Issa, Victor Sarli; Andrade, Lúcia; Bocchi, Edimar Alcides
Renal dysfunction is common during episodes of acute decompensated heart failure, and historical data indicate that the mean creatinine level at admission has risen in recent decades. Different mechanisms underlying this change over time have been proposed, such as demographic changes, hemodynamic and neurohumoral derangements and medical interventions. In this setting, various strategies have been proposed for the prevention of renal dysfunction with heterogeneous results. In the present article, we review and discuss the main aspects of renal dysfunction prevention according to the different stages of heart failure. PMID:23644863
Stefaniak, Katarzyna; Wróżyńska, Magdalena
Protection of common natural goods is one of the greatest challenges man faces every day. Extracting and processing natural resources such as mineral deposits contributes to the transformation of the natural environment. The number of activities designed to keep balance are undertaken in accordance with the concept of integrated order. One of them is the use of comprehensive systems of tailings storage facility monitoring. Despite the monitoring, system failures still occur. The quantitative aspect of the failures illustrates both the scale of the problem and the quantitative aspect of the consequences of tailings storage facility failures. The paper presents vast possibilities provided by the global monitoring in the effective prevention of these failures. Particular attention is drawn to the potential of using multidirectional monitoring, including technical and environmental monitoring by the example of one of the world's biggest hydrotechnical constructions-Żelazny Most Tailings Storage Facility (TSF), Poland. Analysis of monitoring data allows to take preventive action against construction failures of facility dams, which can have devastating effects on human life and the natural environment.
The human failure in the nuclear power plant is analyzed. According to the staff career development and professional qualification 3 stages of the human failure evolution, viz, cognition, logics and emotion are defined. Some human failure prevention measures are brought forward from both the microcosmic and macrocosmic point of view. (author)
Sappok, Alex [Filter Sensing Technologies; Ragaller, Paul [Filter Sensing Technologies; Herman, Andrew [CTS Corporation; Bromberg, L. [Massachusetts Institute of Technology (MIT); Prikhodko, Vitaly Y [ORNL; Parks, II, James E [ORNL; Storey, John Morse [ORNL
The increasing use of diesel and gasoline particulate filters requires advanced on-board diagnostics (OBD) to prevent and detect filter failures and malfunctions. Early detection of upstream (engine-out) malfunctions is paramount to preventing irreversible damage to downstream aftertreatment system components. Such early detection can mitigate the failure of the particulate filter resulting in the escape of emissions exceeding permissible limits and extend the component life. However, despite best efforts at early detection and filter failure prevention, the OBD system must also be able to detect filter failures when they occur. In this study, radio frequency (RF) sensors were used to directly monitor the particulate filter state of health for both gasoline particulate filter (GPF) and diesel particulate filter (DPF) applications. The testing included controlled engine dynamometer evaluations, which characterized soot slip from various filter failure modes, as well as on-road fleet vehicle tests. The results show a high sensitivity to detect conditions resulting in soot leakage from the particulate filter, as well as potential for direct detection of structural failures including internal cracks and melted regions within the filter media itself. Furthermore, the measurements demonstrate, for the first time, the capability to employ a direct and continuous monitor of particulate filter diagnostics to both prevent and detect potential failure conditions in the field.
The factors and conditions which have contributed to many of the corrosion related service failures are discussed based on a review of actual case histories. The anti-corrosion devices which developed as a result of these failure analyses are reviewed, and the method which must be adopted and used to take advantage of the available corrosion prevention techniques is discussed
Fornos Herrando, J.
The reactor cavity of Asco and Vandellos II is dry type, thus a severe accident leading to vessel failure might potentially end up resulting in the loss of containment integrity, depending on the viability to cool the molten core. Therefore, significant radioactive emissions could be released to outside. In the framework of Fukushima Stress Tests, ANAV has analyzed the convenience of carrying out different actions to prevent failure of the containment integrity in order to reduce radioactive emissions. The aim of this paper is to present and describe the main phenomenological aspects associated with two of these actions: containment flooding and reactor cavity flooding.
Based on the performances in Daya Bay Nuclear Power Plant and the common experience from the world nuclear industry, the features and usual kinds of human failures in nuclear power plants are highlighted and the prominent factors on the personal, external and decision problems which might cause the human failures are analyzed. Effective preventive measures have been proposed respectively. Some successful human-failure-prevention practices applied in the Daya Bay Nuclear Power Plant are illustrated specifically
Rau, C.A. Jr.; Becker, D.G.; Besuner, P.M.; Cipolla, R.C.; Egan, G.R.; Gupta, P.; Johnson, D.P.; Omry, U.; Tetelman, A.S.; Rettig, T.W.; Peters, D.C.
