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Sample records for distributed prognostic health

  1. A DISTRIBUTED PROGNOSTIC HEALTH MANAGEMENT ARCHITECTURE

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper introduces a generic distributed prognostic health management (PHM) architecture with specific application to the electrical power systems domain. Current...

  2. Distributed Prognostic Health Management with Gaussian Process Regression

    Data.gov (United States)

    National Aeronautics and Space Administration — Distributed prognostics architecture design is an enabling step for efficient implementation of health management systems. A major challenge encountered in such...

  3. Distributed Prognostic Health Management with Gaussian Process Regression

    Science.gov (United States)

    Saha, Sankalita; Saha, Bhaskar; Saxena, Abhinav; Goebel, Kai Frank

    2010-01-01

    Distributed prognostics architecture design is an enabling step for efficient implementation of health management systems. A major challenge encountered in such design is formulation of optimal distributed prognostics algorithms. In this paper. we present a distributed GPR based prognostics algorithm whose target platform is a wireless sensor network. In addition to challenges encountered in a distributed implementation, a wireless network poses constraints on communication patterns, thereby making the problem more challenging. The prognostics application that was used to demonstrate our new algorithms is battery prognostics. In order to present trade-offs within different prognostic approaches, we present comparison with the distributed implementation of a particle filter based prognostics for the same battery data.

  4. Distributed Prognostics and Health Management with a Wireless Network Architecture

    Science.gov (United States)

    Goebel, Kai; Saha, Sankalita; Sha, Bhaskar

    2013-01-01

    A heterogeneous set of system components monitored by a varied suite of sensors and a particle-filtering (PF) framework, with the power and the flexibility to adapt to the different diagnostic and prognostic needs, has been developed. Both the diagnostic and prognostic tasks are formulated as a particle-filtering problem in order to explicitly represent and manage uncertainties in state estimation and remaining life estimation. Current state-of-the-art prognostic health management (PHM) systems are mostly centralized in nature, where all the processing is reliant on a single processor. This can lead to a loss in functionality in case of a crash of the central processor or monitor. Furthermore, with increases in the volume of sensor data as well as the complexity of algorithms, traditional centralized systems become for a number of reasons somewhat ungainly for successful deployment, and efficient distributed architectures can be more beneficial. The distributed health management architecture is comprised of a network of smart sensor devices. These devices monitor the health of various subsystems or modules. They perform diagnostics operations and trigger prognostics operations based on user-defined thresholds and rules. The sensor devices, called computing elements (CEs), consist of a sensor, or set of sensors, and a communication device (i.e., a wireless transceiver beside an embedded processing element). The CE runs in either a diagnostic or prognostic operating mode. The diagnostic mode is the default mode where a CE monitors a given subsystem or component through a low-weight diagnostic algorithm. If a CE detects a critical condition during monitoring, it raises a flag. Depending on availability of resources, a networked local cluster of CEs is formed that then carries out prognostics and fault mitigation by efficient distribution of the tasks. It should be noted that the CEs are expected not to suspend their previous tasks in the prognostic mode. When the

  5. Distributed Prognostics based on Structural Model Decomposition

    Science.gov (United States)

    Daigle, Matthew J.; Bregon, Anibal; Roychoudhury, I.

    2014-01-01

    Within systems health management, prognostics focuses on predicting the remaining useful life of a system. In the model-based prognostics paradigm, physics-based models are constructed that describe the operation of a system and how it fails. Such approaches consist of an estimation phase, in which the health state of the system is first identified, and a prediction phase, in which the health state is projected forward in time to determine the end of life. Centralized solutions to these problems are often computationally expensive, do not scale well as the size of the system grows, and introduce a single point of failure. In this paper, we propose a novel distributed model-based prognostics scheme that formally describes how to decompose both the estimation and prediction problems into independent local subproblems whose solutions may be easily composed into a global solution. The decomposition of the prognostics problem is achieved through structural decomposition of the underlying models. The decomposition algorithm creates from the global system model a set of local submodels suitable for prognostics. Independent local estimation and prediction problems are formed based on these local submodels, resulting in a scalable distributed prognostics approach that allows the local subproblems to be solved in parallel, thus offering increases in computational efficiency. Using a centrifugal pump as a case study, we perform a number of simulation-based experiments to demonstrate the distributed approach, compare the performance with a centralized approach, and establish its scalability. Index Terms-model-based prognostics, distributed prognostics, structural model decomposition ABBREVIATIONS

  6. Communication Optimizations for a Wireless Distributed Prognostic Framework

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    National Aeronautics and Space Administration — Distributed architecture for prognostics is an essential step in prognostic research in order to enable feasible real-time system health management. Communication...

  7. Distributed Prognostics Based on Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Within systems health management, prognostics focuses on predicting the remaining useful life of a system. In the model-based prognostics paradigm, physics-based...

  8. A Distributed Approach to System-Level Prognostics

    Science.gov (United States)

    Daigle, Matthew J.; Bregon, Anibal; Roychoudhury, Indranil

    2012-01-01

    Prognostics, which deals with predicting remaining useful life of components, subsystems, and systems, is a key technology for systems health management that leads to improved safety and reliability with reduced costs. The prognostics problem is often approached from a component-centric view. However, in most cases, it is not specifically component lifetimes that are important, but, rather, the lifetimes of the systems in which these components reside. The system-level prognostics problem can be quite difficult due to the increased scale and scope of the prognostics problem and the relative Jack of scalability and efficiency of typical prognostics approaches. In order to address these is ues, we develop a distributed solution to the system-level prognostics problem, based on the concept of structural model decomposition. The system model is decomposed into independent submodels. Independent local prognostics subproblems are then formed based on these local submodels, resul ting in a scalable, efficient, and flexible distributed approach to the system-level prognostics problem. We provide a formulation of the system-level prognostics problem and demonstrate the approach on a four-wheeled rover simulation testbed. The results show that the system-level prognostics problem can be accurately and efficiently solved in a distributed fashion.

  9. Requirements Flowdown for Prognostics and Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics and Health Management (PHM) principles have considerable promise to change the game of lifecycle cost of engineering systems at high safety levels by...

  10. Communication Optimizations for a Wireless Distributed Prognostic Framework

    Science.gov (United States)

    Saha, Sankalita; Saha, Bhaskar; Goebel, Kai

    2009-01-01

    Distributed architecture for prognostics is an essential step in prognostic research in order to enable feasible real-time system health management. Communication overhead is an important design problem for such systems. In this paper we focus on communication issues faced in the distributed implementation of an important class of algorithms for prognostics - particle filters. In spite of being computation and memory intensive, particle filters lend well to distributed implementation except for one significant step - resampling. We propose new resampling scheme called parameterized resampling that attempts to reduce communication between collaborating nodes in a distributed wireless sensor network. Analysis and comparison with relevant resampling schemes is also presented. A battery health management system is used as a target application. A new resampling scheme for distributed implementation of particle filters has been discussed in this paper. Analysis and comparison of this new scheme with existing resampling schemes in the context for minimizing communication overhead have also been discussed. Our proposed new resampling scheme performs significantly better compared to other schemes by attempting to reduce both the communication message length as well as number total communication messages exchanged while not compromising prediction accuracy and precision. Future work will explore the effects of the new resampling scheme in the overall computational performance of the whole system as well as full implementation of the new schemes on the Sun SPOT devices. Exploring different network architectures for efficient communication is an importance future research direction as well.

  11. Distributed Prognostics System Implementation on Wireless Embedded Devices

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    National Aeronautics and Space Administration — Distributed prognostics is the next step in the evolution of prognostic methodologies. It is an important enabling technology for the emerging Condition Based...

  12. Prognostics and health management of power electronics

    OpenAIRE

    Alghassi, Alireza

    2016-01-01

    Prognostics and health management (PHM) is a major tool enabling systems to evaluate their reliability in real-time operation. Despite ground-breaking advances in most engineering and scientific disciplines during the past decades, reliability engineering has not seen significant breakthroughs or noticeable advances. Therefore, self-awareness of the embedded system is also often required in the sense that the system should be able to assess its own health state and failure records, and those ...

  13. Requirements Flowdown for Prognostics and Health Management

    Science.gov (United States)

    Goebel, Kai; Saxena, Abhinav; Roychoudhury, Indranil; Celaya, Jose R.; Saha, Bhaskar; Saha, Sankalita

    2012-01-01

    Prognostics and Health Management (PHM) principles have considerable promise to change the game of lifecycle cost of engineering systems at high safety levels by providing a reliable estimate of future system states. This estimate is a key for planning and decision making in an operational setting. While technology solutions have made considerable advances, the tie-in into the systems engineering process is lagging behind, which delays fielding of PHM-enabled systems. The derivation of specifications from high level requirements for algorithm performance to ensure quality predictions is not well developed. From an engineering perspective some key parameters driving the requirements for prognostics performance include: (1) maximum allowable Probability of Failure (PoF) of the prognostic system to bound the risk of losing an asset, (2) tolerable limits on proactive maintenance to minimize missed opportunity of asset usage, (3) lead time to specify the amount of advanced warning needed for actionable decisions, and (4) required confidence to specify when prognosis is sufficiently good to be used. This paper takes a systems engineering view towards the requirements specification process and presents a method for the flowdown process. A case study based on an electric Unmanned Aerial Vehicle (e-UAV) scenario demonstrates how top level requirements for performance, cost, and safety flow down to the health management level and specify quantitative requirements for prognostic algorithm performance.

  14. Power Management for A Distributed Wireless Health Management Architecture

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    National Aeronautics and Space Administration — Distributed wireless architectures for prognostics is an important enabling step in prognostic research in order to achieve feasible real-time system health...

  15. A Distributed Approach to System-Level Prognostics

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    National Aeronautics and Space Administration — Prognostics, which deals with predicting remaining useful life of components, subsystems, and systems, is a key tech- nology for systems health management that leads...

  16. Accelerated Aging Experiments for Capacitor Health Monitoring and Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper discusses experimental setups for health monitoring and prognostics of electrolytic capacitors under nominal operation and accelerated aging conditions....

  17. Health Monitoring and Prognostics for Computer Servers

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    National Aeronautics and Space Administration — Abstract Prognostics solutions for mission critical systems require a comprehensive methodology for proactively detecting and isolating failures, recommending and...

  18. Prognostics Design Solutions in Structural Health Monitoring Systems

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    National Aeronautics and Space Administration — The chapter describes the application of prognostic techniques to the domain of structural health and demonstrates the efficacy of the methods using fatigue data...

  19. Statistical tools for prognostics and health management of complex systems

    Energy Technology Data Exchange (ETDEWEB)

    Collins, David H [Los Alamos National Laboratory; Huzurbazar, Aparna V [Los Alamos National Laboratory; Anderson - Cook, Christine M [Los Alamos National Laboratory

    2010-01-01

    Prognostics and Health Management (PHM) is increasingly important for understanding and managing today's complex systems. These systems are typically mission- or safety-critical, expensive to replace, and operate in environments where reliability and cost-effectiveness are a priority. We present background on PHM and a suite of applicable statistical tools and methods. Our primary focus is on predicting future states of the system (e.g., the probability of being operational at a future time, or the expected remaining system life) using heterogeneous data from a variety of sources. We discuss component reliability models incorporating physical understanding, condition measurements from sensors, and environmental covariates; system reliability models that allow prediction of system failure time distributions from component failure models; and the use of Bayesian techniques to incorporate expert judgments into component and system models.

  20. Prognostics and health management of engineering systems an introduction

    CERN Document Server

    Kim, Nam-Ho; Choi, Joo-Ho

    2017-01-01

    This book introduces the methods for predicting the future behavior of a system’s health and the remaining useful life to determine an appropriate maintenance schedule. The authors introduce the history, industrial applications, algorithms, and benefits and challenges of PHM (Prognostics and Health Management) to help readers understand this highly interdisciplinary engineering approach that incorporates sensing technologies, physics of failure, machine learning, modern statistics, and reliability engineering. It is ideal for beginners because it introduces various prognostics algorithms and explains their attributes, pros and cons in terms of model definition, model parameter estimation, and ability to handle noise and bias in data, allowing readers to select the appropriate methods for their fields of application. Among the many topics discussed in-depth are: • Prognostics tutorials using least-squares • Bayesian inference and parameter estimation • Physics-based prognostics algorithms including non...

  1. Prognostics and Health Monitoring of High Power LED

    Directory of Open Access Journals (Sweden)

    Chris Bailey

    2012-02-01

    Full Text Available Prognostics is seen as a key component of health usage monitoring systems, where prognostics algorithms can both detect anomalies in the behavior/performance of a micro-device/system, and predict its remaining useful life when subjected to monitored operational and environmental conditions. Light Emitting Diodes (LEDs are optoelectronic micro-devices that are now replacing traditional incandescent and fluorescent lighting, as they have many advantages including higher reliability, greater energy efficiency, long life time and faster switching speed. For some LED applications there is a requirement to monitor the health of LED lighting systems and predict when failure is likely to occur. This is very important in the case of safety critical and emergency applications. This paper provides both experimental and theoretical results that demonstrate the use of prognostics and health monitoring techniques for high power LEDs subjected to harsh operating conditions.

  2. Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics has received considerable attention recently as an emerging sub-discipline within SHM. Prognosis is here strictly defined as “predicting the time at...

  3. Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Shuangwen

    2016-10-04

    This presentation was given at the 2016 Annual Conference of the Prognostics and Health Management Society. It covers the current status and challenges and opportunities of prognostics and health management of wind turbines.

  4. Electronic Prognostics for Vehicle Health Management Project

    Data.gov (United States)

    National Aeronautics and Space Administration — All electronic systems are prone to wear-out and eventual failure and this has direct implications for Vehicle Health Management for NASA with its long space...

  5. Accelerated Aging Experiments for Capacitor Health Monitoring and Prognostics

    Science.gov (United States)

    Kulkarni, Chetan S.; Celaya, Jose Ramon; Biswas, Gautam; Goebel, Kai

    2012-01-01

    This paper discusses experimental setups for health monitoring and prognostics of electrolytic capacitors under nominal operation and accelerated aging conditions. Electrolytic capacitors have higher failure rates than other components in electronic systems like power drives, power converters etc. Our current work focuses on developing first-principles-based degradation models for electrolytic capacitors under varying electrical and thermal stress conditions. Prognostics and health management for electronic systems aims to predict the onset of faults, study causes for system degradation, and accurately compute remaining useful life. Accelerated life test methods are often used in prognostics research as a way to model multiple causes and assess the effects of the degradation process through time. It also allows for the identification and study of different failure mechanisms and their relationships under different operating conditions. Experiments are designed for aging of the capacitors such that the degradation pattern induced by the aging can be monitored and analyzed. Experimental setups and data collection methods are presented to demonstrate this approach.

  6. Distributed Damage Estimation for Prognostics based on Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Model-based prognostics approaches capture system knowl- edge in the form of physics-based models of components that include how they fail. These methods consist of...

  7. Algorithm development for Prognostics and Health Management (PHM).

    Energy Technology Data Exchange (ETDEWEB)

    Swiler, Laura Painton; Campbell, James E.; Doser, Adele Beatrice; Lowder, Kelly S.

    2003-10-01

    This report summarizes the results of a three-year LDRD project on prognostics and health management. System failure over some future time interval (an alternative definition is the capability to predict the remaining useful life of a system). Prognostics are integrated with health monitoring (through inspections, sensors, etc.) to provide an overall PHM capability that optimizes maintenance actions and results in higher availability at a lower cost. Our goal in this research was to develop PHM tools that could be applied to a wide variety of equipment (repairable, non-repairable, manufacturing, weapons, battlefield equipment, etc.) and require minimal customization to move from one system to the next. Thus, our approach was to develop a toolkit of reusable software objects/components and architecture for their use. We have developed two software tools: an Evidence Engine and a Consequence Engine. The Evidence Engine integrates information from a variety of sources in order to take into account all the evidence that impacts a prognosis for system health. The Evidence Engine has the capability for feature extraction, trend detection, information fusion through Bayesian Belief Networks (BBN), and estimation of remaining useful life. The Consequence Engine involves algorithms to analyze the consequences of various maintenance actions. The Consequence Engine takes as input a maintenance and use schedule, spares information, and time-to-failure data on components, then generates maintenance and failure events, and evaluates performance measures such as equipment availability, mission capable rate, time to failure, and cost. This report summarizes the capabilities we have developed, describes the approach and architecture of the two engines, and provides examples of their use. 'Prognostics' refers to the capability to predict the probability of

  8. Stress testing on silicon carbide electronic devices for prognostics and health management.

    Energy Technology Data Exchange (ETDEWEB)

    Kaplar, Robert James; Brock, Reinhard C.; Marinella, Matthew; King, Michael Patrick; Smith, Mark A.; Atcitty, Stanley

    2011-01-01

    Power conversion systems for energy storage and other distributed energy resource applications are among the drivers of the important role that power electronics plays in providing reliable electricity. Wide band gap semiconductors such as silicon carbide (SiC) and gallium nitride (GaN) will help increase the performance and efficiency of power electronic equipment while condition monitoring (CM) and prognostics and health management (PHM) will increase the operational availability of the equipment and thereby make it more cost effective. Voltage and/or temperature stress testing were performed on a number of SiC devices in order to accelerate failure modes and to identify measureable shifts in electrical characteristics which may provide early indication of those failures. Those shifts can be interpreted and modeled to provide prognostic signatures for use in CM and/or PHM. Such experiments will also lead to a deeper understanding of basic device physics and the degradation mechanisms behind failure.

  9. Prognostics Health Management for Advanced Small Modular Reactor Passive Components

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Ryan M.; Ramuhalli, Pradeep; Coble, Jamie B.; Mitchell, Mark R.; Wootan, David W.; Hirt, Evelyn H.; Berglin, Eric J.; Bond, Leonard J.; Henager, Charles H.

    2013-10-18

    In the United States, sustainable nuclear power to promote energy security is a key national energy priority. Advanced small modular reactors (AdvSMR), which are based on modularization of advanced reactor concepts using non-light-water reactor (LWR) coolants such as liquid metal, helium, or liquid salt may provide a longer-term alternative to more conventional LWR-based concepts. The economics of AdvSMRs will be impacted by the reduced economy-of-scale savings when compared to traditional LWRs and the controllable day-to-day costs of AdvSMRs are expected to be dominated by operations and maintenance costs. Therefore, achieving the full benefits of AdvSMR deployment requires a new paradigm for plant design and management. In this context, prognostic health management of passive components in AdvSMRs can play a key role in enabling the economic deployment of AdvSMRs. In this paper, the background of AdvSMRs is discussed from which requirements for PHM systems are derived. The particle filter technique is proposed as a prognostics framework for AdvSMR passive components and the suitability of the particle filter technique is illustrated by using it to forecast thermal creep degradation using a physics-of-failure model and based on a combination of types of measurements conceived for passive AdvSMR components.

  10. Embedded diagnostic, prognostic, and health management system and method for a humanoid robot

    Science.gov (United States)

    Barajas, Leandro G. (Inventor); Sanders, Adam M (Inventor); Reiland, Matthew J (Inventor); Strawser, Philip A (Inventor)

    2013-01-01

    A robotic system includes a humanoid robot with multiple compliant joints, each moveable using one or more of the actuators, and having sensors for measuring control and feedback data. A distributed controller controls the joints and other integrated system components over multiple high-speed communication networks. Diagnostic, prognostic, and health management (DPHM) modules are embedded within the robot at the various control levels. Each DPHM module measures, controls, and records DPHM data for the respective control level/connected device in a location that is accessible over the networks or via an external device. A method of controlling the robot includes embedding a plurality of the DPHM modules within multiple control levels of the distributed controller, using the DPHM modules to measure DPHM data within each of the control levels, and recording the DPHM data in a location that is accessible over at least one of the high-speed communication networks.

  11. Prognostics and Health Management of an Automated Machining Process

    Directory of Open Access Journals (Sweden)

    Cheng He

    2015-01-01

    Full Text Available Machine failure modes are presenting a major burden to the operator, the plant, and the enterprise causing significant downtime, labor cost, and reduced revenue. New technologies are emerging over the past years to monitor the machine’s performance, detect and isolate incipient failures or faults, and take appropriate actions to mitigate such detrimental events. This paper addresses the development and application of novel Prognostics and Health Management (PHM technologies to a prototype machining process (a screw-tightening machine. The enabling technologies are built upon a series of tasks starting with failure analysis, testing, and data processing aimed to extract useful features or condition indicators from raw data, a symbolic regression modeling framework, and a Bayesian estimation method called particle filtering to predict the feature state estimate accurately. The detection scheme declares the fault of a machine critical component with user specified accuracy or confidence and given false alarm rate while the prediction algorithm estimates accurately the remaining useful life of the failing component. Simulation results support the efficacy of the approach and match well the experimental data.

  12. Experimental Validation of a Prognostic Health Management System for Electro-Mechanical Actuators

    Data.gov (United States)

    National Aeronautics and Space Administration — The work described herein is aimed to advance prognostic health management solutions for electro-mechanical actuators and, thus, increase their reliability and...

  13. Structural health and prognostics management for offshore wind turbines :

    Energy Technology Data Exchange (ETDEWEB)

    Myrent, Noah J.; Kusnick, Joshua F.; Barrett, Natalie C.; Adams, Douglas E.; Griffith, Daniel

    2013-04-01

    Operations and maintenance costs for offshore wind plants are significantly higher than the current costs for land-based (onshore) wind plants. One way to reduce these costs would be to implement a structural health and prognostic management (SHPM) system as part of a condition based maintenance paradigm with smart load management and utilize a state-based cost model to assess the economics associated with use of the SHPM system. To facilitate the development of such a system a multi-scale modeling approach developed in prior work is used to identify how the underlying physics of the system are affected by the presence of damage and faults, and how these changes manifest themselves in the operational response of a full turbine. This methodology was used to investigate two case studies: (1) the effects of rotor imbalance due to pitch error (aerodynamic imbalance) and mass imbalance and (2) disbond of the shear web; both on a 5-MW offshore wind turbine in the present report. Based on simulations of damage in the turbine model, the operational measurements that demonstrated the highest sensitivity to the damage/faults were the blade tip accelerations and local pitching moments for both imbalance and shear web disbond. The initial cost model provided a great deal of insight into the estimated savings in operations and maintenance costs due to the implementation of an effective SHPM system. The integration of the health monitoring information and O&M cost versus damage/fault severity information provides the initial steps to identify processes to reduce operations and maintenance costs for an offshore wind farm while increasing turbine availability, revenue, and overall profit.

  14. Structural health and prognostics management for offshore wind turbines :

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Daniel; Resor, Brian Ray; White, Jonathan Randall; Paquette, Joshua A.; Yoder, Nathanael C.

    2012-12-01

    Operations and maintenance costs for offshore wind plants are expected to be significantly higher than the current costs for onshore plants. One way in which these costs may be able to be reduced is through the use of a structural health and prognostic management system as part of a condition based maintenance paradigm with smart load management. To facilitate the creation of such a system a multiscale modeling approach has been developed to identify how the underlying physics of the system are affected by the presence of damage and how these changes manifest themselves in the operational response of a full turbine. The developed methodology was used to investigate the effects of a candidate blade damage feature, a trailing edge disbond, on a 5-MW offshore wind turbine and the measurements that demonstrated the highest sensitivity to the damage were the local pitching moments around the disbond. The multiscale method demonstrated that these changes were caused by a local decrease in the blades torsional stiffness due to the disbond, which also resulted in changes in the blades local strain field. Full turbine simulations were also used to demonstrate that derating the turbine power by as little as 5% could extend the fatigue life of a blade by as much as a factor of 3. The integration of the health monitoring information, conceptual repair cost versus damage size information, and this load management methodology provides an initial roadmap for reducing operations and maintenance costs for offshore wind farms while increasing turbine availability and overall profit.

  15. Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Shuangwen

    2015-12-14

    Prognostics and health management is not a new concept. It has been used in relatively mature industries, such as aviation and electronics, to help improve operation and maintenance (O&M) practices. In the wind industry, prognostics and health management is relatively new. The level for both wind industry applications and research and development (R&D) has increased in recent years because of its potential for reducing O&M cost of wind power, especially for turbines installed offshore. The majority of wind industry application efforts has been focused on diagnosis based on various sensing and feature extraction techniques. For R&D, activities are being conducted in almost all areas of a typical prognostics and health management framework (i.e., sensing, data collection, feature extraction, diagnosis, prognosis, and maintenance scheduling). This presentation provides an overview of the current status of wind turbine prognostics and health management that focuses on drivetrain condition monitoring through vibration, oil debris, and oil condition analysis techniques. It also discusses turbine component health diagnosis through data mining and modeling based on supervisory control and data acquisition system data. Finally, it provides a brief survey of R&D activities for wind turbine prognostics and health management, along with future opportunities.

  16. Smart Sensing System for the Prognostic Monitoring of Bone Health

    KAUST Repository

    Afsarimanesh, Nasrin

    2016-06-24

    The objective of this paper is to report a novel non-invasive, real-time, and label-free smart assay technique for the prognostic detection of bone loss by electrochemical impedance spectroscopy (EIS). The proposed system incorporated an antibody-antigen-based sensor functionalization to induce selectivity for the C-terminal telopeptide type one collagen (CTx-I) molecules—a bone loss biomarker. Streptavidin agarose was immobilized on the sensing area of a silicon substrate-based planar sensor, patterned with gold interdigital electrodes, to capture the antibody-antigen complex. Calibration experiments were conducted with various known CTx-I concentrations in a buffer solution to obtain a reference curve that was used to quantify the concentration of an analyte in the unknown serum samples. Multivariate chemometric analyses were done to determine the performance viability of the developed system. The analyses suggested that a frequency of 710 Hz is the most discriminating regarding the system sensitivity. A detection limit of 0.147 ng/mL was achieved for the proposed sensor and the corresponding reference curve was linear in the range of 0.147 ng/mL to 2.669 ng/mL. Two sheep blood samples were tested by the developed technique and the results were validated using enzyme-linked immunosorbent assay (ELISA). The results from the proposed technique match those from the ELISA.

  17. Distributed leadership in health care

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette

    2016-01-01

    Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...

  18. Distribution of lymph node metastasis is a prognostic index in patients with stage III colon cancer.

    Science.gov (United States)

    Kobayashi, Hirotoshi; Ueno, Hideki; Hashiguchi, Yojiro; Mochizuki, Hidetaka

    2006-04-01

    In the TNM classification of colorectal carcinoma, N-staging is dependent on the number of metastases; in the Japanese classification system, staging usually has been based on the distribution of metastases (N1, paracolic; N2, along the major vessels; N3, at the root of major vessels). The aim of our study was to examine whether the concept of the distribution of nodal metastasis could improve the TNM classification for colorectal cancer. We studied the survival rates of 485 and 136 patients with stage III colonic and rectal cancer, respectively, who underwent curative surgery between 1979 and 1998. The patients were categorized into 4 groups: group 1, TNM-N1 classified in J-N1; group 2, TNM-N2 in J-N1; group 3, TNM-N1 in J-N2-3; and group 4, TNM-N2 in J-N2-3. In the colon cancer arm, the 5-year survival rates of the patients in groups 1 to 4 were 74%, 51%, 52%, and 54%, respectively. There was a significant difference in survival rate between groups 1 and 3 (P = .0002). Thus, in colon cancer, nodal metastasis along the major vessels was a bad prognostic factor, even though the number of nodes that were involved was cancer arm, the 5-year survival rates of the patients in each group were 65%, 39%, 60%, and 32%, respectively. Only the number of nodal metastases was an independently significant prognostic variable. This study suggests that adding the concept of nodal distribution to the conventional TNM staging of colon cancer will improve the accuracy in the evaluation of the nodal status.

  19. Distributed computing for global health

    CERN Document Server

    CERN. Geneva; Schwede, Torsten; Moore, Celia; Smith, Thomas E; Williams, Brian; Grey, François

    2005-01-01

    Distributed computing harnesses the power of thousands of computers within organisations or over the Internet. In order to tackle global health problems, several groups of researchers have begun to use this approach to exceed by far the computing power of a single lab. This event illustrates how companies, research institutes and the general public are contributing their computing power to these efforts, and what impact this may have on a range of world health issues. Grids for neglected diseases Vincent Breton, CNRS/EGEE This talk introduces the topic of distributed computing, explaining the similarities and differences between Grid computing, volunteer computing and supercomputing, and outlines the potential of Grid computing for tackling neglected diseases where there is little economic incentive for private R&D efforts. Recent results on malaria drug design using the Grid infrastructure of the EU-funded EGEE project, which is coordinated by CERN and involves 70 partners in Europe, the US and Russi...

  20. A Survey of Health Management User Objectives Related to Diagnostic and Prognostic Metrics

    Science.gov (United States)

    Wheeler, Kevin R.; Kurtoglu, Tolga; Poll, Scott D.

    2010-01-01

    One of the most prominent technical challenges to effective deployment of health management systems is the vast difference in user objectives with respect to engineering development. In this paper, a detailed survey on the objectives of different users of health management systems is presented. These user objectives are then mapped to the metrics typically encountered in the development and testing of two main systems health management functions: diagnosis and prognosis. Using this mapping, the gaps between user goals and the metrics associated with diagnostics and prognostics are identified and presented with a collection of lessons learned from previous studies that include both industrial and military aerospace applications.

  1. Advanced Energy Storage Life and Health Prognostics (INL) FY 2012 Annual Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Jon P. Christophersen

    2012-10-01

    The objective of this work is to develop methodologies that will accurately estimate state-of-health (SOH) and remaining useful life (RUL) of electrochemical energy storage devices using both offline and online (i.e., in-situ) techniques through: · A statistically robust offline battery calendar life estimator tool based on both testing and simulation, and · Novel onboard sensor technology for improved online battery diagnostics and prognostics.

  2. Development of Asset Fault Signatures for Prognostic and Health Management in the Nuclear Industry

    Energy Technology Data Exchange (ETDEWEB)

    Vivek Agarwal; Nancy J. Lybeck; Randall Bickford; Richard Rusaw

    2014-06-01

    Proactive online monitoring in the nuclear industry is being explored using the Electric Power Research Institute’s Fleet-Wide Prognostic and Health Management (FW-PHM) Suite software. The FW-PHM Suite is a set of web-based diagnostic and prognostic tools and databases that serves as an integrated health monitoring architecture. The FW-PHM Suite has four main modules: Diagnostic Advisor, Asset Fault Signature (AFS) Database, Remaining Useful Life Advisor, and Remaining Useful Life Database. This paper focuses on development of asset fault signatures to assess the health status of generator step-up generators and emergency diesel generators in nuclear power plants. Asset fault signatures describe the distinctive features based on technical examinations that can be used to detect a specific fault type. At the most basic level, fault signatures are comprised of an asset type, a fault type, and a set of one or more fault features (symptoms) that are indicative of the specified fault. The AFS Database is populated with asset fault signatures via a content development exercise that is based on the results of intensive technical research and on the knowledge and experience of technical experts. The developed fault signatures capture this knowledge and implement it in a standardized approach, thereby streamlining the diagnostic and prognostic process. This will support the automation of proactive online monitoring techniques in nuclear power plants to diagnose incipient faults, perform proactive maintenance, and estimate the remaining useful life of assets.

  3. Impact of misspecifying the distribution of a prognostic factor on power and sample size for testing treatment interactions in clinical trials.

    Science.gov (United States)

    Reichmann, William M; LaValley, Michael P; Gagnon, David R; Losina, Elena

    2013-02-15

    Interaction in clinical trials presents challenges for design and appropriate sample size estimation. Here we considered interaction between treatment assignment and a dichotomous prognostic factor with a continuous outcome. Our objectives were to describe differences in power and sample size requirements across alternative distributions of a prognostic factor and magnitudes of the interaction effect, describe the effect of misspecification of the distribution of the prognostic factor on the power to detect an interaction effect, and discuss and compare three methods of handling the misspecification of the prognostic factor distribution. We examined the impact of the distribution of the dichotomous prognostic factor on power and sample size for the interaction effect using traditional one-stage sample size calculation. We varied the magnitude of the interaction effect, the distribution of the prognostic factor, and the magnitude and direction of the misspecification of the distribution of the prognostic factor. We compared quota sampling, modified quota sampling, and sample size re-estimation using conditional power as three strategies for ensuring adequate power and type I error in the presence of a misspecification of the prognostic factor distribution. The sample size required to detect an interaction effect with 80% power increases as the distribution of the prognostic factor becomes less balanced. Misspecification such that the actual distribution of the prognostic factor was more skewed than planned led to a decrease in power with the greatest loss in power seen as the distribution of the prognostic factor became less balanced. Quota sampling was able to maintain the empirical power at 80% and the empirical type I error at 5%. The performance of the modified quota sampling procedure was related to the percentage of trials switching the quota sampling scheme. Sample size re-estimation using conditional power was able to improve the empirical power under

  4. A diagnostic and prognostic tool for epidemiologic and economic analyses of dairy herd health management

    DEFF Research Database (Denmark)

    Enevoldsen, Carsten; Sørensen, J.T.; Thysen, Iver;

    1995-01-01

    A computer program framework was established to enable a dairy herd production consultant to perform whole-herd analysis. The diagnostic process was an extensive data analysis 1) to derive key parameters related to production, reproduction, and health and 2) to produce input to a prognostic process....... The prognostic process synthesized the obtained information into short- or long-term prognoses for the herd through a complex herd simulation model. Site specificity of parameter estimation and forecasting and explorability of assumptions and results were major characteristics of the approach. A user acceptance...... problem related to the simulation was addressed through a simultaneous process of development and validation during the introduction of the program framework into veterinary practices. The generally slow adoption of herd simulation models in extension work could be due to lack of credibility of the models...

  5. A diagnostic and prognostic tool for epidemiologic and economic analyses of dairy herd health management

    DEFF Research Database (Denmark)

    Enevoldsen, Carsten; Sørensen, J.T.; Thysen, Iver

    1995-01-01

    A computer program framework was established to enable a dairy herd production consultant to perform whole-herd analysis. The diagnostic process was an extensive data analysis 1) to derive key parameters related to production, reproduction, and health and 2) to produce input to a prognostic process....... The prognostic process synthesized the obtained information into short- or long-term prognoses for the herd through a complex herd simulation model. Site specificity of parameter estimation and forecasting and explorability of assumptions and results were major characteristics of the approach. A user acceptance...... problem related to the simulation was addressed through a simultaneous process of development and validation during the introduction of the program framework into veterinary practices. The generally slow adoption of herd simulation models in extension work could be due to lack of credibility of the models...

  6. An intelligent approach to machine component health prognostics by utilizing only truncated histories

    Science.gov (United States)

    Lu, Chen; Tao, Laifa; Fan, Huanzhen

    2014-01-01

    Numerous techniques and methods have been proposed to reduce the production downtime, spare-part inventory, maintenance cost, and safety hazards of machineries and equipment. Prognostics are regarded as a significant and promising tool for achieving these benefits for machine maintenance. However, prognostic models, particularly probabilistic-based methods, require a large number of failure instances. In practice, engineering assets are rarely being permitted to run to failure. Many studies have reported valuable models and methods that engage in maximizing both truncated and failure data. However, limited studies have focused on cases where only truncated data are available, which is common in machine condition monitoring. Therefore, this study develops an intelligent machine component prognostics system by utilizing only truncated histories. First, the truncated Minimum Quantization Error (MQE) histories were obtained by Self-organizing Map network after feature extraction. The chaos-based parallel multilayer perceptron network and polynomial fitting for residual errors were adopted to generate the predicted MQEs and failure times following the truncation times. The feed-forward neural network (FFNN) was trained with inputs both from the truncated MQE histories and from the predicted MQEs. The target vectors of survival probabilities were estimated by intelligent product limit estimator using the truncation times and generated failure times. After validation, the FFNN was applied to predict the machine component health of individual units. To validate the proposed method, two cases were considered by using the degradation data generated by bearing testing rig. Results demonstrate that the proposed method is a promising intelligent prognostics approach for machine component health.

  7. Prognostics and health management design for rotary machinery systems—Reviews, methodology and applications

    Science.gov (United States)

    Lee, Jay; Wu, Fangji; Zhao, Wenyu; Ghaffari, Masoud; Liao, Linxia; Siegel, David

    2014-01-01

    Much research has been conducted in prognostics and health management (PHM), an emerging field in mechanical engineering that is gaining interest from both academia and industry. Most of these efforts have been in the area of machinery PHM, resulting in the development of many algorithms for this particular application. The majority of these algorithms concentrate on applications involving common rotary machinery components, such as bearings and gears. Knowledge of this prior work is a necessity for any future research efforts to be conducted; however, there has not been a comprehensive overview that details previous and on-going efforts in PHM. In addition, a systematic method for developing and deploying a PHM system has yet to be established. Such a method would enable rapid customization and integration of PHM systems for diverse applications. To address these gaps, this paper provides a comprehensive review of the PHM field, followed by an introduction of a systematic PHM design methodology, 5S methodology, for converting data to prognostics information. This methodology includes procedures for identifying critical components, as well as tools for selecting the most appropriate algorithms for specific applications. Visualization tools are presented for displaying prognostics information in an appropriate fashion for quick and accurate decision making. Industrial case studies are included in this paper to show how this methodology can help in the design of an effective PHM system.

  8. Design of a Prognostics and Health Management System for Electromechanical Equipment Through Time Stress Analysis

    Institute of Scientific and Technical Information of China (English)

    L(U) Ke-hong; QIU Jing; LIU Guan-jun

    2008-01-01

    Time stress includes all kinds of environment and operating stress such as shock, vibration, temperature and electric current that the electromechanical system suffers in the manufacture, transport and operating process. In this paper, the conception of time stress and prognostics and health management (PHM) system are introduced. Then, in order to improve the false alarm recognition and fault prediction capabilities of the electromechanical equipment, a novel PHM architecture for electromechanical equipment is put forward based on a built-in test (BIT) system design technology and time stress analysis method. Finally, the structure, the design and implementing method and the functions of each module of this PHM system are described in detail.

  9. Dependable Wireless Sensor Networks for Prognostics and Health Management: A Survey

    Science.gov (United States)

    2014-10-02

    and N. Zerhouni1 1 Automatic Control and Micro- Mechatronic Systems Department, FEMTO-ST Institute Université de Franche-Comté, Besançon, France...wiem.elghazel@femto-st.fr kamal.medjaher@ens2m.fr noureddine.zerhouni@ens2m.fr 2 Computer Science and Complex Systems Department, FEMTO-ST Institute...maintenance. The key process of the latter is prognostics and health management, a tool that predicts the remaining useful life of engineering assets. As

  10. Alexithymia as a prognostic risk factor for health problems: a brief review of epidemiological studies

    Directory of Open Access Journals (Sweden)

    Kojima Masayo

    2012-12-01

    Full Text Available Abstract The number of articles on alexithymia has been steadily increasing since the word “alexithymia” was coined in the 1970s to denote a common characteristic that is observed among classic psychosomatic patients in whom therapy was unsuccessful. Alexithymia, a disorder of affect regulation, has been suggested to be broadly associated with various mental and physical health problems. However, most available evidence is based on anecdotal reports or cross-sectional observations. To clarify the predictive value of alexithymia for health problems, a systematic review of prospective studies was conducted. A search of the PubMed database identified 1,507 articles on “alexithymia” that were published by July 31, 2011. Among them, only 7 studies examined the developmental risks of alexithymia for health problems among nonclinical populations and 38 studies examined the prognostic value of alexithymia among clinical populations. Approximately half of the studies reported statistically significant adverse effects, while 5 studies demonstrated favorable effects of alexithymia on health outcomes; four of them were associated with surgical interventions and two involved cancer patients. The studies that showed insignificant results tended to have a small sample size. In conclusion, epidemiological evidence regarding alexithymia as a prognostic risk factor for health problems remains un-established. Even though alexithymia is considered to be an unfavorable characteristic for disease control and health promotion overall, some beneficial aspects are suggested. More prospective studies with sufficient sample sizes and follow-up period, especially those involving life course analyses, are needed to confirm the contribution of alexithymia to health problems.

  11. Prognostics and Health Management in Nuclear Power Plants: A Review of Technologies and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Coble, Jamie B.; Ramuhalli, Pradeep; Bond, Leonard J.; Hines, Wes; Upadhyaya, Belle

    2012-07-17

    This report reviews the current state of the art of prognostics and health management (PHM) for nuclear power systems and related technology currently applied in field or under development in other technological application areas, as well as key research needs and technical gaps for increased use of PHM in nuclear power systems. The historical approach to monitoring and maintenance in nuclear power plants (NPPs), including the Maintenance Rule for active components and Aging Management Plans for passive components, are reviewed. An outline is given for the technical and economic challenges that make PHM attractive for both legacy plants through Light Water Reactor Sustainability (LWRS) and new plant designs. There is a general introduction to PHM systems for monitoring, fault detection and diagnostics, and prognostics in other, non-nuclear fields. The state of the art for health monitoring in nuclear power systems is reviewed. A discussion of related technologies that support the application of PHM systems in NPPs, including digital instrumentation and control systems, wired and wireless sensor technology, and PHM software architectures is provided. Appropriate codes and standards for PHM are discussed, along with a description of the ongoing work in developing additional necessary standards. Finally, an outline of key research needs and opportunities that must be addressed in order to support the application of PHM in legacy and new NPPs is presented.

  12. Adaptive Multi-scale Prognostics and Health Management for Smart Manufacturing Systems

    Science.gov (United States)

    Choo, Benjamin Y.; Adams, Stephen C.; Weiss, Brian A.; Marvel, Jeremy A.; Beling, Peter A.

    2017-01-01

    The Adaptive Multi-scale Prognostics and Health Management (AM-PHM) is a methodology designed to enable PHM in smart manufacturing systems. In application, PHM information is not yet fully utilized in higher-level decision-making in manufacturing systems. AM-PHM leverages and integrates lower-level PHM information such as from a machine or component with hierarchical relationships across the component, machine, work cell, and assembly line levels in a manufacturing system. The AM-PHM methodology enables the creation of actionable prognostic and diagnostic intelligence up and down the manufacturing process hierarchy. Decisions are then made with the knowledge of the current and projected health state of the system at decision points along the nodes of the hierarchical structure. To overcome the issue of exponential explosion of complexity associated with describing a large manufacturing system, the AM-PHM methodology takes a hierarchical Markov Decision Process (MDP) approach into describing the system and solving for an optimized policy. A description of the AM-PHM methodology is followed by a simulated industry-inspired example to demonstrate the effectiveness of AM-PHM. PMID:28736651

  13. Health, personal responsibility, and distributive justice

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman

    This PhD dissertation is a contribution to discussions about personal responsibility in relation to distributive justice in health and health care. It is a contribution to contemporary political philosophy in general, but in particular to luck egalitarian theory. I aim to answer three focal...... recent political philosophical discussions of responsibility in egalitarian and luck egalitarian theory to bear on issues of social inequality in health, and access to health care. I argue that distributive justice in health and health care should be sensitive to responsibility, but also that individuals...... questions: 1) What role ought personal responsibility to play in distributive justice in health and health care? 2) What does it take for an individual to be responsible for her own health condition (or responsible in general)? And 3) what is the relation between responsibility and cost...

  14. Distribution of p53 expression in tissue from 774 Danish ovarian tumour patients and its prognostic significance in ovarian carcinomas

    DEFF Research Database (Denmark)

    Hogdall, E.V.S.; Christensen, L.; Frederiksen, K.;

    2008-01-01

    The clinical roles played by normal and altered p53 in cancer are under intensive investigation, but larger studies describing the pattern as well as the prognostic value are still needed. The aim of this study was, using tissue array (TA), to examine the overexpression of p53 protein in 774...... tissue expression were examined. Overall, p53 was expressed in 24/189 (13%) low malignant potential ovarian tumours (LMP) and in 278/585 (48%) ovarian cancers (OC). No significant difference in frequency of p53 tissue expression in LMP tissue was noted with increasing tumour stage (p=0.98). By contrast...... epithelial ovarian tumour tissues from Danish women and to evaluate whether p53 tissue expression levels correlate with clinicopathological parameters and prognosis. The distribution of p53 expression levels at different stages of disease, in different histological subtypes, and the prognostic value of p53...

  15. Prognostics and Health Management of Wind Turbines -- Current Status and Future Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Shuangwen

    2017-04-28

    The global wind industry has seen tremendous growth during the past two decades. However, the industry is challenged by premature component failures, which lead to increased turbine downtime and subsequently, cost of energy for wind power. To mitigate the impacts from these failures, the wind industry has been exploring various areas for improvements ranging from product design, new materials or lubricants, to operation and maintenance (O&M) practices. Condition-based maintenance or prognostics and health management (PHM) has been explored as one enabling technology for improving O&M practices. This chapter provides a brief overview of wind turbine PHM with a focus on operational data mining and condition monitoring of drivetrains. Some future research and development opportunities in wind turbine PHM are also briefly discussed.

  16. Prognostic Health Monitoring System: Component Selection Based on Risk Criteria and Economic Benefit Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Binh T. Pham; Vivek Agarwal; Nancy J Lybeck; Magdy S Tawfik

    2012-05-01

    Prognostic health monitoring (PHM) is a proactive approach to monitor the ability of structures, systems, and components (SSCs) to withstand structural, thermal, and chemical loadings over the SSCs planned service lifespans. The current efforts to extend the operational license lifetime of the aging fleet of U.S. nuclear power plants from 40 to 60 years and beyond can benefit from a systematic application of PHM technology. Implementing a PHM system would strengthen the safety of nuclear power plants, reduce plant outage time, and reduce operation and maintenance costs. However, a nuclear power plant has thousands of SSCs, so implementing a PHM system that covers all SSCs requires careful planning and prioritization. This paper therefore focuses on a component selection that is based on the analysis of a component's failure probability, risk, and cost. Ultimately, the decision on component selection depend on the overall economical benefits arising from safety and operational considerations associated with implementing the PHM system.

  17. Prognostics and health management (PHM) for astronauts: a collaboration project on the International Space Station

    Science.gov (United States)

    Popov, Alexandre; Fink, Wolfgang; Hess, Andrew

    2016-05-01

    Long-duration missions bring numerous risks that must be understood and mitigated in order to keep astronauts healthy, rather than treat a diagnosed health disorder. Having a limited medical support from mission control center on space exploration missions, crew members need a personal health-tracking tool to predict and assess his/her health risks if no preventive measures are taken. This paper refines a concept employing technologies from Prognostics and Health Management (PHM) for systems, namely real-time health monitoring and condition-based health maintenance with predictive diagnostics capabilities. Mapping particular PHM-based solutions to some Human Health and Performance (HH&P) technology candidates, namely by NASA designation, the Autonomous Medical Decision technology and the Integrated Biomedical Informatics technology, this conceptual paper emphasize key points that make the concept different from that of both current conventional medicine and telemedicine including space medicine. The primary benefit of the technologies development for the HH&P domain is the ability to successfully achieve affordable human space missions to Low Earth Orbit (LEO) and beyond. Space missions on the International Space Station (ISS) program directly contribute to the knowledge base and advancements in the HH&P domain, thanks to continued operations on the ISS, a unique human-tended test platform and the only test bed within the space environment. The concept is to be validated on the ISS, the only "test bed" on which to prepare for future manned exploration missions. The paper authors believe that early self-diagnostic coupled with autonomous identification of proper preventive responses on negative trends are critical in order to keep astronauts healthy.

  18. A self-cognizant dynamic system approach for prognostics and health management

    Science.gov (United States)

    Bai, Guangxing; Wang, Pingfeng; Hu, Chao

    2015-03-01

    Prognostics and health management (PHM) is an emerging engineering discipline that diagnoses and predicts how and when a system will degrade its performance and lose its partial or whole functionality. Due to the complexity and invisibility of rules and states of most dynamic systems, developing an effective approach to track evolving system states becomes a major challenge. This paper presents a new self-cognizant dynamic system (SCDS) approach that incorporates artificial intelligence into dynamic system modeling for PHM. A feed-forward neural network (FFNN) is selected to approximate a complex system response which is challenging task in general due to inaccessible system physics. The trained FFNN model is then embedded into a dual extended Kalman filter algorithm to track down system dynamics. A recursive computation technique used to update the FFNN model using online measurements is also derived. To validate the proposed SCDS approach, a battery dynamic system is considered as an experimental application. After modeling the battery system by a FFNN model and a state-space model, the state-of-charge (SoC) and state-of-health (SoH) are estimated by updating the FFNN model using the proposed approach. Experimental results suggest that the proposed approach improves the efficiency and accuracy for battery health management.

  19. Prognostics Health Management and Physics based failure Models for Electrolytic Capacitors

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper proposes first principles based modeling and prognostics approach for electrolytic capacitors. Electrolytic capacitors and MOSFETs are the two major...

  20. Implementation of Remaining Useful Lifetime Transformer Models in the Fleet-Wide Prognostic and Health Management Suite

    Energy Technology Data Exchange (ETDEWEB)

    Agarwal, Vivek [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lybeck, Nancy J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Pham, Binh [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rusaw, Richard [Electric Power Research Inst. (EPRI), Palo Alto, CA (United States); Bickford, Randall [Expert Microsystems, Orangevale, CA (United States)

    2015-02-01

    Research and development efforts are required to address aging and reliability concerns of the existing fleet of nuclear power plants. As most plants continue to operate beyond the license life (i.e., towards 60 or 80 years), plant components are more likely to incur age-related degradation mechanisms. To assess and manage the health of aging plant assets across the nuclear industry, the Electric Power Research Institute has developed a web-based Fleet-Wide Prognostic and Health Management (FW-PHM) Suite for diagnosis and prognosis. FW-PHM is a set of web-based diagnostic and prognostic tools and databases, comprised of the Diagnostic Advisor, the Asset Fault Signature Database, the Remaining Useful Life Advisor, and the Remaining Useful Life Database, that serves as an integrated health monitoring architecture. The main focus of this paper is the implementation of prognostic models for generator step-up transformers in the FW-PHM Suite. One prognostic model discussed is based on the functional relationship between degree of polymerization, (the most commonly used metrics to assess the health of the winding insulation in a transformer) and furfural concentration in the insulating oil. The other model is based on thermal-induced degradation of the transformer insulation. By utilizing transformer loading information, established thermal models are used to estimate the hot spot temperature inside the transformer winding. Both models are implemented in the Remaining Useful Life Database of the FW-PHM Suite. The Remaining Useful Life Advisor utilizes the implemented prognostic models to estimate the remaining useful life of the paper winding insulation in the transformer based on actual oil testing and operational data.

  1. Health, personal responsibility, and distributive justice

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman

    recent political philosophical discussions of responsibility in egalitarian and luck egalitarian theory to bear on issues of social inequality in health, and access to health care. I argue that distributive justice in health and health care should be sensitive to responsibility, but also that individuals...... explains why we have justice-based reasons to reduce social inequality in health. In my second article I investigate and (partly) object to a suggestion put forward by Shlomi Segall, according to which we should exchange the notion of responsibility with a notion of Reasonable Avoidability in the luck......This PhD dissertation is a contribution to discussions about personal responsibility in relation to distributive justice in health and health care. It is a contribution to contemporary political philosophy in general, but in particular to luck egalitarian theory. I aim to answer three focal...

  2. Summary of Nuclear Power Plant Prognostics and Health Management Report: PNNL-21515

    Energy Technology Data Exchange (ETDEWEB)

    Coble, Jamie; Hines, Wesley; Upadhyaya; Belle [University of Tennessee, Knoxville (United States); Ramuhalli, Pradeep [Pacific Northwest National Laboratory, Richland (United States); Bond, Leonard [Iowa State University, Ames (United States)

    2014-08-15

    The recent changes in oil and gas production, as well as wider geo-political events are causing the economics for electricity generation to currently be in a state of some turbulence in the United States (USA). In spite of this, nuclear power continues to meet about a fifth of the electricity needs in the USA. Currently, three separate thrusts to ensure safe and economical nuclear power development to give energy security are being pursued in the USA: longer term operation for the legacy fleet, from 40.60 and possibly 60.80 years; four near-term new nuclear plants with a 60-year design life; and small modular reactors (SMR) design certification, which are expected to employ light water reactor technology, at least in the medium term. Within these activities, attention is turning to enhanced methods for plant component and structural health management. The state of the art in prognostic and health management systems for nuclear power plants was recently reviewed and presented in a report (PNNL-21515); this paper summarizes the key findings of that review.

  3. Review and recent advances in battery health monitoring and prognostics technologies for electric vehicle (EV) safety and mobility

    Science.gov (United States)

    Rezvanizaniani, Seyed Mohammad; Liu, Zongchang; Chen, Yan; Lee, Jay

    2014-06-01

    As hybrid and electric vehicle technologies continue to advance, car manufacturers have begun to employ lithium ion batteries as the electrical energy storage device of choice for use in existing and future vehicles. However, to ensure batteries are reliable, efficient, and capable of delivering power and energy when required, an accurate determination of battery performance, health, and life prediction is necessary. This paper provides a review of battery prognostics and health management (PHM) techniques, with a focus on major unmet needs in this area for battery manufacturers, car designers, and electric vehicle drivers. A number of approaches are presented that have been developed to monitor battery health status and performance, as well as the evolution of prognostics modeling methods. The goal of this review is to render feasible and cost effective solutions for dealing with battery life issues under dynamic operating conditions.

  4. Requirements Specifications for Prognostics: An Overview

    Data.gov (United States)

    National Aeronautics and Space Administration — With recent advancements in prognostics methodologies there has been a significant interest in maturing Prognostics and Health Management (PHM) to increase its...

  5. Prognostic value of heart rate variability in comparison with annual health examinations in very elderly subjects.

    Science.gov (United States)

    Kurita, Akira; Takase, Bonpei; Kodani, Eitaro; Iwahara, Shinichiro; Kusama, Yoshiki; Atarashi, Hirotsugu

    2013-01-01

    The prognostic value of heart rate variability (HRV) in patients with cardiac conditions has been investigated for many years. However, the HRV is superior to annual health examinations for predicting the longevity of very elderly residents of long-term care facilities is unknown. Annual health examinations and subsequently ambulatory Holter ECG recording were performed in 2008 for 71 very elderly subjects, who were then followed up for 3 to 48 months. The patients were divided into 2 groups on the basis of whether they were alive (86 ± 14 years, n=37) or deceased (90 ± 16 years, n=34) at end of follow-up. To assess cardiac autonomic function, HRV was obtained with the MemCalc/Chiram software program after Holter ECG. Age, sex, body-mass index, plasma levels of C-reactive protein and albumin, and the low-frequency/high-frequency ratio did not differ between the 2 groups. However, the standard deviation of all NN intervals (SDNN) and the coefficient of variation of RR intervals (CVRR) were higher in living subjects than in deceased subjects (SDNN: 73.2 ± 13.5 milliseconds vs. 53.2 ± 9.8 milliseconds, CVRR: 9.3% ± 1.7% vs. 7.6% ± 1.3%, p<0.05). The relative risks with an SDNN <65 milliseconds was 1.85 (p<0.05) and that with a CVRR <8% was 1.84 (p<0.05). Kaplan Meier analysis showed that SDNN and CVRR were useful markers for the longevity of very elderly subjects. The present data suggest that annual health examination data does not predict longevity, but that HRV does. The modulation of parasympathetic tone in daily activities plays an important role in the longevity of very elderly residents of long-term care facilities.

  6. Data gateway for prognostic health monitoring of ocean-based power generation

    Science.gov (United States)

    Gundel, Joseph

    On August 5, 2010 the U.S. Department of Energy (DOE) has designated the Center for Ocean Energy Technology (COET) at Florida Atlantic University (FAU) as a national center for ocean energy research and development. Their focus is the research and development of open-ocean current systems and associated infrastructure needed to development and testing prototypes. The generation of power is achieved by using a specialized electric generator with a rotor called a turbine. As with all machines, the turbines will need maintenance and replacement as they near the end of their lifecycle. This prognostic health monitoring (PHM) requires data to be collected, stored, and analyzed in order to maximize the lifespan, reduce downtime and predict when failure is eminent. This thesis explores the use of a data gateway which will separate high level software with low level hardware including sensors and actuators. The gateway will standardize and store the data collected from various sensors with different speeds, formats, and interfaces allowing an easy and uniform transition to a database system for analysis.

  7. Requirements for Prognostic Health Management of Passive Components in Advanced Small Modular Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Ryan M.; Coble, Jamie B.; Ramuhalli, Pradeep

    2013-08-01

    Advanced small modular reactors (aSMRs), which are based on modularization of advanced reactor concepts, may provide a longer-term alternative to traditional light-water reactors and near term small modular reactors (SMRs), which are based on integral pressurized water reactor (iPWR) concepts. aSMRs are conceived for applications in remote locations and for diverse missions that include providing process or district heating, water desalination, and hydrogen production. Several challenges exist with respect to cost-effective operations and maintenance (O&M) of aSMRs, including the impacts of aggressive operating environments and modularity, and limiting these costs and staffing needs will be essential to ensuring the economic feasibility of aSMR deployment. In this regard, prognostic health management (PHM) systems have the potential to play a vital role in supporting the deployment of aSMR systems. This paper identifies requirements and technical gaps associated with implementation of PHM systems for passive aSMR components.

  8. Prognostic value of health-related quality of life for death risk stratification in patients with unresectable glioblastoma.

    Science.gov (United States)

    Paquette, Brice; Vernerey, Dewi; Chauffert, Bruno; Dabakuyo, Sandrine; Feuvret, Loic; Taillandier, Luc; Frappaz, Didier; Taillia, Hervé; Schott, Roland; Ducray, François; Fabbro, Michel; Tennevet, Isabelle; Ghiringhelli, François; Guillamo, Jean-Sébastien; Durando, Xavier; Castera, Daniel; Frenay, Marc; Campello, Chantal; Dalban, Cécile; Skrzypski, Jérome; Chinot, Olivier; Anota, Amélie; Bonnetain, Franck

    2016-08-01

    Glioblastoma is the most common malignant brain tumor in adults. Baseline health-related quality of life (HRQoL) is a major subject of concern for these patients. We aimed to assess the independent prognostic value of HRQoL in unresectable glioblastoma (UGB) patients for death risk stratification. One hundred and thirty-four patients with UGB were enrolled from the TEMAVIR trial. HRQoL was evaluated at baseline using the EORTC QLQ-C30 and BN20 brain cancer module. Clinical and HRQoL parameters were evaluated in univariable and multivariable Cox analysis as prognostic factors for overall survival (OS). Performance assessment and internal validation of the final model were evaluated with Harrel's C-index, calibration plot, and bootstrap sample procedure. Two OS independent predictors were identified: future uncertainty and sensitivity deficit. The final model exhibited good calibration and acceptable discrimination (C statistic = 0.63). The internal validity of the model was verified with robust uncertainties around the hazard ratio. The prognostic score identified three groups of patients with distinctly different risk profiles with median OS estimated at 16.2, 9.2, and 4.5 months. We demonstrated the additional prognostic value of HRQoL in UGB for death risk stratification and provided a score that may help to guide clinical management and stratification in future clinical trials.

  9. The Prognostic Role of Red Blood Cell Distribution Width in Coronary Artery Disease: A Review of the Pathophysiology

    Directory of Open Access Journals (Sweden)

    Kamil Bujak

    2015-01-01

    Full Text Available Red blood cell distribution width (RDW is a measure of red blood cell volume variations (anisocytosis and is reported as part of a standard complete blood count. In recent years, numerous studies have noted the importance of RDW as a predictor of poor clinical outcomes in the settings of various diseases, including coronary artery disease (CAD. In this paper, we discuss the prognostic value of RDW in CAD and describe the pathophysiological connection between RDW and acute coronary syndrome. In our opinion, the negative prognostic effects of elevated RDW levels may be attributed to the adverse effects of independent risk factors such as inflammation, oxidative stress, and vitamin D3 and iron deficiency on bone marrow function (erythropoiesis. Elevated RDW values may reflect the intensity of these phenomena and their unfavorable impacts on bone marrow erythropoiesis. Furthermore, decreased red blood cell deformability among patients with higher RDW values impairs blood flow through the microcirculation, resulting in the diminution of oxygen supply at the tissue level, particularly among patients suffering from myocardial infarction treated with urgent revascularization.

  10. The Prognostic Role of Red Blood Cell Distribution Width in Coronary Artery Disease: A Review of the Pathophysiology

    Science.gov (United States)

    Bujak, Kamil; Wasilewski, Jarosław; Osadnik, Tadeusz; Jonczyk, Sandra; Kołodziejska, Aleksandra; Gierlotka, Marek; Gąsior, Mariusz

    2015-01-01

    Red blood cell distribution width (RDW) is a measure of red blood cell volume variations (anisocytosis) and is reported as part of a standard complete blood count. In recent years, numerous studies have noted the importance of RDW as a predictor of poor clinical outcomes in the settings of various diseases, including coronary artery disease (CAD). In this paper, we discuss the prognostic value of RDW in CAD and describe the pathophysiological connection between RDW and acute coronary syndrome. In our opinion, the negative prognostic effects of elevated RDW levels may be attributed to the adverse effects of independent risk factors such as inflammation, oxidative stress, and vitamin D3 and iron deficiency on bone marrow function (erythropoiesis). Elevated RDW values may reflect the intensity of these phenomena and their unfavorable impacts on bone marrow erythropoiesis. Furthermore, decreased red blood cell deformability among patients with higher RDW values impairs blood flow through the microcirculation, resulting in the diminution of oxygen supply at the tissue level, particularly among patients suffering from myocardial infarction treated with urgent revascularization. PMID:26379362

  11. Multi-agent Prognostics Health and Usage Monitoring (Multi-PHUM) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A prognostic system needs to separate nominal component behavior from the faulty ones even in the cases when those behaviors are similar. Advanced pattern...

  12. Distributed Health Monitoring System for Reusable Liquid Rocket Engines

    Science.gov (United States)

    Lin, C. F.; Figueroa, F.; Politopoulos, T.; Oonk, S.

    2009-01-01

    The ability to correctly detect and identify any possible failure in the systems, subsystems, or sensors within a reusable liquid rocket engine is a major goal at NASA John C. Stennis Space Center (SSC). A health management (HM) system is required to provide an on-ground operation crew with an integrated awareness of the condition of every element of interest by determining anomalies, examining their causes, and making predictive statements. However, the complexity associated with relevant systems, and the large amount of data typically necessary for proper interpretation and analysis, presents difficulties in implementing complete failure detection, identification, and prognostics (FDI&P). As such, this paper presents a Distributed Health Monitoring System for Reusable Liquid Rocket Engines as a solution to these problems through the use of highly intelligent algorithms for real-time FDI&P, and efficient and embedded processing at multiple levels. The end result is the ability to successfully incorporate a comprehensive HM platform despite the complexity of the systems under consideration.

