In utero therapy for lower urinary tract obstruction

Lower urinary tract obstruction has a significant impact on neonatal and child health. Pulmonary hyperplasia and renal impairment could be direct or indirect consequences of this condition leading to significant morbidity and mortality. Evaluation of fetuses with suspected lower urinary tract obstruction is performed not only to confirm the diagnosis but also to assess renal prognosis. Ultrasound examination and urinary analysis aid in the evaluation of these fetuses. The decision to perform fetal intervention in these cases is a difficult one. Vesico‒amniotic fetal shunting, open fetal surgery and more recently endoscopic fetal surgery for this condition are available as possible modalities of fetal intervention. Case selection for fetal intervention is extremely important in order to both avoid unnecessary intervention in those unlikely to survive, and also to avoid procedure related complications in fetuses likely to do well without intervention. Vesico‒amniotic shunting has the advantage of bypassing the obstruction, however it is often associated with complications. Open fetal surgery is not usually recommended because of the complications and high fetal loss rate. Endoscopic surgery to visualise and treat the cause of lower urinary tract obstruction has been tried. Fetal endoscopic surgery is in its infancy and endoscopic procedures are limited to a few groups. This current review addresses evaluation, case selection and therapeutic options for lower urinary tract obstruction in utero. It also discusses the limited data against which the efficacy of the various options can be assessed. The current state of fetal intervention is detailed in the present review. Copyright © 2001 John Wiley & Sons, Ltd.     

A possible prenatal evaluation of renal function by amino acid analysis on fetal urine

Intrauterine treatment of 4 fetuses with urethral obstruction was attempted in the third trimester of pregnancy. The fetuses displayed varying sonographic findings including pyelectasis, caliectasis, hydroureter, bladder dilatation, ascites, hydrops, missing kidneys and oligohydramnios. Ultrasonically guided aspiration from the dilated structures was carried out to relieve pressure on the kidney parenchyme and to collect fluid samples for diagnostic purposes. Amino acid concentrations in the fetal urine showed a pattern similar to plasma in 2 fetuses, a pattern almost like urine in 1 fetus and an intermediate pattern in the 4th fetus. Only the fetus with normal amino acid concentrations in the urine survived: the other 3 died in uremia shortly after birth. In 3 cases cells from the aspirated urine were cultured and used for chromosome analysis. The cell cultures grew fast and karyotyping was possible within 1 week. In 2 fetuses an intrauterine catheter was inserted to drain the kidney permanently into the amniotic cavity. In the first case the catheter was displaced to the fetal abdomen after some days of successful drainage. In the second case the catheter tore the placenta, and the child had to be delivered immediately.     

Zero-inflated models with application to spatial count data

Count data arises in many contexts. Here our concern is with spatial count data which exhibit an excessive number of zeros. Using the class of zero-inflated count models provides a flexible way to address this problem. Available covariate information suggests formulation of such modeling within a regression framework. We employ zero-inflated Poisson regression models. Spatial association is introduced through suitable random effects yielding a hierarchical model. We propose fitting this model within a Bayesian framework considering issues of posterior propriety, informative prior specification and well-behaved simulation based model fitting. Finally, we illustrate the model fitting with a data set involving counts of isopod nest burrows for 1649 pixels over a portion of the Negev desert in Israel.     

基于贝叶斯网的交通事故机理分析

针对道路交通事故的形成机理进行定性、定量研究,根据我国道路交通事故记录数据特征,应用贝叶斯网对事故发生概率进行定量分析.引入"驾驶员紧张度"和"道路线形合理度"两个隐节点,建立了事故分析的贝叶斯网多层隐类模型,采用最大似然估计方法确定了模型的边缘概率和条件概率.将贝叶斯网模型应用于国道104二级公路(K1310+000～K1330+000)的事故分析中,运用贝叶斯网分析软件包Netica对其历史事故记录数据进行分析.结果表明: 贝叶斯网不仅可以定量计算某种道路交通状态下的事故发生概率,而且可以找出影响事故概率的关键原因和最不利状态组合(事故概率最大时的道路交通状态).     

回顾性环境影响评价的特点及发展趋势

依据回顾性环境影响评价的内涵,结合其发展过程和作用,总结了回顾性环境影响评价工作的主要特点,并探索了今后该项工作的发展趋势。     

Compression system check-valve failure hazards

Processes that utilize multistage compression systems (olefins plant compression systems, gas processing, integrated refrigeration systems, etc.) have the potential for overpressure due to single or multiple check-valve failure. Catastrophic equipment failure resulting from overpressure can potentially occur due to compression system discharge, interstage, and/or suction check-valve failure, coincident with compressor shutdown. Depending on system design and application, overpressure values approaching or exceeding 300% of equipment design are possible, while for some equipment, even limited overpressure can result in catastrophic vessel failure due to brittle fracture. Additional hazards associated with compression system fail-to-check scenarios include risks associated with excessive flare loading and compressor rotor reverse rotation. In the case of an ethylene refrigeration compressor at a typical ethylene plant, rotor reverse rotation can potentially exceed overspeed limits.This paper provides risk assessment results based on analyses performed on the three primary compression systems in six ethylene plants. The methodologies used for risk identification screening, detailed risk assessment and evaluation of system dynamics are all presented. Alternative methods for mitigating risks are also discussed, along with check-valve reliability data. An overview of applicable overpressure protection requirements defined in the ASME Boiler and Pressure Vessel Code is provided. This paper will be of interest to anyone who designs or operates multistage compression systems in the chemical, petrochemical or refining industries.     

对某高层酒店建筑给水和消火栓系统设计的体会与思考

生活给水系统设计时,将室内外给水管网分成两套,结合实际情况从安全、经济以及维护管理等因素考虑,在地下室布置成立体双环状给水系统;生活热水采用一台容积式浮动盘管热交换器换热供给热水;从理论上论证了组合型消防栓箱在本工程中的适用性和优越性,提出可将灭火器和消火栓位置设于一处的观点供大家在设计上参考。     

模糊证据权法在地震滑坡危险度区划中的应用

为克服滑坡危险度评价中因子边界划分不确定性和因子权重的主观性问题,引入模糊证据权法,对汶川震区岷江流域雁门乡至映秀段,进行滑坡发生后验概率计算。采用修正后验概率模型,来满足模糊证据权法中证据层间的条件独立性假设,以提高预测结果精度。最后按照预测的滑坡点数,完成研究区滑坡危险度区划。通过与野外实际踏勘数据对比,结果显示:75.24%的已知滑坡点处于修正后验概分级中等危险度以上。表明模糊证据权方法,可较为客观准确地对地震滑坡危险度进行区划,适用于预测以自然因素为主导的事件发生概率。