BackgroundProvision of consumer information and patient education are considered an essential part of chronic diseasemanagement programmes developed for patients with heart failure....Full Text Available
Abstract An increase in chronic disease prevalence is contributing to health care cost growth and decreased quality of life in industrialized nations worldwide. Inadequate management of chronic diseases is a leading cause of hospitalizations and, thus, avoidable expenditures. In this study, we evaluated the impact of nurse-delivered care calls, the primary intervention of a proactive chronic care management (CCM) program, in a population aged 65 and older in Germany. In this analysis, hospital admission rates were evaluated among program enrollees who were diagnosed with diabetes, heart failure, coronary heart disease, or chronic obstructive pulmonary disease. The Intervention group comprised those members who participated in care calls (n?=?13,486), whereas the Comparison group included e...
Background: Intestinal failure (IF) is the dependence upon parenteral nutrition to maintain minimal energy requirements for growth and development. It may occur secondary to a loss of bowel length, disorders of motility, or both. Short bowel syndrome (SBS) is a malabsorptive state resulting from surgical resection, congenital defect, or diseases associated with loss of absorptive surface area. A particularly vexing problem is associated with whole bowel and/or segmental intestinal dysmotility. Motility disorders within the context of SBS and IF may relate to rapid intestinal transit secondary to loss of intestinal length, dysmotility associated with loss or poor antegrade peristalsis, or gastroparesis. Therapy may be classified into medical (prokinetic and antidiarrheal agents) and surgica...
In the years 2004 and 2005, Korea became a prospective nation noteworthy in the world through the epochal development of genetic engineering in our country. Obstinate or incurable diseases were expected to be healed in a few years by a Korean geneticist. So many worldwide patients of obstinate or incurable diseases took notice of the research outcomes and organized an aid association to collect supporting funds. World renowned journals such as 'Nature' and 'Science' published Dr. Hwang's theses. A long and distant way remedy to obstinate diseases seemed to be closer at hand so early. However, a stem cell fraud case emerged throughout the world in late 2005, the pride of the Korean people was destroyed. With this as a momentum, voices of self reflection by scientific circles were raised. The purpose of this study is not in finding the truth of the stem cell research but to propose an effective management ...
Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with major morbidity and mortality. Therapeutic management is difficult, due to lack of conclusive data and individual disease...Full Text Available
Chronic heart failure (HF) is a cardiovascular disease of cardinal importance because of several factors: a) an increasing occurrence due to the aging of the population, primary and secondary prevention...Full Text Available
A mechanistic understanding of fracture in human bone is critical to predicting fracture risk associated with age and disease. Despite extensive work, a mechanistic framework for describing how the underlying microstructure affects the failure mode in bone is lacking.
There is limited information about the true incidence of acute renal failure (ARF). Most studies could not quantify disease frequency in the general population as they are hospital-based and...Full Text Available
Abstract Background: Premature ovarian failure is diagnosed with a picture of amenorrhea, elevated follicle-stimulating hormone (FSH), and age under 40 years. Twenty percent (20%) of patients with premature ovarian failure have a concomitant autoimmune disease. Cases of premature ovarian failure associated with Sj?gren syndrome have been reported in the literature. Patient and method: We report a case of a 42-year-old white woman with Sj?gren syndrome and premature ovarian failure who underwent a reversal of her premature ovarian failure and restoration of normal menses using an elimination diet protocol. The patient was diagnosed with her rheumatological condition in 2005 and started on disease-modifying antirheumatoid drugs, which were taken intermittently due to a concern over medicatio...
Anxiety may cause adverse outcomes through physiologic pathways in patients with cardiac disease. The purpose of this dissertation was to investigate anxiety and its correlates in persons with acute myocardial infarction (AMI) and heart failure (HF). The ...
Percutaneous renal biopsy (PRB) is a safe and effective tool in the diagnosis and management of renal disease. It is the gold standard for evaluating renal parenchymal disease. It is both useful for...Full Text Available
Stabbing paroxysmal pain due to neurological disease can often be controlled by anticonvulsants, whereas steady burning pain is often responsive to tricyclic antidepressants, and to neuroleptics. Overuse...Full Text Available
In the last two decades rectal cancer has changed from a surgically manageddisease into a multidisciplinary treatment model resulting in considerable improvements in the survival and outcome. This...Full Text Available
Ascochyta blight causes significant yield loss in pulse crops worldwide. Integrated diseasemanagement is essential to take advantage of cultivars with partial resistance to this disease. The most effective practices, established by decades of research, use a combination of disease-free seed, destruction or avoidance of inoculum sources, manipulation of sowing dates, seed and foliar fungicides, and cultivars with improved resistance. An understanding of the pathosystems and the inter-relationship between host, pathogen and the environment is essential to be able to make correct decisions for disease control without compromising the agronomic or economic ideal. For individual pathosystems, some components of the integrated management principles may need to be given greater consideration tha...
Customer Relationship Management (CRM) systems can help organizations manage customer interactions more effectively. Like many new technologies, CRM has been accompanied by vendor hype and stories of implementation failure. Work on critical success factors (CSFs) should encourage more appropriate implementation practice; however many CSF studies conclude with a list of factors but provide little further guidance. In particular, there is a need for stronger theoretical models of the entire CRM innovation process which can be used by managers to understand better the underlying causes of success and failure. This paper adopts a novel approach to this problem by firstly developing a conceptual model of CRM innovation and then converting this model into a dynamic simulation model. Some early s...
Acquired cystic kidney disease (ACKD), also known as acquired renal cystic disease (ARCD,) occurs in patients who are on dialysis for end-stage renal disease. It is generally accepted that ACKD develops as a consequence of sustained uremia and can first manifest even before dialysis is initiated while the patient is still in chronic renal failure. The role of immune suppression, particularly in transplant recipients, in the development of ACKD, is still under investigation. The prevalence of ACKD is directly related to the duration of dialysis and the risk of cancer is directly related to the presence of cysts. Herein we review the current understanding of the pathophysiology and imaging implications of ACKD. (orig.)
BackgroundIsoproterenol-induced cardiac hypertrophy in mice has been used in a number of studies to model human cardiac disease. In this study, we compared the transcriptional response...Full Text Available
BackgroundGene expression profiling and the analysis of protein-protein interaction (PPI) networks may support the identification of disease bio-markers and potential drug targets....Full Text Available
Myocarditis, often initiated by viral infection, may progress to autoimmune inflammatory heart disease, dilated cardiomyopathy and heart failure. Although cardiac myosin is a dominant autoantigen...Full Text Available
Sugarcane rusts, brown (caused by Puccinia melanocephala) and orange (caused by P. kuehnii), are agronomically important diseases in Florida. Cultivar resistance is the best means of managing these diseases. Unfortunately, natural infection of brown rust is not always efficient in determining resist...
Forty-four patients with histologically proven Hodgkin's disease underwent initial treatment with extended-field radiation therapy. Nineteen of these patients also received combination chemotherapy....Full Text Available
Despite the recent success of genome-wide association studies (GWASs) in identifying loci consistently associated with coronary artery disease (CAD), a large proportion of the genetic components of...Full Text Available
Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic importance...Full Text Available
Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services...Full Text Available
Background. Erythropoietin deficiency and anemia occur in Chronic Kidney Disease (CKD) and may be treated with Erythropoietin Stimulating Agents (ESAs). The optimal hemoglobin,...Full Text Available
There has been a steady increase in the number of revision total knee arthroplasties being performed in the United States. Hinge knee prostheses are used predominantly in complex primary or revision arthroplasties, often as salvage procedures. Significant improvement of the articulation between the rotating hinge mechanism and tibial component has decreased the stresses that contributed to earlier failures in previous generation designs. Two cases of fracture of the tibial metal post in the rotating hinge of a revision total knee arthroplasty were evaluated and treated at our institution within a 1-month period. We present our experience with this construct failure and subsequent patient management.
Disorders of the adrenal gland are rare and complex, with many potential pitfalls in their management. An understanding of embryology, anatomy, physiology and biochemistry is crucial. Surgical treatment may be required for syndromes of hormonal excess and/or suspicion of neoplasia.
BackgroundManagement of benign tracheal stenosis (BTS) varies with the type and extent of the disease and influenced by the patient's age and general health status, hence we sought...Full Text Available
ObjectivesThis studys examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the...Full Text Available
Evaluating the systolic function of the left ventricle (LV) is important in the hemodynamic management of the critically ill patients with circulatory failure. Echocardiography is considered the standard...Full Text Available
The article maps the risk managementfailures within Anglo Irish Bank, showing that, when banks are systemic in nature, poor internal corporate governance within a Minsky credit cycle can lead to destabilising macroeconomic conditions, which may prolong the effects of a credit-induced downturn. The article highlights a failure of management at Anglo Irish Bank to establish and measure firm-level risks and develop appropriate internal controls to support a culture of prudent credit management. We propose the adoption of a novel supervisory architecture based on the meta-risk regulatory philosophy, which is designed to strengthen risk management practices at banks.
Proper use of quality assurance will provide the basis for an effective management control system for nuclear waste management programs. Control is essential for achieving successful programs free from costly losses and failures and for assuring the public and regulators that the environment and health and safety are being protected. The essence of quality assurance is the conscientious use of planned and systematic actions, based on selecting and applying appropriate requirements from an established quality assurance standard. Developing a quality assurance program consists of using knowledge of the technical and managerial aspects of a project to identify and evaluate risks of loss and failure and then to select appropriate quality assurance requirements that will minimize the risks. Those requirements are integrated into the project planning documents and are carried out as specific actions during ...
This report reviews system safety analysis methods and examines their application to nuclear waste management systems. The safety analysis methods examined include expert opinion, maximum credible accident approach, design basis accidents approach, hazard indices, preliminary hazards analysis, failure modes and effects analysis, fault trees, event trees, cause-consequence diagrams, G0 methodology, Markov modeling, and a general category of consequence analysis models. Previous and ongoing studies on the safety of waste management systems are discussed along with their limitations and potential improvements. The major safety methods and waste management safety related studies are surveyed. This survey provides information on what safety methods are available, what waste management safety areas have been analyzed, and what are potential areas for future study.
Marburg virus belongs to the genus Marburgvirus in the family Filoviridae and causes a severe hemorrhagic fever, known as Marburg hemorrhagic fever (MHF), in both humans and nonhuman primates. Similar to the more widely known Ebola hemorrhagic fever, MHF is characterized by systemic viral replication, immunosuppression and abnormal inflammatory responses. These pathological features of the disease contribute to a number of systemic dysfunctions including hemorrhages, edema, coagulation abnormalities and, ultimately, multiorgan failure and shock, often resulting in death. A detailed understanding of the pathological processes that lead to this devastating disease remains elusive, a fact that contributes to the lack of licensed vaccines or effective therapeutics. This article will review the...
Objective To establish current practice in the use of Read codes for diabetes.Design Cross sectional study.Setting 17 practices in the Battersea...Full Text Available
The study involved 110 randomly selected dairy farms located in the Ontario, Canada counties of Bruce, Grey, Huron, Oxford, Perth, Waterloo and Wellington. Herds were classified as "intensive" and "extensive"....Full Text Available
BACKGROUND: Each component of metabolic syndrome (MS) conveys increased cardiovascular disease risk, but as a combination they become much more powerful. Vigorous early management of the syndrome may...Full Text Available
Although management of warfarin is challenging for patients with chronic kidney disease (CKD), no prospective studies have compared response to warfarin among patients with minimal, moderate, and severe...Full Text Available
Tracheobronchial balloon dilation and stent placement have been well used in the treatment of patients with benign and/or malignant diseases. Balloon dilation is the first option in the treatment of...Full Text Available
Sustainable management of toilet waste must prevent disease transmission but allow reuse of plant nutrients. Inactivation of uterus-derived Ascaris suum eggs was studied in relation...Full Text Available
SummaryConvection-enhanced delivery (CED) of substances within the human brain is becoming a more frequent experimental treatment option in the management of brain tumors, and...Full Text Available
Of 868 patients admitted with pancreatitis between 1971 and 1976, coexisting hyperbilirubinemia was noted in 125 (14%). The patient population was primarily composed of alcoholics (84%) with chronic...Full Text Available
... different personal wellness goals for you. HIV Health Management With a good medical team and a desire to reach wellness goals , people with HIV can have a virtually normal lifespan. Take the HIV Wellness Quiz Test your knowledge and find out where you need to learn ...
At least implicitly, most clinical decisions represent an integration of disease and treatment-based risk assessments. Often, as is the case with acute coronary syndrome (ACS), these decisions need...Full Text Available
Chemoprevention strategies to prevent the development of lung cancer in at-risk individuals are a key component in diseasemanagement. In addition to being highly effective, an ideal chemopreventive...Full Text Available
BackgroundA combination of levodopa (L-DOPA) and carbidopa is the most commonly-used treatment for symptom management in Parkinson's disease. Studies have shown that concomitant...Full Text Available
BackgroundOsteoporosis affects over 200 million people worldwide, and represents a significant cost burden. Although guidelines are available for best practice in osteoporosis, evidence...Full Text Available
Detecting plant health conditions plays a key role in farm pest management and crop protection. In this study, measurement of hyperspectral leaf reflectance in rice crop (Oryzasativa...Full Text Available
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a widely used diagnostic and therapeutic modality in the management of biliary and pancreatic disease. Some of the complications of the procedure,...Full Text Available
The objective of this work group was to identify obstacles to the development of better risk management practices and performance standards in the pipeline industry. An outline of developments in pipeline risk assesment management was presented, including an update of the Risk Based Design and Assessment annex and other CSA Z662 code developments. It was suggested that progress in risk management require that acceptable levels of risk and reliability need to be defined. Environmental and safety consequence analysis was recommended, as well as failure frequency estimation and assessment of distribution systems. Guidelines for Integrity Management Programs (IMPs) were reviewed. It was noted that CSA Z662 will become mandatory for sour gas in 2005 and may become mandatory for all onshore pipelines in 2007. Operating company procedures in relation to hazards with significant ...
Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management.
Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management. (orig.).
Purpose: To evaluate the effect of low-dose radiation therapy and surgery on local control in patients with Ewing's Sarcoma. Materials and Methods: Between 1979 and 1995 24 patients (ages 4-47) with Ewing's sarcoma were treated with combined modality therapy that included multi agent chemotherapy, surgical resection, and radiation therapy. Twelve patients had metastatic disease at the time of presentation (pleura = 3, lung = 5, bone 4). Tumor location was central in 16 and peripheral in 8. Multi agent chemotherapy consisted of vincristine/actinomycin D/cyclophosphamide/doxorubicin in 19. The same agents with the addition of ifosfamide and etoposide were given in 5. The extent of resection was considered to be radical in 14 and of the 16 patients who received preoperative chemotherapy, 5 were found to have a pathologic complete response. All patients with lung metastases at diagnosis received whole-lung irradiation to 1400 cGy in 10 fractions. Radiation therapy to ...
Background:Timely access to publicly funded health services is a priority issue across the healthcare continuum in Canada. The purpose of this study was to examine wait list management...Full Text Available
Often measures of protection and restoration of reinforced concrete structures are not taken until damage occurs which affects power plant operation. These failures can be avoided by predictive civil engineering maintenance and repair. The consequent application and implementation of a life-time management system for power plant buildings is being suggested. (orig.)
Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the ...
Objectives: Intra-operative cisplatin-based intra-peritoneal chemotherapy (IPC) may alter renal function in patients with advanced ovarian cancer. The aim of this study was to describe postoperative alteration of renal function after cisplatin-based IPC and to identify risk factors for moderate to severe acute renal failure. Study design: This prospective observational study was carried out on 77 consecutive patients who underwent cisplatin-based IPC procedures, with (n=23) or without (n=54) intra-peritoneal epinephrine, for advanced ovarian cancer. Postoperative renal function was assessed using serial serum creatinine measurements and was based on serum creatinine changes from pre-operative values, according to the risk, injury, failure, loss, end-stage kidney disease (RIFLE) classificat...
This article describes the design and implementation of an online diabetes self-management intervention for a sample of inner-city African Americans with diabetes. Study participants were randomly assigned to the treatment (26) and control (21) conditions. The results indicate that treatment group participants were more likely to achieve positive outcomes in terms of lowered hemoglobin A1c and body mass index measurements than were control group members. These findings support the development of telehealth interventions to promote effective chronic diseasemanagement in medically underserved communities.
Since the mid-1990s, nuclear power plants in Korea have experienced wall thinning, leaks, and ruptures of secondary side piping caused by flow-accelerated corrosion (FAC). The pipe failures have increased as operating time progresses. In order to prevent the FAC-induced pipe failures and to develop an effective FAC management strategy, KEPRI and KOPEC have conducted a study for developing systematic FAC management technology for secondary side piping of all Korean nuclear power plants. As a part of the study, FAC analyses were performed using the CHECWORKS code. The analysis results were used to select components for inspection and to determine inspection intervals on each nuclear power plant. This paper describes the introduction of the FAC analysis method and the wall thinning trend analysis results by reactor type, system, and water treatment amine. This paper also represents the site application ...
The risk of cyber attacks on process control networks (PCN) is receiving significant attention due to the potentially catastrophic extent to which PCN failures can damage the infrastructures and commodity flows that they support. Risk management addresses the coupled problems of (1) reducing the likelihood that cyber attacks would succeed in disrupting PCN operation and (2) reducing the severity of consequences in the event of PCN failure or manipulation. The Network Security Risk Model (NSRM) developed in this article provides a means of evaluating the efficacy of candidate risk management policies by modeling the baseline risk and assessing expectations of risk after the implementation of candidate measures. Where existing risk models fall short of providing adequate insight into the efficacy of candidate risk management policies due to shortcomings in their structure or ...
Background 2009 pandemic influenza A(H1N1) has led to a global increase in severe respiratory illness. Little is known about kidney outcomes and dialytic requirements in critically ill patients infected with pandemic H1N1. Study Design Prospective observational study. Setting & Participants 50 patients with pandemic H1N1 admitted to any of 7 intensive care units in Manitoba, Canada, were prospectively followed. Outcome & Measurements Outcomes were kidney injury and kidney failure defined using RIFLE (risk, injury, failure, loss, end-stage disease) criteria or need for dialysis therapy. Results The pandemic H1N1 group was composed of 50 critically ill patients with pandemic H1N1 with severe respiratory syndrome (47 confirmed cases, 3 probable). Kidney injury, kidney failure, a...
Soluble TWEAK is a member of the TNF-alpha family of cytokines that has been shown to predict mortality in patients with heart failure. Pulmonary artery hypertension is a devastating disease, in which right ventricular function has been shown to be the major determinant of prognosis. In this hypothesis-generating study, we sought to evaluate the potential usefulness of sTWEAK in the prediction of disease severity in patients with pulmonary artery hypertension. We therefore conducted a retrospective analysis of sTWEAK serum levels in 95 stable patients with PAH. For all patients data on hemodynamic parameters, biomarkers and functional exercise tests were available. Compared to controls, patients with PAH showed significantly decreased levels of sTWEAK [median 314?pg/ml (interquartile range...
