
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Medical Research Council (ref G0701604) and administered by the NIHR-EME (ref 09-800-26)
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BACKGROUND: The prevalence of residual shunt in patients after device closure of atrial septal defect and its impact on long-term outcome has not been previously defined. METHODS: From a prospective, single-institution registry of 408 patients, we selected individuals with agitated saline studies performed 1 year after closure. Baseline echocardiographic, invasive hemodynamic, and comorbidity data were compared to identify contributors to residual shunt. Survival was determined by review of the medical records and the Social Security Death Index. Survival analysis according to shunt included construction of Kaplan-Meier curves and Cox proportional hazards modeling. RESULTS: Among 213 analyzed patients, 27% were men and age at repair was 47 ± 17 years. Thirty patients (14%) had residual shunt at 1 year. Residual shunt was more common with Helex (22%) and CardioSEAL/STARFlex (40%) occluder devices than Amplatzer devices (9%; P = .005). Residual shunts were more common in whites (79% vs 46%, P = .004). At 7.3 ± 3.3 years of follow-up, 13 (6%) of patients had died, including 8 (5%) with Amplatzer, 5 (25%) with CardioSEAL/STARFlex, and 0 with Helex devices. Patients with residual shunting had a higher hazard of death (20% vs 4%, P = .001; hazard ratio 4.95 [1.59-14.90]). In an exploratory multivariable analysis, residual shunting, age, hypertension, coronary artery disease, and diastolic dysfunction were associated with death. CONCLUSIONS: Residual shunt after atrial septal defect device closure is common and adversely impacts long-term survival.
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Background
Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, intraocular pressure is raised without visual loss. Because the crystalline lens has a major mechanistic role, lens extraction might be a useful initial treatment.
Methods
From Jan 8, 2009, to Dec 28, 2011, we enrolled patients from 30 hospital eye services in five countries. Randomisation was done by a web-based application. Patients were assigned to undergo clear-lens extraction or receive standard care with laser peripheral iridotomy and topical medical treatment. Eligible patients were aged 50 years or older, did not have cataracts, and had newly diagnosed primary angle closure with intraocular pressure 30 mm Hg or greater or primary angle-closure glaucoma. The co-primary endpoints were patient-reported health status, intraocular pressure, and incremental cost-effectiveness ratio per quality-adjusted life-year gained 36 months after treatment. Analysis was by intention to treat. This study is registered, number ISRCTN44464607.
Findings
Of 419 participants enrolled, 155 had primary angle closure and 263 primary angle-closure glaucoma. 208 were assigned to clear-lens extraction and 211 to standard care, of whom 351 (84%) had complete data on health status and 366 (87%) on intraocular pressure. The mean health status score (0·87 [SD 0·12]), assessed with the European Quality of Life-5 Dimensions questionnaire, was 0·052 higher (95% CI 0·015–0·088, p=0·005) and mean intraocular pressure (16·6 [SD 3·5] mm Hg) 1·18 mm Hg lower (95% CI –1·99 to –0·38, p=0·004) after clear-lens extraction than after standard care. The incremental cost-effectiveness ratio was £14 284 for initial lens extraction versus standard care. Irreversible loss of vision occurred in one participant who underwent clear-lens extraction and three who received standard care. No patients had serious adverse events.
Interpretation
Clear-lens extraction showed greater efficacy and was more cost-effective than laser peripheral iridotomy, and should be considered as an option for first-line treatment.
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Graphene, due to its exceptional properties, is a promising material for nanotechnology applications. In this context, the ability to tune the properties of graphene-based materials and devices with the incorporation of defects and impurities can be of extraordinary importance. Here we investigate the effect of uniaxial tensile strain on the electronic and magnetic properties of graphene doped with substitutional Ni impurities (Ni_sub). We have found that, although Ni_sub defects are non-magnetic in the relaxed layer, uniaxial strain induces a spin moment in the system. The spin moment increases with the applied strain up to values of 0.3-0.4 \mu_B per Ni_sub, until a critical strain of ~6.5% is reached. At this point, a sharp transition to a high-spin state (~1.9 \mu_B) is observed. This magnetoelastic effect could be utilized to design strain-tunable spin devices based on Ni-doped graphene.