  13. Prognostics for Microgrid Components

    Science.gov (United States)

    Saxena, Abhinav

    2012-01-01

    Prognostics is the science of predicting future performance and potential failures based on targeted condition monitoring. Moving away from the traditional reliability centric view, prognostics aims at detecting and quantifying the time to impending failures. This advance warning provides the opportunity to take actions that can preserve uptime, reduce cost of damage, or extend the life of the component. The talk will focus on the concepts and basics of prognostics from the viewpoint of condition-based systems health management. Differences with other techniques used in systems health management and philosophies of prognostics used in other domains will be shown. Examples relevant to micro grid systems and subsystems will be used to illustrate various types of prediction scenarios and the resources it take to set up a desired prognostic system. Specifically, the implementation results for power storage and power semiconductor components will demonstrate specific solution approaches of prognostics. The role of constituent elements of prognostics, such as model, prediction algorithms, failure threshold, run-to-failure data, requirements and specifications, and post-prognostic reasoning will be explained. A discussion on performance evaluation and performance metrics will conclude the technical discussion followed by general comments on open research problems and challenges in prognostics.

  14. COMPARISON OF RED CELL DISTRIBUTION WIDTH WITH SOFA SCORE AS A PROGNOSTIC MARKER OF SEPSIS IN ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    Shaikh Mohammed Aslam

    2015-12-01

    Full Text Available BACKGROUND Severe sepsis and septic shock are increasing in incidence and contributing significantly to mortality. The prediction of outcome for elderly patients with sepsis may facilitate more aggressive interventions. The SOFA score is a scoring system used to quantify the severity of the patient’s illness based on the degree of organ dysfunction. Various biomarkers are being evaluated for early diagnosis of sepsis. RDW is one of them, which have been shown to predict mortality and morbidity of sepsis. Hence, this study is being done to compare RDW with SOFA score as prognostic marker of sepsis in elderly patients. AIM To compare red cell distribution width with SOFA score as a prognostic marker of sepsis in elderly patients. METHODS A total of 93 elderly patients in sepsis who were admitted to Intensive Care Unit of M. S. Ramaiah Hospitals between October 2013 and September 2015 were included in the study. ROC (Receiver Operating Curve was used to determine the optimal cut-off point for RDW for predicting mortality. ROC of RDW was compared with ROC of SOFA score. RESULTS Mean age of the patients was 70.72±8.02 and most of the patients were in the age group of 61–70yrs. (53.8%. 52(55.9% patients were males and 41(44.1% patients were females. Bronchopneumonia (34.4% and urosepsis (30.1% were the most common causes of sepsis; 61.3% of the patients had SOFA score in the range of 5–10. Mean SOFA score was 7.87097±3.22769. Mean RDW was 14.247±2.1151. CONCLUSION RDW had a sensitivity of 81.6%, specificity of 77.3%, positive predictive value of 80%, and negative predictive value of 79.1% with a cut-off value of 13.75% in predicting mortality in elderly patients in sepsis.

  15. Local-Level Prognostics Health Management Systems Framework for Passive AdvSMR Components. Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    Ramuhalli, Pradeep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Roy, Surajit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hirt, Evelyn H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pardini, Allan F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, Anthony M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Deibler, John E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Pitman, Stan G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Tucker, Joseph C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Prowant, Matthew S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States; Suter, Jonathan D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States

    2014-09-12

    This report describes research results to date in support of the integration and demonstration of diagnostics technologies for prototypical AdvSMR passive components (to establish condition indices for monitoring) with model-based prognostics methods. The focus of the PHM methodology and algorithm development in this study is at the localized scale. Multiple localized measurements of material condition (using advanced nondestructive measurement methods), along with available measurements of the stressor environment, enhance the performance of localized diagnostics and prognostics of passive AdvSMR components and systems.

  16. Distributed data processing for public health surveillance

    Directory of Open Access Journals (Sweden)

    Yih Katherine

    2006-09-01

    Full Text Available Abstract Background Many systems for routine public health surveillance rely on centralized collection of potentially identifiable, individual, identifiable personal health information (PHI records. Although individual, identifiable patient records are essential for conditions for which there is mandated reporting, such as tuberculosis or sexually transmitted diseases, they are not routinely required for effective syndromic surveillance. Public concern about the routine collection of large quantities of PHI to support non-traditional public health functions may make alternative surveillance methods that do not rely on centralized identifiable PHI databases increasingly desirable. Methods The National Bioterrorism Syndromic Surveillance Demonstration Program (NDP is an example of one alternative model. All PHI in this system is initially processed within the secured infrastructure of the health care provider that collects and holds the data, using uniform software distributed and supported by the NDP. Only highly aggregated count data is transferred to the datacenter for statistical processing and display. Results Detailed, patient level information is readily available to the health care provider to elucidate signals observed in the aggregated data, or for ad hoc queries. We briefly describe the benefits and disadvantages associated with this distributed processing model for routine automated syndromic surveillance. Conclusion For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI – a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required.

  17. A prognostic model of the sea ice floe size and thickness distribution

    Directory of Open Access Journals (Sweden)

    C. Horvat

    2015-05-01

    Full Text Available Sea ice exhibits considerable seasonal and longer-term variations in extent, concentration, thickness and age, and is characterized by a complex and continuously changing distribution of floe sizes and thicknesses. Models of sea ice used in current climate models keep track of its concentration and of the distribution of ice thicknesses, but do not account for the floe size distribution and its potential effects on air–sea exchange and sea-ice evolution. Accurately capturing sea-ice variability in climate models may require a better understanding and representation of the distribution of floe sizes and thicknesses. We develop and demonstrate a model for the evolution of the joint sea-ice floe size and thickness distribution that depends on atmospheric and oceanic forcing fields. The model accounts for effects due to multiple processes that are active in the marginal and seasonal ice zones: freezing and melting along the lateral side and base of floes, mechanical interactions due to floe collisions (ridging and rafting and sea-ice fracture due to swell propagation into the ice pack. The model is then examined and demonstrated in a series of idealized test cases.

  18. Health Care Rationing and Distributive Justice

    Directory of Open Access Journals (Sweden)

    Friedrich Breyer

    2009-01-01

    Full Text Available The rapid progress in medical technology makes it unavoidable to ration health care. In the discussion how to ration many people claim that principles of justice in distributing scarce resources should be applied. In this paper we argue that medical resources are not scarce as such but scarcity is a necessary by-product of collective financing arrangements such as social health insurance. So the right question to ask is the determination of the benefit package of such an institution. Hartmut Kliemt is currently involved in a commendable interdisciplinary research project in which principles of 'prioritization' of medical care are studied. This contribution adds a specific perspective to this endeavour: we ask how the goal of distributive justice can be interpreted in this context and compare different approaches to implementing 'just' allocation mechanisms.

  19. Prognostic and health management for engineering systems: a review of the data-driven approach and algorithms

    Directory of Open Access Journals (Sweden)

    Thamo Sutharssan

    2015-07-01

    Full Text Available Prognostics and health management (PHM has become an important component of many engineering systems and products, where algorithms are used to detect anomalies, diagnose faults and predict remaining useful lifetime (RUL. PHM can provide many advantages to users and maintainers. Although primary goals are to ensure the safety, provide state of the health and estimate RUL of the components and systems, there are also financial benefits such as operational and maintenance cost reductions and extended lifetime. This study aims at reviewing the current status of algorithms and methods used to underpin different existing PHM approaches. The focus is on providing a structured and comprehensive classification of the existing state-of-the-art PHM approaches, data-driven approaches and algorithms.

  20. A Rest Time-Based Prognostic Framework for State of Health Estimation of Lithium-Ion Batteries with Regeneration Phenomena

    Directory of Open Access Journals (Sweden)

    Taichun Qin

    2016-11-01

    Full Text Available State of health (SOH prognostics is significant for safe and reliable usage of lithium-ion batteries. To accurately predict regeneration phenomena and improve long-term prediction performance of battery SOH, this paper proposes a rest time-based prognostic framework (RTPF in which the beginning time interval of two adjacent cycles is adopted to reflect the rest time. In this framework, SOH values of regeneration cycles, the number of cycles in regeneration regions and global degradation trends are extracted from raw SOH time series and predicted respectively, and then the three sets of prediction results are integrated to calculate the final overall SOH prediction values. Regeneration phenomena can be found by support vector machine and hyperplane shift (SVM-HS model by detecting long beginning time intervals. Gaussian process (GP model is utilized to predict the global degradation trend, and nonlinear models are utilized to predict the regeneration amplitude and the cycle number of each regeneration region. The proposed framework is validated through experimental data from the degradation tests of lithium-ion batteries. The results demonstrate that both the global degradation trend and the regeneration phenomena of the testing batteries can be well predicted. Moreover, compared with the published methods, more accurate SOH prediction results can be obtained under this framework.

  1. Measurement Science for Prognostics and Health Management for Smart Manufacturing Systems: Key Findings from a Roadmapping Workshop

    Science.gov (United States)

    Weiss, Brian A.; Vogl, Gregory; Helu, Moneer; Qiao, Guixiu; Pellegrino, Joan; Justiniano, Mauricio; Raghunathan, Anand

    2017-01-01

    The National Institute of Standards and Technology (NIST) hosted the Roadmapping Workshop – Measurement Science for Prognostics and Health Management for Smart Manufacturing Systems (PHM4SMS) in Fall 2014 to discuss the needs and priorities of stakeholders in the PHM4SMS technology area. The workshop brought together over 70 members of the PHM community. The attendees included representatives from small, medium, and large manufacturers; technology developers and integrators; academic researchers; government organizations; trade associations; and standards bodies. The attendees discussed the current and anticipated measurement science challenges to advance PHM methods and techniques for smart manufacturing systems; the associated research and development needed to implement condition monitoring, diagnostic, and prognostic technologies within manufacturing environments; and the priorities to meet the needs of PHM in manufacturing. This paper will summarize the key findings of this workshop, and present some of the critical measurement science challenges and corresponding roadmaps, i.e., suggested courses of action, to advance PHM for manufacturing. Milestones and targeted capabilities will be presented for each roadmap across three areas: PHM Manufacturing Process Techniques; PHM Performance Assessment; and PHM Infrastructure – Hardware, Software, and Integration. An analysis of these roadmaps and crosscutting themes seen across the breakout sessions is also discussed. PMID:28664163

  2. Context-Dependent Prognostics and Health Assessment: A Condition-Based Maintenance Approach That Supports Mission Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Allgood, G.O.; Kercel, S.W.

    1999-04-19

    In today's manufacturing environment, plants, systems, and equipment are being asked to perform at levels not thought possible a decade ago. The intent is to improve process operations and equipment reliability, availability, and maintainability without costly upgrades. Of course these gains must be achieved without impacting operational performance. Downsizing is also taking its toll on operations. Loss of personnel, particularly those who represent the corporate history, is depleting US industries of their valuable experiential base which has been relied on so heavily in the past. These realizations are causing companies to rethink their condition-based maintenance policies by moving away from reacting to equipment problems to taking a proactive approach by anticipating needs based on market and customer requirements. This paper describes a different approach to condition-based maintenance-context-dependent prognostics and health assessment. This diagnostic capability is developed around a context-dependent model that provides a capability to anticipate impending failures and determine machine performance over a protracted period of time. This prognostic capability links operational requirements to an economic performance model. In this context, a system may provide 100% operability with less than 100% functionality. This paradigm is used to facilitate optimal logistic supply and support.

  3. Prognostic health monitoring in switch-mode power supplies with voltage regulation

    Science.gov (United States)

    Hofmeister, James P (Inventor); Judkins, Justin B (Inventor)

    2009-01-01

    The system includes a current injection device in electrical communication with the switch mode power supply. The current injection device is positioned to alter the initial, non-zero load current when activated. A prognostic control is in communication with the current injection device, controlling activation of the current injection device. A frequency detector is positioned to receive an output signal from the switch mode power supply and is able to count cycles in a sinusoidal wave within the output signal. An output device is in communication with the frequency detector. The output device outputs a result of the counted cycles, which are indicative of damage to an a remaining useful life of the switch mode power supply.

  4. Prognostic factors and 5-year survival of patients with carcinoma penis: Tertiary health center study

    Directory of Open Access Journals (Sweden)

    A A Shah

    2016-01-01

    Full Text Available Context: To identify prognostic factors in carcinoma penis with its impact on survival. Aims: To find out the relation of various prognostic factors of carcinoma penis with the various outcomes. Settings and Design: Retrospective cohort study. Subjects and Methods: Each patient diagnosed as having carcinoma of penis by incision biopsy and operated from January 2004 to May 2009 at the institute was included in the study (n = 117. Data were collected and analyzed. Statistical Analysis Used: The Chi-square (χ2 test was used to test for the significance of association between the independent (predictor and dependent (outcome variables. Multivariate logistic regression analysis was used to determine predictor variables that predicted the outcome. Five year disease-free survival (DFS and overall survival (OS were calculated using the Kaplan–Meier method. Results: Of the total 117 patients studied, 30 patients died within 5 years (median = 25 months. Recurrences (local or systemic were seen in 23 patients (median = 14 months. Five-year DFS was 80.34% and OS was 72.22%. Kaplan–Meier analysis showed that well to moderately differentiated grade, lymph node negative disease and low stage have higher survivals than poorly differentiated grade, lymph node positive disease and higher stage, respectively. Multiple logistic regression analysis revealed that inguinal lymph node positivity and grade were significantly associated with local or systemic recurrence. Conclusions: Penile cancer patients with advanced disease had poor survival. Tumor grade and inguinal lymph node metastasis are factors affecting DFS. Lymphadenectomy remains an integral part of the management of patients with penile cancer.

  5. The prognostic role of blood lymphocyte subset distribution in patients with resected high-risk primary or regionally metastatic melanoma

    DEFF Research Database (Denmark)

    Hernberg, Micaela; Mattila, Petri S; Rissanen, Marjo;

    2007-01-01

    Cooperative Group adjuvant interferon study. The frequencies of peripheral blood lymphocyte subsets were monitored by flow cytometry using CD3, CD4, CD8, CD56, and CD69 monoclonal antibodies. Patients with low proportions of CD3+CD4+CD69+ cells and of CD3+CD56+ cells before treatment had an improved disease...... independent prognostic factors for overall survival. Our data show that both the proportions of CD3+CD4+CD69+ cells and of CD3+CD56+ cells seem to have a prognostic potential in the natural course of melanoma. These results need to be confirmed in larger studies. Udgivelsesdato: 2007-Oct...

  6. Prognostic differences of World Health Organization - assessed mitotic activity index and mitotic impression by quick scanning in invasive ductal breast cancer patients younger than 55 years

    NARCIS (Netherlands)

    Skaland, Ivar; van Diest, Paul J.; Janssen, Emiel A. M.; Gudlaugsson, Einar; Baak, Jan P. A.

    2008-01-01

    The proliferation marker mitotic activity index is the strongest prognostic indicator in lymph node-negative breast cancer. The World Health Organization (WHO) 2003-defined procedure for determining WHO-mitotic activity index is often replaced by a quick scan mitotic impression. We evaluated the pro

  7. Differential intratumoral distributions of CD8 and CD163 immune cells as prognostic biomarkers in breast cancer.

    Science.gov (United States)

    Fortis, Sotirios P; Sofopoulos, Michael; Sotiriadou, Nectaria N; Haritos, Christoforos; Vaxevanis, Christoforos K; Anastasopoulou, Eleftheria A; Janssen, Nicole; Arnogiannaki, Niki; Ardavanis, Alexandros; Pawelec, Graham; Perez, Sonia A; Baxevanis, Constantin N

    2017-04-18

    Tumor immune cell infiltrates are essential in hindering cancer progression and may complement the TNM classification. CD8+ and CD163+ cells have prognostic impact in breast cancer but their spatial heterogeneity has not been extensively explored in this type of cancer. Here, their potential as prognostic biomarkers was evaluated, depending on their combined densities in the tumor center (TC) and the tumor invasive margin (IM). CD8+ and CD163+ cells were quantified by immunohistochemistry of formalin-fixed, paraffin-embedded (FFPE) tumor tissue samples from a cohort totaling 162 patients with histologically-confirmed primary invasive non-metastatic ductal breast cancer diagnosed between 2000 and 2015. Clinical follow-up (median 6.9 years) was available for 97 of these patients. Differential densities of CD8+ and CD163+ cells in the combined TC and IM compartments (i.e., high(H)/low(L), respectively for CD8+ cells and the reverse L/H combination for CD163+ cells) were found to have significant prognostic value for survival, and allowed better patient stratification than TNM stage, tumor size, lymph node invasion and histological grade. The combined evaluation of CD8+ and CD163+ cell densities jointly in TC and IM further improves prediction of clinical outcomes based on disease-free and overall survival. Patients having the favorable immune signatures had favorable clinical outcomes despite poor clinicopathological parameters. Given the important roles of CD8+ and CD163+ cells in regulating opposing immune circuits, adding an assessment of their differential densities to the prognostic biomarker armamentarium in breast cancer would be valuable. Larger validation studies are necessary to confirm these findings. Study code: IRB-ID 6079/448/10-6-13 Date of approval: 10/06/2013 Retrospective study (2000-2010) First patient prospectively enrolled 14/2/2014.

  8. REGIONAL IMBALANCES IN DISTRIBUTION OF BULGARIAN HEALTH PROFESSIONALS

    Directory of Open Access Journals (Sweden)

    Maria Rohova

    2017-01-01

    Full Text Available Introduction: There are many factors influencing health inequities; health workforce availability and skill mix are among them. Regional distribution of health workers determines access to health services. The aim of this study is to analyse and to assess the distribution of health professionals among the statistical regions and districts in Bulgaria. Methods and materials: The current study uses health professionals to population ratio, Gini index and Lorenz curve to measure and assess the proportionality of health workers distribution. Data are provided from the National Statistical Institute and European Health for All databases. Results and discussion: In Bulgaria, health professionals per population ratio are comparable with the EU average except for the nurses. Beside the shortage of nursing professionals, geographically uneven distribution of health workers is among the main challenges in human resource management.Regional imbalances are significant among the districts in the country. More than half of the physicians are concentrated in 6 districts. The analysis shows an upward trend in imbalances, expressed as absolute or relative differences.The distribution of dentists is much more variant and diverse than this of physicians. The values of Gini index for specialised medical care also reveal considerable imbalances. Conclusions: Differet coefficients have proved the unequal distribution of health workers among the districts.Regional imbalances are not the only reason for health inequities in Bulgaria but they have significant influence in rural and remote areas and in regions with high unemployment, low incomes and ageing population.

  9. A Survey of Health Management User Objectives in Aerospace Systems Related to Diagnostic and Prognostic Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — One of the most prominent technical challenges to effective deployment of health management systems is the vast difference in user objectives with respect to...

  10. Health-Related Quality of Life and Sociodemographic Characteristics as Prognostic Indicators of Long-term Survival in Disease-Free Cervical Cancer Survivors.

    Science.gov (United States)

    Kim, Mi-Kyung; Sim, Jin Ah; Yun, Young Ho; Bae, Duk-Soo; Nam, Joo Hyun; Park, Chong Taik; Cho, Chi-Heum; Lee, Jong-Min; Park, Sang Yoon

    2016-05-01

    Health-related quality-of-life (HRQOL) issues of cancer patients are considered an important clinical outcome. We aimed to investigate the prognostic value of HRQOL on long-term survival outcomes in disease-free cervical cancer survivors (CCSs). The study sample consisted of 860 disease-free CCSs from 6 Korean cancer hospitals recruited for HRQOL survey during 2005 (median time from diagnosis, 5.9 years). Health-related quality-of-life measures included the European Organization for Research and Treatment of Cancer QLQ-C30 and its Cervical Cancer Module (CX24). Survival data were retrieved from the Korean Statistical Office after 6 years from the survey. Health-related quality-of-life domains along with sociodemographic and clinicopathologic variables were analyzed as prognostic factors for survival from the date of survey. During the median follow-up period of 6.3 years after the survey, 30 (3.5%) patients died from all causes. Age, time since diagnosis, and physical activity were independent prognostic factors, which constituted the baseline model along with cancer stage. When HRQOL domains were tested separately against the baseline model, functional scales (physical, role, social, and emotional functioning), global health status, symptom scales (pain and appetite loss), and cervical cancer module items (body image, sexual inactivity, and sexual worry) were significantly associated with survival (P free CCSs are associated with survival.

  11. State of Health Estimation of Li-ion Batteries with Regeneration Phenomena: A Similar Rest Time-Based Prognostic Framework

    Directory of Open Access Journals (Sweden)

    Taichun Qin

    2016-12-01

    Full Text Available State of health (SOH prediction in Li-ion batteries plays an important role in intelligent battery management systems (BMS. However, the existence of capacity regeneration phenomena remains a great challenge for accurately predicting the battery SOH. This paper proposes a novel prognostic framework to predict the regeneration phenomena of the current battery using the data of a historical battery. The global degradation trend and regeneration phenomena (characterized by regeneration amplitude and regeneration cycle number of the current battery are extracted from its raw SOH time series. Moreover, regeneration information of the historical battery derived from corresponding raw SOH data is utilized in this framework. The global degradation trend and regeneration phenomena of the current battery are predicted, and then the prediction results are integrated together to calculate the overall SOH prediction values. Particle swarm optimization (PSO is employed to obtain an appropriate regeneration threshold for the historical battery. Gaussian process (GP model is adopted to predict the global degradation trend, and linear models are utilized to predict the regeneration amplitude and the cycle number of each regeneration region. The proposed framework is validated using experimental data from the degradation tests of Li-ion batteries. The results demonstrate that both the global degradation trend and the regeneration phenomena of the testing batteries can be well predicted. Moreover, compared with the published methods, more accurate SOH prediction results can be obtained under this framework.

  12. The global distribution of health care resources.

    Science.gov (United States)

    Attfield, R

    1990-01-01

    The international disparities in health and health-care provision comprise the gravest problem of medical ethics. The implications are explored of three theories of justice: an expanded version of Rawlsian contractarianism, Nozick's historical account, and a consequentialism which prioritizes the satisfaction of basic needs. The second too little satisfies medical needs to be cogent. The third is found to incorporate the strengths of the others, and to uphold fair rules and practices. Like the first, it also involves obligations transcending those to an agent's relations and fellow-citizens. These conclusions are applied to international health-care provision, which they would transform. PMID:2231643

  13. Standardizing Research Methods for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics and health management (PHM) is a maturing system engineering discipline. As with most maturing disciplines, PHM does not yet have a universally accepted...

  14. A Survey of Artificial Intelligence for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Integrated Systems Health Management includes as key elements fault detection, fault diagnostics, and failure prognostics. Whereas fault detection and diagnostics...

  15. Effect of Air Pollution on Menstrual Cycle Length-A Prognostic Factor of Women's Reproductive Health.

    Science.gov (United States)

    Merklinger-Gruchala, Anna; Jasienska, Grazyna; Kapiszewska, Maria

    2017-07-20

    Air pollution can influence women's reproductive health, specifically menstrual cycle characteristics, oocyte quality, and risk of miscarriage. The aim of the study was to assess whether air pollution can affect the length of the overall menstrual cycle and the length of its phases (follicular and luteal). Municipal ecological monitoring data was used to assess the air pollution exposure during the monitored menstrual cycle of each of 133 woman of reproductive age. Principal component analyses were used to group pollutants (PM10, SO₂, CO, and NOx) to represent a source-related mixture. PM10 and SO₂ assessed separately negatively affected the length of the luteal phase after standardization (b = -0.02; p = 0.03; b = -0.06; p = 0.02, respectively). Representing a fossil fuel combustion emission, they were also associated with luteal phase shortening (b = -0.32; p = 0.02). These pollutants did not affect the follicular phase length and overall cycle length, neither in single- nor in multi-pollutant models. CO and NOx assessed either separately or together as a traffic emission were not associated with overall cycle length or the length of cycle phases. Luteal phase shortening, a possible manifestation of luteal phase deficiency, can result from fossil fuel combustion. This suggests that air pollution may contribute to fertility problems in women.

  16. Distributed Rocket Engine Testing Health Monitoring System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Leveraging the Phase I achievements of the Distributed Rocket Engine Testing Health Monitoring System (DiRETHMS) including its software toolsets and system building...

  17. Distributed Rocket Engine Testing Health Monitoring System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The on-ground and Distributed Rocket Engine Testing Health Monitoring System (DiRETHMS) provides a system architecture and software tools for performing diagnostics...

  18. Tweedie distributions for fitting semicontinuous health care utilization cost data

    OpenAIRE

    2016-01-01

    We explore a statistical distribution that can simultaneously model the probability of zero outcome for non-users of health care utilization and continuous costs for users. We compare this distribution to other com- monly used models on example data and show that it fits cost data well and has some appealing properties that provide flexible use.

  19. On the measurement of the (multidimensional) inequality of health distributions

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    Health outcomes are often described according to two dimensions: quality of life and quantity of life. We analyze the measurement of inequality of health distributions referring to these two dimensions. Our analysis relies on a novel treatment of the quality-of-life dimension, which might not hav...

  20. Risk distribution across multiple health insurance funds in rural Tanzania

    DEFF Research Database (Denmark)

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika

    2014-01-01

    cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health......INTRODUCTION: Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk...... services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. METHODS: Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests...

  1. FLT3 Mutation as a Significant Prognostic Marker in de novo Acute Myeloid Leukemia Patients: Incidence, Distribution and Association with Cytogenetic Findings in a Study from South India

    Directory of Open Access Journals (Sweden)

    Santhi Sarojam

    2014-10-01

    Full Text Available Background: Fms-like tyrosine kinase 3 is a tyrosine kinase receptor that plays an important role in proliferation and differentiation of hematopoietic stem cells. Internal tandem duplication and tyrosine kinase domain mutation are the two most common types of fms-like tyrosine kinase 3 mutations frequently reported in acute myeloid leukemia associated with pathogenesis of this disease. The present study investigates the prevalence and distribution pattern in different acute myeloid leukemia sub- and cytogenetic groups, the association with clinical parameters and the prognostic importance of these mutations in acute myeloid leukemia patients from South India. Methods:Mutation analysis was performed in 276 de novo acute myeloid leukemia patients by polymerase chain reaction restriction fragment length polymorphism using specific restriction enzymes followed by sequencing to confirm the mutations. Kaplan-Meier survival analysis was performed to detect the prognosis. Results: Fms-like tyrosine kinase 3 internal tandem duplication mutations were observed in 20%, tyrosine kinase domain mutation in 4% and dual mutations in 0.3% of the analyzed cases. The internal tandem duplication mutations ranged from 15-107 nucleotides with the majority at the juxta membrane domain of the receptor. Three types of tyrosine kinase domain point mutations were identified: D835Y, D835H and D835V. We observed a significant association between fms-like tyrosine kinase 3 mutations and increased WBC and LDH counts (P<0.001 and blast percentage but not with age, gender and FAB subtypes. A significant association with normal karyotype was observed for the mutants (P=0.002. Survival analysis revealed that the fms-like tyrosine kinase 3 gene mutation was a negative prognostic marker for acute myeloid leukemia patients. The risk stratified analysis showed the mutation to be a risk factor for the intermediate karyotype group, especially for those with normal cytogenetics

  2. Component-Level Prognostics Health Management Framework for Passive Components - Advanced Reactor Technology Milestone: M2AT-15PN2301043

    Energy Technology Data Exchange (ETDEWEB)

    Ramuhalli, Pradeep; Roy, Surajit; Hirt, Evelyn H.; Prowant, Matthew S.; Pitman, Stan G.; Tucker, Joseph C.; Dib, Gerges; Pardini, Allan F.

    2015-06-19

    This report describes research results to date in support of the integration and demonstration of diagnostics technologies for prototypical advanced reactor passive components (to establish condition indices for monitoring) with model-based prognostics methods. Achieving this objective will necessitate addressing several of the research gaps and technical needs described in previous technical reports in this series.

  3. Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies.

    Directory of Open Access Journals (Sweden)

    Yuan-Lan Huang

    Full Text Available AIMS: Multiple studies have investigated the prognostic role of red blood cell distribution width (RDW for patients with heart failure (HF, but the results have been inconsistent. The aim of the present study was to estimate the impact of RDW on the prognosis of HF by performing a systematic review and meta-analysis. METHODS AND RESULTS: The Embase, PubMed, and Web of Science databases were searched up to November 16, 2013 to identify eligible cohort studies. The quality of each study was assessed using the Newcastle-Ottawa Scale (NOS. The association between RDW, either on admission or at discharge, and HF outcomes (all-cause mortality [ACM], heart transplantation, cardiovascular mortality, and rehospitalization, etc. were reviewed. The overall hazard ratio (HR for the effect of RDW on ACM was pooled using a random-effects model, and the publication bias was evaluated using funnel plots and Eggers' tests. Seventeen studies, with a total of 18288 HF patients, were included for systematic review. All eligible studies indicated that RDW on admission and RDW at discharge, as well as its change during treatment, were of prognostic significance for HF patients. The HR for the effect of a 1% increase in baseline RDW on ACM was 1.10 (95% confidence interval: 1.07-1.13, based on pooling of nine studies that provided related data. However, publication bias was observed among these studies. CONCLUSIONS: HF patients with higher RDW may have poorer prognosis than those with lower RDW. Further studies are needed to explore the potential mechanisms underlying this association.

  4. Distributional Orientation and Health Outcomes in OECD Countries.

    Science.gov (United States)

    Safaei, Jalil

    2015-01-01

    This study uses data from the Organisation for Economic Co-operation and Development countries over the 2008-2010 period to construct indicators of "pro-primary" and "pro-secondary" distributions. The former is concerned with the original distribution of income through the market, whereas the latter is concerned with the redistribution efforts of the government. The study ranks these countries along these dimensions to create a distributional orientation map for such countries. It finds that the Scandinavian countries occupy the top rankings in terms of equity in pro-primary distribution, followed by countries with a Bismarckian welfare state regime. The Scandinavian countries also rank very high on equity in pro-secondary distribution, along with some of the top-ranking Bismarckian countries. More significantly, the study finds that the countries' health outcomes are associated more strongly with the pro-primary distributional stance than with the pro-secondary distributional stance. A key policy implication is that to achieve better and more equitable health, it is more effective to design a level playing field for market participants in the first place, than to try to mend inequities after the fact through remedial social policy. © The Author(s) 2015.

  5. A Model-Based Prognostics Approach Applied to Pneumatic Valves

    Data.gov (United States)

    National Aeronautics and Space Administration — Within the area of systems health management, the task of prognostics centers on predicting when components will fail. Model-based prognostics exploits domain...

  6. A Model-based Prognostics Approach Applied to Pneumatic Valves

    Data.gov (United States)

    National Aeronautics and Space Administration — Within the area of systems health management, the task of prognostics centers on predicting when components will fail. Model-based prognostics exploits domain...

  7. Aircraft Anomaly Prognostics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Ridgetop Group will leverage its proven Electromechanical Actuator (EMA) prognostics methodology to develop an advanced model-based actuator prognostic reasoner...

  8. Preoperative red cell distribution width: Not a useful prognostic indicator for 30-day mortality in patients who undergo major- or ultra-major noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Yik-Nang Cheung

    2016-01-01

    Full Text Available Background: Red cell distribution width (RDW has been shown to be associated with mortality in cardiac surgical patients. This study investigates the association of RDW with the 30-day mortality for those patients who undergo major- or ultra-major noncardiac surgery. Methods: Patients who received major- or ultra-major noncardiac surgery between July 2012 and May 2013 were included in the study and patients those with preoperative hemoglobin 13.35% (P = 0.025, odds ratio [OR]: 1.52, INR (P = 0.008, OR: 4.49, albumin level (P < 0.001, OR: 1.10, use of antihypertensives (P = 0.001, OR: 1.82, and preoperative pulse rate (P = 0.006, OR: 1.02 independently predicted the 30-day mortality. However, the area under receiver operating characteristic curve for the prediction of 30-day mortality using RDW was only 0.614. Conclusions: Although preoperative RDW independently predicted 30-day mortality in patients who underwent major- or ultra-major noncardiac surgery, it may not serve as an influential prognostic indicator in view of its low sensitivity and specificity.

  9. [Equity and geographic distribution of financial resources in health systems].

    Science.gov (United States)

    Porto, Silvia Marta

    2002-01-01

    This study focuses on equity in health and specifically the geographic distribution of financial resources. The author reviews the main contemporary theories of social justice and discusses the concept of equity in general and specifically in the health field. Based on the discussion of selected international experiences (United Kingdom, Spain, and Italy), the Resource Allocation Working Party (RAWP) formula used in the United Kingdom is identified as the most adequate distributive methodology, sizing the relative needs based on the population's demographic and epidemiological profiles. Finally, the results are presented from a simulation performed for the Brazilian case, showing that a more equitable geographic distribution of financial resources would require a redistribution favoring the States of the North and Northeast. The article concludes by highlighting that a comparison of actual fund outlays by the Ministry of Health in 1994 and the results of the simulation with the RAWP methodology for the Brazilian case show that the principles written into Brazilian legislation were absent from the geographic distribution of financial resources.

  10. Risk distribution across multiple health insurance funds in rural Tanzania.

    Science.gov (United States)

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-01-01

    Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status to CHF households, but a lower concentration of identified risk factors. Mechanisms for broader risk spreading and cross-subsidisation across the funds are necessary for the promotion of equity. These include risk equalisation to adjust for differential risk distribution and revenue raising capacity of the funds. Expansion of CHF coverage is equally important, by addressing non-financial barriers to CHF enrolment to encourage wealthy non-members to join, as well as subsidised membership for the poorest.

  11. Defining and measuring health inequality: an approach based on the distribution of health expectancy.

    Science.gov (United States)

    Gakidou, E. E.; Murray, C. J.; Frenk, J.

    2000-01-01

    This paper proposes an approach to conceptualizing and operationalizing the measurement of health inequality, defined as differences in health across individuals in the population. We propose that health is an intrinsic component of well-being and thus we should be concerned with inequality in health, whether or not it is correlated with inequality in other dimensions of well-being. In the measurement of health inequality, the complete range of fatal and non-fatal health outcomes should be incorporated. This notion is operationalized through the concept of healthy lifespan. Individual health expectancy is preferable, as a measurement, to individual healthy lifespan, since health expectancy excludes those differences in healthy lifespan that are simply due to chance. In other words, the quantity of interest for studying health inequality is the distribution of health expectancy across individuals in the population. The inequality of the distribution of health expectancy can be summarized by measures of individual/mean differences (differences between the individual and the mean of the population) or inter-individual differences. The exact form of the measure to summarize inequality depends on three normative choices. A firmer understanding of people's views on these normative choices will provide a basis for deliberating on a standard WHO measure of health inequality. PMID:10686732

  12. China's human resources for health: quantity, quality, and distribution.

    Science.gov (United States)

    Anand, Sudhir; Fan, Victoria Y; Zhang, Junhua; Zhang, Lingling; Ke, Yang; Dong, Zhe; Chen, Lincoln C

    2008-11-15

    In this paper, we analyse China's current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses-in 2005, there were 1.9 million licensed doctors and 1.4 million nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Most of China's doctors (67.2%) and nurses (97.5%) have been educated up to only junior college or secondary school level. Since 1998 there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce. Inter-county inequality in the distribution of both doctors and nurses is very high, with most of this inequality accounted for by within-province inequalities (82% or more) rather than by between-province inequalities. Urban-rural disparities in doctor and nurse density account for about a third of overall inter-county inequality. These inequalities matter greatly with respect to health outcomes across counties, provinces, and strata in China; for instance, a cross-county multiple regression analysis using data from the 2000 census shows that the density of health workers is highly significant in explaining infant mortality.

  13. Prognostic Analysis System and Methods of Operation

    Science.gov (United States)

    MacKey, Ryan M. E. (Inventor); Sneddon, Robert (Inventor)

    2014-01-01

    A prognostic analysis system and methods of operating the system are provided. In particular, a prognostic analysis system for the analysis of physical system health applicable to mechanical, electrical, chemical and optical systems and methods of operating the system are described herein.

  14. World distribution, population genetics, and health burden of the hemoglobinopathies.

    Science.gov (United States)

    Williams, Thomas N; Weatherall, David J

    2012-09-01

    Although information about the precise world distribution and frequency of the inherited hemoglobin disorders is still limited, there is no doubt that they are going to pose an increasing burden on global health resources in the future. Their high frequency is a reflection of natural selection combined with a high frequency of consanguineous marriages in many countries, together with an epidemiological transition; whereby, as public health measures improve in the poorer countries of the world, more babies with these disorders are surviving to present for treatment.

  15. Using the {Beta}-binomial distribution to characterize forest health

    Energy Technology Data Exchange (ETDEWEB)

    Zarnoch, S. J. [USDA Forest Service, Southern Research Station, Athens, GA (United States); Anderson, R.L.; Sheffield, R. M. [USDA Forest Service, Southern Research Station, Asheville, NC (United States)

    1995-03-01

    Forest health monitoring programs often use base variables which are dichotomous (i e. alive/dead, damaged/undamaged) to describe the health of trees. Typical sampling designs usually consist of randomly or systematically chosen clusters of trees for observation.It was claimed that contagiousness of diseases for example may result in non-uniformity of affected trees, so that distribution of the proportions, rather than simply the mean proportion, becomes important. The use of the {Beta}-binomial model was suggested for such cases. Use of the {Beta}-binomial distribution model applied in forest health analyses, was described.. Data on dogwood anthracnose (caused by Discula destructiva), a disease of flowering dogwood (Cornus florida L.), was used to illustrate the utility of the model. The {Beta}-binomial model allowed the detection of different distributional patterns of dogwood anthracnose over time and space. Results led to further speculation regarding the cause of the patterns. Traditional proportion analyses like ANOVA would not have detected the trends found using the {Beta}-binomial model, until more distinct patterns had evolved at a later date. The model was said to be flexible and require no special weighting or transformations of data.Another advantage claimed was its ability to handle unequal sample sizes.

  16. Community wide electronic distribution of summary health care utilization data

    Directory of Open Access Journals (Sweden)

    Westert Gert P

    2006-03-01

    Full Text Available Abstract Background In recent years, the use of digital technology has supported widespread sharing of electronic health care data. Although this approach holds considerable promise, it promises to be a complicated and expensive undertaking. This study described the development and implementation of a community wide system for electronic sharing of summary health care utilization data. Methods The development of the community wide data system focused on the following objectives: ongoing monitoring of the health care system, evaluation of community wide individual provider initiatives, identification and development of new initiatives. The system focused on the sharing of data related to hospital acute care, emergency medical services, long term care, and mental health. It was based on the daily distribution of reports among all health care providers related to these services. Results The development of the summary reports concerning health care utilization produced a system wide view of health care in Syracuse, New York on a daily basis. It was not possible to isolate the results of these reports because of the impact of specific projects and other factors. At the same time, the reports were associated with reduction of hospital inpatient stays, improvement of access to hospital emergency departments, reductions in stays for patients discharged to nursing homes, and increased access of mental health patients to hospital inpatient units. Conclusion The implementation of the system demonstrated that summary electronic utilization data could provide daily information that would support the improvement of health care outcomes and efficiency. This approach could be implemented in a simple, direct manner with minimal expenses.

  17. mHealthMon: toward energy-efficient and distributed mobile health monitoring using parallel offloading.

    Science.gov (United States)

    Ahnn, Jong Hoon; Potkonjak, Miodrag

    2013-10-01

    Although mobile health monitoring where mobile sensors continuously gather, process, and update sensor readings (e.g. vital signals) from patient's sensors is emerging, little effort has been investigated in an energy-efficient management of sensor information gathering and processing. Mobile health monitoring with the focus of energy consumption may instead be holistically analyzed and systematically designed as a global solution to optimization subproblems. This paper presents an attempt to decompose the very complex mobile health monitoring system whose layer in the system corresponds to decomposed subproblems, and interfaces between them are quantified as functions of the optimization variables in order to orchestrate the subproblems. We propose a distributed and energy-saving mobile health platform, called mHealthMon where mobile users publish/access sensor data via a cloud computing-based distributed P2P overlay network. The key objective is to satisfy the mobile health monitoring application's quality of service requirements by modeling each subsystem: mobile clients with medical sensors, wireless network medium, and distributed cloud services. By simulations based on experimental data, we present the proposed system can achieve up to 10.1 times more energy-efficient and 20.2 times faster compared to a standalone mobile health monitoring application, in various mobile health monitoring scenarios applying a realistic mobility model.

  18. Distributed Data Storage Model for Cattle Health Monitoring Using WSN

    Directory of Open Access Journals (Sweden)

    Ankit R. Bhavsar

    2013-05-01

    Full Text Available Now a day, wireless sensor networks (WSN are being deployed in various applications like industrial, environmental, health care, societal monitoring. The sensor networks have tendency to generate huge amount of data. Hence data storage techniques become a critical issue for the success of these applications. In this paper, we have proposed a distributed data storage model used for WSN based cattle health monitoring. We have also defined the structure for the same. We have divided this model into two levels namely a local level and a central level. The main aim of storing data locally is to get quick response for any query raised by the user. The second level where the data is centralized is used to make long term decision, planning and policy for the cattle health monitoring.

  19. Prognosis Research Strategy (PROGRESS 2: prognostic factor research.

    Directory of Open Access Journals (Sweden)

    Richard D Riley

    Full Text Available Prognostic factor research aims to identify factors associated with subsequent clinical outcome in people with a particular disease or health condition. In this article, the second in the PROGRESS series, the authors discuss the role of prognostic factors in current clinical practice, randomised trials, and developing new interventions, and explain why and how prognostic factor research should be improved.

  20. Arsenic: geochemical distribution and health risk in Italy

    Science.gov (United States)

    Zuzolo, Daniela; Cicchella, Domenico; Albanese, Stefano; Catani, Vittorio; Dinelli, Enrico; Lima, Annamaria; Valera, Paolo; De Vivo, Benedetto

    2017-04-01

    Characterization of risks to human health is determinant for risk management and population surveillance. This study represent the first work at national scale for Italy about arsenic occurrence, distribution and health impact. We analyzed the As geochemical distribution in different environmental matrices on the whole Italian territory, and assessed both carcinogenic and non-carcinogenic risks for different exposure routes and age groups. The results demonstrate that, in Italy, arsenic is present in significant concentrations both in water (up to 27.2 µg/L) and soils (up to 70 mg/kg). Its presence is mainly controlled by geological processes and locally reflects the industrial history of the Country. The population of the Central Italy, where high content of arsenic in the analyzed samples is due to the presence of alkaline volcanics, are the most exposed to the health risk. Based on the results of our work, it is clear that the consumption of tap water for potable use is the most impactful route for As daily exposure and play an important role in governing potential cancer and non-cancer risks for the considered population. It is interesting to observe that the Incremental Life Cancer Risk through water ingestion show that almost 80% of data falls above the internationally accepted benchmark value of 1 x 10-5. Moreover it was demonstrated that childhood is the most susceptible age stage to As exposure. Geochemical mapping provided a useful tool to spatially analyze and represent data and to highlight the most critic areas and the most exposed population to arsenic at national scale. In conclusion, this study improve knowledge about As occurrence for an entire Country, recognizing an health emerging problem. It might be a good starting point to support the urgently needed policy actions, in order to prevent and reduce the health risk. Moreover, the performed method in this case study research is potentially generalizable and applicable in other countries.

  1. Distilling the Verification Process for Prognostics Algorithms

    Data.gov (United States)

    National Aeronautics and Space Administration — The goal of prognostics and health management (PHM) systems is to ensure system safety, and reduce downtime and maintenance costs. It is important that a PHM system...

  2. Using the beta-binomial distribution to characterize forest health

    Energy Technology Data Exchange (ETDEWEB)

    Zarnoch, S.J.; Anderson, R.L.; Sheffield, R.M.

    1995-12-31

    The beta-binomial distribution is suggested as a model for describing and analyzing the dichotomous data obtained from programs monitoring the health of forests in the United States. Maximum likelihood estimation of the parameters is given as well as asymptotic likelihood ratio tests. The procedure is illustrated with data on dogwood anthracnose infection (caused by Discula destructiva) in the southeastern United States. The parameters estimates have important biological interpretation, and tests of hypotheses are more meaningful than traditional statistical analyses. The value of a modeling approach to dichotomous data analysis is emphasized.

  3. Structural Health and Prognostics Management for Offshore Wind Plants; Final Report of Sandia R&D Activities.

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Daniel Todd [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Wind Energy Technologies Dept.

    2015-04-01

    This final report is a compilation of resear ch efforts - funded by the US Department of Energy Wind and Water Power Technolog ies Office over a four-year period from FY11 through FY14. The goals of this re search program were to develop and evaluate technical innovati ons with promise for maxi mizing revenues and reducing levelized cost of energy (LCOE) for offs hore wind plants - more specifically the goals of the Structural H ealth and Prognostics Management (SHPM) program were to reduce O&M costs and increase energy capture through use of SHPM-based technologies. A technology roadmap was deve loped at the start of the project to guide the research efforts. This roadmap identified and outlined six major research thrust areas each having five stages of ma turity. Research was conducted in each of these thrust areas, as documented throughout this report, although a major focus was on development of damage detection strategi es for the most frequent blade damage conditions and damage mitigation and life-exte nsion strategies via changes in turbine operations (smart loads management). Th e work summarized in this compilation report is the product of the work of many researchers. A summary of the major findings, status of the SHPM Technology Ro admap and recommendations for future work are also provided.

  4. Prognostic value of type D personality for 10-year mortality and subjective health status in patients treated with percutaneous coronary intervention.

    Science.gov (United States)

    Dulfer, K; Hazemeijer, B A F; Van Dijk, M R; Van Geuns, R J M; Daemen, J; Van Domburg, R T; Utens, E M W J

    2015-09-01

    Given the debate around limitations and controversies in type D personality studies, we aimed to evaluate the prognostic value of 'synergistically' analyzed type D personality (interaction z-scores negative affectivity NA, and social inhibition SI) on 10-year mortality and on 10-year subjective health status in percutaneous coronary intervention (PCI) patients. This prospective study comprised a cohort of 1190 consecutive patients who underwent PCI between October 2001 and September 2002 (73% male, mean age: 62years, range [27-90]years). At baseline, type D personality (DS14), and depression/anxiety (HADS) were assessed. Primary endpoint was 10year all-cause mortality; secondary endpoint was 10-year subjective health status (SF-36). After a median follow-up of 10.3years (IQR 9.8-10.8), 293 deaths of any cause (24.6%) were recorded. After adjustment for significant baseline characteristics, personality categories approached and dichotomously approached type D personality were associated with 10-year mortality, ppersonality was not associated with all-cause mortality or subjective health status at 10years. In survivors, higher NA was associated with lower subjective health status. Type D was not associated with mortality after adjusting for continuous depression and anxiety in all approaches. Synergistically analyzed type D was not associated with 10-year all-cause mortality in PCI patients whereas dichotomous type D was. However, after adjustment for depression most of the findings had disappeared. Depression played an important role in this. Type D was not associated with 10-year subjective health status. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. An Approach to Prognostic Decision Making in the Aerospace Domain

    Data.gov (United States)

    National Aeronautics and Space Administration — The field of Prognostic Health Management (PHM) has been undergoing rapid growth in recent years, with development of increasingly sophisticated techniques for...

  6. The Distribution of Health Services in Iran Health Care System: A Case Study at East Azerbaijan

    Directory of Open Access Journals (Sweden)

    Hassan Almaspoor-khangah

    2016-10-01

    Full Text Available Background: It is necessary that various aspects of health information and statistics are identified and measured since health problems are getting more complex day by day. Objective: This study is aimed to investigate the distribution of health services in the health care system in Iran and the case of study is East Azerbaijan province. Methods: This research was a retrospective, descriptive, cross-sectional study. The statistical population included all health service providers in East Azerbaijan Province in the public, private, charity, military, social security, and NGO sectors. In this study, the data from all functional health sectors, including hospitals, health centers, and clinical, rehabilitation centers and all clinics and private offices were studied during 2014. The data relevant to performance were collected according to a pre-determined format (researcher- built checklist which was approved by five professionals and experts Health Services Management (content validity. Results: The study findings showed that the public sector by 45.28% accounted for the highest share of provided services and the private sector, social security, military institutions, charities and NGOs institutions by 25.47%, 18.92%, 4.37%, 3.3%, and 2.66% next rank in providing health services in East Azerbaijan province have been allocated. Conclusion: The results show that most of the health services in East Azerbaijan Province belongs to the public sector and the private sector has managed to develop its services in some parts surpassed the public sector. According to the study findings, Policies should be aimed to create balance and harmony in the provision of services among all service providers.

  7. Right time, right place: improving access to health service through effective retention and distribution of health workers.

    Science.gov (United States)

    Crettenden, Ian; Poz, Mario Dal; Buchan, James

    2013-11-25

    This editorial introduces the 'Right time, Right place: improving access to health service through effective retention and distribution of health workers' thematic series. This series draws from studies in a range of countries and provides new insights into what can be done to improve access to health through more effective human resources policies, planning and management. The primary focus is on health workforce distribution and retention.

  8. A Virtual Laboratory for Aviation and Airspace Prognostics Research

    Science.gov (United States)

    Kulkarni, Chetan; Gorospe, George; Teubert, Christ; Quach, Cuong C.; Hogge, Edward; Darafsheh, Kaveh

    2017-01-01

    Integration of Unmanned Aerial Vehicles (UAVs), autonomy, spacecraft, and other aviation technologies, in the airspace is becoming more and more complicated, and will continue to do so in the future. Inclusion of new technology and complexity into the airspace increases the importance and difficulty of safety assurance. Additionally, testing new technologies on complex aviation systems and systems of systems can be challenging, expensive, and at times unsafe when implementing real life scenarios. The application of prognostics to aviation and airspace management may produce new tools and insight into these problems. Prognostic methodology provides an estimate of the health and risks of a component, vehicle, or airspace and knowledge of how that will change over time. That measure is especially useful in safety determination, mission planning, and maintenance scheduling. In our research, we develop a live, distributed, hardware- in-the-loop Prognostics Virtual Laboratory testbed for aviation and airspace prognostics. The developed testbed will be used to validate prediction algorithms for the real-time safety monitoring of the National Airspace System (NAS) and the prediction of unsafe events. In our earlier work1 we discussed the initial Prognostics Virtual Laboratory testbed development work and related results for milestones 1 & 2. This paper describes the design, development, and testing of the integrated tested which are part of milestone 3, along with our next steps for validation of this work. Through a framework consisting of software/hardware modules and associated interface clients, the distributed testbed enables safe, accurate, and inexpensive experimentation and research into airspace and vehicle prognosis that would not have been possible otherwise. The testbed modules can be used cohesively to construct complex and relevant airspace scenarios for research. Four modules are key to this research: the virtual aircraft module which uses the X

  9. Research on a Defects Detection Method in the Ferrite Phase Shifter Cementing Process Based on a Multi-Sensor Prognostic and Health Management (PHM System

    Directory of Open Access Journals (Sweden)

    Bo Wan

    2016-08-01

    Full Text Available The cementing manufacturing process of ferrite phase shifters has the defect that cementing strength is insufficient and fractures always appear. A detection method of these defects was studied utilizing the multi-sensors Prognostic and Health Management (PHM theory. Aiming at these process defects, the reasons that lead to defects are analyzed in this paper. In the meanwhile, the key process parameters were determined and Differential Scanning Calorimetry (DSC tests during the cure process of resin cementing were carried out. At the same time, in order to get data on changing cementing strength, multiple-group cementing process tests of different key process parameters were designed and conducted. A relational model of cementing strength and cure temperature, time and pressure was established, by combining data of DSC and process tests as well as based on the Avrami formula. Through sensitivity analysis for three process parameters, the on-line detection decision criterion and the process parameters which have obvious impact on cementing strength were determined. A PHM system with multiple temperature and pressure sensors was established on this basis, and then, on-line detection, diagnosis and control for ferrite phase shifter cementing process defects were realized. It was verified by subsequent process that the on-line detection system improved the reliability of the ferrite phase shifter cementing process and reduced the incidence of insufficient cementing strength defects.

  10. Research on a Defects Detection Method in the Ferrite Phase Shifter Cementing Process Based on a Multi-Sensor Prognostic and Health Management (PHM) System

    Science.gov (United States)

    Wan, Bo; Fu, Guicui; Li, Yanruoyue; Zhao, Youhu

    2016-01-01

    The cementing manufacturing process of ferrite phase shifters has the defect that cementing strength is insufficient and fractures always appear. A detection method of these defects was studied utilizing the multi-sensors Prognostic and Health Management (PHM) theory. Aiming at these process defects, the reasons that lead to defects are analyzed in this paper. In the meanwhile, the key process parameters were determined and Differential Scanning Calorimetry (DSC) tests during the cure process of resin cementing were carried out. At the same time, in order to get data on changing cementing strength, multiple-group cementing process tests of different key process parameters were designed and conducted. A relational model of cementing strength and cure temperature, time and pressure was established, by combining data of DSC and process tests as well as based on the Avrami formula. Through sensitivity analysis for three process parameters, the on-line detection decision criterion and the process parameters which have obvious impact on cementing strength were determined. A PHM system with multiple temperature and pressure sensors was established on this basis, and then, on-line detection, diagnosis and control for ferrite phase shifter cementing process defects were realized. It was verified by subsequent process that the on-line detection system improved the reliability of the ferrite phase shifter cementing process and reduced the incidence of insufficient cementing strength defects. PMID:27517935

  11. Research on a Defects Detection Method in the Ferrite Phase Shifter Cementing Process Based on a Multi-Sensor Prognostic and Health Management (PHM) System.

    Science.gov (United States)

    Wan, Bo; Fu, Guicui; Li, Yanruoyue; Zhao, Youhu

    2016-08-10

    The cementing manufacturing process of ferrite phase shifters has the defect that cementing strength is insufficient and fractures always appear. A detection method of these defects was studied utilizing the multi-sensors Prognostic and Health Management (PHM) theory. Aiming at these process defects, the reasons that lead to defects are analyzed in this paper. In the meanwhile, the key process parameters were determined and Differential Scanning Calorimetry (DSC) tests during the cure process of resin cementing were carried out. At the same time, in order to get data on changing cementing strength, multiple-group cementing process tests of different key process parameters were designed and conducted. A relational model of cementing strength and cure temperature, time and pressure was established, by combining data of DSC and process tests as well as based on the Avrami formula. Through sensitivity analysis for three process parameters, the on-line detection decision criterion and the process parameters which have obvious impact on cementing strength were determined. A PHM system with multiple temperature and pressure sensors was established on this basis, and then, on-line detection, diagnosis and control for ferrite phase shifter cementing process defects were realized. It was verified by subsequent process that the on-line detection system improved the reliability of the ferrite phase shifter cementing process and reduced the incidence of insufficient cementing strength defects.

  12. Structural Health and Prognostics Management for Offshore Wind Turbines: Sensitivity Analysis of Rotor Fault and Blade Damage with O&M Cost Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Myrent, Noah J. [Vanderbilt Univ., Nashville, TN (United States). Lab. for Systems Integrity and Reliability; Barrett, Natalie C. [Vanderbilt Univ., Nashville, TN (United States). Lab. for Systems Integrity and Reliability; Adams, Douglas E. [Vanderbilt Univ., Nashville, TN (United States). Lab. for Systems Integrity and Reliability; Griffith, Daniel Todd [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Wind Energy Technology Dept.

    2014-07-01

    Operations and maintenance costs for offshore wind plants are significantly higher than the current costs for land-based (onshore) wind plants. One way to reduce these costs would be to implement a structural health and prognostic management (SHPM) system as part of a condition based maintenance paradigm with smart load management and utilize a state-based cost model to assess the economics associated with use of the SHPM system. To facilitate the development of such a system a multi-scale modeling and simulation approach developed in prior work is used to identify how the underlying physics of the system are affected by the presence of damage and faults, and how these changes manifest themselves in the operational response of a full turbine. This methodology was used to investigate two case studies: (1) the effects of rotor imbalance due to pitch error (aerodynamic imbalance) and mass imbalance and (2) disbond of the shear web; both on a 5-MW offshore wind turbine in the present report. Sensitivity analyses were carried out for the detection strategies of rotor imbalance and shear web disbond developed in prior work by evaluating the robustness of key measurement parameters in the presence of varying wind speeds, horizontal shear, and turbulence. Detection strategies were refined for these fault mechanisms and probabilities of detection were calculated. For all three fault mechanisms, the probability of detection was 96% or higher for the optimized wind speed ranges of the laminar, 30% horizontal shear, and 60% horizontal shear wind profiles. The revised cost model provided insight into the estimated savings in operations and maintenance costs as they relate to the characteristics of the SHPM system. The integration of the health monitoring information and O&M cost versus damage/fault severity information provides the initial steps to identify processes to reduce operations and maintenance costs for an offshore wind farm while increasing turbine availability

  13. A framework for quantifying net benefits of alternative prognostic models

    DEFF Research Database (Denmark)

    Rapsomaniki, Eleni; White, Ian R; Wood, Angela M

    2012-01-01

    New prognostic models are traditionally evaluated using measures of discrimination and risk reclassification, but these do not take full account of the clinical and health economic context. We propose a framework for comparing prognostic models by quantifying the public health impact (net benefit...

  14. A framework for quantifying net benefits of alternative prognostic models

    NARCIS (Netherlands)

    Rapsomaniki, Eleni; White, Ian R.; Wood, Angela M.; Thompson, Simon G.

    2012-01-01

    New prognostic models are traditionally evaluated using measures of discrimination and risk reclassification, but these do not take full account of the clinical and health economic context. We propose a framework for comparing prognostic models by quantifying the public health impact (net benefit) o

  15. Health as normal function: a weak link in Daniels's theory of just health distribution.

    Science.gov (United States)

    Krag, Erik

    2014-10-01

    Drawing on Christopher Boorse's Biostatistical Theory (BST), Norman Daniels contends that a genuine health need is one which is necessary to restore normal functioning - a supposedly objective notion which he believes can be read from the natural world without reference to potentially controversial normative categories. But despite his claims to the contrary, this conception of health harbors arbitrary evaluative judgments which make room for intractable disagreement as to which conditions should count as genuine health needs and therefore which needs should be met. I begin by offering a brief summary of Boorse's BST, the theory to which Daniels appeals for providing the conception of health as normal functioning upon which his overall distributive scheme rests. Next, I consider what I call practical objections to Daniels's use of Boorse's theory. Finally I recount Elseljin Kingma's theoretical objection to Boorse's BST and discuss its impact on Daniels's overall theory. Though I conclude that Boorse's view, so weakened, will no longer be able to sustain the judgments which Daniels's theory uses it to reach, in the end, I offer Daniels an olive branch by briefly sketching an alternative strategy for reaching suitably objective conclusions regarding the health and/or disease status of various conditions.

  16. Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — This chapter presents several performance metrics for offline evaluation of prognostics algorithms. A brief overview of different methods employed for performance...

  17. Measuring inequalities in the distribution of health workers: the case of Tanzania

    Directory of Open Access Journals (Sweden)

    Munga Michael A

    2009-01-01

    Full Text Available Abstract Background The overall human resource shortages and the distributional inequalities in the health workforce in many developing countries are well acknowledged. However, little has been done to measure the degree of inequality systematically. Moreover, few attempts have been made to analyse the implications of using alternative measures of health care needs in the measurement of health workforce distributional inequalities. Most studies have implicitly relied on population levels as the only criterion for measuring health care needs. This paper attempts to achieve two objectives. First, it describes and measures health worker distributional inequalities in Tanzania on a per capita basis; second, it suggests and applies additional health care needs indicators in the measurement of distributional inequalities. Methods We plotted Lorenz and concentration curves to illustrate graphically the distribution of the total health workforce and the cadre-specific (skill mix distributions. Alternative indicators of health care needs were illustrated by concentration curves. Inequalities were measured by calculating Gini and concentration indices. Results There are significant inequalities in the distribution of health workers per capita. Overall, the population quintile with the fewest health workers per capita accounts for only 8% of all health workers, while the quintile with the most health workers accounts for 46%. Inequality is perceptible across both urban and rural districts. Skill mix inequalities are also large. Districts with a small share of the health workforce (relative to their population levels have an even smaller share of highly trained medical personnel. A small share of highly trained personnel is compensated by a larger share of clinical officers (a middle-level cadre but not by a larger share of untrained health workers. Clinical officers are relatively equally distributed. Distributional inequalities tend to be more pronounced

  18. Prognostic factors of improvement in health-related quality of life in atomoxetine-treated children and adolescents with attention-deficit/hyperactivity disorder, based on a pooled analysis.

    Science.gov (United States)

    Montoya, Alonso; Quail, Deborah; Anand, Ernie; Cardo, Esther; Alda, José A; Escobar, Rodrigo

    2014-03-01

    The objective of this study is to identify prognostic factors of treatment response to atomoxetine in improvement of health-related quality of life (HR-QoL), measured by the Child Health and Illness Profile-Child Edition Parent Report Form (CHIP-CE PRF) Achievement and Risk Avoidance domains, in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Pooled data from 3 placebo-controlled trials and separate data from 3 open-label trials of atomoxetine in children and adolescents with ADHD were analyzed using logistic regression methods. Based on baseline impairment in the Achievement and/or Risk Avoidance domains (CHIP-CE PRF Risk Avoidance domains. Data of 190 and 183 subjects from the pooled sample, and 422 and 355 subjects from the open-label trials were included in the analysis of Achievement and Risk Avoidance domains. Baseline CHIP-CE subdomain scores proved to be the most robust prognostic factors for treatment outcome in both domains, based on data from the pooled sample of double-blind studies and from the individual open-label studies (odds ratios [OR] 0.74-1.56, p ADHD Rating Scale scores in the first 4-6 weeks) was another robust prognostic factor, based on data from the open-label studies (OR 2.99-6.19, p factors of atomoxetine treatment outcome in HR-QoL in children and adolescents with ADHD.

