Three-year changes of prothrombotic factors in a cohort of South Africans with a high clinical suspicion of obstructive sleep apnea.

A hypercoagulable state might be one important mechanism linking obstructive sleep apnea (OSA) with incident myocardial infarction and stroke. However, previous studies on prothrombotic factors in OSA are not uniform and cross-sectional. We longitudinally studied prothrombotic factors in relation to OSA risk, adjusting for baseline levels of prothrombotic factors, demographics, metabolic parameters, aspirin use, and life style factors. The Berlin Questionnaire and/or neck circumference were used to define high OSA risk in 329 South African teachers (48.0 % male, 44.6 % black) at baseline and at three-year follow-up. Von Willebrand factor (VWF), fibrinogen, D-dimer, plasminogen activator inhibitor-1, clot lysis time (CLT), and soluble urokinase-type plasminogen activator receptor (suPAR) were measured in plasma. At baseline 35.7 % of participants had a high risk of OSA. At follow-up, persistently high OSA risk, persistently low OSA risk, OSA risk remission, and new-onset OSA risk were present in 26.1 %, 53.2 %, 9.4 %, and 11.3 % of participants, respectively. New-onset OSA risk was associated with a significant and longitudinal increase in VWF, fibrinogen, CLT, and suPAR relative to persistently low OSA risk; in VWF, fibrinogen, and suPAR relative to remitted OSA risk; and in VWF relative to persistently high OSA risk. Persistently high OSA risk was associated with an increase in CLT and suPAR relative to persistently low OSA risk and in D-dimer relative to remitted OSA risk. Remitted OSA risk was associated with D-dimer decrease relative to persistently low OSA risk. In OSA, hypercoagulability is a dynamic process with a most prominent three-year increase in individuals with new-onset OSA risk.

School screening for tuberculosis in high risk areas of Texas

Screening for latent tuberculosis infection (LTBI) is an integral component of an effective tuberculosis control strategy, but one that is often relegated to the lowest priority. In a state with higher than national average rates of tuberculosis, due consideration should be given to LTBI screening. Recent large scale contact investigations in the middle school of Del Rio, Texas, raised questions about the status of school screening for LTBI. An evidence based approach was used to evaluate school screening in high risk areas of Texas. A review of the literature revealed that the current recommendations for LTBI screening in children is based on administration of a risk factor questionnaire that should be based on the four main risk factors for LTBI in children that have been identified. Six representative areas in Texas were identified for evaluation of the occurrence of contact investigations in schools for the period of 2006 to 2009 and any use of school screening programs. Of the five reporting areas that responded, only one utilized a school screening program; this reporting area had the lowest percentage of contact investigations occurring in schools. Contact investigations were most common in middle schools and least common in elementary schools. In metropolitan areas, colleges represented up to 42.9% of contact investigations. The number of contact investigations has increased from 2006 to 2008. This report represents a small sample, and further research into the frequency, distribution and risk for contact investigations in schools and the efficacy of screening programs should be done. ^

THE MEASUREMENT OF HUMANISTIC AND DEHUMANISTIC BEHAVIORS IN HOSPITAL NURSING ENVIRONMENTS

The purpose of this investigation was to develop a reliable scale to measure the social environment of hospital nursing units according to the degree of humanistic and dehumanistic behaviors as perceived by nursing staff in hospitals. The study was based on a conceptual model proposed by Jan Howard, a sociologist. After reviewing the literature relevant to personalization of care, analyzing interviews with patients in various settings, and studying biological, psychological, and sociological frames of reference, Howard proposed the following necessary conditions for humanized health care. They were the dimensions of Irreplaceability, Holistic Selves, Freedom of Action, Status Equality, Shared Decision Making and Responsibility, Empathy, and Positive Affect.^ It was proposed that a scale composed of behaviors which reflected Howard's dimensions be developed within the framework of the social environment of nursing care units in hospitals. Nursing units were chosen because hospitals are traditionally organized around nursing care units and because patients spend the majority of their time in hospitals interacting with various levels of nursing personnel.^ Approximately 180 behaviors describing both patient and nursing staff behaviors which occur on nursing units were developed. Behaviors which were believed to be humanistic as well as dehumanistic were included. The items were classified under the dimensions of Howard's model by a purposively selected sample of 42 nurses representing a broad range of education, experience, and clinical areas. Those items with a high degree of agreement, at least 50%, were placed in the questionnaire. The questionnaire consisted of 169 items including six items from the Marlowe Crowne Social Desirability Scale (Short Form).^ The questionnaire, the Social Environment Scale, was distributed to the entire 7 to 3 shift nursing staff (603) of four hospitals including a public county specialty hospital, a public county general and acute hospital, a large university affiliated hospital with all services, and a small general community hospital. Staff were asked to report on a Likert type scale how often the listed behaviors occurred on their units. Three hundred and sixteen respondents (52% of the population) participated in the study.^ An item analysis was done in which each item was examined in relationship to its correlation to its own dimension total and to the totals of the other dimensions. As a result of this analysis, three dimensions, Positive Affect, Irreplaceability, and Freedom of Action were deleted from the scale. The final scale consisted of 70 items with 26 in Shared Decision Making and Responsibility, 25 in Holistic Selves, 12 in Status Equality, and seven in Empathy. The alpha coefficient was over .800 for all scales except Empathy which was .597.^ An analysis of variance by hospital was performed on the means of each dimension of the scale. There was a statistically significant difference between hospitals with a trend for the public hospitals to score lower on the scale than the university or community hospitals. That the scale scores should be lower in crowded, understaffed public hospitals was not unexpected and reflected that the scale had some discriminating ability. These differences were still observed after adjusting for the effect of Social Desirability.^ In summary, there is preliminary evidence based on this exploratory investigation that a reliable scale based on at least four dimensions from Howard's model could be developed to measure the concept of humanistic health care in hospital settings. ^

