Using NEC contracts to manage risk and avoid disputes

NEC contracts provide an excellent basis to encourage and support risk management through all stages of any project or service provision. Partly because they are good for risk management, NEC contracts have anecdotally helped avoid disputes. After more than 12 years of use for possibly billions of pounds worth of work in probably tens of thousands of projects in more than 20 countries there remains only one piece of case law relating to the use of the NEC. The aim of this paper is to explain how NEC contracts can be used to reflect the particular risk allocation intended by the parties to the contract through the use of the options within the contract. It then explains the key tools and processes in the contract for the ongoing management of risk, including the NEC’s ‘Risk Register’ and the allocation of risk in quotations for the effects of events at the client’s risk.

Demonstration of high-energy 2 omega (526.5 nm) operation on the National Ignition Facility Laser System

A single beamline of the National Ignition Facility (NIF) has been operated at a wavelength of 526.5 nm (2 omega) by frequency converting the fundamental 1053 nm (1 omega) wavelength with an 18.2 mm thick type-I potassium dihydrogen phosphate (KDP) second-harmonic generator (SHG) crystal. Second-harmonic energies of up to 17.9 kJ were measured at the final optics focal plane with a conversion efficiency of 82%. For a similarly configured 192-beam NIF, this scales to a total 2 omega energy of 3.4 MJ full NIF equivalent (FNE).

National Ignition Facility laser performance status

The National Ignition Facility (NIF) is the world's largest laser system. It contains a 192 beam neodymium glass laser that is designed to deliver 1.8 MJ at 500 TW at 351 nm in order to achieve energy gain (ignition) in a deuterium-tritium nuclear fusion target. To meet this goal, laser design criteria include the ability to generate pulses of up to 1.8 MJ total energy, with peak power of 500 TW and temporal pulse shapes spanning 2 orders of magnitude at the third harmonic (351 nm or 3omega) of the laser wavelength. The focal-spot fluence distribution of these pulses is carefully controlled, through a combination of special optics in the 1omega (1053 nm) portion of the laser (continuous phase plates), smoothing by spectral dispersion, and the overlapping of multiple beams with orthogonal polarization (polarization smoothing). We report performance qualification tests of the first eight beams of the NIF laser. Measurements are reported at both 1omega and 3omega, both with and without focal-spot conditioning. When scaled to full 192 beam operation, these results demonstrate, to the best of our knowledge for the first time, that the NIF will meet its laser performance design criteria, and that the NIF can simultaneously meet the temporal pulse shaping, focal-spot conditioning, and peak power requirements for two candidate indirect drive ignition designs.

Interaction between the neuromagnetic responses to sound energy onset and pitch onset suggests common generators

The pitch-onset response (POR) is a negative component of the auditory evoked field which is elicited when the temporal fine structure of a continuous noise is regularized to produce a pitch perception without altering the gross spectral characteristics of the sound. Previously, we showed that the latency of the POR is inversely related to the pitch value and its amplitude is correlated with the salience of the pitch, suggesting that the underlying generators are part of a pitch-processing network [Krumbholz, K., Patterson, R.D., Seither-Preisler, A., Lammertmann, C. & Lütkenhöner, B. (2003) Cereb. Cortex,13, 765-772]. The source of the POR was located near the medial part of Heschl's gyrus. The present study was designed to determine whether the POR originates from the same generators as the energy-onset response (EOR) represented by the N100m/P200m complex. The EOR to the onset of a noise, and the POR to a subsequent transition from noise to pitch, were recorded as the time interval between the noise onset and the transition varied from 500 to 4000 ms. The mean amplitude of the POR increased by approximately 5.9 nA.m with each doubling of the time between noise onset and transition. This suggests an interaction between the POR and the EOR, which may be based on common neural generators.

Using test dose challenges to restore essential therapy in patients with idiopathic anaphylaxis and pharmacophobia: report of a patient with idiopathic anaphylaxis and statin phobia

Idiopathic anaphylaxis (IA) is a well-documented condition in which anaphylaxis occurs in the absence of an identifiable precipitant. However, many patients with IA find it difficult to accept this diagnosis and continue to search for an external cause. It is not uncommon for these highly anxious patients to discontinue essential medications that they feel are responsible for the reaction despite reassurance from their physicians to the contrary. In extreme cases, these patients may develop an actual phobia to preexisting medications and avoid them despite adverse consequences to their health. To illustrate this concept, we report a case involving a female patient with familial hypercholesterolemia who experienced a single episode of IA and developed a "statin phobia," falsely implicating her medication (lovastatin) for the reaction. After 5 years of failed therapy with other antihyperlipidemic agents, the patient finally agreed to undergo test dosing to a similar statin agent atorvastatin. On successful completion of the test, she resumed therapy with atorvastatin and her low-density lipoprotein (LDL) levels were reduced by 50% over 5 months. We conclude that patients with a confirmed diagnosis of IA who manifest phobic responses to beneficial medications should be reassured of the diagnosis promptly by their physician. When reassurance fails and the medication is essential to the patient's health, test dose challenges may be conducted to reintroduce the drug to the patient's regimen.