Since the integrity of the containment penetrations was confirmed under accident management (AM) conditions in the former test, failure criteria tests and aerosol trapping tests were carried out using low-voltage modules and flange gaskets of an actual plant under severe accident (SA) conditions, without AM. The safety margin for failure temperature of the penetrations and the credit for fission product (FP) aerosol trapping effect along the leakage paths of the degraded penetrations were evaluated in the present tests. Failure temperature of the penetrations ranged from 270 to 300degC for low-voltage modules and 300 to 350degC for flange gaskets under 0.4 to 1.0 MPa conditions. Pressure dependency on failure temperature was small. This means that the safety margin of failure temperature under AM condition is more than 70degC. By introducing a equivalent leak ...
Transforming growth factor beta (TGF-@b) has a crucial role in the differentiation of ectodermal cells to neural or epidermal precursors. TGF-@b and bone morphogenetic protein molecules (BMPs) are involved in many developmental processes, including cell proliferation and differentiation, apoptosis, mitotic arrest and intercellular interactions during morphogenesis. Additionally, the failure of central thymic tolerance mechanisms, leading to T cells with a skewed autoreactive response, is being described as a contributor in inflammatory processes in autoimmune diseases such as multiple sclerosis. Since TGF-@b and BMP proteins are crucial for the development of the neural system and the thymus, as well as for the differentiation of T cells, it is essential to further investigate their role i...
Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree ...
Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died ...
A ground-breaking study was recently completed as part of the Seabrook Level 2 PRA update. This study updates the post-core damage phenomena to be consistent with the most recent information and includes accident management activities that should be modeled in the Level 2 PRA. Overall, the result is a Level 2 PRA that fully meets the requirements of the ASME PRA Standard with respect to modeling accident management in the LERF assessment and NRC requirements in Regulatory Guide 1.174 for considering late containment failures. This technical paper deals only with the incorporation of operator actions into the Level 2 PRA based on a comprehensive study of the Seabrook Station accident response procedures and guidance. The paper describes the process used to identify the key operator actions that can influence the Level 2 PRA results and the development of success criteria for these key operator actions. This addresses a key ...
A ground-breaking study was recently completed as part of the Seabrook Level 2 PRA update. This study updates the post-core damage phenomena to be consistent with the most recent information and includes accident management activities that should be modeled in the Level 2 PRA. Overall, the result is a Level 2 PRA that fully meets the requirements of the ASME PRA Standard with respect to modeling accident management in the LERF assessment and NRC requirements in Regulatory Guide 1.174 for considering late containment failures. This technical paper deals only with the incorporation of operator actions into the Level 2 PRA based on a comprehensive study of the Seabrook Station accident response procedures and guidance. The paper describes the process used to identify the key operator actions that can influence the Level 2 PRA results and the development of success criteria for these key operator actions. This addresses a key ...
Twenty-seven histologically confirmed cases of localised Ewing's sarcoma were treated by two different regimes. Radiotherapy alone was used in 13 cases and a combination of chemotherapy and radiotherapy in 14. Single agent chemotherapy (cyclophosphamide) was given sequentially in nine patients and cyclophosphamide and actinomycin-D in five. There is a significant difference in the response to these different regimes. Only 69.2% of patients treated by radiotherapy alone were disease-free, for a median period of 10.4 months and metastases were noticed in 53.8% of cases. The disease-free survival in patients treated by combination therapy (radiotherapy and chemotherapy) was 18.4 months and metastases were seen in only 42.9%. However, no metastases were seen in patients who received cyclophosphamide and actinomycin-D, during a period of 14 months and only one patient showed residual disease. It is concluded that the addition of ...
Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome.
Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet recovery was different for the groups with early and late ...
Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).
Preventing recurrence of surface mining accidents in the coal industry remains a top priority requiring constant vigilance and a substantial commitment from all involved in open pit mining operations. Open pit wall failures, loose rocks rolling down slopes, ground water and stockpiling procedures are common sources of risks in open cut coal operations. This video aims to equip workers with the necessary skills and knowledge to assess and react to the geomechanics hazards in open pit coal operations. Workers need to have the competencies to manage geomechanics hazards to facilitate their own and their workmates' safety. No matter how good the operating systems are, the first line of defence against accidents is the experience, skill and knowledge-based judgment of each individual mine worker. The video covers: Open pit coal mine risk management and geomechanical issues; Terminology, mining cycle, and explanation of ...
DescriptionRoot-knot nematodes (Meloidogyne spp.) are major nematode pests of most tropical crops, making roots less efficient at withdrawing nutrients and water from soil, sometimes causing the total failure of crops grown by resource-poor farmers in Africa. Nematicides are some of the most toxic products used in crop protection, and are inappropriate or too expensive for use on most crops in Africa and there is an urgent need for new methods of nematode management. The fungus Pochonia chlamydosporia is [continued...
Papers are presented under 38 symposia. Subjects included reinforced concrete, protective coatings and linings, cathodic/anodic protection, chemical cleaning of boilers, managing corrosion with plastics, water treatment, HRSG boiler tube failure analysis, corrosion in oil and gas production, corrosion in petroleum refining and gas, processing, pipelines and tanks, high temperature materials, chemical process industry, aerospace equipment, materials technology developments for incinerators and waste fuel-fired processors, materials and corrosion in fossil-fuels conversion and combustion, corrosion in nuclear systems, marine corrosion, building systems, corrosion mechanisms, corrosion inhibitors and corrosion monitoring and measurement.
The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.
Serious complications due to coronary artery fistulae have been described. Most authors recommend early intervention at the time of diagnosis. We present a case of a fistula originating from a dilated left coronary artery and draining into the right atrium, which was diagnosed prenatally by color Doppler echocardiography. During pregnancy, the echocardiographic findings remained unchanged, and there were no signs of heart failure. After birth, the fistula was confirmed by angiography. Additionally, a persistent left superior vena cava draining into the coronary sinus and a very small ventricular septal defect were detected. The fistula was closed successfully by transcatheter coil embolization. At 17 months old the child was in good clinical condition. Prenatal diagnosis of coronary artery fistulae may be possible and may improve perinatal management and outcome. PMID:12047543
Daya Bay Nuclear Power Plant is put into commercial operation in 1994 Until 1996, there are 368 human error events in operating and maintenance area, occupying 39% of total events. These events occurred mainly in the processes of maintenance, test equipment isolation and system on-line, in particular in refuelling and maintenance. The author analyses root causes for human errorievents, which are mainly operator omission or error procedure deficiency; procedure not followed; lack of training; communication failures; work management inadequacy. The protective measures and treatment principle for human error events are also discussed, and several examples applying them are given. Finally, it is put forward that key to prevent human error event lies in the coordination and management, person in charge of work, and good work habits of staffs.
A stochastic linear fractional programming (SLFP) approach is developed for supporting sustainable municipal solid waste management under uncertainty. The SLFP method can solve ratio optimization problems associated with random information, where chance-constrained programming is integrated into a linear fractional programming framework. It has advantages in: (1) comparing objectives of two aspects, (2) reflecting system efficiency, (3) dealing with uncertainty expressed as probability distributions, and (4) providing optimal-ratio solutions under different system-reliability conditions. The method is applied to a case study of waste flow allocation within a municipal solid waste (MSW) management system. The obtained solutions are useful for identifying sustainable MSW management schemes with maximized system efficiency under various constraint-violation risks. The results indicate that SLFP can support in-depth analysis of ...
Multiple myeloma is a highly radiosensitive skeletal malignancy, but bone-seeking radionuclides have not yet found their place in diseasemanagement. We previously reported that the proteasome inhibitor...Full Text Available
This book contains 49 chapters. Some of the titles are: Molecular, Genetic, and Clinical Aspects of the HLA System; The Normal Immune Response; Significance of the ABO Antigen System; The Role of Dialysis in the Management of End-Stage Renal Disease; Access for Dialysis; Patient Selection for Renal Transplantation; The Living Donor in Kidney Transplantation; and Kidney Preservation by Cold Storage.
... Cholesterol High Blood Glucose High Blood Pressure Overweight Physical Activity Small Steps for Your Health Smoking Age, ... blood pressure, unhealthy cholesterol, and high blood glucose. Physical Activity Staying active helps manage your blood glucose, ...
Feline heartworm disease is a very different clinical entity from canine heartworm disease. In cats, the arrival and death of immature heartworms in the pulmonary arteries can cause coughing and dyspnea as early as 3 months postinfection. Adult heartworms suppress the function of pulmonary intravascular macrophages and thus reduce clinical disease in chronic feline heartworm infection. Approximately 80% of asymptomatic cats self-cure. Median survival time for symptomatic cats is 1.5 years, or 4 years if only cats living beyond the day of presentation are considered. Aberrant worm migration is more frequent than it is in dogs, and sudden death can occur with no prior clinical signs. The bacterial endosymbiont Wolbachia likely contributes to the inflammatory pathology of heartworm disease, but its role is not yet fully clear. Unfortunately, the diagnosis, treatment, and management of ...
Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority of primary tumors were centrally located (72%): spine (n = 18), ...
A micro-mechanistic understanding of bone fracture that encompasses how cracks interact with the underlying microstructure and defines their local failure mode is lacking, despite extensive research on the response of bone to a variety of factors like aging, loading, and/or disease. Micro-mechanical models for fracture incorporating such local failure criteria have been widely developed for metallic and ceramic materials systems; however, few such deliberations have been undertaken for the fracture of bone. In fact, although the fracture event in mineralized tissues such as bone is commonly believed to be locally strain controlled, until recently there has been little experimental evidence to support this widely held belief. In the present study, a series of in vitro experiments involving a double-notch bend test geometry are performed in order to shed further light on the nature of the local cracking events that precede ...
Difficulty in recalling the names of people is very common in the early stages of Alzheimer's disease and in mild cognitive impairment (MCI). However, it is not known whether the difficulty in naming people in MCI reflects problems associated with lexical access or with semantic access. The aims of the present study were to investigate semantic and phonological access to proper names by use of a Tip-of-the-tongue (TOT) task in individuals with multidomain amnestic MCI, individuals with amnestic MCI, and healthy controls, as well as to study the relationships between TOT production and performance in a free recall verbal memory test. In the individuals with multidomain amnestic MCI, the main process affected was phonological access; failures in phonological access were related to deficits i...
Purpose To evaluate diseasefailure patterns and overall survival (OS) of women with triple-negative (TN) breast cancer who underwent breast-conserving therapy (BCT) and to understand the relationship of TN tumors with other prognostic factors. Patients and Methods The Surveillance, Epidemiology, and End Results (SEER) registry identified 562 women diagnosed and/or treated with unilateral invasive breast cancer during 2003?2004 at three Emory hospitals. After medical record review, 193 eligible women, with all tumor types, received BCT. Primary endpoints (local, regional, and distant recurrences) and secondary endpoint (OS) were evaluated using chi-square tests and Cox proportional hazards models. Results Of the 193 women, 33 (17.1%) had TN tumors and 160 (82.9%) had non-TN tumors. Patient...
Hsp20, referred to as HspB6, is constitutively expressed in various tissues. Specifically, HspB6 is most highly expressed in different types of muscle including vascular, airway, colonic, bladder, and uterine smooth muscle; cardiac muscle; and skeletal muscle. It can be phosphorylated at Ser-16 by both cAMP- and cGMP-dependent protein kinases (PKA/PKG). Recently, Hsp20 and its phosphorylation have been implicated in multiple physiological and pathophysiological processes including smooth muscle relaxation, platelet aggregation, exercise training, myocardial infarction, atherosclerosis, insulin resistance and Alzheimer's disease. In the heart, key advances have been made in elucidating the significance of Hsp20 in contractile function and cardioprotection over the last decade. This mini-rev...
The aims of this study were to identify risk factors and evaluate the association with clinical outcomes of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI). Data from 2488 consecutive adult patients were analyzed. Patients were classified as having CSA-AKI based on the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria using peak postoperative creatinine in the postoperative intensive care unit (ICU). Multiple stepwise logistic regression analysis was used to identify independent risk factors for CSA-AKI. CSA-AKI occurred in 584 patients (23.5%). CSA-AKI patients had significantly longer aortic cross-clamp and cardiopulmonary bypass times. Furthermore, CSA-AKI patients had higher hospital mortality (5.5% vs 1.5%, PCopyright2...
Acute kidney injury (AKI) is a common complication after allogeneic stem cell transplantation (SCT). Although various risk factors for AKI have been reported, the influence of pretransplant comorbidity on the incidence of AKI has not been well investigated. We performed a retrospective analysis of 207 consecutive patients undergoing myeloablative or nonmyeloablative SCT between 2001 and 2009, using the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) as a representative of pretransplant comorbidities. According to Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, 158 patients (76.3%) developed AKI, and 92 patients (44.4%) developed severe AKI (RIFLE class I or class F) within 100 days after SCT. The cumulative incidence of severe AKI within 1...
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortalit...
Nano-sized silica is a promising material for disease diagnosis, cosmetics and drugs. For the successful application of nano-sized material in bioscience, evaluation of nano-sized material toxicity is important. We previously found that nano-sized silica particles with a diameter of 70nm showed acute liver failure in mice. Here, we performed histological analysis of major organs such as the liver, spleen, lung, kidney, brain and heart in mice, chronically injected with 70-nm silica particles for 4weeks. Histological analysis revealed hepatic microgranulation and splenic megakaryocyte accumulation in these 70-nm silica particles treated mice, while the kidney, lung, brain and heart remained unaffected. Thus, liver and spleen appear to be the major target organs for toxicity by the chronic a...
It is uncertain if downregulation of ?-adrenoceptor signaling pathway is promoted by an enhanced adrenergic tone at an early stage of cardiac disease, or it develops secondary to detrimental local myocardial changes in advanced heart failure. We examined the integrity of ?-adrenoceptor signaling pathway upon chronic infusion of isoproterenol, a ?-adrenoceptor agonist, at a dose producing no structural left ventricular (LV) remodeling and systolic dysfunction. Subcutaneous isoproterenol infusion (400??g?kg?1?h?1 over 16?days) to guinea pigs using osmotic minipumps produced no change in cardiac weights, LV internal dimensions, myocyte cross-sectional area, extent of interstitial fibrosis, and basal contractile function. Isolated, perfused heart preparations from isoproterenol-treated guinea ...
An observational cohort study was conducted to compare the performance of the RIFLE (risk, injury, failure, loss and end-stage kidney disease), AKIN (acute kidney injury network) and conventional graded criteria to identify acute kidney injury (AKI) following SCT and to predict long-term mortality in 141 myeloablative allogeneic SCT (m-allo), 60 non-myeloablative allogeneic SCT (nm-allo) and 48 autologous SCT (auto) cases. The AKIN criteria had less ability to identify patients as having the lowest category, stage 1 (analogous to RIFLE risk): 33% (37%) in m-allo, 23% (32%) in nm-allo and 8.3% (16.7%) in auto. Cox regression showed that categories higher than the intermediate stage were independent predictors of mortality in all three definitions. The areas under receiver operating characte...
Purpose: The occurrence of extraosseous Ewing's sarcoma (ES) in deep soft tissues has been well described, but cases in which this tumor occurs in a primary cutaneous or subcutaneous site have rarely been reported. The superficial variant may be less aggressive than are the more common bony and deep soft tissue counterparts with an apparently favorable outcome. A retrospective review of patients with cutaneous or subcutaneous ES was conducted to analyze outcome and patterns of failure. Methods and Materials: Between July 1985 and March 1997, 14 patients with cutaneous or subcutaneous ES were treated at St. Jude Children's Research Hospital. The median age at presentation was 16 years (range 7-21 years). Anatomic locations included trunk and pelvis (7), upper or lower extremity (4), and head and neck (3). The median size of the lesion was 3 cm (range, 1-12 cm). Thirteen had definitive surgical resections, and one had biopsy of the mass at the time of referral. They ...
This paper begins with an introduction to Guangdong Daya Bay Nuclear Power Station (GNPS) and gives a simple introduction to the operations and maintenance documentation system at GNPS. It then will review the maintenance program guidelines base and the associated problems prior to the application of reliability centered maintenance (RCM). How RCM was implemented at GNPS, how the results of RCM analysis were used to optimize the maintenance program and test program, and what is the interface between RCM and the existing maintenance program will be shown. Next, it will show the successful implementation of RCM at GNPS resulted in the following changes: A new understanding of equipment failure challenges operations and maintenance beliefs, maintenance concepts undergo a large change, maintenance program and periodic testing program are continuously modified and optimized, new on-condition maintenance technologies are introduced, non-productive scheduled overhauls are ...
The efficacy of external flooding of a reactor vessel as a severe accident management strategy is assessed for an AP600-like reactor design. The overall approach is based on the Risk Oriented Accident Analysis Methodology (ROAAM), and the assessment includes consideration of bounding scenarios and sensitivity studies, as well as arbitrary parametric evaluations that allow the delineation of the failure boundaries. Quantification of the input parameters is carried out for an AP600-like design, and the results of the assessment demonstrate that lower head failure is physically unreasonable. Use of this conclusion for any specific application is subject to verifying the required reliability of the depressurization and cavity-flooding systems, and to showing the appropriateness (in relation to the database presented here, or by further testing as necessary) of the thermal insulation design and of the external surface properties ...
The super simulator 'SAMPSON' has been developed to show that there exist certain safety margins for light water reactors under hypothetical severe accidents and to investigate realistic measures of accident management by simulating accidents with a parallel computer. Heat-up of fuel rods and release of fission products from fuels are important factors to evaluate source terms. Models for fuel rod heat-up, hydrogen production due to cladding oxidation and cladding deformation and failure in the core region have been developed in the fuel rod heat-up analysis module. Fuel temperatures were calculated by solving the heat conduction equation. The calculated results for fuel temperature and hydrogen production were compared with CORA-13 experiment results. The comparisons showed prediction capability for the heat-up of fuel rods. The fission product release analysis module incorporates with models for fission product transport within fuel pellets, ...
Summary The steadily growing epidemic of diabetes mellitus poses a threat for global tuberculosis (TB) control. Previous studies have identified an important association between diabetes mellitus and TB. However, these studies have limitations: very few were carried out in low-income countries, with none in Africa, raising uncertainty about the strength of the diabetes mellitus-TB association in these settings, and many critical questions remain unanswered. An expert meeting was held in November 2009 to discuss where there was sufficient evidence to make firm recommendations about joint management of both diseases, to address research gaps and to develop a research agenda. Ten key research questions were identified, of which 4 were selected as high priority: (i) whether, when and how to sc...