New methods have been developed and applied to better quantify and increase the reliability, safety, and availability of electric power plants. Present and potential problem areas have been identified both by development of an improved computerized data base of malfunctions in nuclear power plants and by detailed metallurgical and mechanical failure analyses of selected problems. Significant advances in the accuracy and speed of structural analyses have been made through development and application of the boundary integral equation and influence function methods of stress and fracture mechanics analyses. The currently specified flaw evaluation procedures of the ASME Boiler and Pressure Vessel Code have been computerized. Results obtained from these procedures for evaluation of specific in-service inspection indications have been compared with results obtained utilizing the improved analytical methods. Mathematical methods have also been developed to describe and analyze the statistical variations in materials properties and in component loading, and uncertainties in the flaw size that might be passed by quality assurance systems. These new methods have been combined to develop accurate failure rate predictions based upon probabilistic fracture mechanics. Improved failure prevention strategies have been formulated by combining probabilistic fracture mechanics and cost optimization techniques. The approach has been demonstrated by optimizing the nondestructive inspection level with regard to both reliability and cost. (Auth.)
Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico
Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function. Copyright © 2013 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.
Shields, K.J.; Dooley, R.B.
Properly applied, chemical cleaning is a valuable tool used to prevent tube failures involving overheating and corrosion due to waterside deposits. In many cases, however, cleaning becomes yet an additional cost associated with correction of tube failure incidents. Discussion is focused on approaches taken to appraise tube waterside cleanliness and determine the need to clean, as typically practiced in conventional fossil plants. Also presented is an assessment of the suitability and limitations of these approaches to plants with heat recovery steam generator (HRSG) units. (orig.)
Manning, Jessica; VanDeusen, Karen
Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this…
Zequeira, R.I. [ISTIT FRE CNRS 2732-Equipe LM2S, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes (France)]. E-mail: firstname.lastname@example.org; Berenguer, C. [ISTIT FRE CNRS 2732-Equipe LM2S, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes (France)]. E-mail: email@example.com
A maintenance policy is studied for a system with two types of failure modes: maintainable and non-maintainable. The quality of maintenance actions is modelled by its effect on the system failure rate. Preventive maintenance actions restore the system to a condition between as good as new and as bad as immediately before the maintenance action. The model presented permits to study the equipment condition improvement (improvement factor) as a function of the time of the preventive maintenance action. The determination of the maintenance policy, which minimizes the cost rate for an infinite time span, is examined. Conditions are given under which a unique optimal policy exists.
Zequeira, R.I.; Berenguer, C.
A maintenance policy is studied for a system with two types of failure modes: maintainable and non-maintainable. The quality of maintenance actions is modelled by its effect on the system failure rate. Preventive maintenance actions restore the system to a condition between as good as new and as bad as immediately before the maintenance action. The model presented permits to study the equipment condition improvement (improvement factor) as a function of the time of the preventive maintenance action. The determination of the maintenance policy, which minimizes the cost rate for an infinite time span, is examined. Conditions are given under which a unique optimal policy exists
Petrequin, P.; Barrachin, B.
From the safety view point the primary circuit is considered as the essential barrier against the diffusion of radioactive products in the event of fuel element failure. The safety of the vessel itself, the failure of which is not accounted for in accident analyses, is based chiefly on a series of preventive measures such as the suitable choice of materials and manufacturing process, compliances with detailed specifications concerning tests and defect tolerances, supervision in service. All these points are examined in detail when the safety analysis is performed. In this context the Service de Recherches Metallurgiques Appliquees assists the Department de Surete Nucleaire in the study of special problems such as the prevention of sudden failure and the characterisation of steels as a function of working conditions, particularly neutron irradiation. The report is thus devoted mainly to the presentation of methods to prevent sudden failure, with special emphasis on the limits of application. Some results obtained at the Service de Recherches Metallurgiques Appliquees on steels typical of those used for water reactor vessels (A533 and A508Cl.3) are given by way of example. Part two concentrates on the role of various factors influencing embrittlement by irradiation [fr
Merrick, E.A.; Rivers, A.; Bickford, J.; Marston, T.U.
