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1.
This SAEM position paper clarifies the role of emergency medicine in health care delivery. It builds upon the working definition of emergency medicine developed by the American College of Emergency Physicians in 1994 by describing the health care role of emergency physicians (EPs). EPs are first-contact providers who care for all patients regardless of age, gender, time of presentation, or ability to pay. They remain the only continuously accessible specialty for patients seeking help and solace in the health care system. They are an essential link in the health care continuum between primary care physicians, specialists, the out-of-hospital system, the patient, inpatient services, and communication services. The EP's role is in organizing and monitoring the emergency care delivery system. Part of this role is to better align the health care provider training and ability with the specific medical needs of a patient. The emergency health care system remains the essential medical safety net for all individuals needing care in this country.  相似文献   
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Addressed herein, we reported the fabrication of the graphene oxide (GO) supported monodispersed ruthenium–platinum–nickel (RuPtNi) nanomaterials (3.40 ± 0.32 nm) to be utilized as a catalyst in the process of dimethylamine borane (DMAB) dehydrogenation. The nanoparticles were fabricated through the ultrasonication method by co-reducing the Ru3+, Pt2+ and Ni2+ cations and then the nanomaterials were characterized by X-ray diffraction (XRD), Raman spectroscopy, transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM), electron energy loss spectroscopy (EELS), inductively coupled plasma optical emission spectrometry (ICP-OES), and X-ray photoelectron spectroscopy (XPS). The fabricated nanomaterials showed outstanding efficiency and remarkable reusability in addition to their record catalytic activity at low temperatures and with extreme low concentrations. They had a significantly high turnover frequency (TOF) (727 h?1) and low activation energy (Ea) (49.43 ± 2 kJ mol?1) for DMAB dehydrocoupling. To the best of our knowledge, RuPtNi@GO NPs become a very promising candidate as the best catalyst ever.  相似文献   
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In this study, the functional monomers, N‐methacryloyl‐l ‐aspartic acid and N‐methacryloyl‐l ‐cysteine were synthesized through a reaction between appropriate amino acids and methacryloyl chloride. Then, Pb(II) or Cd(II) ion‐imprinted 2‐hydroxyethyl methacrylate based cryogels were prepared by free radical polymerization method under partially frozen conditions. Following the characterization of matrices, adsorption of heavy metal ions was examined in batch mode from aqueous solution considering several parameters affecting the adsorption performance. The actual adsorption capacities were 44.5, 65.3, and 86.7 mg/g for Cd‐1, Cd‐2, and Cd‐3 cryogels meanwhile those were 41.9, 86.3, and 122.7 mg/g for Pb‐1, Pb‐2, and Pb‐3 cryogels, respectively at optimum pH: 5.5. By increasing temperature, adsorption capabilities of both cryogels were inhibited because of the electrostatic nature of coordinated covalent bonds and collapsing of coordination spheres. The adsorption process was very fast, the equilibrium adsorption was achieved in about 60 min, which was directly related to macroporous structure and interconnected flow‐channels of cryogels. Kinetics and adsorption isotherms were also studied. Langmuir isotherms and pseudo‐second order kinetic model were well suited to adsorption data, which also indicated that the process occurred without any diffusion restrictions or steric hindrances. Finally, the competitive adsorption studies were performed using multi‐ion containing synthetic wastewater to show whether the cryogels developed are suitable for specific heavy metal recycling or not. © 2015 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2016 , 133, 43095.  相似文献   
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Blast induced ground vibrations generated by explosives in tunnel construction may cause structural damages in or close to urban areas. Therefore, the aim in blasting must be to suppress the vibration effects and mitigate the possible hazard on structures. But the psychological character of human response to vibrations involves highly subjective attitudes about what kind of environment is “acceptable” even if no structural damage is occurred. Therefore, we utilize the method of cautious blasting for half-faces that is environmentally friendly, and easy to utilize for tunnel construction. Small charges in this method are detonated sequentially to produce minimum side effects. This method is tested in a tunnel construction in Istanbul with numerous experimental shots. In these experiments, the duration and also quantity of explosives are carefully controlled. Regarding human response, better results are obtained with short durations (about 300 ms) compared to long durations (9000 or 480 ms). The quantity of maximum co-operating explosive charge decreases from 3.088 to 1.744 kg while the vibration levels defined as peak particle velocity (PPV) become more tolerable around 300 ms shot durations.  相似文献   