PurposeTo compare the effectiveness and safety of 25- and 23-gauge sutureless microincision vitrectomy surgery (MIVS) in the management of various vitreoretinal diseases.MethodsEighty-five consecutive patients undergoing sutureless vitrectomy during January to April 2008 were randomized to either 25- or 23-gauge MIVS. Data collected prospectively included best-corrected visual acuity (BCVA), operation time, postoperative visual recovery, postoperative anterior segment change, and complications.ResultsThe most common indications for MIVS were macular hole, macular pucker, vitreous haemorrhage, and diabetic traction retinal detachment. Mean operation times of the 25-gauge (n=38) and 23-gauge groups (n=47) were 33.68 and 34.47?min, respectively (P=0.942). Mean BCVA improved significantl...
BackgroundAlthough benign ampullary tumors are removed endoscopically, due to their potential to progress to malignant disease, the favored treatment for adenocarcinoma is pancreaticoduodenectomy. We reviewed our institutions experience in order to identify which patients were at highest risk of disease progression following surgical resection, as well as evaluate whether localized T1 tumors are best treated by pancreaticoduodenectomy. MethodsWe retrospectively reviewed 157 patients who presented with an ampullary mass, from 2001 to 2010, and identified 51 with benign adenoma and 106 with adenocarcinoma. ResultsPatients with malignant tumors most often presented with larger tumors and jaundice, which alone was predictive of survival (OR = 67). Forty-five percent of patients with pathologic...
Exposure to crystalline silica dust causes multiple diseases, but silicosis and silica dust-associated tuberculosis (TB), in particular, are the two diseases that remain high on the list of occupational health priorities in low-income countries and that still occur in some high-income countries. The prevalence of silica-related TB is exacerbated by the human immunodeficiency virus (HIV) epidemic in low-income countries. This review describes the morphology of silica and the variable potency of the different forms. Sources of crystalline silica are discussed, with emphasis on less commonly recognised sources, such as small-scale mining operations and agriculture. Trends in the prevalence of silicosis are also presented. Although efforts have been made for many years in most countries to reduce silica dust levels, silicosis continues to occur even in young people. The clinical and pathological features and diagnosis of silicosis, with emphasis on ...
The optimal management of men with very favorable clinicopathological factors who develop biochemical recurrence (BCR) after radical prostatectomy (RP) has not been previously reported. Both local and systemic recurrences are unlikely in this cohort. This study examines their management and outcomes. Between October 2000 to March 2010, 1627 men underwent open RP by a single surgeon. In all, 448 (27.5%) met the following criteria for extremely low risk disease: preoperative PSA level <10?ng?ml?1, clinical stage T1c/T2a, Gleason score ?6, estimated cancer volume in the surgical specimen ?5% and no evidence for positive surgical margin. Undetectable PSA was defined as ?0.04?ng?ml?1. BCR was defined as PSA ?0.2?ng?ml...
A retrospective study of Ewing's Sarcoma at The Armed Forces Malignant Diseases Treatment Centre, Command Hospital, Pune, is presented. A total of 38 cases over a period of thirteen years have been studied. Males predominate slightly, and the common age group on presentation has been in the second and third decade. Humerus, pelvis and femur are the bones commonly affected. The initial line of management has been primarily radiotherapy, which has been over the years supplemented by combination chemotherapy. All the cases achieved remission, though only 32 cases (84 per cent) had complete remission, and the remaining only partial remission. The overall survival in those offered aggressive therapy has been over 50 per cent in two years. The present policy in the management of these cases is discussed. (author). 4 tabs.
Severe accident analysis has been performed for the Wolsung nuclear power= plants in Korea to investigate severe accident phenomena of CANDU-600 reactors as a part of Level II PSA study. The accident sequence analyzed in this paper is loss of active heat sinks (LOAH) which is caused by loss of off-site power, diesel generators, and DC power. ISAAC (Integrated Severe Accident Analysis Code) computer code developed by KAERI (Korea Atomic Energy Research Institute) was used in this analysis. This paper describes the important thermal-hydraulics and source term behaviors in the primary system and inside containment, and the failure mechanisms of calandria vessel and containment. In addition, some insights for accident management program (AMP) are also given. (Author) 5 refs., 1 tab., 12 figs.
Severe accident analysis has been performed for the Wolsung nuclear power plants in Korea to investigate severe accident phenomena of CANDU-600 reactors as a part of Level II PSA study. The accident sequence analyzed in this paper is loss of active heat sinks (LOAH) which is caused by loss of off-site power, diesel generators, and DC power, ISAAC(Integrated Severe Accident Analysis Code) computer code developed by KAERI (Korea Atomic Energy Research Institute) was used in this analysis. This paper describes the important thermal-hydraulics and source term behaviors in the primary system and inside containment, and the failure mechanisms of calandria vessel and containment. In addition, some insights for accident management program (AMP) are also given.
Energy consumption of black coal mines in Poland and methods for energy conservation are evaluated. Organizational models of energy management in underground coal mining are discussed. Tasks for dispatcher service for energy consumption control in a coal mine are analyzed: control of energy supplies, control of energy consumption, evaluation of electrical failures and reliability of protection systems, recording accidents and analyzing their causes, optimization of power systems in underground mines. Problems associated with control of energy consumption in a coal mine with mechanized systems for coal mining and use of computerized control systems are discussed. Recommendations for reucing energy consumption in underground coal mining are made. 4 references.
This project is about the simulation design of an engine control unit (ECU) for an Otto cycle engine with electronic fuel injection (EFI). The simulation includes a model for the ECU as well as physical parameters of the engine, which allows closed-loop control and monitoring of various systems.This simulation has been realized using Simulink and Stateflow, which are components of Mathworks' MATLAB software.The program allows control of various parameters of the ECU, as well as the simulation of failures to verify that the designed ECU is fault-tolerant and can control the engine using an open loop control. The main function the ECU provides is fuel metering.Subsequently, this program could be used as a tool to quickly develop and test models of ECU in order to control an engine in laborat...
Today, the use of the arch bars in the treatment of mandibular fractures is common [1]. But it has complications such as damaged teeth, periodontal tissue [2], risk of blood transmitted disease [3] and premature contact with maxillary incisor teeth in anterior deep bite occlusion. Many techniques are used for resolving these problems. In this paper, we describe the technique of using Maxillo-Mandibular Fixation Screws (MMFS) with essig wiring of anterior mandibular teeth in the management of symphyseal fracture of deep bite patients.
Choosing a medical device is complex and requires a transparent process based on reason, evidence and assessment of prioritized public health needs. Poor choices lead to inappropriate use or non-use of medical devices and a waste of resources.This report suggests how an agenda to improve access to appropriate medical devices could be devised from applying the crucial 4 components - Availability, Accessibility, Appropriateness, and Affordability, to the 15 global high-burden diseases and some cross-cutting issues. The results of this exercise suggest several areas of research necessary to help
Trastuzumab increases survival amongst women with human epidermal growth factor receptor (HER)-2 receptor positive metastatic breast cancer, but maternal and fetal risks are associated with advanced disease and its treatment in pregnancy. We present a case of a primigravid with HER-2 positive metastatic breast cancer who received trastuzumab throughout pregnancy. She presented with cerebral metastases, requiring surgical decompression and resection. Reversible oligohydramnios developed during pregnancy. Fetal safety data on trastuzumab in pregnancy is limited, but case reports suggest a recurring pattern of (mostly reversible) oligohydramnios.
Colerectal cancer (CRC) is the second commonest cancer in the Western World. Successful treatment relies significantly on accurate detection and staging of primary disease as well as the early identification of the presence and extent of recurrence. Morphological imaging techniques, particularly computed tomography (CT), are well established and widely available to carry out these tasks in addition to predicting and monitoring response to therapy. This review analyses the current inadequacies for imaging CRC and critically assesses the potential role of functional imaging with positron emission tomography (PET). It was reviewed the current literature, to use the experience from the firs 1000 PET studies carried out at the institution and the perspective of surgical colleagues. It was found little evidence for the use of 2-["1"8F]fluoro-2-deoxy-D-glucose (FDG)-PET for screening asymptomatic individuals and current modalities appear better suited for detection of ...
Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event-free survival (EFS), and overall survival rates from multidisciplinary therapy in Ewing's sarcoma. Methods and Materials: Between 1983 and 1988, 184 children with Ewing's sarcoma were enrolled onto Pediatric Oncology Group 8346 (POG 8346). A total of 178 (97%) met eligibility criteria; 6 had pathology other than Ewing's sarcoma. Induction chemotherapy of cyclophosphamide/doxorubicin (adriamycin )(C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy and C/A, dactinomycin, and vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. Forty patients were randomized to receive SF, whole bone radiation to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF ...
Prepared to make housing project managers, maintenance engineering staff, and designers and architects of HUD - assisted and HUD - insured housing projects and mobile home parks aware of their responsibilities under the Natural Gas Pipeline Safety Act, this handbook provides technical guidance for the reduction of gas leaks and the handling of gas leak incidents in residential areas. The hazards of natural gas, concern over gas safety in residential areas, applicable codes and standards, and sources of information and help are reviewed, along with maintenance and engineering considerations relating to gas pipe failures, the detection of gas leaks, appliance servicing, and pipe installation, repair, and replacement. Housing management considerations are also examined, with attention to recordkeeping and reporting, emergency contingency planning, tenant education, staff qualifications and training, and the development and use ...
To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine the factors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenous fistula(AVF). Forty-nine cases of insufficient hemodialytic AVF were treated in 44 patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis was performed with urokinase, and was followed by PTA. The initial success rate and complications of PTA were evaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient's age, and the duration of renal failure, patency rates were compared within each subgroup using the Kaplan-Meier logrank test. The initial success rate of PTA for insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was 67% at 6 months, and 50% at 12 months. ...
GAO's review of the H-Coal and Exxon projects showed inadequacies in DOE's contracting practices and a failure by DOE to properly plan, manage, and monitor, especially the H-Coal project. The initial Government-industry H-Coal agreements regarding the level of investment by private sponsors and the ceilings imposed on sharing in cost growth were imbalanced. Larger investments by private sponsors and sharing of cost growth provides an incentive to private sponsors to control costs and helps to assure that each party is fully committed to the success of the project. DOE started the H-Coal project prematurely before sufficiently detailed designs were available and without adequate project planning for functions such as construction scheduling, materials handling, inventory systems, and quality control. DOE staffing was inadequate at both projects to effectively monitor progress and contribute to timely decisions. Its contracts ...
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was diagnosed in eight ...
Objective: To assess the efficacy, prospects and future of conservative management of beta thalassemia major patients in a developing country. Design: Patients registered at IHBTS were studied over a period of three years. They consented to being managed on moderate transfusion regimen, aiming to maintain a pre-transfusion haemoglobin(Hgb) level of 9.0 plus minus 1.0 g per dL. We studied their transfusion requirements, status for transfusion transmitted infections (TTls), serum ferritin levels and complications developing as a result of iron overload. Subjects: Initially all registered patients were included in this study. Sporadic patients as well as dropouts occurring due to any reason, (patients concurrently seeking treatment at other centres as well, or complying poorly to advised chelation therapy) were excluded from the study. The data presented here conforms to a cohort of 60 regular patients who adhered best to our selection criteria. ...
Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event free (EFS) and overall survival rates from multi-disciplinary therapy in Ewing's Sarcoma (ES). Materials and Methods: Between 1983 and 1988, 184 children with ES were enrolled onto POG 8346. 178 (97%) met eligibility criteria; 6 had non-ES pathology. Induction treatment of Cyclophosphamide/Adriamycin (C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy (XRT) and C/A, Dactinomycin and Vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. 40 patients were randomized to receive SF, whole bone XRT to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF to 55.8 Gy while 84 were assigned to IF XRT. Results: Of 179 eligible patients, 141 (79%) had ...
The OASIS Registry started annual collection of longitudinal data on patients on home parenteral nutrition (HPN) in 1984. This report describes outcome profiles on 1594 HPN patients in seven disease categories. Analysis showed clinical outcome was principally a reflection of the underlying diagnosis. Patients with Crohn's disease, ischemic bowel disease, motility disorders, radiation enteritis, and congenital bowel dysfunction all had a fairly long-term clinical outcome, whereas those with active cancer and acquired immunodeficiency syndrome (AIDS) had a short-term outcome. The long-term group had a 3-year survival rate of 65 to 80%, they averaged 2.6 complications requiring hospitalization per year, and 49% experienced complete rehabilitation. The short-term group had a mean survival of 6 months; they averaged 4.6 complications per year and about 15% experienced complete rehabilitation. The registry data also indicated HPN ...
Twenty-four patients were studied with both /sup 201/Tl-thallus chloride and /sup 99m/Tc-TBI scintigraphy following exercise. Comparison of the two agents in detecting segmental myocardial ischemia and scar was made in 18 patients with evidence of coronary artery disease on /sup 201/Tl-thallous chloride scintigraphy. Agreement between the two studies was observed in 77% (125 of 162) of left ventricular segments, suggesting that /sup 99m/Tc-TBI can be used as a myocardial perfusion agent. Limitations were related to early high background activity from lungs and liver. The high lung activity and early myocardial redistribution within the 1st hour contributed to the failure of /sup 99m/Tc-TBI to detect 16 segmental defects seen in the immediate post-exercise thallous chloride scan. Persistently high liver activity additionally affected accurate interpretation in the left ventricular segments close to the diaphragm. Improvement in the accuracy of ...
SummaryStudy Objectives: To compare the effect of noninvasive mechanical ventilation (NIV) in severely acidotic with mildly acidotic patients with acute hypercapnic chronic obstructive lung disease (COPD).Design: Comparison of NIV in consecutively enrolled patients with acute hypercapnic COPD with mild (pH 7.25-7.35) or severe (pHPaCO2, duration of NIV treatment, length of stay in hospital and survival.Results (meadian (IQR)): Twenty-nine patients had 36 episodes of acute hypercapnic respiratory failure: Seventeen with pHPaCO2 improve (12 (6-34) vs 12 (4-28)h, respectively, Formula Not Shown ), with similar duration of NIV treatment (60 (35-96) vs 68 (36-48)h, respectively, Formula Not Shown ) and hospital length of stay (8 (7-18) vs 9 (5-17) days, respectively, Formula Not Shown ). Overal...
In 1981, the German Society of Pediatric Oncology initiated a multi-institutional study for the treatment of Ewing's sarcoma. The protocol (Cooperative Ewing's Sarcoma Study, CESS 81) consisted of four courses of a four-drug-regimen (VACA), each course taking nine weeks. Local therapy (radical surgery or resection plus irradiation or radiotherapy alone) was performed after the second course. The results of CESS 81 can be summarized as follows: VACA-chemotherapy is effective in controlling systemic disease. Initial tumor mass and response to initial chemotherapy are of major prognostic value for local control and survival. Permanent local control is a problem, especially in irradiated patients. The high local failure rate in irradiated patients in CESS 81 could be attributable to the following reasons: Late start of local therapy (after 18 weeks of chemotherapy), uneven distribution of prognostic parameters: Large tumors were more often ...
Aluminum toxicity has been implicated in the pathogenesis of a number of clinical disorders in patients with chronic renal failure on long-term intermittent hemodialysis treatment. The predominant disorders have been those involving either bone (osteomalacic dialysis osteodystrophy) or brain (dialysis encephalopathy). In nonuremic patients, an increased brain aluminum concentration has been implicated as a neurotoxic agent in the pathogenesis of Alzheimer's disease and was associated with experimental neurofibrillary degeneration in animals. The brain aluminum concentrations of patients dying with the syndrome of dialysis encephalopathy (dialysis dementia) are significantly higher than in dialyzed patients without the syndrome and in nondialyzed patients. Two potential sources for the increased tissue content of aluminum in patients on hemodialysis have been proposed: (1) intestinal absorption from aluminum containing phosphate-binding ...
Four major natriuretic peptides have been isolated: atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and Dendroaspis-type natriuretic peptide (DNP). Natriuretic peptides play an important role in the regulation of cardiovascular homeostasis maintaining blood pressure and extracellular fluid volume. The classical endocrine effects of natriuretic peptides to modulate fluid and electrolyte balance and vascular smooth muscle tone are complemented by autocrine and paracrine actions that include regulation of coronary blood flow and, therefore, myocardial perfusion; modulation of proliferative responses during myocardial and vascular remodeling; and cytoprotective anti-ischemic effects. The actions of natriuretic peptides are mediated by the specific binding of these peptides to three cell surface receptors: type A natriuretic peptide receptor (NPR-A), type B natriuretic peptide receptor (NPR-B), and type C natriuretic peptide receptor ...
Objective To determine whether a centralised telephone intervention reduces the incidence of death or admission for worsening heart failure in outpatients with chronic heart failure.Design...Full Text Available
Heart failure affects nearly 6 million Americans, with a half-million new cases emerging each year. Whereas up to 50% of heart failure patients die of arrhythmia, the diverse mechanisms underlying...Full Text Available
Failure of a dam is something we hope never happens. But if a failure occurs, it`s important to study the circumstances in order to expand our knowledge base, and then apply what we learn to other structures.
Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the ...
Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the ...
Full text: Tumour ablation with radiofrequency (RF) energy is a relatively new procedure for the treatment of focal malignant disease. At our institution this is currently being used in the treatment of certain liver and lung lesions with the patients involved being enrolled in clinical trials. The poster describes the technique used at our institution for the placement of the radiofrequency ablation electrode using CT fluoroscopy. Criteria for patient selection are included. Complications from the procedure are described, as well as follow up appearances and results. Our results from the treatment of primary and secondary lesions in the liver correlate well with published literature. Treatment is still not as successful as surgical resection but there is significantly less morbidity. Where this method may be appropriate is when the patient is not a candidate for surgical resection. The treatment of colorectal metastases in the lung shows early promise as a ...
Computed tomography (CT) of the thorax shows early promise of important diagnostic advances. We believe that CT often provides information superior to that provided by standard roentgenographic techniques, is capable of significantly influencing patient management, and in selected instances, offers unique information not available by other methods. Computed tomography permits the imaging of mediastinal structures not possible with conventional roentgenographic methods and can diagnose with certainty benign mediastinal conditions such as pericardial cysts and focal or diffuse accumulations of fat. It is ideal for detecting pleural abnormalities and for displaying underlying parenchymal disease in patients with complex pleuroparenchymal shadows on conventional films. Pulmonary metastases unseen on the plain chest film can be detected with greater sensitivity than by any other method. Future applications of CT include the staging of mediastinal ...
