Development of a simulator for training of fetoscopic myelomeningocele surgery

Objective

To develop a realistic simulation model for laparotomy-assisted fetoscopic spina bifida aperta (SBa) surgery, to be used for training purposes and preoperative planning.

Methods

The predefined general requirement was a realistic model of an exteriorized uterus, allowing all neurosurgical steps of the intervention. The uterus was modelled using ultrasound and MRI images of a 25 weeks’ gravid uterus, consisting of flexible polyurethane foam coated with pigmented silicone. The fetal model, contained an opening on the dorsal side for a customizable spinal insert with all the aspects of a SBa, including a cele, placode, and myofascial and skin layer. The model was assessed in a series of validation experiments.

Results

Production costs are low, uterus and fetus are reusable. Placental localization and the level and size of the spinal defect are adjustable, enabling case-specific adaptations. All aspects of the simulator were scored close to realistic or higher for both appearance and functional capacities.

Conclusions

This innovative model provides an excellent training opportunity for centers that are starting a fetoscopic SBa repair program. It is the first simulation model with adjustable spinal defect and placental localisation. Further objective validation is required, but the potential for using this model in preoperative planning is promising.     

典型树种挥发性有机物(VOCs)排放成分谱及排放特征

为研究典型树种的挥发性有机物（VOCs）排放特征,并获得基础排放速率,应用动态封闭式采样系统对毛果杨、北美枫香和马尾松的排放进行了实验室测量.利用热脱附-气相色谱-飞行质谱仪对排放样品进行定性和定量分析,包括异戊二烯、单萜烯、倍半萜烯、烷烃和烯烃,计算获得各树种VOCs排放速率及其排放谱特征.研究表明：毛果杨、北美枫香和马尾松的总VOCs排放速率分别为19.51、17.19和0.67μg/（g·h）.毛果杨的异戊二烯排放最高（18.51μg/（g·h））,占其总排放的94.86%;马尾松排放的异戊二烯仅占4.03%,单萜烯贡献最高,为49.09%;北美枫香的单萜烯排放速率最高,为0.84μg/（g·h）;3个树种排放的倍半萜烯占各自VOCs总排放的比重均较小（<1.5%）;各树种的烷烃排放强度高于倍半萜烯,部分化合物甚至高于异戊二烯和单萜烯的排放强度.反式-β-罗勒烯是毛果杨排放最多的单萜烯化合物,占其单萜烯总排放的99.84%;北美枫香排放的单萜烯主要以香桧烯和β-蒎烯为主;马尾松以α-蒎烯、香桧烯和β-蒎烯为主.石竹烯、葎草烯、δ-杜松烯和β-愈创木烯是主要的倍半萜烯物种.烷烃排放主要为C4和C5的化合物,特别是异丁烷和正丁烷;各树种排放的烯烃中,1-丁烯排放占比最高.     

The effect of ventilation on spontaneous heating of coal

Ventilation plays an important role in the spontaneous heating of coal in an underground coal mine. If the ventilation rate is too high, heat is carried away by convection. If the ventilation rate is too low, the reaction rate becomes oxygen-limited. The effect of ventilation on the spontaneous heating of coal was investigated in an isothermal oven in this study. Experiments were conducted on three U.S. coal samples with ventilation rates ranging from 100 to 500 cm³/min. Experiments under ventilation were conducted to determine the critical ambient temperature, which is the minimum oven temperature required for a coal sample to achieve thermal runaway. Spontaneous heating tests were then conducted at various ventilation rates at the critical ambient temperature and the results were compared with spontaneous heating tests without ventilation. It was found that there is an optimum ventilation flow to produce the maximum rate of temperature rise at the critical ambient temperature. When the coal sample particle size was increased, a higher critical ambient temperature was required. The results in this study have application in the prevention of spontaneous combustion in underground coal mines.     

MASS LOAD ESTIMATION ERRORS UTILIZING GRAB SAMPLING STRATEGIES IN A KARST WATERSHED1

ABSTRACT: Developing a mass load estimation method appropriate for a given stream and constituent is difficult due to inconsistencies in hydrologic and constituent characteristics. The difficulty may be increased in flashy flow conditions such as karst. Many projects undertaken are constrained by budget and manpower and do not have the luxury of sophisticated sampling strategies. The objectives of this study were to: (1) examine two grab sampling strategies with varying sampling intervals and determine the error in mass load estimates, and (2) determine the error that can be expected when a grab sample is collected at a time of day when the diurnal variation is most divergent from the daily mean. Results show grab sampling with continuous flow to be a viable data collection method for estimating mass load in the study watershed. Comparing weekly, biweekly, and monthly grab sampling, monthly sampling produces the best results with this method. However, the time of day the sample is collected is important. Failure to account for diurnal variability when collecting a grab sample may produce unacceptable error in mass load estimates. The best time to collect a sample is when the diurnal cycle is nearest the daily mean.     