  19. Effect of Air Pollution on Menstrual Cycle Length—A Prognostic Factor of Women’s Reproductive Health

    Directory of Open Access Journals (Sweden)

    Anna Merklinger-Gruchala

    2017-07-01

    Full Text Available Air pollution can influence women’s reproductive health, specifically menstrual cycle characteristics, oocyte quality, and risk of miscarriage. The aim of the study was to assess whether air pollution can affect the length of the overall menstrual cycle and the length of its phases (follicular and luteal. Municipal ecological monitoring data was used to assess the air pollution exposure during the monitored menstrual cycle of each of 133 woman of reproductive age. Principal component analyses were used to group pollutants (PM10, SO2, CO, and NOx to represent a source-related mixture. PM10 and SO2 assessed separately negatively affected the length of the luteal phase after standardization (b = −0.02; p = 0.03; b = −0.06; p = 0.02, respectively. Representing a fossil fuel combustion emission, they were also associated with luteal phase shortening (b = −0.32; p = 0.02. These pollutants did not affect the follicular phase length and overall cycle length, neither in single- nor in multi-pollutant models. CO and NOx assessed either separately or together as a traffic emission were not associated with overall cycle length or the length of cycle phases. Luteal phase shortening, a possible manifestation of luteal phase deficiency, can result from fossil fuel combustion. This suggests that air pollution may contribute to fertility problems in women.

  20. Effect of Air Pollution on Menstrual Cycle Length—A Prognostic Factor of Women’s Reproductive Health

    Science.gov (United States)

    Merklinger-Gruchala, Anna; Jasienska, Grazyna; Kapiszewska, Maria

    2017-01-01

    Air pollution can influence women’s reproductive health, specifically menstrual cycle characteristics, oocyte quality, and risk of miscarriage. The aim of the study was to assess whether air pollution can affect the length of the overall menstrual cycle and the length of its phases (follicular and luteal). Municipal ecological monitoring data was used to assess the air pollution exposure during the monitored menstrual cycle of each of 133 woman of reproductive age. Principal component analyses were used to group pollutants (PM10, SO2, CO, and NOx) to represent a source-related mixture. PM10 and SO2 assessed separately negatively affected the length of the luteal phase after standardization (b = −0.02; p = 0.03; b = −0.06; p = 0.02, respectively). Representing a fossil fuel combustion emission, they were also associated with luteal phase shortening (b = −0.32; p = 0.02). These pollutants did not affect the follicular phase length and overall cycle length, neither in single- nor in multi-pollutant models. CO and NOx assessed either separately or together as a traffic emission were not associated with overall cycle length or the length of cycle phases. Luteal phase shortening, a possible manifestation of luteal phase deficiency, can result from fossil fuel combustion. This suggests that air pollution may contribute to fertility problems in women. PMID:28726748

  1. Myelodysplastic syndrome: classification and prognostic systems

    Directory of Open Access Journals (Sweden)

    Rosangela Invernizzi

    2011-12-01

    Full Text Available Myelodysplastic syndromes (MDS are acquired clonal disorders of hematopoiesis, that are characterized most frequently by normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic. MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis of new scientific and clinical information, classification and prognostic systems have recently been updated and minimal diagnostic criteria forMDS have been proposed by expert panels. In addition, in the last few years our ability to define the prognosis of the individual patient with MDS has improved. In this paper World Health Organization (WHO classification refinements and recent prognostic scoring systems for the definition of individual risk are highlighted and current criteria are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies.

  2. Towards Prognostics for Electronics Components

    Science.gov (United States)

    Saha, Bhaskar; Celaya, Jose R.; Wysocki, Philip F.; Goebel, Kai F.

    2013-01-01

    Electronics components have an increasingly critical role in avionics systems and in the development of future aircraft systems. Prognostics of such components is becoming a very important research field as a result of the need to provide aircraft systems with system level health management information. This paper focuses on a prognostics application for electronics components within avionics systems, and in particular its application to an Isolated Gate Bipolar Transistor (IGBT). This application utilizes the remaining useful life prediction, accomplished by employing the particle filter framework, leveraging data from accelerated aging tests on IGBTs. These tests induced thermal-electrical overstresses by applying thermal cycling to the IGBT devices. In-situ state monitoring, including measurements of steady-state voltages and currents, electrical transients, and thermal transients are recorded and used as potential precursors of failure.

  3. Surgery in Brazilian Health Care: funding and physician distribution.

    Science.gov (United States)

    Alonso, Nivaldo; Massenburg, Benjamin B; Galli, Rafael; Sobrado, Lucas; Birolini, Dario

    2017-01-01

    to analyze demographic Brazilian medical data from the national public healthcare system (SUS), which provides free universal health coverage for the entire population, and discuss the problems revealed, with particular focus on surgical care. data was obtained from public healthcare databases including the Medical Demography, the Brazilian Federal Council of Medicine, the Brazilian Institute of Geography and Statistics, and the National Database of Healthcare Establishments. Density and distribution of the medical workforce and healthcare facilities were calculated, and the geographic regions were analyzed using the public private inequality index. Brazil has an average of two physicians for every 1,000 inhabitants, who are unequally distributed throughout the country. There are 22,276 board certified general surgeons in Brazil (11.49 for every 100,000 people). The country currently has 257 medical schools, with 25,159 vacancies for medical students each year, with only around 13,500 vacancies for residency. The public private inequality index is 3.90 for the country, and ranges from 1.63 in the Rio de Janeiro up to 12.06 in Bahia. A significant part of the local population still faces many difficulties in accessing surgical care, particularly in the north and northeast of the country, where there are fewer hospitals and surgeons. Physicians and surgeons are particularly scarce in the public health system nationwide, and better incentives are needed to ensure an equal public and private workforce. analisar dados demográficos do Sistema Único de Saúde (SUS) brasileiro, que promove cobertura de saúde universal a toda população, e discutir os problemas revelados, com particular ênfase nos cuidados cirúrgicos. os dados foram obtidos a partir dos bancos de dados de saúde pública da Demografia Médica, do Conselho Federal de Medicina, do Instituto Brasileiro de Geografia e Estatística e do Cadastro Nacional dos Estabelecimentos de Saúde. A densidade e a

  4. Does the distribution of health care benefits in Kenya meet the principles of universal coverage?

    Science.gov (United States)

    Chuma, Jane; Maina, Thomas; Ataguba, John

    2012-01-10

    The 58th World Health Assembly called for all health systems to move towards universal coverage where everyone has access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Universal coverage involves ensuring that health care benefits are distributed on the basis of need for care and not on ability to pay. The distribution of health care benefits is therefore an important policy question, which health systems should address. The aim of this study is to assess the distribution of health care benefits in the Kenyan health system, compare changes over two time periods and demonstrate the extent to which the distribution meets the principles of universal coverage. Two nationally representative cross-sectional households surveys conducted in 2003 and 2007 were the main sources of data. A comprehensive analysis of the entire health system is conducted including the public sector, private-not-for-profit and private-for-profit sectors. Standard benefit incidence analysis techniques were applied and adopted to allow application to private sector services. The three sectors recorded similar levels of pro-rich distribution in 2003, but in 2007, the private-not-for-profit sector was pro-poor, public sector benefits showed an equal distribution, while the private-for-profit sector remained pro-rich. Larger pro-rich disparities were recorded for inpatient compared to outpatient benefits at the hospital level, but primary health care services were pro-poor. Benefits were distributed on the basis of ability to pay and not on need for care. The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the Kenyan health system to address access barriers and ensure that all Kenyans benefit from health care when they need it.

  5. Does the distribution of health care benefits in Kenya meet the principles of universal coverage?

    Directory of Open Access Journals (Sweden)

    Chuma Jane

    2012-01-01

    Full Text Available Abstract Background The 58th World Health Assembly called for all health systems to move towards universal coverage where everyone has access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Universal coverage involves ensuring that health care benefits are distributed on the basis of need for care and not on ability to pay. The distribution of health care benefits is therefore an important policy question, which health systems should address. The aim of this study is to assess the distribution of health care benefits in the Kenyan health system, compare changes over two time periods and demonstrate the extent to which the distribution meets the principles of universal coverage. Methods Two nationally representative cross-sectional households surveys conducted in 2003 and 2007 were the main sources of data. A comprehensive analysis of the entire health system is conducted including the public sector, private-not-for-profit and private-for-profit sectors. Standard benefit incidence analysis techniques were applied and adopted to allow application to private sector services. Results The three sectors recorded similar levels of pro-rich distribution in 2003, but in 2007, the private-not-for-profit sector was pro-poor, public sector benefits showed an equal distribution, while the private-for-profit sector remained pro-rich. Larger pro-rich disparities were recorded for inpatient compared to outpatient benefits at the hospital level, but primary health care services were pro-poor. Benefits were distributed on the basis of ability to pay and not on need for care. Conclusions The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the Kenyan health system to address access barriers and ensure

  6. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    Science.gov (United States)

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse.

  7. What is the difference? Evidence on the distribution of wealth, health, life expectancy, and health insurance coverage.

    Science.gov (United States)

    Kennickell, Arthur B

    2008-09-10

    There is a literature of long standing that considers the relationship between income and differentials in mortality and morbidity, but information on differentials over the distribution of accumulated wealth have been far more scarce and subject to measurement problems. This paper provides evidence from the Survey of Consumer Finances, which is designed as a survey of wealth, on the distribution of wealth and income and how those distributions have shifted in recent years. Particular attention is paid to the distribution of wealth across minority groups and across age groups. The paper also examines the relationship between wealth and health status, life expectancy, and health insurance coverage.

  8. A prognostic model to predict survival in 867 World Health Organization-defined essential thrombocythemia at diagnosis: a study by the International Working Group on Myelofibrosis Research and Treatment.

    Science.gov (United States)

    Passamonti, Francesco; Thiele, Jürgen; Girodon, Francois; Rumi, Elisa; Carobbio, Alessandra; Gisslinger, Heinz; Kvasnicka, Hans Michael; Ruggeri, Marco; Randi, Maria Luigia; Gangat, Naseema; Vannucchi, Alessandro Maria; Gianatti, Andrea; Gisslinger, Bettina; Müllauer, Leonhard; Rodeghiero, Francesco; d'Amore, Emanuele S G; Bertozzi, Irene; Hanson, Curtis A; Boveri, Emanuela; Marino, Filippo; Maffioli, Margherita; Caramazza, Domenica; Antonioli, Elisabetta; Carrai, Valentina; Buxhofer-Ausch, Veronika; Pascutto, Cristiana; Cazzola, Mario; Barbui, Tiziano; Tefferi, Ayalew

    2012-08-01

    Diagnosis of essential thrombocythemia (ET) has been updated in the last World Health Organization (WHO) classification. We developed a prognostic model to predict survival at diagnosis, named IPSET (International Prognostic Score for ET), studying patients with WHO-defined ET. Age 60 years or older, leukocyte count ≥ 11 × 10(9)/L, and prior thrombosis significantly affected survival, by multivariable Cox regression. On the basis of the hazard ratio, we assigned 2 points to age and 1 each to leukocyte count and thrombosis. So, the IPSET model allocated 867 patients into 3 risk categories with significantly different survival: low (sum of points = 0; median survival not reached), intermediate (sum = 1-2; median survival 24.5 years), and high (sum = 3-4, median survival 13.8 years). The IPSET model was further validated in 2 independent cohorts including 132 WHO-defined ET and 234 Polycythemia Vera Study Group-defined ET patients. The IPSET model was able to predict the occurrence of thrombosis, and not to predict post-ET myelofibrosis. In conclusion, IPSET, based on age ≥ 60 years, leukocyte count ≥ 11 × 10(9)/L, and history of thrombosis allows prognostic assessment of WHO-defined ET and the validation process makes IPSET applicable in all patients phenotypically appearing as ET.

  9. Vehicle Integrated Prognostic Reasoner (VIPR) Metric Report

    Science.gov (United States)

    Cornhill, Dennis; Bharadwaj, Raj; Mylaraswamy, Dinkar

    2013-01-01

    This document outlines a set of metrics for evaluating the diagnostic and prognostic schemes developed for the Vehicle Integrated Prognostic Reasoner (VIPR), a system-level reasoner that encompasses the multiple levels of large, complex systems such as those for aircraft and spacecraft. VIPR health managers are organized hierarchically and operate together to derive diagnostic and prognostic inferences from symptoms and conditions reported by a set of diagnostic and prognostic monitors. For layered reasoners such as VIPR, the overall performance cannot be evaluated by metrics solely directed toward timely detection and accuracy of estimation of the faults in individual components. Among other factors, overall vehicle reasoner performance is governed by the effectiveness of the communication schemes between monitors and reasoners in the architecture, and the ability to propagate and fuse relevant information to make accurate, consistent, and timely predictions at different levels of the reasoner hierarchy. We outline an extended set of diagnostic and prognostics metrics that can be broadly categorized as evaluation measures for diagnostic coverage, prognostic coverage, accuracy of inferences, latency in making inferences, computational cost, and sensitivity to different fault and degradation conditions. We report metrics from Monte Carlo experiments using two variations of an aircraft reference model that supported both flat and hierarchical reasoning.

  10. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Directory of Open Access Journals (Sweden)

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  11. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    OpenAIRE

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac d...

  12. Prognostics in Battery Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Batteries represent complex systems whose internal state vari- ables are either inaccessible to sensors or hard to measure un- der operational conditions. This work...

  13. Particle filter-based prognostics: Review, discussion and perspectives

    Science.gov (United States)

    Jouin, Marine; Gouriveau, Rafael; Hissel, Daniel; Péra, Marie-Cécile; Zerhouni, Noureddine

    2016-05-01

    Particle filters are of great concern in a large variety of engineering fields such as robotics, statistics or automatics. Recently, it has developed among Prognostics and Health Management (PHM) applications for diagnostics and prognostics. According to some authors, it has ever become a state-of-the-art technique for prognostics. Nowadays, around 50 papers dealing with prognostics based on particle filters can be found in the literature. However, no comprehensive review has been proposed on the subject until now. This paper aims at analyzing the way particle filters are used in that context. The development of the tool in the prognostics' field is discussed before entering the details of its practical use and implementation. Current issues are identified, analyzed and some solutions or work trails are proposed. All this aims at highlighting future perspectives as well as helping new users to start with particle filters in the goal of prognostics.

  14. Stratification, competition and risk distribution: health insurance in Germany and the United States.

    Science.gov (United States)

    Abel, T; Wysong, J A

    1992-01-01

    Issues of unequal risk distribution among sickness funds are given increasing attention in the current discussions on the reform of the statutory health insurance system in Germany. This paper examines the structural determinants of risk distribution and points toward the links between social stratification, competition, health risk and insurance status. A model showing the links between basic structural determinants is presented. Using health survey data from Germany and the U.S., statistical analyses are conducted. The results support the model and indicate its applicability for both health care systems. The paper concludes by indicating the relevance of such findings for health policy and future research.

  15. Impact of microbial count distributions on human health risk estimates

    DEFF Research Database (Denmark)

    Ribeiro Duarte, Ana Sofia; Nauta, Maarten

    2015-01-01

    -lognormal distribution. We show that the impact of the choice of different probability distributions to describe concentrations at retail on risk estimates is dependent both on concentration and prevalence levels. We also show that the use of an LOQ should be done consciously, especially when zero-inflation is not used...... on risk estimates, at two different concentration scenarios and at a range of prevalence levels. By using five different parametric distributions, we investigate whether different characteristics of a good fit are crucial for an accurate risk estimate. Among the factors studied are the importance......-inflated Poisson-lognormal distributed data and an existing QMRA model from retail to consumer level, it was possible to assess the difference between expected risk and the risk estimated with using a lognormal, a zero-inflated lognormal, a Poisson-gamma, a zero-inflated Poisson-gamma and a zero-inflated Poisson...

  16. Distributed Data Mining for Aircraft Health Management Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA, DoD, and commercial aircraft operators need to transform vast amounts of aircraft data accumulated in distributed databases into actionable knowledge. We...

  17. Distributed Data Mining for Aircraft Health Management Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aircraft Flight Operations Quality Assurance (FOQA) programs are implemented by most of the aircraft operators. Vast amounts of FOQA data are distributed between...

  18. Prognostics of Power MOSFET

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and...

  19. Income Distribution and Health Status: Econometric Evidence from OECD Countries

    Directory of Open Access Journals (Sweden)

    Vasudeva N.R. Murthy

    2007-01-01

    Full Text Available This research note, using a cross-sectional sample consisting of 27 Organization for Economic Co-operation and Development countries (OECD for the reference year 2002, empirically examines the relationship between health status as measured by infant mortality and the degree of income inequality, given the effect of certain controlled variables. The empirical findings based on the estimation by robust econometric methods, show that in these countries, per capita real gross domestic product, the number of doctors, the level of education, percentage of female smokers in the adult population and income inequality, as reflected by the percentage of the income received by the lowest tenth of the population do impact the level of health status. The results clearly indicate that income inequality affects the level of health status adversely. Policy implications of the research findings are discussed in the research.

  20. Mass media health communication campaigns combined with health-related product distribution: a community guide systematic review.

    Science.gov (United States)

    Robinson, Maren N; Tansil, Kristin A; Elder, Randy W; Soler, Robin E; Labre, Magdala P; Mercer, Shawna L; Eroglu, Dogan; Baur, Cynthia; Lyon-Daniel, Katherine; Fridinger, Fred; Sokler, Lynn A; Green, Lawrence W; Miller, Therese; Dearing, James W; Evans, William D; Snyder, Leslie B; Kasisomayajula Viswanath, K; Beistle, Diane M; Chervin, Doryn D; Bernhardt, Jay M; Rimer, Barbara K

    2014-09-01

    Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics. Published by Elsevier Inc.

  1. Equity in Distribution of Health Care Resources; Assessment of Need and Access, Using Three Practical Indicators.

    Science.gov (United States)

    Omrani-Khoo, Habib; Lotfi, Farhad; Safari, Hossein; Zargar Balaye Jame, Sanaz; Moghri, Javad; Shafii, Milad

    2013-11-01

    Equitable distribution of health system resources has been a serious challenge for long ago among the health policy makers. Conducted studies have mostly ever had emphasis on equality rather than equity. In this paper we have attempted to examine both equality and equity in resources distribution. This is an applied and descriptive study in which we plotted Lorenz and concentration curves to describe graphically the distribution of hemodialysis beds and nephrologists as two complementary resources in health care in relation to hemodialysis patients. To end this, inequality and inequity were measured by calculating Gini- coefficient, concentration and Robin Hood indices. We used STATA and EXCEL software to calculate indicators. The results showed that inequality was not seen in hemodialysis beds in population level. However, distribution of nephrologists without considering population needs was accompanied with some sort of inequality. Gini- coefficient for beds and nephrologists distribution in population level was respectively 0.02 and 0.38. Hence, calculation of concentration index for distribution of hemodialysis beds and nephrologists with regard to population needs indicated that unlike beds distribution, equity gap between nephrologists distribution against patients distribution among the provinces was considerably significant again. Our results imply that although hemodialysis beds in Iran have been distributed in connection with the population need, nephrologists' distribution is not the same as hemodialysis beds one and this imbalance in complementary resources, can affect both efficiency and equitable access to services for population.

  2. Prognostic indicators in alcoholic cirrhotic men

    DEFF Research Database (Denmark)

    Gluud, C; Henriksen, Jens Henrik Sahl; Nielsen, G

    1988-01-01

    information regarding development of variceal hemorrhage, even when easily obtained variables with known prognostic information were included [modified Child-Turcotte's criteria and incapacitation index (a weighted sum of days without normal health)]. During follow-up, 17 patients (29%) died. Applying Cox......'s regression analysis, large varices at endoscopy (p = 0.012) and hepatic vein pressure gradient (p = 0.019) contained significant prognostic information regarding death, in addition to the information contained in the modified Child-Turcotte's criteria and incapacitation index. In conclusion, prediction...

  3. Concordance for prognostic models with competing risks

    DEFF Research Database (Denmark)

    Wolbers, Marcel; Blanche, Paul; Koller, Michael T

    2014-01-01

    The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate i...... of the working model. We further illustrate the methods by computing the concordance probability for a prognostic model of coronary heart disease (CHD) events in the presence of the competing risk of non-CHD death.......The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate...... it to recently proposed time-dependent area under the receiver operating characteristic curve measures. For right-censored data, we investigate inverse probability of censoring weighted (IPCW) estimates of a truncated concordance index based on a working model for the censoring distribution. We demonstrate...

  4. Accelerated Aging System for Prognostics of Power Semiconductor Devices

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is an engineering discipline that focuses on estimation of the health state of a component and the prediction of its remaining useful life (RUL) before...

  5. Prognostics for Ground Support Systems: Case Study on Pneumatic Valves

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics technologies determine the health (or damage) state of a component or sub- system, and make end of life (EOL) and remaining useful life (RUL)...

  6. A Model-based Avionic Prognostic Reasoner (MAPR)

    Data.gov (United States)

    National Aeronautics and Space Administration — The Model-based Avionic Prognostic Reasoner (MAPR) presented in this paper is an innovative solution for non-intrusively monitoring the state of health (SoH) and...

  7. Where are the NGOs and why? The distribution of health and development NGOs in Bolivia.

    Science.gov (United States)

    Galway, Lindsay P; Corbett, Kitty K; Zeng, Leilei

    2012-11-23

    The presence and influence of nongovernmental organizations (NGOs) in the landscape of global health and development have dramatically increased over the past several decades. The distribution of NGO activity and the ways in which contextual factors influence the distribution of NGO activity across geographies merit study. This paper explores the distribution of NGO activity, using Bolivia as a case study, and identifies local factors that are related to the distribution of NGO activity across municipalities in Bolivia. The research question is addressed using a geographic information system (GIS) and multiple regression analyses of count data. We used count data of the total number of NGO projects across Bolivian municipalities to measure NGO activity both in general and in the health sector specifically and national census data for explanatory variables of interest. This study provides one of the first empirical analyses exploring factors related to the distribution of NGO activity at the national scale. Our analyses show that NGO activity in Bolivia, both in general and health-sector specific, is distributed unevenly across the country. Results indicate that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. Results for NGO activity in general and health-sector specific NGO activity were similar. The uneven distribution of NGO activity may suggest a lack of co-ordination among NGOs working in Bolivia as well as a lack of co-ordination among NGO funders. Co-ordination of NGO activity is most needed in regions characterized by high NGO activity in order to avoid duplication of services and programmes and inefficient use of limited resources. Our findings also indicate that neither general nor health specific NGO activity is related to population need, when defined as population health status or education level or poverty levels. Considering these results we discuss broader implications

  8. Differences in metabolism between adeno- and squamous cell non-small cell lung carcinomas: spatial distribution and prognostic value of GLUT1 and MCT4.

    NARCIS (Netherlands)

    Meijer, T.W.H.; Schuurbiers, O.C.J.; Kaanders, J.H.A.M.; Looijen-Salamon, M.G.; Geus-Oei, L.F. de; Verhagen, A.F.T.M.; Lok, J.; Heijden, H.F. van der; Rademakers, S.E.; Span, P.N.; Bussink, J.

    2012-01-01

    BACKGROUND: Hypoxia leads to changes in tumor cell metabolism such as increased glycolysis. In this study, we examined the spatial distribution of the glycolysis and hypoxia related markers glucose transporter 1 (GLUT1) and monocarboxylate transporter 4 (MCT4) expression in relation to the vasculatu

  9. [Equity in health? Health inequalities, ethics, and theories of distributive justice].

    Science.gov (United States)

    Buyx, A M

    2010-01-01

    It is well-documented that the socio-economic status has an important influence on health. In all developed countries, health is closely correlated with income, education, and type of employment, as well as with several other social determinants. While data on this socio-economic health gradient have been available for decades, the moral questions surrounding social health inequalities have only recently been addressed within the field of public health ethics. The present article offers a brief overview of relevant data on social health inequalities and on some explanatory models from epidemiology, social medicine and related disciplines. The main part explores three influential normative accounts addressing the issue of health inequalities. Finally, an agenda for future work in the field of public health ethics and health inequalities is sketched, with particular attention to the German context.

  10. 航空发动机健康管理用户的诊断预测指标体系%Diagnostic and Prognostic Metrics of Aeroengine Health Management Users

    Institute of Scientific and Technical Information of China (English)

    尉询楷; 刘芳; 陈良峰; 朱纪洪; 杨立

    2012-01-01

    The need of different health management users must be met by the top design requirements of aeroengine health management. The user categories and design flow of the health management system were briefly introduced, and then the needs from the field users including logistics, flight, maintenance and fleet management were analyzed. In the perspective of diagnostics and prognostics for health management systems, the mapping relations between the different user requirements and the metrics for diagnostics and prognostics were analyzed, and the respective metrics were built. The results could help the military decision staffs make the research and development top requirements suite better for the field usage needs, also the industrial design engineers could benefit from making more satisfied research regulatory for the user requirements.%航空发动机健康管理的顶层设计必须要满足不同健康管理用户的使用要求。简要介绍了健康管理系统的用户分类和开发流程,重点分析了面向外场使用的后勤、飞行、维修、机群管理等军方健康管理用户的要求。从健康管理诊断和预测的技术实现出发,分别分析了军方不同用户的要求与诊断、预测指标之间的映射关系,建立了相应的诊断和预测指标体系。可为军方制定满足外场使用需求的研制总要求,工业部门制定贴合用户需求的研制规范提供借鉴。

  11. Linking Health Concepts in the Assessment and Evaluation of Water Distribution Systems

    Science.gov (United States)

    Karney, Bryan W.; Filion, Yves R.

    2005-01-01

    The concept of health is not only a specific criterion for evaluation of water quality delivered by a distribution system but also a suitable paradigm for overall functioning of the hydraulic and structural components of the system. This article views health, despite its complexities, as the only criterion with suitable depth and breadth to allow…

  12. A Mobile Robot Testbed for Prognostics-Enabled Autonomous Decision Making

    Data.gov (United States)

    National Aeronautics and Space Administration — The ability to utilize prognostic system health information in operational decision making, especially when fused with information about future operational,...

  13. A Systems Engineering Approach to Electro-Mechanical Actuator Diagnostic and Prognostic Development

    Data.gov (United States)

    National Aeronautics and Space Administration — The authors have formulated a Comprehensive Systems Engineering approach to Electro-Mechanical Actuator (EMA) Prognostics and Health Management (PHM) system...

  14. Prognostics Enhancemend Fault-Tolerant Control with an Application to a Hovercraft Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Fault-Tolerant Control (FTC) is an emerging area of engineering and scientific research that integrates prognostics, health management concepts and intelligent...

  15. Prognostics of Power MOSFET

    Science.gov (United States)

    Celaya, Jose Ramon; Saxena, Abhinav; Vashchenko, Vladislay; Saha, Sankalita; Goebel, Kai Frank

    2011-01-01

    This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and Gaussian process regression to perform prognostics. The approach is validated with experiments on 100V power MOSFETs. The failure mechanism for the stress conditions is determined to be die-attachment degradation. Change in ON-state resistance is used as a precursor of failure due to its dependence on junction temperature. The experimental data is augmented with a finite element analysis simulation that is based on a two-transistor model. The simulation assists in the interpretation of the degradation phenomena and SOA (safe operation area) change.

  16. The geographic distribution of private health insurance in Australia in 2001.

    Science.gov (United States)

    Glover, John; Tennant, Sarah; Duckett, Stephen

    2009-08-17

    Private health insurance has been a major focus of Commonwealth Government health policy for the last decade. Over this period, the Howard government introduced a number of policy changes which impacted on the take up of private health insurance. The most expensive of these was the introduction of the private health insurance rebate in 1997, which had an estimated cost of $3 billion per annum. This article uses information on the geographic distribution of the population with private health insurance cover to identify associations between rates of private health insurance cover and socioeconomic status. The geographic analysis is repeated with survey data on expenditure on private health insurance, to provide an estimate of the rebate flowing to different socioeconomic groups. The analysis highlights the strong association between high rates of private health insurance cover and high socioeconomic status and shows the substantial transfer of funds, under the private health insurance rebate, to those living in areas of highest socioeconomic status, compared with those in areas of lower socioeconomic status, and in particular those in the most disadvantaged areas. The article also provides estimates of private health insurance cover by federal electorate, emphasising the substantial gaps in cover between Liberal Party and Australian Labor Party seats. The article concludes by discussing implications of the uneven distribution of private health insurance cover across Australia for policy formation. In particular, the study shows that the prevalence of private health insurance is unevenly distributed across Australia, with marked differences in prevalence in rural and urban areas, and substantial differences by socioeconomic status. Policy formation needs to take this into account. Evaluating the potential impact of changes in private health insurance requires more nuanced consideration than has been implied in the rhetoric about private health insurance over the last

  17. Distribution and potential health risk of groundwater uranium in Korea.

    Science.gov (United States)

    Shin, Woosik; Oh, Jungsun; Choung, Sungwook; Cho, Byong-Wook; Lee, Kwang-Sik; Yun, Uk; Woo, Nam-Chil; Kim, Hyun Koo

    2016-11-01

    Chronic exposure even to extremely low specific radioactivity of natural uranium in groundwater results in kidney problems and potential toxicity in bones. This study was conducted to assess the potential health risk via intake of the groundwater containing uranium, based on the determination of the uranium occurrence in groundwater. The groundwater was investigated from a total of 4140 wells in Korea. Most of the groundwater samples showed neutral pH and (sub-)oxic condition that was influenced by the mixing with shallow groundwater due to long-screened (open) wells. High uranium contents exceeding the WHO guideline level of 30 μg L(-1) were observed in the 160 wells located mainly in the plutonic bedrock regions. The statistical analysis suggested that the uranium component was present in groundwater by desorption and re-dissolution processes. Predominant uranium phases were estimated to uranyl carbonates under the Korean groundwater circumstances. These mobile forms of uranium and oxic condition facilitate the increase of potential health risk downgradient. In particular, long-term intake of groundwater containing >200 μg U L(-1) may induce internal exposure to radiation as well as the effects of chemical toxicity. These high uranium concentrations were found in twenty four sampling wells of rural areas in this study, and they were mainly used for drinking. Therefore, the high-level uranium wells and neighboring areas must be properly managed and monitored to reduce the exposure risk for the residents by drinking groundwater. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. The Relation Between the Health Workforce distribution and Maternal and Child Health Inequalities

    NARCIS (Netherlands)

    M.A. Sousa (Angelica)

    2016-01-01

    markdownabstractWeak health systems with a shortage of qualified staff, and lack of equipment and medicines impede the delivery of quality health care that is required to prevent maternal and newborn deaths and the attainment of the health-related Millennium Development Goals (MDGs). Using the cases

  19. The Relation Between the Health Workforce distribution and Maternal and Child Health Inequalities

    NARCIS (Netherlands)

    M.A. Sousa (Angelica)

    2016-01-01

    markdownabstractWeak health systems with a shortage of qualified staff, and lack of equipment and medicines impede the delivery of quality health care that is required to prevent maternal and newborn deaths and the attainment of the health-related Millennium Development Goals (MDGs). Using the cases

  20. Relative inequalities in geographic distribution of health care resources in Kermanshah province, Islamic Republic of Iran.

    Science.gov (United States)

    Rezaei, S; Karyani, A K; Fallah, R; Matin, B K

    2016-04-19

    This study aimed to evaluate inequalities in the geographical distribution of human and physical resources in the health sector of Kermanshah province, Islamic Republic of Iran. In a retrospective, cross-sectional study, data from the Statistical Centre of Iran were used to calculate inequality measures (Gini coefficient and index of dissimilarity) over the years 2005-11. The highest Gini coefficient for human resources was observed for pharmacists in 2005 (0.75) and the lowest for paramedics in 2010 and 2011 (0.10). The highest indices of dissimilarity were also for pharmacists in 2005 (29%) and paramedics in 2011 (3%). For physical resources, the highest and lowest Gini coefficients were for rehabilitation centres in 2010 (0.59) and health houses in 2011 (0.12) respectively. Generally, inequalities in the distribution of health care resources were lower at the end of the study period, although there was potential for more equitable distribution of pharmacists, specialists, health houses and beds.

  1. Distributed Impact Detector System (DIDS) Health Monitoring System Evaluation

    Science.gov (United States)

    Prosser, William H.; Madaras, Eric I.

    2010-01-01

    Damage due to impacts from micrometeoroids and orbital debris is one of the most significant on-orbit hazards for spacecraft. Impacts to thermal protection systems must be detected and the damage evaluated to determine if repairs are needed to allow safe re-entry. To address this issue for the International Space Station Program, Langley Research Center and Johnson Space Center technologists have been working to develop and implement advanced methods for detecting impacts and resultant leaks. LaRC funded a Small Business Innovative Research contract to Invocon, Inc. to develop special wireless sensor systems that are compact, light weight, and have long battery lifetimes to enable applications to long duration space structures. These sensor systems are known as distributed impact detection systems (DIDS). In an assessment, the NASA Engineering and Safety Center procured two prototype DIDS sensor units to evaluate their capabilities in laboratory testing and field testing in an ISS Node 1 structural test article. This document contains the findings of the assessment.

  2. OmniPHR: A distributed architecture model to integrate personal health records.

    Science.gov (United States)

    Roehrs, Alex; da Costa, Cristiano André; da Rosa Righi, Rodrigo

    2017-07-01

    The advances in the Information and Communications Technology (ICT) brought many benefits to the healthcare area, specially to digital storage of patients' health records. However, it is still a challenge to have a unified viewpoint of patients' health history, because typically health data is scattered among different health organizations. Furthermore, there are several standards for these records, some of them open and others proprietary. Usually health records are stored in databases within health organizations and rarely have external access. This situation applies mainly to cases where patients' data are maintained by healthcare providers, known as EHRs (Electronic Health Records). In case of PHRs (Personal Health Records), in which patients by definition can manage their health records, they usually have no control over their data stored in healthcare providers' databases. Thereby, we envision two main challenges regarding PHR context: first, how patients could have a unified view of their scattered health records, and second, how healthcare providers can access up-to-date data regarding their patients, even though changes occurred elsewhere. For addressing these issues, this work proposes a model named OmniPHR, a distributed model to integrate PHRs, for patients and healthcare providers use. The scientific contribution is to propose an architecture model to support a distributed PHR, where patients can maintain their health history in an unified viewpoint, from any device anywhere. Likewise, for healthcare providers, the possibility of having their patients data interconnected among health organizations. The evaluation demonstrates the feasibility of the model in maintaining health records distributed in an architecture model that promotes a unified view of PHR with elasticity and scalability of the solution. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services.

    Science.gov (United States)

    Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances

    2011-02-26

    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011

  4. The Nigeria wealth distribution and health seeking behaviour: evidence from the 2012 national HIV/AIDS and reproductive health survey.

    Science.gov (United States)

    Fagbamigbe, Adeniyi F; Bamgboye, Elijah A; Yusuf, Bidemi O; Akinyemi, Joshua O; Issa, Bolakale K; Ngige, Evelyn; Amida, Perpetua; Bashorun, Adebobola; Abatta, Emmanuel

    2015-01-01

    Recently, Nigeria emerged as the largest economy in Africa and the 26th in the world. However, a pertinent question is how this new economic status has impacted on the wealth and health of her citizens. There is a dearth of empirical study on the wealth distribution in Nigeria which could be important in explaining the general disparities in their health seeking behavior. An adequate knowledge of Nigeria wealth distribution will no doubt inform policy makers in their decision making to improve the quality of life of Nigerians. This study is a retrospective analysis of the assets of household in Nigeria collected during the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus 2). We used the principal component analysis methods to construct wealth quintiles across households in Nigeria. At 5% significance level, we used ANOVA to determine differences in some health outcomes across the WQs and chi-square test to assess association between WQs and some reproductive health seeking behaviours. The wealth quintiles were found to be internally valid and coherent. However, there is a wide gap in the reproductive health seeking behavior of household members across the wealth quintiles with members of households in lower quintiles having lesser likelihood (33.0%) to receive antenatal care than among those in the highest quintiles (91.9%). While only 3% were currently using modern contraceptives in the lowest wealth quintile, it was 17.4% among the highest wealth quintile (p health seeking behavior.

  5. [Health Care Insurance in France: its impact on income distribution between age and social groups].

    Science.gov (United States)

    Fourcade, N; Duval, J; Lardellier, R

    2013-08-01

    Our study, based on microsimulation models, evaluates the redistributive impact of health care insurance in France on income distribution between age and social groups. This work sheds light on the debate concerning the respective role of the public health care insurance (PHI) and the private supplemental health care insurance (SHI) in France. The analysis points out that the PHI enables the lowest-income households and the pensioners a better access to health care than they would have had under a complete private SHI. Due to the progressivity of taxes, low-income households contribute less to the PHI and get higher benefits because of a weaker health. Pensioners have low contributions to public health care finance but the highest health care expenditures.

  6. Socioeconomic Distribution of Health and Health Care Utilization in a New Town in Hong Kong, China

    Institute of Scientific and Technical Information of China (English)

    TAK SUN IGNATIUS YU; TZE WAI WONG

    2004-01-01

    Objectives To assess the association of socioeconomic indicators with various chronic and acute illnesses and the utilization of public health care in a new town in Hong Kong, China. Methods Illness experience and socioeconomic and demographic data of 7570 residents from 2022 randomly selected households were collected through telephone interviews. The relationships between socioeconomic indicators and illnesses/choice of health care were explored using stepwise logistic regressions after adjusting for sex and age. Results Significant positive associations were noted between low household income and diabetes mellitus, any chronic illnesses among adults and flu among younger subjects; low educational level and accident-related illness among adults; being born in Chinese mainland and flu, any acute illness in adults. For the utilization of public health care, low household income was the most consistent risk factor. Conclusion This study did not demonstrate a unidirectional socioeconomic gradient in health but supported the hypothesis that socioeconomic deprivation was associated with the utilization of public health care.

  7. State of the art and taxonomy of prognostics approaches, trends of prognostics applications and open issues towards maturity at different technology readiness levels

    Science.gov (United States)

    Javed, Kamran; Gouriveau, Rafael; Zerhouni, Noureddine

    2017-09-01

    Integrating prognostics to a real application requires a certain maturity level and for this reason there is a lack of success stories about development of a complete Prognostics and Health Management system. In fact, the maturity of prognostics is closely linked to data and domain specific entities like modeling. Basically, prognostics task aims at predicting the degradation of engineering assets. However, practically it is not possible to precisely predict the impending failure, which requires a thorough understanding to encounter different sources of uncertainty that affect prognostics. Therefore, different aspects crucial to the prognostics framework, i.e., from monitoring data to remaining useful life of equipment need to be addressed. To this aim, the paper contributes to state of the art and taxonomy of prognostics approaches and their application perspectives. In addition, factors for prognostics approach selection are identified, and new case studies from component-system level are discussed. Moreover, open challenges toward maturity of the prognostics under uncertainty are highlighted and scheme for an efficient prognostics approach is presented. Finally, the existing challenges for verification and validation of prognostics at different technology readiness levels are discussed with respect to open challenges.

  8. Significance analysis of prognostic signatures.

    Directory of Open Access Journals (Sweden)

    Andrew H Beck

    Full Text Available A major goal in translational cancer research is to identify biological signatures driving cancer progression and metastasis. A common technique applied in genomics research is to cluster patients using gene expression data from a candidate prognostic gene set, and if the resulting clusters show statistically significant outcome stratification, to associate the gene set with prognosis, suggesting its biological and clinical importance. Recent work has questioned the validity of this approach by showing in several breast cancer data sets that "random" gene sets tend to cluster patients into prognostically variable subgroups. This work suggests that new rigorous statistical methods are needed to identify biologically informative prognostic gene sets. To address this problem, we developed Significance Analysis of Prognostic Signatures (SAPS which integrates standard prognostic tests with a new prognostic significance test based on stratifying patients into prognostic subtypes with random gene sets. SAPS ensures that a significant gene set is not only able to stratify patients into prognostically variable groups, but is also enriched for genes showing strong univariate associations with patient prognosis, and performs significantly better than random gene sets. We use SAPS to perform a large meta-analysis (the largest completed to date of prognostic pathways in breast and ovarian cancer and their molecular subtypes. Our analyses show that only a small subset of the gene sets found statistically significant using standard measures achieve significance by SAPS. We identify new prognostic signatures in breast and ovarian cancer and their corresponding molecular subtypes, and we show that prognostic signatures in ER negative breast cancer are more similar to prognostic signatures in ovarian cancer than to prognostic signatures in ER positive breast cancer. SAPS is a powerful new method for deriving robust prognostic biological signatures from clinically

  9. Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services.

    Science.gov (United States)

    Norheim, Ole F

    2016-05-11

    Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population's health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes.

  10. The intravertebral distribution of bone density: correspondence to intervertebral disc health and implications for vertebral strength

    Science.gov (United States)

    Jackman, T. M.; Morgan, S. R.; Barest, G. D.; Morgan, E. F.

    2015-01-01

    Summary This study's goal was to determine associations among the intravertebral heterogeneity in bone density, bone strength, and intervertebral disc (IVD) health. Results indicated that predictions of vertebral strength can benefit from considering the magnitude of the density heterogeneity and the congruence between the spatial distribution of density and IVD health. Introduction This study aims to determine associations among the intravertebral heterogeneity in bone density, bone strength, and IVD health Methods Regional measurements of bone density were performed throughout 30 L1 vertebral bodies using microcomputed tomography (μCT) and quantitative computed tomography (QCT). The magnitude of the intravertebral heterogeneity in density was defined as the interquartile range and quartile coefficient of variation in regional densities. The spatial distribution of density was quantified using ratios of regional densities representing different anatomical zones (e.g., anterior to posterior regional densities). Cluster analysis was used to identify groups of vertebrae with similar spatial distributions of density. Vertebral strength was measured in compression. IVD health was assessed using two scoring systems. Results QCT- and μCT-based measures of the magnitude of the intravertebral heterogeneity in density were strongly correlated with each other (p<0.005). Accounting for the interquartile range in regional densities improved predictions of vertebral strength as compared to predictions based only on mean density (R2=0.59 vs. 0.43; F-test p-value=0.018). Specifically, after adjustment for mean density, vertebral bodies with greater heterogeneity in density exhibited higher strength. No single spatial distribution of density was associated with high vertebral strength. Analyses of IVD scores suggested that the health of the adjacent IVDs may modulate the effect of a particular spatial distribution of density on vertebral strength. Conclusions Noninvasive

  11. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

    Science.gov (United States)

    Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

    2016-09-01

    Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. Accelerated Aging with Electrical Overstress and Prognostics for Power MOSFETs

    Science.gov (United States)

    Saha, Sankalita; Celaya, Jose Ramon; Vashchenko, Vladislav; Mahiuddin, Shompa; Goebel, Kai F.

    2011-01-01

    Power electronics play an increasingly important role in energy applications as part of their power converter circuits. Understanding the behavior of these devices, especially their failure modes as they age with nominal usage or sudden fault development is critical in ensuring efficiency. In this paper, a prognostics based health management of power MOSFETs undergoing accelerated aging through electrical overstress at the gate area is presented. Details of the accelerated aging methodology, modeling of the degradation process of the device and prognostics algorithm for prediction of the future state of health of the device are presented. Experiments with multiple devices demonstrate the performance of the model and the prognostics algorithm as well as the scope of application. Index Terms Power MOSFET, accelerated aging, prognostics

  13. Electrical Power Transmission and Distribution Safety. Module SH-40. Safety and Health.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on electrical power transmission and distribution safety is one of 50 modules concerned with job safety and health. This module focuses on some of the general safety rules, techniques, and procedures that are essential in establishing a safe environment for the electrical power transmission worker. Following the introduction,…

  14. Impact of microbial distributions on food safety II. Quantifying impacts on public health and sampling

    NARCIS (Netherlands)

    Jongenburger, I.; Bassett, J.; Jackson, T.; Gorris, L.G.M.; Jewell, K.; Zwietering, M.H.

    2012-01-01

    The distributions of microorganisms in foods impact the likelihood that a foodstuff will cause illness and therefore also impact the consequential public health burden. As part of food safety management systems, food is sampled and microbiologically tested. The effectiveness of the sampling programm

  15. Attitudes of Germans towards distributive issues in the German health system.

    Science.gov (United States)

    Ahlert, Marlies; Pfarr, Christian

    2016-05-01

    Social health care systems are inevitably confronted with the scarcity of resources and the resulting distributional challenges. Since prioritization implies distributional effects, decisions regarding respective rules should take citizens' preferences into account. In this study we concentrate on two distributive issues in the German health system: firstly, we analyze the acceptance of prioritizing decisions concerning the treatment of certain patient groups, in this case patients who all need a heart operation. We focus on the patient criteria smoking behavior, age and whether the patient has or does not have young children. Secondly, we investigate Germans' opinions towards income-dependent health services. The results reveal the strong effects of individuals' attitudes regarding general aspects of the health system on priorities, e.g. that individuals with an unhealthy lifestyle should not be prioritized. In addition, experience of limited access to health services is found to have a strong influence on citizens' attitudes, too. Finally, decisions on different prioritization criteria are found to be not independent.

  16. Advanced air distribution: improving health and comfort while reducing energy use.

    Science.gov (United States)

    Melikov, A K

    2016-02-01

    Indoor environment affects the health, comfort, and performance of building occupants. The energy used for heating, cooling, ventilating, and air conditioning of buildings is substantial. Ventilation based on total volume air distribution in spaces is not always an efficient way to provide high-quality indoor environments at the same time as low-energy consumption. Advanced air distribution, designed to supply clean air where, when, and as much as needed, makes it possible to efficiently achieve thermal comfort, control exposure to contaminants, provide high-quality air for breathing and minimizing the risk of airborne cross-infection while reducing energy use. This study justifies the need for improving the present air distribution design in occupied spaces, and in general the need for a paradigm shift from the design of collective environments to the design of individually controlled environments. The focus is on advanced air distribution in spaces, its guiding principles and its advantages and disadvantages. Examples of advanced air distribution solutions in spaces for different use, such as offices, hospital rooms, vehicle compartments, are presented. The potential of advanced air distribution, and individually controlled macro-environment in general, for achieving shared values, that is, improved health, comfort, and performance, energy saving, reduction of healthcare costs and improved well-being is demonstrated. Performance criteria are defined and further research in the field is outlined. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Model of health? Distributed preparedness and multi-agency interventions surrounding UK regional airports.

    Science.gov (United States)

    Warren, Adam; Bell, Morag; Budd, Lucy

    2012-01-01

    The liberalisation of the European aviation sector has multiplied paths of entry into the United Kingdom (UK) for the international traveller. These changing mobilities necessitate a reconceptualisation of the border as a series of potentially vulnerable nodes occurring within, and extending beyond, national boundaries. In this paper, we consider the border through the lens of port health, the collective term for various sanitary operations enacted at international transport terminals. In the UK, a critical player in the oversight of port health is the Health Protection Agency (HPA), which became a non-Departmental public body in 2005. A major part of port health is preparedness, a set of techniques aimed at managing, and responding to, emergencies of public health concern. More recently, certain jurisdictions have embarked on public health preparedness work across a number of different geographical scales. Using methods pioneered by the military, this form of 'distributed preparedness' is of increased interest to social science and medical scholars. With reference to case studies conducted in localities surrounding two UK regional airports following the 2009-10 H1N1 influenza pandemic, we consider the extent to which distributed preparedness as a concept and a set of practices can inform current debates - in the UK, and beyond - concerning interventions at the border 'within'.

  18. Equality in Distribution of Human Resources: the Case of Iran's Ministry of Health and Medical Education.

    Science.gov (United States)

    Mobaraki, H; Hassani, A; Kashkalani, T; Khalilnejad, R; Chimeh, E Ehsani

    2013-01-01

    Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study. We evaluated the equity of human resources' distribution among Iran's medical science universities between 2005 and 2009 by inequality measures including Lorenze curve, Gini coefficient and Rabin hood indexes. In the distribution 60403 recruitment licenses among medical universities with 72456140 covered populations, Gini coefficient was 0.167 and Robin Hood Index 0.11. Calculations indicated Recruitment licenses are equitably distributed in MOH&ME of Iran. However a portion of recruitment licenses should redistributed for achieving perfect equal distribution among all public medical universities of Iran.

  19. Prognostic relevance of morphological classification models for myelodysplastic syndromes in an era of the revised International Prognostic Scoring System.

    Science.gov (United States)

    van Spronsen, Margot F; Ossenkoppele, Gert J; Westers, Theresia M; van de Loosdrecht, Arjan A

    2016-03-01

    Numerous morphological classification models have been developed to organise the heterogeneous spectrum of myelodysplastic syndromes (MDS). While the 2008 update of the World Health Organisation (WHO) is the current standard, the publication of the revised International Prognostic Scoring System (IPSS-R) has illustrated the need for supplemental prognostic information. The aim of this study was to investigate whether morphological classification models for MDS - of both the French-American-British (FAB) group and WHO - provide reliable criteria for their classification into homogeneous and clinically relevant categories with prognostic relevance beyond the IPSS-R. We reclassified 238 MDS patients using each of the FAB, WHO 2001 and WHO 2008 criteria and studied classification categories in terms of clinical, haematological and cytogenetic features. Subsequently, we calculated prognostic scores using the IPSS-R and investigated whether the morphological classification models had significantly prognostic value in patients stratified by the IPSS-R and vice versa. By adopting the FAB, WHO 2001 and WHO 2008 classifications, MDS patients were organised into homogeneous categories with intrinsic prognostic information. However, whereas the morphological classification models showed no prognostic value beyond the IPSS-R, the IPSS-R had significant prognostic value beyond the FAB, WHO 2001 and WHO 2008 classifications. Even though morphological classification models for MDS might be clinically relevant from a prognostic point of view, their relevance in terms of risk stratification is evidently limited in light of the IPSS-R. Therefore, we suggest to stop the use of morphological classification models for MDS for risk stratification in routine clinical practice.

  20. Lifecycle Prognostics Architecture for Selected High-Cost Active Components

    Energy Technology Data Exchange (ETDEWEB)

    N. Lybeck; B. Pham; M. Tawfik; J. B. Coble; R. M. Meyer; P. Ramuhalli; L. J. Bond

    2011-08-01

    There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

  1. Community-based health insurance in poor rural China: the distribution of net benefits.

    Science.gov (United States)

    Wang, Hong; Yip, Winnie; Zhang, Licheng; Wang, Lusheng; Hsiao, William

    2005-11-01

    The collapse of China's Cooperative Medical System (CMS) in 1978 resulted in the lack of an organized financing scheme for health care, adversely affecting rural farmers' access to health care, especially among the poor. The Chinese government recently announced a policy to re-establish some forms of community-based insurance (CBI). Many existing schemes involve low premiums but high co-payments. We hypothesized that such benefit design leads to unequal distribution of the "net benefits" (NB)--benefits net of payment--because even though low premiums are more affordable to poor farmers, high co-payments may have a significant deterrent effect on the poor in the use of services in CBI. To test this hypothesis empirically, we estimated the probability of farmers joining a re-established CBI using logistic regression, and the utilization of health care services for those who joined the scheme using the two-part model. Based on the estimations, we predicted the distribution of NB among those who joined the CBI and for the entire population in the community. Our data came from a household survey of 4160 members of 1173 households conducted in six villages in Fengshan Township, Guizhou Province, China. Three principal findings emerged from this study. First, income is an important factor influencing farmers' decision to join a CBI despite the premium representing a very small fraction of household income. Secondly, both income and health status influence enrollees' utilization of health services: richer/sicker participants obtain greater NB from the CBI than poorer/healthier members, meaning that the poorer/healthier participants subsidize the rich/sick. Thirdly, wealthy farmers benefit the most from the CBI with low premium and high co-payment features at every level of health status. In conclusion, policy recommendations related to the improvement of the benefit distribution of CBI schemes are made based on the results from this study.

  2. Prognostic factors in lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Starklint, Henrik; Halberg, Poul

    2006-01-01

    To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis.......To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis....

  3. Metrics for Offline Evaluation of Prognostic Performance

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostic performance evaluation has gained significant attention in the past few years.*Currently, prognostics concepts lack standard definitions and suffer from...

  4. The spatial distribution of health resources within countries and communities: examples from India and Zambia.

    Science.gov (United States)

    Akhtar, R; Izhar, N

    1986-01-01

    "Between one country and another, one province and another and even one locality and another there will always exist a certain inequality in the conditions of life, which it will be possible to reduce to a minimum but never entirely remove", Friedrich Engels, 1875, Quoted from D. M. Smith's Where the Grass is Greener; Geographical Perspectives on Inequality. London, 1979. And it is true that there are wide disparities in the availability of welfare facilities including health at international, national, regional and inter-regional levels. At the same time such disparities are increasing over time. In terms of spatial distribution, not only the developing world but even developed countries such as the U.S.A. and the United Kingdom, face problems resulting from wide imbalances in the provision of welfare facilities. In this paper, an attempt has been made to study inequalities in the distribution of health facilities in India and Zambia.

  5. Video distribution techniques over WiMAX networks for m-Health applications.

    Science.gov (United States)

    Markarian, Garik; Mihaylova, Lyudmila; Tsitserov, Dmitry V; Zvikhachevskaya, A

    2012-01-01

    In this paper, we propose a novel approach for video distribution over IEEE 802.16 networks for mobile Healthcare (m-Health) applications. The technique incorporates resource distribution, scheduling, and content-aware video streaming taking advantage of a flexible quality of service functionality offered by IEEE 802.16/WiMAX technology. The proposed technique is thoroughly investigated using network simulator software under various real-life m-Health scenarios, which include streaming video over medium access control layer service connections. It is shown that the technique is fully compatible with the WiMAX standard specification and allows a 9-16% increase in the overall network throughput, which is dependent upon the initial system configuration and the selection of WiMAX user parameters.

  6. Distributed fiber optic sensors embedded in technical textiles for structural health monitoring

    Science.gov (United States)

    Krebber, Katerina; Lenke, Philipp; Liehr, Sascha; Noether, Nils; Wendt, Mario; Wosniok, Aleksander

    2010-09-01

    Technical textiles with embedded distributed fiber optic sensors have been developed for the purposes of structural health monitoring in geotechnical and civil engineering. The distributed fiber optic sensors are based on Brillouin scattering in silica optical fibers and OTDR in polymer optical fibers. Such "smart" technical textiles can be used for reinforcement of geotechnical and masonry structures and the embedded fiber optic sensors can provide information about the condition of the structures and detect the presence of any damages and destructions in real time. Thus, structural health monitoring of critical geotechnical and civil infrastructures can be realized. The paper highlights the results achieved in this innovative field in the framework of several German and European projects.

  7. The spatial distribution of health vulnerability to heat waves in Guangdong Province, China

    Directory of Open Access Journals (Sweden)

    Qi Zhu

    2014-10-01

    Full Text Available Background: International literature has illustrated that the health impacts of heat waves vary according to differences in the spatial variability of high temperatures and the social and economic characteristics of populations and communities. However, to date there have been few studies that quantitatively assess the health vulnerability to heat waves in China. Objectives: To assess the spatial distribution of health vulnerability to heat waves in Guangdong Province, China. Methods: A vulnerability framework including dimensions of exposure, sensitivity, and adaptive capacity was employed. The last two dimensions were called social vulnerability. An indicator pool was proposed with reference to relevant literatures, local context provided by relevant local stakeholder experts, and data availability. An analytic hierarchy process (AHP and a principal component analysis were used to determine the weight of indicators. A multiplicative vulnerability index (VI was constructed for each district/county of Guangdong province, China. Results: A total of 13 items (two for exposure, six for sensitivity, and five for adaptive capacity were proposed to assess vulnerability. The results of an AHP revealed that the average VI in Guangdong Province was 0.26 with the highest in the Lianzhou and Liannan counties of Qingyuan (VI=0.50 and the lowest in the Yantian district of Shenzhen (VI=0.08. Vulnerability was gradiently distributed with higher levels in northern inland regions and lower levels in southern coastal regions. In the principal component analysis, three components were isolated from the 11 social vulnerability indicators. The estimated vulnerability had a similar distribution pattern with that estimated by AHP (Intraclass correlation coefficient (ICC=0.98, p<0.01. Conclusions: Health vulnerability to heat waves in Guangdong Province had a distinct spatial distribution, with higher levels in northern inland regions than that in the southern coastal

  8. Distribution of Industrial Farms in the United States and Socioeconomic, Health, and Environmental Characteristics of Counties

    Directory of Open Access Journals (Sweden)

    S. M. Rafael Harun

    2013-01-01

    Full Text Available The method of producing food animals has changed in the United States over the past century, moving from traditional burns to enclosed structures resembling industrial buildings, where animals are raised in high stocking density (commonly known as “Concentrated Animal Feeding Operations,” CAFOs. The objective to maximize profit has resulted in poor farm management; raised issues of environmental pollution, public health, animal rights, and environmental justice, and had socio-economic impacts. Studies concerning the issues are limited to specific regions and types of CAFOs. In addition, studies on the spatial distribution and temporal changes of CAFO at a country scale are lacking. This study bridges some of the gaps by analyzing the spatial distribution of industrial farms in the United States in 2002 and 2007 and their relationship with vulnerable population and exploring the relationships among the concentrations of farms, socio-economic, health, and environmental characteristics of the counties. A range of spatial statistics tools were applied in this study. The study revealed variations in spatial distribution depending on the type of the CAFOs. The issue of environmental justice was found prevalent depending on the types of industrial farms. Each type of industrial farm was found to interact uniquely with the selected demographic, health, and environmental parameters.

  9. Endodontic surgery prognostic factors.

    Science.gov (United States)

    Azarpazhooh, Amir; Shah, Prakesh S

    2011-01-01

    Medline, (PubMed) and the Cochrane databases together with hand searching of the following journals: Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology (name changed to Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics in 1995), Endodontics and Dental Traumatology (name changed to Dental Traumatology in 2001), Journal of Oral and Maxillofacial Surgery, and International Journal of Oral and Maxillofacial Surgery. Clinical studies evaluating apical surgery with placement of a root-end filling were included. Studies on apical surgery with orthograde root canal filling or about apicectomy alone without root-end filling were excluded, as were experimental and animal studies. Only studies with ≥ ten patients with a minimum six month follow-up period and clearly defined radiographic and clinical healing criteria, with healing reported for at least two categories of a specific prognostic factor were accepted. Studies reporting in English, German, French, Spanish, Italian, Portuguese and Scandinavian languages were included. All studies were assessed separately by two of the three authors, with disagreements resolved by discussion. Prognostic factors were divided into patient related, tooth-related or treatment-related factors. The reported percentages of healed teeth were pooled per category. The statistical method of Mantel-Haenszel was applied to estimate the odds ratios and their 95% confidence intervals. Homogeneity was assessed using Woolf's test. With regard to tooth-related factors, the following were identified as predictors of healing: absence of preoperative pain or signs, good density of the root canal filling and a periapical lesion size of ≤ 5 mm. With regard to treatment-related factors, teeth treated with the use of an endoscope tended to have higher healed rates than teeth treated without the use of an endoscope. Although the clinician may be able to control treatment

  10. Intracellular pH distribution as a cell health indicator in Saccharomyces cerevisiae

    DEFF Research Database (Denmark)

    Aabo, Thomas; Glückstad, Jesper; Siegumfeldt, Henrik

    2011-01-01

    Internal pH regulation is vital for many cell functions, including transport mechanisms and metabolic enzyme activity. More specifically, transport mechanisms are to a wide degree governed by internal pH distributions. We introduce the term standard deviation of the intracellular pH (s.......d.(pHint)) to describe the internal pH distributions. The cellular pH distributional response to external stress such as heat has not previously been determined. In this study, the intracellular pH (pHi) and the s.d.(pHint) of Saccharomyces cerevisiae cells exposed to supralethal temperatures were measured using...... temperatures than pHi. s.d.(pHint) is therefore proposed as an early health/vitality indicator in S. cerevisiae cells exposed to heat stress....

  11. Structural health monitoring of PC structures with novel types of distributed sensors

    Science.gov (United States)

    Yang, Caiqian; Wu, Zhishen; Zhang, Yufeng

    2010-04-01

    In this paper, the structural health monitoring of a pre-stressed concrete (PC) structure based on two types of distributed sensing techniques is addressed. The sensing elements are Brillouin scattering-based fiber optic sensors (FOSs) and HCFRP (hybrid carbon fiber reinforced polymer) sensors composed of three types of carbon tows. Both types of sensors are characterized by a broad-based and distributed sensing function. The HCFRP sensors are bonded on PC tendon, steel reinforcing bar, and embedded in tensile and compressive concrete sides with epoxy resins and putties. The FOSs are embedded in the tensile and compressive concrete sides where the HCFRP sensors are embedded as well. The distributed sensors are arranged to detect and monitor the initiation and propagation of cracks, yielding of steel reinforcements and corrosion of PC tendons. The experimental investigations demonstrate that the initiation and location of cracks, yielding of steel reinforcements, corrosion of PC tendons and structural health of PC structures can be effectively detected and monitored with such kinds of distributed sensing systems.

  12. Assessment of the aerosols distribution in the Bucharest metropolitan area in relation with health effects

    Science.gov (United States)

    Zoran, M. A.; Dida, M. R.

    2013-06-01

    MODIS Terra/Aqua time-series satellite images and in- situ monitoring of particle matter PM2.5 and PM10 have been used in an effort to qualitatively assess distribution of aerosols in the greater Bucharest area during 2010-2011 period. It was found that PM2.5 and PM10 aerosols exhibit their highest concentration mostly in the central part mainly due to road traffic as well as in the industrialized parts outside of city's centre. An epidemiological study examining the relationships between adverse health outcomes and exposure to air pollutants in metropolitan agglomeration of Bucharest used ambient air pollution measurements like as PM10 and PM2.5 levels as a proxy for personal exposure levels. The measurements of environmental concentrations of particulate matter air pollutants have been correlated with health effects on respiratory health status of school children in urban/periurban areas of Bucharest.

  13. MICRONUCLEI: A PROGNOSTIC TOOL

    Directory of Open Access Journals (Sweden)

    Ankit

    2014-10-01

    Full Text Available Squamous cell carcinoma is one the most common oral mucosal malignant tumor, diagnosis of oral squamous cell carcinoma rarely presents difficulty, it is the cancer staging and histo pathological grading that are more important for prognosis, micronuclei are good prognostic indicator. Micronuclei screening can be done easily by exfoliative cytology, one of the most valuable diagnostic method other than routine histopathology (H and E-stained sections and immunohistochemistry. It has been used in the detection of oral squamous cell carcinoma and has been shown to have a sensitivity of 94%, specificity of 100%, and an accuracy of 95%. Micronuclei frequencies were also found to be raised with increasing histological grades of squamous cell carcinoma.