Computed tomography (CT) of the thorax shows early promise of important diagnostic advances. We believe that CT often provides information superior to that provided by standard roentgenographic techniques, is capable of significantly influencing patient management, and in selected instances, offers unique information not available by other methods. Computed tomography permits the imaging of mediastinal structures not possible with conventional roentgenographic methods and can diagnose with certainty benign mediastinal conditions such as pericardial cysts and focal or diffuse accumulations of fat. It is ideal for detecting pleural abnormalities and for displaying underlying parenchymal disease in patients with complex pleuroparenchymal shadows on conventional films. Pulmonary metastases unseen on the plain chest film can be detected with greater sensitivity than by any other method. Future applications of CT include the staging of mediastinal ...
A Lawrence Livermore National Laboratory (LLNL) Management Pre-Start Review (MPR) Team was formed to independently verify the operational readiness of Building 368 (B368) Biosafety Level III (BSL-3) Facility to conduct research with biological pathogens and toxins including those considered Select Agents. Review objectives and criteria were developed from the DOE/NNSA and LLNL requirements. These were provided in the Implementation Plan for the Biosafety Level III (BSL-3) Facility Management Pre-Start Review (BSL-3 MPR) at Lawrence Livermore National Laboratory that was reviewed and approved by DOE/NNSA-LSO. The formal part of the LLNL MPR for the BSL-3 Facility was begun in August of 2005 but work on the MPR was stopped in October of 2005 due to the need for LLNL to reassess organizational and operational controls and respond to Centers for Disease Control and Prevention inquiries related to a shipping incident involving ...
Heart failure has been singled out as an emerging epidemic, which could be the result of increased incidence and/or increased survival leading to increased prevalence. Knowledge of the responsibility...Full Text Available
Ultimate compressive strength and failure modes were studied using 24- ... to 81 % of the average ultimate compressive strength (UCS). Figure 1 (a) is the failure ...
Congestive heart failure (CHF) is a leading cause of morbidity and mortality. CHF is marked by atrial and ventricular enlargement and reduced cardiac contractility, as well as an association...Full Text Available
Diagnostic accuracy of the currently available serum markers of cardiac injury, such as myoglobin, creatine kinase and its myocardial isoform, are altered in patients with renal failure. It is shown...Full Text Available
The use of indigenous bacterial root endophytes with biocontrol activity against soil-borne phytopathogens is an environmentally-friendly and ecologically-efficient action within an integrated diseasemanagement framework. The earliest steps of olive root colonization by Pseudomonas fluorescens PICF7 and Pseudomonas putida PICP2, effective biocontrol agents (BCAs) against Verticillium wilt of olive (Olea europaea L.) caused by the fungus Verticillium dahliae Kleb., are here described. A gnotobiotic study system using in vitro propagated olive plants, differential fluorescent-protein tagging of bacteria, and confocal laser scanning microscopy analysis have been successfully used to examine olive roots?Pseudomonas spp. interactions at the single-cell level. In vivo simultaneous visualization...
Purpose. To examine the impact of residual limb osteomyelitis (RLO) on the rehabilitation of lower limb amputees. Method. Retrospective review of the casenotes of patients with RLO. Information sought included details of amputation, clinical features of investigations for and management of RLO and its effect on rehabilitation. Results. There were seven transfemoral and three transtibial amputees. Indications for amputation were vascular disease in nine cases, trauma in one. In each case, delayed wound healing or residual limb pain prompted radiological, hematological and microbiological investigations. Average time between amputation and diagnosis was 187 days. One patient died before treatment commenced. Two transtibial amputees were treated with intravenous antibiotics while rehabilitati...
A Quantitative Computed Tomography (QCT) method, simplifying the well-known technique proposed by Genant (1982) and applied to a standard third generation whole body CT scanner is described. This technique was applied in the measurement of the trabecular bone which has high sensitivity for metabolic changes. The BMC (Bone Mineral Content) measured in different groups of subjects (healthy postmenopausal patients versus women with postmenopausal osteoporosis) showed a highly significant difference (p<0.001). The precision of repositioning (coefficient of variation 1.8% to 2.3%, obtained in healty male patients) and the good, linear relationship computed from the phantom values, minimize measurement errors. Since this method is quickly applied and involves low-dose radiation-exposure, it could be introduced in the clinical study of metabolic bone diseases.
Abstract Alcoa World Alumina Australia mines bauxite under lease agreements with the Government of Western Australia. The leases lie in the Darling Range to the east of Perth, the capital and major population center. In addition to bauxite and other mineral ores, the Darling Range is a major potable water source and harbors a species-rich forest dominated by Jarrah (Eucalyptus marginata), a significant commercial timber. Conservation and recreation are important land uses in the region. Social and political pressures have led to stringent governmental requirements for restoration. In addition, a summer drought period, a soil deficient in most nutrients, water management challenges, an introduced disease, caused by Phytophthora cinnamomi Rands, and a post-mining ecosystem that must be condu...
Abstract Imatinib mesylate is the first of a novel group of drugs that specifically target protein tyrosine kinases, which are central to the pathogenesis of human cancer. It has been approved for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumor and has been found efficacious in other neoplastic diseases. Nilotinib and dasatinib, a second-generation of tyrosine kinase inhibitors (TKIs), were developed in response to findings of emerging imatinib resistance or intolerance to the drug. Cutaneous reactions are the most common nonhematologic side effect of these drugs, and their management is challenging especially in the absence of alternative anticancer agents. The present review focuses on the clinical characteristics and the hypothesized molecular pathogenesis o...
Hepatocellular carcinoma (HCC) represents a major health problem as it afflicts an increasing number of patients worldwide. Albeit most of the risk factors for HCC are known, this is a deadly syndrome with a life expectancy at the time of diagnosis of less than 1?year. Definition of the molecular principles governing the neoplastic transformation of the liver is an urgent need to facilitate the clinical management of patients, based on innovative methods to detect the disease in its early stages and on more efficient therapies. In the present study, we have combined the analysis of a murine model and human samples of HCC to identify genes differentially expressed early in the process of hepatocarcinogenesis, using a microarray-based approach. Expression of 190 genes was impaired in murine ...
We have developed a flexible radioactive polyurethane patch incorporating {beta}-emitting radionuclide (166Ho) to treat malignant skin lesions. We covered the tumor surface (n=133) with the radioactive patch for 33.58 {+-} 5.33 minutes. Radiation dose delivered was 35 Gy for Bowen's disease (n=78), Kaposi sarcoma (n=25), actinic keratosis (n=5), and 50 Gy for BCC (n=17) and squamous carcinoma (n=8). Complete response was observed in 91.7% after the first therapeutic trial, 96.2% after 2nd and 97.7% after 4th trial with excellent cosmetic outcome for 31.15{+-}13.88 months of follow-up. Radioactive patch therapy is effective for superficial skin cancers that are impractical for surgery.
Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important risk factor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases for salvage after failure of non-surgical ...
Methods: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. Results: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting germ cell tumors ...
Nowadays the safety of Nuclear Power Plants is becoming more and more significant. Therefore consideration of severe accidents shall be included in both design and operating process of Nuclear Power Plants. In particular ground motion forms one of the important natural hazards. For structural analysis both linear-elastic and non-linear methods are specified by the engineering codes for earthquake resistance design. However, time history analysis is required for investigation of non-linear structural behaviour. Moreover, non-linearities are often caused by the presence of damage. This can be detected by means of structural health monitoring and subsequently system identification. In this paper the advantages of both dynamic time history analysis and damage detection by means of wavelet analysis are discussed. First, the non-linear behaviour of a frame structure due to an artificial earthquake motion is analyzed. A comparison to non-time history techniques is performed as well. Next, ...
The article deals with the following topics: reliability calculation as a basis of a maintenance strategy leads to the knowledge which equipment seems to be critical in the context of a supply interruption; procedure of a risk management; information for a risk assessment: probability of an equipment malfunction, reliability calculation on the system level, failure cost, maintenance cost, further conditions. The article shows an example for a calculation. [German] Die Zuverlaessigkeitsberechnung als Grundlage einer Instandhaltungsstrategie fuehrt zu der Kenntnis, welche Betriebsmittel kritisch im Hinblick auf eine Versorgungsunterbrechung sind. Eine anschliessende Risikobetrachtung schliesst deshalb neben der Betrachtung der nichtgelieferten Energie auch die uebrigen Kosten einer Stoerung ein, die mit den finanziellen Aufwendungen fuer eine Instandhaltung zu vergleichen sind. Im Folgenden wird ein Vorschlag fuer eine Risikobewertung von ...
The existence, in real-time, of transmission constraints, demand forecasting errors, generator failures, and other factors impose additional costs through the need to run more expensive generation. These costs can appear as a significant component of the wholesale price to demand served by electricity markets operated over transmission networks. In the England & Wales Pool these costs are passed through directly to supply companies. The Transmission System Operator ({open_quotes}TSO{close_quotes}) can exert significant influence on these costs through improved availability of transmission circuits and through appropriate investment, but has no incentive to do so. Since the inception of the Pool, these costs have increased in level and volatility, and have proved difficult to hedge. In response, St Clements Services were instrumental in assisting Pool members to develop an {open_quotes}Uplift Incentive Management Scheme{close_quotes} which ...
The electricity sector is Canada's largest single source of greenhouse gas (GHG) emissions. This paper discussed electricity and carbon pricing approaches to reducing GHG emissions in the electricity sector. An overview of the links between electricity pricing and climate change was presented, and current and emerging trends in electricity pricing related to encouraging energy conservation were reviewed. Market prices and failures were discussed. Approaches to pricing electricity included an increase in block prices; time-of-use prices; demand-side management and energy efficiency; and carbon pricing in Canada and electricity pricing signals. The study showed that several provincial utilities in Canada are experimenting with market-based pricing approaches for electricity and carbon that may help to reduce GHG emissions over time. Concerns over electricity supply and the negative environmental impacts of electricity production may lead to the ...
The electricity sector is Canada's largest single source of greenhouse gas (GHG) emissions. This paper discussed electricity and carbon pricing approaches to reducing GHG emissions in the electricity sector. An overview of the links between electricity pricing and climate change was presented, and current and emerging trends in electricity pricing related to encouraging energy conservation were reviewed. Market prices and failures were discussed. Approaches to pricing electricity included an increase in block prices; time-of-use prices; demand-side management and energy efficiency; and carbon pricing in Canada and electricity pricing signals. The study showed that several provincial utilities in Canada are experimenting with market-based pricing approaches for electricity and carbon that may help to reduce GHG emissions over time. Concerns over electricity supply and the negative environmental impacts of electricity production may lead ...
Renewable energy systems have been suggested as appropriate technologies for developing countries for many years. But they are less attractive to low-income rural and urban populations for reasons of risk and initial capital outlay, and market penetration is usually small as a result. Technology transfer by outside intervention appears unlikely to deliver to enough people in Africa; only self propagating technologies have managed that to date. Unfortunately target populations in developing countries have little capital and are understandably reluctant to take risks. Outside interests see little likelihood of profit and have already demonstrated reluctance to invest in many developing countries. Benefit from technology relies on continued use after purchase and is rightly associated with reliability and availability. Mean time to repair may be a better measure of appropriateness than mean time between failures. Technology based on the idea of ...
BACKGROUND: Although definitions vary, infected nonunion has been defined as a state of failure of union and persistence of infection at the fracture site for 6 to 8 months.>). Infected nonunions of the supracondylar region of the femur are uncommon and are mostly due to a severe open fracture with extensive comminution and segmental bone loss or after internal fixation of a comminuted closed fracture. Associated factors include exposed bone devoid of vascularized periosteal coverage for more than 6 weeks, purulent discharge, a positive bacteriological culture from the depth of the wound, and histologic evidence of necrotic bone containing empty lacunae. Soft-tissue loss with multiple sinuses, osteomyelitis, osteopenia, complex deformities with limb-length inequality, stiffness of the adjacent joint, polybacterial multidrug-resistant infection, and smoking all complicate treatment and recovery. Although uncommon in incidence, infected nonunions of the long bones ...
Burner nozzles were often redesigned in order to improve flow design and manufacturing quality. Maintenance intervals, however, are not satisfactory for the operators of such plants. There is no definitive answer as to whether upgraded design allows to lengthen these intervals or whether additional measures are required. Gas turbines may break down for a large number of reasons. This article shows that many of the causes of operational failure and damage are preventable. Damage management will be successful if manufacturers, operators and independent institutions work together.(orig.) [German] Es wurden in der Vergangenheit mehrfach Veraenderungen an den Brennerduesen vorgenommen. Dabei wurden Verbesserungen in der stroemungstechnischen Auslegung und der Fertigungsqualitaet erzielt. Die derzeit noch gueltigen Wartungsintervalle sind fuer den Betreiber unbefriedigend. Inwieweit diese Intervalle mit der modifizierten Ausruestung verlaengert ...
Experience in the diagnosis and treatment of infertility has led to an increased understanding of the prominent role male factors play in many couples' inability to conceive. While many forms of male factor infertility are amenable to treatment, for some patients there is no corrective therapy available. For this reason, a great deal of attention has been focused on developing technologies for semen processing and sperm utilization in cases of decreased semen quality. One area of research is the development of more sophisticated methods of assessing sperm function, as well as methods of sperm preparation. Progress is also being made in the application of technologies such as intrauterine insemination and in vitro fertilization in the treatment of male factor infertility. Such developments have improved prospects for fertility among patients suffering from decreased semen quality, as well as those suffering from such disorders as ejaculatory failure and congenital ...
Power system components, especially components failure, can significantly affect the reliability of a power system. Data about failure rate in electrical products were obtained from products life testing and analyzed in order to predict reliability. The distribution curve fitting method was used to estimate failure probability. Ten relays of different life times have been used to illustrate the validity of this analytical technique. 3 refs., 3 tabs.
A survey was conducted of experience with steam generator tubes at nuclear power stations during 1976. Failures were reported at 25 out of 68 water-cooled reactors. The causes of these failures and the repair and inspection procedures designed to cope with them are summarized. Examination of the data indicates that corrosion was the major cause of steam generator tube failures. Improvements are needed in steam generator design, condenser integrity and secondary water chemistry control. (author).
This report documents the investigation regarding the failure of CPVC piping that was used to connect a solar hot water system to standard plumbing in a home. Details of the failure are described along with numerous pictures and diagrams. A potential failure mechanism is described and recommendations are outlined to prevent such a failure.
Aging is the most significant risk factor for a range of degenerative disease such as cardiovascular, neurodegenerative and metabolic disorders. While the cause of aging and its associated diseases...Full Text Available
Aging is a biological process that affects most cells, organisms and species. Human aging is associated with increased susceptibility to a variety of chronic diseases, including cardiovascular disease,...Full Text Available
Extensive investigations and detailed analysis of the failure reason of 9DVN002ZV fan in Daya Bay Nuclear Power Station showed that the fan destroy was caused by the failure of non-drive end bear. The direct cause of this bearing' failure was its improper assembly caused by improper maintenance procedure, and the root cause was too small internal radial clearance after mounting. The factor affecting bearing internal radial clearance, the relationship between clearance and operating life time and fan failure process were discussed. (authors)
The failure took place on a welded elbow pipe which exhibited a catastrophic transverse rupture. The failure was located on the welding HAZ region, parallel to the welding path. Branching cracks were detected at the edge of the rupture area. Deposits of corrosion products were also spotted. The optical microscope analysis showed the presence of transgranular failures which were related to the stress corrosion cracking (SCC) and were predominantly caused by the welding residual stress. The significant difference in hardness between the welded area and the pipe confirmed the findings. Moreover, the failure was also caused by the low Mo content in the stainless steel pipe which was detected by means of spark emission spectrometer. (orig.)
Program Plans, Implementation, & Results Energy Management at Federal Facilities Energy Management at DOE Fleet Management Interagency Coordination Interagency Energy...
This paper describes a risk based approach and inspection planning as part of the Pipeline Integrity Management (PIM) system for the 95.5 km long 18'' GASVOL gas pipeline in the South eastern region of Brazil transporting circa 5 000 000 m3 dry gas per day. Pipeline systems can be subject to several degradation mechanisms and inspection and monitoring are used to ensure system integrity. Modern pipeline regulations and codes are normally based on a core safety or risk philosophy. The detailed design requirements presented in design codes are practical interpretations established so as to fulfill these core objectives. A given pipeline, designed, constructed and installed according to a pipeline code is therefore the realization of a structure, which, along its whole length, meets the applicable safety objectives of that code. The main objective of Pipeline Integrity Management (PIM) is to control and document the integrity of ...
Monogenic autoinflammatory diseases encompass a distinct and growing clinical entity of multisystem inflammatory diseases with known genetic defects in the innate immune system. The diseases...Full Text Available
Heart disease, cancer, and cerebrovascular disease together cause more than two out of three deaths in the United States annually. These three diseases are largely a result of widespread risk factors...Full Text Available
S>Hydrogen-induced delayed failure in an alpha-beta titanium alloy (4Al-- 4Mn) was sensitive to microstructure. A quenched structure was less susceptible to delayed failure than aged or annealed structures. The tendency for delayed failure was magnified in all structures by an increase in hydrogen content or an increase in strength level. Hydrogen-induced delayed failure occurred by a process of crack initiation and controlled crack growth. Delayed failures resulting from creep were also encountered. Plastic strain resulting from creep tended to retard crack initiation. Changes occurring in material under static load prior to formation of cracks were reversible, as long as no appreciable plastic strain occurred, indicating stress-induced diffusion of hydrogen. Hydrogen-induced delayed failure disappeared at both high and low ...
...Advances in Chronic Kidney Disease-The purpose of Advances Chronic Kidney Disease is to provide in-depth, scholarly review articles about the care and mana ... Advances in Chronic Kidney Disease - Elsevier Home Products User Resources About Us Support & Contact Elsevier Websites Advanced Product ...Search Browse Journals Advances in Chronic Kidney Disease Advances in Chronic Kidney Disease Additional Information Related Publications Editorial Board Journal Online e- Alert Readers ...year: 6 Tips Title This is my tip content Visit Advances in Chronic Kidney Disease Online! The purpose of Advances Chronic Kidney Disease is ...
Breaker failure relaying has been generally achieved through the use of a current monitoring relay to determine whether current continues to flow into a fault after a breaker has been instructed to interrupt the circuit. If current continues to flow after a predefined period of time, the circuit breaker is considered to have failed. Steps must then be taken to trip the next set of upstream breakers in the power system to remove the faulted circuit and prevent system damage. However, with industrial power systems, this may be the utility`s breakers on the feeding transmission line. Regardless, breaker failure schemes must be designed to isolate both the faulted circuit and the failed circuit breaker. This paper discusses a new and innovative method of protecting a circuit breaker from the failure described above, plus other failures that go unprotected with conventional schemes, this providing total ...
