Safety of tetanus toxoid in pregnant women: A hospital-based case-control study of congenital anomalies

Reported are the results of the Latin American Collaborative Study of Congenital Malformations (ECLAMC), a hospital-based case-control study of 34 293 malformed and 34 477 matched nonmalformed newborn controls. No statistical differences were found between the malformed and control groups, exposed or not exposed to tetanus toroid.

金川镍矿岩体移动与开采稳定性研究

The two major issues in mining industry are work safety and protection of ground environment when carrying on underground mining activities. Cut-and-fill mining method is increasingly applied in China owing to its advantages of controlling ground pressure and protecting the ground environment effectively. However, some cut-and-fill mines such as Jinchuan nickel mine which has big ore body, broken rock mass and high geostress have unique characteristics on the law of ground pressure and rock mass movement that distinguish from other mining methods. There are still many problems unknown and it is necessary for the further analysis. In this dissertation, vast field survey, geology trenching and relative data analysis are carried out. The distribution of ground fissures and the correlation of the fissures with the location of underground ore body is presented. Using of monitoring data by three-dimension fissure meter and GPS in Jinchuan Deposit Ⅱ, the rule of the surface deformation and the reason of ground fissures generation are analyzed. It is shown that the stress redistribution in surrounding rocks resulting from mining, the existence of the void space underground and the influence of on-going mining activities are three main reasons for the occurrence of ground fissures. Based on actual section planes of No.1 ore body, a large-scale 3D model is established. By this model, the complete process of excavation and filling is simulated and the law of rock mass movement and stability caused by Cut-and-fill Mining is studied. According to simulation results, it is concluded that the deformation of ground surface is still going on developing; the region of subsidence on the ground surface is similar with a circle; the area on the hanging wall side is larger than one on the lower wall side; the contour plots show the centre of subsidence lay on the hanging wall side and the position is near the ore body boundary of 1150m and 1250m where ore body is the thickest. Along strike-line of Jinchuan Deposit Ⅱ, the deformation at the middle of filling body is larger than that in the two sides. Because of the irregular ore body, stress concentrates at the boundary of ore body. With the process of excavation and filling, the high stress release and the stress focus disappear on the hanging wall side. The cut-and-fill mechanism is studied based on monitoring data and numerical simulation. The functions of filling body are discussed. In this dissertation, it is concluded that the stress of filling body is just 2MPa, but the stress of surrounding rock mass is 20MPa. We study the surface movement influenced by the elastic modulus of backfill. The minimal value of the elastic modulus of backfill which can guarantee the safety production of cut-and-fill mine is obtained. Finally, based on the real survey results of the horizontal ore layer and numerical simulation, it is indicated that the horizontal ore layer has destroyed. Key words: cut-and-filling mining, 3D numerical simulation, field monitoring, rock mass movement, cut-and-filling mechanism, the elastic modulus of backfill, the horizontal ore layer

金川矿山岩体移动规律及竖井变形、破坏机理研究

The Jinchuan Nickel Mine is the largest underground mine with cut-and-fill mining in China. It is very difficult to be exploited for very low safety stability of rock mass caused by complex geological conditions, developed faults, cracked rock mass and high stress. In this paper, the laws of rock mass movement、mechanics of shaft deformation and destroy were analyzed based on the collection of date, the detailed field engineering investigations, ground movement monitoring by GPS, theoretical analysis and numerical simulation. According to the GPS monitoring result of ground surface movement, there are different ground movement characteristics among the three Mine area of Jinchuan Nickel Mine. In No. 2 Mine area, the ground movement funnel with apparent asymmetry is developing, the influence scope is larger in the up faulted block than in the down faulted block, and the centre of ground movement is moving along the up faulted block direction with increasing depth of mining. Moreover, the tunnels in the corresponding area with the centre of ground movement are damaged seriously. In Longshou Mine area, the ground movement funnel is also developing, but the moving path and the nonlinear characters are more sophisticated because of the long-term effects of open excavating and the effects of underground mining together. In No. 3 Mine area, the underground mining impact on surface is not serious for the time of mining activity is not for long, but the ground movement funnel is also forming now. The underground mining has caused widespread land subsidence in Jinchuan Nickel Mine area, but the phenomena of surface raise appeared in some partial areas of Longshou Mine area and No. 3 Mine area. Analysis proved that the reason for the open pit bottom raise is the slope deformation activation caused by the excavation from open pit into underground mine; and that the raise of surface in No.3 Mine area is caused by the effect of elastic foundation due to underground mining. Although the GPS Monitoring results show the amount of subsidence is increasing constantly, the subsidence rate has a descending tendency with fluctuation in Jinchuan No. 2 Mine area. The subsidence rate curve is a time function and exists an extreme point, the rate increasing before extreme point and decreasing after the extreme point ,but the scale of decreasing rate will be very small after the rate decreasing up to a certain degree, moreover, the characteristics is different among different areas, which have some relation with the distance to the mining section and the dip of the ore body. ArcView is GIS software, which we adopted as a development platform, and made secondary development by its development language “avenue”, through which we developed a ground movement analysis and forecast System for Jinchuan Nickel Mine, which contain three modules : management of ground movement information; analysis and evaluation of ground movement; and ground movement forecast. In the module of evaluation, using the technique of MATLAB6.5 program with VB6.0, the system can achieve the ANN prediction model for GPS monitoring data, data preparation results analysis and model integrated was realized by Avenue programming. Finally, the author analyzed the mechanical of deformation and destroy of the No. 14 shaft, and its repair and artificial-support effectiveness also given detailed demonstration in various aspect. The result showed that the reason for the destroy of No. 14 shaft is underground mining, and being the case, the destroy of the shaft also has its special features, which mainly contains forked stress contour for mining steep ore and fault effect caused by mining activities. The repair and artificial-support played some restrictions on the rock mass movement and deformation, but did not show a strong or marked effect. With the increasing of mining depth and large-scale, the closure rock of the shaft will still deformed, even be destroyed.