A discussion is presented of bolting degradation or failure experience in pressure boundary and component support applications in US commercial nuclear plants and the industry program to prevent failures in the future. The focus turns to steps which plant owners can take today to guard against pressure boundary bolt failure or degradation for existing plants or units being constructed. 'Tools' or products which the plant owner can expect from current industry programs which will be available in the near future to aid in understanding and improving bolting practices are described. (author)
Thomas, Roger E; Crichton, Andrew; Thomas, Bennett C
Patients having cataract surgery have often earlier undergone a trabeculectomy for glaucoma. However, cataract surgery may be associated with failure of the previous glaucoma surgery and antimetabolites may be used with cataract surgery to prevent such failure. There is no systematic review on whether antimetabolites with cataract surgery prevent failure of a previous trabeculectomy. To assess the effects of antimetabolites with cataract surgery on functioning of a previous trabeculectomy. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2014), EMBASE (January 1980 to June 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to June 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 10 June 2014. We also searched the Science Citation Index database (July 2013) and reference lists of potentially relevant studies. Randomised controlled trials (RCTs) of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Two review authors independently reviewed the titles and abstracts from the electronic searches. Two review authors independently assessed relevant full-text articles and entered data. We identified no RCTs to test the effectiveness of antimetabolites with cataract surgery in individuals with the intention of preventing failure of a previous trabeculectomy. There are no RCTs of antimetabolites with cataract surgery in people with a functioning trabeculectomy. Appropriately powered RCTs
Savanheimo, Nora; Vehkalahti, Miira M
In Helsinki Public Dental Service (PDS) the Special Oral Health Care Unit (SOHCU) provides comprehensive dental treatments under general anaesthesia (GA). For the present study, all dental treatment given under GA for generally healthy children (n = 102) below 16 years of age (range 2.3-15.8) during a 1-year period and dental treatment and visits of these children in the preceding 2 years in Helsinki PDS was recorded in detail. These children were referred to the SOHCU because of serious difficulties in dental care due to large treatment needs or failures in psychological and chemical management, including sedation. To describe treatments given to generally healthy children under GA and to evaluate preventive aspects of their dental care in the preceding 2 years. The study was cross-sectional and retrospective. Data came from the patients' individual records. Treatments under GA included an average of 6.0 restorations (SD = 2.7, range 0-12) and 1.7 extractions (SD = 2.1, range 0-10). In the 2 preceding years, these children had visited dentist an average of 5.1 times (SD = 2.7, range 1-14) with an average of 2.4 restorations (SD = 1.9, range 0-12) and 0.5 extractions (SD = 1.4, range 0-10). Of the restorations made, 36% were temporary. Of all visits, those with an operative approach accounted for 35%, preventive for 37%, operative and preventive for 5%, and visits with total uncooperation for 23%. Of the children, 90% had at least one preventive visit. Children treated under conscious sedation in the preceding 2 years received less prevention (P = 0.02). Remaining without preventive measures was most likely for those children exhibiting visits with total uncooperation (odds ratio = 4.6; P = 0.004) and for those receiving numerous temporary fillings (odds ratio = 4.1; P = 0.0005). The uncooperative high-caries children pose a demanding challenge to PDS. The early identification of high-caries risk and efforts of intensive preventive care are in key position to
Park, Rae Joon; Je, Moo Sung; Park, Chang Kyoo [Korea Atomic Energy Research Institute, TaeJon (Korea, Republic of)
As a part of the evaluation of accident management strategies for severe accident prevention or mitigation in a station blackout scenario for YGN 3 and 4, an external vessel cooling strategy for the prevention of reactor vessel failure has been estimated using the MAAP4 computer code. The sensitivity studies have been performed such as actuating timings and the number of spray pumps used. To explore external vessel cooling strategies, containment spray pumps were actuated by varying time spanning core uncovery, core melting and relocation of molten core material. It was shown that flooding of the reactor cavity using the containment spray system may prevent reactor vessel failure but may not prevent the failure of the relocation of molten core material during the station blackout sequence of YGN 3 and 4. Reactor vessel failure can be prevented by external vessel cooling using condensed water from the operation of two containment spray pumps at the time of core melting and using water from the operation of one containment spray pumps at the time of core melting and using water from the operation of one containment spray pump at the time of core uncovery. (Author) 46 refs., 26 figs., 5 tabs.
