In Case of Emergency: Implementing Disaster Clauses in Publisher Contracts

Joanne Romano, Licensing and Serials Librarian for The Texas Medical Center Library, presented “In Case of Emergency--Implementing Disaster Clauses in Publisher Contracts” to the National Network of Libraries of Medicine/Southeastern/Atlantic Region’s Emergency Response and Preparedness Advisory Committee, (NN/LM-SE/A ERAC) on November 17, 2010, in St. Petersburg, FLA at the Marriott Vinoy Renaissance Resort. Included were slides of the devastation after the 8.8 magnitude earthquake in the Maule region of Chile, how The TMC Library assisted, lessons learned, and advice for how to include disaster clauses in publisher licenses. The NN/LM-SE/A ERAC group invited Ms. Romano to present at their bi-meeting after learning of her library’s key role from other NLM officers. As a result, Ms. Romano was then invited as a guest speaker on for NN/LM-SE/A region’s annual webinar, “Beyond the Sea”, which also included speakers from John Wiley & Sons, Inc., the publisher who worked with The TMC Library in providing emergency access to researchers at the University de Talca, Talca, Chile.

Los internamientos no voluntarios por razón de trastorno psíquico: especial consideración al procedimiento a seguir en los casos de urgencia médica

La ambigüedad y carencias de la regulación sobre internamientos no voluntarios por razón de trastorno psíquico, unidas a la declaración de inconstitucionalidad que afecta a algunas de sus disposiciones por carecer del debido rango legal, exigen la elaboración de una normativa completa y bien estructurada de la materia. La reciente STC 141/2012, de 2 de julio, enjuicia por primera vez un caso de internamiento psiquiátrico urgente desde la óptica del derecho fundamental a la libertad personal, y el TC aprovecha la coyuntura para desarrollar minuciosamente las garantías que han de respetarse en tales casos con el fin de evitar vulneraciones arbitrarias del mismo. Este trabajo analiza la novedosa doctrina que sienta el TC en dicha sentencia.

Lifelines in case of Natural Disaster Emergencies

In order to handle Natural disasters, emergency areas are often individuated over the territory, close to populated centres. In these areas, rescue services are located which respond with resources and materials for population relief. A method of automatic positioning of these centres in case of a flood or an earthquake is presented. The positioning procedure consists of two distinct parts developed by the research group of Prof Michael G. H. Bell of Imperial College, London, refined and applied to real cases at the University of Bologna under the coordination of Prof Ezio Todini. There are certain requirements that need to be observed such as the maximum number of rescue points as well as the number of people involved. Initially, the candidate points are decided according to the ones proposed by the local civil protection services. We then calculate all possible routes from each candidate rescue point to all other points, generally using the concept of the "hyperpath", namely a set of paths each one of which may be optimal. The attributes of the road network are of fundamental importance, both for the calculation of the ideal distance and eventual delays due to the event measured in travel time units. In a second phase, the distances are used to decide the optimum rescue point positions using heuristics. This second part functions by "elimination". In the beginning, all points are considered rescue centres. During every interaction we wish to delete one point and calculate the impact it creates. In each case, we delete the point that creates less impact until we reach the number of rescue centres we wish to keep.

Residential energy resources management by a SCADA system in case of excess wind generation

The end consumers in a smart grid context are seen as active players. The distributed generation resources applied in smart home system as a micro and small-scale systems can be wind generation, photovoltaic and combine heat and power facility. The paper addresses the management of domestic consumer resources, i.e. wind generation, solar photovoltaic, combined heat and power, electric vehicle with gridable capability and loads, in a SCADA system with intelligent methodology to support the user decision in real time. The main goal is to obtain the better management of excess wind generation that may arise in consumer’s distributed generation resources. The optimization methodology is performed in a SCADA House Intelligent Management context and the results are analyzed to validate the SCADA system.