VARIATIONS IN NORTHERN SIERRA NEVADA STREAMFLOW: IMPLICATIONS OF CLIMATE CHANGE1

ABSTRACT: Historical records of streamflow for an eastward- and a westward-draining stream in the northern Sierra Nevada have been analyzed for evidence of changes in runoff characteristics and patterns of variability. A trend of increasing and more variable winter streamflow began in the mid-1960s. Mean monthly streaniflow during December through March was substantially greater for water years 1965–1990 compared to water years 1939–1964. Increased winter and early-spring streamflow during the later period is attributed to small increases in temperature, which increase the rain-to-snow ratio at lower altitudes and cause the snowpack to melt earlier in the season at higher altitudes. The timing of snowmelt runoff on the western slope of the Sierra Nevada is more sensitive than it is on the eastern slope to changes in temperature, owing to predominantly lower altitudes on the west side. This difference in sensitivity suggests that basins on the east side of the Sierra Nevada have a more reliable water supply (as snow storage) than western-slope basins during warming trends.     

Global assessment of the biodiversity safeguards of development banks that finance infrastructure

Infrastructure development is a major driver of biodiversity loss globally. With upward of US$2.5 trillion in annual investments in infrastructure, the financial sector indirectly drives this biodiversity loss. At the same time, biodiversity safeguards (project-level biodiversity impact mitigation requirements) of infrastructure financiers can help limit this damage. The coverage and harmonization of biodiversity safeguards are important factors in their effectiveness and therefore warrant scrutiny. It is equally important to examine the extent to which these safeguards align with best-practice principles for biodiversity impact mitigation outlined in international policies, such as that of the International Union for Conservation of Nature. We assessed the biodiversity safeguards of public development banks and development finance institutions for coverage, harmonization, and alignment with best practice. We used Institute of New Structural Economics and Agence Française de Développement's global database to identify development banks that invest in high-biodiversity-footprint infrastructure and have over US$500 million in assets. Of the 155 banks, 42% (n = 65) had biodiversity safeguards. Of the existing safeguards, 86% (56 of 65) were harmonized with International Finance Corporation (IFC) Performance Standard 6 (PS6). The IFC PS6 (and by extension the 56 safeguard policies harmonized with it) had high alignment with international best practice in biodiversity impact mitigation, whereas the remaining 8 exhibited partial alignment, incorporating few principles that clarify the conditions for effective biodiversity offsetting. Given their dual role in setting benchmarks and leveraging private finance, infrastructure financiers in development finance need to adopt best-practice biodiversity safeguards if the tide of global biodiversity loss is to be stemmed. The IFC PS6, if strengthened, can act as a useful template for other financier safeguards. The high degree of harmonization among safeguards is promising, pointing to a potential for diffusion of practices.     

Preparedness for anthrax attack: the effect of knowledge on the willingness to treat patients

Little is known about the factors that may impact on the willingness of physicians and nurses to treat patients during a bioterrorism attack. This survey was conducted among 76 randomly selected nurses and physicians in the emergency rooms of three public hospitals in order to analyse the relationship between knowledge, profession and the willingness to treat anthrax. The study finds that the willingness of physicians and nurses to come to work is 50% greater among the group with the highest knowledge about anthrax (P < 0.0001). Within that group, the willingness to treat patients suspected of being infected with anthrax was 37% greater (P < 0.0001) and the willingness to treat patients diagnosed with anthrax was 28% greater (P = 0.004) than in the other groups. These results imply that enhancement of knowledge among health care workers may improve their willingness to come to work and treat patients infected with anthrax during a bioterrorism attack.     

Revealing the socioeconomic impact of small disasters in Colombia using the DesInventar database

Small disasters are usually the product of climate variability and climate change. Analysis of them illustrates that they increase difficulties for local development—frequently affecting the livelihoods of poor people and perpetuating their level of poverty and human insecurity—and entail challenges for a country's development. In contrast to extreme events, small disasters are often invisible at the national level and their effects are not considered as relevant from a macroeconomic standpoint. Nevertheless, their accumulated impact causes economic, environmental and social problems. This paper presents the results of an evaluation of the DesInventar database, developed in 1994 by the Network for Social Studies in Disaster Prevention in Latin America. In addition, it proposes a new version of the Local Disaster Index developed in 2005 within the framework of the Disaster Risk and Management Indicators Program for the Americas, with the support of the Inter‐American Development Bank.