Najafpour, Zhila; Hasoumi, Mojtaba; Behzadi, Faranak; Mohamadi, Efat; Jafary, Mohamadreza; Saeedi, Morteza
Failure Mode and Effect Analysis (FMEA) is a method used to assess the risk of failures and harms to patients during the medical process and to identify the associated clinical issues. The aim of this study was to conduct an assessment of blood transfusion process in a teaching general hospital, using FMEA as the method. A structured FMEA was recruited in our study performed in 2014, and corrective actions were implemented and re-evaluated after 6 months. Sixteen 2-h sessions were held to perform FMEA in the blood transfusion process, including five steps: establishing the context, selecting team members, analysis of the processes, hazard analysis, and developing a risk reduction protocol for blood transfusion. Failure modes with the highest risk priority numbers (RPNs) were identified. The overall RPN scores ranged from 5 to 100 among which, four failure modes were associated with RPNs over 75. The data analysis indicated that failures with the highest RPNs were: labelling (RPN: 100), transfusion of blood or the component (RPN: 100), patient identification (RPN: 80) and sampling (RPN: 75). The results demonstrated that mis-transfusion of blood or blood component is the most important error, which can lead to serious morbidity or mortality. Provision of training to the personnel on blood transfusion, knowledge raising on hazards and appropriate preventative measures, as well as developing standard safety guidelines are essential, and must be implemented during all steps of blood and blood component transfusion.
Carrington, Melinda J; Stewart, Simon; de Courten, Barbora
AIMS: The primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF). Methods NIL-CHF is a randomized controlled trial of a hybrid, home- and clinic-...
Xanthopoulos, A.S.; Koulouriotis, D.E.; Botsaris, P.N.
Despite the fact that the fields of pull type production control policies and condition-based preventive maintenance have much in common contextually, they have evolved independently up to now. In this investigation, an attempt is made to bridge the gap between these two branches of knowledge by introducing the single-stage Kanban system with deterioration failures and condition-based preventive maintenance. The formalism of continuous time Markov chains is used to model the system and expressions for eight performance metrics are derived. Two important, from a managerial perspective, constrained optimization problems for the proposed model are defined where the objective is the simultaneous optimization of the Kanban policy, the preventive maintenance policy and the inspection schedule under conflicting performance criteria. Multiple instances of each optimization problem are solved by means of the augmented Lagrangian genetic algorithm. The results from the optimization trials coupled by the results from extensive numerical examples facilitate the thorough investigation of the system’s behaviour. - Highlights: • Kanban system with deterioration failures and preventive maintenance is introduced. • The system is modeled as a continuous time Markov chain. • Expressions for eight performance metrics are derived. • The behavior of the system is studied through numerical examples. • Optimization results for selected performance metrics are presented
The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.
Qvist, Palle; Rebollar, Rubeén; Lidón, Iván
This paper presents the process used to devise the Teamwork Failure Prevention Questionnaire (TFP Questionnaire), a tool that allows teams with problems in functioning to be detected early. The TFP Questionnaire was formulated in a project management course at the University of Zaragoza (Spain......). In this course, teams of five or six students have to manage a project for a real client. The questionnaire was then tested on students on this course and on a similar one at Aalborg University (Denmark). This article analyses the psychometric characteristics of the TFP Questionnaire and then presents...
James Alfred Loader
Full Text Available Taking its cue from Rudolf Bultmann’s famous verdict that the Old Testament is a ‘failure’ (‘Scheitern’, the article reviews three influential negative readings of Israel’s history as told in the Former Prophets. It is then argued that awareness of the theological problem posed by Israel’s history enabled the redactors of both the former and the latter prophetic collections to deal with the element of human failure in a way that facilitated Israel’s retaining of her faith. Next, the sapiential insight in failing human discernment is drawn into the equation. Failure of human action is here interrelated with failure to comprehend God’s order. By virtue of its incorporation into the totality of the Tanak, this insight became a constructive part of Israel’s faith. Therefore the concept of failure comprises more than coming to terms with Israel’s catastrophic history. Since it is encoded in Israel’s Holy Scripture, ‘failure’ is a major concept within the Old Testament internally and is therefore not suitable as a verdict over the Old Testament by an external value judgement. ‘Failure’ thus becomes a key hermeneutical category, not merely so that the Old Testament could become a ‘promise’ for the New Testament to fulfil, but as a manifestation of limits in human religion and thought. Far from undermining self-esteem, constructive use of the concept of her own failure sustained Israel in her catastrophe and should be adopted by Christianity – not least in South Africa, where the biblical message was often misappropriated to bolster apartheid.
ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu
Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.
These proceedings contain the thirteen papers presented at a seminar on crack arrest concepts for failure prevention and life extension. They provide a picture of the current position of crack arrest testing, models and applications, discussion of the relevance of recent research to industrial problems, and an assessment of whether the application of crack arrest models provides additional safety. Separate abstracts have been prepared for seven papers of relevance to the nuclear industry and, in particular, reactor pressure vessels. (UK)
Symons, Nicholas R A; Almoudaris, Alex M; Nagpal, Kamal; Vincent, Charles A; Moorthy, Krishna
To investigate the nature of process failures in postoperative care, to assess their frequency and preventability, and to explore their relationship to adverse events. Adverse events are common and are frequently caused by failures in the process of care. These processes are often evaluated independently using clinical audit. There is little understanding of process failures in terms of their overall frequency, relative risk, and cumulative effect on the surgical patient. Patients were observed daily from the first postoperative day until discharge by an independent surgeon. Field notes on the circumstances surrounding any nonroutine or atypical event were recorded. Field notes were assessed by 2 surgeons to identify failures in the process of care. Preventability, the degree of harm caused to the patient, and the underlying etiology of process failures were evaluated by 2 independent surgeons. Fifty patients undergoing major elective general surgery were observed for a total of 659 days of postoperative care. A total of 256 process failures were identified, of which 85% were preventable and 51% directly led to patient harm. Process failures occurred in all aspects of care, the most frequent being medication prescribing and administration, management of lines, tubes, and drains, and pain control interventions. Process failures accounted for 57% of all preventable adverse events. Communication failures and delays were the main etiologies, leading to 54% of process failures. Process failures are common in postoperative care, are highly preventable, and frequently cause harm to patients. Interventions to prevent process failures will improve the reliability of surgical postoperative care and have the potential to reduce hospital stay.
Lehner, J.R.; Lin, C.C.; Luckas, W.J.; Pratt, W.T.
Brookhaven National Laboratory, under the auspices of the US Nuclear Regulatory Commission, is investigating accident management strategies which could help preserve containment integrity or minimize releases during a severe accident. The strategies considered make use of existing plant systems and equipment in innovative ways to reduce the likelihood of containment failure or to mitigate the release of fission products to the environment if failure cannot be prevented. Many of these strategies would be implemented during the later stages of a severe accident, i.e. after vessel breach, and sizable uncertainties exist regarding some of the phenomena involved. The identification and assessment process for containment and release strategies is described, and some insights derived from its application to specific containment types are presented. 2 refs., 5 figs., 2 tabs
Full Text Available Powder metallurgy is used for the production of a number of mechanical parts and is an essential production method. These are great advantages such as product cost effectiveness and product uniqueness. In general, however parts created by powder metallurgy have low strength because of low density. In order to increase strength as well as density, new techniques such as high-velocity-compaction (HVC was developed and further investigation has been conducted on improvement of techniques and optimum condition using computer simulation. In this study, the effects of aspect ratio and specimen size of iron green bodies on failure strength of uniaxial compression and failure behavior were examined using a split Hopkinson pressure Bar. The diameters of specimens were 12.5 mm and 25 mm the aspect ratios (thickness/diameter were 0.8 and 1.2.
Liu, David Donhang; Sampson, Michael J.
presentation. The model can be used to explain the Intel-reported reliability degradation in MLCCs with respect to the reduction of dielectric thickness. It can also be used to estimate the reliability of a MLCC based on its construction and microstructure parameters such as dielectric thickness, average grain size, and number of dielectric layers. Measures for preventing early failures are also discussed in this document.
