Is there a role for fetal interventions in gastroschisis management? – An updated comprehensive review

We conducted a comprehensive evidence-based review on the epidemiology and current standard of care of gastroschisis management as well as the pathophysiology, rationale and feasibility of fetal therapy as a viable alternative. Gastroschisis is a periumbilical abdominal wall defect characterized by abdominal viscera herniation in utero. It affects 4 in 10 000 live births, but the prevalence has steadily increased in recent years. Gastroschisis is typically diagnosed on routine second-trimester ultrasound. The overall prognosis is favorable, but complex gastroschisis, which accounts for about 10% to 15% of cases, is associated with a higher mortality, significant disease burden and higher healthcare costs due to long- and short-term complications. The current standard of care has yet to be established but generally involves continued fetal surveillance and multidisciplinary perinatal care. Postnatal surgical repair is achieved with primary closure, staged silo closure or sutureless repair. Experimental animal studies have demonstrated the feasibility of in utero closure, antiinflammatory therapy and prenatal regenerative therapy. However, reports of early preterm delivery and amnioinfusion trials have failed to show any benefit in humans. Further experimental studies and human trials are necessary to demonstrate the potential benefit of fetal therapy in gastroschisis.     

Use of coatings to minimise acid emissions during ceramic tile firing

The manufacture of traditional ceramic products (ceramic tiles, roof tiles, and bricks) is often associated with the emission of F, Cl, and S compounds during the firing stage. According to the literature, fluorine emissions can be reduced by adding CaCO₃ to the raw materials mixture used in fabricating these products. However, data available to the authors indicate that this procedure, which has been successfully applied in manufacturing structural ceramics (roof tiles and bricks), is ineffective in ceramic tile manufacture and modifies tile end properties.This paper examines the possibility of reducing such emissions by applying coatings of alkaline-earth carbonates on to the ceramic tile bottom surface to retain the acid compounds emitted during tile firing. The effectiveness of MgCO₃, CaCO₃, SrCO₃, and BaCO₃ coatings for retaining these acid emissions was studied, using the evolved gas analysis (EGA) technique with a TG-DSC-FTIR-QM instrument.The SrCO₃ coating was found to provide the greatest retention, showing that SO₂ and HCl were retained more efficiently than HF. The presence of fluorides, chlorides, and sulphates of Ca, Sr, and Ba was verified in the respective fired coatings, confirming the existence of chemical reactions between the emitted acid compounds and the coating materials at high temperature.     

基于结构方程模型的安全生产行政执法绩效分析

为加强对企业安全生产的监督和完善行政执法的评估体系,构建了企业安全生产行政执法绩效评估指标体系。利用调查问卷的方式,获得行政执法部门的绩效评价数据。根据结构方程模型(SEM)相关原理设计绩效评价的测量模型,通过AMOS17.0软件对评价体系进行分析,得到各指标的标准化估计值。利用标准化估计值分析各潜变量对企业安全生产执法的影响权重,各观察变量对企业安全生产执法的影响权重,并进行排序,结果显示:行政执法的合法性>执法人员的素质>执法的合理性>执法的文明性>执法的公开性。     

The impact of the BP Baker report

Introduction

This study examined the impact of the British Petroleum (BP) Baker Panel Report, reviewing the March 2005 BP-Texas City explosion, on the field of process safety.

Method

Three hundred eighty-four subscribers of a process safety listserv responded to a survey two years after the BP Baker Report was published.

Results

Results revealed respondents in the field of process safety are familiar with the BP Baker Report, feel it is important to the future safety of chemical processing, and believe that the findings are generalizable to other plants beyond BP-Texas City. Respondents indicated that few organizations have administered the publicly available BP Process Safety Culture Survey. Our results also showed that perceptions of contractors varied depending on whether respondents were part of processing organizations (internal perspective) or government or consulting agencies (external perspective).

Conclusions

This research provides some insight into the beliefs of chemical processing personnel regarding the transportability and generalizability of lessons learned from one organization to another.

Impact on Industry

This study has implications for both organizational scientists and engineers in that it reveals perceptions about the primary mechanism used to share lessons learned within one industry about one major catastrophe (i.e., investigation reports). This study provides preliminary information about the perceived impact of a report such as this one.     