This thesis - Resource Management in Broadband Communication Networks - deals with different ways of optimizing the available resources of data- or telecommunication networks. Especially topics like optimal routing, load balancing and fast recovery of routes in case of link failures are covered. The first part gives a brief description of some of the existing protocols for routing and controlling resources, such as RSVP, OSPF, BGP, PNNI, etc. The remaining part concerns the following two fundamentally different approaches to resource management etc.: - Software agents - Simulated ants In the beginning of the part concerning software agents a description of what exactly constitutes software agents, according to the scientists and according to the organization, FIPA is given. After this, the main results from the IMPACT project are presented. The IMPACT project is an EU-project that aimed at developing a demonstration ...
Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal < about 5cc, B: mouthful 5-50 cc, C: Large > 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using C0-60 teletherapy machine. A total of 10Gy(2Gy/fr. X 5 days)was delivered without correction of lung density. Results : In group A, all patients ...
The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The ...
We describe a 59-year-old patient who developed acute renal failure because of rhabdomyolysis after extensive red fire ant bites. This case illustrates a serious systemic reaction that may occur from...Full Text Available
Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water...Full Text Available
Forty-six patients with end-stage renal failure were subjected to iliac crest biopsy before the initiation of a dialysis programme and regardless of the presence of skeletal symptoms....Full Text Available
BackgroundThe rhizomes of Cynodon dactylon are used for the treatment of heart failure in folk medicine. In the present study, we investigated the effects of hydroalcoholic...Full Text Available
Angiotensin II has adverse actions in heart failure including vasoconstriction, aldosterone secretion, and activation of the sympathetic nervous system. Valsartan, a potent specific angiotensin II type 1 receptor blocker, may produce beneficial effects in heart failure. The purpose of this study was to evaluate the steady-state pharmacokinetics of valsartan 40, 80, and 160 mg each given every 12 h for 7 days in heart failure patients. Eighteen patients with chronic stable heart failure and left ventricular ejection fractions power model, showed that doubling the dose increased the AUC and Cmax 1.8 times. The pharmacokinetics of valsartan are predictable in heart failure patients within the dose range of 40-160 mg BID. Age did not appear to have influenced the valsartan clearance in heart failure patients. The pharmacokinetic values were higher in heart ...
BackgroundAlthough dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF), the mechanism underlying DCM is not well understood. Previously, it has been demonstrated...Full Text Available
Background:The cardiac sodium–calcium exchanger (NCX1) is a key sarcolemmal protein for the maintenance of calcium homeostasis in the heart. Since heart failure...Full Text Available
Premature menopause, ovarian failure younger than 40 years of age, is relatively rare but may preclude childbearing for some women who delay attempts at fertility. We present five kindreds in which...Full Text Available
AimsTo determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure.Methods...Full Text Available
ObjectiveThe aim of this study was to ascertain whether all cervical cancer patients who received adjuvant concurrent chemoradiation (CCRT) for high risk of treatment failure after...Full Text Available
Sodium monofluoroacetate (1080) is a vertebrate pesticide widely used for possum control in New Zealand. Fluoroacetate is also a toxic component of poisonous plants found in Australia, South Africa, South America, and India. Because of its importance and effectiveness in pest control and the highly toxic nature of this compound, its acute sub-lethal and target organ toxicity have been extensively studied. In relation to its use as a pesticide its environmental fate, persistence, non-target impacts and general toxicology have been and continue to be extensively studied. Toxic baits must be prepared and used with extreme care, otherwise humans, livestock, and non-target wildlife will be put at risk. The high risk of secondary poisoning of dogs is a cause for concern. 1080 acts by interfering with cellular energy production. Possums die from heart failure, usually within 6-18 h of eating baits. Long-term exposure to sub-lethal doses can have harmful effects and strict ...
The natriuretic peptides are considered to be cardioprotective; however, their receptors have not been identified in human myocardium using radiolabeled analogs. Dendroaspis natriuretic peptide (DNP) has been recently identified as a new member of this peptide family and is thought to be less susceptible to enzymatic degradation. Therefore, we have developed the novel radiolabeled analog [125I]-DNP and used this to localize high-affinity (K(D)=0.2 nmol/L), saturable, specific binding sites in adult human heart (n=6) and coronary artery (n=8). In competition binding experiments, atrial natriuretic peptide and brain type natriuretic peptide had greater affinity for [125I]-DNP binding sites than C-type natriuretic peptide and the natriuretic peptide receptor (NPR)-C ligand, cANF. This rank order of potency suggested binding of [125I]-DNP was specific to NPR-A. Messenger RNA encoding NPR-A was identified in left ventricle and coronary artery smooth muscle, and expression was confirmed by ...
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortality. Further, the resolution of T2DM has long been understood to precede weight loss, and this finding provides important clues about the physiologic ...
Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients. Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate ("9"9"mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers. The B/ST ratio for the skull correlated well with serum bone-specific alkaline phosphatase (BAP) (r=0.735, p<0.001), serum deoxypyridinoline (DPD) (r=0.806, p<0.001) and intact parathyroid hormone (intact PTH) (r=0.701, ...
The reliability of an electrical power system is influenced by the operation of circuit-breaker (CB). A good indicator of circuit-breaker condition is its switching time. Based on it some of the critical circuit-breaker irregularities can be detected and removed before they develop to a failure. In this paper, the evaluation of time measurements (timings) in case of different failures will be carried out for two circuit-breaker solutions, i.e. with spring and hydraulic drive. Moreover, the relationships between switching time and failure type/location will be derived. Thereby, the influence of failure trend will also be taken into account. (author)
Presented are the results of the investigation of the kinetics and micromechanism of the failure in impact bending of oriented-crystallized specimens having the eutectic composition Ni_3Al-Ni_3Nb and of the bimetal composed of 45 steel + M3 copper. The failure kinetics was studied by high-speed filming, whereas the fractures were studied by electron fractography. The particularities of the failure of the laminar-type composite materials were found. Analyzed was the effect of the kinetic factors and the mechanism of failure upon its energy consumption.
... with the additional US funds supporting Islamic ... the FATA and NWFP, keeping Pakistan's government and ... Without these madrassas, the TTP is left ...
Aluminum electrolytic capacitors, with 1043 failures, are a good example. Also, categorization by size and voltage reveals such frequencies of occurrence as ...
... which extend beyond the upper airway. These include attention deficit hyperactivity disorder, learning disorders, failure to thrive, and enuresis. Tonsillectomies ...
Pain is necessary for survival but chronic pain is disabling and causes significant health and economic problems. This study provides an understanding of the future for spinal cord stimulation. Stimulation by means of chronically implanted electrodes, was carried out in 200 patients with pain of varied benign organic etiology. In 177 of them, pain was confined to the failed back syndrome. Most patients were referred by a Pain Management Service. 226 epidural implants were used: 80 unipolar, 59 Resume, 12 bipolar, and 75 quadripolar. Patients were followed for periods of 6 months to 12 years, with a mean follow-up of 44 months. 84 patients (42%) were able to control their pain by stimulation alone, 22 patients (11%) needed occasional analgesic supplements along with their stimulation program. Pain secondary to failed back syndrome, multiple sclerosis, peripheral vascular disease, sympathetic dystrophy and diabetic neuropathy responded favorably. ...
Between 1984 and 1988, seven women with breast cancer were treated with intraoperative electron beam therapy (IOEBT). All patients were Caucasian. Patient age ranged from 37 to 62 (median 53) years. Histopathology was infiltrating duct carcinoma (6/7) or medullary carcinoma (1/7). Four tumors were staged T1 N0 MO, one T1 N1 MO, one T2 N1 MO, and one lesion was recurrent. At the time of primary lumpectomy or axillary node dissection, a dose of 10 or 15 Gy IOEBT was administered to the tumor bed with 6 or 9 MeV electrons through the lumpectomy wound. All patients received 45 or 50 Gy over five to six weeks with 6 MV photons to the breast and, in four patients, to the regional nodes. Three patients received adjuvant chemotherapy and tamoxifen. No post-operative complications were observed. All patients are alive as of August, 1989, with no evidence of recurrent disease. Excellent cosmesis is the rule. Clinical and technical aspects of treatment are presented along ...
Because toxicity with the use of 3000 centiGray (cGy) of total lymphoid irradiation (TLI) was observed in an earlier study, 2000-cGy treatments were delivered in a 2-portal format to 7 patients and in a modified 3-portal fashion to 6 patients, as part of a randomized, investigator-blinded trial of TLI treatment for refractory rheumatoid arthritis. Analysis of combined data from the 13 patients revealed statistically significant improvement in 5 clinical indicators of disease activity at the end of TLI and 6 and 12 months later, accompanied by T4-specific immunosuppression. Management considerations resulted in the introduction of prednisone therapy in 5 patients, methotrexate in 4, and azathioprine in 1 during the interval of 8-12 months post-TLI. Herpes zoster occurred in 5 patients prior to the initiation of this additional therapy. These data indicate that, in patients with rheumatoid arthritis, a TLI dose of 2000 cGy is sufficient to ...
Stability concerns of the Par Pond Dam, an embankment structure in the Savannah River Site complex, resulted in a comprehensive evaluation of the state of its integrity. Specifically, excessive seepage through the embankment, slope failure due to an earthquake event as well as liquefaction potential of the embankment and the foundation are addressed and the potential of failure is evaluated. Lastly, remedial benefits of the addition of a berm structure are also assessed.
Heart failure goes beyond mechanical dysfunction and involves an interplay of multiple pathophysiologic mechanisms, including inflammation, tissue remodeling, neurohormonal and endocrine signaling, and interactions with the renal and nervous systems. This article highlights some novel biomarkers that may aid in diagnosis, treatment, and prognosis of acute heart failure, specifically focusing on ST2, endoglin, galectin-3, cystatin C, neutrophil gelatinase?associated lipocalin, midregional pro-adrenomedullin, chromogranin A, adiponectin, resistin, and leptin and their emerging clinical roles.
AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.Full Text Available
A case study is presented about the failure of a stainless steel blade reinforcing band in a steam turbine. The inspection results and analysis of samples of material are discussed. Being pitting corrosion and cracks the main defects found, a study of chemical composition and heat treatment state of the steel is made and findings are related to type of failure. (orig.)
1 The decreased binding of drugs and dyes to plasma proteins from male and female rats with acute renal failure has been investigated using equilibrium dialysis at 37 degrees C. 2 Acute renal failure...Full Text Available
Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin electron beam therapy. The mean interval between the first and the second courses of therapy was 41.3 ...
Because of heightened media coverage, a 24-hour news cycle and the potential miscommunication of health messages across all levels of government during the onset of the H1N1 influenza outbreak in spring 2009, the Illinois Department of Public Health (IDPH) decided to evaluate its H1N1 influenza A communications system. IDPH wanted to confirm its disease information and instructions were helping stakeholders prepare for and respond to a novel influenza outbreak. In addition, the time commitment involved in preparing, issuing, monitoring, updating, and responding to H1N1 federal guidelines/updates and media stories became a heavy burden for IDPH staff. The process and results of the H1N1 messaging survey represent a best practice that other health departments and emergency management agencies can replicate to improve coordination efforts with stakeholder groups during both emergency preparedness and response phases. Importantly, the H1N1 survey ...
The objective was to characterize imaging findings of benign notochordal cell tumors (BNCTs). Clinical and imaging data for 9 benign notochordal cell tumors in 7 patients were reviewed retrospectively. Conventional radiographs (n = 9), bone scintigrams (n = 2), computed tomographic images (n = 7), and magnetic resonance images (n = 8) were reviewed. Eight of the 9 lesions were stained with hematoxylin-eosin and microscopically examined. There were 3 male and 4 female patients with an age range of 22 to 55 years (average age, 44 years). Two patients had two lesions at different sites. The lesions involved the cervical spine in 4 patients, the lumbar spine in 2, the sacrum in 2, and the coccyx in 1. The most common symptom was mild pain. The lesions of 2 patients were found incidentally during imaging studies for unrelated conditions. Five patients underwent surgical procedures. One patient died of surgical complications. All other patients have been well without recurrent or progressive ...
Most of previous study for creep rupture of RPV lower head under severe accident condition, have been focused on global failure of RPV lower head. In contract, the local failure of the RPV nozzle region has not been studied in detail. The existence and features of nozzle failure in LAVA-ICI specimen of KAERI and LHF-4 specimen of Sandia National Lab., are observed. It is confirmed that the nozzle failure of LHF-4 specimen is due to the hoop stress in the RPV. The tensile tests in various temperatures and the creep rupture tests in various temperatures and stresses, are accomplished. The finite element analysis for LAVA-ICI experiment was confirmed, and the stress and deformation analysis results are used in LAVA-ICI experiment. 17 refs., 34 figs., 3 tabs. (Author)
In the field of Living Probabilistic Safety Assessment (LPSA) the reliability data updating is an important factor. In risk analysis equipment failure data is needed to estimate the frequencies of events contributing to risk posed by a facility. Five years data of emergency diesel generator (EDG) of Daya Bay Nuclear Power Plant (NPP) has been studied in this paper. The data updating process has been done by using two methods, i.e., the classical method and Bayesian method. The aim of using these methods is to calculate the operational failure rate (@l) and demand failure probability (p). The results show that the operational failure rate is 1.7E-3 per hour and the demand failure probability is 2.4E-2 demand per day for Daya Bay NPP. By comparing the results obtain from classical and Bayesi...
Microelectronic failure analysis (FA) has been an integral part of the development of state-of-the-art integrated circuits. FA of MicroElectroMechanical Systems (MEMS) is moving from its infancy stage to assume an important role in the successful design, fabrication, performance and reliability analysis for this new technology. In previous work, the authors focused on the application of several techniques developed for integrated circuit analysis to an earlier version of a surface micromachined microengine fabricated at Sandia. Recently, they have identified important new failure modes in binary counters that incorporate a newer design of the microengine, using a subset of integrated circuit failure analysis techniques including optical microscopy, focused ion beam (FIB) techniques, atomic force microscopy (AFM), and scanning electron microscopy (SEM). The primary failure mode they have identified is ...
The authors assess the role of Computed Topography in the diagnosis and management of multiple myeloma (MM) and investigate if Computed Tomography findings can influence the clinical approach, prognosis and treatment. 273 multiple myeloma patients submitted to Computed Tomography June 1994, to December, 1996. The patients were 143 men and 130 women (mean age: 65 years): 143 were stage I, 38 stage II and 92 stage III according to Durie and Salomon's clinical classification. All patients were submitted to blood tests, spinal radiography and Computed Tomography, the latter with serial 5-mm scans on several vertebral bodies. Computed Tomography despicted vertebral arch and process involvement in 3 cases with the vertebral pedicle sign. Moreover, Computed Tomography proved superior to radiography in showing the spread of myelomatous masses into the soft tissues in a case with solitary permeative lesion in the left public bone, which facilitated subsequent biopsy. As for ...
The management of risks of explosives are described. Administrative and procedural controls are considered. The safety management plan involves hazard identification, risk analysis, assessment and control. The current position of explosives safety is considered. 4 tabs.
The publication presents an outline of the subject of energy management and attempts to test the hypotheses that targeted knowledge management may result in new developments and potentials, and if these are at all desirable. On this basis, a knowledge management system will be developed that may effectively promote developments and potentials in the field of energy management. The tools and fundamentals of energy management are looked into, and the given situation and desired goals are identified by means of an enquiry. This is a scientific study that aims at providing empirical information on the situation and views on the subject of energy management. The analysis, which is supported by an enquiry sheet, is to provide a basis for testing the assumed hypothesis. Further, the potential acceptance and utilization potential of decisive knowledge ...
Alzheimer's disease (AD) is the most common form of dementia in the elderly. Although traditionally considered a disease of neurofibrillary tangles and amyloid plaques, structural and functional changes...Full Text Available
Peripheral vascular diseases (PVD) are referred to as diseases affecting the blood vessels other than the heart and the brain. Interventional endovascular treatment whenever feasible has become the...Full Text Available
Cerebral atrophy rate is increasingly used as an outcome measure for Alzheimer's disease (AD) trials. We used the Alzheimer's disease Neuroimaging initiative (ADNI) dataset to assess if adjusting...Full Text Available
Objectives:Copy number variants (CNVs) have been recognized as a source of genetic variation that contributes to disease phenotypes. Alzheimer disease (AD) has high heritability...Full Text Available
Polycystic kidney disease (PKD) is one of the leading causes of end-stage renal disease in humans and is characterized by progressive cyst formation, renal enlargement, and abnormal tubular development....Full Text Available
Background/Aims:Inflammatory bowel disease (IBD) was previously thought a rare disease among children in Kuwait since most diarrhea cases were attributed to infections....Full Text Available
Infections have been implicated in the pathogenesis of a number of autoimmune diseases, and Yersinia enterocolitica (YE) might play a role in the development of autoimmune thyroid disease...Full Text Available
Forty-one Spanish families with polycystic kidney disease 1 (PKD1) were studied for evidence of linkage disequilibrium between the disease locus and six closely linked markers. Four of these loci--three...Full Text Available
BackgroundAlzheimer's Disease (AD) is the most common neurodegenerative disease and the leading cause of dementia among senile subjects. It has been proposed that AD can be caused...Full Text Available
STUDY OBJECTIVE: To estimate the incidence rate of newly diagnosed cases of coeliac disease in Italy. DESIGN: This was a descriptive study of coeliac disease incidence in the period 1990-91. SETTING:...Full Text Available
BackgroundSexual function is impaired in women with inflammatory bowel disease (IBD) as compared to normal controls. We examined disease specific determinants of different aspects...Full Text Available
Chronic wasting disease (CWD) is a contagious, fatal prion disease of deer and elk that continues to emerge in new locations. To explore the means by which prions are transmitted with high efficiency...Full Text Available
One of the modifiable risk factors associated with coronary heart disease (CHD) is hypercholesterolemia. This paper reviews the major plasma lipids and how they relate to coronary heart disease. Among...Full Text Available
Chagas disease, caused by infection with Trypanosoma cruzi, is an important cause of cardiovascular disease. It is increasingly clear that parasite-derived prostaglandins potently modulate...Full Text Available
Enzootic Glassers's disease was investigated to study the epidemiology of the disease strains on a farm where it presented a problem. Restriction endonuclease fingerprinting (REF) analysis technique...Full Text Available
BackgroundPeriodontal disease in diabetic patients presents higher severity and prevalence; and increased severity of ligature-induced periodontal disease has been verified in diabetic...Full Text Available
Aberrant transglutaminase (TG) activity has been implicated in the pathology of numerous diseases including Huntington disease and Alzheimer disease. To fully characterize the role of TGs in...Full Text Available
The purpose of this report is to advise managers on the status of Year 2000 readiness at the Laboratory and provide a summary of critical issues to be addressed in order to ensure that the Year 2000 date rollover will not disrupt Laboratory Operations. The Laboratory`s Year 2000 council members are in the first phase of Year 2000 plans: gathering data and assessing the status of their divisions or programs. This first snapshot of the Laboratory Year 2000 readiness assessment is expected to grow and change over time as more refined assessments, plans, and schedules are developed and as more information becomes available. Here are findings to date: (1) Embedded systems` status not known. (2) Preliminary cost estimates for Year 2000 repairs, testing, and implementation are estimated to be at least $5.9 million, not including embedded systems. (3) The Laboratory is required to make unavoidable purchases of Year 2000-compliant products. (4) The Year 2000 short-term ...