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Microbial coal liquefaction/solubilization of three low-rank Turkish coals (Bursa-Kestelek, Kütahya-Seyitömer and Mu?la-Yata?an lignite) was attempted by using a white-rot fungus (Phanerochaete chrysosporium DSM No. 6909); chemical compositions of the products were investigated. The lignite samples were oxidized by nitric acid under moderate conditions and then oxidized samples were placed on the agar medium of Phanerochaete chrysosporium. FTIR spectra of raw lignites, oxidized lignites and liquid products were recorded, and the acetone-soluble fractions of these samples were identified by GC-MS technique. Results show that the fungus affects the nitro and carboxyl/carbonyl groups in oxidized lignite sample, the liquid products obtained by microbial effects are the mixture of water-soluble compounds, and show limited organic solubility.  相似文献   
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This paper reports on the use of Antimony (Sb) polymer film to generate stable Q-switching pulses in Erbium-doped fiber laser (EDFL) cavity. The SA is fabricated by coating a thin layer of Sb on a polyvinyl alcohol (PVA) film through physical vapour deposition (PVD) process. A 1 × 1 mm area of the film SA is cut and integrated into between two fiber ferrules inside the laser cavity for intra-cavity loss modulation. Self-starting and stable Q-switched pulses are obtained within a pump power range from 60 to 142 mW. Within this range, the repetition rate increases from 70.82 to 98.04 kHz, while pulse width decreases from 7.42 to 5.36 μs. The fundamental frequency signal-to-noise ratio of the pulse signal is 74 dB, which indicates the excellent stability of the pulses. The maximum output power and pulse energy are 8.45 mW and 86.19 nJ, respectively. Our demonstration shows that Sb film SA capable of generating stable pulses train operating at 1.55-micron region.  相似文献   
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The aim of this study was to prepare magnetic beads that could be used for the removal of heavy‐metal ions from synthetic solutions. Magnetic poly(ethylene glycol dimethacrylate–1‐vinyl‐1,2,4‐triazole) [m‐poly(EGDMA–VTAZ)] beads were produced by suspension polymerization in the presence of a magnetite Fe3O4 nanopowder. The specific surface area of the m‐poly(EGDMA–VTAZ) beads was 74.8 m2/g with a diameter range of 150–200 μm, and the swelling ratio was 84%. The average Fe3O4 content of the resulting m‐poly(EGDMA–VTAZ) beads was 14.8%. The maximum binding capacities of the m‐poly(EGDMA–VTAZ) beads from aquous solution were 284.3 mg/g for Hg2+, 193.8 mg/g for Pb2+, 151.5 mg/g for Cu2+, 128.1 mg/g for Cd2+, and 99.4 mg/g for Zn2+. The affinity order on a mass basis was Hg2+ > Pb2+ > Cu2+ > Cd2+> Zn2+. The binding capacities from synthetic waste water were 178.1 mg/g for Hg2+, 132.4 mg/g for Pb2+, 83.5 mg/g for Cu2+, 54.1 mg/g for Cd2+, and 32.4 mg/g for Zn2+. The magnetic beads could be regenerated (up to ca. 97%) by a treatment with 0.1M HNO3. These features make m‐poly(EGDMA–VTAZ) beads potential supports for heavy‐metal removal under a magnetic field. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009  相似文献   
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Periphytic algal assemblages, comprising bacillariophytes, cyanophytes and chlorophytes of standing dead trees in Lake Kenyir, a tropical drowned forest reservoir, were studied during 1995. A total of 317 algal taxa were identified in this study. The monthly floral mean species richness and cell count data demonstrated significant temporal differences between the months, in one-way anova (P < 0.05). Both redundancy analysis and cluster analysis on monthly blue-green abundance and diatom assemblages exhibited conspicuous groupings among the months, with underpinning seasonal differences. The responses were not similar, however, between the upstream and downstream ends of the lake. The grouping or clustering of months can be generalized as: (i) November, December and January as the monsoonal months; (ii) February, March, April and May as the transitional months; and (iii) June to October as the dry months. Based on stepwise multiple regression with forward selection, alkalinity and dissolved oxygen concentration were significant environmental predictors at the downstream dam sampling site, and reactive silica, electrical conductivity, Secchi depth transparency and sunshine hours were significant predicators at the upstream riverine sampling site, based on Monte Carlo tests. Being a ploymictic, mesotrophic lake, the limnology and temporal changes for Lake Kenyir appears to be complex and driven by monsoons, as evidenced from the temporal changes in its periphytic algae communities, particularly the diatom assemblages. The downstream sampling site (site 1) at the dam, in the main basin and deeper zone of the lake, the seasonal amplitude was likely complex because of thermocline formation and stratification processes. In contrast, the upstream sampling site in the Petang River (site 2) exhibited a clearer distinction between the dry and monsoon months, based on its cyanophyte and diatom floral assemblages. These study results are pertinent for lake management, especially for developing biomonitoring programmes or lake productivity studies, as well as for climate change studies, within the context of tropical lake ecology.  相似文献   
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