  14. Prognostic effect of estrogen receptor status across age in primary breast cancer

    DEFF Research Database (Denmark)

    Bentzon, N.; During, M.; Rasmussen, B.B.;

    2008-01-01

    Estrogen receptor (ER) status is considered as an important prognostic factor as well as a predictive factor for endocrine responsiveness in breast cancer. We analyzed the distribution of ER status across age and estimated variations in the prognostic impact of ER status related to patients' age...

  15. The ideal of equal health revisited: definitions and measures of inequity in health should be better integrated with theories of distributive justice.

    Science.gov (United States)

    Norheim, Ole Frithjof; Asada, Yukiko

    2009-11-18

    The past decade witnessed great progress in research on health inequities. The most widely cited definition of health inequity is, arguably, the one proposed by Whitehead and Dahlgren: "Health inequalities that are avoidable, unnecessary, and unfair are unjust." We argue that this definition is useful but in need of further clarification because it is not linked to broader theories of justice. We propose an alternative, pluralist notion of fair distribution of health that is compatible with several theories of distributive justice. Our proposed view consists of the weak principle of health equality and the principle of fair trade-offs. The weak principle of health equality offers an alternative definition of health equity to those proposed in the past. It maintains the all-encompassing nature of the popular Whitehead/Dahlgren definition of health equity, and at the same time offers a richer philosophical foundation. This principle states that every person or group should have equal health except when: (a) health equality is only possible by making someone less healthy, or (b) there are technological limitations on further health improvement. In short, health inequalities that are amenable to positive human intervention are unfair. The principle of fair trade-offs states that weak equality of health is morally objectionable if and only if: (c) further reduction of weak inequality leads to unacceptable sacrifices of average or overall health of the population, or (d) further reduction in weak health inequality would result in unacceptable sacrifices of other important goods, such as education, employment, and social security.

  16. Diagnostic and Prognostic Models for Generator Step-Up Transformers

    Energy Technology Data Exchange (ETDEWEB)

    Vivek Agarwal; Nancy J. Lybeck; Binh T. Pham

    2014-09-01

    In 2014, the online monitoring (OLM) of active components project under the Light Water Reactor Sustainability program at Idaho National Laboratory (INL) focused on diagnostic and prognostic capabilities for generator step-up transformers. INL worked with subject matter experts from the Electric Power Research Institute (EPRI) to augment and revise the GSU fault signatures previously implemented in the Electric Power Research Institute’s (EPRI’s) Fleet-Wide Prognostic and Health Management (FW-PHM) Suite software. Two prognostic models were identified and implemented for GSUs in the FW-PHM Suite software. INL and EPRI demonstrated the use of prognostic capabilities for GSUs. The complete set of fault signatures developed for GSUs in the Asset Fault Signature Database of the FW-PHM Suite for GSUs is presented in this report. Two prognostic models are described for paper insulation: the Chendong model for degree of polymerization, and an IEEE model that uses a loading profile to calculates life consumption based on hot spot winding temperatures. Both models are life consumption models, which are examples of type II prognostic models. Use of the models in the FW-PHM Suite was successfully demonstrated at the 2014 August Utility Working Group Meeting, Idaho Falls, Idaho, to representatives from different utilities, EPRI, and the Halden Research Project.

  17. Studying the Distribution of Outpatient Services in Health Care System in East Azerbaijan

    Directory of Open Access Journals (Sweden)

    Ali janati

    2017-02-01

    Full Text Available Background and Objectives: It is necessary that various aspects of health information and statistics are identified and measured since health problems are getting more complex day by day. This study was aimed to investigate the distribution of outpatient services in East Azerbaijan province. Material and Methods : This research was a descriptive, cross-sectional study. In this study, the data from all functional health sectors, including hospitals, health centers, and all clinics and private offices (public, private, charitable, military, social security and NGOs sectors in 2014 were studied. The relevant performance data were collected according to pre-determined format (researcher-made check list approved by five professionals and experts in health services management (content validity. The study was conducted in different sites including Deputy of Treatment, health section of University of Medical Sciences, Social Security Organization, Iran Health Insurance, Imam Khomeini Relief Committee, Welfare Organization and healthcare organizations of the oil industry. In order to analyze the data, SPSS 18 software was used. Results: The information and data were collected according to pre-determined format     (researcher-made check list approved by five professionals and experts in health services management (content validity and reliability. In general, the highest and the lowest outpatient services, have been provided in the private sector (53.6% and the charitable sector (0.6%, respectively. Social security with 27.7% and public sector with 13.4% are the largest providers of outpatient services after private sector in this province. Conclusion: The results showed that the private sector in comparison with public sector is at the forefront of outpatient services. So, policies and decisions should be aimed to protecting and reinforcing these sectors.

  18. Prediction of outcome from intensive care: a prospective cohort study comparing Acute Physiology and Chronic Health Evaluation II and III prognostic systems in a United Kingdom intensive care unit.

    Science.gov (United States)

    Beck, D H; Taylor, B L; Millar, B; Smith, G B

    1997-01-01

    To evaluate the ability of two prognostic systems to predict hospital mortality in adult intensive care patients. Prospective cohort study. A mixed medical and surgical intensive care unit (ICU) in the United Kingdom. A total of 1,144 patients consecutively admitted to the study. None. Acute Physiology and Chronic Health Evaluation (APACHE) II and III prognostic systems were applied to assess probabilities of hospital mortality, which were compared with the actual outcome. The overall goodness-of-fit of both models was assessed. Hospital death rates were higher than those predicted by each system. Risk estimates showed a strong positive correlation between both systems (nonsurvivors r2 = 0.756, p best overall total correct classification rate was 80.6% for APACHE III and 77.9% for APACHE II (both for a decision criterion of 40%). The areas under the receiver operating characteristic curves were 0.806 and 0.847 for APACHE II and III, respectively, confirming the better discrimination of APACHE III. When patients were classified by diagnostic categories, risk predictions did not fit uniformly across the spectrum of disease groups. For both models, mortality ratios were highest for trauma patients and lowest for the group with respiratory disease. APACHE II predictions for patients with gastrointestinal disease were significantly better. Risk estimates for surgical admissions were superior with APACHE II (MR = 1.27) compared with APACHE III (MR = 1.56), but were similar for medical patients (1.22 vs. 1.28 for APACHE II and III, respectively). Bias induced by factors reflecting the clinical practice in an individual ICU (e.g., admission criteria, treatment before admission) may have considerable impact on risk estimates. The identification of such factors appears to be a prerequisite for the meaningful interpretation of observed and predicted death rates on the individual ICU level. Both predictive models demonstrated a similar degree of overall goodness-of-fit. APACHE

  19. Measuring health inequalities in Albania: a focus on the distribution of general practitioners.

    Science.gov (United States)

    Theodorakis, Pavlos N; Mantzavinis, Georgios D; Rrumbullaku, Llukan; Lionis, Christos; Trell, Erik

    2006-02-21

    The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. The aim of the present study was to examine available human medical resources in primary care and identify possible inequalities regarding the distribution of general practitioners in Albania between 2000 and 2004. With census data, we investigated the degree of inequality by calculating relative inequality indices. We plotted the Lorenz curves and calculated the Gini, Atkinson and Robin Hood indices and decile ratios, both before and after adjusting for mortality and consultation rates. The Gini index for the distribution of general practitioners in 2000 was 0.154. After adjusting for mortality it was 0.126, while after adjusting for consultation rates it was 0.288. The Robin Hood index for 2000 was 11.2%, which corresponds to 173 general practitioners who should be relocated in order to achieve equality. The corresponding figure after adjusting for mortality was 9.2% (142 general practitioners), while after adjusting for consultation rates the number was 20.6% (315). These figures changed to 6.3% (100), 6.3% (115) and 19.8% (315) in 2004. There was a declining trend in the inequality of distribution of general practitioners in Albania between 2000 and 2004. The trend in inequality was apparent irrespective of the relative inequality indicator used. The level of inequality varied depending on the adjustment method used. Reallocation strategies for general practitioners in Albania could be the key in alleviating the inequalities in primary care workforce distribution.

  20. Measuring health inequalities in Albania: a focus on the distribution of general practitioners

    Directory of Open Access Journals (Sweden)

    Mantzavinis Georgios D

    2006-02-01

    Full Text Available Abstract Background The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. The aim of the present study was to examine available human medical resources in primary care and identify possible inequalities regarding the distribution of general practitioners in Albania between 2000 and 2004. Methods With census data, we investigated the degree of inequality by calculating relative inequality indices. We plotted the Lorenz curves and calculated the Gini, Atkinson and Robin Hood indices and decile ratios, both before and after adjusting for mortality and consultation rates. Results The Gini index for the distribution of general practitioners in 2000 was 0.154. After adjusting for mortality it was 0.126, while after adjusting for consultation rates it was 0.288. The Robin Hood index for 2000 was 11.2%, which corresponds to 173 general practitioners who should be relocated in order to achieve equality. The corresponding figure after adjusting for mortality was 9.2% (142 general practitioners, while after adjusting for consultation rates the number was 20.6% (315. These figures changed to 6.3% (100, 6.3% (115 and 19.8% (315 in 2004. Conclusion There was a declining trend in the inequality of distribution of general practitioners in Albania between 2000 and 2004. The trend in inequality was apparent irrespective of the relative inequality indicator used. The level of inequality varied depending on the adjustment method used. Reallocation strategies for general practitioners in Albania could be the key in alleviating the inequalities in primary care workforce distribution.

  1. Spatial Distribution, Sources Apportionment and Health Risk of Metals in Topsoil in Beijing, China.

    Science.gov (United States)

    Sun, Chunyuan; Zhao, Wenji; Zhang, Qianzhong; Yu, Xue; Zheng, Xiaoxia; Zhao, Jiayin; Lv, Ming

    2016-07-20

    In order to acquire the pollution feature and regularities of distribution of metals in the topsoil within the sixth ring road in Beijing, a total of 46 soil samples were collected, and the concentrations of twelve elements (Nickel, Ni, Lithium, Li, Vanadium, V, Cobalt, Co, Barium, Ba, Strontium, Sr, Chrome, Cr, Molybdenum, Mo, Copper, Cu, Cadmium, Cd, Zinc, Zn, Lead, Pb) were analyzed. Geostatistics and multivariate statistics were conducted to identify spatial distribution characteristics and sources. In addition, the health risk of the analyzed heavy metals to humans (adult) was evaluated by an U.S. Environmental Protection Agency health risk assessment model. The results indicate that these metals have notable variation in spatial scale. The concentration of Cr was high in the west and low in the east, while that of Mo was high in the north and low in the south. High concentrations of Cu, Cd, Zn, and Pb were found in the central part of the city. The average enrichment degree of Cd is 5.94, reaching the standard of significant enrichment. The accumulation of Cr, Mo, Cu, Cd, Zn, and Pb is influenced by anthropogenic activity, including vehicle exhaustion, coal burning, and industrial processes. Health risk assessment shows that both non-carcinogenic and carcinogenic risks of selected heavy metals are within the safety standard and the rank of the carcinogenic risk of the four heavy metals is Cr > Co > Ni > Cd.

  2. Beyond the art of governmentality: unmasking the distributional consequences of health policies.

    Science.gov (United States)

    Coyte, Peter C; Holmes, Dave

    2006-06-01

    The aim of this article is to critique health policy discourses that are taken for granted. This perspective will allow for the identification of 'exclusionary' health policies, which we define as policies that are thought to offer universal benefit, despite yielding adverse effects for significant groups of people in society. As such, policies that are said to be designed 'for all' frequently benefit only a subset of the population. Our intent is to highlight the distributional consequences of certain health policies that are largely institutionalized in contemporary society. We believe that these distributional effects are explicit representations of power in society and that institutions may provide individual 'choice' and 'freedom' that, in turn, yields separation as an outcome, a separating equilibrium. Specifically, if those who benefit from policies of partition are numerous and are to obtain significant advantage or incur limited costs, or if those who are adversely affected are scarce (or hidden), or the size of these adverse effects are small (or perceived to be minor), then partition becomes more likely as a 'legitimate', but exclusionary, instrument of public policy.

  3. Spatial Distribution, Sources Apportionment and Health Risk of Metals in Topsoil in Beijing, China

    Directory of Open Access Journals (Sweden)

    Chunyuan Sun

    2016-07-01

    Full Text Available In order to acquire the pollution feature and regularities of distribution of metals in the topsoil within the sixth ring road in Beijing, a total of 46 soil samples were collected, and the concentrations of twelve elements (Nickel, Ni, Lithium, Li, Vanadium, V, Cobalt, Co, Barium, Ba, Strontium, Sr, Chrome, Cr, Molybdenum, Mo, Copper, Cu, Cadmium, Cd, Zinc, Zn, Lead, Pb were analyzed. Geostatistics and multivariate statistics were conducted to identify spatial distribution characteristics and sources. In addition, the health risk of the analyzed heavy metals to humans (adult was evaluated by an U.S. Environmental Protection Agency health risk assessment model. The results indicate that these metals have notable variation in spatial scale. The concentration of Cr was high in the west and low in the east, while that of Mo was high in the north and low in the south. High concentrations of Cu, Cd, Zn, and Pb were found in the central part of the city. The average enrichment degree of Cd is 5.94, reaching the standard of significant enrichment. The accumulation of Cr, Mo, Cu, Cd, Zn, and Pb is influenced by anthropogenic activity, including vehicle exhaustion, coal burning, and industrial processes. Health risk assessment shows that both non-carcinogenic and carcinogenic risks of selected heavy metals are within the safety standard and the rank of the carcinogenic risk of the four heavy metals is Cr > Co > Ni > Cd.

  4. Towards Prognostics for Electronics Components

    Data.gov (United States)

    National Aeronautics and Space Administration — Electronics components have an increasingly critical role in avionics systems and in the development of future aircraft systems. Prognostics of such components is...

  5. Prognostic factors of fulminant hepatitis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-mao; MA Lin; YANG Yue-bo; SHI Zhong-jie; ZHOU Shui-sheng

    2005-01-01

    @@ Fulminant hepatitis (FH) refers to liver diseases that have severe state and complicated manifestations. It will endanger patients'lives and health largely. The incidence of fulminant hepatitis in pregnancy (FHP) is 66 times of patients not in pregnancy,1 which is more dangerous and is one of the major causes of maternal and perinatal death in China. In order to predict the prognoses of FHP and decrease maternal and perinatal death rate, we summarized clinical information of 25 cases of FHP admitted to our hospital and investigated into prognostic factors that influenced FHP.

  6. Distributed personal health information management system for dermatology at the homes for senior citizens.

    Science.gov (United States)

    Lavanya, J; Goh, K W; Leow, Y H; Chio, M T W; Prabaharan, K; Kim, E; Kim, Y; Soh, C B

    2006-01-01

    A distributed personal health information management system (D-PHIMS) has been tested at a nursing home for the senior citizens (NHSC) in Singapore. The personal health information management system (PHIMS) from the University of Washington was customized to Singapore's context for teledermatology. A clinical trial commenced in October 2005 is ongoing and the survey results obtained indicate that the participants are satisfied with the D-PHIMS system. The diagnosis and treatment recommendations made by the dermatologists using the D-PHIMS diagnosis module were effective in most cases based on feedback from the nursing staff at the elderly nursing home. The results suggest that a teledermatology system could become a useful tool for the nursing homes and to control increasing healthcare costs for elderly care.

  7. Spatial modelling of arsenic distribution and human health effects in Lake Victoria basin, Tanzania

    Science.gov (United States)

    Ijumulana, Julian; Mtalo, Felix; Bhattacharya, Prosun

    2016-04-01

    Increasing incidences of naturally occurring geogenic pollutants in drinking water sources and associated human health risks are the two major challenges requiring detailed knowledge to support decision making process at various levels. The presence, location and extent of environmental contamination is needed towards developing mitigation measures to achieve required standards. In this study we are developing a GIS-based model to detect and predict drinking water pollutants at the identified hotspots and monitor its variation in space. In addition, the mobility of pollutants within the affected region needs to be evaluated using topographic and hydrogeological data. Based on these geospatial data on contaminant distribution, spatial relationship of As and F contamination and reported human health effects such as dental caries, dental fluorosis, skeletal fluorosis and bone crippling, skin and other cancers etc. can be modeled for potential interventions for safe drinking water supplies.

  8. Structural health monitoring of cylindrical bodies under impulsive hydrodynamic loading by distributed FBG strain measurements

    Science.gov (United States)

    Fanelli, Pierluigi; Biscarini, Chiara; Jannelli, Elio; Ubertini, Filippo; Ubertini, Stefano

    2017-02-01

    Various mechanical, ocean, aerospace and civil engineering problems involve solid bodies impacting the water surface and often result in complex coupled dynamics, characterized by impulsive loading conditions, high amplitude vibrations and large local deformations. Monitoring in such problems for purposes such as remaining fatigue life estimation and real time damage detection is a technical and scientific challenge of primary concern in this context. Open issues include the need for developing distributed sensing systems able to operate at very high acquisition frequencies, to be utilized to study rapidly varying strain fields, with high resolution and very low noise, while scientific challenges mostly relate to the definition of appropriate signal processing and modeling tools enabling the extraction of useful information from distributed sensing signals. Building on previous work by some of the authors, we propose an enhanced method for real time deformed shape reconstruction using distributed FBG strain measurements in curved bodies subjected to impulsive loading and we establish a new framework for applying this method for structural health monitoring purposes, as the main focus of the work. Experiments are carried out on a cylinder impacting the water at various speeds, proving improved performance in displacement reconstruction of the enhanced method compared to its previous version. A numerical study is then carried out considering the same physical problem with different delamination damages affecting the body. The potential for detecting, localizing and quantifying this damage using the reconstruction algorithm is thoroughly investigated. Overall, the results presented in the paper show the potential of distributed FBG strain measurements for real time structural health monitoring of curved bodies under impulsive hydrodynamic loading, defining damage sensitive features in terms of strain or displacement reconstruction errors at selected locations along

  9. The spatial distribution of vulnerability to the health impacts of flooding in the Mekong Delta, Vietnam

    Science.gov (United States)

    Phung, Dung; Rutherford, Shannon; Dwirahmadi, Febi; Chu, Cordia; Do, Cuong Manh; Nguyen, Thuy; Duong, Nam Chi

    2016-06-01

    Flooding causes significant public health issues. The Mekong Delta has been considered the region to be the most vulnerable to flooding in Vietnam. This study assessed the spatial vulnerability of the health impacts of flooding in the Mekong Delta region, Vietnam. This study applied a vulnerability assessment framework which was computed as the function of three dimensions: exposure, sensitivity, and adaptive capacity. The indicators for each dimension were derived from the relevant literature, consultations with experts, and data availability. An analytic hierarchy process (AHP) and a principal component analysis (PCA) were used to determine the weight of indicators. Vulnerability indexes (VIs) were then computed for each province. A total of 29 indicators (sensitivity index, 14; adaptive capacity index, 13; and exposure index, 2) were employed to evaluate the vulnerability to the health impacts of flooding at a provincial level. The results of AHP revealed that the highest VIs were found in the Dong Thap and An Giang provinces (VI, 1.948 and 1.574, respectively). VIs were distributed with higher indexes in upstream provinces close to a river than in coastal provinces. PCA generated three components from the 29 indicators, and the VIs computed from the PCA method are in substantial agreement with the AHP method (ICC = 0.71, p Vietnam. Individual plans for health preparedness and adaption to flooding should be developed for each province in the Mekong Delta region.

  10. The distribution of net benefits under the National Health Insurance programme in Taiwan.

    Science.gov (United States)

    Huang, Nicole; Yip, Winnie; Chou, Yiing-Jenq; Wang, Pen-Jen

    2007-01-01

    The redistributive effects of a social insurance programme are determined by how the programme is paid for-who pays and how much do they pay?-and how the benefits are distributed. As a result, the redistributive effects of a social health insurance programme should be evaluated on the basis of its net benefit-the difference between benefits and payment. Among the rich body of empirical analysis on equity in health care financing, however, most studies have relied on partial analysis, assessing equity by source of financing while ignoring the benefit side, or looking at equity in benefits but ignoring the funding side. Either approach risks misleading findings. In this study, therefore, the primary objective was to assess the distribution of net benefits across income groups under Taiwan's National Health Insurance (NHI) programme. This study observed a nationally representative sample of 74 012 NHI enrolees from 1996 to 2000. The unique NHI databases in Taiwan provide comprehensive enrolment and utilization information, and allowed linkage to each enrolee's income tax files. In addition to crude estimates, two-part models and ordinary least-square models were used to adjust inpatient and outpatient benefits for health care needs (age, sex, major disease status and physical disability). After adjusting for health care needs, the distribution of net benefits showed an apparent pro-poor pattern, with the lowest income group receiving the highest net benefits (NT$3353) and the top income group receiving the lowest net benefits (-NT$3072) in 1996. Although a clear pro-poor pattern was observed among those enrolees who paid wage-based premiums, this vertically equitable pattern was less evident among the enrolees who paid fixed premiums. Overall, a trend of increasing net benefits was observed in all income groups between 1996 and 2000, and all the NHI enrolees can be considered better off over time. In addition to contributing to the limited literature on equity in net

  11. The health workforce crisis in Bangladesh: shortage, inappropriate skill-mix and inequitable distribution

    Directory of Open Access Journals (Sweden)

    RajaChowdhury Ahmed

    2011-01-01

    Full Text Available Abstract Background Bangladesh is identified as one of the countries with severe health worker shortages. However, there is a lack of comprehensive data on human resources for health (HRH in the formal and informal sectors in Bangladesh. This data is essential for developing an HRH policy and plan to meet the changing health needs of the population. This paper attempts to fill in this knowledge gap by using data from a nationally representative sample survey conducted in 2007. Methods The study population in this survey comprised all types of currently active health care providers (HCPs in the formal and informal sectors. The survey used 60 unions/wards from both rural and urban areas (with a comparable average population of approximately 25 000 which were proportionally allocated based on a 'Probability Proportion to Size' sampling technique for the six divisions and distribution areas. A simple free listing was done to make an inventory of the practicing HCPs in each of the sampled areas and cross-checking with community was done for confirmation and to avoid duplication. This exercise yielded the required list of different HCPs by union/ward. Results HCP density was measured per 10 000 population. There were approximately five physicians and two nurses per 10 000, the ratio of nurse to physician being only 0.4. Substantial variation among different divisions was found, with gross imbalance in distribution favouring the urban areas. There were around 12 unqualified village doctors and 11 salespeople at drug retail outlets per 10 000, the latter being uniformly spread across the country. Also, there were twice as many community health workers (CHWs from the non-governmental sector than the government sector and an overwhelming number of traditional birth attendants. The village doctors (predominantly males and the CHWs (predominantly females were mainly concentrated in the rural areas, while the paraprofessionals were concentrated in the urban

  12. Distribution of Health Effects and Cost-effectiveness of Varicella Vaccination are Shaped by the Impact on Herpes Zoster

    Directory of Open Access Journals (Sweden)

    Alies van Lier

    2015-10-01

    Conclusions: Cost-effectiveness of varicella vaccination depends strongly on the impact on HZ and the economic time horizon. Our findings reveal ethical dilemmas as varicella vaccination may result in unequal distribution of health effects between generations.

  13. Prognostic factors for poor recovery in acute whiplash patients.

    NARCIS (Netherlands)

    Hendriks, E.J.M.; Scholten-Peeters, G.G.M.; Windt, D.A.W.M. van der; Neeleman-van der Steen, C.W.M.; Oostendorp, R.A.B.; Verhagen, A.P.

    2005-01-01

    The objective of our prospective inception cohort study was to identify prognostic factors for poor recovery in patients with whiplash-associated disorders grade 1 or 2 who still had neck pain and accompanying complaints 2 weeks after the accident. The study was carried out in a primary health care

  14. Prognostic factors for poor recovery in acute whiplash patients

    NARCIS (Netherlands)

    Hendriks, E.J.M.; Scholten-Peeters, G.G.M.; Windt - Mens, van der D.A.W.M.; Steen, de C.W. Neeleman-van; Oostendorp, R.A.B.; Verhagen, A.P.

    2005-01-01

    The objective of our prospective inception cohort study was to identify prognostic factors for poor recovery in patients with whiplash-associated disorders grade 1 or 2 who still had neck pain and accompanying complaints 2 weeks after the accident. The study was carried out in a primary health care

  15. An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania.

    Science.gov (United States)

    Kuwawenaruwa, August; Borghi, Josephine; Remme, Michelle; Mtei, Gemini

    2017-07-11

    There is limited evidence on how health care inputs are distributed from the sub-national level down to health facilities and their potential influence on promoting health equity. To address this gap, this paper assesses equity in the distribution of health care inputs across public primary health facilities at the district level in Tanzania. This is a quantitative assessment of equity in the distribution of health care inputs (staff, drugs, medical supplies and equipment) from district to facility level. The study was carried out in three districts (Kinondoni, Singida Rural and Manyoni district) in Tanzania. These districts were selected because they were implementing primary care reforms. We administered 729 exit surveys with patients seeking out-patient care; and health facility surveys at 69 facilities in early 2014. A total of seventeen indices of input availability were constructed with the collected data. The distribution of inputs was considered in relation to (i) the wealth of patients accessing the facilities, which was taken as a proxy for the wealth of the population in the catchment area; and (ii) facility distance from the district headquarters. We assessed equity in the distribution of inputs through the use of equity ratios, concentration indices and curves. We found a significant pro-rich distribution of clinical staff and nurses per 1000 population. Facilities with the poorest patients (most remote facilities) have fewer staff per 1000 population than those with the least poor patients (least remote facilities): 0.6 staff per 1000 among the poorest, compared to 0.9 among the least poor; 0.7 staff per 1000 among the most remote facilities compared to 0.9 among the least remote. The negative concentration index for support staff suggests a pro-poor distribution of this cadre but the 45 degree dominated the concentration curve. The distribution of vaccines, antibiotics, anti-diarrhoeal, anti-malarials and medical supplies was approximately

  16. Research on technology application of integrated fault prognostic and health management%多机种一体化故障预测与健康管理技术应用研究

    Institute of Scientific and Technical Information of China (English)

    毛海涛; 潘华

    2015-01-01

    基于故障预测与健康管理的自主式保障是新一代飞机和直升机设计的基本能力,是航空装备综合保障领域的重要变革。研究介绍了飞机PHM系统体系结构,划分出机载PHM系统和地面PHM系统,提出机载PHM系统采用分层智能推理机构,地面PHM系统宿驻在地面自主保障信息系统,并优化了PHM系统工作过程;根据现实与可能,提出了实用性的综合智能故障诊断方法和维修任务预测算法;从多机种一体化保障需要,提出了飞机多机种自主式保障设计关键技术和研究方向。%AL (autonomic logistics) based on PHM (prognostics and health management) is a basic capacity of the new generation airplane and helicopter,as well as an important revolution in the field of aviation equipment integrated logistic sup⁃port. The structure of PHM system including on⁃board and off⁃line systems is introduced in this paper. The organization of intelli⁃gent hierarchy inference is adopted in on⁃board system. The off⁃line system is stationed in the ground AL information system. An utility method of intelligent fault diagnosis and an algorithm of maintenance task prediction are proposed. On the other hand,the key technology and research direction on the AL design of multi kind airplanes are put forward.

  17. Regional distribution of physicians: the role of comprehensive private health insurance in Germany.

    Science.gov (United States)

    Sundmacher, Leonie; Ozegowski, Susanne

    2016-05-01

    In recent years, the co-existence in Germany of two parallel comprehensive insurance systems-statutory health insurance (SHI) and private health insurance (PHI)-has been posited as a possible cause of a persistent unequal regional distribution of physicians. The present study investigates the effect of the proportion of privately insured patients on the density of SHI-licensed physicians, while controlling for regional variations in the average income from SHI patients. The proportion of residents in a district with private health insurance is estimated using complete administrative data from the SHI system and the German population census. Missing values are estimated using multiple imputation techniques. All models control for the estimated average income ambulatory physicians generate from treating SHI insured patients and a well-defined set of covariates on the level of districts in Germany in 2010. Our results show that every percentage change in the proportion of residents with private health insurance is associated with increases of 2.1 and 1.3 % in the density of specialists and GPs respectively. Higher SHI income in rural areas does not compensate for this effect. From a financial perspective, it is rational for a physician to locate a new practice in a district with a high proportion of privately insured patients. From the perspective of patients in the SHI system, the incentive effects of PHI presumably contribute to a concentration of health care services in wealthy and urban areas. To date, the needs-based planning mechanism has been unable to address this imbalance.

  18. Nutritional status and fat tissue distribution in health adults from some places in central Banat

    Directory of Open Access Journals (Sweden)

    Pavlica Tatjana

    2010-01-01

    Full Text Available Introduction. The aim of this study was to determine, relying on anthropological parameters, nutritional status, fat tissue distribution and possible health risk in adult population of Central Banal. Material and methods. 730 subjects of both genders (average age 4O.19±11.36y underwent following measurements: height, weight, waist and hip circumference. Results and discussion. Central Banat population was characterized by great height (males: 178.40±7.24 cm: females: 163.06±6.32 cm. The average BMI was at the lower limit of overweight category (males: 26.59 kg/m2; females: 25.29 kg/m2. Overweight and obesity were found in 55.5% of examined subjects. In males, normal weight was recorded only in the youngest age group (20-29y, while in older age groups the percentage of overweight and obese males increased with age. In females, normal weight was recorded till the age of 50, after which overweight category was mainly present. Regarding both of the sexes, obesity was most frequent in the age group 50-59 (22%. The average waist circumference was lower than the cut-off values recommended by WHO (96.43 cm in males and 82.49 cm in females. According to fat distribution, normal values were recorded in males younger that 39y, after which there was an increase m risk central obesity. In females, normal fat distribution was mainly present in all ages, although the percentage of the risk category increased with age. The highest percentage of the subjects of both sexes showed no health risk. Conclusion. Our results indicate the need for preventive action towards obesity consequences and obesity inducing surroundings.

  19. Size distribution of particle-associated polybrominated diphenyl ethers (PBDEs) and their implications for health

    Science.gov (United States)

    Lyu, Yan; Xu, Tingting; Li, Xiang; Cheng, Tiantao; Yang, Xin; Sun, Xiaomin; Chen, Jianmin

    2016-03-01

    In order to better understand the size distribution of particle-associated PBDEs and their deposition pattern in the human respiratory tract, we carried out a 1-year campaign during 2012-2013 for the measurement of size-resolved particles at the urban site of Shanghai. The results showed that particulate PBDEs exhibited a bimodal distribution with a mode peak in the accumulation particle size range and the second mode peak in the coarse particle size ranges. As the number of bromine atoms in the molecule increases, accumulation-mode peak intensity increased while coarse-mode peak intensity decreased. This change was consistent with the variation of PBDEs' subcooled vapor pressure. Absorption and adsorption processes dominated the distribution of PBDEs among the different size particles. The evaluated deposition flux of Σ13 PBDEs was 26.8 pg h-1, in which coarse particles contributed most PBDEs in head and tracheobronchial regions, while fine-mode particles contributed major PBDEs in the alveoli region. In association with the fact that fine particles can penetrate deeper into the respiratory system, fine-particle-bound highly brominated PBDEs can be inhaled more deeply into human lungs and cause a greater risk to human health.

  20. Particle-size distribution of polybrominated diphenyl ethers (PBDEs) and its implications for health

    Science.gov (United States)

    Lyu, Y.; Xu, T.; Li, X.; Cheng, T.; Yang, X.; Sun, X.; Chen, J.

    2015-12-01

    In order better to understand the particle-size distribution of particulate PBDEs and their deposition pattern in human respiratory tract, we made an one year campaign 2012-2013 for the measurement of size-resolved aerosol particles at Shanghai urban site. The results showed that particulate PBDEs exhibited a bimodal distribution with a mode peak in the accumulation particle size range and the second mode peak in the coarse particle size ranges. As the number of bromine atoms in the molecule increased, accumulation mode peak intensity increased while coarse mode peak intensity decreased. This change was the consistent with the variation of PBDEs' sub-cooled vapor pressure. Absorption and adsorption process dominated the distribution of PBDEs among the different size particles. Evaluated deposition flux of Σ13PBDE was 26.8 pg h-1, in which coarse particles contributed most PBDEs in head and tracheobronchial regions, while fine mode particles contributed major PBDEs in the alveoli region. In associated with the fact that fine particles can penetrate deeper into the respiratory system, fine particle-bound highly brominated PBDEs can be inhaled more deeply into human lungs and cause a greater risk to human health.

  1. Structural health monitoring using fiber optic distributed sensors for vacuum-assisted resin transfer molding

    Science.gov (United States)

    Eum, S. H.; Kageyama, K.; Murayama, H.; Uzawa, K.; Ohsawa, I.; Kanai, M.; Kobayashi, S.; Igawa, H.; Shirai, T.

    2007-12-01

    In this study we implemented manufacturing process and strain monitoring of a composite structure by optical fiber sensors for vacuum-assisted resin transfer molding (VaRTM). Optical fibers with fiber Bragg gratings were embedded into a glass fiber reinforced plastic specimen made by VaRTM and the applicability of structural health monitoring with fiber Bragg grating (FBG) sensors based on optical frequency domain reflectometry (OFDR) was investigated. In this study, long-gage FBGs which are 10 times longer than ordinary FBGs (which are about 10 mm long) were employed for distributed sensing. We can easily map the strain or temperature profile along gratings by OFDR and the spatial resolution of this sensing technique is about 1 mm. The resin flow process in VaRTM could be monitored by measuring the difference in temperature between the resin and preform. Then, the shrinkage of resin could be also monitored during the curing process. The specimen was then subjected to a bending load in a three-point bending test and the strain distributions along the FBGs were measured. From these results we could show the applicability of distributed sensors to quality assurance of a composite structure made by VaRTM and assessment of the structural integrity of in-service composite structures.

  2. Prognostics Applied to Electric Propulsion UAV

    Science.gov (United States)

    Goebel, Kai; Saha, Bhaskar

    2013-01-01

    Health management plays an important role in operations of UAV. If there is equipment malfunction on critical components, safe operation of the UAV might possibly be compromised. A technology with particular promise in this arena is equipment prognostics. This technology provides a state assessment of the health of components of interest and, if a degraded state has been found, it estimates how long it will take before the equipment will reach a failure threshold, conditional on assumptions about future operating conditions and future environmental conditions. This chapter explores the technical underpinnings of how to perform prognostics and shows an implementation on the propulsion of an electric UAV. A particle filter is shown as the method of choice in performing state assessment and predicting future degradation. The method is then applied to the batteries that provide power to the propeller motors. An accurate run-time battery life prediction algorithm is of critical importance to ensure the safe operation of the vehicle if one wants to maximize in-air time. Current reliability based techniques turn out to be insufficient to manage the use of such batteries where loads vary frequently in uncertain environments.

  3. Distribution, sources and health risk assessment of mercury in kindergarten dust

    Science.gov (United States)

    Sun, Guangyi; Li, Zhonggen; Bi, Xiangyang; Chen, Yupeng; Lu, Shuangfang; Yuan, Xin

    2013-07-01

    Mercury (Hg) contamination in urban area is a hot issue in environmental research. In this study, the distribution, sources and health risk of Hg in dust from 69 kindergartens in Wuhan, China, were investigated. In comparison with most other cities, the concentrations of total mercury (THg) and methylmercury (MeHg) were significantly elevated, ranging from 0.15 to 10.59 mg kg-1 and from 0.64 to 3.88 μg kg-1, respectively. Among the five different urban areas, the educational area had the highest concentrations of THg and MeHg. The GIS mapping was used to identify the hot-spot areas and assess the potential pollution sources of Hg. The emissions of coal-power plants and coking plants were the main sources of THg in the dust, whereas the contributions of municipal solid waste (MSW) landfills and iron and steel smelting related industries were not significant. However, the emission of MSW landfills was considered to be an important source of MeHg in the studied area. The result of health risk assessment indicated that there was a high adverse health effect of the kindergarten dust in terms of Hg contamination on the children living in the educational area (Hazard index (HI) = 6.89).

  4. Distribution of Malaria Case in Simpenan Public Health Centre Sukabumi District in 2011

    Directory of Open Access Journals (Sweden)

    Hubullah Fuadzy

    2012-12-01

    Full Text Available The number of malaria in Simpenan public health centre area needs a quick step in the patients finding by malaria microscopic officers, both by Active Case Detection (ACD and Passive Case Detection (PCD. The objective of th is article is to determine the distribution of malaria cases at Simpenan public health centre in Sukabumi during 2011. Data collection was carried out by malaria officersfrom Simpenan public health centre by identifying malaria parasite with microscope to any gold miners who just got home and was having a highfever. Malaria cases during the year 2011 experienced an increasing trend (R2 = 0.0175 from January (8.86% to December (15.18%, 79 cases of malaria was found and the peak of cases happened in December. Malaria was notfound in the age group of 0-14 years, but cases ofmalaria were found in productive age group (15-44 years old = 83%, 45-59 years old = 14%, 2: 60 years old = 3%, and also to all people working as gold miners in malaria-endemic areas i.e. Aceh, Bangka, Jambi, Kalimantan, Medan, Papua, Riau, and Sumbawa. This indicated that malaria in Simpenan was predicted as import cases.

  5. Distributed Lag Models: Examining Associations Between the Built Environment and Health.

    Science.gov (United States)

    Baek, Jonggyu; Sánchez, Brisa N; Berrocal, Veronica J; Sanchez-Vaznaugh, Emma V

    2016-01-01

    Built environment factors constrain individual level behaviors and choices, and thus are receiving increasing attention to assess their influence on health. Traditional regression methods have been widely used to examine associations between built environment measures and health outcomes, where a fixed, prespecified spatial scale (e.g., 1 mile buffer) is used to construct environment measures. However, the spatial scale for these associations remains largely unknown and misspecifying it introduces bias. We propose the use of distributed lag models (DLMs) to describe the association between built environment features and health as a function of distance from the locations of interest and circumvent a-priori selection of a spatial scale. Based on simulation studies, we demonstrate that traditional regression models produce associations biased away from the null when there is spatial correlation among the built environment features. Inference based on DLMs is robust under a range of scenarios of the built environment. We use this innovative application of DLMs to examine the association between the availability of convenience stores near California public schools, which may affect children's dietary choices both through direct access to junk food and exposure to advertisement, and children's body mass index z scores.

  6. Health monitoring of electric power communication line using a distributed optical fiber sensor

    Science.gov (United States)

    Lu, Lidong; Liang, Yun; Li, Binglin; Guo, Jinghong; Zhang, Hao; Zhang, Xuping

    2014-11-01

    Optical fiber ground wire (OPGW) is used for both the earth line and communication line in electric power systems. It is important to find an effective to monitor the status of OPGW and diagnose some possible damages. Fault location of the optical fiber transmission line, lightning stroke location and early-warning of ice covering of OPGW are common tasks for OPGW health monitoring and maintenance. As to these issues, Brillouin optical time domain reflectometry (BOTDR) is employed for the health monitoring of OPGW. In experiment, a positive electrode with high pulsed current and a negative electrode are adopted to form a lightning impulse system with duration time of 200ms for simulation of the lightning stroke process, and a tensile force loading apparatus is also constructed to simulate the strain influence of the ice covering on the OPGW. Experimental results demonstrate that the BOTDR can sensitively locate the lightning stroke incidents with the quantity of electric discharging larger than 100C and the strain component has little interference on temperature monitoring as the fiber contained in the OPGW is generally free of strain, and in the ice covering condition the strain feature appears only when the extra tensile force on the OPGW is over 30kN. In addition, the vibration of OPGW does not disturb both the temperature and strain monitoring. As to further applications of distributed optical fiber sensors (DOFS) for the OPGW health monitoring, it is important to enhance its spatial resolution.

  7. A Modeling Framework for Prognostic Decision Making and its Application to UAV Mission Planning

    Data.gov (United States)

    National Aeronautics and Space Administration — The goal of prognostic decision making (PDM) is to utilize information on anticipated system health changes in selecting future actions. One of the key challenges in...

  8. A Testbed for Implementing Prognostic Methodologies on Cryogenic Propellant Loading Systems

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics technologies determine the health state of a system and predict its remaining useful life. With this information, operators are able to make...

  9. Investigating the Effect of Damage Progression Model Choice on Prognostics Performance

    Data.gov (United States)

    National Aeronautics and Space Administration — The success of model-based approaches to systems health management depends largely on the quality of the underly- ing models. In model-based prognostics, it is...

  10. Integrating Prognostics in Automated Contingency Management Strategies for Advanced Aircraft Controls Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Automated Contingency Management (ACM) is an emerging and game-changing area of engineering and scientific research that integrates prognostics and health management...

  11. Prognostic Fault Detection and Isolation for EMA and EPS Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — In response to NASA SBIR topic X1.04, Ridgetop Group will extend and adapt RingDown: an innovative system for the non-invasive prognostic monitoring of the health of...

  12. Towards Prognostics of Power MOSFETs: Accelerated Aging and Precursors of Failure

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper presents research results dealing with power MOSFETs (metal oxide semiconductor field effect tran- sistor) within the prognostics and health management of...

  13. Implementation of Prognostic Methodologies to Cryogenic Propellant Loading Test-bed

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics methodologies determine the health state of a system and predict the end of life and remaining useful life. This information enables operators to take...

  14. Real-Time Prognostics of a Rotary Valve Actuator

    Science.gov (United States)

    Daigle, Matthew

    2015-01-01

    Valves are used in many domains and often have system-critical functions. As such, it is important to monitor the health of valves and their actuators and predict remaining useful life. In this work, we develop a model-based prognostics approach for a rotary valve actuator. Due to limited observability of the component with multiple failure modes, a lumped damage approach is proposed for estimation and prediction of damage progression. In order to support the goal of real-time prognostics, an approach to prediction is developed that does not require online simulation to compute remaining life, rather, a function mapping the damage state to remaining useful life is found offline so that predictions can be made quickly online with a single function evaluation. Simulation results demonstrate the overall methodology, validating the lumped damage approach and demonstrating real-time prognostics.

  15. Prognostic value of circulating CD34+ cells in myelodysplastic syndromes.

    Science.gov (United States)

    Cesana, Clara; Klersy, Catherine; Brando, Bruno; Nosari, Annamaria; Scarpati, Barbara; Scampini, Linda; Molteni, Alfredo; Nador, Guido; Santoleri, Luca; Formenti, Marta; Valentini, Marina; Mazzone, Antonino; Morra, Enrica; Cairoli, Roberto

    2008-11-01

    We studied circulating (C)CD34(+) cells by flow cytometry in 96 patients with myelodysplastic syndromes (MDS) at diagnosis, and in a subset of 35 cases during follow-up. CCD34(+) counts were stratified within both International Prognostic Scoring System (IPSS) and World Health Organization (WHO) categories. Counts >10/microl were associated with poorer leukemia-free survival, a prognostic value for evolution independent from that of WHO, and a higher progression probability within intermediate-risk IPSS and WHO classes. When serial measurements were performed, counts >10/microl more frequently correlated to evolution. Separating newly diagnosed patients on the basis of 10/microl cut-off of circulating CD34(+) cells retains prognostic utility, especially in intermediate-risk MDS.

  16. A Model-based Prognostics Approach Applied to Pneumatic Valves

    Directory of Open Access Journals (Sweden)

    Matthew J. Daigle

    2011-01-01

    Full Text Available Within the area of systems health management, the task of prognostics centers on predicting when components will fail. Model-based prognostics exploits domain knowledge of the system, its components, and how they fail by casting the underlying physical phenomena in a physics-based model that is derived from first principles. Uncertainty cannot be avoided in prediction, therefore, algorithms are employed that help in managing these uncertainties. The particle filtering algorithm has become a popular choice for model-based prognostics due to its wide applicability, ease of implementation, and support for uncertainty management. We develop a general model-based prognostics methodology within a robust probabilistic framework using particle filters. As a case study, we consider a pneumatic valve from the Space Shuttle cryogenic refueling system. We develop a detailed physics-based model of the pneumatic valve, and perform comprehensive simulation experiments to illustrate our prognostics approach and evaluate its effectiveness and robustness. The approach is demonstrated using historical pneumatic valve data from the refueling system.

  17. Pediatric acute kidney injury: Appraisal of predictors and prognostic indicators

    Directory of Open Access Journals (Sweden)

    Samuel Nkachukwu Uwaezuoke

    2017-01-01

    Full Text Available Acute kidney injury (AKI is a major contributor to childhood morbidity and mortality worldwide. In spite of the advances in renal replacement therapy, there has been a minimal reduction in AKI-related morbidity and mortality. Identifying the prognostic indicators and the risk factors that predict disease onset and progression, and instituting appropriate measures will lead to better survival outcomes. This narrative review seeks to appraise the predictors and prognostic indicators of pediatric AKI. Several biomarkers clearly stand out as predictors and prognostic indicators of the acute disease. Some of them are urine angiotensinogen, fibroblast growth factor-23, cystacin C, neutrophil gelatinase-associated lipocalin, tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7. Combining few of these biomarkers with clinical prediction models has improved their predictive and prognostic utility for AKI. Hemodynamic parameters such as indexed systemic oxygen delivery and mean arterial blood pressure have been proved to be reliable in predicting the occurrence and progression of the disease and its outcomes. Miscellaneous predictors and prognostic indicators like AKI definition criteria, presence of co-morbidities, and health-related quality of life assessment have also been documented from evidence-based studies. An understanding and application of these indices will obviously help to reduce AKI mortality in children.

  18. A Model-Based Prognostics Approach Applied to Pneumatic Valves

    Science.gov (United States)

    Daigle, Matthew J.; Goebel, Kai

    2011-01-01

    Within the area of systems health management, the task of prognostics centers on predicting when components will fail. Model-based prognostics exploits domain knowledge of the system, its components, and how they fail by casting the underlying physical phenomena in a physics-based model that is derived from first principles. Uncertainty cannot be avoided in prediction, therefore, algorithms are employed that help in managing these uncertainties. The particle filtering algorithm has become a popular choice for model-based prognostics due to its wide applicability, ease of implementation, and support for uncertainty management. We develop a general model-based prognostics methodology within a robust probabilistic framework using particle filters. As a case study, we consider a pneumatic valve from the Space Shuttle cryogenic refueling system. We develop a detailed physics-based model of the pneumatic valve, and perform comprehensive simulation experiments to illustrate our prognostics approach and evaluate its effectiveness and robustness. The approach is demonstrated using historical pneumatic valve data from the refueling system.

  19. Modelling spatial distribution of snails transmitting parasitic worms with importance to human and animal health and analysis of distributional changes in relation to climate

    DEFF Research Database (Denmark)

    Pedersen, Ulrik Bo; Midzi, Nicholas; Mduluza, Takafira

    2014-01-01

    The environment, the on-going global climate change and the ecology of animal species determine the localisation of habitats and the geographical distribution of the various species in nature. The aim of this study was to explore the effects of such changes on snail species not only of interest...... to naturalists but also of importance to human and animal health. The spatial distribution of freshwater snail intermediate hosts involved in the transmission of schistosomiasis, fascioliasis and paramphistomiasis (i.e. Bulinus globosus, Biomphalaria pfeifferi and Lymnaea natalensis) were modelled by the use...... of a maximum entropy algorithm (Maxent). Two snail observation datasets from Zimbabwe, from 1988 and 2012, were compared in terms of geospatial distribution and potential distributional change over this 24-year period investigated. Climate data, from the two years were identified and used in a species...

  20. Distributed leadership - Strenghtening the condition for continious innovation in primary health organizations

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Ulhøi, John Parm

    study of four units within a Danish hospital with about 4500 employees. Our findings identify a mix of emergent and contextualized leadership which needs time to be enacted. Furthermore, we find that resource allocation, social capital accumulation, collaborative work culture, and legitimacy building......Public hospitals need to change and innovate to handle the challenges of increasing demands for more, faster, better and cheaper health provision. Practicing leadership does not occur in a sterile context but in a highly contextual and social setting. This in turn invites for focussing...... on distributed leadership as a means to influence resource availability, decision making and goal setting in an organizational setting. The overall RQ guiding this research is: how does DL need to be enacted to enable change and continuous innovation in healthcare. We first introduce a theory developing case...

  1. Age rationing and the just distribution of health care: is there a duty to die?

    Science.gov (United States)

    Battin, Margaret Pabst

    1987-01-01

    The author analyzes the argument that a policy involving distributive justice in the allocation of scarce health care resources, based on the strategy of rational self interest maximation under a veil of ignorance (Rawls/Daniels), would result in an age rationing system of voluntary, socially encouraged, direct termination of the lives of the elderly rather than their medical abandonment. She maintains that such a policy would be a fair response only in a situation of substantial scarcity of resources that cannot be relieved without introducing greater injustices. Battin suggests that some of the current pressure on resources could be reduced by pruning waste and the expenses attributable to paternalistic imposition of treatment and to the practice of defensive medicine. She also advocates reconsideration of societal priorities assigned to various social goods.

  2. Distributed Fiber Optic Sensor for On-Line Monitoring of Coal Gasifier Refractory Health

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Anbo [Center for Photonics Technology, Blacksburgh, VA (United States); Yu, Zhihao [Center for Photonics Technology, Blacksburgh, VA (United States)

    2015-11-30

    This report summarizes technical progress on the program “Distributed Fiber Optic Sensor for On-Line Monitoring of Coal Gasifier Refractory Health,” funded by the National Energy Technology Laboratory of the U.S. Department of Energy, and performed by the Center for Photonics Technology of the Bradley Department of Electrical and Computer Engineering at Virginia Tech. The scope of work entails analyses of traveling grating generation technologies in an optical fiber, as well as the interrogation of the gratings to infer a distributed temperature along the fiber, for the purpose of developing a real-time refractory health condition monitoring technology for coal gasifiers. During the project period, which is from 2011-2015, three different sensing principles were studied, including four-wave mixing (FWM), coherent optical time-domain reflectometer (C-OTDR) and Brillouin optical time-domain analysis (BOTDA). By comparing the three methods, the BOTDA was selected for further development into a complete bench-top sensing system for the proposed high-temperature sensing application. Based on the input from Eastman Chemical, the industrial collaborator on this project, a cylindrical furnace was designed and constructed to simulate typical gasifier refractory temperature conditions in the laboratory, and verify the sensor’s capability to fully monitor refractory conditions on the back-side at temperatures up to 1000°C. In the later stages of the project, the sensing system was tested in the simulated environment for its sensing performance and high-temperature survivability. Through theoretical analyses and experimental research on the different factors affecting the sensor performance, a sensor field deployment strategy was proposed for possible future sensor field implementations.

  3. Spatial distribution and health risk assessment for groundwater contamination from intensive pesticide use in arid areas.

    Science.gov (United States)

    El Alfy, Mohamed; Faraj, Turki

    2017-02-01

    Arid and semiarid areas face major challenges in the management of scarce groundwater. This valuable resource is under pressures of population, economic expansion, contamination and over-exploitation. This research investigates groundwater vulnerability to pesticide contamination in the Al-Kharj area of Saudi Arabia. It explores the spatial distribution of pesticide concentrations in groundwater and other relevant factors. Thin permeable soils, permeable aquifers and shallow water tables, which are prevalent in the area, are especially vulnerable to pesticides. Analyses of 40 groundwater samples were performed using a gas chromatograph mass spectrometer coupled with a quadrupole mass spectrometer with a GC column. The analysis was conducted to detect 32 pesticides from different chemical families, and a total of 22 pesticides were detected. All 40 water samples were positive for at least one of the pesticides studied. In total, 21 compounds were above the quantification limit and 10 of them exceeded the legal limit. Total pesticide levels ranged from 0.18 to 2.21 μg/L, and 68 % of the analyzed samples exceeded the maximum allowable pesticide concentrations established by the European Community. Comparison of the daily intake peak (DIP) and daily intake mean (DIM) relative to the acceptable daily intake (ADI) shows that groundwater contamination with pesticides is a serious problem. Prolonged exposure to pesticides can cause adverse effects to human health and the ecosystem. Spatial distribution maps of groundwater contamination were developed using GIS. These maps will help risk managers identify vulnerable sources and provide a relative assessment of pesticide hazards to human health and the environment.

  4. Distribution of major health risks: findings from the Global Burden of Disease study.

    Directory of Open Access Journals (Sweden)

    Anthony Rodgers

    2004-10-01

    Full Text Available BACKGROUND: Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness. METHODS AND FINDINGS: For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity 43%-61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1-3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median. CONCLUSIONS: Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to

  5. Physician distribution and attrition in the public health sector of Ethiopia

    Directory of Open Access Journals (Sweden)

    Assefa T

    2016-12-01

    Full Text Available Tsion Assefa,1 Damen Haile Mariam,1 Wubegzier Mekonnen,1 Miliard Derbew,2 Wendimagegn Enbiale3 1School of Public Health, 2School of Medicine, Addis Ababa University, Addis Ababa, 3College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia Background: Shortages and imbalances in physician workforce distribution between urban and rural and among the different regions in Ethiopia are enormous. However, with the recent rapid expansion in medical education training, it is expected that the country can make progress in physician workforce supply. Therefore, the aim of this study was to examine the distribution of physician workforce in Ethiopia and assess the role of retention mechanisms in the reduction of physician migration from the public health sector of Ethiopia. Methods: This organizational survey examined physician workforce data from 119 hospitals from 5 regions (Amhara, Oromia, Southern Nations Nationalities and Peoples Region [SNNPR], Tigray, and Harari and 2 city administrations (Addis Ababa and Dire Dawa City. Training opportunity, distribution, and turnover between September 2009 and July 2015 were analyzed descriptively. Poisson regression model was used to find the association of different covariates with physician turnover. Results: There were 2,300 medical doctors in 5 regions and 2 city administrations in ~6 years of observations. Of these, 553 (24.04% medical doctors moved out of their duty stations and the remaining 1,747 (75.96% were working actively. Of the actively working, the majority of the medical doctors, 1,407 (80.5%, were males, in which 889 (50.9% were born after the year 1985, 997 (57% had work experience of <3 years, and most, 1,471 (84.2%, were general practitioners. Within the observation period, physician turnover among specialists ranged from 21.4% in Dire Dawa to 43.3% in Amhara region. The capital, Addis Ababa, was the place of destination for 32 (82% of the physicians who moved out to

  6. Global Distribution, Public Health and Clinical Impact of the Protozoan Pathogen Cryptosporidium

    Directory of Open Access Journals (Sweden)

    Lorenza Putignani

    2010-01-01

    Full Text Available Cryptosporidium spp. are coccidians, oocysts-forming apicomplexan protozoa, which complete their life cycle both in humans and animals, through zoonotic and anthroponotic transmission, causing cryptosporidiosis. The global burden of this disease is still underascertained, due to a conundrum transmission modality, only partially unveiled, and on a plethora of detection systems still inadequate or only partially applied for worldwide surveillance. In children, cryptosporidiosis encumber is even less recorded and often misidentified due to physiological reasons such as early-age unpaired immunological response. Furthermore, malnutrition in underdeveloped countries or clinical underestimation of protozoan etiology in developed countries contribute to the underestimation of the worldwide burden. Principal key indicators of the parasite distribution were associated to environmental (e.g., geographic and temporal clusters, etc. and host determinants of the infection (e.g., age, immunological status, travels, community behaviours. The distribution was geographically mapped to provide an updated picture of the global parasite ecosystems. The present paper aims to provide, by a critical analysis of existing literature, a link between observational epidemiological records and new insights on public health, and diagnostic and clinical impact of cryptosporidiosis.

  7. Particle-size distribution of polybrominated diphenyl ethers (PBDEs and its implications for health

    Directory of Open Access Journals (Sweden)

    Y. Lyu

    2015-12-01

    tract, we made an one year campaign 2012–2013 for the measurement of size-resolved aerosol particles at Shanghai urban site. The results showed that particulate PBDEs exhibited a bimodal distribution with a mode peak in the accumulation particle size range and the second mode peak in the coarse particle size ranges. As the number of bromine atoms in the molecule increased, accumulation mode peak intensity increased while coarse mode peak intensity decreased. This change was the consistent with the variation of PBDEs' sub-cooled vapor pressure. Absorption and adsorption process dominated the distribution of PBDEs among the different size particles. Evaluated deposition flux of Σ13PBDE was 26.8 pg h−1, in which coarse particles contributed most PBDEs in head and tracheobronchial regions, while fine mode particles contributed major PBDEs in the alveoli region. In associated with the fact that fine particles can penetrate deeper into the respiratory system, fine particle-bound highly brominated PBDEs can be inhaled more deeply into human lungs and cause a greater risk to human health.

  8. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Science.gov (United States)

    Mehta, Chitra; Dara, Babita; Mehta, Yatin; Tariq, Ali M.; Joby, George V.; Singh, Manish K.

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045). Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study. PMID:27052066

  9. Wearable Sensor Localization Considering Mixed Distributed Sources in Health Monitoring Systems.

    Science.gov (United States)

    Wan, Liangtian; Han, Guangjie; Wang, Hao; Shu, Lei; Feng, Nanxing; Peng, Bao

    2016-03-12

    In health monitoring systems, the base station (BS) and the wearable sensors communicate with each other to construct a virtual multiple input and multiple output (VMIMO) system. In real applications, the signal that the BS received is a distributed source because of the scattering, reflection, diffraction and refraction in the propagation path. In this paper, a 2D direction-of-arrival (DOA) estimation algorithm for incoherently-distributed (ID) and coherently-distributed (CD) sources is proposed based on multiple VMIMO systems. ID and CD sources are separated through the second-order blind identification (SOBI) algorithm. The traditional estimating signal parameters via the rotational invariance technique (ESPRIT)-based algorithm is valid only for one-dimensional (1D) DOA estimation for the ID source. By constructing the signal subspace, two rotational invariant relationships are constructed. Then, we extend the ESPRIT to estimate 2D DOAs for ID sources. For DOA estimation of CD sources, two rational invariance relationships are constructed based on the application of generalized steering vectors (GSVs). Then, the ESPRIT-based algorithm is used for estimating the eigenvalues of two rational invariance matrices, which contain the angular parameters. The expressions of azimuth and elevation for ID and CD sources have closed forms, which means that the spectrum peak searching is avoided. Therefore, compared to the traditional 2D DOA estimation algorithms, the proposed algorithm imposes significantly low computational complexity. The intersecting point of two rays, which come from two different directions measured by two uniform rectangle arrays (URA), can be regarded as the location of the biosensor (wearable sensor). Three BSs adopting the smart antenna (SA) technique cooperate with each other to locate the wearable sensors using the angulation positioning method. Simulation results demonstrate the effectiveness of the proposed algorithm.

  10. Wearable Sensor Localization Considering Mixed Distributed Sources in Health Monitoring Systems

    Directory of Open Access Journals (Sweden)

    Liangtian Wan

    2016-03-01

    Full Text Available In health monitoring systems, the base station (BS and the wearable sensors communicate with each other to construct a virtual multiple input and multiple output (VMIMO system. In real applications, the signal that the BS received is a distributed source because of the scattering, reflection, diffraction and refraction in the propagation path. In this paper, a 2D direction-of-arrival (DOA estimation algorithm for incoherently-distributed (ID and coherently-distributed (CD sources is proposed based on multiple VMIMO systems. ID and CD sources are separated through the second-order blind identification (SOBI algorithm. The traditional estimating signal parameters via the rotational invariance technique (ESPRIT-based algorithm is valid only for one-dimensional (1D DOA estimation for the ID source. By constructing the signal subspace, two rotational invariant relationships are constructed. Then, we extend the ESPRIT to estimate 2D DOAs for ID sources. For DOA estimation of CD sources, two rational invariance relationships are constructed based on the application of generalized steering vectors (GSVs. Then, the ESPRIT-based algorithm is used for estimating the eigenvalues of two rational invariance matrices, which contain the angular parameters. The expressions of azimuth and elevation for ID and CD sources have closed forms, which means that the spectrum peak searching is avoided. Therefore, compared to the traditional 2D DOA estimation algorithms, the proposed algorithm imposes significantly low computational complexity. The intersecting point of two rays, which come from two different directions measured by two uniform rectangle arrays (URA, can be regarded as the location of the biosensor (wearable sensor. Three BSs adopting the smart antenna (SA technique cooperate with each other to locate the wearable sensors using the angulation positioning method. Simulation results demonstrate the effectiveness of the proposed algorithm.

  11. Distribution and cost of wheelchairs and scooters provided by Veterans Health Administration.

    Science.gov (United States)

    Hubbard, Sandra L; Fitzgerald, Shirley G; Vogel, Bruce; Reker, Dean M; Cooper, Rory A; Boninger, Michael L

    2007-01-01

    During fiscal years 2000 and 2001, the Veterans Health Administration provided veterans with more than 131,000 wheelchairs and scooters at a cost of $109 million. This national study is the first to investigate Veterans Health Administration costs in providing wheelchairs and scooters and to compare regional prescription patterns. With a retrospective design, we used descriptive methods to analyze fiscal years 2000 and 2001 National Prosthetics Patient Database data (cleaned data set of 113,724 records). Wheelchairs were categorized by function, weight, and adjustability options for meeting individual needs (e.g., axle position, camber, position of wheels, tilt, and recline options). Results displayed a cost distribution that was negatively skewed by low-cost accessories coded as wheelchairs. Of the standard manual wheelchairs, 3.5% could be considered beyond the customary cost. Regionally, 71% to 86% of all wheelchairs provided were manual wheelchairs, 5% to 11% were power wheelchairs, and 5% to 20% were scooters. The considerable variation found in the types of wheelchairs and scooters provided across Veterans Integrated Service Networks may indicate a need for evidence-based prescription guidelines and clinician training in wheeled-mobility technologies.

  12. Pb Distribution in Groundwater and Its Impact to the Health of Indonesia’s Capital Citizen

    Science.gov (United States)

    Zulfaris, D. Y.; Prayogi, T. E.; Alam, B. Y. C. S.; Fadly, M.; Memed, M. W.; Daryanto, A.; Abdillah, F.; Nasution, E. M.; Sudianto, J. R.; Giarto, B.; Maliki, F.; Nuraeni, N.