The role of radiation therapy in local tumor control and decreased incidence of pulmonary metastasis is reported in 271 patients who were entered into the Intergroup Ewing's Sarcoma Study with more than one year follow-up and on whom all radiotherapy records were reviewed. The majority of the patients were irradiated to the primary tumor with doses of 4500 to 6500 rad in five to six weeks in combination with systemic administration of three drugs (vincristine, actinomycin-D and cyclophosphamide) or four drugs (vincristine, actinomycin-D, cyclophosphamide and adriamycin). One of the groups of patients was treated with three drugs and bilateral pulmonary irradiation (1500 rad, uncorrected dose, in two weeks). Preliminary analysis shows an overall local primary tumor control of 89%. Patients with lesions in the pelvis had a local failure rate of 17% (9 of 52) and in the humerus 23% (7 of 31). Factors affecting local recurrences are analyzed in detail. Distant ...
This paper presents the regulatory experience gained from Wolsong Units 2,3 and 4 - Special Safety System Instrumentation Uncertainty for Trip Setpoint and Allowable Values. The equipment diversity method for the defense against common mode failure was applied to the transmitters of shutdown system number 2. However the Units experienced an unexpected drift problem with which the performance did not meet the Technical Specification (Tech Spec) Surveillance Requirements (SR). Discussed are the background, status and corrective actions, regulatory positions and issues to be solved for the drift problem. It was an instrument uncertainty methodology that the designer of safety system should have shown when the drift problem occurred. For deeper understanding of the problem, we present the background of Tech Spec SR for setpoints in Korean PWR and in CANDU reactors. The Setpoint Verification Test(SVT) and Calibration Test(CT) shall be achieved by recording sufficient ...
This paper is a progress report on the role of radiation therapy (RT) in local tumor control and the decreased incidence of pulmonary metastasis in 251 patients entered in the Intergroup Ewing's Sarcoma Study. All were followed for more that 1 year, and their RT records were reviewed. Doses to the primary tumor in the range of 4,500--6,500 rad were administered over approximately 5 to 6 weeks in combination with 4 drugs, i.e., vincristine (VCR), dactinomycin (DAC), cyclophosphamide (CY), and adriamycin, or only the first 3. One group of patients received the 3 drugs and bilateral pulmonary irradiation (approximately 1,500 rad in 2 wk). Preliminary analysis showed a local primary tumor control of approximately 90%. Patients with lesions in the pelvis and humerus had local failure rates of 13% (7 of 54) and 21.4% (6 of 28), respectively. The treatment groups differed significantly in the incidence of pulmonary metastasis. Patients treated with the 4 drugs (regimen 1) ...
Data communication in a computer network environment is facing serious security threats from numerous sources such as viruses, worms, Zombies etc. These threats can be broadly characterized as internal or external security threats. Internal threats are mainly attributed to sneaker-nets, utility modems and unauthorized users, which can be minimized by skillful network administration, password management and optimum usage policy definition. The external threats need more serious attention as these attacks are mostly coming from public networks such as Internet. Frequency and complexity of such attacks is much higher as compared to internal attacks. This paper presents a host based network layer screening of external and internal IP packets for logging, analyzing and real-time detection of possible IP spoofing and Denial of Service attacks. This work can also be used in tuning security rules definition for gateway firewalls. Software has been developed which ...
Improved uranium utilization by means of extended burnup via routine end-of-cycle coastdown has been analyzed, with a specific focus on pressurided water reactors. Both computer and simple analytic models have been developed to determine the optimal coastdown length. Coastdown has been compared with the use of higher fuel-enrichment to achieve comparable burnup values. Temperature and Power coastdown modes were analyzed and changes in the plant thermodynamic efficiency determined. Effects on fuel integrity due to coastdown were examined using a fuel reliability code (SPEAR). Finally the effects on coastdown duration of major parameters involved in charaterizing reactor operation and the economic enviroment were examined. It was found that natural uranium savings up to 7% could be achieved in a typical application by the use of routine pre-planned coast down up to the economic optimun. If coastdown is carried out all the way up to the economic breakeven point yellowcake savings sum up ...
Since the first operation of nuclear steam generator early 1960s, its performance requirements have been met but the steam generator problems have been met but the steam generator problems have been major cause of reducing the operational reliability, plant safety and availability. U-tube assembly of steam generator forms the primary system pressure boundary of the plant and have experienced several types of tube degradation problems. Tube failure and leakage resulting from the degradation will cause radioactive contamination of secondary system by the primary coolant, and this may lead to unplanned plant outages and costly repair operations such as tube plugging or steam generator replacement. For the case of steam generators for heavy water reactors, e.g. Wolsong 2, 3, and 4 NPP, a high cost of heavy water will be imposed additionally. During the plant operation, steam generator tubes can potentially be subject to adverse environmental conditions which will cause ...
...American Journal of Kidney Diseases-The American Journal of Kidney Diseases (AJKD), the official journal of the National Kidney Foundation, is ... American Journal of Kidney Diseases - Elsevier Home Products User Resources About Us Support & Contact Elsevier Websites Advanced Product ...Search Browse Journals American Journal of Kidney Diseases American Journal of Kidney Diseases Official Journal of the National Kidney Foundation Additional Information Related Publications ...Article Tracking for Editors Reviewers Advertisers/Sponsors Advertisers Media Kit Societies National Kidney Foundation ISSN: 0272-6386 Imprint: SAUNDERS Actions Submit ...
BackgroundIncrease in the incidence of hyperuricemia associated with gout as well as hypertension, renal diseases and cardiovascular diseases has been a public health concern. We...Full Text Available
Contagious diseases are a threat to animal health and productivity, both nationally and at the farm level. This makes implementation of biosecurity measures to prevent their introduction and...Full Text Available
Hypersensitivity Pneumonitis (HP) is an interstitial lung disease that develops following repeated exposure to inhaled environmental antigens. The disease is characterized by alveolitis, granuloma formation...Full Text Available
Hypophosphatasia is a congenital disease characterized by deficiency of serum and tissue non-specific alkaline phosphatase activity. The disease occurs due to mutations in the liver/bone/kidney alkaline...Full Text Available
BackgroundSeveral studies have suggested an association between periodontal disease and prematurity but this finding has not been consistently observed.MethodsCase...Full Text Available
The identification of individuals at risk for Alzheimer's disease (AD) is essential for the timely administration of treatment approaches aimed at slowing the onset or progression of the disease....Full Text Available
While the etiology of Parkinson's disease remains largely elusive, there is accumulating evidence suggesting that mitochondrial dysfunction occurs prior to the onset of symptoms in Parkinson's disease....Full Text Available
Rheumatoid arthritis (RA) is a debilitating autoimmune disease of global prevalence. The disease is characterized by synovial inflammation leading to cartilage and bone damage. Most of the conventional...Full Text Available
AIM: To search the independent factors determining gastric juice acidity and to investigate the acidity of gastric juices in various benign and malignant upper gastrointestinal diseases.METHODS:...Full Text Available
AIM: To investigate the effects of gallbladder stones on motor functions of the gallbladder and the dynamics of bile flow in asymptomatic gallstone disease.METHODS: Quantitative hepatobiliary...Full Text Available
In contrast to the increasing availability of information pertaining to the care of children with chronic kidney disease (CKD) from large-scale observational and interventional studies, epidemiological...Full Text Available
BackgroundMultiple myeloma is a hematologic malignancy associated with the development of a destructive osteolytic bone disease.ResultsMathematical...Full Text Available
ObjectiveTo develop a simple summary risk score for the prediction of Alzheimer disease in elderly persons based on their vascular risk profiles.DesignFull Text Available
This revision of the APT Waste Management Plan details the waste management requirements and issues specific to the APT plant for design considerations, construction, and operation. The APT Waste Management Plan is by its nature a living document and will be reviewed at least annually and revised as required.
Environmental Protection Agency Energy Management and Conservation Program ...Environmental Protection Agency Office of Administration and Resources Management 1200 Pennsylvania Avenue, NW (3101A) ...MANAGEMENT AND ADMINISTRATION 7 Energy Management Infrastructure 7 Senior Agency Official and Energy Team 7
OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel....Full Text Available
Title: FY 2004 Energy Management and Conservation Program Annual Report ...Energy Management and Conservation Program ...Environmental Protection Agency Office of Administration and Resources Management 1200 Pennsylvania Avenue, NW (3101A)
Keywords: energy, management, conservation, program, fiscal, year, 2005, annual, ...S Environmental Protection Agency Energy Management and Conservation Program ...ENVIRONMENTAL P ROTECTION AGENCY Energy Management and Conservation Program Fiscal Year 2005 Annual Report
This probabilistic analysis of WIPP TRUDOCK crane failure is based on two sources of failure data. The source for operator errors is the report by Swain and Guttman, NUREG/CR-1278-F, August 1983. The source for crane cable hook breaks was initially made by WIPP/WID-96- 2196, Rev. O by using relatively old (1970s) U.S. Navy data (NUREG-0612). However, a helpful analysis by R.K. Deremer of PLG guided the authors to values that were more realistic and more conservative, with the recommendation that the crane cable/hook failure rate should be 2.5 x 10-6 per demand. This value was adopted and used. Based on these choices a mean failure rate of 9.70 x 10-3(1/yr) was calculated. However, a mean rate by itself does not reveal the level of confidence to be associated with this number. Guidance to making confidence calculations came from the report by Swain and Guttman, who stated that ...
9 9 simulated Purex waste oxides was investigated as a function of Na/sub 2/O, CaO and P/sub 2/O/sub 5/ content. All compositions lost some sulfate at 50 to 100 deg C above the softening point. In generai the volatility decreased with increase of either Na/ sub 2/O or CaO relative to P/sub 2/O/sub 5/, but no simple correlation Was indicated. Softening temperatures were lowered by inc ease in Na/sub 2/O vs CaO. Ceramic solids were obtained but no true glasses. Attempts to produce glasses by addition of varying combinations of Al/sub 2/O/sub 3/, PbO, BaO, and B/sub 2/O/ sub 3/ to simulated Pure x waste plus phosphite were unsuccessful. The use of 0.005 M Na/sub 2/C/O/sub 3/ to precipitate calcium from wastes containing up to 3 ppm of phosphate was demonstrated in four pilot plant runs and produced a decrease in the hardness of the waste leaving the clarifier. An inadvertent Sr/ sup 90/ and Cs/sup 137/ breakthrough occurred during one run which was caused ...
The purpose of this document is to describe the NIF Project Organization and the roles and responsibilities of the managers charged with executing the Project.
Sep 2, 2008 ... Abstract: This tutorial is intended to serve as a guide towards proper hazardous waste management. Knowing the regulations, different ...
This document deals with energy management in buildings. It presents the conditions for a good implementation of energy management. These conditions include the total involvement of the management and the training of the staff. The structure of this implementation is presented together with the tools for an efficient energy management. Eventually, information on air quality and comfort in buildings is provided, as well as the management of complaints linked to them. (TEC). 1 tab.
Patients with heterotaxy syndrome often have complex cardiac and extracardiac anomalies requiring further detailed diagnostic evaluation. They often present severe cardiac failure early in life. Newer radiological modalities in the form of spiral computed tomography (CT) and three-dimensional reconstruction of spiral CT allow clear definition of the anatomy of these anomalies. A 59-year-old woman was diagnosed with polysplenia and multiple anomalies in an abdominal ultrasonography (US) during a control medical examination due to a trivial dietary mistake. She was then referred to our institution for further examination of these anomalies and an additional thoraco-abdominal computed tomography (CT) examination. The patient was totally asymptomatic at the time of admission. There was no significant past history and no abnormal laboratory data. We performed abdominal, pelvic and thoracic CT examinations using Somatom Siemens Emotion scanner. Non-enhanced sections were ...
Polyethylene gas piping is expected to be in service for times on the order of 50 years depending on service conditions. Therefore research research on piping materials and pipes has two principal objectives: (a) developing methods for predicting when a pipe will fail and (b) improving the material for piping. The prediction of long time failure hinges on the development of short time test methods which relate to long time failure. The improvement in the behavior of current materials also hinges on the use of test methods of short duration relative to the anticipated life time of the pipe in service. One of the primary criterion for an acceptable test method is that it produces the same type of failure as is observed after long time failure in service. It has been found that P.E. pipe material fails in a brittle mode after long periods of time. The failure mode is called brittle ...
The TS-1 and TS-2 TREAT transient experiments subjected a low burnup (2 MWd/kg) and a medium burnup (58 MWd/kg), respectively, FFTF irradiated fuel pin to unprotected 5 cents/s overpower transient conditions. The fuel pin failure response was similar in the two tests, which demonstrated a large margin to failure (P/P_0 > 3) and a favorable upper level failure location. Thus, for these transient conditions, burnup effects on transient performance appeared to be minimal in the range tested. Pin disruption in the medium burnup TS-2 test was more severe due to the higher fission gas pressurization, but failure occurred at only a 5% lower power level than for the low burnup TS-1 fuel pin. Both tests exhibited axial extrusion of molten fuel to the region above the fuel column several seconds before pin failure, demonstrating a potentially beneficial inherent safety mechanism to delay ...
Airborne pollutants can cause failures in switching and computing equipment. This paper focuses on a subset of such pollutants - airborne fine particles (<2.5 [mu]m diameter). It begins by examining the extent to which different improvements in heating, ventilating and air conditioning (HVAC) systems reduce indoor concentrations of fine particles. For each modification, the consequent reduction in soiling rate is derived. The concomitant increase in operating costs is also calculated. These costs are then compared with the costs of failures in telephone switching offices, leading to estimates of failure rate reductions that would make improvements cost-effective. Finally, the reduction in failures required to offset the costs of the improvements are compared with documented differences in failure rates between unimproved and improved environments. This study suggests that, in ...
This paper presents a method for the optimal design of high voltage transmission lines taking into consideration shielding and backflashover failure rates. The minimization of suitably defined performance indices, which relate the failures caused by lightning in a transmission line to both line insulation level and tower footing resistance, is aimed. Optimum values for both line insulation level and tower footing resistance are calculated. The method is applied on several operating Hellenic transmission lines of 150 and 400kV, respectively, carefully selected among others, due to their high failure rates during lightning thunderstorms. Special attention has been paid on open loop lines, where a possible failure could bring the system out of service causing significant problems. The obtained design parameters, which reduce the failure rates caused by lightning, are compared with the ...
This study describes the formulations to optimize the time interval of inspections and/or replacements of equipment/parts taking into account the probability density functions (PDF) for failure rates and parameters of failure distribution functions (FDF) and evaluates the optimized results of these time intervals using our formulations by comparing with those using only representative values of failure rates and the parameters of FDF instead of using these PDFs. The PDFs are obtained with Bayesian method and the representative values are obtained with likelihood estimation method. However, any significant difference is not observed between both optimized results within our preliminary calculations. (author)
A wood/polymer composite was produced by impregnating Ramin wood with methyl methacrylate monomer and subsequently polymerizing it by gamma irradiation. To assess the improvement in compression strength of the wood caused by the polymer impregnation, a microbuckling compression failure mechanism was used to model the compression failure of the composite. Such a mechanism was found to predict a linear relationship between the compression strength and the percentage polymer impregnation (by weight). Uniaxial compression test results at 45({plus minus}5)% and 90({plus minus}5)% relative humidity levels, after being statistically analysed, showed that such a linear relationship was valid for up to 100% polymer impregnation. (author).
A wood/polymer composite was produced by impregnating Ramin wood with methyl methacrylate monomer and subsequently polymerizing it by gamma irradiation. To assess the improvement in compression strength of the wood caused by the polymer impregnation, a microbuckling compression failure mechanism was used to model the compression failure of the composite. Such a mechanism was found to predict a linear relationship between the compression strength and the percentage polymer impregnation (by weight). Uniaxial compression test results at 45(#+-#5)% and 90(#+-#5)% relative humidity levels, after being statistically analysed, showed that such a linear relationship was valid for up to 100% polymer impregnation. (author).
Oak Ridge National Laboratory (ORNL) has for over ten years provided materials testing and failure analysis services to various coal conversion and utilization facilities in the United States. ORNL was involved in these types of activities at all four of the major coal liquefaction pilot plants. This paper presents a summary of activities at Wilsonville over the past two and one-half years. Some details of these activities are discussed below. Failure analysis of elastomers, stainless steels, and alloys is discussed. 6 refs., 9 figs., 13 tabs.
The wind industry has experienced premature turbine component failures during the past years. With the increase in turbine size, these failures, especially those found in the major drivetrain components, i.e. main shaft, gearbox, and generator, have become extremely costly. Given that the gearbox is the most costly component in the drivetrain to fix, the National Renewable Energy Laboratory (NREL) initiated the Gearbox Reliability Collaborative (GRC) to determine the causes for premature gearbox failures and subsequently, recommend improvements to gearbox design, manufacture, and operational practices. The GRC has two identical test gearboxes, which are planned for a dynamometer and a field test, respectively.
A fuel plate examination was conducted in the hot cell and canal to determine the possible failure modes for three plates leaking fission products. The plates were irradiated in the Extended Life Aluminide Fuel (ELAF) program in support of university research reactor goals to increase the limits presently allowed. The examination indicated pitting corrosion to be the failure mode. Other failure modes such as: (a) nonbonded swelling, (b) excessive fuel swelling, and (c) overheating of the plates were not observed.
We used epidemiologic data for human West Nile virus (WNV) disease in Colorado from 2003 and 2007 to determine 1) the degree to which estimates of vector-borne disease occurrence is influenced by spatial...Full Text Available
Laboratory-based surveillance of Lyme disease in Connecticut during 1984 and 1985 identified 3,098 persons with suspected Lyme disease; 1,149 were defined as cases. Lyme disease incidence in Connecticut...Full Text Available
The aims of this study were to quantify the severity and extent of subclinical interstitial lung disease as depicted on HRCT and to study the relationship between the patterns of lung disease quantified by HRCT and the functional parameters and bronchoalveolar lavage findings in patients with rheumatic diseases. The results confirm that HRCT is a sensitive tool in detecting interstitial lung disease in patients with rheumatic diseases with no signs and symptoms of pulmonary involvement. The relationship between the different HRCT patterns and bronchoalveolar lavage cell profiles can identify patients at higher risk of developing irreversible lung fibrosis. A long-term, prospective follow-up study is needed to determine whether these patients will develop over pulmonary disease.