M A Pokachalova
Full Text Available The present literature review presents current views on pathophysiologic aspects of the formation and progression of cognitive disorders in chronic heart failure in elderly patients. Advanced age itself is an important predictor of the development of cardiovascular, neurodegenerative and other diseases. Involutive changes of cardiovascular system are known to potentiate the development of chronic heart failure. Heart failure in older people usually develops gradually. Formation of the cognitive deficit in heart disease is associated with chronic cerebral ischemia as well as a cascade of neurochemical processes occurring in the brain, eventually forming a vicious circle. Often the symptoms of cerebral ischemia due to reduced stroke volume occur much earlier than congestion signs in other organs and systems. Chronic cerebral ischemia that occurs due to violation of cerebral hemodynamics, is associated with both extracerebral and intracerebral causes, which in turn contributes to the development of chronic brain hypoxia and aggravation of cognitive dysfunction. Thus, the features of the development and course of disease in people of older age groups indicate that in geriatric practice existing diagnostic schemes are not always applicable. When observing patients of elderly and senile age with chronic heart failure, during the assessment of their condition and running diagnostic tests, special attention should be payed to the earliest detection of cognitive dysfunction signs in order to correct the patient's treatment and improve quality of life.
This book covers most aspects of imaging studies in patients with renal failure. The initial chapter provides basic information on contrast agents, intravenous urography, and imaging findings in the urinary tract disorders responsible for renal failure and in patients who have undergone transplantation. It illustrates common gastro-intestinal abnormalities seen on barium studies in patients with renal failure. It illustrates the cardiopulmonary complications of renal failure and offers advice for radiologic differentiation. It details different aspects of skeletal changes in renal failure, including a basic description of the pathophysiology of the changes; many excellent illustrations of classic bone changes, arthritis, avascular necrosis, and soft-tissue calcifications; and details of bone mineral analysis
Sharma, Bhuvnesh Kumar; Subhakta, P K J P; Narayana, A
The whole universe is intermingling into a unit in the period of globalization. Different cultures, life-styles and sciences are co-operating with each other in this situation. World Health Organization is working towards collaborating all prevalent medical sciences for attainment of good health and family welfare for each and every individual by 2020. Astrology is a part of Indian heritage. Astrology means the art of predicting or determining the influence of the planets and stars on human affairs. The origin of this word is from Greek word astron, star + logos (discourse). The account of deeds of good and bad during the present life and previous lives, their consequences of health or ill health during this life i.e. what, when and how the things takes place will be clearly known through Astrology. Highly advanced knowledge related to Astrology on medicine is preserved in Indian scriptures and the knowledge was transmitted from generation to generation. It is also a good source for health promotion, preventive, curative and other medical aspects. Brief direction related to astrological medical aspects is also available in Ayurvedic literature (Carakasamhită, Suśrutasamhhită, Aşţăngasangraha, Aşţăngahŗdaya, Sărngadharasamhită , Băvaprakăśa etc.) Some Ayurvedic practitioners, scholars and scientists realize the need of astrological knowledge related to medicine in the present time. In ancient times physician, astrologer and purŏhita (Hindu priest) simultaneously looked after the health and family welfare of individual, families and country. Astrologer guides medication and suitable time for the better cure of ailments. Even the medicinal herbs were collected and treated at appropriate time for their efficacy. Astrology and Ayurvĕda are inseparable sciences of life. Hence, in this article, a concise astrological evaluation related to health promotion, preventive and curative aspects of Astrology is being presented.
Jang, Hoon; Hong, Kwonho; Choi, Youngsok
Premature ovarian failure is one of the side effects of chemotherapy in pre-menopausal cancer patients. Preservation of fertility has become increasingly important in improving the quality of life of completely recovered cancer patients. Among the possible strategies for preserving fertility such as ovarian tissue cryopreservation, co-treatment with a pharmacological adjuvant is highly effective and poses less of a burden on the human body. Melatonin is generally produced in various tissues and acts as a universally acting antioxidant in cells. Melatonin is now more widely used in various biological processes including treating insomnia and an adjuvant during chemotherapy. In this review, we summarize the information indicating that melatonin may be useful for reducing and preventing premature ovarian failure in chemotherapy-treated female patients. We also mention that many adjuvants other than melatonin are developed and used to inhibit chemotherapy-induced infertility. This information will give us novel insights on the clinical use of melatonin and other agents as fertoprotective adjuvants for female cancer patients.
Full Text Available Heart failure is currently a real public health problem due to the extremely high morbidity and mortality of this disease. In this context, cardiovascular prevention measures should be implemented as early as possible. In addition to classic prevention measures, a number of extremely important specific recommendations should be considered: informing patients about their underlying disease, identifying the cardiovascular and non-cardiovascular factors that have led to cardiac decompensation, reducing daily salt consumption, monitoring body weight, forbidding smoking and recreational substances, conducting a regular exercise program under supervision, and increasing adherence to treatment.