    2017-03-01

    This study aims to measure the Pb distribution in Jakarta Capital Region’s groundwater and its recommendation based on the standards of The Health Minister Decree No. 492 / MENKES / PES / IV / 2010 about The Drinking Water Monitoring. The study also aims to analyze the impact of Pb intoxication in the human body. The study activity uses the field data that carried out by Geological Agency, Ministry of Energy and Mineral Resources, Indonesia from March to April 2015. The methods used in this study are direct observation and hydrogeological measurement to measure physics and chemistry parameters. The result showed that the Levels of heavy metals Pb (Lead) in the west - southwest of Jakarta Groundwater basin (Ciputat, Pamulang, Ciledug, Kebayoran, Pondok Cina, Pondok Jagung, and Serpong) are beyond the quality standards that has been suggested by the ministry of health. The government set the standard in 0.1 mg/L while these areas have the Pb content of up to 0.654 mg/L. In addition, Pb anomalies also occur in Muara Angke, Kamal Muara, and Kapuk Region of North Jakarta which has a very High level of Pb which is about 1.09 mg / Liter. Pb intoxication in humans can affect the reproductive system, mutagenicity, carcinogenicity, and have bad effects to the nervous system of infants and children.

  13. Prognostic markers for idiopathic pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Guo Xiaomin; Jin Hongfang; Du Junbao

    2014-01-01

    Objective The objective of this study is to review the research on the prognostic markers of idiopathic pulmonary arterial hypertension (IPAH).Date sources We searched literature from PubMed and CNKI databases both in English and Chinese up to 2013.Study selection Data about mortality and cut-off value are from clinical trials and identified by analysis.Results IPAH is an unexplained,progressive,and rare disease characterized by increased pulmonary artery pressure and pulmonary vascular resistance.The diagnosis is difficult,mortality of IPAH is high,and the survival periods are only 2-3 years after diagnosis.Investigations in recent years have identified a range of prognostic markers for IPAH,including the 6-minute walking test,red blood cell distribution width,and platelet levels,as well as imaging findings.Changes in these markers are important sources of information to predict the prognosis of patients with IPAH,which carries significant benefits for treatment planning.Conclusion Even though the prognosis of IPAH has been investigated,the mortality is also high.More accurate and meaningful assessment for the prognosis of IPAH is required.

  14. Prognostics & Health Management: A NASA Perspective

    Science.gov (United States)

    Boyer, Roger L.

    2015-01-01

    How can advanced automation techniques developed by NASA to perform Fault Detection, Isolation, and Recovery (FDIR) in space missions be used here on Earth in the Oil & Gas industry? Whether on a Mars orbiter or an oil platform, having an intelligent machine to back up the crew/operators to help monitor and diagnose the systems for possible problems and aid in determining a corrective action/response is an important and useful attribute for multiple industries.

  15. Spatial Distribution and Fuzzy Health Risk Assessment of Trace Elements in Surface Water from Honghu Lake.

    Science.gov (United States)

    Li, Fei; Qiu, Zhenzhen; Zhang, Jingdong; Liu, Chaoyang; Cai, Ying; Xiao, Minsi

    2017-09-04

    Previous studies revealed that Honghu Lake was polluted by trace elements due to anthropogenic activities. This study investigated the spatial distribution of trace elements in Honghu Lake, and identified the major pollutants and control areas based on the fuzzy health risk assessment at screening level. The mean total content of trace elements in surface water decreased in the order of Zn (18.04 μg/L) > Pb (3.42 μg/L) > Cu (3.09 μg/L) > Cr (1.63 μg/L) > As (0.99 μg/L) > Cd (0.14 μg/L), within limits of Drinking Water Guidelines. The results of fuzzy health risk assessment indicated that there was no obvious non-carcinogenic risk to human health, while carcinogenic risk was observed in descending order of As > Cr > Cd > Pb. As was regarded to have the highest carcinogenic risk among selected trace elements because it generally accounted for 64% of integrated carcinogenic risk. Potential carcinogenic risk of trace elements in each sampling site was approximately at medium risk level (10(-5) to 10(-4)). The areas in the south (S4, S13, and S16) and northeast (S8, S18, and S19) of Honghu Lake were regarded as the risk priority control areas. However, the corresponding maximum memberships of integrated carcinogenic risk in S1, S3, S10-S13, S15, and S18 were of relatively low credibility (50-60%), and may mislead the decision-makers in identifying the risk priority areas. Results of fuzzy assessment presented the subordinate grade and corresponding reliability of risk, and provided more full-scale results for decision-makers, which made up for the deficiency of certainty assessment to a certain extent.

  16. The Challenge of Universal Eye Health in Latin America: distributive inequality of ophthalmologists in 14 countries

    Science.gov (United States)

    Hong, Hannah; Mújica, Oscar J; Anaya, José; Lansingh, Van C; López, Ellery; Silva, Juan Carlos

    2016-01-01

    Background No comprehensive study currently exists on the supply of ophthalmologists across Latin America. We explored sociogeographic inequalities in the availability and distribution of ophthalmologists across 14 Latin American countries. Methods The National Ophthalmologic Societies of Argentina, Bolivia, Brazil, Colombia, Costa Rica, Chile, the Dominican Republic, Ecuador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela provided data on affiliated ophthalmologists by first-order subnational divisions in 2013. Human Development Index (HDI) estimates at the corresponding subnational division were used as equity stratifiers. Distributional inequality of ophthalmologists within each country was assessed by the health concentration index (HCI) and the index of dissimilarity (ID), along with the mean level of ophthalmologists per population. Results Across all countries studied, there were 5.2 ophthalmologists per 100 000 population on average (95% CI 5.0 to 5.4) in 2013, with a mean HCI of 0.26 (0.16 to 0.37) and a mean relative ID of 22.7% (20.9% to 24.7%). There was wide inequality in ophthalmologist availability between countries, ranging from 1.2 (1.1 to 1.4) in Ecuador to 8.6 (8.5 to 8.8) in Brazil. All countries had positive (ie, pro-rich) HCI values ranging from 0.68 (0.66 to 0.71) in Guatemala to 0.02 (−0.11 to 0.14) in Venezuela. Correspondingly, redistributive potential to achieve equity was closest in Venezuela (ID: 1.5%) and farthest in Guatemala (ID: 60.3%). Benchmarked against regional averages, most countries had a lower availability of ophthalmologists and higher relative inequality. Conclusions There is high inequality in the level and distribution of ophthalmologists between and within countries in Latin America, with a disproportionate number concentrated in more developed, socially advantaged areas. More equitable access to ophthalmologists could be achieved by implementing incentivised human resources redistribution programmes and

  17. Prognostics for Ground Support Systems: Case Study on Pneumatic Valves

    Science.gov (United States)

    Daigle, Matthew; Goebel, Kai

    2011-01-01

    Prognostics technologies determine the health (or damage) state of a component or sub-system, and make end of life (EOL) and remaining useful life (RUL) predictions. Such information enables system operators to make informed maintenance decisions and streamline operational and mission-level activities. We develop a model-based prognostics methodology for pneumatic valves used in ground support equipment for cryogenic propellant loading operations. These valves are used to control the flow of propellant, so failures may have a significant impact on launch availability. Therefore, correctly predicting when valves will fail enables timely maintenance that avoids launch delays and aborts. The approach utilizes mathematical models describing the underlying physics of valve degradation, and, employing the particle filtering algorithm for joint state-parameter estimation, determines the health state of the valve and the rate of damage progression, from which EOL and RUL predictions are made. We develop a prototype user interface for valve prognostics, and demonstrate the prognostics approach using historical pneumatic valve data from the Space Shuttle refueling system.

  18. Analysis of the distributional impact of out-of-pocket health payments: evidence from a public health insurance program for the poor in Mexico.

    Science.gov (United States)

    Garcia-Diaz, Rocio; Sosa-Rubi, Sandra G; Sosa-Rub, Sandra G

    2011-07-01

    Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day.

  19. PROGNOSTIC FACTORS IN PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    N. A. Gorban

    2014-08-01

    Full Text Available Prostate cancer is most common and its heterogenicity is presently apparent. There is a continuous search for the factors allowing the prediction of the poor course and biological difference of tumors. The College of American Pathologists classifies the currently known prognostic factors into 3 categories: 1 the factors whose prognostic importance and successful use have been proven in practice; 2 those that have been widely studied biologically and clinically, but the significance of which needs to be proven in extensive statistical studies; 3 all other factors that have been inadequately studied to demonstrate their prognostic value. Category 1 prognostic factors, such as prostate-specific antigen levels, TNM stage, Gleason grading, and the status of surgical margins, enjoy wide application. Category 2 factors are not used IN clinical practice so extensively. The value of some Category 3 factors (the biomarkers p53, Ki-67, Bcl-2, receptors of androgens is indubitably and they claim to be widely applied in clinical practice with time. The clinical significance of molecular biological markers calls for further investigation.

  20. PROGNOSTIC FACTORS IN PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    N. A. Gorban

    2010-01-01

    Full Text Available Prostate cancer is most common and its heterogenicity is presently apparent. There is a continuous search for the factors allowing the prediction of the poor course and biological difference of tumors. The College of American Pathologists classifies the currently known prognostic factors into 3 categories: 1 the factors whose prognostic importance and successful use have been proven in practice; 2 those that have been widely studied biologically and clinically, but the significance of which needs to be proven in extensive statistical studies; 3 all other factors that have been inadequately studied to demonstrate their prognostic value. Category 1 prognostic factors, such as prostate-specific antigen levels, TNM stage, Gleason grading, and the status of surgical margins, enjoy wide application. Category 2 factors are not used IN clinical practice so extensively. The value of some Category 3 factors (the biomarkers p53, Ki-67, Bcl-2, receptors of androgens is indubitably and they claim to be widely applied in clinical practice with time. The clinical significance of molecular biological markers calls for further investigation.

  1. Lung neuroendocrine tumours: deep sequencing of the four World Health Organization histotypes reveals chromatin-remodelling genes as major players and a prognostic role for TERT, RB1, MEN1 and KMT2D.

    Science.gov (United States)

    Simbolo, Michele; Mafficini, Andrea; Sikora, Katarzyna O; Fassan, Matteo; Barbi, Stefano; Corbo, Vincenzo; Mastracci, Luca; Rusev, Borislav; Grillo, Federica; Vicentini, Caterina; Ferrara, Roberto; Pilotto, Sara; Davini, Federico; Pelosi, Giuseppe; Lawlor, Rita T; Chilosi, Marco; Tortora, Giampaolo; Bria, Emilio; Fontanini, Gabriella; Volante, Marco; Scarpa, Aldo

    2017-03-01

    Next-generation sequencing (NGS) was applied to 148 lung neuroendocrine tumours (LNETs) comprising the four World Health Organization classification categories: 53 typical carcinoid (TCs), 35 atypical carcinoid (ACs), 27 large-cell neuroendocrine carcinomas, and 33 small-cell lung carcinomas. A discovery screen was conducted on 46 samples by the use of whole-exome sequencing and high-coverage targeted sequencing of 418 genes. Eighty-eight recurrently mutated genes from both the discovery screen and current literature were verified in the 46 cases of the discovery screen, and validated on additional 102 LNETs by targeted NGS; their prevalence was then evaluated on the whole series. Thirteen of these 88 genes were also evaluated for copy number alterations (CNAs). Carcinoids and carcinomas shared most of the altered genes but with different prevalence rates. When mutations and copy number changes were combined, MEN1 alterations were almost exclusive to carcinoids, whereas alterations of TP53 and RB1 cell cycle regulation genes and PI3K/AKT/mTOR pathway genes were significantly enriched in carcinomas. Conversely, mutations in chromatin-remodelling genes, including those encoding histone modifiers and members of SWI-SNF complexes, were found at similar rates in carcinoids (45.5%) and carcinomas (55.0%), suggesting a major role in LNET pathogenesis. One AC and one TC showed a hypermutated profile associated with a POLQ damaging mutation. There were fewer CNAs in carcinoids than in carcinomas; however ACs showed a hybrid pattern, whereby gains of TERT, SDHA, RICTOR, PIK3CA, MYCL and SRC were found at rates similar to those in carcinomas, whereas the MEN1 loss rate mirrored that of TCs. Multivariate survival analysis revealed RB1 mutation (p = 0.0005) and TERT copy gain (p = 0.016) as independent predictors of poorer prognosis. MEN1 mutation was associated with poor prognosis in AC (p = 0.0045), whereas KMT2D mutation correlated with longer survival in SCLC

  2. [Prognostic factors in resuscitation].

    Science.gov (United States)

    Bahloul, F; Le Gall, J R; Loirat, P; Alperovitch, A; Patois, E

    1988-10-08

    The outcome from intensive care is known to be influenced by such factors as age, previous health status, severity of the disease and diagnosis. In order to assess the influence of each individual factor, 3,687 patients from 38 French intensive care units were studied. For each patient were recorded: age, simplified acute physiological score (SAPS), previous health status, diagnosis, type of intensive care unit (medicine, scheduled or elective surgery) and immediate outcome. Each of these factors was found to influence the immediate survival rate. A multivariate analysis ranked the factors in the following order: SAPS, age, type of intensive care unit and previous health status. Diagnosis played a role in the prognosis since with a 10-15 points SAPS mortality was nil for drug overdose, 12 per cent for chronic obstructive pulmonary disease and 38 per cent for cardiogenic shock. However, a single diagnosis was made in only 37 per cent of the patients, as against 3 diagnoses in 17 per cent and 4 diagnoses or more in 7 per cent. When the type of intensive care unit was considered, the mean death rate was 20 per cent in medicine, 27 per cent in scheduled surgery and 5 per cent in elective surgery (P less than 0.001). Since this study showed a definite influence of each of the four factors on immediate survival, intensive care patients can be described and classified according to this system. However, it must be stressed that individual prognoses are extremely vague.

  3. Modelling spatial distribution of snails transmitting parasitic worms with importance to human and animal health and analysis of distributional changes in relation to climate

    Directory of Open Access Journals (Sweden)

    Ulrik B. Pedersen

    2014-05-01

    Full Text Available The environment, the on-going global climate change and the ecology of animal species determine the localisation of habitats and the geographical distribution of the various species in nature. The aim of this study was to explore the effects of such changes on snail species not only of interest to naturalists but also of importance to human and animal health. The spatial distribution of freshwater snail intermediate hosts involved in the transmission of schistosomiasis, fascioliasis and paramphistomiasis (i.e. Bulinus globosus, Biomphalaria pfeifferi and Lymnaea natalensis were modelled by the use of a maximum entropy algorithm (Maxent. Two snail observation datasets from Zimbabwe, from 1988 and 2012, were com- pared in terms of geospatial distribution and potential distributional change over this 24-year period investigated. Climate data, from the two years were identified and used in a species distribution modelling framework to produce maps of pre- dicted suitable snail habitats. Having both climate- and snail observation data spaced 24 years in time represent a unique opportunity to evaluate biological response of snails to changes in climate variables. The study shows that snail habitat suit- ability is highly variable in Zimbabwe with foci mainly in the central Highveld but also in areas to the South and West. It is further demonstrated that the spatial distribution of suitable habitats changes with variation in the climatic conditions, and that this parallels that of the predicted climate change.

  4. Development and Validation of a Lifecycle-based Prognostics Architecture with Test Bed Validation

    Energy Technology Data Exchange (ETDEWEB)

    Hines, J. Wesley [Univ. of Tennessee, Knoxville, TN (United States); Upadhyaya, Belle [Univ. of Tennessee, Knoxville, TN (United States); Sharp, Michael [Univ. of Tennessee, Knoxville, TN (United States); Ramuhalli, Pradeep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jeffries, Brien [Univ. of Tennessee, Knoxville, TN (United States); Nam, Alan [Univ. of Tennessee, Knoxville, TN (United States); Strong, Eric [Univ. of Tennessee, Knoxville, TN (United States); Tong, Matthew [Univ. of Tennessee, Knoxville, TN (United States); Welz, Zachary [Univ. of Tennessee, Knoxville, TN (United States); Barbieri, Federico [Univ. of Tennessee, Knoxville, TN (United States); Langford, Seth [Univ. of Tennessee, Knoxville, TN (United States); Meinweiser, Gregory [Univ. of Tennessee, Knoxville, TN (United States); Weeks, Matthew [Univ. of Tennessee, Knoxville, TN (United States)

    2014-11-06

    On-line monitoring and tracking of nuclear plant system and component degradation is being investigated as a method for improving the safety, reliability, and maintainability of aging nuclear power plants. Accurate prediction of the current degradation state of system components and structures is important for accurate estimates of their remaining useful life (RUL). The correct quantification and propagation of both the measurement uncertainty and model uncertainty is necessary for quantifying the uncertainty of the RUL prediction. This research project developed and validated methods to perform RUL estimation throughout the lifecycle of plant components. Prognostic methods should seamlessly operate from beginning of component life (BOL) to end of component life (EOL). We term this "Lifecycle Prognostics." When a component is put into use, the only information available may be past failure times of similar components used in similar conditions, and the predicted failure distribution can be estimated with reliability methods such as Weibull Analysis (Type I Prognostics). As the component operates, it begins to degrade and consume its available life. This life consumption may be a function of system stresses, and the failure distribution should be updated to account for the system operational stress levels (Type II Prognostics). When degradation becomes apparent, this information can be used to again improve the RUL estimate (Type III Prognostics). This research focused on developing prognostics algorithms for the three types of prognostics, developing uncertainty quantification methods for each of the algorithms, and, most importantly, developing a framework using Bayesian methods to transition between prognostic model types and update failure distribution estimates as new information becomes available. The developed methods were then validated on a range of accelerated degradation test beds. The ultimate goal of prognostics is to provide an accurate assessment for

  5. Declining rates of health problems associated with crack smoking during the expansion of crack pipe distribution in Vancouver, Canada.

    Science.gov (United States)

    Prangnell, Amy; Dong, Huiru; Daly, Patricia; Milloy, M J; Kerr, Thomas; Hayashi, Kanna

    2017-02-03

    Crack cocaine smoking is associated with an array of negative health consequences, including cuts and burns from unsafe pipes, and infectious diseases such as HIV. Despite the well-established and researched harm reduction programs for injection drug users, little is known regarding the potential for harm reduction programs targeting crack smoking to reduce health problems from crack smoking. In the wake of recent crack pipe distribution services expansion, we utilized data from long running cohort studies to estimate the impact of crack pipe distribution services on the rates of health problems associated with crack smoking in Vancouver, Canada. Data were derived from two prospective cohort studies of community-recruited people who inject drugs in Vancouver between December 2005 and November 2014. We employed multivariable generalized estimating equations to examine the relationship between crack pipe acquisition sources and self-reported health problems associated with crack smoking (e.g., cut fingers/sores, coughing blood) among people reported smoking crack. Among 1718 eligible participants, proportions of those obtaining crack pipes only through health service points have significantly increased from 7.2% in 2005 to 62.3% in 2014 (p pipes only through other sources (e.g., on the street, self-made), those acquiring pipes through health service points only were significantly less likely to report health problems from smoking crack (adjusted odds ratio: 0.82; 95% confidence interval: 0.73-0.93). These findings suggest that the expansion of crack pipe distribution services has likely served to reduce health problems from smoking crack in this setting. They provide evidence supporting crack pipe distribution programs as a harm reduction service for crack smokers.

  6. Congener specific distribution and health risk assessment of polychlorinated biphenyls in urban soils

    Directory of Open Access Journals (Sweden)

    Bhupander Kumar

    2012-10-01

    Full Text Available Polychlorinated biphenyls (PCBs were primarily used in transformers and capacitors, lubricants, flame retardants, plasticizers, paint, carbonless papers, etc. These are capable of long-range atmospheric transport and have been designated as persistent organic pollutants by the Stockholm Convention. Due to their characteristic properties, PCBs are found worldwide in all environmental matrices (including human and biota. Soils are usually considered to be the source as well as sink for environmental pollutants, with cumulative effects of long-range atmospheric transport and local sources. Around the world, comparatively higher concentrations of PCBs have been reported in urban soils than suburban or rural soils. Higher amount of PCBs in urban soils may cause toxicological health risks to urban residents through ingestion, inhalation and skin contact. This paper presents the PCB distribution in soils from Delhi, India, and exposure risk estimates for human health through soil ingestion. The concentration of ΣPCBs ranged between 1.08-100.67 ng g–1 (mean 21.16 ng g–1±5.24 ng g–1, which was much lower than the Canadian soil quality guideline value of 1.3 mg/kg or 1300 ng g–1. Human health risk estimates through the soil ingestion pathway were made in terms of lifetime average daily dose (LADD, incremental lifetime cancer risks and non-carcinogenic hazard quotient (HQ. The LADD for Delhi adults and children was 3.02x10–8 mg kg–1 d–1 and 1.57x10–7 mg kg–1 d–1, respectively, which corresponds to toxic equivalent quotients (TEQ intake of 0.105 pg TEQ kg–1 d–1 (0.735 pg TEQ kg–1 week–1 and 0.543 pg TEQ kg–1 d–1 (3.801 pg TEQ kg–1 week–1, respectively. The estimated LADD for Delhi residents was lower than the acceptable

  7. [Prevalence and geographic distribution of cancer in the health area of Guadalajara].

    Science.gov (United States)

    Alonso Gordo, José M; Jiménez del Val, Dolores; Palacios Rojo, Juan José; Royo Sánchez, Carlos; Urbina Torija, Juan Román; Santiago González, Catalina; Bárcena Marugán, Aurora

    2004-01-01

    The total cancer prevalence falls within the range of 2%-3% of the population. Some data suggests differences in terms of whether the environment is urban or rural, other geographical factors and in the area surrounding nuclear power plants. This study is aimed at ascertaining said prevalences and the distribution thereof in the different geographical areas of the Guadalajara Healthcare District. Point prevalence study in 1999 based on a systematic review of cases at primary and secondary sources in the Guadalajara Health District, including invasive malignant tumors among individuals over age 14. The overall and specific distribution in terms of the place of residence, region and proximity to nuclear power plants is analyzed, raw and adjusted prevalences/100,000 inhabitants and CI 95% prevalence index. A total of 2,717 cases were detected (raw prevalence: 2034.6/10(5)), there being a 50%-50% ratio between the urban and rural environments. The adjusted prevalence (worldwide population) is 1295.2/10(5), being greater in the urban environment (1479.9/10(5)) than in the rural environment (1136.3/10(5)). With regard to the geographic regions, solely thyroid cancer is more prevalent among women in the most depressed, mountainous areas, although involving a low-level casuistic. The cancer prevalences found are similar to those published and, following an age-based adjustment, are greater in the urban than in the rural environment. The differences among regions are related to the demographic and geographical characteristics and to the environment being urban.

  8. Bayesian distributed lag interaction models to identify perinatal windows of vulnerability in children's health.

    Science.gov (United States)

    Wilson, Ander; Chiu, Yueh-Hsiu Mathilda; Hsu, Hsiao-Hsien Leon; Wright, Robert O; Wright, Rosalind J; Coull, Brent A

    2017-07-01

    Epidemiological research supports an association between maternal exposure to air pollution during pregnancy and adverse children's health outcomes. Advances in exposure assessment and statistics allow for estimation of both critical windows of vulnerability and exposure effect heterogeneity. Simultaneous estimation of windows of vulnerability and effect heterogeneity can be accomplished by fitting a distributed lag model (DLM) stratified by subgroup. However, this can provide an incomplete picture of how effects vary across subgroups because it does not allow for subgroups to have the same window but different within-window effects or to have different windows but the same within-window effect. Because the timing of some developmental processes are common across subpopulations of infants while for others the timing differs across subgroups, both scenarios are important to consider when evaluating health risks of prenatal exposures. We propose a new approach that partitions the DLM into a constrained functional predictor that estimates windows of vulnerability and a scalar effect representing the within-window effect directly. The proposed method allows for heterogeneity in only the window, only the within-window effect, or both. In a simulation study we show that a model assuming a shared component across groups results in lower bias and mean squared error for the estimated windows and effects when that component is in fact constant across groups. We apply the proposed method to estimate windows of vulnerability in the association between prenatal exposures to fine particulate matter and each of birth weight and asthma incidence, and estimate how these associations vary by sex and maternal obesity status in a Boston-area prospective pre-birth cohort study. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Distributed multisensor processing, decision making, and control under constrained resources for remote health and environmental monitoring

    Science.gov (United States)

    Talukder, Ashit; Sheikh, Tanwir; Chandramouli, Lavanya

    2004-04-01

    Previous field-deployable distributed sensing systems for health/biomedical applications and environmental sensing have been designed for data collection and data transmission at pre-set intervals, rather than for on-board processing These previous sensing systems lack autonomous capabilities, and have limited lifespans. We propose the use of an integrated machine learning architecture, with automated planning-scheduling and resource management capabilities that can be used for a variety of autonomous sensing applications with very limited computing, power, and bandwidth resources. We lay out general solutions for efficient processing in a multi-tiered (three-tier) machine learning framework that is suited for remote, mobile sensing systems. Novel dimensionality reduction techniques that are designed for classification are used to compress each individual sensor data and pass only relevant information to the mobile multisensor fusion module (second-tier). Statistical classifiers that are capable of handling missing/partial sensory data due to sensor failure or power loss are used to detect critical events and pass the information to the third tier (central server) for manual analysis and/or analysis by advanced pattern recognition techniques. Genetic optimisation algorithms are used to control the system in the presence of dynamic events, and also ensure that system requirements (i.e. minimum life of the system) are met. This tight integration of control optimisation and machine learning algorithms results in a highly efficient sensor network with intelligent decision making capabilities. The applicability of our technology in remote health monitoring and environmental monitoring is shown. Other uses of our solution are also discussed.

  10. A Physics-Based Modeling Framework for Prognostic Studies

    Science.gov (United States)

    Kulkarni, Chetan S.

    2014-01-01

    Prognostics and Health Management (PHM) methodologies have emerged as one of the key enablers for achieving efficient system level maintenance as part of a busy operations schedule, and lowering overall life cycle costs. PHM is also emerging as a high-priority issue in critical applications, where the focus is on conducting fundamental research in the field of integrated systems health management. The term diagnostics relates to the ability to detect and isolate faults or failures in a system. Prognostics on the other hand is the process of predicting health condition and remaining useful life based on current state, previous conditions and future operating conditions. PHM methods combine sensing, data collection, interpretation of environmental, operational, and performance related parameters to indicate systems health under its actual application conditions. The development of prognostics methodologies for the electronics field has become more important as more electrical systems are being used to replace traditional systems in several applications in the aeronautics, maritime, and automotive fields. The development of prognostics methods for electronics presents several challenges due to the great variety of components used in a system, a continuous development of new electronics technologies, and a general lack of understanding of how electronics fail. Similarly with electric unmanned aerial vehicles, electrichybrid cars, and commercial passenger aircraft, we are witnessing a drastic increase in the usage of batteries to power vehicles. However, for battery-powered vehicles to operate at maximum efficiency and reliability, it becomes crucial to both monitor battery health and performance and to predict end of discharge (EOD) and end of useful life (EOL) events. We develop an electrochemistry-based model of Li-ion batteries that capture the significant electrochemical processes, are computationally efficient, capture the effects of aging, and are of suitable

  11. Prognostic Accuracy of Electroencephalograms in Preterm Infants

    DEFF Research Database (Denmark)

    Fogtmann, Emilie Pi; Plomgaard, Anne Mette; Greisen, Gorm;

    2017-01-01

    (267 infants). Any aEEG background abnormality was a predictor of abnormal outcome. For prediction of a developmental quotient ...CONTEXT: Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant. OBJECTIVE: To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants...... for predicting neurodevelopmental outcome. DATA SOURCES: The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported...

  12. The Yin: An adverse health perspective of nanoceria: uptake, distribution, accumulation, and mechanisms of its toxicity.

    Science.gov (United States)

    Yokel, Robert A; Hussain, Salik; Garantziotis, Stavros; Demokritou, Philip; Castranova, Vincent; Cassee, Flemming R

    2014-10-01

    This critical review evolved from a SNO Special Workshop on Nanoceria panel presentation addressing the toxicological risks of nanoceria: accumulation, target organs, and issues of clearance; how exposure dose/concentration, exposure route, and experimental preparation/model influence the different reported effects of nanoceria; and how can safer by design concepts be applied to nanoceria? It focuses on the most relevant routes of human nanoceria exposure and uptake, disposition, persistence, and resultant adverse effects. The pulmonary, oral, dermal, and topical ocular exposure routes are addressed as well as the intravenous route, as the latter provides a reference for the pharmacokinetic fate of nanoceria once introduced into blood. Nanoceria reaching the blood is primarily distributed to mononuclear phagocytic system organs. Available data suggest nanoceria's distribution is not greatly affected by dose, shape, or dosing schedule. Significant attention has been paid to the inhalation exposure route. Nanoceria distribution from the lung to the rest of the body is less than 1% of the deposited dose, and from the gastrointestinal tract even less. Intracellular nanoceria and organ burdens persist for at least months, suggesting very slow clearance rates. The acute toxicity of nanoceria is very low. However, large/accumulated doses produce granuloma in the lung and liver, and fibrosis in the lung. Toxicity, including genotoxicity, increases with exposure time; the effects disappear slowly, possibly due to nanoceria's biopersistence. Nanoceria may exert toxicity through oxidative stress. Adverse effects seen at sites distal to exposure may be due to nanoceria translocation or released biomolecules. An example is elevated oxidative stress indicators in the brain, in the absence of appreciable brain nanoceria. Nanoceria may change its nature in biological environments and cause changes in biological molecules. Increased toxicity has been related to greater surface Ce(3

  13. Geographic distribution of need and access to health care in rural population: an ecological study in Iran

    Directory of Open Access Journals (Sweden)

    Najafi Behzad

    2011-09-01

    Full Text Available Abstract Introduction Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The current study aimed to evaluate the distribution of need and access to health care services among Iran's rural population between 2006 and 2009. Methods Census data on population's characteristics in each province were obtained from the Statistical Centre of Iran and National Organization for civil registration. Data about the Rural Health Houses (RHHs were obtained from the Ministry of Health. The Health Houses-to-rural population ratio (RHP, crude birth rate (CBR and crude mortality rate (CMR in rural population were calculated in order to compare their distribution among the provinces. Lorenz curves of RHHs, CMR and CBR were plotted and their decile ratio, Gini Index and Index of Dissimilarity were calculated. Moreover, Spearman rank-order correlation was used to examine the relation between RHHs and CMR and CBR. Results There were substantial differences in RHHs, CMR and CBR across the provinces. CMR and CBR experienced changes toward more equal distributions between 2006 and 2009, while inverse trend was seen for RHHs. Excluding three provinces with markedly changes in data between 2006 and 2009 as outliers, did not change observed trends. Moreover; there was a significant positive relationship between CMR and RHP in 2009 and a significant negative association between CBR and RHP in 2006 and 2009. When three provinces with outliers were excluded, these significant associations were disappeared. Conclusion Results showed that there were significant variations in the distribution of RHHs, CMR and CBR across the country. Moreover, the distribution of RHHs did not reflect the needs for health care in terms of CMR and CBR in the study period.

  14. DISTRIBUTED OPTICAL FIBER SENSOR FOR LONG-DISTANCE OIL PIPELINE HEALTH

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    A fully distributed optical fiber sensor (DOFS) for monitoring long-distance oil pipeline health is proposed based on optical time domain reflectometry (OTDR). A smart and sensitive optical fiber cable is installed along the pipeline acting as a sensor. The experiments show that the cable swells when exposed to oil and induced additional bending losses inside the fiber, and the optical attenuation of the fiber coated by a thin skin with periodical hardness is sensitive to deformation and vibration caused by oil leakage, tampering,or mechanical impact. The region where the additional attenuation occurred is detected and located by DOFS based on OTDR, the types of pipeline accidents are identified according to the characteristics of transmitted optical power received by an optical power meter. Another prototype of DOFS based on a forward traveling frequency-modulated continuous-wave (FMCW) is also proposed to monitor pipeline. The advantages and disadvantages of DOFSs based on OTDR and FMCW are discussed. The experiments show that DOFSs are capable of detecting and locating distant oil pipeline leakages and damages in real time with an estimated precision of ten meters over tens of kilometers.

  15. Geographical distribution, accumulation kinetics and infants health risk of organochlorines in human breast milk from Indonesia

    Energy Technology Data Exchange (ETDEWEB)

    Sudaryanto, A.; Kunisue, T.; Iwata, H. [Center for Marine Environmental Studies, Ehime Univ., Matsuyama (Japan); Tanabe, S. [Agency for the Assessment and Application of Technology, Jakarta (Indonesia)

    2004-09-15

    Worldwide production and use of organochlorine compounds (OCs) have led to their widespread occurrence in the environment and bioaccumulation in various organisms, including humans. In Indonesia, large usage and production of OCs in the past, particularly OCs pesticides for agricultural and vector-borne disease eradication programs may implicate contaminations of OCs in the environment. Previous studies dealing with mussels as bioindicator reported widespread occurrence of OCs in the coastal environment of this country, and found hot spots of contamination in the waters surroundings Java Island. Occurrence of OCs were also reported in various environmental compartments including fish, sediment and air. However, data on levels of OCs in humans are very scarce. Hence this study has highlighted the accumulation of OCs in human milk from Indonesia, particularly in Java Island where industrial and intensive agriculture are taking place. In this study, concentrations of classical OCs, such as polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethanes and its metabolites (DDTs), hexachlorocyclohexane isomers (HCHs), chlordane compounds (CHLs), hexachlorobenzene (HCB), and the most recently identified microcontaminants, tris (4-chlorophenyl) methanol (TCPMOH) and tris (4-chlorophenyl) methane (TCPMe) were determined in human breast milk collected from several locations in Indonesia to elucidate their distribution in relation to their site activities, to assess their possible association with maternal characteristics and to evaluate the possible potential risk of OCs in breast-milk on infant's health.

  16. Privacy protection in HealthGrid: distributing encryption management over the VO.

    Science.gov (United States)

    Torres, Erik; de Alfonso, Carlos; Blanquer, Ignacio; Hernández, Vicente

    2006-01-01

    Grid technologies have proven to be very successful in tackling challenging problems in which data access and processing is a bottleneck. Notwithstanding the benefits that Grid technologies could have in Health applications, privacy leakages of current DataGrid technologies due to the sharing of data in VOs and the use of remote resources, compromise its widespreading. Privacy control for Grid technology has become a key requirement for the adoption of Grids in the Healthcare sector. Encrypted storage of confidential data effectively reduces the risk of disclosure. A self-enforcing scheme for encrypted data storage can be achieved by combining Grid security systems with distributed key management and classical cryptography techniques. Virtual Organizations, as the main unit of user management in Grid, can provide a way to organize key sharing, access control lists and secure encryption management. This paper provides programming models and discusses the value, costs and behavior of such a system implemented on top of one of the latest Grid middlewares. This work is partially funded by the Spanish Ministry of Science and Technology in the frame of the project Investigación y Desarrollo de Servicios GRID: Aplicación a Modelos Cliente-Servidor, Colaborativos y de Alta Productividad, with reference TIC2003-01318.

  17. Tumor Microenvironment Gene Signature as a Prognostic Classifier and Therapeutic Target

    Science.gov (United States)

    2016-06-01

    AWARD NUMBER: W81XWH-14-1-0107 TITLE: Tumor Microenvironment Gene Signature as a Prognostic Classifier and Therapeutic Target PRINCIPAL...AND SUBTITLE Tumor Microenvironment Gene Signature as a 5a. CONTRACT NUMBER W81XWH-14-1-0107 Prognostic Classifier and Therapeutic Target 5b...Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT We identified a tumor microenvironment -based activated fibroblast

  18. Data-Driven Lead-Acid Battery Prognostics Using Random Survival Forests

    Science.gov (United States)

    2014-10-02

    Data-Driven Lead-Acid Battery Prognostics Using Random Survival Forests Erik Frisk1, Mattias Krysander2, and Emil Larsson3 1,2,3 Department of...driven approach using random survival forests is proposed where the prognostic algorithm has access to fleet manage- ment data including 291 variables...but it is also used to, for example, power auxiliary units such as heating and kitchen Erik Frisk et al. This is an open-access article distributed

  19. Classical distributive justice and the European healthcare system: rethinking the foundations of European health care in an age of crises.

    Science.gov (United States)

    Bauzon, Stéphane

    2015-04-01

    The state subvention and distribution of health care not only jeopardize the financial sustainability of the state, but also restrict without a conclusive rational basis the freedom of patients to decide how much health care and of what quality is worth what price. The dominant biopolitics of European health care supports a healthcare monopoly in the hands of the state and the medical profession, which health care should be (re)opened to the patient's authority to deal directly for better basic health care. In a world where it is impossible for all to receive equal access to the best of basic health care, one must critically examine the plausible scope of the authority of the state to limit access to better basic health care. Classical distributive justice affords a basis for re-examining the current European ideology of equality, human dignity, and solidarity that supports healthcare systems with unsustainable egalitarian concerns. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J

    2014-01-01

    OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We...... stratification of ulcerated lesions. METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. RESULTS: The presence...... of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal...

  1. Analytic prognostic for petrochemical pipelines

    CERN Document Server

    Jaoude, Abdo Abou; El-Tawil, Khaled; Noura, Hassan; Ouladsine, Mustapha

    2012-01-01

    Pipelines tubes are part of vital mechanical systems largely used in petrochemical industries. They serve to transport natural gases or liquids. They are cylindrical tubes and are submitted to the risks of corrosion due to high PH concentrations of the transported liquids in addition to fatigue cracks due to the alternation of pressure-depression of gas along the time, initiating therefore in the tubes body micro-cracks that can propagate abruptly to lead to failure. The development of the prognostic process for such systems increases largely their performance and their availability, as well decreases the global cost of their missions. Therefore, this paper deals with a new prognostic approach to improve the performance of these pipelines. Only the first mode of crack, that is, the opening mode, is considered.

  2. Structural health monitoring of an existing PC box girder bridge with distributed HCFRP sensors in a destructive test

    Science.gov (United States)

    Yang, Caiqian; Wu, Zhishen; Zhang, Yufeng

    2008-06-01

    The application of hybrid carbon fiber reinforced polymer (HCFRP) sensors was addressed to monitor the structural health of an existing prestressed concrete (PC) box girder bridge in a destructive test. The novel HCFRP sensors were fabricated with three types of carbon tows in order to realize distributed and broad-based sensing, which is characterized by long-gauge length and low cost. The HCFRP sensors were bonded on the bottom and side surfaces of the existing bridge to monitor its structural health. The gauge lengths of the sensors bonded on the bottom and side surfaces were 1.5 m and 1.0 m, respectively. The HCFRP sensors were distributed on the bridge for two purposes. One was to detect damage and monitor the structural health of the bridge, such as the initiation and propagation of new cracks, strain distribution and yielding of steel reinforcements. The other purpose was to monitor the propagation of existing cracks. The good relationship between the change in electrical resistance and load indicates that the HCFRP sensors can provide actual infrastructures with a distributed damage detection and structural health monitoring system. Corrections were made to this article on 13 May 2008. The corrected electronic version is identical to the print version.

  3. Distribution of Effort-Reward Imbalance in Denmark and Its Prospective Association With a Decline in Self-Rated Health

    NARCIS (Netherlands)

    Rugulies, Reiner; Aust, Birgit; Siegrist, Johannes; von dem Knesebeck, Olaf; Bultmann, Ute; Bjorner, Jakob B.; Burr, Hermann

    2009-01-01

    Objective: To analyze the distribution of effort-reward imbalance (ERI) and to investigate its impact on self-rated health in a representative sample of the Danish workforce. Methods: We studied 4977 employees who responded to a questionnaire in 2000, of which 3470 responded to a follow-up survey in

  4. Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa.

    Science.gov (United States)

    Macha, Jane; Harris, Bronwyn; Garshong, Bertha; Ataguba, John E; Akazili, James; Kuwawenaruwa, August; Borghi, Josephine

    2012-03-01

    In Ghana, Tanzania and South Africa, health care financing is progressive overall. However, out-of-pocket payments and health insurance for the informal sector are regressive. The distribution of health care benefits is generally pro-rich. This paper explores the factors influencing these distributions in the three countries. Qualitative data were collected through focus group discussions and in-depth interviews with insurance scheme members, the uninsured, health care providers and managers. Household surveys were also conducted in all countries. Flat-rate contributions contributed to the regressivity of informal sector voluntary schemes, either by design (in Tanzania) or due to difficulties in identifying household income levels (in Ghana). In all three countries, the regressivity of out-of-pocket payments is due to the incomplete enforcement of exemption and waiver policies, partial or no insurance cover among poorer segments of the population and limited understanding of entitlements among these groups. Generally, the pro-rich distribution of benefits is due to limited access to higher level facilities among poor and rural populations, who rely on public primary care facilities and private pharmacies. Barriers to accessing health care include medical and transport costs, exacerbated by the lack of comprehensive insurance coverage among poorer groups. Service availability problems, including frequent drug stock-outs, limited or no diagnostic equipment, unpredictable opening hours and insufficient skilled staff also limit service access. Poor staff attitudes and lack of confidence in the skills of health workers were found to be important barriers to access. Financing reforms should therefore not only consider how to generate funds for health care, but also explicitly address the full range of affordability, availability and acceptability barriers to access in order to achieve equitable financing and benefit incidence patterns.

  5. Gear Fatigue Diagnostics and Prognostics

    Science.gov (United States)

    2013-01-01

    The first objective was to collect meaningful gear fault progression data starting from healthy NASA-designed spur test gears and ending with failed...and D. P. Townsend, "Analysis of the effects of surface pitting and wear on the vibration of a gear transmission system," Tribology International...Reporting Period: April 15, 2012 to September 27, 2012 Attached is the Gear Fatigue Diagnostics and Prognostics project progress report for the

  6. Uncertainty Representation and Interpretation in Model-based Prognostics Algorithms based on Kalman Filter Estimation

    Science.gov (United States)

    2012-09-01

    different decisions as com- pared to an unmanned aerial vehicle (UAV) mission reconfig- uration based on prognostics indication on power train fail- ures...Degradation Modeling Training Trajectories Test Trajectory Parameter Estimation State-space Representation Prognostics Dynamic System Realization Health...and ASME. Kai Goebel received the degree of Diplom-Ingenieur from the Technische University Munchen, Germany in 1990. He received the M.S. and Ph.D

  7. Social deprivation and exposure to health promotion. A study of the distribution of health promotion resources to schools in England

    Directory of Open Access Journals (Sweden)

    Reidpath Daniel D

    2010-08-01

    Full Text Available Abstract Background Area deprivation is a known determinant of health. It is also known that area deprivation is associated with lower impact health promotion. It is less well known, however, whether deprived areas are less responsive to health promotion, or whether they are less exposed. Using data from a national, school-based campaign to promote vaccination against the human papilloma virus (HPV, the relationship between area deprivation and exposure was examined. Methods Taking advantage of a health promotion campaign to provide information to schools about HPV vaccination, a cross sectional study was conducted to examine the relationship between area level, social deprivation, and take-up of (i.e., exposure to available health promotion material. The sample was 4,750 schools across England, including government maintained and independent schools. The relationship between area deprivation and exposure was examined using bi- and multivariate logistic regression. Results It was found that schools in the least deprived quintile had 1.32 times the odds of requesting health promotion materials than schools in the most deprived areas (p = .01. This effect was independent of the school size, the type of school, and the geographic region. Conclusion The relationship between area deprivation and the impact of health promotion may be due, at least in part, to differential levels of exposure. The study was limited in scope, pointing to the need for more research, but also points to potentially important policy implications.

  8. Resource distribution in mental health services: changes in geographic location and use of personnel in Norwegian mental health services 1979-1994.

    Science.gov (United States)

    Pedersen, Per Bernhard; Lilleeng, Solfrid

    2000-03-01

    BACKGROUND: During the last decades, a central aim of Norwegian health policy has been to achieve a more equal geographical distribution of services. Of special interest is the 1980 financial reform. Central government reimbursements for the treatment of in-patients were replaced by a block grant to each county, based on indicators of relative "need". AIMS OF THE STUDY: The aim of this paper is to assess whether the distribution of specialized mental health services did take the course suggested by the proponents of the reform (i.e. a more equal distribution), or the opposite (i.e. a more unequal distribution) as claimed by the opponents. METHODS: Man year per capita ratios were used as indicators for the distribution of mental health services by county. Ratios were estimated for "all personnel", and for MDs and psychologists separately. Man years were assigned to counties by location of services (i.e. in which county the services were produced), and by residence of users (i.e. in which county the services were consumed). Indicators of geographic variation were estimated using the standard deviation (STD) as a measure of absolute variation, and the coefficient of variation (CV) and the Gini index as indicators of relative variation. Indicators were estimated for 1979, 1984, 1989 and 1994, based on data for all specialized adult mental health services in the country. Changes in distributions over the period were tested, using Levene's test of homogeneity. RESULTS: Relative variations in the distribution of personnel by location of services were substantially reduced over the period, the CV being reduced by more than 50% for all groups. Variations in the personnel ratios by residence of users were smaller at the start of the period, and the reductions were also smaller. Still, relative variations were reduced by 20-35, 40 and 60% approximately for "all personnel", MDs and psychologists respectively. In spite of a major increase in the supply of MDs and psychologists

  9. Employment precariousness in Spain: prevalence, social distribution, and population-attributable risk percent of poor mental health.

    Science.gov (United States)

    Vives, Alejandra; Vanroelen, Christophe; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Caries; Benavides, Fernando G; Benach, Joan

    2011-01-01

    As a consequence of labor market flexibilization, nonstandard employment has expanded and standard employment has declined. In many cases, these transformations are best described as an evolution toward precarious employment, which is considered a major determinant of health and health inequalities. Using the Employment Precariousness Scale (EPRES), this study aims to determine the prevalence of precarious employment in the waged and salaried workforce in Spain, to describe its distribution across social groups defined by occupational class, gender, age, and immigrant status, and to estimate the proportion of cases of poor mental health potentially attributable to employment precariousness. Data are from the Psychosocial Work Environment Survey conducted in 2004-5 on a representative sample of the Spanish workforce. Findings indicate a high prevalence of employment precariousness, affecting nearly 6.5 million workers, with almost 900,000 of them exposed to high precariousness. These estimates are higher than the proportion of fixed-term employment reported in regular statistical sources but may today be an underestimation, given the current economic crisis. Additionally, a significant proportion of cases of poor mental health are potentially attributable to employment precariousness. Both the proportion of cases of poor mental health attributable to and the prevalence of employment precariousness were highly unequally distributed across the study sample, indicating that this may be a significant contributor to social inequalities in mental health.

  10. Occurrence, distribution, and dechlorination of polychlorinated biphenyls and health risk assessment in Selangor River basin.

    Science.gov (United States)

    Sakai, Nobumitsu; Dayana, Emmy; Abu Bakar, Azizi; Yoneda, Minoru; Nik Sulaiman, Nik Meriam; Ali Mohd, Mustafa

    2016-10-01

    Polychlorinated biphenyls (PCBs) were monitored in surface water collected in the Selangor River basin, Malaysia, to identify the occurrence, distribution, and dechlorination process as well as to assess the potential adverse effects to the Malaysian population. Ten PCB homologs (i.e., mono-CBs to deca-CBs) were quantitated by using gas chromatography-mass spectrometry (GC/MS). The total concentration of PCBs in the 10 sampling sites ranged from limit of detection to 7.67 ng L(-1). The higher chlorinated biphenyls (tetra-CBs to deca-CBs) were almost not detected in most of the sampling sites, whereas lower chlorinated biphenyls (mono-CBs, di-CBs, and tri-CBs) dominated more than 90 % of the 10 homologs in all the sampling sites. Therefore, the PCB load was estimated to be negligible during the sampling period because PCBs have an extremely long half-life. The PCBs, particularly higher chlorinated biphenyls, could be thoroughly dechlorinated to mono-CBs to tri-CBs by microbial decomposition in sediment or could still be accumulated in the sediment. The lower chlorinated biphenyls, however, could be resuspended or desorbed from the sediment because they have faster desorption rates and higher solubility, compared to the higher chlorinated biphenyls. The health risk for the Malaysia population by PCB intake that was estimated from the local fish consumption (7.2 ng kg(-1) bw day(-1)) and tap water consumption (1.5 × 10(-3)-3.1 × 10(-3) ng kg(-1) bw day(-1)) based on the detected PCB levels in the surface water was considered to be minimal. The hazard quotient based on the tolerable daily intake (20 ng kg(-1) bw day(-1)) was estimated at 0.36.

  11. Equality in Distribution of Human Resources: the Case of Iran’s Ministry of Health and Medical Education

    Science.gov (United States)

    Mobaraki, H; Hassani, A; Kashkalani, T; Khalilnejad, R; Chimeh, E Ehsani

    2013-01-01

    Background: Background: Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study. Methods: We evaluated the equity of human resources’ distribution among Iran’s medical science universities between 2005 and 2009 by inequality measures including Lorenze curve, Gini coefficient and Rabin hood indexes. Results: In the distribution 60403 recruitment licenses among medical universities with 72456140 covered populations, Gini coefficient was 0.167 and Robin Hood Index 0.11. Conclusions: Calculations indicated Recruitment licenses are equitably distributed in MOH&ME of Iran. However a portion of recruitment licenses should redistributed for achieving perfect equal distribution among all public medical universities of Iran. PMID:23865035

  12. Equality in Distribution of Human Resources: the Case of Iran’s Ministry of Health and Medical Education

    Directory of Open Access Journals (Sweden)

    R Khalilnejad

    2013-01-01

    Full Text Available Background: Background: Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study.Methods: We evaluated the equity of human resources’ distribution among Iran’s medical science universities between 2005 and 2009 by inequality measures including Lorenze curve, Gini coefficient and Rabin hood indexes.Results: In the distribution 60403 recruitment licenses among medical universities with 72456140 covered populations, Gini coefficient was 0.167 and Robin Hood Index 0.11.Conclusions: Calculations indicated Recruitment licenses are equitably distributed in MOH&ME of Iran. However a portion of recruitment licenses should redistributed for achieving perfect equal distribution among all public medical universities of Iran.

  13. A New Multivariate Approach for Prognostics Based on Extreme Learning Machine and Fuzzy Clustering.

    Science.gov (United States)

    Javed, Kamran; Gouriveau, Rafael; Zerhouni, Noureddine

    2015-12-01

    Prognostics is a core process of prognostics and health management (PHM) discipline, that estimates the remaining useful life (RUL) of a degrading machinery to optimize its service delivery potential. However, machinery operates in a dynamic environment and the acquired condition monitoring data are usually noisy and subject to a high level of uncertainty/unpredictability, which complicates prognostics. The complexity further increases, when there is absence of prior knowledge about ground truth (or failure definition). For such issues, data-driven prognostics can be a valuable solution without deep understanding of system physics. This paper contributes a new data-driven prognostics approach namely, an "enhanced multivariate degradation modeling," which enables modeling degrading states of machinery without assuming a homogeneous pattern. In brief, a predictability scheme is introduced to reduce the dimensionality of the data. Following that, the proposed prognostics model is achieved by integrating two new algorithms namely, the summation wavelet-extreme learning machine and subtractive-maximum entropy fuzzy clustering to show evolution of machine degradation by simultaneous predictions and discrete state estimation. The prognostics model is equipped with a dynamic failure threshold assignment procedure to estimate RUL in a realistic manner. To validate the proposition, a case study is performed on turbofan engines data from PHM challenge 2008 (NASA), and results are compared with recent publications.

  14. Accelerated Aging in Electrolytic Capacitors for Prognostics

    Science.gov (United States)

    Celaya, Jose R.; Kulkarni, Chetan; Saha, Sankalita; Biswas, Gautam; Goebel, Kai Frank

    2012-01-01

    The focus of this work is the analysis of different degradation phenomena based on thermal overstress and electrical overstress accelerated aging systems and the use of accelerated aging techniques for prognostics algorithm development. Results on thermal overstress and electrical overstress experiments are presented. In addition, preliminary results toward the development of physics-based degradation models are presented focusing on the electrolyte evaporation failure mechanism. An empirical degradation model based on percentage capacitance loss under electrical overstress is presented and used in: (i) a Bayesian-based implementation of model-based prognostics using a discrete Kalman filter for health state estimation, and (ii) a dynamic system representation of the degradation model for forecasting and remaining useful life (RUL) estimation. A leave-one-out validation methodology is used to assess the validity of the methodology under the small sample size constrain. The results observed on the RUL estimation are consistent through the validation tests comparing relative accuracy and prediction error. It has been observed that the inaccuracy of the model to represent the change in degradation behavior observed at the end of the test data is consistent throughout the validation tests, indicating the need of a more detailed degradation model or the use of an algorithm that could estimate model parameters on-line. Based on the observed degradation process under different stress intensity with rest periods, the need for more sophisticated degradation models is further supported. The current degradation model does not represent the capacitance recovery over rest periods following an accelerated aging stress period.

  15. Metrics for Evaluating Performance of Prognostic Techniques

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is an emerging concept in condition basedmaintenance(CBM)ofcriticalsystems.Alongwith developing the fundamentals of being able to confidently predict...

  16. Simulating Degradation Data for Prognostic Algorithm Development

    Data.gov (United States)

    National Aeronautics and Space Administration — PHM08 Challenge Dataset is now publicly available at the NASA Prognostics Respository + Download INTRODUCTION - WHY SIMULATE DEGRADATION DATA? Of various challenges...

  17. Societal preferences for distributive justice in the allocation of health care resources: a latent class discrete choice experiment.

    Science.gov (United States)

    Skedgel, Chris; Wailoo, Allan; Akehurst, Ron

    2015-01-01

    Economic theory suggests that resources should be allocated in a way that produces the greatest outputs, on the grounds that maximizing output allows for a redistribution that could benefit everyone. In health care, this is known as QALY (quality-adjusted life-year) maximization. This justification for QALY maximization may not hold, though, as it is difficult to reallocate health. Therefore, the allocation of health care should be seen as a matter of distributive justice as well as efficiency. A discrete choice experiment was undertaken to test consistency with the principles of QALY maximization and to quantify the willingness to trade life-year gains for distributive justice. An empirical ethics process was used to identify attributes that appeared relevant and ethically justified: patient age, severity (decomposed into initial quality and life expectancy), final health state, duration of benefit, and distributional concerns. Only 3% of respondents maximized QALYs with every choice, but scenarios with larger aggregate QALY gains were chosen more often and a majority of respondents maximized QALYs in a majority of their choices. However, respondents also appeared willing to prioritize smaller gains to preferred groups over larger gains to less preferred groups. Marginal analyses found a statistically significant preference for younger patients and a wider distribution of gains, as well as an aversion to patients with the shortest life expectancy or a poor final health state. These results support the existence of an equity-efficiency tradeoff and suggest that well-being could be enhanced by giving priority to programs that best satisfy societal preferences. Societal preferences could be incorporated through the use of explicit equity weights, although more research is required before such weights can be used in priority setting. © The Author(s) 2014.

  18. Combining estimates of interest in prognostic modelling studies after multiple imputation: current practice and guidelines

    Directory of Open Access Journals (Sweden)

    Holder Roger L

    2009-07-01

    Full Text Available Abstract Background Multiple imputation (MI provides an effective approach to handle missing covariate data within prognostic modelling studies, as it can properly account for the missing data uncertainty. The multiply imputed datasets are each analysed using standard prognostic modelling techniques to obtain the estimates of interest. The estimates from each imputed dataset are then combined into one overall estimate and variance, incorporating both the within and between imputation variability. Rubin's rules for combining these multiply imputed estimates are based on asymptotic theory. The resulting combined estimates may be more accurate if the posterior distribution of the population parameter of interest is better approximated by the normal distribution. However, the normality assumption may not be appropriate for all the parameters of interest when analysing prognostic modelling studies, such as predicted survival probabilities and model performance measures. Methods Guidelines for combining the estimates of interest when analysing prognostic modelling studies are provided. A literature review is performed to identify current practice for combining such estimates in prognostic modelling studies. Results Methods for combining all reported estimates after MI were not well reported in the current literature. Rubin's rules without applying any transformations were the standard approach used, when any method was stated. Conclusion The proposed simple guidelines for combining estimates after MI may lead to a wider and more appropriate use of MI in future prognostic modelling studies.

  19. Updating time-to-failure distributions based on field observations and sensor data.

    Energy Technology Data Exchange (ETDEWEB)

    Lowder, Kelly S.; Briand, Daniel; Shirah, Donald

    2006-10-01

    Enterprise level logistics and prognostics and health management (PHM) modeling efforts use reliability focused failure distributions to characterize the probability of failure over the lifetime of a component. This research characterized the Sandia National Laboratories developed combined lifecycle (CMBL) distribution and explored methods for updating this distribution as systems age and new failure data becomes available. The initial results obtained in applying a Bayesian sequential updating methodology to the CMBL distribution shows promise. This research also resulted in the development of a closed-form full life cycle (CFLC) distribution similar to the CMBL distribution but with slightly different, yet commonly recognized, input parameters. Further research is warranted to provide additional theoretical validation of the distributions, complete the updating methods for the CMBL distribution, evaluate a Bayesian updating methodology for the CFLC distribution, and determine which updating methods would be most appropriate for enterprise level logistics and PHM modeling.

  20. [Prognostic factors in hantavirus infections].

    Science.gov (United States)

    Kaya, Selçuk

    2014-01-01

    The hantaviruses classified in Hantavirus genus of Bunyaviridae family, may cause two different types of clinical conditions, namely hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Mortality may reach up to 40% in these infections. Hantavirus subtypes (Sin Nombre, Hantaan, Seoul, Puumala, Dobrava, etc) with different virulences represent one of the most significant factors affecting the mortality. Additionally, many other factors including age, gender, humoral immune response, genetic factors, patient's clinical and laboratory findings, transfusion, mechanical ventilation requirement, antiviral treatment and immunotherapy administered to the patient are prognostically important. Increasing age had an unfavorable effect on mortality. While the disease is commonly observed in the male gender, mortality rate is higher in the female gender. The higher the emergent neutralizing antibody response, the virus spread, the number of the infected cells and the cytotoxic T lymphocyte-mediated injury will be lower. The requirement for dialysis is reported to be higher with a poorer prognosis in individuals with HLA-B8, -DR3, -DQ2 alleles, and those with HLA-B27 allele usually experience a milder clinical course. Clinically, the risk of mortality increases in patients with multiple, central nervous system hemorrhage, sepsis, disseminated intravascular coagulation (DIC) and secondary infection. The presence of adult respiratory distress syndrome (ARDS), the requirement for mechanical ventilation, the presence of dyspnea and hemoconcentration in HPS are reported to be the most important prognostic factors associated with death. The correlation of severity and the transfusion requirement with mortality was demonstrated. High serum levels of white blood cells, blood urea nitrogen (BUN), creatinine phophokinase (CPK), C-reactive protein (CRP), prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer and INR (International

  1. Diagnostic Reasoning using Prognostic Information for Unmanned Aerial Systems

    Science.gov (United States)

    Schumann, Johann; Roychoudhury, Indranil; Kulkarni, Chetan

    2015-01-01

    With increasing popularity of unmanned aircraft, continuous monitoring of their systems, software, and health status is becoming more and more important to ensure safe, correct, and efficient operation and fulfillment of missions. The paper presents integration of prognosis models and prognostic information with the R2U2 (REALIZABLE, RESPONSIVE, and UNOBTRUSIVE Unit) monitoring and diagnosis framework. This integration makes available statistically reliable health information predictions of the future at a much earlier time to enable autonomous decision making. The prognostic information can be used in the R2U2 model to improve diagnostic accuracy and enable decisions to be made at the present time to deal with events in the future. This will be an advancement over the current state of the art, where temporal logic observers can only do such valuation at the end of the time interval. Usefulness and effectiveness of this integrated diagnostics and prognostics framework was demonstrated using simulation experiments with the NASA Dragon Eye electric unmanned aircraft.

  2. Prognostic models in obstetrics: available, but far from applicable.

    Science.gov (United States)

    Kleinrouweler, C Emily; Cheong-See, Fiona M; Collins, Gary S; Kwee, Anneke; Thangaratinam, Shakila; Khan, Khalid S; Mol, Ben Willem J; Pajkrt, Eva; Moons, Karel G M; Schuit, Ewoud

    2016-01-01

    Health care provision is increasingly focused on the prediction of patients' individual risk for developing a particular health outcome in planning further tests and treatments. There has been a steady increase in the development and publication of prognostic models for various maternal and fetal outcomes in obstetrics. We undertook a systematic review to give an overview of the current status of available prognostic models in obstetrics in the context of their potential advantages and the process of developing and validating models. Important aspects to consider when assessing a prognostic model are discussed and recommendations on how to proceed on this within the obstetric domain are given. We searched MEDLINE (up to July 2012) for articles developing prognostic models in obstetrics. We identified 177 papers that reported the development of 263 prognostic models for 40 different outcomes. The most frequently predicted outcomes were preeclampsia (n = 69), preterm delivery (n = 63), mode of delivery (n = 22), gestational hypertension (n = 11), and small-for-gestational-age infants (n = 10). The performance of newer models was generally not better than that of older models predicting the same outcome. The most important measures of predictive accuracy (ie, a model's discrimination and calibration) were often (82.9%, 218/263) not both assessed. Very few developed models were validated in data other than the development data (8.7%, 23/263). Only two-thirds of the papers (62.4%, 164/263) presented the model such that validation in other populations was possible, and the clinical applicability was discussed in only 11.0% (29/263). The impact of developed models on clinical practice was unknown. We identified a large number of prognostic models in obstetrics, but there is relatively little evidence about their performance, impact, and usefulness in clinical practice so that at this point, clinical implementation cannot be recommended. New efforts should be directed

  3. Development and Validation of a Lifecycle-based Prognostics Architecture with Test Bed Validation

    Energy Technology Data Exchange (ETDEWEB)

    Hines, J. Wesley [Univ. of Tennessee, Knoxville, TN (United States); Upadhyaya, Belle [Univ. of Tennessee, Knoxville, TN (United States); Sharp, Michael [Univ. of Tennessee, Knoxville, TN (United States); Ramuhalli, Pradeep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jeffries, Brien [Univ. of Tennessee, Knoxville, TN (United States); Nam, Alan [Univ. of Tennessee, Knoxville, TN (United States); Strong, Eric [Univ. of Tennessee, Knoxville, TN (United States); Tong, Matthew [Univ. of Tennessee, Knoxville, TN (United States); Welz, Zachary [Univ. of Tennessee, Knoxville, TN (United States); Barbieri, Federico [Univ. of Tennessee, Knoxville, TN (United States); Langford, Seth [Univ. of Tennessee, Knoxville, TN (United States); Meinweiser, Gregory [Univ. of Tennessee, Knoxville, TN (United States); Weeks, Matthew [Univ. of Tennessee, Knoxville, TN (United States)

    2014-11-06

    On-line monitoring and tracking of nuclear plant system and component degradation is being investigated as a method for improving the safety, reliability, and maintainability of aging nuclear power plants. Accurate prediction of the current degradation state of system components and structures is important for accurate estimates of their remaining useful life (RUL). The correct quantification and propagation of both the measurement uncertainty and model uncertainty is necessary for quantifying the uncertainty of the RUL prediction. This research project developed and validated methods to perform RUL estimation throughout the lifecycle of plant components. Prognostic methods should seamlessly operate from beginning of component life (BOL) to end of component life (EOL). We term this "Lifecycle Prognostics." When a component is put into use, the only information available may be past failure times of similar components used in similar conditions, and the predicted failure distribution can be estimated with reliability methods such as Weibull Analysis (Type I Prognostics). As the component operates, it begins to degrade and consume its available life. This life consumption may be a function of system stresses, and the failure distribution should be updated to account for the system operational stress levels (Type II Prognostics). When degradation becomes apparent, this information can be used to again improve the RUL estimate (Type III Prognostics). This research focused on developing prognostics algorithms for the three types of prognostics, developing uncertainty quantification methods for each of the algorithms, and, most importantly, developing a framework using Bayesian methods to transition between prognostic model types and update failure distribution estimates as new information becomes available. The developed methods were then validated on a range of accelerated degradation test beds. The ultimate goal of prognostics is to provide an accurate assessment for

  4. Distribution of health literacy strengths and weaknesses across socio-demographic groups

    DEFF Research Database (Denmark)

    Beauchamp, Alison; Buchbinder, Rachelle; Dodson, Sarity

    2015-01-01

    Background: Recent advances in the measurement of health literacy allow description of a broad range of personal and social dimensions of the concept. Identifying differences in patterns of health literacy between population sub-groups will increase understanding of how health literacy contributes...... providers' (ES -1.00 [95 % CI -1.24, -0.75]), and 'Navigating the healthcare system' (ES -0.72 [95 % CI -0.97, -0.48]). Similar patterns and ES were seen for participants born overseas compared with those born in Australia. Smaller ES were seen for sex, age group, private health insurance status, number...