The stereoscopic (cyclopean) motion aftereffect is dependent upon the temporal frequency of adapting motion

This study investigated whether the stereoscopic (cyclopean) motion aftereffect (induced by adaptation to moving binocular disparity information) is dependent upon the temporal frequency or speed of adapting motion. The stereoscopic stimuli were gratings created from disparity embedded in a dynamic random-dot stereogram. Across different combinations of stereoscopic spatial frequency, temporal frequency and speed of adapting motion, the duration of the aftereffect was dependent upon temporal frequency (maximal aftereffect=1-2 cyc s(-1)). These results support the idea that stereoscopic motion is processed by a cortical mechanism that computes cyclopean motion energy.

Differential effects of trivalent and pentavalent arsenicals on cell proliferation and cytokine secretion in normal human epidermal keratinocytes

There is strong evidence from epidemiologic studies of an association between chronic exposure to inorganic arsenic (iAs) and hyperpigmentation, hyperkeratosis, and neoplasia in the skin. Although it is generally accepted that methylation is a mechanism of arsenic detoxification, recent studies have suggested that methylated arsenicals also have deleterious biological effects. In these studies we compare the effects of inorganic arsenicals (arsenite (iAs(III)) and arsenate (iAs(V))) and trivalent and pentavalent methylated arsenicals (methylarsine oxide (MAs(III)O), complex of dimethylarsinous acid with glutathione (DMAs(III)GS), methylarsonic acid (MAs(V)), and dimethylarsinic acid (DMAs(V))) in human keratinocyte cultures. Viability testing showed that the relative toxicities of the arsenicals were as follows: iAs(III) > MAs(III)O > DMAs(III)GS > DMAs(V) > MAs(V) > iAs(V). Trivalent arsenicals induced an increase in cell proliferation at concentrations in the 0.001 to 0.01 microM range, while at high concentrations (>0.5 microM) cell proliferation was inhibited. Pentavalent arsenicals did not stimulate cell proliferation. As seen in the viability studies, the methylated forms of As(V) were more cytotoxic than iAs(V). Exposure to low doses of trivalent arsenicals stimulated secretion of the growth-promoting cytokines, granulocyte macrophage colony stimulating factor and tumor necrosis factor-alpha. DMAs(V) reduced cytokine secretion at concentrations at which proliferation and viability were not affected. These data suggest that methylated arsenicals, products of the metabolic conversion of inorganic arsenic, can significantly affect viability and proliferation of human keratinocytes and modify their secretion of inflammatory and growth-promoting cytokines.

Severe serum sickness-like reaction to oral penicillin drugs: three case reports

BACKGROUND

Because the use of heterologous sera has diminished, the incidence of serum sickness has declined. However, serum sickness-like reactions to nonprotein drugs continue to occur.

METHODS

We report three cases of severe serum sickness-like reactions in adults to oral penicillin drugs.

RESULTS

In each patient, significant symptom resolution occurred within 24 hours of starting therapy with oral corticosteroids.

CONCLUSIONS

Serum sickness-like reactions to oral penicillin drugs may be more common than reported in the literature and can be very severe. No specific laboratory finding is universally present or definitively diagnostic. As with classic serum sickness, the diagnosis of serum sickness-like reaction is made clinically. In severe cases such as those presented here with debilitating joint symptoms or life-threatening angioedema, a diagnostic-therapeutic trial of prednisone, 40 to 60 mg at least once daily, is warranted.

Exposure duration affects the perceived direction of cyclopean type II plaids

This study investigated the effect of exposure duration on the perceived direction of cyclopean Type I and Type II plaids moving in the X/Y plane. The cyclopean plaids were created from grating components defined by binocular disparity embedded in a dynamic random-dot stereogram. The results showed that the cyclopean Type I plaid appeared to move in the intersection-of-constraints (IOC) direction across the range of exposures tested. However, the cyclopean Type II plaids appeared to move in a direction different from the IOC with short exposures but near the IOC with long exposures. This perceived directional shift was also obtained with luminance-defined Type II plaids. A common pattern-motion mechanism that processes cyclopean and luminance motion signals appears responsible for the perceived directional shift of the Type II plaids.

Listening to deaf speech: does experience count?

Listening for intelligibility in disordered speech involves a complex interaction of factors, including listener experience. This study examines intelligibility as perceived by two groups (experienced and inexperienced listeners) in interpreting deaf speech. Speech samples were gathered from a hearing-impaired child over thirteen months, immediately post cochlear implantation. Results indicate that experienced listeners interpret more of disordered speech than inexperienced, but while experience appears to be a factor in intelligibility judgements, it does not alone guarantee higher intelligibility rating.