海底金属矿床充水条件及矿坑突水的断层效应研究

The Xinli mine area of Sanshandao mine is adjacent to the Bohai Sea and its main exploitable ore deposit occurs in the undersea rock mass. The mine is the biggest undersea gold mine of China after production. The mine area faces a latent danger of water bursting, even sudden seawater inrush. There is no mature experience in undersea mining in China so far. The vein ore deposit is located in the lower wall of a fault; its possible groundwater sources mainly include bittern, Quaternary pore water and modern seawater. To ensure the safety of undersea mining, to survey the flooding conditions of the ore deposit using proper measures and study the potential seawater inrush pattern are the key technical problems. With the Xinli mine area as a case study, the engineering geological conditions of the Xinli mine area are surveyed in situ, the regional structural pattern and rock mass framework characteristics are found out, the distribution of the structural planes are modeled by a Monte Carlo method and the connectivity coefficients of rock mass structural planes are calculated. The regional hydro-geological conditions are analyzed and the in-situ hydro-geological investigation and sampling are performed in detail, the hydrochemistry and isotopes testing and groundwater dynamic monitoring are conducted, the recharge, runoff, discharge conditions are specified and the sources of flooding are distinguished. Some indices are selected from the testing results to calculate the proportion of each source in some water discharge points and in the whole water discharge of the Xinli mine area. The temporal and spatial variations of each water source of the whole ore deposit flooding are analyzed. According to the special project conditions in the Xinli mine area, the permeability coefficient tensors of the rock mass in Xinli mine area are calculated based on a fracture geometry measurement method, in terms of the connectivity and a few hydraulic testing results, a modified synthetic permeability coefficient are calculated. The hydro-geological conceptual and mathematical model are established，the water yield of mine is predicted using Visual Modflow code. The spreading law of surrounding rock mass deformation and secondary stress are studied by numerical analysis; the intrinsic mechanism of the faults slip caused by the excavation of ore deposit is analyzed. The results show that the development of surrounding rock mass deformation and secondary stress of vein ore deposit in the lower wall of a fault, is different from that in a thick-big ore deposit. The secondary stress caused by the excavation of vein ore deposit in the lower wall of a fault, is mainly distributed in the upper wall of the fault, one surface subsidence center will occur. The influences of fault on the rock mass movement, secondary stress and hydro-geological structures are analyzed; the secondary stress is blocked by the fault and the tensile stress concentration occurs in the rock mass near the fault, the original water blocking structure is destructed and the permeable structure is reconstructed, the primary structural planes begin to expand and newborn fissures occur, so the permeability of the original permeable structure is greatly enhanced, so the water bursting will probably occur. Based on this knowledge, the possible water inrush pattern and position of the Xinli mine area are predicted. Some computer programs are developed using object-oriented design method under the development platform Visual Studio.Net. These programs include a Monte Carlo simulation procedure, a joint diagrammatizing procedure, a structural planes connectivity coefficient calculating procedure, a permeability tensor calculating procedure, a water chemical formula edit and water source fixture conditions calculating procedure. A new computer mapping algorithm of joint iso-density diagram is raised. Based on the powerful spatial data management and icon functions of Geographic Information System, the pit water discharge dynamic monitoring data management information systems are established with ArcView.