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Cette thèse propose une lecture anthropologique de la consommation d’alcool. Elle met de l’avant une approche novatrice qui repose sur le concept de « métaphysique du quasi- arrêt ». Cette approche a été développée à la suite d’une recherche ethnographique réalisée dans la région de la Beauce, au Québec. Au lieu de considérer la consommation d’alcool comme un problème social ou de santé publique, j’ai cherché à comprendre comment et pourquoi l’on boit, en Beauce, en me laissant guider par les buveurs et les buveuses côtoyés sur place. En prenant part à de nombreuses soirées où la bière est omniprésente, que ce soit dans les garages, les bars ou l’aréna local, je me suis laissé affecter par les sensations ressenties et par les paroles prononcées lorsque les buveurs éprouvent ce qu’ils appellent le « feeling du moment ». En prenant du recul, j’ai constaté que les Beaucerons qui boivent ont développé des stratégies défensives pour échapper à la tentative de contrôle de la société québécoise sur leurs conduites alcooliques et, plus largement, sur l’alcoolisme. En effet, dans la perspective de la « métaphysique du quasi-arrêt », la quantité de verres consommés n’a d’importance qu’eu égard au « feeling du moment »; les normes culturelles ou médicales liées à la consommation d’alcool ne tiennent pas, et c’est pourquoi cette approche permet d’expliquer des discours et des pratiques liés à la consommation d’alcool qui, à première vue, semblent paradoxaux, voire complètement absurdes. Pour bien montrer en quoi l’approche mise de l’avant se distingue, mais surtout pour expliquer comment la consommation excessive d’alcool en est venue à représenter, en anthropologie comme dans d’autres disciplines, une pratique problématique qu’il faut comprendre pour la combattre, une première partie de la thèse consiste en une mise en perspective historique de l’alcoolisme en tant que concept scientifique et enjeu de société. Y sont passées en revue les approches et concepts développés, depuis la fin du XVIIe siècle, par des médecins, des psychologues, des économistes, des sociologues et des anthropologues euro-américains pour aborder ce genre de consommation. Je suggère que ces scientifiques mènent, depuis plus de deux siècles, une véritable croisade contre les « buveurs excessifs ». Collaborant avec l’État, les mouvements de tempérance et les entreprises privées, ils ont contribué à contenir les abus d’alcool en Occident. Dans la seconde partie de la thèse, l’ethnographie sert de support au déploiement de la perspective théorique développée à l’issue du travail de terrain. Il s’agit d’analyser comment les buveurs d’alcool vivent et font durer le « feeling du moment » au cours du boire social. Sur le terrain, j’ai découvert que les buveurs d’alcool ont inventé onze stratégies pour vivre et faire durer le « feeling du moment » en consommant de l’alcool avec les autres. Ces stratégies constituent une forme de résistance face à une société qui cherche à contrôler les conduites alcooliques.
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Type 1 neurofibromatosis is a relatively common inherited disease of the nervous system, with a frequency of almost 1 in 3000. It is associated with neurofibromas of various sites. Our case report is about the surgical management of a giant neurofibroma of the right gluteal fold in a 46-year-old male with NF1. The patient presented with increasing edema and accelerated growth of the mass; he underwent percutaneous embolization of lesion vessels that induced necrosis of the neurofibroma. The patient was taken to the operating room, where surgical resection of the bulk of the lesion was undertaken. The postoperative course was complicated by delayed wound closure managed with antibiotics and vacuum-assisted wound closure. Giant neurofibromas similar to this tumor require complex preoperative, intraoperative and postoperative management strategies. Surgical debulk is best managed with preoperative percutaneous embolization that help to avoid surgical bleeding. Postoperative delayed wound closure was managed with the application of negative pressure in a closed environment that triggers granulation and tissue formation.
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Negative-pressure therapy or vacuum-assisted closure (VAC) has been used in clinical applications since the 1940’s and has increased in popularity over the past decade. This dressing technique consists of an open cell foam dressing put into the wound cavity, a vacuum pump produces a negative pressure and an adhesive drape. A controlled sub atmospheric pressure from 75 to 150 mmHg is applied. The vacuum-assisted closure has been applied by many clinicians to chronic wounds in humans; however it cannot be used as a replacement for surgical debridement. The initial treatment for every contaminated wound should be the necrosectomy. The VAC therapy has a complementary function and the range of its indications includes pressure sores, stasis ulcers, chronic wounds such as diabetic foot ulcers, post traumatic and post operative wounds, infected wounds such as necrotizing fasciitis or sternal wounds, soft-tissue injuries, bone exposed injuries, abdominal open wounds and for securing a skin graft. We describe our experience with the VAC dressing used to manage acute and chronic wounds in a series of 135 patients, with excellent results together with satisfaction of the patients.