Signals of resilience to ocean change: high thermal tolerance of early stage Antarctic sea urchins (Sterechinus neumayeri) reared under present-day and future pCO2 and temperature

We tested the hypothesis that development of the Antarctic urchin Sterechinus neumayeri under future ocean conditions of warming and acidification would incur physiological costs, reducing the tolerance of a secondary stressor. The aim of this study is twofold: (1) quantify current austral spring temperature and pH near sea urchin habitat at Cape Evans in McMurdo Sound, Antarctica and (2) spawn S. neumayeri in the laboratory and raise early developmental stages (EDSs) under ambient (-0.7 °C; 400 µatm pCO2) and future (+2.6 °C; 650 and 1,000 µatm pCO2) ocean conditions and expose four EDSs (blastula, gastrula, prism, and 4-arm echinopluteus) to a one hour acute heat stress and assess survivorship. Results of field data from 2011 to 2012 show extremely stable inter-annual pH conditions ranging from 7.99 to 8.08, suggesting that future ocean acidification will drastically alter the pH-seascape for S. neumayeri. In the laboratory, S. neumayeri EDSs appear to be tolerant of temperatures and pCO2 levels above their current habitat conditions. EDSs survived acute heat exposures >20 °C above habitat temperatures of -1.9 °C. No pCO2 effect was observed for EDSs reared at -0.7 °C. When reared at +2.6 °C, small but significant pCO2 effects were observed at the blastula and prism stage, suggesting that multiple stressors are more detrimental than single stressors. While surprisingly tolerant overall, blastulae were the most sensitive stage to ocean warming and acidification. We conclude that S. neumayeri may be unexpectedly physiologically tolerant of future ocean conditions.

UV laser-induced high resolution cleaving of Si wafers for micro-nano devices and polymeric waveguide characterization

In this work we propose a method for cleaving silicon-based photonic chips by using a laser based micromachining system, consisting of a ND:YVO4laser emitting at 355 nm in nanosecond pulse regime and a micropositioning system. The laser makes grooved marks placed at the desired locations and directions where cleaves have to be initiated, and after several processing steps, a crack appears and propagate along the crystallographic planes of the silicon wafer. This allows cleavage of the chips automatically and with high positioning accuracy, and provides polished vertical facets with better quality than the obtained with other cleaving process, which eases the optical characterization of photonic devices. This method has been found to be particularly useful when cleaving small-sized chips, where manual cleaving is hard to perform; and also for polymeric waveguides, whose facets get damaged or even destroyed with polishing or manual cleaving processing. Influence of length of the grooved line and speed of processing is studied for a variety of silicon chips. An application for cleaving and characterizing sol–gel waveguides is presented. The total amount of light coupled is higher than when using any other procedure.

Integral Bridge for High-Speed Railway

The structural continuity of fully integral bridges entails many advantages and some drawbacks. Among the latter, the cyclic expansions and contractions of the deck caused by seasonal thermal variations impose alternating displacements at the piers and abutments, with effects that may be difficult to establish reliably. The advantages include easier construction and cheaper maintenance but, especially, horizontal loads can be transmitted to the ground in a much better way than in conventional bridges. This paper first presents a methodology for dealing with the problems that the cyclic displacements imposed raise at the abutments and at the bridge piers. At the former, large pressures may develop, possibly accompanied by undesirable surface settlements. At the latter, the degree of cracking and the ability to carry the specified loads may be in question. Having quantified the drawbacks, simplified but realistic analyses are conducted of the response of an integral bridge to braking and seismic loads. It is shown that integral bridges constitute an excellent alternative in the context of the requirements posed by new high-speed railway lines.