  5. Prognostic factors of long term disability due to mental disorders : a systematic review

    NARCIS (Netherlands)

    Cornelius, L.R.; van der Klink, J.J.; Groothoff, J.W.; Brouwer, S.

    2011-01-01

    Introduction In the past few decades, mental health problems have increasingly contributed to sickness absence and long-term disability. However, little is known about prognostic factors of return to work (RTW) and disability of persons already on sick leave due to mental health problems. Understand

  6. Prognostic factors of long term disability due to mental disorders : a systematic review

    NARCIS (Netherlands)

    Cornelius, L.R.; van der Klink, J.J.; Groothoff, J.W.; Brouwer, S.

    Introduction In the past few decades, mental health problems have increasingly contributed to sickness absence and long-term disability. However, little is known about prognostic factors of return to work (RTW) and disability of persons already on sick leave due to mental health problems.

  7. Relationship between Trust, Distributed Leadership and Job Performance in Health Care Context

    DEFF Research Database (Denmark)

    Jain, Ajay K.; Günzel-Jensen, Franziska

    2014-01-01

    Purpose: This study aims at investigating the effect of vertical trust on distributed leadership and performance as mediated by job satisfaction, and further to see the role of DL in carrying out the effect of satisfaction on employees´ performance. Design: Grounded in literature on organizational...... satisfaction mediates the relationship between vertical trust and distributed leadership, and further distributed leadership had a positive impact on job performance. Furthermore, the results also showed that job satisfaction had a positively significant impact on distributed leadership and employees......´ performance. Moreover, distributed leadership has affected employees´ performance positively and it carries the impact of job satisfaction on performance. Implications: The study showed that trust and job satisfaction are important triggers of DL. Furthermore, results are also interesting because literature...

  8. Relationship between Trust, Distributed Leadership and Job Performance in Health Care Context

    DEFF Research Database (Denmark)

    Jain, Ajay K.; Günzel-Jensen, Franziska

    2014-01-01

    ´ performance. Moreover, distributed leadership has affected employees´ performance positively and it carries the impact of job satisfaction on performance. Implications: The study showed that trust and job satisfaction are important triggers of DL. Furthermore, results are also interesting because literature......Purpose: This study aims at investigating the effect of vertical trust on distributed leadership and performance as mediated by job satisfaction, and further to see the role of DL in carrying out the effect of satisfaction on employees´ performance. Design: Grounded in literature on organizational...... satisfaction mediates the relationship between vertical trust and distributed leadership, and further distributed leadership had a positive impact on job performance. Furthermore, the results also showed that job satisfaction had a positively significant impact on distributed leadership and employees...

  9. Examining levels, distribution and correlates of health insurance coverage in Kenya.

    Science.gov (United States)

    Kazungu, Jacob S; Barasa, Edwine W

    2017-09-01

    To examine the levels, inequalities and factors associated with health insurance coverage in Kenya. We analysed secondary data from the Kenya Demographic and Health Survey (KDHS) conducted in 2009 and 2014. We examined the level of health insurance coverage overall, and by type, using an asset index to categorise households into five socio-economic quintiles with quintile 5 (Q5) being the richest and quintile 1 (Q1) being the poorest. The high-low ratio (Q5/Q1 ratio), concentration curve and concentration index (CIX) were employed to assess inequalities in health insurance coverage, and logistic regression to examine correlates of health insurance coverage. Overall health insurance coverage increased from 8.17% to 19.59% between 2009 and 2014. There was high inequality in overall health insurance coverage, even though this inequality decreased between 2009 (Q5/Q1 ratio of 31.21, CIX = 0.61, 95% CI 0.52-0.0.71) and 2014 (Q5/Q1 ratio 12.34, CIX = 0.49, 95% CI 0.45-0.52). Individuals that were older, employed in the formal sector; married, exposed to media; and male, belonged to a small household, had a chronic disease and belonged to rich households, had increased odds of health insurance coverage. Health insurance coverage in Kenya remains low and is characterised by significant inequality. In a context where over 80% of the population is in the informal sector, and close to 50% live below the national poverty line, achieving high and equitable coverage levels with contributory and voluntary health insurance mechanism is problematic. Kenya should consider a universal, tax-funded mechanism that ensures revenues are equitably and efficiently collected, and everyone (including the poor and those in the informal sector) is covered. © 2017 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  10. Prognostic radiographic aspects of spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Saraste, H.; Brostroem, L.A.; Aparisi, T.

    1984-01-01

    A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping.

  11. Concordance for prognostic models with competing risks

    NARCIS (Netherlands)

    M. Wolbers (Marcel); S. Blanche (Stephane); M. Koller (Michael); J.C.M. Witteman (Jacqueline); T.A. Gerds (Thomas)

    2014-01-01

    textabstractThe concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and

  12. Health insurance coverage, income distribution and healthcare quality in local healthcare markets.

    Science.gov (United States)

    Damianov, Damian S; Pagán, José A

    2013-08-01

    We develop a theoretical model of a local healthcare system in which consumers, health insurance companies, and healthcare providers interact with each other in markets for health insurance and healthcare services. When income and health status are heterogeneous, and healthcare quality is associated with fixed costs, the market equilibrium level of healthcare quality will be underprovided. Thus, healthcare reform provisions and proposals to cover the uninsured can be interpreted as an attempt to correct this market failure. We illustrate with a numerical example that if consumers at the local level clearly understand the linkages between health insurance coverage and the quality of local healthcare services, health insurance coverage proposals are more likely to enjoy public support.

  13. Possible health effects of liquefied petroleum gas on workers at filling and distribution stations of Gaza governorates.

    Science.gov (United States)

    Sirdah, M M; Al Laham, N A; El Madhoun, R A

    2013-03-01

    Liquefied petroleum gas (LPG) is widely used in the Gaza Strip for domestic purposes, in agriculture and industry and, illegally, in cars. This study aimed to identify possible health effects on workers exposed to LPG in Gaza governorates. Data were collected by a questionnaire interview, and haematological and biochemical analyses of venous blood samples were made from 30 workers at filling and distribution stations and 30 apparently healthy controls. Statistically significant differences were found in all self-reported health-related complaints among LPG workers versus controls. LPG workers had significantly higher values of red blood cell counts, haemoglobin, haematocrit mean corpuscular haemoglobin and platelet counts. They also had significantly higher values of kidney function tests (urea, creatinine and uric acid) and liver function enzyme activities (aspartate aminotransferase and alanine aminotransferase). LPG workers at Gaza Strip petroleum stations are at higher risk for health-related symptoms and clinical abnormalities.

  14. The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution.

    Science.gov (United States)

    Huang, Lei; Wu, Haiyun; van der Kuijp, Tsering Jan

    2015-01-01

    Chronic arsenic exposure through drinking water has been a vigorously studied and debated subject. However, the existing literature does not allow for a thorough examination of the potential regional discrepancies that may arise among arsenic-related health outcomes. The purpose of this article is to provide an updated review of the literature on arsenic exposure and commonly discussed health effects according to global geographical distribution. This geographically segmented approach helps uncover the discrepancies in the health effects of arsenic. For instance, women are more susceptible than men to a few types of cancer in Taiwan, but not in other countries. Although skin cancer and arsenic exposure correlations have been discovered in Chile, Argentina, the United States, and Taiwan, no evident association was found in mainland China. We then propose several globally applicable recommendations to prevent and treat the further spread of arsenic poisoning and suggestions of future study designs and decision-making.

  15. Staff and bed distribution in public sector mental health services in ...

    African Journals Online (AJOL)

    2014-11-02

    Nov 2, 2014 ... eastern coast of South Africa (SA). The province has an approximate ... corresponds to the population distribution in the province. Method. In this ... human resources and non-governmental organisations. Conclusion. Owing to ...

  16. Specialty pharmacies and other restricted drug distribution systems: financial and safety considerations for patients and health-system pharmacists.

    Science.gov (United States)

    Kirschenbaum, Bonnie E

    2009-12-15

    To discuss the role of restricted drug distribution systems in the implementation of risk evaluation and mitigation strategies (REMS), health-system pharmacists' concerns associated with the use of specialty pharmacies and other restricted drug distribution systems, reimbursement policies for high-cost specialty drugs, supply chain models for traditional and specialty drugs, and emerging trends in the management of and reimbursement for specialty pharmaceuticals. Restricted drug distribution systems established by pharmaceutical manufacturers, specialty pharmacies, or other specialty suppliers may be a component of REMS, which are required by the Food and Drug Administration for the management of known or potential serious risks from certain drugs. Concerns of health-system pharmacists using specialty suppliers include access to pharmaceuticals, operational challenges, product integrity, financial implications, continuity of care, and patient safety. An ambulatory care patient taking a specialty drug product from home to a hospital outpatient clinic or inpatient setting for administration, a practice known as "brown bagging," raises concerns about product integrity and institutional liability. An institution's finances, tolerance for liability, and ability to skillfully manage the processes involved often determine its choice between an approach that prohibits brown bagging but is costly and one that permits the practice under certain conditions and is less costly. The recent shift from a traditional supply chain model to a specialty pharmacy supply chain model for high-cost pharmaceuticals has the potential to increase pharmaceutical costs for health systems. A dialogue is needed between health-system pharmacists and group purchasing organizations to address the latter's role in mitigating the financial implications of this change and to help clarify the safety issues. Some health plans have shifted part of the cost of expensive drugs to patients by establishing a

  17. Data Analysis of EMR in Distributed Database with Respect to Today's E -Health Apps

    Directory of Open Access Journals (Sweden)

    Onkar S Kemkar

    2012-06-01

    Full Text Available Comparative effectiveness research has been an ongoing effort to identify best-practices for health care. A doctor’s EHR in the office is supposed to be able to connect with outside sources of patient data, other clinicians using the same or different EMRs. Of most urgency, though, is the desire to connect a clinician with the local hospital. And, of all of the integrations, this one is the most difficult.This paper focuses on the use of data from an electronic medical record (EMR within a health care organization. It discusses how health provider extracts data from multiple sources in a near real-time fashion. Here also we discuss how national patient identity number can be used for healthcare transaction, how health data can be made protected by using the HIPPA concepts, how we can maintain the security of the patient data.

  18. Addressing Health Workforce Distribution Concerns: A Discrete Choice Experiment to Develop Rural Retention Strategies in Cameroon

    Directory of Open Access Journals (Sweden)

    Paul Jacob Robyn

    2015-03-01

    Full Text Available Background Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001 and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58 respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001. On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001, was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on

  19. The Digital Distribution of Public Health News Surrounding the Human Papillomavirus Vaccination: A Longitudinal Infodemiology Study

    OpenAIRE

    Mahoney, L Meghan; Tang, Tang; Ji, Kai; Ulrich-Schad, Jessica

    2015-01-01

    Background New media changes the dissemination of public health information and misinformation. During a guest appearance on the Today Show, US Representative Michele Bachmann claimed that human papillomavirus (HPV) vaccines could cause “mental retardation”. Objective The purpose of this study is to explore how new media influences the type of public health information users access, as well as the impact to these platforms after a major controversy. Specifically, this study aims to examine th...

  20. [Multidimensional measurement of precarious employment: social distribution and its association with health in Catalonia (Spain)].

    Science.gov (United States)

    Benach, Joan; Julià, Mireia; Tarafa, Gemma; Mir, Jordi; Molinero, Emilia; Vives, Alejandra

    2015-01-01

    To show the prevalence of precarious employment in Catalonia (Spain) for the first time and its association with mental and self-rated health, measured with a multidimensional scale. A cross-sectional study was conducted using data from the II Catalan Working Conditions Survey (2010) with a subsample of employed workers with a contract. The prevalence of precarious employment using a multidimensional scale and its association with health was calculated using multivariate log-binomial regression stratified by gender. The prevalence of precarious employment in Catalonia was high (42.6%). We found higher precariousness in women, youth, immigrants, and manual and less educated workers. There was a positive gradient in the association between precarious employment and poor health. Precarious employment is associated with poor health in the working population. Working conditions surveys should include questions on precarious employment and health indicators, which would allow monitoring and subsequent analyses of health inequalities. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. Measuring the Distributional Impact of Public Health Spending on Poverty in Nigeria

    Directory of Open Access Journals (Sweden)

    Olawale Ibrahim Olateju

    2009-05-01

    Full Text Available Most African health systems are replicas of what was inherited from the colonial era and are therefore unevenly weighted toward privileged elites and Urban centers. Improved health status leads to increased productivity, educational performance, higher life expectancy, savings and investments, and decreased debts and expenditure on health care. Ultimately this would lead to greater equity, economic return, and social and political stability. The health impacts of climate change can occur through a number of direct and indirect causal pathways, and the severity is in part determined by the adaptive capacity of the population. Those groups particularly at risk include poorer countries and communities, those geographically vulnerable to extreme weather events, and those highly dependent on agriculture for their livelihood.The paper examines the impact of public health expenditure, and poverty among the general populace. The trend of the country human development index and public expenditure on health were analyzed using correlation coefficient and regression analysis and simple descriptive analysis. The findings reveal that the variations in the human development index could be traced to the budget estimates

  2. Optimal distribution of medical backpacks and health surveillance assistants in Malawi.

    Science.gov (United States)

    Kunkel, Amber G; Van Itallie, Elizabeth S; Wu, Duo

    2014-09-01

    Despite recent progress, Malawi continues to perform poorly on key health indicators such as child mortality and life expectancy. These problems are exacerbated by a severe lack of access to health care. Health Surveillance Assistants (HSAs) help bridge this gap by providing community-level access to basic health care services. However, the success of these HSAs is limited by a lack of supplies and long distances between HSAs and patients. To address this issue, we used large-scale weighted p-median and capacitated facility location problems to create a scalable, three-tiered plan for optimal allocation of HSAs, HSA designated medical backpacks, and backpack resupply centers. Our analysis uses real data on the location and characteristics of hospitals, health centers, and the general population. In addition to offering specific recommendations for HSA, backpack, and resupply center locations, it provides general insights into the scope of the proposed HSA backpack program scale-up. In particular, it demonstrates the importance of local health centers to the resupply network. The proposed assignments are robust to changes in the underlying population structure, and could significantly improve access to medical supplies for both HSAs and patients.

  3. A Prognostic Method for Scheduling Maintenance on the P2- Marx Modulator

    Energy Technology Data Exchange (ETDEWEB)

    Benwell, Andrew; Burkhart, Craig; Kemp, Mark; Macken, Koen; Nguyen, Minh; MacNair, Dave; Olsen, Jeff; Larsen, Ray; /SLAC

    2010-06-10

    The SLAC National Accelerator Laboratory is developing a second generation Marx-type modulator for the ILC, the P2-Marx. The modulator is expected to operate reliably in excess of 10{sup 5} hours with minimum downtime. A prognostic system is being implemented with the development of the P2-Marx to monitor and track the health of key high voltage components. This paper discusses the way in which the prognostic system will be implemented and used to monitor the health of the P2-Marx modulator.

  4. IDH Mutations: Genotype-Phenotype Correlation and Prognostic Impact

    Directory of Open Access Journals (Sweden)

    Xiao-Wei Wang

    2014-01-01

    Full Text Available IDH1/2 mutation is the most frequent genomic alteration found in gliomas, affecting 40% of these tumors and is one of the earliest alterations occurring in gliomagenesis. We investigated a series of 1305 gliomas and showed that IDH mutation is almost constant in 1p19q codeleted tumors. We found that the distribution of IDH1R132H, IDH1nonR132H, and IDH2 mutations differed between astrocytic, mixed, and oligodendroglial tumors, with an overrepresentation of IDH2 mutations in oligodendroglial phenotype and an overrepresentation of IDH1nonR132H in astrocytic tumors. We stratified grade II and grade III gliomas according to the codeletion of 1p19q and IDH mutation to define three distinct prognostic subgroups: 1p19q and IDH mutated, IDH mutated—which contains mostly TP53 mutated tumors, and none of these alterations. We confirmed that IDH mutation with a hazard ratio = 0.358 is an independent prognostic factor of good outcome. These data refine current knowledge on IDH mutation prognostic impact and genotype-phenotype associations.

  5. Prognostication of information exchange efficiency in operator’s group

    Directory of Open Access Journals (Sweden)

    V. O. Bychkovskyi

    2014-09-01

    Full Text Available Introduction. The function load in modern systems distributes often between several operators. Prognostication of information exchange efficiency between operators is actual problem. Problem statement. The problem solving is possible with distinguishing the individual operator and all other operators. In such situation it is possible to carry out the prognosis procedure on macroscopic level. Theoretical results. Parities between indicators of efficiency and relative errors of operators are established. Laws of operator relative error changes are defined. Dependence of the operator error relations in the beginning and in the end of prognostication is analyzed. Time of task performance in view with the provided requirements to a relative error of one or other operators is defined. It is shown that prognostication procedure provides definition of a necessary parity of operator relative errors in the beginning of their work for maintenance of their certain parity through set time at the set parameters which consider constants of increase efficiency of work. Conclusion. The results give the chance to pass from the static description and an estimation of work efficiency of operator’s group to the dynamic description and formation of look-ahead model which considers processes of a mutual information exchange between operators.

  6. Public health and pipe breaks in water distribution systems: analysis with internet search volume as a proxy.

    Science.gov (United States)

    Shortridge, Julie E; Guikema, Seth D

    2014-04-15

    Drinking water distribution infrastructure has been identified as a factor in waterborne disease outbreaks and improved understanding of the public health risks associated with distribution system failures has been identified as a priority area for research. Pipe breaks may pose a risk, as their occurrence and repair can result in low or negative pressure, potentially allowing contamination of drinking water from adjacent soils. However, measuring this phenomenon is challenging because the most likely health impact is mild gastrointestinal (GI) illness, which is unlikely to result in a doctor or hospital visit. Here we present a novel method that uses data mining techniques and internet search volume to assess the relationship between pipe breaks and symptoms of GI illness in two U.S. cities. Weekly search volume for the terms diarrhea and vomiting was used as the response variable with the number of pipe breaks in each city as a covariate as well as additional covariates to control for seasonal patterns, search volume persistence, and other sources of GI illness. The fit and predictive accuracy of multiple regression and data mining techniques were compared, with the best performance obtained using random forest and bagged regression tree models. Pipe breaks were found to be an important and positively correlated predictor of internet search volume in multiple models in both cities, supporting previous investigations that indicated an increased risk of GI illness from distribution system disturbances. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Anopheles plumbeus (Diptera: Culicidae) in Germany: updated geographic distribution and public health impact of a nuisance and vector mosquito.

    Science.gov (United States)

    Heym, Eva C; Kampen, Helge; Fahle, Marcus; Hohenbrink, Tobias L; Schäfer, Mandy; Scheuch, Dorothee E; Walther, Doreen

    2017-01-01

    The aim of this study was to map the current spatial distribution of Anopheles plumbeus in Germany, a potential vector of malaria parasites and West Nile virus. Reports of mass occurrence and nuisance connected with artificial breeding site usage by this species were analysed. Distribution data were collected from 2011 to 2014 mainly through trapping and submissions of adult mosquito specimens to a citizen science project. In the framework of the latter, additional information was gathered on recent nuisance incidents caused by An. plumbeus, including a longitudinal analysis of mosquito occurrence and the impact of management measures at a nuisance site in south-western Germany. Based on the most comprehensive set of collection data obtained during the last decades, An. plumbeus is shown to be widely distributed over Germany. The data also indicate a continuing extension of the breeding site repertoire of the species from natural to artificial habitats that facilitate mass development. Increasing incidents of persistent nuisance suggest that this mosquito species is rarely diagnosed correctly and managed adequately. As An. plumbeus is both a serious nuisance pest and a potential vector species, awareness of this species and the public health problems linked to it should be raised among pest managers and public health personnel. © 2016 John Wiley & Sons Ltd.

  8. Education policies and health inequalities: evidence from changes in the distribution of Body Mass Index in France, 1981-2003.

    Science.gov (United States)

    Etile, Fabrice

    2014-03-01

    This paper contributes to the debate over the effectiveness of education policies in reducing overall health inequalities as compared to public health actions directed at the less-educated. Recentered Influence Function (RIF) regressions are used to decompose the contribution of education to the changing distribution of Body Mass Index (BMI) in France, between 1981 and 2003, into a composition effect (the shift in population education due to a massive educational expansion), and a structure effect (a changing educational gradient in BMI). Educational expansion has reduced overall BMI inequality by 3.4% for women and 2.3% for men. However, the structure effect on its own has produced a 10.9% increase in overall inequality for women, due to a steeper education gradient starting from the second quartile of the distribution. This structure effect on overall inequality is also large (7.6%) for men, albeit insignificant as it remains concentrated in the last decile. Educational expansion policies can thus reduce overall BMI inequalities; but attention must still be paid to the BMI gradient in education even for policies addressing overall rather than socioeconomic health inequalities.

  9. Distributive justice and global health: a call for a global corporate tax.

    Science.gov (United States)

    Blum, J D

    2007-06-01

    Significant efforts have been directed toward addressing the financial needs of the developing world for assistance with public health and related development problems. Both public and private organizations have made considerable economic contributions to assist with immediate and long term health challenges, and there is growing international support for programs of national debit relief. Still, there is a need for additional resources to combat international health problems, which go beyond largesse. This paper calls for the creation of a legally rooted, global tax as a mechanism for consistent long term funding. Specifically, the paper proposes engagement of the World Trade Organization as a vehicle to sponsor a global tax on multinational corporations who have benefited most from the international trading scheme.

  10. Potential health and safety impacts from distribution and storage of alcohol fuels

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, S.E.; Gasper, J.R.

    1980-06-01

    This assessment includes three major sections. Section 1 is a synopsis of literature on the health and safety aspects of neat alcohols, alcohol-gasoline blends, and typical gasoline. Section 2 identifies the toxic properties of each fuel type and describes existing standards and regulations and suggests provisions for establishing others. Section 3 analyzes the major safety and health risks that would result from the increased use of each type of alcohol fuel. Potential accidents are described and their probable impacts on occupational and public populations are determined. An attempt was made to distill the important health and safety issues and to define gaps in our knowledge regarding alcohol fuels to highlight the further research needed to circumvent potential helth and safety problems.

  11. Advanced air distribution: Improving health and comfort while reducing energy use

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor

    2015-01-01

    -quality indoor environments at the same time as low-energy consumption. Advanced air distribution, designed to supply clean air where, when, and as much as needed, makes it possible to efficiently achieve thermal comfort, control exposure to contaminants, provide high-quality air for breathing and minimizing...

  12. PROGNOSTIC FACTORS ANALYSIS FOR STAGEⅠ RECTAL CANCER

    Institute of Scientific and Technical Information of China (English)

    武爱文; 顾晋; 薛钟麒; 王怡; 徐光炜

    2001-01-01

    To explore the death-related factors of stageⅠrectal cancer patients. Methods: 89 cases of stage I rectal cancer patients between 1985 and 2000 were retrospectively studied for prognostic factors. Factors including age, gender, tumor size, circumferential occupation, gross type, pathological type, depth of tumor invasion, surgical procedure, adjuvant chemotherapy and postoperative complication were chosen for cox multivariate analysis (forward procedure) using Spss software (10.0 version). Results: multivariate analysis demonstrated that muscular invasion was an independent negative prognostic factor for stageⅠrectal cancer patients (P=0.003). Conclusion: Muscular invasion is a negative prognostic factor for stage I rectal cancer patients.

  13. A Framework for Smart Distribution of Bio-signal Processing Units in M-Health

    NARCIS (Netherlands)

    Mei, Hailiang; Widya, Ing; Broens, Tom; Pawar, Pravin; Halteren, van Aart; Shishkov, Boris; Sinderen, van Marten

    2007-01-01

    This paper introduces the Bio-Signal Processing Unit (BSPU) as a functional component that hosts (part of ) the bio-signal information processing algorithms that are needed for an m-health application. With our approach, the BSPUs can be dynamically assigned to available nodes between the bio-signal

  14. An Infrastructure for the Development of Health Care Information Systems from Distributed Components.

    Science.gov (United States)

    Deibel, Stephan R. A.; Greenes, Robert A.

    1995-01-01

    Discusses limitations in the development of health care information systems; explains component methodology for complex software development, including component interface semantics; and describes Arachne, a development environment available via the Internet consisting of a set of tools that enables applications to be constructed through…

  15. The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms.

    Science.gov (United States)

    Malm, Annika; Axelsson, Gösta; Barregard, Lars; Ljungqvist, Jakob; Forsberg, Bertil; Bergstedt, Olof; Pettersson, Thomas J R

    2013-09-01

    There are relatively few studies on the association between disturbances in drinking water services and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerning GI illness may be a useful source of information. This study investigates if there is an increased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted in Gothenburg, a Swedish city with 0.5 million inhabitants with a surface water source of drinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea, vomiting or abdominal pain) were recorded for a three-year period, including also sex, age, and geocoded location of residence. The number of contacts with the HCC in the affected geographical areas were recorded during eight periods of disturbances in the water works (e.g. short stops of chlorine dosing), six periods of large disturbances in the distribution network (e.g. pumping station failure or pipe breaks with major consequences), and 818 pipe break and leak repairs over a three-year period. For each period of disturbance the observed number of calls was compared with the number of calls during a control period without disturbances in the same geographical area. In total about 55, 000 calls to the HCC due to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants and year, but much higher (>200) for children water works or in the distribution network. Our results indicate that GI symptoms due to disturbances in water works or the distribution network are rare. The number of serious failures was, however limited, and further studies are needed to be able to assess the risk of GI illness in such cases. The technique of using geocoded HCC data together with geocoded records of disturbances in the drinking water network was feasible.

  16. Time distribution of epileptic seizures during video-EEG monitoring. Implications for health insurance systems in developing countries.

    Science.gov (United States)

    Quiroga, R C; Pirra, L; Podestá, C; Leiguarda, R C; Rabinowicz, A L

    1997-12-01

    An attempt was made to identify guidelines to help establish epilepsy monitoring units in developing countries. We assessed the time distribution of seizures during video-EEG monitoring and we also estimated the minimum time required for such a procedure and the impact of these variables upon the health insurance system. Mean time for recording five stereotyped clinical events was 72 hours, with a significant number of events recorded between midnight and 0600 hours (P < 0.05). This pilot study may help to establish local policies that will warrant an adequate work-up for our patients.

  17. Impact of health facility-based insecticide treated bednet distribution in Malawi: progress and challenges towards achieving universal coverage.

    Directory of Open Access Journals (Sweden)

    Jacek Skarbinski

    Full Text Available BACKGROUND: High levels of insecticide treated bednet (ITN use reduce malaria burden in countries with intense transmission such as Malawi. Since 2007 Malawi has implemented free health facility-based ITN distribution for pregnant women and children <5 years old (under-5s. We evaluated the progress of this targeted approach toward achieving universal ITN coverage. METHODS: We conducted a cross-sectional household survey in eight districts in April 2009. We assessed household ITN possession, ITN use by all household members, and P. falciparum asexual parasitemia and anemia (hemoglobin <11 grams/deciliter in under-5s. RESULTS: We surveyed 7,407 households containing 29,806 persons. Fifty-nine percent of all households (95% confidence interval [95% CI]: 56-62, 67% (95% CI: 64-70 of eligible households (i.e., households with pregnant women or under-5s, and 40% (95% CI: 36-45 of ineligible households owned an ITN. In households with at least one ITN, 76% (95% CI: 74-78 of all household members, 88% (95% CI: 87-90 of under-5s and 90% (95% CI: 85-94 of pregnant women used an ITN the previous night. Of 6,677 ITNs, 92% (95% CI: 90-94 were used the previous night with a mean of 2.4 persons sleeping under each ITN. In multivariable models adjusting for district, socioeconomic status and indoor residual spraying use, ITN use by under-5s was associated with a significant reduction in asexual parasitemia (adjusted odds ratio (aOR 0.79; 95% CI: 0.64-0.98; p-value 0.03 and anemia (aOR 0.79; 95% CI 0.62-0.99; p-value 0.04. Of potential targeted and non-targeted mass distribution strategies, a campaign distributing 1 ITN per household might increase coverage to 2.1 household members per ITN, and thus achieve near universal coverage often defined as 2 household members per ITN. CONCLUSIONS: Malawi has substantially increased ITN coverage using health facility-based distribution targeting pregnant women and under-5s, but needs to supplement these activities with

  18. Highly precise distributed Brillouin scattering sensor for structural health monitoring of optical ground wire cable

    Science.gov (United States)

    Zou, Lufan; Ravet, Fabien; Bao, Xiaoyi; Chen, Liang

    2004-07-01

    A distributed Brillouin scattering sensor with high special precision has been developed for the measurement of small damages/cracks of 1.5 cm. The out-layer damaged regions in an optical ground wire (OPGW) cable have been identified successfully by measuring the strain distributions every 5 cm using this technology. The stress increased to 127 kN which corresponds to more than 7500 micro-strain in the fibers. The locations of structural indentations comprising repaired and undamaged regions are found and distinguished using their corresponding strain data. The elongation of repaired region increases with time on 127 kN. These results are quantified in terms of the fiber orientation, stress, and behavior relative to undamaged sections.

  19. Security threats and solutions in distributed, interoperable health information systems using middleware.

    Science.gov (United States)

    Blobel, B; Holena, M

    1997-01-01

    Increasingly, distributed, interoperable healthcare information systems, which meet the shared care paradigm, work across the boundaries of policy, organisational, and technological domains and are based on middleware concepts. Especially in healthcare with its sensitive personal and medical data, such systems require advanced data security measures. In the paper, a common object-oriented security model for middleware systems and advertisements for implementation are proposed, corresponding the security requirement of both the user and the application environment.

  20. Intestinal gas content and distribution in health and in patients with functional gut symptoms

    OpenAIRE

    Bendezú, Álvaro; Barba, Elisabeth; Burri, Emanuel; Cisternas, Daniel; Malagelada Prats, Carolina; Segui, Santi; Accarino Garaventa, Anna María; Quiroga, Sergi; Monclús Lahoya, Eva; Navazo Álvaro, Isabel; Malagelada Benapres, Juan Ramon; Azpiroz Vidaur, Fernando

    2015-01-01

    Background: The precise relation of intestinal gas to symptoms, particularly abdominal bloating and distension remains incompletely elucidated. Our aim was to define the normal values of intestinal gas volume and distribution and to identify abnormalities in relation to functional-type symptoms. Methods:Abdominal computed tomography scans were evaluated in healthy subjects (n = 37) and in patients in three conditions: basal (when they were feeling well; n = 88), during an episode of abdomi...

  1. Developing and comparing two different prognostic indexes for predicting disease-free survival of nonmetastatic breast cancer patients

    OpenAIRE

    TOKATLI, Zehra Füsun; Türe, Mevlüt; Ömürlü, İmran Kurt; ALAS, Ruşen Çoşar; Uzal, Mustafa Cem

    2011-01-01

    To determine 2 different prognostic indexes (PI) for the differentiation of subgroups of nonmetastatic breast cancer patients with the Cox regression analysis and survival tree (ST) methods and the additional usage of the Kaplan-Meier estimates to investigate the predictive power of these methods. Materials and methods: Prognostic factors data were collected for 410 patients. The Cox regression analysis examines the relationship of the survival distribution and covariates. The ST method is ...

  2. To count or not to count deaths: reranking effects in health distribution evaluation.

    Science.gov (United States)

    Arrighi, Yves; Abu-Zaineh, Mohammad; Ventelou, Bruno

    2015-02-01

    Populations' structures and sizes can be a result of healthcare policy decisions. We use a two-period theoretical framework and a dynamic microsimulation model to examine the consequences of this assertion on the appraisal of alternative health policy options. Results show that standard welfare-in-health measures are sensitive to changes in populations' sizes, in that taking into account the (virtual) existence of the dead can alter the ranking of policy options. Disregarding differences in the survivals induced by alternative policies can bias programmes' ranking in favour of less live-saving policies. The paper alerts on the risk of policy misranking by the use of ex-post cross-sectional analyses, neglecting deaths occurring in the past as well as counterfactual deaths in alternative policy scenarios.

  3. Metrics for Evaluating Performance of Prognostics Techniques

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is an emerging concept in condition based maintenance (CBM) of critical systems. Along with developing the fundamentals of being able to confidently...

  4. Tackling V&V for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — We believe our approach to gathering and organizing prognostics V the descriptive text recorded proved on occasion to be insufficient to serve as a standalone...

  5. Diagnostic and Prognostic Biomarkers in Melanoma

    Science.gov (United States)

    Leininger, Jennifer; Hamby, Carl; Safai, Bijan

    2014-01-01

    Melanoma is a lethal melanocytic neoplasm. Unfortunately, the histological diagnosis can be difficult at times. Distinguishing ambiguous melanocytic neoplasms that are benign nevi from those that represent true melanoma is important both for treatment and prognosis. Diagnostic biomarkers currently used to assist in the diagnosis of melanoma are usually specific only for melanocytic neoplasms and not necessarily for their ability to metastasize. Traditional prognostic biomarkers include depth of invasion and mitotic count. Newer diagnostic and prognostic biomarkers utilize immunohistochemical staining as well as ribonucleic acid, micro-ribonucleic acid, and deoxyribonucleic acid assays and fluorescence in situ hybridization. Improved diagnostic and prognostic biomarkers are of increasing importance in the treatment of melanoma with the development of newer and more targeted therapies. Herein, the authors review many of the common as well as newer diagnostic and prognostic biomarkers used in melanoma. PMID:25013535

  6. Model-based Prognostics under Limited Sensing

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is crucial to providing reliable condition-based maintenance decisions. To obtain accurate predictions of component life, a variety of sensors are often...

  7. Pediatric renal transplantation: Results and prognostic factors

    Directory of Open Access Journals (Sweden)

    Po-Cheng Huang

    2013-04-01

    Conclusion: For pediatric patients, we found that renal transplantation is now a safe and effective surgical procedure for children with end-stage renal disease. Acute rejection and male gender were identified as prognostic factors for poor graft survival.

  8. Evaluating Algorithm Performance Metrics Tailored for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics has taken center stage in Condition Based Maintenance (CBM) where it is desired to estimate Remaining Useful Life (RUL) of a system so that remedial...

  9. Detection and Prognostics on Low Dimensional Systems

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper describes the application of known and novel prognostic algorithms on systems that can be described by low dimensional, potentially nonlinear dynamics....

  10. Prognostic indicators influencing short term outcomes among ...

    African Journals Online (AJOL)

    Prognostic indicators influencing short term outcomes among operated head injury patients ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... indicators for short term outcomes in operated head injury patients at KCMC.

  11. Prognostic indices in childhood heart failure

    African Journals Online (AJOL)

    hood heart failure and highlight the factors that affect out- come among cases of heart failure ... month period were studied prospectively. Diagnosis of heart ... a case-fatality rate of 24% among the study population. Poor prognostic indices ...

  12. Precursor Parameter Identification for IGBT Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Precursor parameters have been identified to enable development of a prognostic approach for insulated gate bipolar transistors (IGBT). The IGBT were subjected to...

  13. Prognostic Factors for Refractory Status Epilepticus

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2013-03-01

    Full Text Available Researchers at the Mayo Clinic, Rochester, MN studied the outcome and identified prognostic factors for refractory status epilepticus (RSE in 54 adult patients, median age 52 years [range 18-93].

  14. Heavy Metal Distribution in Street Dust from Traditional Markets and the Human Health Implications.

    Science.gov (United States)

    Kim, Jin Ah; Park, Jin Hee; Hwang, Won Ju

    2016-08-13

    Street dust is a hazard for workers in traditional markets. Exposure time is longer than for other people, making them vulnerable to heavy metals in street dust. This study investigated heavy metal concentrations in street dust samples collected from different types of markets. It compared the results with heavy metal concentrations in heavy traffic and rural areas. Street dust was significantly enriched with most heavy metals in a heavy traffic area while street dust from a fish market was contaminated with cupper (Cu), lead (Pb) and zinc (Zn). Street dust from medicinal herb and fruit markets, and rural areas were not contaminated. Principal component and cluster analyses indicated heavy metals in heavy traffic road and fish market dust had different sources. Relatively high heavy metal concentration in street dust from the fish market may negatively affect worker's mental health, as depression levels were higher compared with workers in other markets. Therefore, intensive investigation of the relationship between heavy metal concentrations in street dust and worker's health in traditional marketplaces should be conducted to elucidate the effect of heavy metals on psychological health in humans.

  15. Matrix factorization to time-frequency distribution for structural health monitoring

    Science.gov (United States)

    Chang, Chia-Ming; Huang, Shieh-Kung

    2016-04-01

    Structural health monitoring enables structural information to be acquired through sensing technology, and is of need to early detect problems and damages in structures. Health monitoring strategies are often realized through a combination of qualitative sensing systems and high-performance structural integrity assessment methods. Structural deviations can be then effectively identified by interpreting the raw sensor measurements using signal processing techniques. The objective of this study is to develop a new structural health monitoring method that applies a matrix factorization algorithm to a time-frequency representation of multi-channel signals measured from a structure. This method processes vibrational input and/or output responses of structures to improve raw data quality, to estimate structural responses, to derive signal features, and to detect structural variations. For example, the proposed method can reduce the signal noise by utilizing first few principle vectors to reconstruct the measured signals. For frequency-domain responses, this method can smooth the phase to obtain a better input-output relationship of a structure. Additionally, the method removes abnormal signals in time series, allowing better understanding of structural behavior. Due to communication loss, this method is able to recover lost data from other channel measurements in a structure. Moreover, the proposed method transforms the signal components into a specific domain and then yield meaningful characteristics. All these features are numerically verified using experimental data, and the proposed method permits more detailed investigation of structural behavior.

  16. Health implications of PAH release from coated cast iron drinking water distribution systems in The Netherlands.

    Science.gov (United States)

    Blokker, E J Mirjam; van de Ven, Bianca M; de Jongh, Cindy M; Slaats, P G G Nellie

    2013-05-01

    Coal tar and bitumen have been historically used to coat the insides of cast iron drinking water mains. Polycyclic aromatic hydrocarbons (PAHs) may leach from these coatings into the drinking water and form a potential health risk for humans. We estimated the potential human cancer risk from PAHs in coated cast iron water mains. In a Dutch nationwide study, we collected drinking water samples at 120 locations over a period of 17 days under various operational conditions, such as undisturbed operation, during flushing of pipes, and after a mains repair, and analyzed these samples for PAHs. We then estimated the health risk associated with an exposure scenario over a lifetime. During flushing, PAH levels frequently exceeded drinking water quality standards; after flushing, these levels dropped rapidly. After the repair of cast iron water mains, PAH levels exceeded the drinking water standards for up to 40 days in some locations. The estimated margin of exposure for PAH exposure through drinking water was > 10,000 for all 120 measurement locations, which suggests that PAH exposure through drinking water is of low concern for consumer health. However, factors that differ among water systems, such as the use of chlorination for disinfection, may influence PAH levels in other locations.

  17. 新一代航空电子综合化及预测与健康管理技术%Technologies of New Generation Avionics Integration and Prognostics and Health Management

    Institute of Scientific and Technical Information of China (English)

    赵宁社; 翟正军; 王国庆

    2011-01-01

    Based on the introduction of the evolution of avionics systems, the main features of the new generation integrated avionics system are analyzed and the key technology of avionics PHM are probed deeply, including physical-of-failure(POF), stress damage assessment, failure precursor and canary. Moreover, the key technology and applications of the PHM-related information fusion, artificial intelligence, data mining and prognostics are thoroughly analyzed. Finally, the architecture of new generation integrated modular avionics system and PHM are researched and given.%在介绍航空电子系统发展演变历史的基础上,分析了新一代综合化航电系统的主要特征,深入探讨了航空电子预测与健康管理(PHM)的关键技术,包括失效机理分析、应力损伤评估、故障先兆以及预警电路(canary)4个类别,详细分析了PHM相关的信息融合、人工智能、数据挖掘与预测等技术的实现方法与应用,研究并给出了新一代综合模块化航空电子系统与PHM的体系架构.

  18. Prognostic limitations of the Daumas-Duport grading scheme in infratentorial neuroglial tumors in children.

    Science.gov (United States)

    Gilles, Floyd H; Tavaré, C Jane; Leviton, Alan; Hedley-Whyte, E Tessa; Sotrel, Anna; Adelman, Lester; Davis, Richard L; Rorke, Lucy B

    2004-01-01

    The Daumas-Duport grading scheme (DDGS) utilizes four histologic features in an additive method (grade 1 if none present, grade 2 if only one is present, etc.). Its efficacy in achieving prognostically homogeneous groups of childhood infratentorial neuroglial tumors and its concordance with World Health Organization (WHO) diagnoses has not been evaluated. We investigated these questions using the Childhood Brain Tumor Consortium (CBTC) database of 1241 neuroglial tumors limited to the infratentorial compartment. We calculated survival function estimates for various DDGS grades as well as the histologic features within each grade. The feature of endothelial prominence improved survival expectation, whereas the remaining three features of nuclear atypia, mitoses, and necrosis were associated with worsened survival. Survival estimates for tumors with DDGS grades 2 and 3 did not differ. Some grades contained feature subsets with significantly different survival distributions. The survival distributions of DDGS grade 1, DDGS grade 2 with only endothelial prominence, and DDGS grade 3 with nuclear atypia and endothelial prominence were not significantly different. DDGS grade within WHO diagnoses had no significant effect on survival expectation. We conclude that grading by summation of only four histologic features, as in the DDGS, is inappropriate for assessment of childhood neuroglial tumors. A classification scheme considering the complete histologic content is more likely to provide clinically useful diagnoses. Such a scheme, based on the CBTC database is available. This scheme uses 26 histologic features identified as reliable in read-reread studies.

  19. Diversity and Distribution of Host Animal Species of Hantavirus and Risk to Human Health in Jiuhua Mountain Area, China

    Institute of Scientific and Technical Information of China (English)

    HU Xing Qiang; LI Shi Guang; LIU Hong; WANG Jun; HUA Ri Mao

    2014-01-01

    Objective To investigate the diversity and the distribution of host animal species of hantavirus and the effect on human health in Jiuhua Mountain area, China. Methods The host animal species of hantavirus was surveyed by using the trap method and the species diversity was evaluated by using the Simpson, Shannon-Weaner, and Pielou indices. Hantavirus antigens or antibodies in lung and blood samples of all the captured host animals were detected by direct or indirect immunofluorescence. Results Nine animal species of hantavirus were distributed in the forest ecosystem of Jiuhua Mountain. Of these, Niviventer confucianus and Apodemus agrarius were predominant, and N. confucianus, Rattus norvegicus, and Mus musculus had relatively large niche breadth index values. The host animals in the eastern and western mountain regions shared similar biodiversity index characteristics, predominant species, and species structures. Hantavirus was detected in 5 host animal species in Jiuhua Mountain area, the carriage rate of hantavirus was 6.03%. The average density of host animals in forest areas of the mountainous area was only 2.20%, and the virus infection rate in the healthy population was 2.33%. Conclusion The circulation of hantavirus was low in the forest areas of Jiuhua Mountain and did not pose a threat to human health.

  20. A Modified Nottingham Prognostic Index for Breast Cancer Patients Diagnosed in Denmark 1978-1994

    DEFF Research Database (Denmark)

    Rostgaard, Klaus; Mouridsen, Henning T.; Væth, Michael;

    2001-01-01

    Stage of disease is a predictor of breast cancer survival. We used data from the Danish Cancer Register amd the Daniish Breast Cancer Cooperative Group to study stage distribution in 0-69-years-old Danish breast cancer patients diagnosed in 1978-1994. We constructed a modified Nottingham Prognostic...

  1. An optimization method for condition based maintenance of aircraft fleet considering prognostics uncertainty.

    Science.gov (United States)

    Feng, Qiang; Chen, Yiran; Sun, Bo; Li, Songjie

    2014-01-01

    An optimization method for condition based maintenance (CBM) of aircraft fleet considering prognostics uncertainty is proposed. The CBM and dispatch process of aircraft fleet is analyzed first, and the alternative strategy sets for single aircraft are given. Then, the optimization problem of fleet CBM with lower maintenance cost and dispatch risk is translated to the combinatorial optimization problem of single aircraft strategy. Remain useful life (RUL) distribution of the key line replaceable Module (LRM) has been transformed into the failure probability of the aircraft and the fleet health status matrix is established. And the calculation method of the costs and risks for mission based on health status matrix and maintenance matrix is given. Further, an optimization method for fleet dispatch and CBM under acceptable risk is proposed based on an improved genetic algorithm. Finally, a fleet of 10 aircrafts is studied to verify the proposed method. The results shows that it could realize optimization and control of the aircraft fleet oriented to mission success.

  2. Prognostic markers of canine pyometra

    Directory of Open Access Journals (Sweden)

    M.C. Sant'Anna

    2014-12-01

    Full Text Available The pyometra is a disease that affects middle age and elderly female dogs during diestrus. Hormonal, microbiological, biochemical and hematological aspects are well described. However, few studies have evaluated the role of each in the prognosis of canine pyometra. The aim of this study was to identify markers associated with clinical worsening of dogs with pyometra. We prospectively evaluated 80 dogs with pyometra treated surgically. Group 1 consisted of dogs that were discharged within 48 hours after surgery and Group 2 consisted of those who required prolonged hospitalization or died. The findings of hematological, biochemical and blood lactate levels were compared between groups and variables such as bacterial multidrug resistance, systemic inflammatory response syndrome (SIRS, hyperlactatemia and increased creatinine were analyzed through the dispersion of frequencies between groups. Among the variables studied, the presence of SIRS and elevated serum creatinine >2.5mg/mL were effective in predicting the worsening of the disease and can be used as prognostic markers of canine pyometra.

  3. Uveal Melanoma Treatment and Prognostication.

    Science.gov (United States)

    Dogrusöz, Mehmet; Jager, Martine J; Damato, Bertil

    2017-01-01

    Approximately 90% of uveal melanoma develop in the choroid, with the remainder arising in the ciliary body or the iris. The treatment of uveal melanoma is aimed at conserving the eye and useful vision, and, if possible, preventing metastatic disease. Enucleation is now reserved for tumors that are large and/or involve the optic disc, having largely been replaced by various forms of radiotherapy (plaque brachy-therapy, proton beam or stereotactic radiotherapy) and laser therapy. Whereas iridectomy and iridocyclectomy are widely performed, transscleral exoresection of choroidal tumors is performed only in a few centers because it requires special skills and hypotensive anesthesia. Transretinal endoresection using vitrectomy equipment is easier but controversial because of concerns about tumor seeding. Long-term postoperative surveillance is necessary to identify and treat local tumor recurrence and any other complications, such as radiation-induced morbidity, and to provide counseling to the patient. Factors predicting metastasis include older age, large tumor size, ciliary body involvement, extraocular spread, epithelioid cytomorphology, chromosome 3 loss and chromosome 8q gain, class 2 gene expression profile, loss of BRCA1-associated protein-1 (BAP1), and the presence of inflammation. Prognostication is enhanced by multi-variable analysis combining clinical, histologic, and genetic factors, also taking the patient's age and sex into account. As there is a lack of options for treating metastases, much research is focused on identifying potential therapeutic targets. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  4. Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya.

    Science.gov (United States)

    Macharia, Peter M; Odera, Patroba A; Snow, Robert W; Noor, Abdisalan M

    2017-09-12

    In high to moderate malaria transmission areas of Kenya, long-lasting insecticidal nets (LLINs) are provided free of charge to pregnant women and infants during routine antenatal care (ANC) and immunization respectively. Quantities of LLINs distributed to clinics are quantified based on a combination of monthly consumption data and population size of target counties. However, this approach has been shown to lead to stock-outs in targeted clinics. In this study, a novel LLINs need quantification approach for clinics in the routine distribution system was developed. The estimated need was then compared to the actual allocation to identify potential areas of LLIN over- or under-allocation in the high malaria transmission areas of Western Kenya. A geocoded database of public health facilities was developed and linked to monthly LLIN allocation. A network analysis approach was implemented using the location of all public clinics and topographic layers to model travel time. Estimated travel time, socio-economic and ANC attendance data were used to model clinic catchment areas and the probability of ANC service use within these catchments. These were used to define the number of catchment population who were likely to use these clinics for the year 2015 equivalent to LLIN need. Actual LLIN allocation was compared with the estimated need. Clinics were then classified based on whether allocation matched with the need, and if not, whether they were over or under-allocated. 888 (70%) public health facilities were allocated 591,880 LLINs in 2015. Approximately 682,377 (93%) pregnant women and infants were likely to have attended an LLIN clinic. 36% of the clinics had more LLIN than was needed (over-allocated) while 43% had received less (under-allocated). Increasing efficiency of allocation by diverting over supply of LLIN to clinics with less stock and fully covering 43 clinics that did not receive nets in 2015 would allow for complete matching of need with distribution. The

  5. Polycyclic aromatic hydrocarbons (PAHs) in multimedia environment of Heshan coal district, Guangxi: distribution, source diagnosis and health risk assessment.

    Science.gov (United States)

    Huang, Huan-Fang; Xing, Xin-Li; Zhang, Ze-Zhou; Qi, Shi-Hua; Yang, Dan; Yuen, Dave A; Sandy, Edward H; Zhou, Ai-Guo; Li, Xiao-Qian

    2016-10-01

    Mining activities are among the major culprits of the wide occurrences of soil and water pollution by PAHs in coal district, which have resulted in ecological fragilities and health risk for local residents. Sixteen PAHs in multimedia environment from the Heshan coal district of Guangxi, South China, were measured, aiming to investigate the contamination level, distribution and possible sources and to estimate the potential health risks of PAHs. The average concentrations of 16 PAHs in the coal, coal gangue, soil, surface water and groundwater were 5114.56, 4551.10, 1280.12 ng g(-1), 426.98 and 381.20 ng L(-1), respectively. Additionally, higher soil and water PAH concentrations were detected in the vicinities of coal or coal gangue dump. Composition analysis, isomeric ratio, Pearson correlation analysis and principal component analysis were performed to diagnose the potential sources of PAHs in different environmental matrices, suggesting the dominant inputs of PAHs from coal/coal combustion and coal gangue in the soil and water. Soil and water guidelines and the incremental lifetime risk (ICLR) were used to assess the health risk, showing that soil and water were heavily contaminated by PAHs, and mean ICLRcoal/coal-gangue and mean ICLRsoil were both significantly higher than the acceptable levels (1 × 10(-4)), posing high potential carcinogenic risk to residents, especially coal workers. This study highlights the environmental pollution problems and public health concerns of coal mining, particularly the potential occupational health hazards of coal miners exposed in Heshan.

  6. Health impact and cost-effectiveness of a private sector bed net distribution: experimental evidence from Zambia

    Science.gov (United States)

    2013-01-01

    Background Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). Methods The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia’s cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme. Results The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia’s NMCP. Conclusions The results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial. PMID:23506170

  7. Distribution of ideal cardiovascular health by educational levels from 1978 to 2006

    DEFF Research Database (Denmark)

    Olsen, Gitte S; Holm, Ann-Sofie S; Jørgensen, Torben

    2014-01-01

    BACKGROUND: The focus on improvements in ideal cardiovascular health is a relatively new approach and to our knowledge nobody has published the trend in regard to educational difference. DESIGN: Time trend analysis from six cross-sectional studies in 1978-2006 from the south-western part of the c......, the educational difference was less pronounced probably because very few men reached an ideal cardiovascular risk profile. This stresses the importance for preventive efforts targeting low educated groups, and men in particular.......% in 2006. From 1991, an educational difference occurred, increasing to a 5-fold difference in 2006 between the highest and lowest educated women. For men, a less pronounced increase occurred from 1% in 1978 to 5% in 2006; a change which was only significant among the highest educated. An educational...... difference occurred from 1986 to 1999 between the highest and lowest educated men, but was no longer present in 2006. CONCLUSIONS: The trend for women shows an increasing proportion in ideal cardiovascular health with a more unfavourable risk profile among women with a low educational level. For men...

  8. Dioxin distribution characteristics and health risk assessment in different size particles of fly ash from MSWIs in China.

    Science.gov (United States)

    Wu, Simiao; Zhou, Jizhi; Pan, Yun; Zhang, Jia; Zhang, Lingen; Ohtsuka, Nobutoshi; Motegi, Mamoru; Yonemochi, Shinichi; Oh, Kokyo; Hosono, Shigeo; Qian, Guangren

    2016-04-01

    During the process of treating and recycling Municipal Solid Waste Incinerators (MSWIs) fly ash, polychlorinated dibenzo-p-dioxins (PCDD/Fs) and polychlorinated dibenzofurans (dl-PCBs) in fly ash may potentially mobilize in the atmosphere and be widely distributed in the environment because of the inevitable re-suspension. Thus, this work presents the distributions of PCDD/Fs and dl-PCBs in inhalable coarse particles (Dp10-2.5 (particle diameter in μm)), fine particles (Dpash and original fly ash from four MSWI plants in China. The results show that PCDD/Fs and dl-PCBs preferentially concentrated in Dp10-2.5 and Dpash, but the distribution of PCDD/Fs congeners in Dp10-2.5 and Dpash. The main TEQ contribution included 1,2,3,7,8-PeCDD, 2,3,7,8-TeCDD in PCDDs and 2,3,4,7,8-PeCDF in PCDFs for Dp10-2.5, Dpash. Furthermore, the mass and TEQ contribution of dl-PCBs was relatively low. In addition, compared with the fluidized bed, the samples from the grate-type furnaces had significantly lower dioxin concentrations. In terms of potential health risk, the non-carcinogenic risk of PCDD/Fs in Dp10-2.5 and Dpash during the process of recycle and disposal.

  9. Combining spatial distribution with oral bioaccessibility of metals in smelter-impacted soils: implications for human health risk assessment.

    Science.gov (United States)

    Pelfrêne, Aurélie; Détriché, Sébastien; Douay, Francis

    2015-02-01

    Geostatistical analysis and GIS-based spatial mapping have been widely used for risk assessment of environmental pollution. The objectives of this study were to: (1) investigate the spatial variability of pseudototal concentrations of Cd, Pb, and Zn; (2) estimate the degree of contamination on the basis of pollution indexes; and (3) combine geostatistical analysis with oral bioaccessibility to better assess the population's exposure to metals in smelter-impacted soils. Implications for human health risks were assessed by considering soil as a contaminant source, a release mechanism of contaminated soil to the hands, ingestion as an exposure route, and metal bioaccessibility. The bioaccessibility data in the gastric (G) and gastrointestinal (GI) phases were integrated into the standard hazard quotient-based risk assessment method. Using pollution indices showed that the entire area studied was highly polluted in terms of soil metal concentrations. However, the spatial pattern of health risk levels did not coincide with the spatial distribution of the degree of soil contamination. Introducing the bioaccessible fraction of metals from soils into the exposure calculations resulted in a substantial decrease in calculated risk (HI, hazard index) and provided a more realistic estimate of exposure to the three metals. For the highly exposed population, 46% of the soils studied provided an HI-G > 1.0 and 15% provided an HI-GI > 1.0, suggesting probable adverse health effects in children. The present study highlights the importance of conducting studies taking into account metal bioaccessible values in risk assessment.

  10. Distribution of bacteria in inhalable particles and its implications for health risks in kindergarten children in Hong Kong

    Science.gov (United States)

    Deng, Wenjing; Chai, Yemao; Lin, Huiying; So, Winnie W. M.; Ho, K. W. K.; Tsui, A. K. Y.; Wong, R. K. S.

    2016-03-01

    Health risks in children caused by bacteria in indoor environments have attracted much attention in recent years. There are many harmful bacteria, and children have greater health risks than adults in the same environment. To investigate the association between children's health risks and the distribution and concentration of bacteria in particulate matter smaller than 2.5 μm in indoor and outdoor air at three kindergartens in Hong Kong, quantitative polymerase chain reaction was used to determine the concentration of bacteria, and the terminal restriction fragment length polymorphism method targeting 16S ribosomal RNA genes was used to predict the phylogenetic airborne bacterial community structures. The bacterial concentrations indoors were higher than those outdoors in the three kindergartens, but no obvious differences were found (P > 0.05). Statistical analysis showed that the different schools had significantly different concentrations (P bacteria in schools downtown (in Kowloon) was the greatest, reaching 3.3 × 103 to 4.95 × 104 cells per m3. However, the results showed no significant differences between the microbial populations obtained indoors and those obtained outdoors. The dominant genera were very similar among the six samples. Our results suggest that the majority of the inhalable bacteria were harmless to humans. Only a small fraction of microbial pathogens were identified, and their relative abundance appeared to increase as the concentration of particulate matter pollution increased. Analysis of these bacteria can give important clues regarding the exposure of kindergarten children to bacteria in indoor and outdoor air.

  11. The Distribution and Health Risk Assessment of Metals in Soils in the Vicinity of Industrial Sites in Dongguan, China

    Science.gov (United States)

    Liu, Chao; Lu, Liwen; Huang, Ting; Huang, Yalin; Ding, Lei; Zhao, Weituo

    2016-01-01

    Exponential industrialization and rapid urbanization have resulted in contamination of soil by metals from anthropogenic sources in Dongguan, China. The aims of this research were to determine the concentration and distribution of various metals (arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), lead (Pb) and zinc (Zn)) in soils and identify their potential health risks for local residents. A total of 106 soil samples were collected from the vicinity of industrial sites in Dongguan. Two types of samples were collected from each site: topsoil (0–20 cm, TS) and shallow soil (20–50 cm, SS). Results showed that the soils were contaminated by metals and pollution was mainly focused on TS. The geoaccumulation index (Igeo) and pollution indexes (PI) implied that there was a slight increase in the concentrations of Cd, Cu, Hg, Ni, and Pb, but the metal pollution caused by industrial activities was less severe, and elements of As and Cr exhibited non-pollution level. The risk assessment results suggested that there was a potential health risk associated with As and Cr exposure for residents because the carcinogenic risks of As and Cr via corresponding exposure pathways exceeded the safety limit of 10−6 (the acceptable level of carcinogenic risk for humans). Furthermore, oral ingestion and inhalation of soil particles are the main exposure pathways for As and Cr to enter the human body. This study may provide basic information of metal pollution control and human health protection in the vicinity of industrial regions. PMID:27548198

  12. A distributed health data network analysis of survival outcomes: the International Consortium of Orthopaedic Registries perspective.

    Science.gov (United States)

    Banerjee, Samprit; Cafri, Guy; Isaacs, Abby J; Graves, Stephen; Paxton, Elizabeth; Marinac-Dabic, Danica; Sedrakyan, Art

    2014-12-17

    The International Consortium for Orthopaedic Registries is a multinational initiative established by the United States Food and Drug Administration to develop a health data network aimed at providing a robust infrastructure to facilitate evidence-based decision-making on performance of medical devices. Through the International Consortium for Orthopaedic Registries, individual data holders have complete control of their data and can choose to participate in studies of their choice. In this article, we present an overview of the data extraction process and the analytic strategy employed to answer several device performance-related questions in total hip arthroplasty and total knee arthroplasty. In the process, we discuss some nuances pertinent to International Consortium for Orthopaedic Registries data that pose certain statistical challenges, and we briefly suggest strategies to be adopted to address them.

  13. Distributed leadership - Strenghtening the condition for continious innovation in primary health organizations

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Ulhøi, John Parm

    study of four units within a Danish hospital with about 4500 employees. Our findings identify a mix of emergent and contextualized leadership which needs time to be enacted. Furthermore, we find that resource allocation, social capital accumulation, collaborative work culture, and legitimacy building......Public hospitals need to change and innovate to handle the challenges of increasing demands for more, faster, better and cheaper health provision. Practicing leadership does not occur in a sterile context but in a highly contextual and social setting. This in turn invites for focussing...... mediate the DL-continuous innovation relationship at the unit level. The studies’ findings contribute to the leadership and innovation literature and might be of insight for those interested in the management of public organizations....

