Evaluating annoyance mitigation in the screening of train-induced noise and ground vibrations using a single-leaf traffic barrier

External sources such as traffic and construction work cause noise and vibration in nearby buildings, potentially annoying human residents. Today, almost every fifth European is harmfully affected by traffic noise and vibration. Wave barriers placed on or embedded within the soil between the source and the receiver can mitigate the transmission of ground vibration, and the airborne noise transmission can be reduced in a similar manner with a screen acting as a noise barrier. As a novel approach, the present work explores the efficiency of combining ground vibration and noise barriers into one. To this end, numerical experiments were performed by a semi-analytic finite-element method for ground vibration and the boundary-element method for sound propagation. This involved time-harmonic analyses carried out in order to study the performance of various configurations of barriers focusing on vertical barriers rigidly attached to the ground surface or embedded into the soil. Parametric analyses were conducted on the achieved vibration and noise mitigation with different types of ground-vibration barriers and noise barriers, respectively. The combined effect of the noise and ground vibration barriers were then assessed to investigate their potential for possibly reducing the negative impact on lineside residents. The aim of this work, though, is to highlight a metric, recently developed, which reports the probability on the number of residents who could be annoyed by intrusive railway noise and vibration. It is shown that a single structural-element can target a combined reduction of around 15% probability in annoyance to vibration levels combined with a 12 dB insertion loss which amounts to a 30% reduction in probability of annoyance due to railway traffic intrusive noise.

Fatal poisoning in drug addicts in the Nordic countries in 2012

This report is a follow-up to a study on fatal poisoning in drug addicts conducted in 2012 by a Nordic working group. Here we analyse data from the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. Data on sex, number of deaths, places of death, age, main intoxicants and other drugs detected in the blood were recorded. National data are presented and compared between the Nordic countries and with data from similar studies conducted in 1991, 1997, 2002 and 2007. The death rates (number of deaths per 100,000 inhabitants) increased in drug addicts in Finland, Iceland and Sweden but decreased in Norway compared to the rates in earlier studies. The death rate was stable in Denmark from 1991 to 2012. The death rate remained highest in Norway (5.79) followed by Denmark (5.19) and Iceland (5.16). The differences between the countries diminished compared to earlier studies, with death rates in Finland (4.61) and Sweden (4.17) approaching the levels in the other countries. Women accounted for 15-27% of the fatal poisonings. The median age of the deceased drug addicts was still highest in Denmark, and deaths of addicts >45 years old increased in all countries. Opioids remained the main cause of death, but medicinal opioids like methadone, buprenorphine, fentanyl and tramadol mainly replaced heroin. Methadone was the main intoxicant in Denmark and Sweden, whereas heroin/morphine caused the most deaths in Norway. Finland differed from the other Nordic countries in that buprenorphine was the main intoxicant with only a few heroin/morphine and methadone deaths. Deaths from methadone, buprenorphine and fentanyl increased immensely in Sweden compared to 2007. Poly-drug use was widespread in all countries. The median number of drugs per case varied from 4 to 5. Heroin/morphine, medicinal opioids, cocaine, amphetamines, benzodiazepines and alcohol were the main abused drugs. However, less widely used drugs, like gamma-hydroxybutyric acid (GHB), methylphenidate, fentanyl and pregabalin, appeared in all countries. New psychotropic substances emerged in all countries, with the largest selection, including MDPV, alpha-PVP and 5-IT, seen in Finland and Sweden.

Upper limb arterial thromboembolism: a systematic review on incidence, risk factors, and prognosis, including a meta-analysis of risk-modifying drugs

OBJECTIVES

The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF).

METHODS

We searched MEDLINE for studies on the epidemiology of upper limb thromboembolism from 1965 to June 2012. We also searched for contemporary, phase III randomized trial data on systemic (non-stroke) thromboembolism comparing warfarin with new oral anticoagulants (OACs) in patients with atrial fibrillation published after the year 1999.

RESULTS

The incidence of upper limb thromboembolectomy was 3.3 per 100 000 person-years among men and 5.2 per 100 000 person-years among women; the risk of limb amputation, stroke and death after thromboembolectomy was increased. There was an increased risk of thromboembolectomy of the upper limb in patients with AF diagnosed with hypertension (hazard ratio [HR] 2.2-2.9), myocardial infarction (HR 2.9-3.9), heart failure (HR 1.6-1.9), and stroke (HR 2.2-3.8). For those diagnosed with diabetes mellitus, the risk was non-significantly increased by 1.2-1.4. Females had a 1.8-fold (95% confidence interval [CI] 1.5-2.3) fold increased risk of thromboembolectomy as compared with men. The risk reduction for systemic embolism with new OACs as compared with warfarin in patients with AF is similar to that seen with warfarin (odds ratio 0.79, 95% CI 0.38-1.64).

CONCLUSIONS

Age, female sex, AF, hypertension, diabetes, myocardial infarction, heart failure and stroke are most common risk factors for thromboembolectomy of the upper limb. The availability of new OACs holds promise for reducing the risk of systemic thromboembolism, but specific data are still limited.

Atrial fibrillation and upper limb thromboembolectomy: a national cohort study

BACKGROUND

The risk factors associated with, and the incidence of systemic embolism in patients with atrial fibrillation (AF) are poorly understood.

OBJECTIVES

We studied the association between AF and upper limb thromboembolectomy involving brachial, ulnar or radial artery in a national cohort study that included all individuals aged 40-99 years with incident AF.