Maximizing the Social Welfare of Virtual Power Players Operation in Case of Excessive Wind Power

The integration of growing amounts of distributed generation in power systems, namely at distribution networks level, has been fostered by energy policies in several countries around the world, including in Europe. This intensive integration of distributed, non-dispatchable, and natural sources based generation (including wind power) has caused several changes in the operation and planning of power systems and of electricity markets. Sometimes the available non-dispatchable generation is higher than the demand. This generation must be used; otherwise it is wasted if not stored or used to supply additional demand. New policies and market rules, as well as new players, are needed in order to competitively integrate all the resources. The methodology proposed in this paper aims at the maximization of the social welfare in a distribution network operated by a virtual power player that aggregates and manages the available energy resources. When facing a situation of excessive non-dispatchable generation, including wind power, real time pricing is applied in order to induce the increase of consumption so that wind curtailment is minimized. This method is especially useful when actual and day-ahead resources forecast differ significantly. The distribution network characteristics and concerns are addressed by including the network constraints in the optimization model. The proposed methodology has been implemented in GAMS optimization tool and its application is illustrated in this paper using a real 937-bus distribution network with 20.310 consumers and 548 distributed generators, some of them non-dispatchable and with must take contracts. The implemented scenario corresponds to a real day in Portuguese power system.

Efficacy of an eradication protocol in case of Pseudomonas aeruginosa primo-infections in children with cystic fibrosis

Introduction: Patients with cystic fibrosis (CF) are more susceptible to pathogens like P. aeruginosa (PA). PA primo-­‐infections require particular attention, as with failure in eradication, there is accelerated lung deterioration. The main aim of this study is to assess the rate of PA eradication according to our particular protocol with inhaled tobramycin and oral ciprofloxacin, as there is no consensus in the literature on what eradication protocol the best is. Methods: Retrospective single centre study with data analysis from June 1st 2007 to June 1st 2011 of patients who had primo-­‐infections exclusively treated by 3 x 28 days of inhaled tobramycin and oral ciprofloxacin for the first and last 21 days. Success in eradication is defined by ≥ 3 negative bacteriologies for 6 months after the beginning of the protocol. If ≥ 1 bacteriology is positive, we consider the eradication as a failure. Results: Out of 41 patients, 18 were included in our analysis. 7 girls (38.9%) and 11 boys (61.1%) followed the eradication protocol. Boys had 12 primo-­‐infections and girls had 8. Among these 20 primo-­‐infections, 16 (80%) had an all-­‐overall success in eradication and 4 (20%) a failure. No significant statistical difference for age between these groups (t-­‐test = 0.07, p = 0.94), neither for FEV1% (t-­‐test = 0.96, p = 0.41) nor BMI (t-­‐test = 1.35, p = 0.27). Rate of success was 100% for girls and 66.6% for boys. Conclusion: Our protocol succeeded in an overall eradication rate of 80%, without statistical significant impact on FEV1 % and BMI values. However, there is a sex difference with eradication rates in girls (100%) and boys (66.6%). A sex difference has not yet been reported in the literature. This should be evaluated in further studies.

Feed the ICU patient 'gastric' first, and go post-pyloric only in case of failure.

In a randomised trial comparing early enteral feeding by gastric and post-pyloric routes, White and colleagues have shown that gastric feeding is possible and efficient in the vast majority of critically ill patients. But the authors' conclusion that gastric is equivalent to post-pyloric is true in only the least severe patients. Given the extra workload and costs, post-pyloric is now clearly indicated in case of gastric feeding failure.

Decreased Probability of Initial Pain Cessation in Classic Trigeminal Neuralgia Treated With Gamma Knife Surgery in Case of Previous Microvascular Decompression: A Prospective Series of 45 Patients With >1 Year of Follow-up.

BACKGROUND: Microvascular decompression (MVD) is the reference technique for pharmacoresistant trigeminal neuralgia (TN). OBJECTIVE: To establish whether the safety and efficacy of Gamma Knife surgery for recurrent TN are influenced by prior MVD. METHODS: Between July 1992 and November 2010, 54 of 737 patients (45 of 497 with >1 year of follow-up) had a history of MVD (approximately half also with previous ablative procedure) and were operated on with Gamma Knife surgery for TN in the Timone University Hospital. A single 4-mm isocenter was positioned in the cisternal portion of the trigeminal nerve at a median distance of 7.6 mm (range, 3.9-11.9 mm) anterior to the emergence of the nerve. A median maximum dose of 85 Gy (range, 70-90 Gy) was delivered. RESULTS: The median follow-up time was 39.5 months (range, 14.1-144.6 months). Thirty-five patients (77.8%) were initially pain free in a median time of 14 days (range, 0-180 days), much lower compared with our global population of classic TN (P = .01). Their actuarial probabilities of remaining pain-free without medication at 3, 5, 7, and 10 years were 66.5%, 59.1%, 59.1%, and 44.3%. The hypoesthesia actuarial rate at 1 year was 9.1% and remained stable until 12 years (median, 8 months). CONCLUSION: Patients with previous MVD showed a significantly lower probability of initial pain cessation compared with our global population with classic TN (P = .01). The toxicity was low (only 9.1% hypoesthesia); furthermore, no patient reported bothersome hypoesthesia. However, the probability of maintaining pain relief without medication was 44.3% at 10 years, similar to our global series of classic TN (P = .85). ABBREVIATIONS: BNI, Barrow Neurological InstituteCI, confidence intervalCTN, classic trigeminal neuralgiaGKS, Gamma Knife surgeryHR, hazard ratioMVD, microvascular decompressionTN, trigeminal neuralgia.