  14. Prognostic factors of long term disability due to mental disorders: a systematic review.

    Science.gov (United States)

    Cornelius, L R; van der Klink, J J L; Groothoff, J W; Brouwer, S

    2011-06-01

    INTRODUCTION In the past few decades, mental health problems have increasingly contributed to sickness absence and long-term disability. However, little is known about prognostic factors of return to work (RTW) and disability of persons already on sick leave due to mental health problems. Understanding these factors may help to develop effective prevention and intervention strategies to shorten the duration of disability and facilitate RTW. METHOD We reviewed systematically current scientific evidence about prognostic factors for mental health related long term disability, RTW and symptom recovery. Searching PubMed, PsycINFO, Embase, Cinahl and Business Source Premier, we selected articles with a publication date from January 1990 to March 2009, describing longitudinal cohort studies with a follow-up period of at least 1 year. Participants were persons on sick leave or receiving disability benefit at baseline. We assessed the methodological quality of included studies using an established criteria list. Consistent findings in at least two high quality studies were defined as strong evidence and positive findings in one high quality study were defined as limited evidence. RESULTS Out of 796 studies, we included seven articles, all of high methodological quality describing a range of prognostic factors, according to the ICF-model categorized as health-related, personal and external factors. We found strong evidence that older age (>50 years) is associated with continuing disability and longer time to RTW. There is limited evidence for the association of other personal factors (gender, education, history of previous sickness absence, negative recovery expectation, socio-economic status), health related (stress-related and shoulder/back pain, depression/anxiety disorder) and external i.e., job-related factors (unemployment, quality and continuity of occupational care, supervisor behavior) with disability and RTW. We found limited evidence for the association of

  15. [Prognostic value of AgNORs in breast cancer].

    Science.gov (United States)

    Aubele, M; Auer, G; Jütting, U

    1994-03-01

    Silver stained AgNORs were investigated by means of a semiautomatic image analysis system. Paraffin sections from 137 invasive ductal carcinomas of the breast were available with clinical and histological data, several DNA distribution parameters, and follow-up data of about 10 years (45 to 165 months). By means of the Chi 2-test the correlation of AgNOR features with the other variables was investigated. A significant correlation was found between AgNORs and the histological grading, and between AgNORs and most of the DNA parameters. Tumor size (pT) and pTNM-stage showed significant correlation with one of the AgNOR parameters: standard deviation (SD) of average AgNOR area and of AgNOR number, respectively. No correlation was found between AgNORs and the axillary nodal status (pN). The prognostic significance of AgNORs was estimated by using Cox regression analysis. In a multivariate approach offering all parameters available one AgNOR feature (coefficient of variation of relative AgNOR area) ranked at the third position beyond the SD of DNA distribution and the pTNM-staging. Considering the distant-recurrence free interval of patients instead of the survival time the same AgNOR feature showed an independent prognostic value.

  16. 现代配电网健康指数理论最新研究进展%Recent Development of Health Index Theory for Modern Distribution Network

    Institute of Scientific and Technical Information of China (English)

    周莉梅; 马钊; 盛万兴

    2016-01-01

    The origin and concept of Health Index for power equipment are briefly introduced and domestic research work related to Health Index concept for distribution network is outlined.Then the definition of Health Index for distribution network is discussed.Research status and recent development of Health Index theory for modern distribution network both domestic and abroad are described and existing problems of distribution assets management and Health Index theory application in China are pointed out.Finally the main problem existing and improvement direction of present Health Index research for distribution network are put forward in the paper.%简要介绍了电力设备健康指数的起源和概念,以及国内在配电网健康指数概念方面的相关研究工作,进而探讨了配电网健康指数的定义;概述了国内外在配电资产管理和健康指数理论方面的研究现状与进展情况,指出了我国在配电资产管理和健康指数理论应用方面存在的一些问题;最后,针对目前配电网健康指数理论研究存在的主要问题提出了未来的改进方向.

  17. Real-time appraisal of the spatially distributed heat related health risk and energy demand of cities

    Science.gov (United States)

    Keramitsoglou, Iphigenia; Kiranoudis, Chris T.; Sismanidis, Panagiotis

    2016-08-01

    The Urban Heat Island (UHI) is an adverse environmental effect of urbanization that increases the energy demand of cities, impacts the human health, and intensifies and prolongs heatwave events. To facilitate the study of UHIs the Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens (IAASARS/NOA) has developed an operational real-time system that exploits remote sensing image data from Meteosat Second Generation - Spinning Enhanced Visible and Infrared Imager (MSG-SEVIRI) and generates high spatiotemporal land surface temperature (LST) and 2 m air temperature (TA) time series. These datasets form the basis for the generation of higher value products and services related to energy demand and heat-related health issues. These products are the heatwave hazard (HZ); the HUMIDEX (i.e. an index that describes the temperature felt by an individual exposed to heat and humidity); and the cooling degrees (CD; i.e. a measure that reflects the energy needed to cool a building). The spatiotemporal characteristics of HZ, HUMIDEX and CD are unique (1 km/5 min) and enable the appraisal of the spatially distributed heat related health risk and energy demand of cities. In this paper, the real time generation of the high spatiotemporal HZ, HUMIDEX and CD products is discussed. In addition, a case study corresponding to Athens' September 2015 heatwave is presented so as to demonstrate their capabilities. The overall aim of the system is to provide high quality data to several different end users, such as health responders, and energy suppliers. The urban thermal monitoring web service is available at http://snf-652558.vm.okeanos.grnet.gr/treasure/portal/info.html.

  18. Spatial distribution mapping of drinking water fluoride levels in Karnataka, India: fluoride-related health effects.

    Science.gov (United States)

    Chowdhury, Chitta R; Shahnawaz, Khijmatgar; Kumari, Divya; Chowdhury, Avidyuti; Bedi, Raman; Lynch, Edward; Harding, Stewart; Grootveld, Martin

    2016-11-01

    (1) To estimate the concentrations of fluoride in drinking water throughout different zones and districts of the state of Karnataka. (2) To investigate the variation of fluoride concentration in drinking water from different sources, and its relationships to daily temperature and rainfall status in the regional districts. (3) To develop an updated fluoride concentration intensity map of the state of Karnataka, and to evaluate these data in the context of fluoride-related health effects such as fluorosis and their prevalence. Aqueous standard solutions of 10, 100 and 1,000 ppm fluoride (F(-)) were prepared with analytical grade Na(+)/F(-) and a buffer; TISAB II was incorporated in both calibration standard and analysis solutions in order to remove the potentially interfering effects of trace metal ions. This analysis was performed using an ion-selective electrode (ISE), and mean determination readings for n = 5 samples collected at each Karnataka water source were recorded. The F(-) concentration in drinking water in Karnataka state was found to vary substantially, with the highest mean values recorded being in the north-eastern zone (1.61 ppm), and the lowest in the south-western one (only 0.41 ppm). Analysis of variance (ANOVA) demonstrated that there were very highly significant 'between-zone' and 'between-districts-within-zones' sources of variation (p water source F(-) levels within this state. The southern part of Karnataka has low levels of F(-) in its drinking water, and may require fluoridation treatment in order to mitigate for dental caries and further ailments related to fluoride deficiency. However, districts within the north-eastern region have contrastingly high levels of fluoride, an observation which has been linked to dental and skeletal fluorosis. This highlights a major requirement for interventional actions in order to ensure maintenance of the recommended range of fluoride concentrations (0.8-1.5 ppm) in Karnataka's drinking water

  19. Estimation of customer lifetime value of a health insurance with interest rates obeying uniform distribution

    Science.gov (United States)

    Widyawan, A.; Pasaribu, U. S.; Henintyas, Permana, D.

    2015-12-01

    Nowadays some firms, including insurer firms, think that customer-centric services are better than product-centric ones in terms of marketing. Insurance firms will try to attract as many new customer as possible while maintaining existing customer. This causes the Customer Lifetime Value (CLV) becomes a very important thing. CLV are able to put customer into different segments and calculate the present value of a firm's relationship with its customer. Insurance customer will depend on the last service he or she can get. So if the service is bad now, then customer will not renew his contract though the service is very good at an erlier time. Because of this situation one suitable mathematical model for modeling customer's relationships and calculating their lifetime value is Markov Chain. In addition, the advantages of using Markov Chain Modeling is its high degree of flexibility. In 2000, Pfeifer and Carraway states that Markov Chain Modeling can be used for customer retention situation. In this situation, Markov Chain Modeling requires only two states, which are present customer and former ones. This paper calculates customer lifetime value in an insurance firm with two distinctive interest rates; the constant interest rate and uniform distribution of interest rates. The result shows that loyal customer and the customer who increase their contract value have the highest CLV.

  20. Characterizing distribution, sources, and potential health risk of polybrominated diphenyl ethers (PBDEs) in office environment.

    Science.gov (United States)

    Li, Yue; Chen, Ling; Wen, Zhi-Hao; Duan, Yan-Ping; Lu, Zhi-Bo; Meng, Xiang-Zhou; Zhang, Wen

    2015-03-01

    This study evaluated the levels and spatial distribution of PBDEs in 9 typical offices in Shanghai, China through the sample analysis of air and settled dust (floor dust, desktop dust and dust in computer case). PBDEs in air ranged from 93 to 322 pg/m(3), while the PBDEs levels in dust varied from 247 to 3.3 × 10(4) ng/g. Spatial variability of PBDEs in office dust was evident and likely influenced by air exchange and the use of electronic devices. A significant positive linear correlation was observed between the power usage rate and PBDE levels in both office air (R(2) = 0.81) and settled dust (R(2) = 0.94). The PBDEs exposure via inhalation and dust ingestion were both analyzed to estimate the life-time cancer risk, which is 1.34 × 10(-22) to 7.16 × 10(-22), significantly lower than the threshold level (10(-6)). Non-cancer risk indicated by the hazard index (<1) is also low in current exposure conditions.

  1. Distribution and Potential Health Risks of Arsenic, Selenium, and Fluorine in Natural Waters in Tibet, China

    Directory of Open Access Journals (Sweden)

    Yuan Tian

    2016-12-01

    Full Text Available The contents of major and trace elements were analyzed in 204 different types of water samples in 138 villages across 51 counties and cities of Tibet. The average concentrations of arsenic (As, selenium, and fluorine for each water category decreased in the following order: arsenic (in μg/L: hot spring 241.37 > lake 27.46 > stream 22.11 > shallow well 11.57 > deep well 6.22, selenium (in μg/L: deep well 0.85 > shallow well 0.68 > stream 0.62 > hot spring 0.39 > lake 0.36, and fluorine (in mg/L: hot spring 2.10 > lake 1.06 > deep well 0.45 > stream 0.20 > shallow well 0.15. The distribution of arsenic in Tibetan waters ranged between 77.35 μg/L in Ali prefecture and 1.17 μg/L in Chamdo prefecture, with intermediate values of 4.39, 2.52, 2.10, 1.68, and 1.51 μg/L in the prefectures of Shigatse, Nagchu, Lhasa, Lhoka, and Nyingchi, respectively. Carbonatite is a major source of elements in these waters. The non-carcinogenic risk in Tibet caused by heavy metals in drinking water is low overall, except in Ali prefecture’s surface and shallow ground waters, which contain high levels of As. Thus, deep well water in Tibet is safe to drink.

  2. Centimeter spatial resolution of distributed optical fiber sensor for structural health monitoring

    Science.gov (United States)

    Zou, Lufan; Bao, Xiaoyi; Wan, Yidun; Ravet, Fabien; Chen, Liang

    2004-11-01

    We present a sensing principle of the coherent probe-pump based Brillouin sensor (CPPBBS) that offers a new method to achieve centimeter spatial resolution with high frequency resolution. A combination of continuous wave (cw) and pulse source as the probe (Stokes) beam and cw laser as the pump beam have resulted in stronger Brillouin interaction of Stokes and pump inside the pulse-length in the form of cw-pump and pulse-pump interactions. We find that the coherent portion inside the pulse-length of these two interactions due to the same phase has a very high Brillouin amplification. The Brillouin profile originating from the coherent interaction of pulse-pump with cw-pump results in high temperature and strain accuracy with centimeter resolution, which allows us to detect 1.5 cm out-layer crack on an optical ground wire (OPGW) cable. The out-layer damaged regions on an optical ground wire (OPGW) cable have been identified successfully by measuring the strain distributions every 5 cm using this technology. The stress increased to 127 kN which corresponds to more than 7500 micro-strain in the fibers. The locations of structural indentations comprising repaired and undamaged regions are found and distinguished using their corresponding strain data. The elongation of repaired region increases with time on the stress of 127 kN. These results are quantified in terms of the fiber orientation, stress, and behavior relative to undamaged sections.

  3. Abundance, diversity, and distribution of mosquito vectors in selected ecological regions of Kenya: public health implications.

    Science.gov (United States)

    Lutomiah, Joel; Bast, Joshua; Clark, Jeffrey; Richardson, Jason; Yalwala, Santos; Oullo, David; Mutisya, James; Mulwa, Francis; Musila, Lillian; Khamadi, Samoel; Schnabel, David; Wurapa, Eyako; Sang, Rosemary

    2013-06-01

    The diversity of mosquito arbovirus vectors was investigated to define regional risk of arbovirus transmission in Kenya. Mosquitoes were sampled between April, 2007 and December, 2010 at thirteen sites across seven administrative provinces and ecological zones. CDC light traps were used to collect mosquitoes while human-landing collection was conducted in five of the sites to target day-feeding Aedes (Stegomyia) species. Over 524,000 mosquitoes were collected and identified into 101 species, 30 of them known vectors of arboviruses endemic to Kenya. Ae. (Neomelaniconion) mcintoshi and Ae. (Aedimorphus) ochraceus were most abundant in Garissa in the arid northeastern province, and Mansonia uniformis and Mn. africana in semi-arid Baringo in the Rift Valley Province. Ae. ochraceus, Mn. africana and Mn. uniformis were also significant in Nyanza Province, while Ae. (Neomelaniconion) circumluteolus predominated in Budalangi, Western Province. Aedes (Stegomyia) aegypti was predominant in Rabai in the Coast Province but insignificant in the western and Nyanza sites. Culex pipiens was abundant in Rift Valley and Nyanza Provinces around the lake shores. This study highlights the potential for emergence and re-emergence of arboviral diseases among vulnerable populations. This calls for comprehensive mapping of vector distribution and abundance for planning focused vector control measures.

  4. Human Health Risk Assessment Simulations in a Distributed Environment for Shuttle Launch

    Science.gov (United States)

    Thirumalainambi, Rajkumar; Bardina, Jorge

    2004-01-01

    During the launch of a rocket under prevailing weather conditions, commanders at Cape Canaveral Air Force station evaluate the possibility of whether wind blown toxic emissions might reach civilian and military personnel in the near by area. In our model, we focused mainly on Hydrogen chloride (HCL), Nitrogen oxides (NOx) and Nitric acid (HNO3), which are non-carcinogenic chemicals as per United States Environmental Protection Agency (USEPA) classification. We have used the hazard quotient model to estimate the number of people at risk. It is based on the number of people with exposure above a reference exposure level that is unlikely to cause adverse health effects. The risk to the exposed population is calculated by multiplying the individual risk and the number in exposed population. The risk values are compared against the acceptable risk values and GO or NO-go situation is decided based on risk values for the Shuttle launch. The entire model is simulated over the web and different scenaria can be generated which allows management to choose an optimum decision.

  5. The globally distributed genus Alexandrium: multifaceted roles in marine ecosystems and impacts on human health.

    Science.gov (United States)

    Anderson, Donald M; Alpermann, Tilman J; Cembella, Allan D; Collos, Yves; Masseret, Estelle; Montresor, Marina

    2012-02-01

    The dinoflagellate genus Alexandrium is one of the major harmful algal bloom (HAB) genera with respect to the diversity, magnitude and consequences of blooms. The ability of Alexandrium to colonize multiple habitats and to persist over large regions through time is testimony to the adaptability and resilience of this group of species. Three different families of toxins, as well as an as yet incompletely characterized suite of allelochemicals are produced among Alexandrium species. Nutritional strategies are equally diverse, including the ability to utilize a range of inorganic and organic nutrient sources, and feeding by ingestion of other organisms. Many Alexandrium species have complex life histories that include sexuality and often, but not always, cyst formation, which is characteristic of a meroplanktonic life strategy and offers considerable ecological advantages. Due to the public health and ecosystem impacts of Alexandrium blooms, the genus has been extensively studied, and there exists a broad knowledge base that ranges from taxonomy and phylogeny through genomics and toxin biosynthesis to bloom dynamics and modeling. Here we present a review of the genus Alexandrium, focusing on the major toxic and otherwise harmful species.

  6. A Distributed Approach to System-Level Prognostics

    Science.gov (United States)

    2012-09-01

    charge vari- ables qi are governed by q̇1 = −V1/Rp1 − (iFL + iFR + iBR + iBL) (c27) q̇2 = −V2/Rp2 − (iFL + iFR + iBR + iBL) (c28) q̇3 = −V3/Rp3 − (iFL... iFR + iBR + iBL) (c29) q̇4 = −V4/Rp4 − (iFL + iFR + iBR + iBL). (c30) 3We use a simple model here only for demonstration purposes. More detailed...TmBL hdBL, haBL i∗BL T ∗mBL c21,c25,c38,c42 M8 TdBR, TmBR hdBR, haBR i∗BR T ∗mBR c22,c26,c39,c43 M9 iFL, eiFL ∅ uFL, ω∗FL i∗FL c11,c15,c36,c44 M10 iFR

  7. A Survey of Attitudes towards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer

    Directory of Open Access Journals (Sweden)

    David G. Watt

    2015-01-01

    Full Text Available Introduction. The systemic inflammatory response (SIR plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems. Methods. An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer. Results. Of those invited by the survey (n=238, 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia. Conclusions. The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.

  8. Persistence, distribution, and impact of distinctly segmented microparticles on cochlear health following in vivo infusion.

    Science.gov (United States)

    Ross, Astin M; Rahmani, Sahar; Prieskorn, Diane M; Dishman, Acacia F; Miller, Josef M; Lahann, Joerg; Altschuler, Richard A

    2016-06-01

    Delivery of pharmaceuticals to the cochleae of patients with auditory dysfunction could potentially have many benefits from enhancing auditory nerve survival to protecting remaining sensory cells and their neuronal connections. Treatment would require platforms to enable drug delivery directly to the cochlea and increase the potential efficacy of intervention. Cochlear implant recipients are a specific patient subset that could benefit from local drug delivery as more candidates have residual hearing; and since residual hearing directly contributes to post-implantation hearing outcomes, it requires protection from implant insertion-induced trauma. This study assessed the feasibility of utilizing microparticles for drug delivery into cochlear fluids, testing persistence, distribution, biocompatibility, and drug release characteristics. To allow for delivery of multiple therapeutics, particles were composed of two distinct compartments; one containing polylactide-co-glycolide (PLGA), and one composed of acetal-modified dextran and PLGA. Following in vivo infusion, image analysis revealed microparticle persistence in the cochlea for at least 7 days post-infusion, primarily in the first and second turns. The majority of subjects maintained or had only slight elevation in auditory brainstem response thresholds at 7 days post-infusion compared to pre-infusion baselines. There was only minor to limited loss of cochlear hair cells and negligible immune response based on CD45+ immunolabling. When Piribedil-loaded microparticles were infused, Piribedil was detectable within the cochlear fluids at 7 days post-infusion. These results indicate that segmented microparticles are relatively inert, can persist, release their contents, and be functionally and biologically compatible with cochlear function and therefore are promising vehicles for cochlear drug delivery. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1510-1522, 2016.

  9. Prognostic DNA Methylation Markers for Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Siri H. Strand

    2014-09-01

    Full Text Available Prostate cancer (PC is the most commonly diagnosed neoplasm and the third most common cause of cancer-related death amongst men in the Western world. PC is a clinically highly heterogeneous disease, and distinction between aggressive and indolent disease is a major challenge for the management of PC. Currently, no biomarkers or prognostic tools are able to accurately predict tumor progression at the time of diagnosis. Thus, improved biomarkers for PC prognosis are urgently needed. This review focuses on the prognostic potential of DNA methylation biomarkers for PC. Epigenetic changes are hallmarks of PC and associated with malignant initiation as well as tumor progression. Moreover, DNA methylation is the most frequently studied epigenetic alteration in PC, and the prognostic potential of DNA methylation markers for PC has been demonstrated in multiple studies. The most promising methylation marker candidates identified so far include PITX2, C1orf114 (CCDC181 and the GABRE~miR-452~miR-224 locus, in addition to the three-gene signature AOX1/C1orf114/HAPLN3. Several other biomarker candidates have also been investigated, but with less stringent clinical validation and/or conflicting evidence regarding their possible prognostic value available at this time. Here, we review the current evidence for the prognostic potential of DNA methylation markers in PC.

  10. Why are public health authorities not concerned about Ebola in the US? Part I. Fat tailed distributions

    CERN Document Server

    Bar-Yam, Yaneer

    2014-01-01

    US public health authorities claim imposing quarantines on healthcare workers returning from West Africa is incorrect according to science. Their positions rely upon a set of studies and experience about outbreaks and transmission mechanisms in Africa as well as assumptions about what those studies imply about outbreaks in the US. According to this view the probability of a single infection is low and that of a major outbreak is non-existent. In a series of brief reports we will provide insight into why properties of networks of contagion that are not considered in traditional statistics suggest that risks are higher than those assumptions suggest. We begin with the difference between thin and fat tailed distributions applied to the number of infected individuals that can arise from a single one. Traditional epidemiological models consider the contagion process as described by $R_0$, the average number of new infected individuals arising from a single case. However, in a complex interdependent society it is p...

  11. Prognostics of Proton Exchange Membrane Fuel Cells stack using an ensemble of constraints based connectionist networks

    Science.gov (United States)

    Javed, Kamran; Gouriveau, Rafael; Zerhouni, Noureddine; Hissel, Daniel

    2016-08-01

    Proton Exchange Membrane Fuel Cell (PEMFC) is considered the most versatile among available fuel cell technologies, which qualify for diverse applications. However, the large-scale industrial deployment of PEMFCs is limited due to their short life span and high exploitation costs. Therefore, ensuring fuel cell service for a long duration is of vital importance, which has led to Prognostics and Health Management of fuel cells. More precisely, prognostics of PEMFC is major area of focus nowadays, which aims at identifying degradation of PEMFC stack at early stages and estimating its Remaining Useful Life (RUL) for life cycle management. This paper presents a data-driven approach for prognostics of PEMFC stack using an ensemble of constraint based Summation Wavelet- Extreme Learning Machine (SW-ELM) models. This development aim at improving the robustness and applicability of prognostics of PEMFC for an online application, with limited learning data. The proposed approach is applied to real data from two different PEMFC stacks and compared with ensembles of well known connectionist algorithms. The results comparison on long-term prognostics of both PEMFC stacks validates our proposition.

  12. The inescapable question of fairness in Pay-for-performance bonus distribution: a qualitative study of health workers' experiences in Tanzania.

    Science.gov (United States)

    Chimhutu, Victor; Songstad, Nils Gunnar; Tjomsland, Marit; Mrisho, Mwifadhi; Moland, Karen Marie

    2016-11-25

    During the last decade there has been a growing concern about the lack of results in the health sectors of many low income countries. Progress has been particularly slow in maternal- and child health. Prompted by the need to accelerate progress towards these health outcomes, pay-for- performance (P4P) schemes have been initiated in a number of countries. This paper explores the perceptions and experiences of health workers with P4P bonus distribution in the health system context of rural Tanzania. This qualitative study was based on the P4P pilot in Pwani Region of Tanzania. The study took place in 11 health care facilities in Rufiji District. The study informants and participants were different cadres of health workers assigned to different outpatient and inpatient departments at the health facilities, and local administrators of the P4P bonus distribution. Thirty two in-depth interviews (IDIs) with administrators and health care workers, and six focus group discussions (FGDs with Reproductive and Child Health (RCH) staff, non-RCH staff and non-medical staff were conducted. Collected data was analyzed through qualitative content analysis. The study found that the bonus distribution modality employed in the P4P programme was experienced as fundamentally unjust. The bonuses were calculated according to the centrality of the health worker position in meeting targeted indicators, drawn from the reproductive and child health (RCH) section. Both RCH staff and non-RCH perceived the P4P bonus as unfair. Non-RCH objected to getting less bonus than RCH staff, and RCH staff running the targeted RCH services, objected to not getting more P4P bonus. Non-RCH staff and health administrators suggested a flat-rate across board as the fairest way of distributing P4P bonuses. The perceived unfairness affected work motivation, undermined teamwork across departments and created tensions in the social relations at health facilities. Our results suggest that the experience of unfairness

  13. Multivariate meta-analysis of prognostic factor studies with multiple cut-points and/or methods of measurement.

    Science.gov (United States)

    Riley, Richard D; Elia, Eleni G; Malin, Gemma; Hemming, Karla; Price, Malcolm P

    2015-07-30

    A prognostic factor is any measure that is associated with the risk of future health outcomes in those with existing disease. Often, the prognostic ability of a factor is evaluated in multiple studies. However, meta-analysis is difficult because primary studies often use different methods of measurement and/or different cut-points to dichotomise continuous factors into 'high' and 'low' groups; selective reporting is also common. We illustrate how multivariate random effects meta-analysis models can accommodate multiple prognostic effect estimates from the same study, relating to multiple cut-points and/or methods of measurement. The models account for within-study and between-study correlations, which utilises more information and reduces the impact of unreported cut-points and/or measurement methods in some studies. The applicability of the approach is improved with individual participant data and by assuming a functional relationship between prognostic effect and cut-point to reduce the number of unknown parameters. The models provide important inferential results for each cut-point and method of measurement, including the summary prognostic effect, the between-study variance and a 95% prediction interval for the prognostic effect in new populations. Two applications are presented. The first reveals that, in a multivariate meta-analysis using published results, the Apgar score is prognostic of neonatal mortality but effect sizes are smaller at most cut-points than previously thought. In the second, a multivariate meta-analysis of two methods of measurement provides weak evidence that microvessel density is prognostic of mortality in lung cancer, even when individual participant data are available so that a continuous prognostic trend is examined (rather than cut-points). © 2015 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  14. Chemistry, distribution, and metabolism of tomato carotenoids and their impact on human health.

    Science.gov (United States)

    Khachik, Frederick; Carvalho, Lorena; Bernstein, Paul S; Muir, Garth J; Zhao, Da-You; Katz, Nikita B

    2002-11-01

    Recent epidemiological studies have suggested that the consumption of tomatoes and tomato-based food products reduce the risk of prostate cancer in humans. This protective effect has been attributed to carotenoids, which are one of the major classes of phytochemicals in this fruit. The most abundant carotenoid in tomato is lycopene, followed by phytoene, phytofluene, zeta-carotene, gamma-carotene, beta-carotene, neurosporene, and lutein. The distribution of lycopene and related carotenoids in tomatoes and tomato-based food products has been determined by extraction and high-performance liquid chromatography-UV/Visible photodiode array detection. Detailed qualitative and quantitative analysis of human serum, milk, and organs, particularly prostate, have revealed the presence of all the aforementioned carotenoids in biologically significant concentrations. Two oxidative metabolites of lycopene, 2,6-cyclolycopene-1,5-diols A and B, which are only present in tomatoes in extremely low concentrations, have been isolated and identified in human serum, milk, organs (liver, lung, breast, liver, prostate, colon) and skin. Carotenoids may also play an important role in the prevention of age-related macular degeneration, cataracts, and other blinding disorders. Among 25 dietary carotenoids and nine metabolites routinely found in human serum, mainly (3R,3'R,6'R)-lutein, (3R,3'R)-zeaxanthin, lycopene, and their metabolites were detected in ocular tissues. In this review we identified and quantified the complete spectrum of carotenoids from pooled human retinal pigment epithelium, ciliary body, iris, lens, and in the uveal tract and in other tissues of the human eye to gain a better insight into the metabolic pathways of ocular carotenoids. Although (3R,3'R,6'R)-lutein, (3R,3'R)-zeaxanthin, and their metabolites constitute the major carotenoids in human ocular tissues, lycopene and a wide range of dietary carotenoids have been detected in high concentrations in ciliary body and

  15. Assessing equity in the geographical distribution of community pharmacies in South Africa in preparation for a national health insurance scheme.

    Science.gov (United States)

    Ward, Kim; Sanders, David; Leng, Henry; Pollock, Allyson M

    2014-07-01

    To investigate equity in the geographical distribution of community pharmacies in South Africa and assess whether regulatory reforms have furthered such equity. Data on community pharmacies from the national department of health and the South African pharmacy council were used to analyse the change in community pharmacy ownership and density (number per 10,000 residents) between 1994 and 2012 in all nine provinces and 15 selected districts. In addition, the density of public clinics, alone and with community pharmacies, was calculated and compared with a national benchmark of one clinic per 10,000 residents. Interviews were conducted with nine national experts from the pharmacy sector. Community pharmacies increased in number by 13% between 1994 and 2012--less than the 25% population growth. In 2012, community pharmacy density was higher in urban provinces and was eight times higher in the least deprived districts than in the most deprived ones. Maldistribution persisted despite the growth of corporate community pharmacies. In 2012, only two provinces met the 1 per 10,000 benchmark, although all provinces achieved it when community pharmacies and clinics were combined. Experts expressed concerns that a lack of rural incentives, inappropriate licensing criteria and a shortage of pharmacy workers could undermine access to pharmaceutical services, especially in rural areas. To reduce inequity in the distribution of pharmaceutical services, new policies and legislation are needed to increase the staffing and presence of pharmacies.

  16. Variations in Concentration and Distribution of Health-Related Elements Affected by Environmental and Genotypic Differences in Rice Grains

    Institute of Scientific and Technical Information of China (English)

    REN Xue-liang; LIU Qing-long; WU Dian-xing; SHU Qing-yao

    2006-01-01

    A research work was conducted to investigate the variations in concentration and distribution of health-related elements affected by environmental and genotypic differences in rice grains. The grain of Xieqingzao B (indica rice variety) and Xiushui 110 (japonica rice variety) were divided into: hull, bran and milled rice, based on the conventional rice consumption and process. Xieqingzao B was grown at four different locations, and at one location, it was planted in the same field and season as Xiushui 110. In addition, another four indica and four japonica varieties were cultivated in the same field and time to analyze the elements in milled rice. The average concentrations of total P and phytic acid P were the highest in the bran, followed by milled rice and hull; Zn, K, Mg, and As concentrations were the highest in bran, followed by hull and milled rice, while Fe, Ca, and Cu concentrations were the highest in the hull, but similar in bran and milled rice. The result indicated that genotype and environment significantly affected the concentrations of all the tested elements, while the distribution of the above elements in grains was not in the same order as concentration. Moreover, all the elements except 97.7% of Cu and 93.2% of Fe was deposited in the hull on average, were mostly distributed either in the bran (37.3% and 57.7% for K and phytic acid P) or in milled rice (41.7%, 42.6%, 40.3%, 49.8% for Zn, Mg, As, total P, respectively).

  17. [Public scientific knowledge distribution in health information, communication and information technology indexed in MEDLINE and LILACS databases].

    Science.gov (United States)

    Packer, Abel Laerte; Tardelli, Adalberto Otranto; Castro, Regina Célia Figueiredo

    2007-01-01

    This study explores the distribution of international, regional and national scientific output in health information and communication, indexed in the MEDLINE and LILACS databases, between 1996 and 2005. A selection of articles was based on the hierarchical structure of Information Science in MeSH vocabulary. Four specific domains were determined: health information, medical informatics, scientific communications on healthcare and healthcare communications. The variables analyzed were: most-covered subjects and journals, author affiliation and publication countries and languages, in both databases. The Information Science category is represented in nearly 5% of MEDLINE and LILACS articles. The four domains under analysis showed a relative annual increase in MEDLINE. The Medical Informatics domain showed the highest number of records in MEDLINE, representing about half of all indexed articles. The importance of Information Science as a whole is more visible in publications from developed countries and the findings indicate the predominance of the United States, with significant growth in scientific output from China and South Korea and, to a lesser extent, Brazil.

  18. Hierarchical Distributed-Lag Models: Exploring Varying Geographic Scale and Magnitude in Associations Between the Built Environment and Health.

    Science.gov (United States)

    Baek, Jonggyu; Sanchez-Vaznaugh, Emma V; Sánchez, Brisa N

    2016-03-15

    It is well known that associations between features of the built environment and health depend on the geographic scale used to construct environmental attributes. In the built environment literature, it has long been argued that geographic scales may vary across study locations. However, this hypothesized variation has not been systematically examined due to a lack of available statistical methods. We propose a hierarchical distributed-lag model (HDLM) for estimating the underlying overall shape of food environment-health associations as a function of distance from locations of interest. This method enables indirect assessment of relevant geographic scales and captures area-level heterogeneity in the magnitudes of associations, along with relevant distances within areas. The proposed model was used to systematically examine area-level variation in the association between availability of convenience stores around schools and children's weights. For this case study, body mass index (weight kg)/height (m)2) z scores (BMIz) for 7th grade children collected via California's 2001-2009 FitnessGram testing program were linked to a commercial database that contained locations of food outlets statewide. Findings suggested that convenience store availability may influence BMIz only in some places and at varying distances from schools. Future research should examine localized environmental or policy differences that may explain the heterogeneity in convenience store-BMIz associations.

  19. Pollution level, phase distribution and health risk of polycyclic aromatic hydrocarbons in indoor air at public places of Hangzhou, China

    Energy Technology Data Exchange (ETDEWEB)

    Lu Hao [Department of Environmental Science, Zhejiang University, Hangzhou, Zhejiang, 310028 (China)], E-mail: luhaozju@163.com; Zhu Lizhong [Department of Environmental Science, Zhejiang University, Hangzhou, Zhejiang, 310028 (China)], E-mail: zlz@zju.edu.cn; Chen Shuguang [Department of Environmental Science, Zhejiang University, Hangzhou, Zhejiang, 310028 (China)], E-mail: chenshuguang@zju.edu.cn

    2008-04-15

    PAHs pollution survey in air of public places was conducted in Hangzhou, China. The most serious PAHs pollution was observed in indoor air of shopping centers and the slightest was in train stations. The molecular weight of chrysene (MW 228) appeared to be the dividing line for the PAHs with a larger or smaller distribution in the vapor or particulate phase. Concentrations of 15 PAHs on PM{sub 2.5} accounted for 71.3% of total particulate PAHs, and followed by PM{sub 2.5-10} fraction (17.6%) and >PM{sub 10} fraction (11.1%). In shopping centers and supermarkets, emission of 2-4 rings PAHs occurred from indoor sources, whereas 5-6 rings PAHs predominantly originated from transport of outdoor air. In temples, PAHs in indoor air mainly originated from incense burning. Health risks associated with the inhalation of PAHs were assessed, and naphthalene made the greatest contribution (62.4%) to the total health risks. - Concentrations of PAHs in the air of selected public places in Hangzhou correspond to 10{sup -3} life-time lung cancer risk.

  20. Prognostic Factors of Long Term Disability Due to Mental Disorders: A Systematic Review

    OpenAIRE

    Cornelius, L. R.; van der Klink, J. J. L.; Groothoff, J. W.; Brouwer, S.

    2010-01-01

    Introduction In the past few decades, mental health problems have increasingly contributed to sickness absence and long-term disability. However, little is known about prognostic factors of return to work (RTW) and disability of persons already on sick leave due to mental health problems. Understanding these factors may help to develop effective prevention and intervention strategies to shorten the duration of disability and facilitate RTW. Method We reviewed systematically current scientific...

  1. The Distribution and Health Risk Assessment of Metals in Soils in the Vicinity of Industrial Sites in Dongguan, China

    Directory of Open Access Journals (Sweden)

    Chao Liu

    2016-08-01

    Full Text Available Exponential industrialization and rapid urbanization have resulted in contamination of soil by metals from anthropogenic sources in Dongguan, China. The aims of this research were to determine the concentration and distribution of various metals (arsenic (As, cadmium (Cd, chromium (Cr, copper (Cu, mercury (Hg, nickel (Ni, lead (Pb and zinc (Zn in soils and identify their potential health risks for local residents. A total of 106 soil samples were collected from the vicinity of industrial sites in Dongguan. Two types of samples were collected from each site: topsoil (0–20 cm, TS and shallow soil (20–50 cm, SS. Results showed that the soils were contaminated by metals and pollution was mainly focused on TS. The geoaccumulation index (Igeo and pollution indexes (PI implied that there was a slight increase in the concentrations of Cd, Cu, Hg, Ni, and Pb, but the metal pollution caused by industrial activities was less severe, and elements of As and Cr exhibited non-pollution level. The risk assessment results suggested that there was a potential health risk associated with As and Cr exposure for residents because the carcinogenic risks of As and Cr via corresponding exposure pathways exceeded the safety limit of 10−6 (the acceptable level of carcinogenic risk for humans. Furthermore, oral ingestion and inhalation of soil particles are the main exposure pathways for As and Cr to enter the human body. This study may provide basic information of metal pollution control and human health protection in the vicinity of industrial regions.

  2. PROGNOSTIC SIGNIFICANCE OF CD56 EXPRESSION IN ACUTE LEUKEMIAS

    Directory of Open Access Journals (Sweden)

    B. M. Ahmed

    2014-12-01

    Conclusions. CD56 antigenic expression in AML cases represents an adverse prognostic factor. It should be regularly investigated in cases of AML for better prognostic stratification and assessment. KEY WORDS: CD56; leukemia, myeloid; prognosis

  3. Prognostics-Enabled Power Supply for ADAPT Testbed Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Ridgetop's role is to develop electronic prognostics for sensing power systems in support of NASA/Ames ADAPT testbed. The prognostic enabled power systems from...

  4. Distribution pattern following systemic mesenchymal stem cell injection depends on the age of the recipient and neuronal health.

    Science.gov (United States)

    Fabian, Claire; Naaldijk, Yahaira; Leovsky, Christiane; Johnson, Adiv A; Rudolph, Lukas; Jaeger, Carsten; Arnold, Katrin; Stolzing, Alexandra

    2017-04-18

    Mesenchymal stem cells (MSCs) show therapeutic efficacy in many different age-related degenerative diseases, including Alzheimer's disease. Very little is currently known about whether or not aging impacts the transplantation efficiency of MSCs. In this study, we investigated the distribution of intravenously transplanted syngeneic MSCs derived from young and aged mice into young, aged, and transgenic APP/PS1 Alzheimer's disease mice. MSCs from male donors were transplanted into female mice and their distribution pattern was monitored by PCR using Y-chromosome specific probes. Biodistribution of transplanted MSCs in the brains of APP/PS1 mice was additionally confirmed by immunofluorescence and confocal microscopy. Four weeks after transplantation into young mice, young MSCs were found in the lung, axillary lymph nodes, blood, kidney, bone marrow, spleen, liver, heart, and brain cortex. In contrast, young MSCs that were transplanted into aged mice were only found in the brain cortex. In both young and aged mouse recipients, transplantation of aged MSCs showed biodistribution only in the blood and spleen. Although young transplanted MSCs only showed neuronal distribution in the brain cortex in young mice, they exhibited a wide neuronal distribution pattern in the brains of APP/PS1 mice and were found in the cortex, cerebellum, hippocampus, olfactory bulb, and brainstem. The immunofluorescent signal of both transplanted MSCs and resident microglia was robust in the brains of APP/PS1 mice. Monocyte chemoattractant-1 levels were lowest in the brain cortex of young mice and were significantly increased in APP/PS1 mice. Within the hippocampus, monocyte chemoattractant-1 levels were significantly higher in aged mice compared with younger and APP/PS1 mice. We demonstrate in vivo that MSC biodistribution post transplantation is detrimentally affected by aging and neuronal health. Aging of both the recipient and the donor MSCs used attenuates transplantation efficiency

  5. Proceedings of the Annual Conference of the Prognostics and Health Management Society (PHM 2014) Held in Fort Worth, TX on September 29 - October 2, 2014. Invited Session on Corrosion Monitoring, Sensing, Detection and Prediction

    Science.gov (United States)

    2014-12-23

    that accelerometer and gyroscope measurements coin- cide with translational and rotational forces acting on the body, respectively, two FDI estimators...health and state-of-charge in lithium-ion batteries. M.Sc. Tesis . Department of Elec- trical Engineering, Universidad de Chile. Rubin, D. (1987

  6. Modelling spatial distribution of snails transmitting parasitic worms with importance to human and animal health and analysis of distributional changes in relation to climate

    DEFF Research Database (Denmark)

    Pedersen, Ulrik Bo; Midzi, Nicholas; Mduluza, Takafira;

    2014-01-01

    of a maximum entropy algorithm (Maxent). Two snail observation datasets from Zimbabwe, from 1988 and 2012, were compared in terms of geospatial distribution and potential distributional change over this 24-year period investigated. Climate data, from the two years were identified and used in a species...

  7. Developing a CD-CBM Anticipatory Approach for Cavitation - Defining a Model-Based Descriptor Consistent Across Processes, Phase 1 Final Report Context-Dependent Prognostics and Health Assessment: A New Paradigm for Condition-based Maintenance SBIR Topic No. N98-114

    Energy Technology Data Exchange (ETDEWEB)

    Allgood, G.O.; Dress, W.B.; Kercel, S.W.

    1999-06-01

    The objective of this research, and subsequent testing, was to identify specific features of cavitation that could be used as a model-based descriptor in a context-dependent condition-based maintenance (CD-CBM) anticipatory prognostic and health assessment model. This descriptor is based on the physics of the phenomena, capturing the salient features of the process dynamics. The test methodology and approach were developed to make the cavitation features the dominant effect in the process and collected signatures. This would allow the accurate characterization of the salient cavitation features at different operational states. By developing such an abstraction, these attributes can be used as a general diagnostic for a system or any of its components. In this study, the particular focus will be pumps. As many as 90% of pump failures are catastrophic. They seem to be operating normally and fail abruptly without warning. This is true whether the failure is sudden hardware damage requiring repair, such as a gasket failure, or a transition into an undesired operating mode, such as cavitation. This means that conventional diagnostic methods fail to predict 90% of incipient failures and that in addressing this problem, model-based methods can add value where it is actually needed.

  8. Potential toxic trace element (PTE) contamination in Baoji urban soil (NW China): spatial distribution, mobility behavior, and health risk.

    Science.gov (United States)

    Li, Xiaoping; Wu, Ting; Bao, Hongxiang; Liu, Xianyu; Xu, Changlin; Zhao, Yanan; Liu, Dongying; Yu, Hongtao

    2017-07-06

    Rapid urbanization and industrialization may cause increased exposure levels to potential toxic trace elements (PTEs) and associated health risks for population living in cities. The main objectives of this study are to investigate systematically the occurrence, source, fate, and risk of PTE contamination from industrial influence in Baoji urban soil. Seven PTE levels (Pb, Zn, Cu, Cr, V, Sb, and As) were surveyed in 50 composite samples from Baoji urban soil by wavelength dispersive X-ray fluorescence spectrometry. Results reveal that the long-term industrial activities have increased PTEs Pb (409.20 mg/kg mean value), Cu (107.19 mg/kg mean value), Zn (374.47 mg/kg mean value), and Sb (26.00 mg/kg mean value) to enrich in urban soil at the different extents. The same results concur with the significant similarity of spatial distribution patterns of Pb, Zn, Cu, and Sb (slightly similar distribution) interpolated by GIS, implying a considerable Pb, Zn, Cu, and Sb contamination pool in urban soil disturbance from local metallic industrial activities. Whereas As in study area mainly controls parent material leaching and therefore has natural sources. Cr and V with the heterogeneous spatial distributions are possibly inclined to coal combustion sources. Those conclusions are also confirmed by the results of multivariate analysis. The chemical forms of PTEs fractionated by BCR three-stage sequential extraction procedure show that Pb and Cu are highly associated to the reducible phase (62.55 and 36.41%, respectively). However, Zn is highly associated to the oxidizable phase (33.68%), and a significant concentration is associated to acid and water extractable fractionation of 15.93% for Zn and 34.40% for Pb. In contrast, As, Cr, V, and Sb are mainly bound to the residual phase (>65% for all elements) with low concentrations retained to water extractable fractionation. The health risk assessed by a new classification Modified Integrate Risk Assessment Code (MI

  9. Prognostic scores for use in African meningococcal epidemics.

    Science.gov (United States)

    Ajayi-Obe, E. K.; Lodi, E.; Alkali, A. S.; Galbati, M.; Rooney, C.; Mannoni, B.; Grim, P.; Nasidi, A.; Mohammed, I.

    1998-01-01

    Current WHO guidelines for the case management of meningococcal infections during epidemics in developing countries often cannot be applied, largely because of the limited health resources in such countries. Several scoring scales based on clinical and laboratory features in numerous combinations have been developed for the management of meningococcal infections in developed countries, and these have facilitated early identification of patients with fulminant disease and thus early intervention and reduction in mortality. Unfortunately such scoring scales are not appropriate for use in developing countries. We identified hypotension, tachycardia, tachypnoea, delay in capillary refill time, coma, absence of neck stiffness and petechiae and/or purpura as simple prognostic factors of meningococcal disease. Two scores were developed: score I, which includes all seven prognostic factors, had a sensitivity and specificity of 80% and 94%, respectively. Score II, which excluded hypotension, had a sensitivity and specificity of 73.3% and 89.7%, respectively. Quick and simple scoring scales are therefore not only applicable but useful for the case management of patients in meningococcal epidemics in developing countries. PMID:9648355

  10. Prognostic and survival analysis of presbyopia: The healthy twin study

    Science.gov (United States)

    Lira, Adiyani; Sung, Joohon

    2015-12-01

    Presbyopia, a vision condition in which the eye loses its flexibility to focus on near objects, is part of ageing process which mostly perceptible in the early or mid 40s. It is well known that age is its major risk factor, while sex, alcohol, poor nutrition, ocular and systemic diseases are known as common risk factors. However, many other variables might influence the prognosis. Therefore in this paper we developed a prognostic model to estimate survival from presbyopia. 1645 participants which part of the Healthy Twin Study, a prospective cohort study that has recruited Korean adult twins and their family members based on a nation-wide registry at public health agencies since 2005, were collected and analyzed by univariate analysis as well as Cox proportional hazard model to reveal the prognostic factors for presbyopia while survival curves were calculated by Kaplan-Meier method. Besides age, sex, diabetes, and myopia; the proposed model shows that education level (especially engineering program) also contribute to the occurrence of presbyopia as well. Generally, at 47 years old, the chance of getting presbyopia becomes higher with the survival probability is less than 50%. Furthermore, our study shows that by stratifying the survival curve, MZ has shorter survival with average onset time about 45.8 compare to DZ and siblings with 47.5 years old. By providing factors that have more effects and mainly associate with presbyopia, we expect that we could help to design an intervention to control or delay its onset time.

  11. Multimodal Degradation Prognostics Based on Switching Kalman Filter Ensemble.

    Science.gov (United States)

    Lim, Pin; Goh, Chi Keong; Tan, Kay Chen; Dutta, Partha

    2017-01-01

    For accurate prognostics, users have to determine the current health of the system and predict future degradation pattern of the system. An increasingly popular approach toward tackling prognostic problems involves the use of switching models to represent various degradation phases, which the system undergoes. Such approaches have the advantage of determining the exact degradation phase of the system and being able to handle nonlinear degradation models through piecewise linear approximation. However, limitations of such existing methods include, limited applicability due to the discretization of predicted remaining useful life, insufficient robustness due to the use of single models and others. This paper circumvents these limitations by proposing a hybrid of ensemble methods with switching methods. The proposed method first implements a switching Kalman filter (SKF) to classify between various linear degradation phases, then predict the future propagation of fault dimension using appropriate Kalman filters for each phase. This proposed method achieves both continuous and discrete prediction values representing the remaining life and degradation phase of the system, respectively. The proposed framework is shown via a case study on benchmark simulated aeroengine data sets. The evaluation of the proposed framework shows that the proposed method achieves better accuracy and robustness against noise compared with other methods reported in the literature. The results also indicate the effectiveness of the SKF in detecting the switching point between various degradation modes.

  12. Prognostic factors for neckpain in general practice.

    NARCIS (Netherlands)

    Hoving, J.L.; Vet, H.C.W. de; Twisk, J.W.R.; Devillé, W.L.J.M.; Windt, D. van der; Koes, B.W.; Bouter, L.M.

    2004-01-01

    Prognostic studies on neck pain are scarce and are typically restricted to short-term follow-up only. In this prospective cohort study, indicators of short- and long-term outcomes of neck pain were identified that can easily be measured in general practice. Patients between 18 and 70 years of age, s

  13. Prognostic factors in Guillain-Barre syndrome

    Directory of Open Access Journals (Sweden)

    Semra Mungan

    2014-12-01

    Full Text Available Objective: Guillain–Barre syndrome (GBS is an immune-mediated disorder of peripheral nerves resulting as acute inflammatory demyelinating polyradiculoneuropathy. GBS has a heterogeneous clinical course and laboratory findings. Acute onset and progressive course, and is usually associated with a good prognosis but some forms have a poor prognosis. Factors that can affect the prognosis of GBS have been investigated in several studies. Assessment of poor prognostic factors of GBS plays a vital role in the management and monitorization of patients. Methods: In this retrospective study of patients admitted to the acute phase of GBS removing clinical and laboratory profiles and was planned to investigate the prognostic factors. Results: Totally 23 patients (Female/male: 16/7 were recruited. Mean age was 47 (range: 17-70 years. Statistically significant poor prognostic factors were advanced age (p=0.042, erythrocyte sedimentation rate (p=0.027 and serum albumin level (p=0.007. Conclusion: Advanced age, increased ESR and decreased albumin levels were found as poor prognostic factors in GBS.

  14. Diagnostic and prognostic models: applications and methods

    NARCIS (Netherlands)

    Zuithoff, N.P.A.|info:eu-repo/dai/nl/313995494

    2012-01-01

    Prediction modelling, both diagnostic and prognostic, has become a major topic in clinical research and practice. Traditionally, clinicians intuitively combine and judge the documented patient information, on e.g. risk factors and test results, to implicitly assess the probability or risk of having

  15. The biology of melanoma prognostic factors.

    NARCIS (Netherlands)

    Spatz, A.; Stock, N.; Batist, G.; Kempen, L.C.L.T. van

    2010-01-01

    Cutaneous melanoma still represents a paradox among all solid tumors. It is the cancer for which the best prognostic markers ever identified in solid tumors are available, yet there is very little understanding of their biological significance. This review focuses on recent biological data that shed

  16. Relationship between Regional Body Fat Distribution and Diabetes Mellitus: 2008 to 2010 Korean National Health and Nutrition Examination Surveys

    Science.gov (United States)

    Choi, Soo In; Chung, Dawn; Lim, Jung Soo; Lee, Mi Young; Shin, Jang Yel; Chung, Choon Hee

    2017-01-01

    Background The aim of this study was to investigate the association between regional body fat distribution, especially leg fat mass, and the prevalence of diabetes mellitus (DM) in adult populations. Methods A total of 3,181 men and 3,827 postmenopausal women aged 50 years or older were analyzed based on Korea National Health and Nutrition Examination Surveys (2008 to 2010). Body compositions including muscle mass and regional fat mass were measured using dual-energy X-ray absorptiometry. Results The odds ratios (ORs) for DM was higher with increasing truncal fat mass and arm fat mass, while it was lower with increasing leg fat mass. In a partial correlation analysis adjusted for age, leg fat mass was negatively associated with glycosylated hemoglobin in both sexes and fasting glucose in women. Leg fat mass was positively correlated with appendicular skeletal muscle mass and homeostasis model assessment of β cell. In addition, after adjusting for confounding factors, the OR for DM decreased gradually with increasing leg fat mass quartiles in both genders. When we subdivided the participants into four groups based on the median values of leg fat mass and leg muscle mass, higher leg fat mass significantly lowered the risk of DM even though they have smaller leg muscle mass in both genders (P<0.001). Conclusion The relationship between fat mass and the prevalence of DM is different according to regional body fat distribution. Higher leg fat mass was associated with a lower risk of DM in Korean populations. Maintaining leg fat mass may be important in preventing impaired glucose tolerance. PMID:28029016

  17. Accelerated Aging System for Prognostics of Power Semiconductor Devices

    Science.gov (United States)

    Celaya, Jose R.; Vashchenko, Vladislav; Wysocki, Philip; Saha, Sankalita

    2010-01-01

    Prognostics is an engineering discipline that focuses on estimation of the health state of a component and the prediction of its remaining useful life (RUL) before failure. Health state estimation is based on actual conditions and it is fundamental for the prediction of RUL under anticipated future usage. Failure of electronic devices is of great concern as future aircraft will see an increase of electronics to drive and control safety-critical equipment throughout the aircraft. Therefore, development of prognostics solutions for electronics is of key importance. This paper presents an accelerated aging system for gate-controlled power transistors. This system allows for the understanding of the effects of failure mechanisms, and the identification of leading indicators of failure which are essential in the development of physics-based degradation models and RUL prediction. In particular, this system isolates electrical overstress from thermal overstress. Also, this system allows for a precise control of internal temperatures, enabling the exploration of intrinsic failure mechanisms not related to the device packaging. By controlling the temperature within safe operation levels of the device, accelerated aging is induced by electrical overstress only, avoiding the generation of thermal cycles. The temperature is controlled by active thermal-electric units. Several electrical and thermal signals are measured in-situ and recorded for further analysis in the identification of leading indicators of failures. This system, therefore, provides a unique capability in the exploration of different failure mechanisms and the identification of precursors of failure that can be used to provide a health management solution for electronic devices.

  18. Distribution and health risk assessment of some organic and inorganic substances in a petroleum facility in central Mexico

    Science.gov (United States)

    Flores-Serrano, R. M.; Torres, L. G.; Flores, C.; Castro, A.; Iturbe, R.

    An oil distribution and storage station was subjected to an Environmental Auditory and results showed soil contamination in part of the surface. An assessment of the site was required in order to fulfill a complete characterization of the contaminants present in soil and groundwater, as well as to establish the probable sources of contamination. Besides, a health risk assessment was performed to set remediation goals. The aim of this work is to show how the entire characterization and risk assessment process performed in this storage station from central Mexico, regarding to subsoil and groundwater. Thirty sample points were examined. Total petroleum hydrocarbons concentrations in soil were in a very low range (20-268 mg/kg). Ethylbenzene, methyl tert-butyl ether, tert-amyl methyl ether, and lead were identified in one sampling point. Iron and zinc were found in all soil samples. There was no correlation between total petroleum hydrocarbons and any of the metals or between both metals. Only two out of four monitoring wells showed total petroleum hydrocarbons levels (1.4 and 66 mg/L, respectively). Regarding lead, all four monitored wells showed lead concentrations (0.043-0.15 mg/L). Results suggested that metal concentrations were not associated to petroleum contamination, but to iron scrap deposits placed over the soil; nevertheless more data is needed to make a clear conclusion. Health risk assessment showed that none of the evaluated contaminants represented a risk either for the on-site or the off-site receptors, since the hazardous quotients estimated did not exceed the acceptable values.

  19. Phthalate esters in main source water and drinking water of Zhejiang Province (China): Distribution and health risks.

    Science.gov (United States)

    Wang, Xiaofeng; Lou, Xiaoming; Zhang, Nianhua; Ding, Gangqiang; Chen, Zhijian; Xu, Peiwei; Wu, Lizhi; Cai, Jianmin; Han, Jianlong; Qiu, Xueting

    2015-10-01

    To evaluate the distributions and health risks of phthalate esters in the main source water and corresponding drinking water of Zhejiang Province, the concentrations of 16 phthalate esters in water samples from 19 sites were measured from samples taken in the dry season and wet season. The concentration of the total phthalate ester congeners in source water ranged from 1.07 μg/L to 7.12 μg/L in the wet season, from 0.01 μg/L to 1.58 μg/L in the dry season, from 1.18 μg/L to 15.28 μg/L from drinking water in the wet season, and from 0.16 μg/L to 1.86 μg/L from drinking water in the dry season. Of the 16 phthalate esters, dimethyl phthalate, dibutyl phthalate, di-(2-ethyl-hexyl) phthalate, di-iso-butyl phthalate, bis-2-n-butoxyethyl phthalate, and dicyclohexyl phthalate were present in the samples analyzed, dominated by di-iso-butyl phthalate and di-(2-ethyl-hexyl) phthalate. The concentrations of phthalate esters in the wet season were all relatively higher than those in the dry season, and the drinking water had higher concentrations of phthalate esters than source water. The phthalate ester congeners studied pose little health risk to nearby citizens. Environ Toxicol Chem 2015;34:2205-2212. © 2015 SETAC.

  20. Prognostic factors of acute aluminum phosphide poisoning

    Directory of Open Access Journals (Sweden)

    Louriz M

    2009-06-01

    Full Text Available Background : In Morocco, acute aluminum phosphide poisoning (AAlPP is a serious health care problem. It results in high mortality rate despite the progress of critical care. Aims : The present paper aims at determining the characteristics of AAlPP and evaluating its severity factors. Setting and design: We studied consecutive patients of AAlPP admitted to the medical intensive care unit (ICU (Ibn Sina Hospital, Rabat, Morocco between January 1992 and December 2007. Materials and Methods : Around 50 parameters were collected, and a comparison was made between survivor and nonsurvivor groups. Statistical Analysis : Data were analyzed using Fisher exact test, Mann-Whitney U test and Cox regression model. Results : Forty-nine patients were enrolled: 31 females and 18 males; their average age was 26± 11 years. The ingested dose of aluminum phosphide was 1.2± 0.7 g. Self-poisoning was observed in 47 cases, and the median of delay before admission to the hospital was 5.3 hours (range, 2.9-10 hours. Glasgow coma scale was 14± 2. Shock was reported in 42.6% of the patients. pH was 7.1± 0.4, and bicarbonate concentration was 16.3± 8.8 mmol/L. Electrocardiogram abnormalities were noted in 28 (57% cases. The mortality rate was 49% (24 cases. The prognostic factors were APACHE II (P= 0.01, low Glasgow coma scale (P= 0.022, shock (P= 0.0003, electrocardiogram abnormalities (P= 0.015, acute renal failure (P= 0.026, low prothrombin rate (P= 0.020, hyperleukocytosis (P= 0.004, use of vasoactive drugs (P< 0.001, use of mechanical ventilation (P= 0.003. Multivariate analysis by logistic regression revealed that mortality in AAlPP correlated with shock (RR = 3.82; 95% CI= 1.12-13.38; P= 0.036 and altered consciousness (RR= 3.26; 95% CI= 1.18-8.99; P= 0.022. Conclusion : AAlPP is responsible for a high mortality, which is primarily due to hemodynamic failure.

  1. A new prognostic histopathologic classiifcation ofnasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Hai-YunWang; Shie-LeeCheah; MingLee; LiGao; Hui-ZhongZhang; Jie-HuaHe; HaoJiang; Pei-QingMa; Xiao-DongZhu; LiangZeng; Chun-YanChen; Yih-LeongChang; GangChen; Ma-YanHuang; ShaFu; QiongShao; An-JiaHan; Hai-GangLi; Chun-KuiShao; Pei-YuHuang; Chao-NanQian; Tai-XiangLu; Ka-FaiTo; Jin-TianLi; WeiminYe; IngemarErnberg; HoKeungNg; JosephT.S.Wee; Yi-XinZeng; Hans-OlovAdami; AnthonyT.C.Chan1; Jian-YongShao; JacquelineS.G.Hwang; Hai-QiangMai; Yan-FenFeng; EllenT.Chang; Chen-PingWang; MichaelKoonMingKam

    2016-01-01

    Background:The current World Health Organization (WHO) classiifcation of nasopharyngeal carcinoma (NPC) con‑veys little prognostic information. This study aimed to propose an NPC histopathologic classiifcation that can poten‑tially be used to predict prognosis and treatment response. Methods:We initially developed a histopathologic classiifcation based on the morphologic traits and cell differentia‑tion of tumors of 2716 NPC patients who were identiifed at Sun Yat‑sen University Cancer Center (SYSUCC) (training cohort). Then, the proposed classiifcation was applied to 1702 patients (retrospective validation cohort) from hospitals outside SYSUCC and 1613 patients (prospective validation cohort) from SYSUCC. The effcacy of radiochemotherapy and radiotherapy modalities was compared between the proposed subtypes. We used Cox proportional hazards models to estimate hazard ratios (HRs) with 95% conifdence intervals (CI) for overall survival (OS). Results:The 5‑year OS rates for all NPC patients who were diagnosed with epithelial carcinoma (EC; 3708 patients), mixed sarcomatoid‑epithelial carcinoma (MSEC; 1247 patients), sarcomatoid carcinoma (SC; 823 patients), and squamous cell carcinoma (SCC; 253 patients) were 79.4%, 70.5%, 59.6%, and 42.6%, respectively (P<0.001). In mul‑tivariate models, patients with MSEC had a shorter OS than patients with EC (HR=1.44, 95% CI=1.27–1.62), SC (HR=2.00, 95% CI=1.76–2.28), or SCC (HR=4.23, 95% CI=3.34–5.38). Radiochemotherapy signiifcantly improved survival compared with radiotherapy alone for patients with EC (HR=0.67, 95% CI=0.56–0.80), MSEC (HR=0.58, 95% CI=0.49–0.75), and possibly for those with SCC (HR=0.63; 95% CI=0.40–0.98), but not for patients with SC (HR=0.97, 95% CI=0.74–1.28). Conclusions:The proposed classiifcation offers more information for the prediction of NPC prognosis compared with the WHO classiifcation and might be a valuable tool to guide treatment decisions for subtypes that are

  2. Prognostic Models in Adults Undergoing Physical Therapy for Rotator Cuff Disorders: Systematic Review.

    Science.gov (United States)

    Braun, Cordula; Hanchard, Nigel C; Batterham, Alan M; Handoll, Helen H; Betthäuser, Andreas

    2016-07-01

    Rotator cuff-related disorders represent the largest subgroup of shoulder complaints. Despite the availability of various conservative and surgical treatment options, the precise indications for these options remain unclear. The purpose of this systematic review was to synthesize the available research on prognostic models for predicting outcomes in adults undergoing physical therapy for painful rotator cuff disorders. The MEDLINE, EMBASE, CINAHL, Cochrane CENTRAL, and PEDro databases and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to October 2015 were searched. The review included primary studies exploring prognostic models in adults undergoing physical therapy, with or without other conservative measures, for painful rotator cuff disorders. Primary outcomes were pain, disability, and adverse events. Inclusion was limited to prospective investigations of prognostic factors elicited at the baseline assessment. Study selection was independently performed by 2 reviewers. A pilot-tested form was used to extract data on key aspects of study design, characteristics, analyses, and results. Risk of bias and applicability were independently assessed by 2 reviewers using the Prediction Study Risk of Bias Assessment tool (PROBAST). Five studies were included in the review. These studies were extremely heterogeneous in many aspects of design, conduct, and analysis. The findings were analyzed narratively. All included studies were rated as at high risk of bias, and none of the resulting prognostic models was found to be usable in clinical practice. There are no prognostic models ready to inform clinical practice in the context of the review question, highlighting the need for further research on prognostic models for predicting outcomes in adults who undergo physical therapy for painful rotator cuff disorders. The design and conduct of future studies should be receptive to developing methods. © 2016 American Physical Therapy

  3. The Biochemical Prognostic Factors of Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Myung Won Lee

    2014-06-01

    Full Text Available BackgroundPatients with subclinical hypothyroidism (SHT are common in clinical practice. However, the clinical significance of SHT, including prognosis, has not been established. Further clarifying SHT will be critical in devising a management plan and treatment guidelines for SHT patients. Thus, the aim of this study was to investigate the prognostic factors of SHT.MethodsWe reviewed the medical records of Korean patients who visited the endocrinology outpatient clinic of Severance Hospital from January 2008 to September 2012. Newly-diagnosed patients with SHT were selected and reviewed retrospectively. We compared two groups: the SHT maintenance group and the spontaneous improvement group.ResultsThe SHT maintenance group and the spontaneous improvement group had initial thyroid-stimulating hormone (TSH levels that were significantly different (P=0.035. In subanalysis for subjects with TSH levels between 5 to 10 µIU/mL, the spontaneous improvement group showed significantly lower antithyroid peroxidase antibody (anti-TPO-Ab titer than the SHT maintenance group (P=0.039. Regarding lipid profiles, only triglyceride level, unlike total cholesterol and low density lipoprotein cholesterol, was related to TSH level, which is correlated with the severity of SHT. Diffuse thyroiditis on ultrasonography only contributed to the severity of SHT, not to the prognosis. High sensitivity C-reactive protein and urine iodine excretion, generally regarded as possible prognostic factors, did not show any significant relation with the prognosis and severity of SHT.ConclusionOnly initial TSH level was a definite prognostic factor of SHT. TPO-Ab titer was also a helpful prognostic factor for SHT in cases with mildly elevated TSH. Other than TSH and TPO-Ab, we were unable to validate biochemical prognostic factors in this retrospective study for Korean SHT patients.

