Coupled mechanical creep and bio-compression and residual settlement in a multi-stage municipal solid waste landfill, Korea.

Based on a field monitored dataset measured at landfill #1 over 21 years, the characteristics of settlement coupling mechanical creep and biodegradation and the residual settlement were analyzed. Since landfill #1 is a multi-stage municipal solid waste (MSW) landfill where dykes are constructed after landfilling for subsequent waste fills, the waste decomposition between the lower and upper lifts was quite different and it is difficult to discern between the mechanical creep and bio-compression on the settlement curves. The compression ratio coupled with mechanical creep and bio-compression and the residual compression ratio were determined as 0.233 and 0.068, respectively. This implies that biodegradation was gradually and significantly reduced in the MSW settlement behavior after the residual settlement began. The starting date of residual settlement was distributed between 3821 and 5402 days from the initial date of landfilling. The settlement coupling mechanical creep and biodegradation (SMB) was 2.9 times larger than the residual settlement (SRS), and the duration of SMB is determined to be 0.3 times that of SRS. In addition, the remnant methane gas content existed in the landfill gas, and low-level biodegradation was still generated in the waste buried for more than 10 years after the residual settlement began.

The Effect of Direct Communication between Emergency Physicians and Interventional Cardiologists on Door to Balloon Times in STEMI

We developed an institutional protocol mandating emergency physicians to contact the interventional cardiologist directly in all cases of ST-segment elevation myocardial infarction (STEMI) and hypothesized that this would reduce door-to-balloontimes (DTBT). From January 2004 to July 2006, 208 patients with STEMI were treated with primary percutaneous coronary intervention (PCI). A total of 144 patients were treated before implementing the new protocol ("before") and 64 patients were treated after the implementation ("after"). The DTBT was significantly reduced from 148+/-101 min to 108+/-56 min (p<0.05). While only 25% of the "before'' patients received PCI within 90 min after arrival, 50% of the "after'' patients received PCI within 90 min (p<0.05). There were no significant differences between two groups in other outcomes (postprocedural TIMI flow, mortality, subsequent stroke, heart failure, shock, reinfarction, length of stay in intensive care unit, and the total hospital length of stay). In conclusion, mandating emergency physicians to directly notify interventional cardiologists of all STEMI patients reduces DTBT.