The case is presented of a 64-year-old man who complained on admission of discomfort in the right shoulder at the time of excision of a large section of the axillary skin which contained extra-mammary Paget disease. Shortly thereafter, radiological studies of the humerus and scapula showed obvious malignant disease which proved to be metastatic upon biopsy of the humerus and pathological studies of the excised area of extra-mammary Paget disease in the axillary skin. The patient died twelve months after the diagnosis was established with widespread metastatic disease. The literature on the subject was reviewed and it was demonstrated that metastases to the skeleton from lesions of the skin are relatively rare. This case is exceptional because of the rapid fatal course and the extent of metastatic disease originating in extra-mammary Paget disease of the axillary ...
of the Intelligent Control System (ICS) for reusable rocket engines. .... the incoming measurements with corresponding estimates, a sensor failure can be ...
Several randomized studies have been completed in prostate cancer that show a benefit to immediate postoperative treatment in patients undergoing prostatectomy. In one of the studies, there was even...Full Text Available
Mangroves are disappearing rapidly worldwide despite their well documented biodiversity and the ecosystem services they provide. Failure to link ecological processes and their societal benefits has...Full Text Available
The location of defective LMFBR fuel pins by the determination of gas tag isotopic ratios is discussed. The application of this method to the FFTF Reactor briefly described.
The coolant activity analysis to obtain the information about the fuel failure has been studied long before. And several codes have been developed to estimate the number of fuel failures through evaluating volatile and inert fission products release in coolant from the defective fuel. These codes use a fission product diffusion model coupled with a mass balance in the gap and coolant. But each code has a different model to assess fuel failure. In order to develop the model to estimate the number of fuel failures we analysis well-known code's models such as CHIRON, CADE, IODYNE, and CAAP and compare accuracy through Korean PWR activity data
Corrosion failures in circuits of foreign NPPs are considered. According to American statistics there are more corrosion failures in two-circuit NPPs than in NPPs with one circuit. Steam generators mostly suffer from ''corrosion denting''. Lately pitting corrosion becomes a potentially serious problem. Steam generator vertical tubes are mainly subjected to this corrosion type. Attention is drawn to intercrystalline corrosion. The causes of corrosion are described. The problem of optimization of structural materials is discussed to reduce corrosion failures as well as other methods of decreasing corrosion failures. Organization of nondestructive testing, increased requirements to water and steam purity are of great importance.
A general purpose Emergency Generator Set (EGS) is considered for a methodological study and related reliability behavior is analyzed. In particular in a procedure of reliability and availability analysis of a EGS, dependent failure events need a complex mathematical model as state-space model to be a accurately evaluated. Furthermore these dependent failure events are one of the most important reliability characteristic of EGS. This paper suggests a procedure for reliability calculations in presence of dependent failure based on the evaluation of a equivalent failure rate that can be fitted to a network reduction method by simple mathematical calculations. The simplified models analyzed show a good accuracy for a wide range of variation of main reliability characteristics of EGS and utility. The advantages obtained are very useful on reliability evaluation because the possibility of use of network ...
... position must not be penalized in their NCO Evaluation Report (NCOER). ... failure to perform MOS-, SQI-, or ASI-related duties after counseling. ...
The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver...Full Text Available
Effects of soil pH on damping-off of sugar beet by R. solani (AG2-2) and soil suppressiveness against the disease were studied by comparing disease incidences in pasteurized versus non-pasteurized, infested soils. Soil pH was correlated neither to disease incidence in five soils ranging from pH?4.5 to 7.2 nor to indigenous disease suppressiveness, the difference in disease incidences between non-treated soil and its pasteurized counterpart. When an alkaline soil was acidified with H2SO4, disease suppression markedly declined, increasing disease incidence in the non-pasteurized soil. Inversely, disease suppression was enhanced when an acidic soil was neutralized by adding Ca(OH)2. Soil amendment with dried peanut plant residue suppressed the disease in two pasteurized, near-neutral soils, l...
This report is a compilation of worksheets from the waste management units of Savannah River Plant. Information is presented on the following: Solid Waste Management Units having received hazardous waste or hazardous constituents with a known release to the environment; Solid Waste Management Units having received hazardous waste or hazardous constituents with no known release to the environment; Solid Waste Management Units having received no hazardous waste or hazardous constituents; Waste Management Units having received source; and special nuclear, or byproduct material only.
The importance of radiation management for nuclear facilities including nuclear power plants has increased as the general public understanding has progressed, and necessary information for management must be processed exactly and quickly. In nuclear power plants, radiation management is performed by each individual operation, and collected information is managed by the system of each operation. The distributed-processing radiation management system has been developed aiming to use a general-purpose LAN and make quick and efficient use of information managed by individual operations. This paper describes the system configuration and functions. (author)
The instrument ball bearings are the key components of movable components for various kinds of measuring and control instruments; they often operate in the environmental condition of high-speed and light preload. In general, the non metal, disposable oilimpregnated retainer material has been used for these kinds of high precision miniature bearing. The engineering practice shows that the common failure mode of them is the wear which appears under the condition of insufficient lubrication condition. As the results, the vibration and noise will be enlarged, so does the frictional torque, which makes the ball bearings to lose its original working accuracy. It is the lifetime test of bearings that can enable the designers and manufacturers to chose the material of the bearing properly, optimize the product structure, mend the manufacturing technique process, and to enhance the technical level of the bearing products significantly. In this paper, the wear lifetime ...
According to the California Earthquake Authority, only about 12% of current California residences are covered by any form of earthquake insurance, down from about 30% in 1996 following the 1994, M6.7 Northridge earthquake. Part of the reason for this decreasing rate of insurance uptake is the high deductible, either 10% or 15% of the value of the structure, and the relatively high cost of the premiums, as much as thousands of dollars per year. The earthquake insurance industry is composed of the CEA, a public-private partnership; modeling companies that produce damage and loss models similar to the FEMA HAZUS model; and financial companies such as the insurance, reinsurance, and investment banking companies in New York, London, the Cayman Islands, Zurich, Dubai, Singapore, and elsewhere. In setting earthquake insurance rates, financial companies rely on models like HAZUS, that calculate on risk and exposure. In California, the process begins with an official earthquake forecast by the ...
Japan`s coke industry was developed as the basic part for iron and steel industry. The paper addresses two factors as a characteristic of Japan-unique management. One topic is operation management and equipment management of coke factory; the second topic is human resource training in a company that lies under each management. The concepts and actual methods of these topics are introduced by showing examples. The paper discusses the improvement of the working environment and measures for future employment caused by the aging problem in Japan. 5 figs.
DOE`s Office of Environmental Management (EM) is responsible for managing waste and cleaning up contamination at DOE sites across the United States. A substantial fraction of the work performed for EM includes sampling and analysis activities. This paper outlines the Sample Management Programs, achievements to date, and future directions.
U.S. Department of Energy (DOE) Policy 450.4, Safety Management System Policy commits to institutionalizing an Integrated Safety Management System (ISMS) throughout the DOE complex as a means of accomplishing its missions safely. DOE Acquisition Regulation 970.5204-2 requires that contractors manage and perform work in accordance with a documented safety management system.
The Joint Convention on the Safety of Spent Fuel management and on the Safety of Radioactive Waste Management is the first legal instrument to directly address the safety of spent fuel and radioactive waste management on a global scale. The Joint Convention entered into force in 2001. This paper describes its process and its main achievements to date. The perspectives to establish of a Global Waste Safety Regime based on the Joint Convention are also discussed. (authors)
Following the executive summary, this document contains the following: (1) waste management facilities design objectives; (2) AVLIS production plant wastes; (3) waste management design criteria; (4) waste management plan description; and (5) waste management plan implementation. 17 figures, 18 tables.
The failure of receivers has been one of the main operating problems at the White Cliffs solar thermal power plant. This Technical Note reports the results of an initial investigation that identifies the cause as having been their thermal fatiguing of the tube walls. The fatigue appears to be caused by unstable heat transfer at vapor qualities below the point where critical heat flux is generally exceeded. Methods for avoiding this problem are tested.
Failure of multiple components due to a common cause represents one of the most important issues in evaluation of system reliability or unavailability. The frequency of such events has relatively low expectancy, when compared to random failures, which affect individual components. However, in many cases the consequence is a direct loss of safety system or mitigative safety function. For this reason, the modeling of a common cause failure (CCF) and its presentation in fault tree structure is of the uttermost importance in probabilistic safety analyses (PSA). Amongst the different techniques available to reduce the impact of common cause failures, the most important operations related technique, is that of staggered testing. In the TAPP 3,4 Level-1 PSA it was found that the contribution of Common Cause Failures to the Core Damage Frequency (CDF) was significant. The Common Cause ...
The purpose of the Microelectronic Evaluation Laboratory at Sandia is to develop a program for evaluating CMOS LSI (complementary metal oxide silicon - large scale integrated) technology devices which are being used for the first time in a weapon system. These evaluations are based on accelerated aging studies and electrical tests to determine the reliability and life of the devices. In accelerated aging, specific, controlled stresses are applied to the device to accelerate time-to-failure. Data are used tin mathematical models to estimate life in acutal use. The stresses used for this technology are temperature and voltage. The devices are stored at temperatures with or without voltage applied (steady-state or cyclical) and periodically tested until at least 50% failures are encountered. Since most current technologies use epoxy-die-attachment, aging temperatures must be under 200/sup 0/C. This delays device failure, and a ...
Only a small number of radiation accidents in the United States have been severe enough to result in multi-organ failure (MOF). Medical details of selected medical misadministration and criticality cases are reviewed, with an emphasis on pathophysiology. The four criticality cases are particularly relevant for analysis of MOF, since medical treatment was supportive and did not appreciably alter the clinical evolution of radiation injury. PMID:15975871
This paper investigates the calculation of availability for parallel transmission lines (two or more) in the same tower or on the same right of way. As in many studies, the development of mathematical models is an important step. The models are justified using historical data and known characteristics of power system elements. A statistical method was used to generalize the failure rate and repair rate from real operating data. Application of the new model (which combines common-mode, simultaneous independent, and dependent outages) is discussed.
This report contains the results of a survey of reactor coolant pump shaft seal reliability. The survey sample is representatively large (approx. = 27% of total US commercial plant population) and includes the three industry seal suppliers (Bingham-Williamette, Byron Jackson, and Westinghouse). Operationally incurred/induced problems and seal redesign parameters are identified. Failure hypotheses in the form of fault trees have been developed to describe the failure mechanisms. Recommendations are made for seal reliability improvement.
The paper presents results of studies on the effect of heat treatment on strength and pattern of 40Kh steel impact failure. Loading levels corresponding to macroscopic spalling microdamage initiation in the material are determined for three initial states. Metallographic study on the spalling failure pattern for 40Kh steel in different initial states and data on microhardness measurement are presented.
Probabilistic assessment methods can be used to identify specific plant vulnerabilities. Application of such methods can also facilitate selection among system design alternatives available for safety enhancements. The quality of assessment results is however strongly dependent on realistic and accurate input data for modelling of system component behaviour and failure modes during conditions to be assessed. Use of conservative input data may not lead to results providing guidance on safety upgrades. Adequate input data for probabilistic assessments seems to be lacking for at least failure modes of some electrical components when exposed to a fire. This report presents an attempt to improve the situation with respect to such input data. In order to take advantage of information in existing documentation of fire incident occurrences some of the lessons learned from the fire at Browns Ferry Nuclear Power Plant on March 22, 1975 are discussed in ...
A historical overview of corrosion problems found in power plant condensers and mitigation procedures is presented. The paper is organized according to alloy type and failure mode. Alloys considered are copper-base alloys, stainless steels and titanium. Failure modes discussed include erosion-corrosion, sulfide attack, environmentally assisted cracking, galvanic corrosion, steam condensate corrosion, pitting corrosion, and dealloying. Mitigation procedures discussed include cathodic protection, ferrous ion injection, as well as tube cleaning and layup practices.
Power devices such as MOSFETSs and IGBTs, include parasitic structures that can give rise to destructive failures such as breakdown and latch-up. To determine a suitable strategy for device radiation hardening, simulation software like MEDICI-2D can be used to model the effects of technological modifications and device parameters that are difficult to measure experimentally. (authors).
On February 9, 1995 ComEd experienced a pipe type cable failure on 138kV line 13717. Line 1737 is a bulk power transmission cable circuit connecting The Fisk and Crawford generating stations located within city limits. The line is approximately 4.5 miles long and was originally installed in 1975. This line is forced cooled, has 2,500 KCMIL copper conductors with 505 mils of paper insulation in an 8 inch pritec coated steel pipe. The splices are constructed with Voltalit castings. The failure occurred approximately 3,500 feet from Crawford Station. It was easy to locate the failure since the cable joint casing was breached resulting in the loss of approximately 2,600--2,700 gallons of dielectric fluid. Upon field examination B Phase was determined to have failed. The failure occurred 12 inches inside the casing in an area where it was impossible to install a long connector or add an additional short ...
Reliability has an impact on wind energy project costs and benefits. Both life test data and field failure data can be used for reliability analysis. In wind energy industry, wind farm operators have greater interest in recording wind turbine operating data. However, field failure data may be tainted or incomplete, and therefore it needs a more general mathematical model and algorithms to solve the model. The aim of this paper is to provide a solution to this problem. A three-parameter Weibull failure rate function is discussed for wind turbines and the parameters are estimated by maximum likelihood and least squares. Two populations of German and Danish wind turbines are analyzed. The traditional Weibull failure rate function is also employed for comparison. Analysis shows that the three-parameter Weibull function can obtain more accuracy on reliability growth of wind turbines. This work will be ...
A 25m wind turbine blade was tested to failure when subjected to a flapwise load. With the test setup, it was possible to test the blade to failure at three diffe-rent locations. The objective of these tests is to learn about how a wind turbine blade fails when exposed to a large flapwise load and how failures propagate. The report shows also results from ultra sonic scan of the surface of the blade and it is seen to be very useful for the detection of defects, especially in the layer between the skin laminate and the load carrying main spar. Acoustic emission was successfully used as sensor for the detection of damages in the blade during the test. The report contains measurements of the total deflection of the blade, the local deflection of the skin and the load carrying main spar and also measurement of strain all as a function of the applied load and up to failure of the blade. The 'post ...
A modified boundary element approach was used to analyze the response of offshore piles subjected to external soil movements. The computer model employed to solve the pile-soil problem was able to model pile head and tip loading, and loading caused by lateral movement of soil. A nonlinear pile-soil interface element with the ability to represent a hardening or softening plastic response prior to reaching an ultimate state was incorporated. With the program, 4 failure modes can be determined: flow of the soil slide past an intact stationary pile; rotation of the pile with the soil at failure along the full pile length; translation of the pile with the sliding soil, resulting in failure of the supporting soil; and the long-pile mode, in which the maximum bending moment in the pile reaches the yield moment of the pile before complete development of the other 3 modes. Theoretical solutions for a realistic hypothetical offshore ...
As part of the Nondestructive Evaluation Reliability Program sponsored by the US Nuclear Regulatory Commission, the Pacific Northwest Laboratory is developing a method that uses risk-based approaches to establish in-service inspection plans for nuclear power plant components. This method uses probabilistic risk assessment (PRA) results and Failure Modes and Effects Analysis (FEMA) techniques to identify and prioritize the most risk-important systems and components for inspection. The Surry Nuclear Power Station Unit 1 was selected for pilot applications of this method. The specific systems addressed in this report are the reactor pressure vessel, the reactor coolant, the low-pressure injection, and the auxiliary feedwater. The results provide a risk-based ranking of components within these systems and relate the target risk to target failure probability values for individual components. These results will be used to guide the development of ...
Development in organic farming has been stimulated by farmers and consumers becoming interested in healthy food products and sustainable environment. Organic agriculture is a holistic production management system which is based on the principles of health, ecology, care, and fairness. Organic development in Uganda has focused more on the crop sector than livestock sector and has primarily involved the private sector, like organic products export companies and non-governmental organizations. Agriculture in Uganda and many African countries is predominantly traditional, less mechanized, and is usually associated with minimum use of chemical fertilizers, pesticides, and drugs. This low external input agriculture also referred to as "organic by default" can create basis for organic farming where agroecological methods are introduced and present an alternative in terms of intensification to the current low-input/low-output systems. Traditional farming should not be ...
This report was prepared in response to a request from the Nuclear Energy Research Advisory Committee (NERAC) subcommittee on ''Long-Term Isotope Research and Production Plans.'' The NERAC subcommittee has asked for a reply to a number of questions regarding (1) ''How well does the Department of Energy (DOE) infrastructure sme the need for commercial and medical isotopes?'' and (2) ''What should be the long-term role of the federal government in providing commercial and medical isotopes?' Our report addresses the questions raised by the NERAC subcommittee, and especially the 10 issues that were raised under the first of the above questions (see Appendix). These issues are related to the isotope products offered by the DOE Isotope Production Sites, the capabilities and condition of the facilities used to produce these products, the management of the isotope production ...
Background and purpose: Local treatment for non-metastatic Ewing's sarcoma family tumors (ESFTs) is controversial. Results achieved in a single institution in patients with ESFT of the humerus are presented. Materials and methods: Patients treated between 1983 and 2000 for ESFT of the humerus were included. The impact of local treatment (surgery, radiotherapy or both) on outcome was assessed. Results: 55 patients: 34 males (62%); 21 females (38%); mean age: 17.9 (range: 3-40). Local treatment: surgery in 27 patients (49%), radiotherapy in 17 (31%) and surgery followed by radiotherapy in 11 (20%). After a mean follow-up of 15 years (range: 7-25 years), 27 patients (49%) remained continuously disease free, 27 (49%) relapsed and one died of chemotherapy toxicity. The local recurrence rate was 13% overall: 18% (3/17) after radiotherapy, 7% (2/27) after surgery and 19% (2/11) after surgery followed by adjuvant radiotherapy (p = ns). On the contrary, the 10-year EFS ...
Oryctes agamemnon (Burmeister 1847) (Coleoptera, Scarabaeidae) was accidentally introduced in the southwestern oases of Tunisia (Tozeur) around 1980 and spread to the Rjim Maatoug region. In these areas O. agamemnon was specific to date palm trees causing severe damage that can result in potential danger due to collapse of the tree. This study was conducted from April 2004 to March 2006 in 4 sites in the region of Rjim Maatoug. Different levels of palm tree attack were determined, ovioposition sites were identified, and pest damage was described in detail to specify their relative importance and to indicate factors governing palm tree attack. Eggs were individually oviposited in the attacked parts. Dead parts of palm trees were the main target of O. agamemnon including the respiratory roots, tough, trunk bark, dry petiole and the periphery of the crown. The crown itself was not attacked. Feeding by larvae caused significant damage. The biggest danger occurred when heavy attacks of ...