METHODS

Data were retrieved from the Danish National Vascular Registry, the National Registry of Patients, the Danish Civil Registration System and Statistics Denmark.

RESULTS

In total, 131,476 patients (68,042 men and 63,434 women) with AF without previous thromboembolectomy in the upper limb were registered. In the study cohort, 130 men underwent upper limb thromboembolectomy over 220,890 person-years of observation, whilst 275 women underwent thromboembolectomy over 197,777 patient-years. The incidence per 100,000 person-years was 58.9 (95% CI, 49.2-69.8) for men and 139.1 (95% CI, 123.1-156.5) for women. The relative risk of thromboembolectomy among patients with AF compared to the background population was 7.5 (95% CI, 6.3-8.9) for men, and 9.3 (95% CI, 8.3-10.5) for women. Women with AF had a relative thromboembolectomy risk of 1.8 (95% CI, 1.5-2.3) compared to men with AF. Among patients with AF, history of hypertension (HR 2.2-2.9), myocardial infarction (HR 2.9-3.9), heart failure (HR 1.6-1.9) and stroke (HR 2.2-3.8) were significantly associated with increased risk of thromboembolectomy in both men and women.

CONCLUSIONS

AF substantially increases the risk of upper limb thromboembolectomy. This risk is higher with increasing age, female gender, and associated with hypertension, myocardial infarction, heart failure and stroke.

Upper-limb thrombo-embolectomy: national cohort study in Denmark

OBJECTIVES

We investigated the incidence of thrombo-embolectomy in upper-limb and prognosis with respect to arm amputation, stroke and death.

METHODS

We performed a national cohort study of individuals, aged 40-99 years, and undergoing first-time thrombo-embolectomy in the brachial, ulnar or radial artery in Denmark from 1990 to 2002. The data were retrieved from the National Vascular Registry and from the National Registry of Patients and the Civil Registration System. Patients were followed until 2006 to ascertain the occurrence of amputation and stroke and until 2007 with respect to death.

RESULTS

In total, 1377 incident cases of thrombo-embolectomy were registered, comprising 504 (36.6%) males with a mean age of 72.0 (standard deviation (SD) 12.4) years and 873 (63.4%) females with a mean age of 77.2 (SD 11.7) years. Incidence was 3.3 (95% confidence interval (CI): 3.1-3.7) for males and 5.2 (95% CI: 4.9-5.6) for females per 100000 person-years. After thrombo-embolectomy, upper-limb amputation was performed in 11 (incidence 2.2%; 95% CI: 1.2-3.4) males and 31 (3.6%; 95% CI: 2.5-4.9) females. Age- and sex-specific risk of stroke was 2-16 times higher, and risk of death 3-11 times higher, than in the general population.

CONCLUSIONS

Upper-limb thrombo-embolectomy is associated with an increased risk of limb amputation, stroke and death.

Optimalization of the detection of NAD dependent Pasteurellaceae from the respiratory tract of slaughterhouse pigs

NAD dependent members of the family Pasteurellaceae were cultured from the nasal cavity, surface and cut surface of the tonsils, and from the apical and caudal lobes of the lungs of 303 slaughterhouse pigs from 5 different herds in order to obtain information on the ecology of these bacteria. The specimens were plated on two different selective agar media using a special dilution technique that resulted in a good separation of individual colonies. Bacteriological results were compared with serological and pathological findings. The bacteriological examination demonstrated that NAD dependent Pasteurellaceae belonging to the taxa previously described could be isolated from the surface and cut surface of the tonsils, and from lungs with and without gross pathologic lesions. Haemophilus parasuis was detected mainly from the nasal cavity, and Actinobacillus pleuropneumoniae mainly from the surface and cut surface of the tonsils (42%). From two herds, 19% and 24% respectively of the animals without antibodies against A. pleuropneumoniae serotypes 1 and 2 harboured the bacteria mainly in the tonsils. This may reflect a very recent infection or may suggest that A. pleuropneumoniae can colonize the tonsils without inducing a serologic reaction. Serological and bacteriological evidence of more than one serotype in the same herd indicates that natural infection with one serotype does not necessarily protect against another.

Clonal analysis of the Actinobacillus pleuropneumoniae population in a geographically restricted area by multilocus enzyme electrophoresis

The genetic diversity among 250 isolates of Actinobacillus pleuropneumoniae from lungs of pigs with pleuropneumonia and from tonsils of apparently healthy pigs at slaughter was estimated by multilocus enzyme electrophoresis. The Danish strains were derived from both specific-pathogen-free and conventional herds. Sixty-six percent of the isolates belonged to three electrophoretic types (ETs) of a total of 37 ETs detected. While five biotype 2 isolates constituted a separate ET closely related to biotype 1 isolates, the type strain of the species (Shope 4074) belonged to its own ET, with a genetic distance of 0.30 from its nearest neighbor. Isolates of serotypes traditionally considered to have less pathogenic potential (serotypes 6, 10, and 12) from herds with acute outbreaks of pleuropneumonia belonged to the same ETs as isolates from apparently healthy pigs, suggesting that factors such as cross immunity and management may lead to divergent clinical results. Isolates from four herds harboring more than one serotype showed distinct profiles between the serotypes, indicating no or only limited chromosomal recombination among clones. Isolates from tonsils belonged to the same ET as isolates from lungs. The same ET was isolated from widely different parts of the world. Evidence from this study indicates that multilocus enzyme electrophoresis may be a valuable tool for the epidemiological analysis of A. pleuropneumoniae.