Dynamic Effects On Culverts for High Speed Trains

Culverts are very common in recent railway lines. Wild life corridors and drainage conducts often fall in this category of partially buried structures. Their dynamic behavior has received far less attention than other structures such as bridges but its large number makes that study an interesting challenge from the point of view of safety and savings. In this paper a complete study of a culvert, including on-site measurements as well as numerical modelling, will be presented. The structure belongs to the high speed railway line linking Segovia and Valladolid, in Spain. The line was opened to traffic in 2004. Its dimensions (3x3m) are the most frequent along the line. Other factors such as reduced overburden (0.6m) and an almost right angle with the track axis make it an interesting example to extract generalized conclusions. On site measurements have been performed in the structure recording the dynamic response at selected points of the structure during the passage of high speed trains at speeds ranging between 200 and 300km/h. The measurements by themselves provide a good insight into the main features of the dynamic behaviour of the structure. A 3D finite element model of the structure, representing its key features was also studied as it allows further understanding of the dynamic response to the train loads . In the paper the discrepancies between predicted and measured vibration levels will be analyzed and some advices on numerical modelling will be proposed

Safety-related issues for high-speed railway bridges

Railway bridges have specific requirements related to safety, which often are critical aspects of design. In this paper the main phenomena are reviewed, namely vertical dynamic effects for impact effect of moving loads and resonance in high-speed, service limit states which affect the safety of running traffic, and lateral dynamic effects.

Low-power, high-speed FFT processor for MB-OFDM UWB application

This paper presents a low-power, high-speed 4-data-path 128-point mixed-radix (radix-2 & radix-2 2 ) FFT processor for MB-OFDM Ultra-WideBand (UWB) systems. The processor employs the single-path delay feedback (SDF) pipelined structure for the proposed algorithm, it uses substructure-sharing multiplication units and shift-add structure other than traditional complex multipliers. Furthermore, the word lengths are properly chosen, thus the hardware costs and power consumption of the proposed FFT processor are efficiently reduced. The proposed FFT processor is verified and synthesized by using 0.13 µm CMOS technology with a supply voltage of 1.32 V. The implementation results indicate that the proposed 128-point mixed-radix FFT architecture supports a throughput rate of 1Gsample/s with lower power consumption in comparison to existing 128-point FFT architectures

Wheel-Rail Contact Forces in High-Speed Simply Supported Bridges at Resonance

The response of high-speed bridges at resonance, particularly under flexural vibrations, constitutes a subject of research for many scientists and engineers at the moment. The topic is of great interest because, as a matter of fact, such kind of behaviour is not unlikely to happen due to the elevated operating speeds of modern rains, which in many cases are equal to or even exceed 300 km/h ( [1,2]). The present paper addresses the subject of the evolution of the wheel-rail contact forces during resonance situations in simply supported bridges. Based on a dimensionless formulation of the equations of motion presented in [4], very similar to the one introduced by Klasztorny and Langer in [3], a parametric study is conducted and the contact forces in realistic situations analysed in detail. The effects of rail and wheel irregularities are not included in the model. The bridge is idealised as an Euler-Bernoulli beam, while the train is simulated by a system consisting of rigid bodies, springs and dampers. The situations such that a severe reduction of the contact force could take place are identified and compared with typical situations in actual bridges. To this end, the simply supported bridge is excited at resonace by means of a theoretical train consisting of 15 equidistant axles. The mechanical characteristics of all axles (unsprung mass, semi-sprung mass, and primary suspension system) are identical. This theoretical train permits the identification of the key parameters having an influence on the wheel-rail contact forces. In addition, a real case of a 17.5 m bridges traversed by the Eurostar train is analysed and checked against the theoretical results. The influence of three fundamental parameters is investigated in great detail: a) the ratio of the fundamental frequency of the bridge and natural frequency of the primary suspension of the vehicle; b) the ratio of the total mass of the bridge and the semi-sprung mass of the vehicle and c) the ratio between the length of the bridge and the characteristic distance between consecutive axles. The main conclusions derived from the investigation are: The wheel-rail contact forces undergo oscillations during the passage of the axles over the bridge. During resonance, these oscillations are more severe for the rear wheels than for the front ones. If denotes the span of a simply supported bridge, and the characteristic distance between consecutive groups of loads, the lower the value of , the greater the oscillations of the contact forces at resonance. For or greater, no likelihood of loss of wheel-rail contact has been detected. The ratio between the frequency of the primary suspension of the vehicle and the fundamental frequency of the bridge is denoted by (frequency ratio), and the ratio of the semi-sprung mass of the vehicle (mass of the bogie) and the total mass of the bridge is denoted by (mass ratio). For any given frequency ratio, the greater the mass ratio, the greater the oscillations of the contact forces at resonance. The oscillations of the contact forces at resonance, and therefore the likelihood of loss of wheel-rail contact, present a minimum for approximately between 0.5 and 1. For lower or higher values of the frequency ratio the oscillations of the contact forces increase. Neglecting the possible effects of torsional vibrations, the metal or composite bridges with a low linear mass have been found to be the ones where the contact forces may suffer the most severe oscillations. If single-track, simply supported, composite or metal bridges were used in high-speed lines, and damping ratios below 1% were expected, the minimum contact forces at resonance could drop to dangerous values. Nevertheless, this kind of structures is very unusual in modern high-speed railway lines.