Meningococcal disease is an infection caused by Neisseria meningitidis. Genetic factors contribute to host susceptibility and progression to disease, but the genes responsible for disease development are largely unknown. We report here a genome-wide association study for host susceptibility to meningococcal disease using 475 individuals with meningococcal disease (cases) and 4,703 population controls from the UK. We performed, in Western European and South European cohorts (consisting of 968 cases and 1,376 controls), two replication studies for the most significant SNPs. A cluster of complement factor SNPs replicated independently in both cohorts, including SNPs within complement factor H (CFH) (rs1065489 (p.936D
SummaryBackground Persistent Lyme Disease Symptoms (PLDS) have included fatigue, headaches, poor concentration and memory, lightheadedness, joint pain, and mood disturbances. Evidence-based guidelines committees disagree over the severity of PLDS. The 2004 International Lyme and Associated Diseases Society (ILADS) concluded that PLDS are severe. The 2006 Infectious Disease Society of America (IDSA) guidelines committee concluded that PLDS are nothing more than the "aches and pains of daily living" and an ad hoc International Lyme group concluded that PLDS are "symptoms common in persons who have never had Lyme disease." Hypothesis Clinical trials validate the severity of persistent Lyme disease symptoms. Evaluation of the Hypothesis There are 22 standardized instruments used to measure the...
Leakage after oesophageal anastomosis or perforation remains a challenge for the surgeon. Traditional management has been operative repair or intensive conservative management. Both treatments are...Full Text Available
This book chapter discusses sugarcane culture and history, describes arthropod biologies and injury, and identifies sugarcane pest management factors to consider for people interested in commercial sugarcane production. Arthropod groups include 10 orders and 40 families. Sugarcane pest management ...
... POSITION VACANT: Program Manager (Advance Materials and Manufacturing), AD-340-4. Salary ranges from ... POTENTIAL: Program Manager (Advanced Materials and Manufacturing), AD-340-4. LOCATION: Directorate ...
Over the past 10 years, the original partnership of clinician and statistician for the running of clinical research projects, especially clinical trials, has come to be supplemented by the data manager...Full Text Available
The scope of our problems with nuclear waste management is outlined. Present and future inventories of nuclear wastes are assessed for risk. A discussion of what is presently being done to solve waste management problems and what might be done in the future are presented. (DC)
BackgroundResearch has shown that the long term management of food allergy is suboptimal. Our study aims to provide direction for improvement, by evaluating food allergy management...Full Text Available
The DOE strategy recognizes that public perception of low-level waste management practices is not positive. Actions are included that are aimed at opening the system to the public. A better informed public will be able to better assess the performance of the low-level waste management system.
The Waste Management Project manages and integrates (non-TWRS) waste management activities at the site. Activities include management of Hanford wastes as well as waste transferred to Hanford from other DOE, Department of Defense, or other facilities. This work includes handling, treatment, storage, and disposal of radioactive, nonradioactive, hazardous, and mixed solid and liquid wastes. Major Waste Management Projects are the Solid Waste Project, Liquid Effluents Project, and Analytical Services. Existing facilities (e.g., grout vaults and canyons) shall be evaluated for reuse for these purposes to the maximum extent possible.
The primary purpose of the Waste Management Program Plan is to provide an annual report of how Waste Management's operations are conducted, what facilities are being used to manage wastes, what forces are acting to change current waste management systems, and what plans are in store for the coming fiscal year. In addition, this document projects activities for several years beyond the coming fiscal year in order to adequately plan for safe handling, storage, and disposal of radioactive wastes generated at the Savannah River Site and for developing technology for improved management of wastes. In this document, work descriptions and milestone schedules are current as of December 1991.
The main objective of this paper is to demonstrate that it makes good business sense to identify risks and hazards of an operation and take appropriate steps to manage them effectively. Developing and implementing an effective risk and hazard management plan also contibutes to other industry requirements and standards. Development of a risk management system, key elements of a risk management plan, and hazards and risk analysis methods are outlined. Comparing potential risk to the cost of prevention is also discussed. It is estimated that the cost of developing and preparing the first risk management plan varies between $50,000 to $200,000. 3 refs., 2 figs., 1 tab.
This Waste Management Plan functions as a management and planning tool for managing waste streams generated as a result of operations at the Idaho CERCLA Disposal Facility (ICDF) Complex. The waste management activities described in this plan support the selected remedy presented in the Waste Area Group 3, Operable Unit 3-13 Final Record of Decision for the operation of the Idaho CERCLA Disposal Facility Complex. This plan identifies the types of waste that are anticipated during operations at the Idaho CERCLA Disposal Facility Complex. In addition, this plan presents management strategies and disposition for these anticipated waste streams.
Westinghouse Electric Corporation is aggressively applying cost-time management to bolster timely, cost-effective cleanup and waste management activities at sites it manages for the U.S. Department of Energy (DOE). Cost-time management is a diagnostic technique which is applicable to virtually any process. It identifies opportunities to reduce cycle-times and costs. When applied to cleanup and waste management at DOE facilities, cost-time profile analysis helps identify actions to improve productivity and quality. Moreover, by reducing cycle-times and costs, it achieves significant savings to taxpayers. (author)
... of waste food generated at McMurdo Station. Some of the difficulties of disposing of waste food ... change waste generation or management at the site? Yes. This will be a temporary waste management ...
AbstractObjective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health...Full Text Available
Objectives: To evaluate the training of pharmacists in Accra, Ghana, in the syndromic management of STIs. Methods: We randomly selected 50 pharmacy outlets that had...Full Text Available
The Directive establishes a single manager for the Department of Defense Military Working Dog Program, provides policy, prescribes procedures, and assigns responsibilities.
This guide is intended to provide the necessary guidance to successfully manage the NAVMED Navy Occupational Health Information Management System (NOHIMS) at NAVMED sites and the NAVSEA Occupational Safety and Health Record Keeping System (OSHRKS) at NAVSEA sites. Outlines procedures to manage system operations, procedures to resolve hardware, software and communications problems, and procedures outside the realm of system operations that are required for a successful system. This guide is intended for the System and Functional Managers use. The System Manager is the individual designated to provide overall ADP management to the entire local configuration. Usually responsible for file backup, daily operations of the CPU, security, supplies, equipment, operating software and technical ADP guidance to the local functional users.
Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents. Methods: American...Full Text Available
Background. The coexistence of neoplasm and abdominal aortic aneurysm (AAA) presents a real management challenge. This paper reviews the literature on the prevalence, diagnosis,...Full Text Available
... Advances in Complex Systems ( ACS) 413 (413) 2001-2011 Springer Advances in Data Analysis and Classification 59 (59) 2008-2011 Advances in Management Advances In Management ...
... In this manner, a JBI-enabled COI would have the full suite of JBI information management capabilities, but would still be based on and have full ...
The purpose of this report is to provide management with performance data on key performance indicators selected from the FFTF Early Warning System performance indicators.
The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division...Full Text Available
A set of computer programs is described which constitutes a clone database management system. Maintenance of the database and the stocks of material is designed to be under the control of one person...Full Text Available
Borna disease virus (BDV) uses a unique strategy of replication and transcription which takes place in the nucleus, unlike other known, nonsegmented, negative-stranded RNA viruses of animal origin....Full Text Available
The sequential events and the inflammatory mediators that characterize disease onset and progression of ulcerative colitis (UC) are not well known. In this study, we evaluated the early pathologic events...Full Text Available
BackgroundOne of the more common behavioral manifestations of dementia-related disorders is severe problems with out-of-home mobility. Various efforts have been attempted to attain...Full Text Available
Krabbe disease (KD) is an inherited neurological disorder caused by the deficiency of galactocerebrosidase activity resulting in accumulation of psychosine, which leads to energy depletion,...Full Text Available
The objective of the current research was to examine the association of herd level disease incidence with the return over feed (ROF) (milk income minus feed cost) herd profit index offered through Canwest...Full Text Available
BackgroundThis study focuses on the role of an Internet-based group for people who have an autoimmune liver disease, primary biliary cirrhosis. Primary biliary...Full Text Available
BackgroundCharacterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the...Full Text Available
The mouse is the leading organism for disease research. A rich resource of genetic variation occurs naturally in inbred and special strains owing to spontaneous mutations. However, one can also obtain...Full Text Available
Background and objectives: While many patients with end-stage renal disease (ESRD) have impaired physical and psychologic well-being, less is known about these health domains in patients with advanced...Full Text Available
BackgroundAlthough symptoms of sleepiness and fatigue are common among adults with Chronic Kidney Disease (CKD), little is known about the prevalence of these symptoms...Full Text Available
Sexually transmitted diseases (STDs) represent a major public health problem in the country, cause patients enormous suffering, and cost the nation billions of dollars annually. Demographic, sociological,...Full Text Available
Breast cancer is a progressive and potentially fatal disease that affects women of all ages. Like all progressive diseases, early and reliable diagnosis is the key for successful treatment and annihilation....Full Text Available
The authors’ objective was to analyze the impact of respiratory impairment on the risk of physical functional limitations among adults with chronic obstructive pulmonary disease (COPD)....Full Text Available
ObjectivesThe aims of this study were to evaluate the prevalence of otolaryngologic diseases in Korea.MethodsWe obtained data from the 2008 Korea...Full Text Available
Eight recreational parks located in a Lyme disease endemic area of southern New York State were surveyed for the presence of ticks during the summer of 1985 by drag sampling. Ixodes dammini, the primary...Full Text Available
Physical activity is associated with reduced risk of several age-related diseases as well as with increased longevity in both rodents and humans. Though these associations are well established, evidence...Full Text Available
Background and objectives: Chronic kidney disease (CKD) is associated with impaired physical activity. However, it is unclear whether the associations of physical activity with mortality are modified...Full Text Available
Diseases of man caused by the virus of herpes simplex fall into two broad categories. The primary disease occurs only once in any individual's life and is caused by transmission of virus from an already...Full Text Available
Organisms in the genus Mycobacterium cause a variety of human diseases. One member of the genus, M. ulcerans, causes a necrotizing skin disease called Buruli ulcer....Full Text Available
The outcome of patients admitted to intensive care units is known to be influenced by such factors as age, previous health status, severity of disease, and diagnosis. To estimate the outcome of such...Full Text Available
Arriving at a firm diagnosis of neurosarcoidosis continues to pose serious problems, particularly when evidence of granulomatous disease outside the nervous system is lacking. The commonest mode of...Full Text Available
Objective:Parkinson disease (PD) may affect the autonomic nervous system and may cause constipation; however, few studies have explored constipation preceding the motor onset of...Full Text Available
In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)
Liver fluke disease is a chronic parasitic inflammatory disease of the bile ducts. Infection occurs through ingestion of fluke-infested, fresh-water raw fish. The most well-known species that cause...Full Text Available
Study objectiveThe study aim was to improve our understanding of the relationships between contextual socioeconomic characteristics and coronary heart disease (CHD)...Full Text Available
Stargardt disease (STGD) is the major form of inherited juvenile macular degeneration. Pyridinium bis-retinoid A2E is a major component of lipofuscin which accumulates in retinal pigment epithelium...Full Text Available
BackgroundAlzheimer's disease, known to be associated with the gradual loss of memory, is characterized by low concentration of acetylcholine in the hippocampus and cortex part of...Full Text Available
The identification and validation of biomarkers for diagnosing Alzheimer's disease (AD) and other forms of dementia are increasingly important. To date, ELISA measurement of β-amyloid(1–42),...Full Text Available
Over 200 mutations in the retina specific member of the ATP-binding cassette transporter super-family (ABCA4) have been associated with a diverse group of human retinal diseases....Full Text Available
We describe here seven cases (from five kindreds) of Anderson's disease, which is characterized by diarrhea, steatorrhea, hypobetalipoproteinemia with low levels of cholesterol, triglycerides, and phospholipids,...Full Text Available
Viruses, and more particularly retroviruses, have been postulated to play a role in the pathogenesis of autoimmune diseases. In a search for spumaretrovirus infection markers, we screened a group of...Full Text Available
We have developed a new strategy for immunization of wild rabbit populations against myxomatosis and rabbit hemorrhagic disease (RHD) that uses recombinant viruses based on a naturally attenuated field...Full Text Available
An association of Hirschsprung disease with polydactyly, unilateral renal agenesis, hypertelorism, and congenital deafness is described in sibs (brother and sister) of consanguineous parents. It is...Full Text Available
BackgroundThe long-term goal of the GKDZI (Genetics of Kidney Disease in Zuni Indians) Study is to identify genes, environmental factors, and genetic-environmental...Full Text Available
Though the genetic background of ischaemic and haemorrhagic stroke is often polygenetic or multifactorial, it can in some cases result from a monogenic disease, particularly in young adults. Besides...Full Text Available
Mycobacterium ulcerans is the causative agent of Buruli ulcer, the third most common mycobacterial disease after tuberculosis and leprosy. It is an emerging infectious disease that...Full Text Available
Most human diseases are related in some way to the loss or gain in gene functions. Regulation of gene expression is a complex process. In addition to genetic mechanisms, epigenetic causes are...Full Text Available
A striking common feature of many autoimmune diseases in humans and experimental animals, despite differences in pathology, is that females are highly susceptible to autoimmune conditions compared to...Full Text Available
Few diseases exemplify the integration of research from bench to bedside as well as neonatal lupus, often referred to as a model of passively acquired autoimmunity. In essence, this disease encompasses...Full Text Available
Southern tick-associated rash illness (STARI) is a Lyme disease-like infection described in patients in the southeastern and south-central United States, where classic Lyme disease is relatively rare....Full Text Available
Two infants were seen with severe ascites detected before birth, a previously unreported presentation of Niemann-Pick disease type C. In the second infant no diagnostic storage cells were present in...Full Text Available
Objectives. To assess the feasibility of treating musculoskeletal pain in the lower back and/or lower extremities in persons with Parkinson's disease (PD) with cranial electrotherapy...Full Text Available
ObjectivesThe aim of this study was to investigate the effect of cigarette smoking on clinical parameters and signs anemia of chronic disease in chronic periodontitis patients.Full Text Available
Erythrocyte transketolase activity and the effect of adding thiamine pyrophosphate (% thiamine pyrophosphate effect) were measured in 111 subjects suspected to suffer from Leigh's disease (subacute...Full Text Available
A conference entitled ‘2nd International Berlin Bat Meeting: Bat Biology and Infectious Diseases’ was held between the 19 and 21 of February 2010 in Berlin, Germany. Researchers from...Full Text Available
Periodontal diseases are infections of the tissues supporting the dentition. Recognition that relatively specific microfloras are associated with distinct clinical forms of periodontal disease has prompted...Full Text Available
Objective:To investigate the combined effect of both pioglitazone and methotrexate on disease activity of rheumatoid arthritis in a biphasic study; experimental and clinical.Methods:Experimentally:...Full Text Available
Many epidemiological evidences have proven the association between smoking and periodontal disease. The causality can be further established by linking findings of traditional epidemiological studies...Full Text Available
Background:We analyzed the effects of a docosahexaenoic acid (DHA) supplementation in patients affected with late onset Stargardt disease (STGD).Methods:DHA...Full Text Available
Since polyglutamine (polyQ) aggregate formation has been implicated as playing an important role in expanded CAG repeat diseases, it is important to understand the biophysics underlying the...Full Text Available
Huntington's disease (HD) is one of several neurodegenerative disorders caused by expansion of CAG repeats in a coding gene. Somatic CAG expansion rates in HD vary between organs, and the greatest instability...Full Text Available
Enterotoxigenic Escherichia coli (ETEC) is a leading cause of diarrhea in travelers to countries where the disease is endemic and causes a major disease burden in the indigenous population,...Full Text Available
Paratuberculosis (Johne's disease), an endemic mycobacteriosis of cattle that is caused by Mycobacterium paratuberculosis, is characterized by incoercible diarrhea and fecal shedding of bacteria. The...Full Text Available
This study examined the genetic basis of hypertension and renal disease in Dahl SS/Mcwi (Dahl Salt-Sensitive) rats using a complete chromosome substitution panel of consomic rats in which each of the...Full Text Available
Hepatocellular carcinoma (HCC) is one of the most critical global health issues. With frequent association of viral liver disease, HCC is highly complex, harboring both cancer and chronic liver disease....Full Text Available
This study was designed to identify the causes of the development of carpal tunnel syndrome (CTS) associated with end stage kidney disease (ESKD). A total of 112 patients with ESKD, 64 on hemodialysis...Full Text Available
BackgroundIn 1988, the SPILI project was established in order to evaluate the cardiovascular disease (CVD) risk profile of the inhabitants of Spili, in rural Crete, Greece. The first...Full Text Available
Alterations in basement membrane components, notably proteoglycans, in a rat model of polycystic kidney disease have been investigated. Rats were fed phenol II (2-amino-4-hydroxyphenyl-5-phenyl thiazole)...Full Text Available
To assess the effects of increasing the mineral content of parenteral nutrition solutions on the biochemical and radiological indicators of metabolic bone disease of prematurity 27 neonates who required...Full Text Available
BackgroundSepsis or bacteraemia, however rare, is a significant cause of high mortality and serious complications in children. In previous studies skin disease or skin infections...Full Text Available
Background:Erectile dysfunction in type-2 diabetes may be an independent marker for coronary artery disease. Present study was undertaken to investigate whether type-2 diabetic...Full Text Available
BackgroundMutations of the amyloid precursor protein gene (APP) are found in familial forms of Alzheimer's disease (AD) and some lead to the elevated production...Full Text Available
BackgroundWidespread availability of geographic information systems software has facilitated the use of disease mapping in academia, government and private sector. Maps that display...Full Text Available
MRI plays an increasingly important role for assessment of patients with chronic liver disease. MRI has numerous advantages, including lack of ionizing radiation and the possibility of performing...Full Text Available
BACKGROUND--Interstitial lung diseases are characterised by the recruitment of mononuclear cells to disease sites where maturation occurs and activation products, including lysozyme (LZM), are released....Full Text Available
BackgroundChronic kidney disease and end-stage renal disease are major causes of morbidity and mortality that are seen far more commonly in the aged population. Interestingly, kidney...Full Text Available
BackgroundTraditionally in pediatric HIV, the CD4+ T-lymphocyte percent is used in monitoring disease progression due to the variability in absolute CD4+ T-lymphocyte...Full Text Available
A form for the clinical evaluation of bovine digital disease was developed. In this article, each section of the resulting Digit Evaluation Form is discussed and justified. By following the...Full Text Available
OBJECTIVE: To assess the association between erectile dysfunction (ED) and the long-term risk of coronary artery disease (CAD) and the role of age as a modifier of this association.PARTICIPANTS...Full Text Available