Allez, Matthieu; Karmiris, Konstantinos; Louis, Edouard
The first ECCO pathogenesis workshop focused on anti-TNF therapy failures in inflammatory bowel diseases (IBDs). The overall objective was to better understand and explore primary non response and loss of response to anti-TNF agents in IBD. The outcome of this workshop is presented into two parts....... This first section addresses definitions, frequency and pharmacological aspects of anti-TNF therapy failure, including pharmacokinetics of anti-TNF monoclonal antibodies and immune and non-immune mediated clearance of anti-TNF mAbs. The second section concerns the biological roles of TNF and TNF antagonists...
This cumulative “habilitation” thesis focuses on myocardial regeneration by means of cell therapy and on experimental and clinical approaches. To supplement the articles published by the author the work gives an overview of the pathogenesis of heart failure and remodeling of the heart, taking into account the role of nitric oxide and statins. Further, the treatment of ischemic heart failure including organ transplantation and mechanical circulatory support is discussed. Different approaches t...
Martynova, O.I.; Gladyshev, B.P.; Zhivilova, L.M.; Yurchevskij, E.B.
Some general aspects of preventing corrosion of thermal power plant equipment are considered. Application of oxidation water chemistry regime, high purity feedwater, automatic control of water quality indices (conductivity, content of chlorides, sulfides, sodium, oxygen, hydrogen) is recommended. Necessity in statistics and creation of methods for quantitative evalution of economic losses during power equipment failures due to violation of water chemistry regime standards is indicated
Full Text Available Nuclear power plants are highly complex systems and the issues related to their safety are of primary importance. Probabilistic safety assessment is regarded as the most widespread methodology for studying the safety of nuclear power plants. As maintenance is one of the most important factors for affecting the reliability and safety, an enhanced preventive maintenance optimization model based on a three-stage failure process is proposed. Preventive maintenance is still a dominant maintenance policy due to its easy implementation. In order to correspond to the three-color scheme commonly used in practice, the lifetime of system before failure is divided into three stages, namely, normal, minor defective, and severe defective stages. When the minor defective stage is identified, two measures are considered for comparison: one is that halving the inspection interval only when the minor defective stage is identified at the first time; the other one is that if only identifying the minor defective stage, the subsequent inspection interval is halved. Maintenance is implemented immediately once the severe defective stage is identified. Minimizing the expected cost per unit time is our objective function to optimize the inspection interval. Finally, a numerical example is presented to illustrate the effectiveness of the proposed models.
Fernández Río, Francisco Javier; Cecchini Estrada, José Antonio; Méndez Giménez, Antonio; Prieto Saborit, José Antonio
Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.20...
... Other diseases. Chronic diseases — such as diabetes, HIV, hyperthyroidism, hypothyroidism, or a buildup of iron (hemochromatosis) or ... transplantation or support with a ventricular assist device. Prevention The key to preventing heart failure is to ...
Full Text Available Purpose: The present review summarizes the updated literature on the social aspects of suicidal behavior and prevention in adolescents. Recent findings: The predictive role of psychiatric disorders and past history are well recognized in adolescent suicide, but the role of social and cultural factors is less clear. Studies have focused on the importance of ethnicity, gender, family characteristics, and socioeconomic status. More recently, attention has been addressed to broader social risk factors, such as bullying in adolescents, suicide contagion, sexual orientation, and the popular media. Further empirical evidence is needed to advance our understanding of suicidal youth, develop better assessment tools, and formulate effective prevention and treatment programs. Summary: Suicidal behavior remains an important clinical problem and major cause of death in youth. Social factors may be at least as important as genetics. Advancing our understanding of underlying cultural and sociological issues in youth suicide will help clinicians achieve more efficient prediction, prevention and treatment.
Actions to reduce radioactive emissions: prevention of containment failure by flooding Containment and Reactor Cavity; Acciones para la reduccion de emisiones radiactivas: prevencion del fallo de la Contencion mediante la inundacion de la Contencion y de la Cavidad del Reactor
Fornos Herrando, J.
The reactor cavity of Asco and Vandellos II is dry type, thus a severe accident leading to vessel failure might potentially end up resulting in the loss of containment integrity, depending on the viability to cool the molten core. Therefore, significant radioactive emissions could be released to outside. In the framework of Fukushima Stress Tests, ANAV has analyzed the convenience of carrying out different actions to prevent failure of the containment integrity in order to reduce radioactive emissions. The aim of this paper is to present and describe the main phenomenological aspects associated with two of these actions: containment flooding and reactor cavity flooding.