Criteria for Ballast Flight Initiation Induced by High Speed Trains

One of the phenomena that limit the velocity of trains in high speed lines is the so- called “ballast pick-up”. It is a ballast train-induced-wind erosion (or BATIWE) that can produce damage to the train under body and the infrastructure surrounding the tracks. The analysis of the measurements taken during several passes of the train allows for a criterion of ballast flight initiation to be obtained. The first rotation of a ballast stone occurs when the impulse given to the stone (arising from the aerodynamic loading produced by the wind gust genera ted by the passing train) overpasses a critical impulse. This impulse depends on the physical properties of the stone (mass, shape, moment of inertia, etc. ...) and its posture on the track bed. The aim of this paper is to report on the experimental results obtained in the ADIF’S Brihuega (Guadalajara) test station, in the Madrid to Barcelona high speed line, and the way they can be used to support the feasibility of the definition of a criterion to evaluate the BA TIWE capability of trains. The results obtained show the feasibility of the proposed method, and contribute to a method of BATIWE characterization, which can be relevant for the development of train interoperability standardization.

Alta velocidad ferroviaria en California(USA): cuarta parte (IV) Fresno-Sacramento (Roseville) = High speed railway in California (USA): fourth part (IV) Fresno-Sacramento (Roseville)

Implantación de la Red de Alta velocidad Ferroviaria en California. Tramo Fresno-Sacramento. El presente articúlo es la cuarta parte de la serie "Alta Velocidad Ferroviaria en California (CHSRS)". Recoge la Alternativa "Stockton Arch", que el Proyecto FARWEST presenta a la prevista por la Authority (CHSRA), para la Línea HSR Fresno-Sacramento, en programación y en trazado. Éste discurre, desde la gran Terminal de Fresno (implantada en las afueras al suroeste de la ciudad) por el segmento sur del "mar interior" (que en el Terciario Superior ocupaba el actual Valle Central), hasta Stockton, y por el segmento norte, hasta Sacramento. El Paet de Ripperdan (~ pK 40) queda conectado por carretera con el PAET de Oroloma de la Línea HSR Fresno-San Francisco (Golden Gate Alternative). La última parte del trazado de la Línea HSR Fresno-Sacramento (Stockton Arch Alternative), coincide en alineación y rasante con la Línea HSR San Francisco-Sacramento (Crossing Bay Alternative) a la altura de Roseville, donde se emplaza la gran terminal norte de la red de California, desde la que se unirá ésta con la de Nevada, por Reno. This article forras the fourth part of the series entitled "High Speed Railway in California (CHSRS)". It addresses the "Stockton Arch" alternative, which the FARWESTProjectpresents in scheduling and in alignment as to that provided for by the Authority (CHSRA) for the Fresno-Sacramento HSR Line. The latter runs from the grand Fresno Terminal (located in the outskirts to the southwest ofthe city) through the south segment ofthe "inland sea" (which oceupied the current Central Valley in the Upper Tertiary) to Stockton and through the north segment to Sacramento. The Ripperdan TSAP (post ofpassing and stabling trains), — kilometer point 40, conneets with the Oroloma TSAP ofthe Fresno-San Francisco HSR Line (Golden Gate Alternative) by road. The last part of the Fresno-Sacramento HSR Line alignment (Stockton Arch Alternative), coincides in alignment and grade with the San Francisco-Sacramento HSR Line (Crossing Bay Alternative) at Roseville, where the great north terminal ofthe California network is located, from which the latter will be linked with Nevada s network through Reno.