大型反倾岩体变形破坏机制及稳定性分析———以金沙江宽谷坝址龙蟠边坡为例

A large number of catastrophic accidents were aroused by the instability and destruction of anti-dip rock masses in the worldwide engineering projects, such as hydropower station, mine, railways and so on. Problems in relation to deformation and failure about anti-dip rock slopes are significant for engineering geology research. This dissertation takes the Longpan slope in the Jinsha River as a case to study the deformation mechanism of large-scale anti-dip rock masses and the slope stability analysis method. The primary conclusions are as follows. The Dale Reach of Jinsha River, from Longpan to the debouchment of Chongjiang tributary, is located in the southeastern margin of the Qinghai-Tibet Plateau. Longpan slope is the right embankment of Dale dam, it is only 26 km to the Shigu and 18 km to Tiger Leaping Gorge. The areal geology tectonic structures here area are complicated and blurry. Base on the information of geophysical exploration (CSAMT and seismology) and engineering geological investigation, the perdue tectonic pattern of Dale Reach is put forward for the first time in this paper. Due to the reverse slip of Longpan fault and normal left-rotation of Baihanchang fault, the old faulted valley came into being. The thick riverbed sediments have layered characters of different components and corresponding causes, which attribute to the sedimentary environments according with the new tectonic movements such as periodic mountain uplifting in middle Pleistocene. Longpan slope consists of anti-dip alternate sandstone and slate stratums, and the deformable volume is 6.5×107m3 approximately. It was taken for an ancient landslide or toppling failure in the past so that Dale dam became a vexed question. Through the latest field surveying, displacement monitoring and rock masses deforming characters analyses, the geological mechanism is actually a deep-seated gravitational bending deformation. And then the discrete element method is used to simulate the deforming evolution process, the conclusion accords very well with the geo-mechanical patterns analyses. In addition strength reduction method based on DEM is introduced to evaluate the factor of safety of anti-dip rock slope, and in accordance with the expansion way of the shear yielding zones, the progressive shear failure mechanism of large-scale anti-dip rock masses is proposed for the first time. As an embankment or a close reservoir bank to the lower dam, the stability of Longpan slope especially whether or not resulting in sliding with high velocity and activating water waves is a key question for engineering design. In fact it is difficult to decide the unified slip surface of anti-dip rock slope for traditional methods. The author takes the shear yielding zones acquired form the discrete element strength reduction calculation as the potential sliding surface and then evaluates the change of excess pore pressure and factor of stability of the slope generated by rapid drawdown of ponded water. At the same time the dynamic response of the slope under seismic loading is simulated through DEM numerical modeling, the following results are obtained. Firstly the effective effect of seismic inertia force is resulting in accumulation of shear stresses. Secondly the discontinuous structures are crucial to wave transmission. Thirdly the ultimate dynamic response of slope system takes place at the initial period of seismic loading. Lastly but essentially the effect of earthquake load to bringing on deformation and failure of rock slope is the coupling effect of shear stresses and excess pore water pressure accumulation. In view of limitations in searching the critical slip surface of rock slope of the existing domestic and international software for limit equilibrium slope stability analyses, this article proposes a new method named GA-Sarma Algorithm for rock slope stability analyses. Just as its name implies, GA-Sarma Algorithm bases on Genetic Algorithm and Sarma method. GA-Sarma Algorithm assumes the morphology of slip surface to be a broken line with traceability to extend along the discontinuous surface structures, and the slice boundaries is consistent with rock mass discontinuities such as rock layers, faults, cracks, and so on. GA-Sarma Algorithm is revolutionary method that is suitable for global optimization of the critical slip surface for rock slopes. The topics and contents including in this dissertation are closely related to the difficulties in practice, the main conclusions have been authorized by the engineering design institute. The research work is very meaningful and useful for the engineering construction of Longpan hydropower station.