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AIMS: The aim of this study was to observe the percentage of thromboembolic and haemorrhagic events over a 2-year follow-up in patients with non-valvular atrial fibrillation (NVAF) undergoing closure of the left atrial appendage (LAA) with an occlusion device. Observed events and CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke history), CHA2DS2-VASc (also adding: vascular disease and sex) and HAS-BLED (hypertension, abnormal liver/renal function, stroke history, bleeding predisposition, labile international normalised ratios, elderly, drugs/alcohol use)-predicted events were compared. METHODS: LAA closure with an occlusion device was performed in 167 NVAF patients contraindicated for oral anticoagulants and recruited from 12 hospitals between 2009 and 2013. At least two transoesophageal echocardiograms were performed in the first 6 months postimplantation. Antithrombotics included clopidogrel and aspirin. Patients were monitored for death, stroke, major and relevant bleeding and hospitalisation for concomitant conditions. Mean age was 74.68±8.58, median follow-up was 24 months, 5.38% had intraoperative complications and implantation was successful in 94.6% of subjects. Mortality during follow-up was 10.8%, mostly (9.5%) non-cardiac related. Bleeding occurred in 10.1% of subjects, 5.7% major and 4.4% minor though relevant, and 4.4% suffered stroke. Major bleeding and stroke/transient ischaemic attack events within 2 years (annual event rates, 290 patients/year) were less frequent than expected from CHADS2 (2.4% vs 9.6%), CHA2DS2-VASc (2.4% vs 8.3%) and HAS-BLED (3.1% vs 6.6%) risk scores (p<0.001, p=0.003, p=0.047, respectively). CONCLUSIONS: LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation.
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En esta tesis se estudia la fricción en juntas rocosas utilizando el Método de Elementos Discretos (DEM). En particular, se estudia la influencia de la rugosidad de las superficies de la junta, la elasticidad, la fractura, y el nivel de carga de compresión sobre el comportamiento de cierre y de cizalla de las juntas rocosas. Por primera vez la rugosidad de las juntas considerada como auto-afín es utilizada para estudiar la fricción de juntas rocosas, la rugosidad se describe mediante tres parámetros: el exponente de rugosidad, la longitud de correlación auto-afín y la varianza de alturas. Mediante un algoritmo de computadora basado en métodos espectrales, ocho superficies autoafines isotrópicas con diferente rugosidad fueron creadas. Posteriormente, las ocho superficies fueron utilizadas como moldes para generar las juntas utilizando elementos discretos. Antes de realizar las simulaciones de compresión y cizallaura, se calibraron las propiedades elásticas y de fractura (criterio de fractura elíptico basado en esfuerzos) de las juntas numéricas a los datos experimentales (obtenidos previamente) de unas muestras de mortero mediante la utilización de un volumen elemental representativo (REV). Una vez que las propiedades mecánicas de las juntas se obtuvieron mediante la calibración del REV, se realizaron las pruebas de cierre (prueba de compresión) de las ocho juntas DEM. Se utilizaron dos niveles de esfuerzo de compresión para las pruebas de cierre: 14 MPa y 21 MPa. Después, las ocho juntas DEM fueron cizalladas en dos direcciones mutuamente perpendiculares. Para cada dirección de cizalla y cada nivel de esfuerzo de compresión (14 y 21 MPa), las juntas fueron cizalladas usando uno de los tres modelos mecánicos siguientes: 1) un modelo rígido, en el que las juntas no se pueden deformar, excepto en su superficie, 2) un modelo puramente elástico, en el que las juntas se pueden deformar en todo su volumen y 3) un modelo elástico con fractura en el que las juntas se pueden deformar en su volumen y, si el esfuerzo sobre las uniones entre partículas excede cierto nivel de esfuerzo máximo, las uniones se rompen de una manera irreversible. El uso de estos tres modelos mecánicos nos permitirá estudiar de manera sistemática: la influencia de la rugosidad (modelo rígido), la influencia de la elasticidad y rugosidad (modelo puramente elástico) y, finalmente, el efecto combinado de la rugosidad de las juntas, la elasticidad y la fractura (modelo elástico con fractura). El estudio de los resultados obtenidos de las simulaciones DEM es seguido por una análisis energético el cual permite estudiar la evolución de los diferentes tipos de energía en función del desplazamiento de cizalla: energía elástica almacenada en el sistema, energía de fricción entre elementos discretos, el trabajo relacionado con la dilatación de la junta y la energía disipada por el amortiguamiento interno del DEM.