  4. Conceptualizing prognostic awareness in advanced cancer: a systematic review.

    Science.gov (United States)

    Applebaum, Allison J; Kolva, Elissa A; Kulikowski, Julia R; Jacobs, Jordana D; DeRosa, Antonio; Lichtenthal, Wendy G; Olden, Megan E; Rosenfeld, Barry; Breitbart, William

    2014-09-01

    This systematic review synthesizes the complex literature on prognostic awareness in cancer. A total of 37 studies examining cancer patients' understanding of their prognosis were included. Prognostic awareness definitions and assessment methods were inconsistent across studies. A surprisingly high percentage of patients (up to 75%) were unaware of their poor prognosis, and in several studies, even their cancer diagnosis (up to 96%), particularly in studies conducted outside of North America. This review highlights surprisingly low rates of prognostic awareness in patients with advanced cancer as well as discrepancies in prognostic awareness assessment, suggesting the need for empirically validated measures of prognostic awareness.

  5. Levels, distribution, and health risks of polycyclic aromatic hydrocarbons in four freshwater edible fish species from the Beijing market.

    Science.gov (United States)

    Wu, Wen-Jing; Qin, Ning; He, Wei; He, Qi-Shuang; Ouyang, Hui-Ling; Xu, Fu-Liu

    2012-01-01

    We first estimated the content of polycyclic aromatic hydrocarbons (PAHs) in the brain, liver, bladder, roe, and muscle of four species of edible freshwater fish from the Beijing market. The distribution characteristics of PAHs in these tissues and organs were analyzed to determine their health risks to humans. The results showed that the residual levels of wet weight and lipid-normalized weight ∑PAHs in various tissues of these fish ranged from 0.51 ng·g(-1) to 28.78 ng·g(-1) and from 93.62 ng·g(-1) to 8203.43 ng·g(-1), respectively. The wet weight contents of ∑PAHs were relatively higher in the brain and lower in the liver and muscle. But the differences were not significant. And the differences of lipid-normalized weight PAHs were significant, which in the bighead carp were found significantly the highest, followed in crucian carp, and the lowest in grass carp and carp. The contents of ∑PAHs were the highest in the liver and the lowest in the brain. In the tissues with a higher lipid content, higher residual levels of PAHs were found. The carcinogenic risks for humans from residual ∑PAHs in the various fish tissues were far below 10(-5).

  6. Red cell distribution width and risk of cardiovascular mortality: Insights from National Health and Nutrition Examination Survey (NHANES)-III.

    Science.gov (United States)

    Shah, Neeraj; Pahuja, Mohit; Pant, Sadip; Handa, Aman; Agarwal, Vratika; Patel, Nileshkumar; Dusaj, Raman

    2017-04-01

    Red cell distribution width (RDW) has been linked to cardiovascular disease. We sought to determine whether addition of RDW improved the Framingham risk score (FRS) model to predict cardiovascular mortality in a healthy US cohort. We performed a post-hoc analysis of the National Health and Nutritional Examination Survey-III (1988-94) cohort, including non-anemic subjects aged 30-79years. Primary endpoint was death from coronary heart disease (CHD). We divided the cohort into three risk categories: 20%. RDW>14.5 was considered high. Kaplan-Meier survival curves and Cox proportional hazards models were created. Discrimination, calibration and reclassification were used to assess the value of addition of RDW to the FRS model. We included 7005 subjects with a mean follow up of 14.1years. Overall, there were 233 (3.3%) CHD deaths; 27 (8.2%) in subjects with RDW>14.5 compared to 206 (3.1%) in subjects with RDW≤14.5 (prisk NRI of 9.6% (p=0.011). Absolute integrated discrimination index (IDI) was 0.004 (p=0.02), with relative IDI of 10.4%. Our study demonstrates that RDW is a promising biomarker which improves prediction of cardiovascular mortality over and above traditional cardiovascular risk factors. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Prognostics Methodology for Complex Systems

    Science.gov (United States)

    Gulati, Sandeep; Mackey, Ryan

    2003-01-01

    An automatic method to schedule maintenance and repair of complex systems is produced based on a computational structure called the Informed Maintenance Grid (IMG). This method provides solutions to the two fundamental problems in autonomic logistics: (1) unambiguous detection of deterioration or impending loss of function and (2) determination of the time remaining to perform maintenance or other corrective action based upon information from the system. The IMG provides a health determination over the medium-to-longterm operation of the system, from one or more days to years of study. The IMG is especially applicable to spacecraft and both piloted and autonomous aircraft, or industrial control processes.

  8. Meta-Analysis of Survival Curve Data Using Distributed Health Data Networks: Application to Hip Arthroplasty Studies of the International Consortium of Orthopaedic Registries

    Science.gov (United States)

    Cafri, Guy; Banerjee, Samprit; Sedrakyan, Art; Paxton, Liz; Furnes, Ove; Graves, Stephen; Marinac-Dabic, Danica

    2015-01-01

    The motivating example for this paper comes from a distributed health data network, the International Consortium of Orthopaedic Registries (ICOR), which aims to examine risk factors for orthopedic device failure for registries around the world. Unfortunately, regulatory, privacy, and propriety concerns made sharing of raw data impossible, even if…

  9. Frailty in Chinese Peritoneal Dialysis Patients: Prevalence and Prognostic Significance

    Directory of Open Access Journals (Sweden)

    Jack Kit-Chung Ng

    2016-10-01

    Full Text Available Background/Aims: Previous studies showed that frailty is prevalent in both pre-dialysis and dialysis patients. However, the prevalence and prognostic implication of frailty in Chinese peritoneal dialysis (PD patients remain unknown. Methods: We used a validated questionnaire to determine the Frailty Score of 193 unselected prevalent PD patients. All patients were then followed for 2 years for their need of hospitalization and mortality. Results: Amongst the 193 patients, 134 (69.4% met the criteria of being frail. Frailty Score significantly correlated with Charlson's comorbidity score (r = 0.40, p Conclusions: Frailty is prevalent among Chinese PD patients. Frail PD patients have a high risk of requiring hospitalization and their hospital stay tends to be prolonged. Early identification may allow timely intervention to prevent adverse health outcomes in this group of patients.

  10. The geographical distribution and habitats of three liver fluke intermediate hosts in South - Africa and the health implications involved

    Directory of Open Access Journals (Sweden)

    K. N. de Kock

    2008-09-01

    persons and authorities were totally unsuccessful. In view of statistics available for elsewhere in the world, it would be unwise to assume that no problems exist in this regard in South Africa. The number of people suffering from fasciolosis was already estimated at 2.4 million in 61 countries in 1995 and another 180 million at risk of becoming infected, with the highest prevalence’s reported from Bolivia, China, Ecuador, Egypt, France, Iran, Peru and Portugal. The results of recent serological assays for the detection of fasciolosis in cattle herds in selected areas in South Africa indicated positive cases from localities that closely correspond to the geographical distribution of the three Lymnaea species in this country. According to reports in the literature, the high prevalence of fasciolosis in livestock in the highlands of Ethiopia couldhave serious health implications for people in the area because they have to use the same water resources. In many rural areas in South Africa local populations also have no other options than to share natural water resources with their livestock. In most instances these water bodies harbour at least one of the Lymnaea species which can maintain the life cycle of fasciola. Under such conditions residents could daily be exposed to the risk of becoming infected. It is a matter of concern that epidemiological research with regard to human fasciolosis is such aneglected subject in South Africa. In our opinion epidemiological surveys should be conducted to determine the prevalence of human fasciolosis in specific areas which could be selected on the basis of using the geographical distribution of the three Linnaean species as guidelines. Efforts should also be made to conduct surveys to update the geographical distribution of the snail intermediate hosts and awareness programmes should be launched in rural areas at risk.

  11. Design, Development, and Testing of a UAV Hardware-in-the-Loop Testbed for Aviation and Airspace Prognostics Research

    Science.gov (United States)

    Kulkarni, Chetan; Teubert, Chris; Gorospe, George; Burgett, Drew; Quach, Cuong C.; Hogge, Edward

    2016-01-01

    The airspace is becoming more and more complicated, and will continue to do so in the future with the integration of Unmanned Aerial Vehicles (UAVs), autonomy, spacecraft, other forms of aviation technology into the airspace. The new technology and complexity increases the importance and difficulty of safety assurance. Additionally, testing new technologies on complex aviation systems & systems of systems can be very difficult, expensive, and sometimes unsafe in real life scenarios. Prognostic methodology provides an estimate of the health and risks of a component, vehicle, or airspace and knowledge of how that will change over time. That measure is especially useful in safety determination, mission planning, and maintenance scheduling. The developed testbed will be used to validate prediction algorithms for the real-time safety monitoring of the National Airspace System (NAS) and the prediction of unsafe events. The framework injects flight related anomalies related to ground systems, routing, airport congestion, etc. to test and verify algorithms for NAS safety. In our research work, we develop a live, distributed, hardware-in-the-loop testbed for aviation and airspace prognostics along with exploring further research possibilities to verify and validate future algorithms for NAS safety. The testbed integrates virtual aircraft using the X-Plane simulator and X-PlaneConnect toolbox, UAVs using onboard sensors and cellular communications, and hardware in the loop components. In addition, the testbed includes an additional research framework to support and simplify future research activities. It enables safe, accurate, and inexpensive experimentation and research into airspace and vehicle prognosis that would not have been possible otherwise. This paper describes the design, development, and testing of this system. Software reliability, safety and latency are some of the critical design considerations in development of the testbed. Integration of HITL elements in

  12. Physics Based Electrolytic Capacitor Degradation Models for Prognostic Studies under Thermal Overstress

    Science.gov (United States)

    Kulkarni, Chetan S.; Celaya, Jose R.; Goebel, Kai; Biswas, Gautam

    2012-01-01

    Electrolytic capacitors are used in several applications ranging from power supplies on safety critical avionics equipment to power drivers for electro-mechanical actuators. This makes them good candidates for prognostics and health management research. Prognostics provides a way to assess remaining useful life of components or systems based on their current state of health and their anticipated future use and operational conditions. Past experiences show that capacitors tend to degrade and fail faster under high electrical and thermal stress conditions that they are often subjected to during operations. In this work, we study the effects of accelerated aging due to thermal stress on different sets of capacitors under different conditions. Our focus is on deriving first principles degradation models for thermal stress conditions. Data collected from simultaneous experiments are used to validate the desired models. Our overall goal is to derive accurate models of capacitor degradation, and use them to predict performance changes in DC-DC converters.

  13. Prognostic Value of Colorectal Cancer Biomarkers

    Directory of Open Access Journals (Sweden)

    Paolo Bianchi

    2011-04-01

    Full Text Available Despite the large amount of data in cancer biology and many studies into the likely survival of colorectal cancer (CRC patients, knowledge regarding the issue of CRC prognostic biomarkers remains poor. The Tumor-Node-Metastasis (TNM staging system continues to be the most powerful and reliable predictor of the clinical outcome of CRC patients. The exponential increase of knowledge in the field of molecular genetics has lead to the identification of specific alterations involved in the malignant progression. Many of these genetic alterations were proposed as biomarkers which could be used in clinical practice to estimate CRC prognosis. Recently there has been an explosive increase in the number of putative biomarkers able to predict the response to specific adjuvant treatment. In this review we explore and summarize data concerning prognostic and predictive biomarkers and we attempt to shed light on recent research that could lead to the emergence of new biomarkers in CRC.

  14. Prognostic Factors in Patients with Pancreatic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    HANYue; SUICheng-guang1; RUANZhi-ping

    2004-01-01

    To evaluate the major prognostic factors in patients with pancreatic carcinoma.Methods : 113 cases of a particular disease were retrospectively analysed and 9 factors for prognosis were studied by muitivaritate analysis with Cox proportional hazards survival model. Survival rate was calculated by Kaplan-Meier estimation. Results:In this group,survival time was 0.1 to 82 months,and the median survival time was 3 months.Overall survival rates at month 6,12,18,36 were 35.6%, 20.3%, 15.9% and 6.2%, respectively.Multivariate analyses revealed significant prognostic factors as follows:jaundice, metastasis, therapy method and synthetic therapy. Conchusion: The prognosis of pancreatic carcinoma is determined by various factors. Jaundice and metastasis are independent predictors of poor survival.Radical operation and synthetic therapy will improve the prognosis.

  15. Prognostic Gene Expression Profiles in Breast Cancer

    DEFF Research Database (Denmark)

    Sørensen, Kristina Pilekær

    Each year approximately 4,800 Danish women are diagnosed with breast cancer. Several clinical and pathological factors are used as prognostic and predictive markers to categorize the patients into groups of high or low risk. Around 90% of all patients are allocated to the high risk group...... clinical courses, and they may be useful as novel prognostic biomarkers in breast cancer. The aim of the present project was to predict the development of metastasis in lymph node negative breast cancer patients by RNA profiling. We collected and analyzed 82 primary breast tumors from patients who...... and the time of event. Previous findings have shown that high expression of the lncRNA HOTAIR is correlated with poor survival in breast cancer. We validated this finding by demonstrating that high HOTAIR expression in our primary tumors was significantly associated with worse prognosis independent...

  16. [Prognostic factors of early breast cancer].

    Science.gov (United States)

    Almagro, Elena; González, Cynthia S; Espinosa, Enrique

    2016-02-19

    Decision about the administration of adjuvant therapy for early breast cancer depends on the evaluation of prognostic factors. Lymph node status, tumor size and grade of differentiation are classical variables in this regard, and can be complemented by hormonal receptor status and HER2 expression. These factors can be combined into prognostic indexes to better estimate the risk of relapse or death. Other factors are less important. Gene profiles have emerged in recent years to identify low-risk patients who can forgo adjuvant chemotherapy. A number of profiles are available and can be used in selected cases. In the future, gene profiling will be used to select patients for treatment with new targeted therapies. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  17. Diagnostic and prognostic epigenetic biomarkers in cancer.

    Science.gov (United States)

    Costa-Pinheiro, Pedro; Montezuma, Diana; Henrique, Rui; Jerónimo, Carmen

    2015-01-01

    Growing cancer incidence and mortality worldwide demands development of accurate biomarkers to perfect detection, diagnosis, prognostication and monitoring. Urologic (prostate, bladder, kidney), lung, breast and colorectal cancers are the most common and despite major advances in their characterization, this has seldom translated into biomarkers amenable for clinical practice. Epigenetic alterations are innovative cancer biomarkers owing to stability, frequency, reversibility and accessibility in body fluids, entailing great potential of assay development to assist in patient management. Several studies identified putative epigenetic cancer biomarkers, some of which have been commercialized. However, large multicenter validation studies are required to foster translation to the clinics. Herein we review the most promising epigenetic detection, diagnostic, prognostic and predictive biomarkers for the most common cancers.

  18. Prognostic Gene Expression Profiles in Breast Cancer

    DEFF Research Database (Denmark)

    Sørensen, Kristina Pilekær

    Each year approximately 4,800 Danish women are diagnosed with breast cancer. Several clinical and pathological factors are used as prognostic and predictive markers to categorize the patients into groups of high or low risk. Around 90% of all patients are allocated to the high risk group...... clinical courses, and they may be useful as novel prognostic biomarkers in breast cancer. The aim of the present project was to predict the development of metastasis in lymph node negative breast cancer patients by RNA profiling. We collected and analyzed 82 primary breast tumors from patients who...... and the time of event. Previous findings have shown that high expression of the lncRNA HOTAIR is correlated with poor survival in breast cancer. We validated this finding by demonstrating that high HOTAIR expression in our primary tumors was significantly associated with worse prognosis independent...

  19. [Maternal and foetal prognostic during severe toxemia].

    Science.gov (United States)

    Rachdi, Radhouane; Kaabi, Mehdi; Zayene, Houssine; Basly, Mohamed; Messaoudi, Fathi; Messaoudi, Lotfi; Chibani, Mounir

    2005-02-01

    Severe gravidic toxemia gives heavy maternal and foetal morbidity and mortality. The purpose of our study is to loosen the factors of bad maternal and foetal prognostic. It's a retrospective study about 100 cases of severe and complicated gravidic toxemia repertorieted in the maternity of Military Hospital of Tunis. Maternal morbidity is dominated by the complications of hypertension and a blood disorders. We raised 4 cases of eclampsia, 9 cases of retro placental hematome and 5 cases of HELLP syndrome. We don't deplore any maternal death. Perinatal mortality is 28.8%. The rate of delay intra-uterine growth was 43.8% and the prematurity 65.9%. More toxemia appears early during pregnancy more maternal and foetal prognostic is compromised.

  20. Analysis of contemporary HIV/AIDS health care costs in Germany: Driving factors and distribution across antiretroviral therapy lines.

    Science.gov (United States)

    Treskova, Marina; Kuhlmann, Alexander; Bogner, Johannes; Hower, Martin; Heiken, Hans; Stellbrink, Hans-Jürgen; Mahlich, Jörg; Schulenburg, Johann-Matthias Graf von der; Stoll, Matthias

    2016-06-01

    To analyze contemporary costs of HIV health care and the cost distribution across lines of combination antiretroviral therapy (cART). To identify variations in expenditures with patient characteristics and to identify main cost determinants. To compute cost ratios between patients with varying characteristics.Empirical data on costs are collected in Germany within a 2-year prospective observational noninterventional multicenter study. The database contains information for 1154 HIV-infected patients from 8 medical centers.Means and standard deviations of the total costs are estimated for each cost fraction and across cART lines and regimens. The costs are regressed against various patient characteristics using a generalized linear model. Relative costs are calculated using the resultant coefficients.The average annual total costs (SD) per patient are &OV0556;22,231.03 (8786.13) with a maximum of &OV0556;83,970. cART medication is the major cost fraction (83.8%) with a mean of &OV0556;18,688.62 (5289.48). The major cost-driving factors are cART regimen, CD4-T cell count, cART drug resistance, and concomitant diseases. Viral load, pathology tests, and demographics have no significant impact. Standard non-nucleoside reverse transcriptase inhibitor-based regimens induce 28% lower total costs compared with standard PI/r regimens. Resistance to 3 or more antiretroviral classes induces a significant increase in costs.HIV treatment in Germany continues to be expensive. Majority of costs are attributable to cART. Main cost determinants are CD4-T cells count, comorbidity, genotypic antiviral resistance, and therapy regimen. Combinations of characteristics associated with higher expenditures enhance the increasing effect on the costs and induce high cost cases.

  1. Carotid intima-media thickness value distributions in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Santos, Itamar S; Bittencourt, Márcio S; Oliveira, Ilka R S; Souza, Angelita G; Meireles, Danilo P; Rundek, Tatjana; Foppa, Murilo; Bezerra, Daniel C; Freire, Cláudia M V; Roelke, Leonard H; Carrilho, Sayonara; Benseñor, Isabela M; Lotufo, Paulo A

    2014-11-01

    Carotid intima-media thickness (IMT) is a noninvasive measurement of early atherosclerosis. Most IMT studies have involved populations with low rates of racial blending. The aim of the present article is to describe IMT value distributions and analyze the influence of sex and race on IMT values in a large Brazilian sample, a setting with a high rate of racial admixture. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a multicenter cohort of 15,105 adult (aged 35-74 years) civil servants in six Brazilian cities. Baseline assessment included IMT measurements in both common carotid arteries. Race was self-reported. We studied the association between sex and race with IMT values using multiple linear regression models. We conducted analyses in all and low-risk individuals, defined as those without classical cardiovascular risk factors. We analyzed complete IMT data from 10,405 ELSA-Brasil participants. We present nomograms by age for all and low-risk individuals, stratified by sex and race. We found that men had significantly higher maximal IMT values compared with women (β = 0.058; P < 0.001). This association remained for low-risk individuals (β = 0.027; P = 0.001). In addition, Brown and White individuals had lower maximal IMT values compared with Black individuals for all (β = -0.034 and β = -0.054, respectively; P < 0.001) and low-risk individuals (β = -0.027; P = 0.013 and β = -0.035; P < 0.001, respectively). We found significantly higher IMT values in men. We found significantly higher IMT values in Black individuals than White and Brown individuals. These results persisted when analyses were restricted to low-risk individuals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Distribution of heavy metals in muscles and internal organs of Korean cephalopods and crustaceans: risk assessment for human health.

    Science.gov (United States)

    Mok, Jong Soo; Kwon, Ji Young; Son, Kwang Tae; Choi, Woo Seok; Shim, Kil Bo; Lee, Tae Seek; Kim, Ji Hoe

    2014-12-01

    Samples of seven species of cephalopods and crustaceans were collected from major fish markets on the Korean coast and analyzed for mercury (Hg) using a direct Hg analyzer and for the metals cadmium (Cd), lead (Pb), chromium, silver, nickel, copper, and zinc using inductively coupled plasma mass spectrometry. The distributions of heavy metals in muscles, internal organs, and whole tissues were determined, and a risk assessment was conducted to provide information concerning consumer safety. The heavy metals accumulated to higher levels (P organs than in muscles for all species. The mean concentrations of Cd, which had the highest concentrations of the three hazardous metals (Cd, Pb, and Hg), in all internal organs (except those of blue crab) exceeded the regulatory limits set by Korea and the European Union. The Cd concentrations in all whole tissues of squid and octopus (relatively large cephalopods), red snow crab, and snow crab exceeded the European Union limits. The estimated dietary intake of Cd, Pb, and Hg for each part of all species accounted for 1.73 to 130.57%, 0.03 to 0.39%, and 0.93 to 1.67%, respectively, of the provisional tolerable daily intake adopted by the Joint Food and Agriculture Organization and World Health Organization Expert Committee on Food Additives; the highest values were found in internal organs. The hazard index (HI) is recognized as a reasonable parameter for assessing the risk of heavy metal consumption associated with contaminated food. Because of the high HI (>1.0) of the internal organs of cephalopods and the maximum HI for whole tissue of 0.424, consumers eating internal organs or whole tissues of cephalopods could be at risk of high heavy metal exposure. Therefore, the internal organs of relatively large cephalopods and crabs (except blue crab) are unfit for consumption. However, consumption of flesh after removing internal organs is a suitable approach for decreasing exposure to harmful metals.

  3. Source, distribution, and health risk assessment of polycyclic aromatic hydrocarbons in urban street dust from Tianjin, China.

    Science.gov (United States)

    Yu, Binbin; Xie, Xiujie; Ma, Lena Q; Kan, Haidong; Zhou, Qixing

    2014-02-01

    To better assess and understand potential health risk of urban residents exposed to urban street dust, the total concentration, sources, and distribution of 16 polycyclic aromatic hydrocarbons (PAHs) in 87 urban street dust samples from Tianjin as a Chinese megacity that has undergone rapid urbanization were investigated. In the meantime, potential sources of PAHs were identified using the principal component analysis (PCA), and the risk of residents' exposure to PAHs via urban street dust was calculated using the Incremental Lifetime Cancer Risk (ILCR) model. The results showed that the total PAHs (∑PAHs) in urban street dust from Tianjin ranged from 538 μg kg(-1) to 34.3 mg kg(-1), averaging 7.99 mg kg(-1). According to PCA, the two to three- and four to six-ring PAHs contributed 10.3 and 89.7 % of ∑PAHs, respectively. The ratio of the sum of major combustion specific compounds (ΣCOMB) / ∑PAHs varied from 0.57 to 0.79, averaging 0.64. The ratio of Ant/(Ant + Phe) varied from 0.05 to 0.41, averaging 0.10; Fla/(Fla + Pyr) from 0.40 to 0.68, averaging 0.60; BaA/(BaA + Chry) from 0.29 to 0.51, averaging 0.38; and IcdP/(IcdP + BghiP) from 0.07 to 0.37, averaging 0.22. The biomass combustion, coal combustion, and traffic emission were the main sources of PAHs in urban street dust with the similar proportion. According to the ILCR model, the total cancer risk for children and adults was up to 2.55 × 10(-5) and 9.33 × 10(-5), respectively.

  4. Machinery prognostics and prognosis oriented maintenance management

    CERN Document Server

    Yan, Jihong

    2014-01-01

    This book gives a complete presentatin of the basic essentials of machinery prognostics and prognosis oriented maintenance management, and takes a look at the cutting-edge discipline of intelligent failure prognosis technologies for condition-based maintenance.  Latest research results and application methods are introduced for signal processing, reliability moelling, deterioration evaluation, residual life prediction and maintenance-optimization as well as applications of these methods.

  5. Potential Prognostic Markers for Human Prostate Cancer

    Science.gov (United States)

    2001-03-01

    Prostate 35: 185-192, 1998 osteoblasts on prostate carcinoma proliferation and chemo- 32. Trikha M, Cai Y, Grignon D, Honn KV: Identification taxis ...Markers for Human Prostate Cancer PRINCIPAL INVESTIGATOR: Bruce R. Zetter, Ph.D. CONTRACTING ORGANIZATION: Children’s Hospital Boston, Massachusetts...March 2001 Final (1 Sep 98 - 28 Feb 01) 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Potential Prognostic Markers for Human Prostate Cancer DAMD17-98-1

  6. Prognostic Analysis of the Tactical Quiet Generator

    Energy Technology Data Exchange (ETDEWEB)

    Hively, Lee M [ORNL

    2008-09-01

    The U.S. Army needs prognostic analysis of mission-critical equipment to enable condition-based maintenance before failure. ORNL has developed and patented prognostic technology that quantifies condition change from noisy, multi-channel, time-serial data. This report describes an initial application of ORNL's prognostic technology to the Army's Tactical Quiet Generator (TQG), which is designed to operate continuously at 10 kW. Less-than-full power operation causes unburned fuel to accumulate on internal components, thereby degrading operation and eventually leading to failure. The first objective of this work was identification of easily-acquired, process-indicative data. Two types of appropriate data were identified, namely output-electrical current and voltage, plus tri-axial acceleration (vibration). The second objective of this work was data quality analysis to avoid the garbage-in-garbage-out syndrome. Quality analysis identified more than 10% of the current data as having consecutive values that are constant, or that saturate at an extreme value. Consequently, the electrical data were not analyzed further. The third objective was condition-change analysis to indicate operational stress under non-ideal operation and machine degradation in proportion to the operational stress. Application of ORNL's novel phase-space dissimilarity measures to the vibration power quantified the rising operational stress in direct proportion to the less-than-full-load power. We conclude that ORNL's technology is an excellent candidate to meet the U.S. Army's need for equipment prognostication.

  7. Prognostic factors in young ovarian cancer patients

    DEFF Research Database (Denmark)

    Klar, M; Hasenburg, A; Hasanov, M;

    2016-01-01

    OBJECTIVES: We evaluated in a large study meta-database of prospectively randomised phase III trials the prognostic factors for progression-free survival (PFS) and overall survival (OS) in patients 40 years of age with advanced epithelial ovarian cancer. METHODS: A total of 5055 patients...... epithelial ovarian cancer, excellent performance status, who had received complete macroscopic upfront cytoreduction and ≥5 chemotherapy cycles. RESULTS: For patients

  8. Risk and prognostic factors for non-specific musculoskeletal pain: A synthesis of evidence from systematic reviews classified into ICF dimensions

    OpenAIRE

    2009-01-01

    A wide variety of risk factors for the occurrence and prognostic factors for persistence of non-specific musculoskeletal pain (MSP) are mentioned in the literature. A systematic review of all these factors is not available. Thus a systematic review was conducted to evaluate MSP risk factors and prognostic factors, classified according to the dimensions of the International Classification of Functioning, Disability and Health. Candidate systematic reviews were identified in electronic medical ...

  9. A Policy Review on The Distribution of Health Operational Aid Funds in Achieving Maternal and Child Health Program (MDGs 4, 5 in Three Districts/Cities of East Java Province

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi

    2015-06-01

    Full Text Available Background: Health Policy Regulation Number 494/Menkes/SK/IV/2010 on the distribution of BOK funds to local government is one of the government’s responsibility for the development of public health in improving health promotion and prevention efforts in order to accelerate the achievement of MDGs in Health. The purpose of the study is to provide policy recommendations regarding to BOK in achieving the goals of maternal and child health programs. Methods: Secondary data review of the district health profile in 2009-2011 and analysis on the primary data collected from focus group discussion (FGD with invited technical implementor from district health office and health centers as well as some of the staffs of the local government that handle BOK. Results: The decline in maternal and infant mortality rates are still slow and cases of malnutrition increased from the three profile data review Sampang, Gresik and Sidoarjo. Local governments pay little commitment in developing priority strategies of maternal and child health programs in the form of a local action and innovation plan. BOK preventive promotive activities are lacking of monitoring and accountability controls, especially in health centers located far from the district center. Financial accountability is less precise to the programs and targetes, having seen the data of maternal and child health outcomes KN1-KN4 coverage which rose in 2010, but then fell back in 2011. Conclusion: Evaluation and monitoring are needed on the utilization of BOK funds, supervising the activities by the district/city health office, as well as by local community leaders. Prioritise monitoring the health centers in the area with high MMR and IMR. Suggestion: Needed routine and periodic mentoring and coaching in the form of technical assistance related to the utilization of BOK.

  10. New prognostic biomarkers in multiple myeloma

    Directory of Open Access Journals (Sweden)

    Aneta Szudy-Szczyrek

    2016-01-01

    Full Text Available Multiple myeloma is a malignant neoplastic disease, characterized by uncontrolled proliferation and accumulation of plasma cells in the bone marrow, which is usually connected with production of a monoclonal protein. It is the second most common hematologic malignancy. It constitutes approximately 1% of all cancers and 10% of hematological malignancies. Despite the huge progress that has been made in the treatment of multiple myeloma in the past 30 years including the introduction of new immunomodulatory drugs and proteasome inhibitors, it is still an incurable disease. According to current data, the five-year survival rate is 45%. Multiple myeloma is a very heterogeneous disease with a very diverse clinical course, which is expressed by differences in effectiveness of therapeutic strategies and ability to develop chemoresistance. This diversity implies the need to define risk stratification factors that would help to create personalized and optimized therapy and thereby improve treatment outcomes. Prognostic markers that aim to objectively evaluate the risk of a poor outcome, relapse and the patient’s overall outcome are useful for this purpose. The existing, widely used prognostic classifications, such as the Salmon-Durie classification or ISS, do not allow for individualization of treatment. As a result of the development of diagnostic techniques, especially cytogenetics and molecular biology, we were able to discover a lot of new, more sensitive and specific prognostic factors. The paper presents recent reports on the role of molecular, cytogenetic and biochemical alterations in pathogenesis and prognosis of the disease.

  11. New prognostic markers in liver cirrhosis.

    Science.gov (United States)

    Di Martino, Vincent; Weil, Delphine; Cervoni, Jean-Paul; Thevenot, Thierry

    2015-05-28

    Determining the prognosis of cirrhotic patients is not an easy task. Prognostic scores, like Child-Pugh and Model of End-stage Liver Disease scores, are commonly used by hepatologists, but do not always reflect superimposed events that may strongly influence the prognosis. Among them, bacterial intestinal translocation is a key phenomenon for the development of cirrhosis-related complications. Several biological variables (C-reactive protein, serum free cortisol, copeptin, von Willebrand factor antigen) are surrogates of "inflammatory stress" and have recently been identified as potential prognostic markers in cirrhotic patients. Most of these above mentioned markers were investigated in pilot studies with sometimes a modest sample size but allow us to catch a glimpse of the pathophysiological mechanisms leading to the worsening of cirrhosis. These new data should generate further well-designed studies to better assess the benefit for liver function of preventing intestinal bacterial translocation and microvascular thrombosis. The control of infection is vital and among all actors of immunity, vitamin D also appears to act as an anti-infective agent and therefore has probably a prognostic value.

  12. PROGNOSTIC FACTORS OF SURVIVAL IN RENAL CANCER

    Directory of Open Access Journals (Sweden)

    A. V. Seriogin

    2009-01-01

    Full Text Available The purpose of the study was to reveal the independent anatomic, histological, and clinical factors of cancer-specific survival in patients with renal-cell carcinoma (RCC. For this, the authors retrospectively analyzed their experience with radical surgical treatments in 73 RCC patients operated on at the Department of Urology and Surgical Andrology, Russian Medical Academy of Postgraduate Education, from January 1, 1999 to December 31, 2004; their outcomes have become known by the present time. There was a statistically significant correlation of cancer-specific survival with its parameters, such as pathological stage of a tumor, its maximum pathological size, differentiation grade, involvement of regional lymph nodes, venous tumor thrombosis, level of thrombocytosis, and degree of the clinical symptoms of the disease. Multivariate analysis of survival in RCC in relation to the prognostic factors could reveal odd ratios for the limit values of significant prognostic factors. The statistically significant prognostic values established in the present study, as well as the molecular factors the implication of which is being now investigated can become in future an effective addition to the TNM staging system to define indications for certain treatments and to predict survival in RCC  

  13. Microvascular structure as a prognostically relevant endpoint.

    Science.gov (United States)

    Agabiti-Rosei, Enrico; Rizzoni, Damiano

    2017-05-01

    Remodelling of subcutaneous small resistance arteries, as indicated by an increased media-to-lumen ratio, is frequently present in hypertensive, obese, or diabetic patients. The increased media-to-lumen ratio may impair organ flow reserve. This may be important in the maintenance and, probably, also in the progressive worsening of hypertensive disease. The presence of structural alterations represents a prognostically relevant factor, in terms of development of target organ damage or cardiovascular events, thus allowing us a prediction of complications in hypertension. In fact, media-to-lumen ratio of small arteries at baseline, and possibly their changes during treatment may have a strong prognostic significance. However, new, non-invasive techniques are needed before suggesting extensive application of the evaluation of remodelling of small arteries for the cardiovascular risk stratification in hypertensive patients. Some new techniques for the evaluation of microvascular morphology in the retina, currently under clinical investigation, seem to represent a promising and interesting future perspective. The evaluation of microvascular structure is progressively moving from bench to bedside, and it could represent, in the near future, an evaluation to be performed in all hypertensive patients, to obtain a better stratification of cardiovascular risk, and, possibly, it might be considered as an intermediate endpoint in the evaluation of the effects of antihypertensive therapy, provided that a demonstration of a prognostic value of non-invasive measures of microvascular structure is made available.

  14. PROGNOSTIC FACTORS OF SURVIVAL IN RENAL CANCER

    Directory of Open Access Journals (Sweden)

    A. V. Seriogin

    2014-08-01

    Full Text Available The purpose of the study was to reveal the independent anatomic, histological, and clinical factors of cancer-specific survival in patients with renal-cell carcinoma (RCC. For this, the authors retrospectively analyzed their experience with radical surgical treatments in 73 RCC patients operated on at the Department of Urology and Surgical Andrology, Russian Medical Academy of Postgraduate Education, from January 1, 1999 to December 31, 2004; their outcomes have become known by the present time. There was a statistically significant correlation of cancer-specific survival with its parameters, such as pathological stage of a tumor, its maximum pathological size, differentiation grade, involvement of regional lymph nodes, venous tumor thrombosis, level of thrombocytosis, and degree of the clinical symptoms of the disease. Multivariate analysis of survival in RCC in relation to the prognostic factors could reveal odd ratios for the limit values of significant prognostic factors. The statistically significant prognostic values established in the present study, as well as the molecular factors the implication of which is being now investigated can become in future an effective addition to the TNM staging system to define indications for certain treatments and to predict survival in RCC  

  15. Evaluation of informative materials on leishmaniasis distributed in Brazil: criteria and basis for the production and improvement of health education materials

    Directory of Open Access Journals (Sweden)

    Zélia Maria Profeta da Luz

    Full Text Available Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA, five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

  16. Evaluation of informative materials on leishmaniasis distributed in Brazil: criteria and basis for the production and improvement of health education materials.

    Science.gov (United States)

    da Luz, Zélia Maria Profeta; Pimenta, Denise Nacif; Rabello, Ana; Schall, Virgínia

    2003-01-01

    Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA), five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

  17. Poverty in the midst of plenty: unmet needs and distribution of health care resources in South Korea.

    Directory of Open Access Journals (Sweden)

    Jongho Heo

    Full Text Available BACKGROUND: The unmet needs for health care have been used as an alternative measurement to monitor equity in health services. We sought to examine contextual influences on unmet needs for health care whereas precedent studies have been focused on individual characteristics on them. METHODS AND FINDINGS: The current study conducted multilevel logistic regression analysis to assess the effects of individual- and contextual-level predictors in meeting individual health care needs in South Korea. We sampled 7,200 individuals over the age of 19 in the Fourth Korea National Health and Nutrition Examination Survey in 2009. Included in the regression model were individual predictors such as demographic variables, socio-economic status, and self-rated health; the density of beds and physicians in public and private sectors within different regions were used as contextual-level predictors. This study showed the inverse association between unmet needs and regional resources in private sectors after controlling for the effects of individual-level predictors. CONCLUSION: Our findings suggest that increasing regional resources in private sectors might produce inefficiency in the health care system and inequity in access to health services, particularly where the competition in private health care sectors was highly stimulated under the fee-for-service reimbursement scheme. Policies for the reallocation of health care resources and for reduction of individual health care costs are needed in Korea.

  18. Cross-National Validation of Prognostic Models Predicting Sickness Absence and the Added Value of Work Environment Variables

    NARCIS (Netherlands)

    Roelen, Corne A. M.; Stapelfeldt, Christina M.; Heymans, Martijn W.; van Rhenen, Willem; Labriola, Merete; Nielsen, Claus V.; Bultmann, Ute; Jensen, Chris

    2015-01-01

    Purpose To validate Dutch prognostic models including age, self-rated health and prior sickness absence (SA) for ability to predict high SA in Danish eldercare. The added value of work environment variables to the models' risk discrimination was also investigated. Methods 2,562 municipal eldercare w

  19. [Study of risk factors of enterobiasis in schoolchildren and development of a prognostic table for primary screening].

    Science.gov (United States)

    Markin, A V; Terekhova, T V; Khromenkova, E P

    1996-01-01

    Risk factors for enterobiasis were qualitatively and quantitatively assessed by a questionnaire given to 277 health schoolchildren and 277 schoolchildren who suffered from enterobiasis. A prognostic table was developed for primary screening of risk groups. Preventive measures are recommended in the paper.

  20. A REVIEW OF SLOW SPEED BEARING DIAGNOSTICS AND PROGNOSTICS

    Directory of Open Access Journals (Sweden)

    SYLVESTER A. AYE

    2014-10-01

    Full Text Available This paper reviews the literature in diagnostics and prognostics of slow rotating bearings. Diagnostics and prognostics involve data acquisition and processing. The diagnostics and prognostics of rotating machinery is a subject of much on-going research. There are three approaches to diagnostics and prognostics which include data driven techniques, model based techniques and experience based approach. The review looks at current diagnostics and prognostics approaches to bearings in general and slow rotating bearings in particular and future trends. Bayesian techniques are currently gaining widespread application in diagnostics and prognostics of slow rotating bearings and mechanical systems as a result of their ability to handle the stochastic nature of the data well at varying operating conditions.

  1. PD-L2: A prognostic marker in chromophobe renal cell carcinoma?

    Science.gov (United States)

    Erlmeier, Franziska; Weichert, Wilko; Autenrieth, Michael; Wiedemann, Max; Schrader, Andres Jan; Hartmann, Arndt; Ivanyi, Philipp; Steffens, Sandra

    2017-05-01

    In the context of cancer immunotherapy, PD-1 as well as PD-L1 has been widely studied in renal cell carcinoma (RCC). PD-1 and PD-L1 play a significant role as prognostic markers in clear cell renal cell carcinoma. In contrast, little is known about PD-L2 expression patterns in RCC, especially in rarer subtypes. The aim of this study was to evaluate the prevalence, distribution and prognostic impact of PD-L2 expression in chromophobe (ch)RCC. Eighty-one patients who underwent renal surgery due to chRCC were retrospectively evaluated. Tumor specimens were analyzed for PD-L2 expression by immunohistochemistry. Expression data were associated with clinicopathological parameters and overall survival (OS). Twenty-three (28.4%) patients showed a PD-L2 > median (PD-L2 high) staining intensity. No significant association between clinicopathological parameters and PD-L2 expression was identified. A significant difference between 5- and 10-year OS in dependence of PD-L2 expression was found (PD-L2 low 96.4 and 87.7% vs. PD-L2 high 87.1 and 56%; log rank, p = 0.029). However, in multivariate analysis PD-L2 expression failed to be proofed as an independent prognostic factor. In conclusion, to our knowledge this is the first study evaluating the prognostic impact of PD-L2 in a considerably large cohort of chRCC. Our results showed a significant diminished OS in dependence of PD-L2 expression. This implicates that PD-L2 might play a role as prognostic marker in chRCC demanding further evaluation.

  2. Distribution of cardiovascular disease and associated risk factors by county type and health insurance status: results from the 2008 Ohio Family Health Survey.

    Science.gov (United States)

    Kariisa, Mbabazi; Seiber, Eric

    2015-01-01

    Epidemiologic studies have documented a disproportionate burden of chronic diseases in Appalachia, showing the area to be underserved by the health-care system. Nothing is known about how the health status of the Appalachian population compares with other rural or non-rural populations in the same state. We examined the associations among county type, health insurance category, and health outcomes in poorer adult Ohioans. We obtained data from the 2008 Ohio Family Health Survey, a complex landline- and cell phone-based survey of 50,944 noninstitutionalized households. We constructed bivariate analyses examining health status measures across various insurance categories and metropolitan, suburban, rural, and Appalachian counties in Ohio. Medicaid enrollees living in Appalachian and rural counties tended to be in poorer health and have a greater prevalence of smoking than non-Medicaid enrollees. Within rural and Appalachian regions, Medicaid enrollees were more likely than non-Medicaid enrollees to have lower self-rated health (54.8%, 95% confidence interval [CI] 44.1, 65.5 in rural regions and 52.1%, 95% CI 44.7, 59.5 in Appalachian regions). Appalachian and rural Medicaid enrollees were at an increased likelihood of having several chronic diseases compared with non-Medicaid enrollees. Our findings suggest that rural and Ohio Appalachian Medicaid enrollees were more likely to have hypertension, cardiovascular disease, and overall poorer health than non-Medicaid enrollees. These findings have important policy implications for health-care reform, highlighting regional disparities in provider coverage. These underserved regions would need an increase in the provider base to positively impact proposed Medicaid expansion programs.

  3. Prognostic Tools in Patients With Advanced Cancer: A Systematic Review.

    Science.gov (United States)

    Simmons, Claribel P L; McMillan, Donald C; McWilliams, Kerry; Sande, Tonje A; Fearon, Kenneth C; Tuck, Sharon; Fallon, Marie T; Laird, Barry J

    2017-05-01

    In 2005, the European Association for Palliative Care made recommendations for prognostic markers in advanced cancer. Since then, prognostic tools have been developed, evolved, and validated. The aim of this systematic review was to examine the progress in the development and validation of prognostic tools. Medline, Embase Classic and Embase were searched. Eligible studies met the following criteria: patients with incurable cancer, >18 years, original studies, population n ≥100, and published after 2003. Descriptive and quantitative statistical analyses were performed. Forty-nine studies were eligible, assessing seven prognostic tools across different care settings, primary cancer types, and statistically assessed survival prediction. The Palliative Performance Scale was the most studied (n = 21,082), comprising six parameters (six subjective), was externally validated, and predicted survival. The Palliative Prognostic Score composed of six parameters (four subjective and two objective), the Palliative Prognostic Index composed of nine parameters (nine subjective), and the Glasgow Prognostic Score composed of two parameters (two objective) and were all externally validated in more than 2000 patients with advanced cancer and predicted survival. Various prognostic tools have been validated but vary in their complexity, subjectivity, and therefore clinical utility. The Glasgow Prognostic Score would seem the most favorable as it uses only two parameters (both objective) and has prognostic value complementary to the gold standard measure, which is performance status. Further studies comparing all proved prognostic markers in a single cohort of patients with advanced cancer are needed to determine the optimal prognostic tool. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  4. Treatment outcome of thymic epithelial tumor: prognostic factors and optimal postoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dong Ryul; Ahn, Yong Chan; Kim, Kwan Min; Kim, Jhin Gook; Shim, Young Mog; Han, Jung Ho [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    This study was conducted to analyze treatment outcome and prognostic significance of World Health Organization (WHO)-defined thymic epithelial tumor (TET) subtype and to assess optimal radiation target volume in patients receiving surgery and adjuvant radiation therapy with TET. The record of 160 patients with TET, who received surgical resection at the Samsung medical Center, from December 1994 to June 2004, were reviewed. 99 patients were treated with postoperative radiation therapy (PORT). PORT was recommended when patients had more than one findings among suspicious incomplete resection or positive resection margin or Masaoka stage II {approx} IV or WHO tumor type B2 {approx} C. PORT performed to primary tumor bed only with a mean dose of 54 Gy. The prognostic factor and pattern of failure were analyzed retrospectively. The overall survival rate at 5 years was 87.3%. Age (more than 60 years 77.8%, less than 60 years 91.1%; {rho} = 0.03), Masaoka stage (I 92.2%, II 95.4%, III 82.1%, IV 67.5%; {rho} = 0.001), WHO tumor type (A-B1 96.0%, B2-C 82.3%; {rho} = 0.001), Extent of resection (R0 resection 92.3%, R1 or 2 resection 72.6%; {rho} = 0.001) were the prognostic factors according to univariate analysis. But WHO tumor type was the only significant prognostic factor according to multivariate analysis. Recurrence was observed in 5 patients of 71 Masoka stage I-III patients who received grossly complete tumor removal (R0, R1 resection ) and PORT to primary tumor bed. Mediastinal recurrence was observed in only one patients. There were no recurrence within irradiation field. WHO tumor type was the important prognostic factor to predict survival of patients with TET. This study suggest that PORT to only primary tumor bed was optimal. To avoid pleura-or pericardium-based recurrence, further study of effective chemotherapy should be investigated.

  5. Retrospective study of prognostic factors in pediatric invasive pneumococcal disease

    Science.gov (United States)

    Peng, Chun-Chih; Chang, Hung-Yang; Huang, Daniel Tsung-Ning; Chang, Lung; Lei, Wei-Te

    2017-01-01

    Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion, S. pneumoniae remains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission

  6. Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis

    Science.gov (United States)

    Agarwal, Avinash; Yadav, Ambuj; Consul, Shuchi; Kumar, Sukriti; Prakash, Ved; Gupta, Anil Kumar; Bhattacharjee, Annesh

    2016-01-01

    Background Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity and mortality. Methods Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically and by laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted as either discharged to home or death. Results The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus, systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamic oxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected to multivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorable outcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in mean APACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively, compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04). Conclusion Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of the DKA-associated mortality. PMID:27586452

  7. Individual participant data meta-analysis of prognostic factor studies: state of the art?

    Directory of Open Access Journals (Sweden)

    Abo-Zaid Ghada

    2012-04-01

    Full Text Available Abstract Background Prognostic factors are associated with the risk of a subsequent outcome in people with a given disease or health condition. Meta-analysis using individual participant data (IPD, where the raw data are synthesised from multiple studies, has been championed as the gold-standard for synthesising prognostic factor studies. We assessed the feasibility and conduct of this approach. Methods A systematic review to identify published IPD meta-analyses of prognostic factors studies, followed by detailed assessment of a random sample of 20 articles published from 2006. Six of these 20 articles were from the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in traumatic brain injury collaboration, for which additional information was also used from simultaneously published companion papers. Results Forty-eight published IPD meta-analyses of prognostic factors were identified up to March 2009. Only three were published before 2000 but thereafter a median of four articles exist per year, with traumatic brain injury the most active research field. Availability of IPD offered many advantages, such as checking modelling assumptions; analysing variables on their continuous scale with the possibility of assessing for non-linear relationships; and obtaining results adjusted for other variables. However, researchers also faced many challenges, such as large cost and time required to obtain and clean IPD; unavailable IPD for some studies; different sets of prognostic factors in each study; and variability in study methods of measurement. The IMPACT initiative is a leading example, and had generally strong design, methodological and statistical standards. Elsewhere, standards are not always as high and improvements in the conduct of IPD meta-analyses of prognostic factor studies are often needed; in particular, continuous variables are often categorised without reason; publication bias and availability bias are rarely

  8. A Survey of Metrics for Performance Evaluation of Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is an emerging concept in condition basedmaintenance(CBM)ofcriticalsystems.Alongwith developing the fundamentals of being able to confidently predict...

  9. Evaluating Prognostics Performance for Algorithms Incorporating Uncertainty Estimates

    Data.gov (United States)

    National Aeronautics and Space Administration — Uncertainty Representation and Management (URM) are an integral part of the prognostic system development.1As capabilities of prediction algorithms evolve, research...

  10. Prognostic Value Of Immunoglobulin Profile In Human Papilloma Virus Infection

    National Research Council Canada - National Science Library

    Chattopadhyay S P

    2001-01-01

    Present study aimed at defining the prognostic value of immunoglobulin profile in human papilloma virus infection by assessing and correlating the levels of immunoglobulin with type, number, duration...

  11. Thrombocytosis as a prognostic marker in gastrointestinal cancers

    Science.gov (United States)

    Voutsadakis, Ioannis A

    2014-01-01

    Thrombocytosis is an adverse prognostic factor in many types of cancer. These include breast cancer, ovarian and other gynecologic cancers, renal cell carcinoma and lung cancers. In gastrointestinal cancers of various locations and histologic types, thrombocytosis has been reported in general to be associated with adverse clinical outcomes. Platelet count measurement is well standardized and available in every clinical laboratory, making its use as a prognostic marker practical. This paper will discuss the data on the prognostic value of thrombocytosis in gastrointestinal cancers as well as pathogenic aspects of the association that strengthen the case for its use in clinical prognostication. PMID:24567794

  12. A clinically based prognostic index for diffuse large B-cell lymphoma with a cut-off at 70 years of age significantly improves prognostic stratification: population-based analysis from the Danish Lymphoma Registry.

    Science.gov (United States)

    Gang, Anne O; Pedersen, Michael; d'Amore, Francesco; Pedersen, Lars M; Jensen, Bo A; Jensen, Paw; Møller, Michael B; Mourits-Andersen, Hans T; Pedersen, Robert S; Klausen, Tobias W; de N Brown, Peter

    2015-01-01

    The introduction of rituximab and generally improved health among elderly patients have increased the survival of patients with diffuse large B-cell lymphoma (DLBCL). The International Prognostic Index (IPI) from 1992 is based on pre-rituximab data from clinical trials including several lymphoma subtypes. We applied IPI factors to a population-based rituximab-treated cohort of 1990 patients diagnosed 2000-2010 and explored new factors and the optimal prognostic age cut-off for DLBCL. Multivariate-analyses (MVA) confirmed the prognostic value of all IPI factors except the presence of > 1 extranodal lesion. The optimal age cut-off was 70 years. In a MVA of albumin, lymphocyte count, sex, immunoglobulin G, bulky disease, hemoglobin and B-symptoms, only albumin was prognostic. We propose: (1) a modified DLBCL prognostic index (DLBCL-PI) including: age (70 years), performance status (PS), lactate dehydrogenase (LDH), stage and albumin level, and (2) a separate age-adjusted DLBCL-PI for patients ≤ 70 years including PS, LDH, albumin level and > 1 extranodal lesion, however excluding stage.

  13. From wealth to health: modelling the distribution of income per capita at the sub-national level using night-time light imagery

    Directory of Open Access Journals (Sweden)

    Tandon Ajay

    2005-02-01

    Full Text Available Abstract Background Sub-national figures providing information about the wealth of the population are useful in defining the spatial distribution of both economic activity and poverty within any given country. Furthermore, since several health indicators such as life expectancy are highly correlated with household welfare, sub-national figures allow for the estimation of the distribution of these health indicators within countries when direct measurement is difficult. We have developed methods that utilize spatially distributed information, including night-time light imagery and population to model the distribution of income per capita, as a proxy for wealth, at the country and sub-national level to support the estimation of the distribution of correlated health indicators. Results A first set of analysis are performed in order to propose a new global model for the prediction of income per capita at the country level. A second set of analysis is then confirming the possibility to transfer the country level approach to the sub-national level on a country by country basis before underlining the difficulties to create a global or regional models for the extrapolation of sub-national figures when no country data set exists. Conclusions The methods described provide promising results for the extrapolation of national and sub-national income per capita figures. These results are then discussed in order to evaluate if the proposed methods could not represent an alternative approach for the generation of consistent country specific and/or global poverty maps disaggregated to some sub-national level.

  14. Comparison of Two Probabilistic Fatigue Damage Assessment Approaches Using Prognostic Performance Metrics

    Directory of Open Access Journals (Sweden)

    Xuefei Guan

    2011-01-01

    Full Text Available In this paper, two probabilistic prognosis updating schemes are compared. One is based on the classical Bayesian approach and the other is based on newly developed maximum relative entropy (MRE approach. The algorithm performance of the two models is evaluated using a set of recently developed prognostics-based metrics. Various uncertainties from measurements, modeling, and parameter estimations are integrated into the prognosis framework as random input variables for fatigue damage of materials. Measures of response variables are then used to update the statistical distributions of random variables and the prognosis results are updated using posterior distributions. Markov Chain Monte Carlo (MCMC technique is employed to provide the posterior samples for model updating in the framework. Experimental data are used to demonstrate the operation of the proposed probabilistic prognosis methodology. A set of prognostics-based metrics are employed to quantitatively evaluate the prognosis performance and compare the proposed entropy method with the classical Bayesian updating algorithm. In particular, model accuracy, precision, robustness and convergence are rigorously evaluated in addition to the qualitative visual comparison. Following this, potential development and improvement for the prognostics-based metrics are discussed in detail.

  15. Emphysematous pyelonephritis: clinical characteristics and prognostic factors.

    Science.gov (United States)

    Lu, Yu-Chuan; Chiang, Bing-Juin; Pong, Yuan-Hung; Chen, Chung-Hsin; Pu, Yeong-Shiau; Hsueh, Po-Ren; Huang, Chao-Yuan

    2014-03-01

    Emphysematous pyelonephritis is a severe necrotizing infection of the renal parenchyma and perirenal tissues that is caused by gas-producing bacterial pathogens. The aim of the present study was to determine the clinical characteristics and prognostic factors of patients with emphysematous pyelonephritis. We retrospectively analyzed the clinical and laboratory data, imaging findings, and outcomes of 32 patients with emphysematous pyelonephritis. Receiver operating characteristic curve analysis was carried out on variables that were significantly associated with patient mortality. The overall survival rate was 87.5% (28/32). Escherichia coli (43.6%) was the most common organism cultured from urine and blood specimens. Hypoalbuminemia, shock as the presenting feature, bacteremia, need for hemodialysis and polymicrobial infection were significantly more common in cases resulting in death. The area under the receiver operating characteristic curve was 0.96. The cut-off point determined by the maximum Youden index (0.93) for three of these five factors yielded a sensitivity of 1.00 and specificity of 0.93. Shock as an initial presentation (P = 0.039) and polymicrobial infection (P = 0.010) were significantly associated with poor outcome. There were no significant differences in the clinical or laboratory features of the patients who did or did not undergo nephrectomy. Hypoalbuminemia, shock as an initial presentation, bacteremia, indications for hemodialysis and polymicrobial infection represent prognostic factors for mortality in patients with emphysematous pyelonephritis. Patients presenting with more than two of these prognostic factors carry the highest risk of mortality, and they require timely diagnosis and aggressive management. © 2013 The Japanese Urological Association.

  16. [Development and evaluation of an internet-based educational system about herbs and dietary supplements through periodical distribution of information to health professionals].

    Science.gov (United States)

    Asahina, Yasuko; Hori, Satoko; Ohtani, Hisakazu; Sawada, Yasufumi

    2009-06-01

    Herbs and dietary supplements (HDS) are widely used, and health professionals are in an ideal position to educate patients about them. However, it is sometimes difficult to evaluate their risks and benefits with limited information and what is worse, many health professionals in Japan are unconcerned with HDS. Therefore, we aimed to develop an internet-based educational system to periodically provide information about HDS to medical doctors and pharmacists in order to increase their awareness. Monographs about selected HDS, accompanied with educational quizzes, were prepared to meet pharmacists' needs. Examples of clinical Q&A cases about drug interactions involving HDS were prepared. The material was distributed weekly to registered health professionals by e-mail and via WWW pages. Two hundred and forty-four health professionals evaluated the system by questionnaire. The questionnaire results revealed that 1) more than 75% of responders evaluated the system as useful, 2) compilation of information into educational quizzes and cases encouraged health professionals to learn about HDS with less difficulty, and 3) e-mails led them to learn periodically and to be more concerned about the safety of HDS. In conclusion, the developed information system for HDS was proved to be useful and should serve to improve the understanding of health professionals about this issue.

  17. Performance of four ischemic stroke prognostic scores in a Brazilian population

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster

    2016-02-01

    Full Text Available ABSTRACT Objective Ischemic stroke (IS prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certified primary stroke center. In-hospital mortality and modified Rankin score at discharge were defined as the outcome measures. The performance of National Institutes of Health Stroke Scale (NIHSS, Stroke Prognostication Using Age and NIHSS (SPAN-100, Acute Stroke Registry and Analysis of Lausanne (ASTRAL, and Totaled Health Risks in Vascular Events (THRIVE were compared. Results Two hundred six patients with a mean ± SD age of 67.58 ± 15.5 years, being 55.3% male, were included. The four scales were significantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality.

  18. Utility of Hippocrates’ prognostic aphorism to predict death in the modern era: prospective cohort study

    Science.gov (United States)

    Montgomery, Patrick R

    2014-01-01

    Objective To determine if one of Hippocrates’ aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. Design Secondary analysis of an existing population based cohort study. Setting Manitoba Study of Health and Aging. Participants 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. Main outcome measure Time to death. Methods We recreated the hippocratic prognosticator using an item that measures appetite drawn from the Center for Epidemiologic Studies-depression subscale, and the mini-mental state examination, with a score of >25 being considered as normal. People with normal cognition and appetite were compared with those with either poor cognition or poor appetite. We constructed Cox regression models, adjusted for age, sex, education, and functional status. Results The prognostic aphorism predicted death, with an unadjusted hazard ratio of 2.37 (95% confidence interval 1.93 to 2.88) and a hazard ratio of 1.71 (1.37 to 2.12) adjusted for age, sex, and education. Both poor appetite and poor cognition predicted death. The sensitivity and specificity were not, however, sufficient for the measure to be used alone. Conclusion An aphorism devised by Hippocrates millennia ago can predict death in the modern era. PMID:25512328

  19. Utility of Hippocrates' prognostic aphorism to predict death in the modern era: prospective cohort study.

    Science.gov (United States)

    St John, Philip D; Montgomery, Patrick R

    2014-12-15

    To determine if one of Hippocrates' aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. Secondary analysis of an existing population based cohort study. Manitoba Study of Health and Aging. 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. Time to death. We recreated the hippocratic prognosticator using an item that measures appetite drawn from the Center for Epidemiologic Studies-depression subscale, and the mini-mental state examination, with a score of >25 being considered as normal. People with normal cognition and appetite were compared with those with either poor cognition or poor appetite. We constructed Cox regression models, adjusted for age, sex, education, and functional status. The prognostic aphorism predicted death, with an unadjusted hazard ratio of 2.37 (95% confidence interval 1.93 to 2.88) and a hazard ratio of 1.71 (1.37 to 2.12) adjusted for age, sex, and education. Both poor appetite and poor cognition predicted death. The sensitivity and specificity were not, however, sufficient for the measure to be used alone. An aphorism devised by Hippocrates millennia ago can predict death in the modern era. © St John et al 2014.

  20. Role functioning before start of adjuvant treatment was an independent prognostic factor for survival and time to failure. A report from the Nordic adjuvant interferon trial for patients with high-risk melanoma

    DEFF Research Database (Denmark)

    Brandberg, Yvonne; Johansson, Hemming; Aamdal, Steinar

    2013-01-01

    To investigate the role of health-related quality of life (HRQoL) at randomization as independent prognostic factors for survival and time to failure, and to explore associations between HRQoL and treatment effects.......To investigate the role of health-related quality of life (HRQoL) at randomization as independent prognostic factors for survival and time to failure, and to explore associations between HRQoL and treatment effects....