Efficacy of an eradication schema in case of Pseudomonas aeruginosa primo-infection in children with cystic fibrosis

Introduction: Patients with Cystic fibrosis (CF) are more susceptible to pathogens like P. aeruginosa (PA). PA primo-infection requires particular attention as failure in eradication is associated with accelerated lung deterioration. The main aim of this study is to assess the rate of PA eradication according to our particular protocol with inhaled tobramycin and oral ciprofloxacin, as there is no consensus in the literature on what eradication protocol is optimal. Methods: Retrospective single centre study with data analysis from June 1st 2007 to June 1st 2011 of patients with PA primo-infection exclusively treated by 3 x 28 days of inhaled tobramycin and oral ciprofloxacin for the first and last 21 days. Success in eradication is defined by ≥ 3 negative bacteriologies for 6 months after the beginning of the protocol. If ≥ 1 bacteriology is positive, we consider the eradication as a failure. Results: Out of 41 patients, 18 followed the eradication protocol and were included in our analysis (7 girls (38.9%) and 11 boys (61.1%)). Boys had 12 primo-infections and girls had 8. Among these 20 primo-infections, 16 (80%) had an overall success in eradication and 4 (20%) a failure. There was no significant statistical differences in age between these groups (t-test = 0.07, p = 0.94), nor for FEV1% (t-test = 0.96, p = 0.41) or BMI (t-test = 1.35, p = 0.27). Rate of success was 100% for girls and 66.6% for boys. Conclusion: Our protocol succeeded in an overall eradication rate of 80%, without statistical significant impact on FEV1 % and BMI values. However, there was a sex difference with eradication rates in girls (100%) and boys (66.6%). A sex difference has not yet been reported in the literature. This should be evaluated in further studies.

APROS model validation in case of fast transients in a boiling water reactor

This Master´s thesis investigates the performance of the Olkiluoto 1 and 2 APROS model in case of fast transients. The thesis includes a general description of the Olkiluoto 1 and 2 nuclear power plants and of the most important safety systems. The theoretical background of the APROS code as well as the scope and the content of the Olkiluoto 1 and 2 APROS model are also described. The event sequences of the anticipated operation transients considered in the thesis are presented in detail as they will form the basis for the analysis of the APROS calculation results. The calculated fast operational transient situations comprise loss-of-load cases and two cases related to a inadvertent closure of one main steam isolation valve. As part of the thesis work, the inaccurate initial data values found in the original 1-D reactor core model were corrected. The input data needed for the creation of a more accurate 3-D core model were defined. The analysis of the APROS calculation results showed that while the main results were in good accordance with the measured plant data, also differences were detected. These differences were found to be caused by deficiencies and uncertainties related to the calculation model. According to the results the reactor core and the feedwater systems cause most of the differences between the calculated and measured values. Based on these findings, it will be possible to develop the APROS model further to make it a reliable and accurate tool for the analysis of the operational transients and possible plant modifications.

High-resolution esophageal long-term ECG allows detailed atrial wave morphology analysis in case of atrial ectopic beats

Detection of arrhythmic atrial beats in surface ECGs can be challenging when they are masked by the R or T wave, or do not affect the RR-interval. Here, we present a solution using a high-resolution esophageal long-term ECG that offers a detailed view on the atrial electrical activity. The recorded ECG shows atrial ectopic beats with long coupling intervals, which can only be successfully classified using additional morphology criteria. Esophageal high-resolution ECGs provide this information, whereas surface long-term ECGs show poor atrial signal quality. This new method is a promising tool for the long-term rhythm monitoring with software-based automatic classification of atrial beats.