Alta velocidad ferroviaria en California(USA): tercera parte (III) Fresno-Los Ángeles-San Diego = High speed railway in California(USA): third part (III) Fresno-Los Ángeles-San Diego

Implantación de la Red de Alta velocidad Ferroviaria en California. Tramo Fresno-Los Angeles-San Diego. Este artículo, tercera parte de la serie que describe la red de Alta Velocidad Ferroviaria de California (CHSRS), se ocupa de la línea Fresno-Los Angeles Airport-San Diego Airport, con el trazado propuesto en la Alternativa Missions Trail del Proyecto FARWEST, caracterizada por el paso directo de las montañas de Tehachapi, mediante dos grandes túneles de 27,5 Km (17 mile) y 25,6 Km (15,9 mile) de longitud. También por el emplazamiento de la estación terminal de Los Angeles, junto al Aeropuerto Internacional de Los Angeles y la sustitución de la circunvalación ferroviaria de la aglomeración urbana de Los Angeles, a través de Inland Empire, por el ramal Anaheim-Riverside, que da acceso a esa región, y que es cabecera de la futura Dessert Express a Las Vegas. The third of a series describing the California High Speed Railway (CHSRS), this article refers to the Fresno-Los Angeles Airport-San Diego Airport line, with the alignment as proposed in the Missions Trail Alternative of the FARWEST Project, characterized by the direct Tehachapi mountain pass through two large tunnels 27.5 Km (17 miles) and 25.6 Km (15.9 miles) long and also to the siting of the Los Angeles terminal station next to the Los Angeles International Airport and the replacement of the Los Angeles urban conglomeration railway by-pass through Inland Empire, by the Anaheim-Riverside branch providing access to that region and which is the head of the future Desert Express to Las Vegas.

Does high speed rail compete fairly with other transportation modes? Madrid-Barcelona case study

Transportation modes produce many external costs such as congestion, accidents, and environmental impacts (pollution, noise and so on). From the microeconomic theory it is well known that in order to maximize social welfare, transportation modes should internalize the marginal costs they produce. Allocative efficiency is achieved when all transportation modes are priced at their social marginal cost. The objective of this research is to evaluate to what extent different passenger transport modes internalize their social marginal costs. This analysis is important since it affects the competitiveness of the different transport modes for a given OD pair. The case study analyzed is the corridor Madrid-Barcelona in Spain and the different transport modes have been considered (cars, buses, high-speed train and air). The research calculates the marginal social cost per user for each transportation mode, and it compares it with the average fare—allowing for the effect of discriminatory taxes—currently paid by the users. The external costs are calculated according to the guidelines established by the European Union. The gap between the marginal social cost and the price paid by users will provide the extra cost per passenger that each transport mode should have to pay for internalizing the external cost it produces. The research shows that external costs already produced by road and air transport modes are much higher than those produced by rail. However, the results show that road transport already internalizes every external costs it produces because users pay high fuel taxes. In other words, although rail transportation produces lower external costs, road transportation pays more than it should on the basis of the social marginal costs. The results of this work might be of help for Europ ean policy actions to be undertaken in the future.

Fórmulas para el cálculo del factor de impacto de estructuras semienterradas en líneas de ferrocarril de alta velocidad = Dynamic factors for underpasses in high speed train lines

Los pasos inferiores son muy numerosos en las líneas de ferrocarril. Su comportamiento dinámico ha recibido mucha menos atención que el de otras estructuras como los puentes, pero su elevado número hace que su estudio sea económicamente relevante con vista a optimizar su forma, manteniendo la seguridad. El proyecto de puentes según el Eurocódigo incluye comprobaciones de estados límite de tensiones bajo carga dinámica. En el caso de pasos inferiores, las comprobaciones pueden resultar tan costosas como aquellas de puentes, pese a que su coste es mucho menor. Por tanto, se impone la búsqueda de unas reglas de cálculo simplificado que pongan en consonancia el coste de la estructura con el esfuerzo necesario para su proyecto. Este artículo propone un conjunto de reglas basadas en un estudio paramétrico = Underpasses are common in modern railway lines. Wildlife corridors and drainage conduits often fall into this category of partially buried structures. Their dynamic behavior has received far less attention than that of other structures such as bridges, but their large number makes their study an interesting challenge from the viewpoint of safety and cost savings. The bridge design rules in accordance with the Eurocode involve checks on stresses according to dynamic loading. In the case of underpasses, those checks may be as much as those for bridges. Therefore, simplified design rules may align the design effort with their cost. Such a set of rules may provide estimations of response parameters based on the key parameters influencing the result. This paper contains a proposal based on a parametric study.