Using the RE-AIM framework to translate a research-based falls prevention intervention into a community-based program: lessons learned

Problem

Exercise-based research interventions demonstrate reduced risk and rates of falls for community dwelling older adults; however, little is known about effective mechanisms for the translation, implementation, and maintenance of these interventions in community settings.

Method

The RE-AIM framework was used to assess the translatability of an effective exercise-based research intervention in a community setting. Questions included: Reach — Would the target population attend? Effectiveness — What was the adherence and compliance to the program? Were there individual improvements in falls risk factors? Adoption: Would staff at the center adopt the program and offer it past the funding period? Implementation — What adaptations, including optimal frequency and duration, should be made to meet the community needs, still adhere to core elements and achieve similar outcomes? Maintenance — Would the program be sustained by our community partners?

Discussion

The process of translating a controlled research intervention targeting older adults at risk of falls into a community setting was challenging. Licensed professionals developed the infrastructure to safely and effectively deliver the program. The end product was highly appealing program to our target audience, resulted in improved outcomes and was successfully adopted and maintained by the community partner.

Summary

Partnerships between community and healthcare providers are key to successful implementation of falls prevention interventions. Lessons learned from this experience can be applied to the translation of future exercise-based falls prevention interventions.     

Modelling spills of water-reactive chemicals

This paper describes part of a programme of work undertaken at the Health and Safety Laboratory (HSL) to investigate the behaviour of selected water-reactive chemicals. Following an accidental release, such substances react exothermically with any water present, generating acidic vapours. The STAWaRS (Source Term Assessment of Water Reactive Substances) software was developed for the Health and Safety Executive (HSE) by ESR Technology to model this complex process. The aims of the study described here were to provide experimental validation of the heats of hydrolysis used within STAWaRS, and to perform sensitivity studies on selected STAWaRS input parameters.The heat of hydrolysis of acetyl chloride was measured and showed good correlation with the value used within STAWaRS. Some of the variables that influence the severity of acetyl chloride spills are examined, with reference to predictions made by the STAWaRS model. The heats of hydrolysis of titanium tetrachloride previously measured at HSL are also discussed, and the effect of adopting these experimentally derived values for modelling spills is shown for a hypothetical land use planning case. This study demonstrates the importance of using experimentally validated values for STAWaRS input parameters.     

Effects of significant damage of flame gap surfaces in flameproof electrical apparatus on flame gap efficiency

Electrical apparatus for use in the presence of explosive gas atmospheres has to be specially designed to prevent the apparatus from igniting the gas. Flameproof design is one of several options, and one requirement is then that any holes and slits in the enclosure wall be designed to prevent a possible gas explosion inside the enclosure from being transmitted to an explosive gas cloud outside it. Current standards (IEC) require that joint surfaces have a surface roughness of <6.3 μm. Any damaged joint surface has be restored to this quality. The present investigation has demonstrated that flame gap surfaces in flameproof electrical apparatuses can suffer considerable mechanical and corrosive damage before the flame gaps no longer function satisfactorily. In some cases very significant mechanical surface damage in fact improves the gap performance. This indicates that current high costs of repairing and replacing flameproof electrical apparatus in process plants offshore and onshore can be reduced considerably without any increase of the explosion risk.     

On the development of a new hybrid risk assessment process using occupational accidents’ data: Application on the Greek Public Electric Power Provider

The occupational accidents have a major impact upon human integrity and also bring about high costs for the social health and insurance system of a country. In addition, risk analysis is an essential process for the safety policy of a company, having as main aim the effacement of any potential of damage in a productive procedure, while the quantified risk evaluation is the most crucial part of the whole procedure of assessing hazards in the work. The main goal of this study is double: a) the development and presentation of a new hybrid risk assessment process (HRAP) and b) the application of HRAP in the Greek Public Power Corporation (PPC) (the unique electric power provider and the largest industry in Greece), by using occupational accidents that have been recorded, during the 12-year period of 1993-2004. The new process consists of four distinct phases a) the hazard sources’ identification phase, b) the risk consideration phase, c) the risk-evaluation phase, and d) the phase of the risk assessment and safety-related decision making. The results show that in some cases the risk value has been calculated in PPC to be higher than 500 (in the risk rating of 0-1000), which imposes the taking of suppressive measures for abolishing the danger source, while the fatal accident frequency rate (per 10⁸ man-hrs) is FAFR ≅ 2.4.