急倾斜金属矿体开采岩体移动规律与变形趋势预测研究

Rockmass movement due to mining steep metallic ore body is a considerable question in the surface movement and deformation issue caused by underground mining. Research on coal mining induced rockmass movement and its prediction problem have been performed for a long-term, and have achieved great progress at home and abroad. However, the rockmass movement caused by mining steep metal mine is distinctivly different from coal seam mining.. Existing surface movement laws and deformation prediction methods are not applicable to the rockmass movement caused by mining steep metal mine. So far the home and abroad research to this theory is presently at an early stage, and there isn’t mature theory or practical prediction method, which made a great impact on production. In this paper, the research object—Jinchuan nickel mine, which is typical steep metal mine, characterized by complex geological conditions, developed faults, cracked rockmass, high geostress, and prominent engineering stability problems. In addition, backfill mining method is used in the mine, the features of rockmass movement caused by this mining method are also different from other mining methods. In this paper, the laws of rock mass movement, deformation and destroy mechanism, and its prediction were analyzed based on the collection of data, detailed in-sit engineering geology survey, ground movement monitoring by GPS, theoretical analysis and numerical simulation. According to the GPS monitoring of ground surface movement, ground subsidence basin with apparent asymmetry is developing, the influence scope is larger in the upper faulted block than in the lower faulted block, and the center of ground movement is moving along the upper faulted block direction with increasing depth of mining. During the past half and seven years, the largest settlement has amounted to 1287.5mm, and corresponding horizontal displacement has amounted to 664.6mm. On the ground surface, two fissure belts show a fast-growing trend of closure. To sum up, mining steep metal mine with backfill method also exist the same serious problem of rockmass movement hazards. Fault, as a low intensity zone in rockmass, when it located within the region of mining influence, the change of potential energy mainly consumed in fault deformation associated with rockmass structure surface friction, which is the essence of displacement and stress barrier effects characterized by fault rupture zone. when steep fault located in the tensile deformation region incurred by underground excavation, no matter excavation in hangingwall or in footwall of the fault, there will be additional tensile stress on the vertical fault plane and decrease in the shear strength, and always showing characteristics of normal fault slip, which is the main reason of fault escarpment appeared on the ground surface. The No.14 shaft deformation and failure is triggered by fault activation, which showed with sidewall move, rupture, and break down features as the main form of a concentrated expression of fault effects. The size and orientation of principal stress in surrounding rock changed regularly with mining; therefore, roadway deformation and damage at different stages have different characteristics and distribution models. During the process of mining, low-intensity weak structures surface always showed the most obvious reaction, accompany with surface normal stress decrease and shear strength bring down, to some extent, occurred with relative slide and deformation. Meanwhile, the impact of mining is a relatively long process, making the structure surface effect of roadway deformation and damage more prominent than others under the influence of mining. Roadway surrounding rockmass deformation caused by the change of strain energy density field after excavation mainly belongs to elastic deformation, and the correspondented damage mainly belongs to brittle rupture, in this circumstance, surrounding rockmass will not appear large deformation. The large deformation of surrounding rockmass can only be the deformation associated with structure surface friction or the plastic deformation of itself, which mainly caused by the permanent self-weigh volume force，and long-term effect of mining led to the durability of this deformation Good pitting fill effect and supporting effect of backfill, as well as the friction of rockmass structure surface lead to obvious macro-rockmass movement with long-lag characteristics. In addition, the loss of original intensity and new structure surface arisen increased flexibility in rockmass and fill deformation in structure surface, which made the time required for rockmass potential energy translate into deformation work associated with plastic deformation and structure surface friction consumed much, and to a large extent, eliminated the time needed to do those plastic work during repeated mining, all of which are the fundamental reason of rockmass movement aftereffect more significant than before. Mining steep deposits in high tectonic stress area and in gravity stress area have different movement laws and deformation mechanism. The steep deposit, when the vertical size of the mining areas is smaller than the horizontal size of the orebody, no matter mining in gravity stress area or in high tectonic stress area, they have similar features of ground movement with mining horizontal orebody; contrarily, there will appear double settlement centers on the ground surface under the condition of mining in high tectonic stress area, while there will always be a single center under the other condition. Meanwhile the ground movement lever, scale of mining influence area and macro features of ground movement, deformation and fracture are also different from mining in gravity stress area, and the fundamental reason lies in the impact of orientation of the maximum principal stress on rock movement features in in-site rock stress field. When mining thick and steep deposit, the ground surface movement and deformation characteristic curves are significantly different from excavating the horizontal ore bed and thin steep deposit. According to the features of rockmass movement rate, the development process of mining-induced rockmass movement is divided into three stages: raising stage, steadily stage and gradually decay stage. Considering the actual exploitation situation, GPS monitoring results and macro-characteristics of surface movement, the current subsidence pattern of Jinchuan No.2 mine is in the early stage of development. Based on analysis of surface movement rate, surface subsidence rate increase rapidly when mining in double lever at the same time, and reach its peak until the exploitation model ended. When double lever mining translate into single, production decreased, surface subsidence rate suddenly start to reduce and maintain a relatively low value, and the largest subsidence center will slowly move along with the hangingwall ore body direction with increasing depth of mining, at the same time, the scope and extent of subsidence in footwall ore body will begin magnify, and a sub-settlement center will appear on ground surface, accompanied with the development and closure trend of ground fissure, the surrounding rockmass of shaft and roadway will be confronted to more frequent and severe deformation and failure, and which will have a negative impact on the overall stability of No.2 mine mining. On the premise of continuity of rockmass movement, gray system model can be used in ground rockmass movement prediction for good results. Under the condition of backfill mining step by step, the loose effect of compact status of the hard, broken rockmass led to lower energy release rate, although surrounding rockmass has high elastic energy, loose and damage occurred in the horizontal ore body, which made the mining process safety without any large geological hazards. During the period of mining the horizontal ore body to end, in view of its special “residual support role”, there will be no large scale rockmass movement hazards. Since ground surface movement mainly related to the intensity of mining speed and backfill effect, on the premise of constant mining speed, during the period of mining the horizontal ore body to end, the rate of ground surface rockmass movement and deformation won’t have sudden change.

Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature

Cryotherapy is widely used in rehabilitation; however, its effectiveness after anterior cruciate ligament (ACL) reconstruction remains uncertain. To investigate the effectiveness and safety of cryotherapy following ACL reconstruction through a systematic review, randomized and quasi-randomized clinical trials were searched in the databases: MEDLINE, EMBASE, CENTRAL PEDro, SportDiscus, CINAHL, LILACS (June 2013). the primary outcomes measures were pain, edema and adverse events; the secondary outcomes were knee function, analgesic medication use, range of motion, blood loss, hospital stay, quality of life and patient satisfaction. the methodological quality of studies was evaluated using the Cochrane Collaboration risk-of-bias tool. Ten trials (a total of 573 patients) were included. Results of meta-analysis showed that the use of cold compression devices produced a significant reduction in pain scores 48 h after surgery (p < 0.00001), compared to no cryotherapy. the risk for adverse events did not differ between patients receiving cryotherapy versus no treatment (p = 1.00). the limited evidence currently available is insufficient to draw definitive conclusions on the effectiveness of cryotherapy for other outcomes. There is a need for well designed, good quality randomized trials to answer other questions related to this intervention and increase the precision of future systematic reviews. (C) 2014 Elsevier B.V. All rights reserved.

Development of process control methodology for tracking the quality and safety of pain, agitation and sedation management in critical care units

Objective: To develop sedation, pain, and agitation quality measures using process control methodology and evaluate their properties in clinical practice. Design: A Sedation Quality Assessment Tool was developed and validated to capture data for 12-hour periods of nursing care. Domains included pain/discomfort and sedation-agitation behaviors; sedative, analgesic, and neuromuscular blocking drug administration; ventilation status; and conditions potentially justifying deep sedation. Predefined sedation-related adverse events were recorded daily. Using an iterative process, algorithms were developed to describe the proportion of care periods with poor limb relaxation, poor ventilator synchronization, unnecessary deep sedation, agitation, and an overall optimum sedation metric. Proportion charts described processes over time (2 monthly intervals) for each ICU. The numbers of patients treated between sedation-related adverse events were described with G charts. Automated algorithms generated charts for 12 months of sequential data. Mean values for each process were calculated, and variation within and between ICUs explored qualitatively. Setting: Eight Scottish ICUs over a 12-month period. Patients: Mechanically ventilated patients. Interventions: None. Measurements and Main Results: The Sedation Quality Assessment Tool agitation-sedation domains correlated with the Richmond Sedation Agitation Scale score (Spearman [rho] = 0.75) and were reliable in clinician-clinician (weighted kappa; [kappa] = 0.66) and clinician-researcher ([kappa] = 0.82) comparisons. The limb movement domain had fair correlation with Behavioral Pain Scale ([rho] = 0.24) and was reliable in clinician-clinician ([kappa] = 0.58) and clinician-researcher ([kappa] = 0.45) comparisons. Ventilator synchronization correlated with Behavioral Pain Scale ([rho] = 0.54), and reliability in clinician-clinician ([kappa] = 0.29) and clinician-researcher ([kappa] = 0.42) comparisons was fair-moderate. Eight hundred twenty-five patients were enrolled (range, 59-235 across ICUs), providing 12,385 care periods for evaluation (range 655-3,481 across ICUs). The mean proportion of care periods with each quality metric varied between ICUs: excessive sedation 12-38%; agitation 4-17%; poor relaxation 13-21%; poor ventilator synchronization 8-17%; and overall optimum sedation 45-70%. Mean adverse event intervals ranged from 1.5 to 10.3 patients treated. The quality measures appeared relatively stable during the observation period. Conclusions: Process control methodology can be used to simultaneously monitor multiple aspects of pain-sedation-agitation management within ICUs. Variation within and between ICUs could be used as triggers to explore practice variation, improve quality, and monitor this over time