V. V. Likhvantsev
Full Text Available Congestive heart failure is consistently associated with adverse outcomes, and is characterized by a twofold increase in mortality in noncardiac surgery. In this regard, developing the methods aimed to prevent and treatacute heart failure (AHF in the intraoperative period remain a challenging problem.Objective. To evaluate the efficacy of preoperative levosimendan infusion in reduction both mortality and duration of treatment of elderly patients with reduced left ventricular ejection fraction in noncardiac surgery.Material and Methods. Design: Multicenter blind randomized placebocontrolled study. Patients: 81 patients operated on abdominal organs. The main endpoint of the study: The length of stay in the Intensive Care Unit (ICU and at the hospital were chosen as the primary endpoints. The secondary endpoints of the study were 30 day and annual mortality, the rate of acute myocardial infarction and stroke.Results. Levosimendan infusion at a rate of 0,05 μg/kg/min — 0,1 μg/kg/min to patients with low left ven tricular ejection fraction just before the surgery reduced the length of stay in ICU for 2 days and required hospital stay for 3 days. NTproBNP showed the best ratio of sensitivity/specificity in predicting 30day mortality in cumulative group: AUC=0,86 (90,77 to 0,93, P<0,0001. From other indicators the most informative were the Inotropes scoring, no change or decrease of a left ventricular ejection fraction, and cardiac index.Conclusion. To reduce perioperative mortality, the intravenous infusion of levosimendan at a rate of 0,05—0,1 μg/kg/min in elderly patients with low left ventricular ejection fraction is recommened as a preoperative preparation the day before the alleged noncardiac surgery.
Full Text Available Aim: The Emergency Department is one of the most challenging wards of the hospital for studying patient safety and the prevention of treatment errors is the basic rule in the quality of health care. The present study was conducted to evaluate the selected risk processes of Pediatric Emergency of Qaem Educational Hospital in Mashhad by the Healthcare Failure Mode and Effects Analysis (HFMEA methodology. Materials and Methods: A mixed method was used to analyze failure modes and their effects with HFMEA. Five high-risk processes of the Pediatric Emergency were identified and analyzed. To classify failure modes, nursing errors in clinical management model; for classifying factors affecting error, the approved model by the United Kingdom National Health System; and for determining solutions for improvement, Theory of Inventive Problem Solving was used. Results: In 5 selected processes, 28 steps, 80 sub-processes and 254 potential failure modes were identified with HFMEA. Thirty-seven (14.5% failure modes as high-risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors as 62.3%, and knowledge and skill as 8.1% respectively. Also, 23.6% of preventive measures were in the category of human resource management strategy. Conclusion: Using the proactive method of HFMEA for identifying the possible failure of treatment procedures, determining the effective cause on each failure mode and proposing the improvement strategies, has high efficiency and effectiveness.
It is the common experience of power generating companies worldwide that the main causes of forced outages on power plant are those due to boiler tube failures on fossil units. The main reason for the large number of failures are the severe environmental conditions in fossil boilers as the effects of stress, temperature, temperature gradients, corrosion, erosion and vibration combine to produce degradation of the tube steel. Corrosion by oxidation, by combustion products and by impure boiler water can significantly reduce the tube wall thickness and result in failure of a tube many years before its designed service life. Errors can also occur in the design manufacturer, storage, operation, and maintenance of boiler tubing and the wrong material installed in a critical location can lead to premature failure. Altogether, experts in the US and UK, from many different disciplines, have identified seven broad categories of boiler tube failure mechanisms. 1 tab., 2 figs
Potter, K. W.
Urban expansion is not often considered a major factor contributing to dam failure. But if urbanization occurs without mitigation of the hydrologic impacts, the risk of dam failure will increase. Of particular concern are increases in the volume of storm runoff resulting from increases in the extent of impervious surfaces. Storm runoff volumes are not regulated for much the U.S, and where they are, the required control is commonly less than 100%. Unmitigated increases in runoff volume due to urbanization can pose a risk to dams. A recent technical advisory committee of Dane County has recommended that the county require 100% control of stormwater volumes for new developments. The primary motivation was to prevent increases in the water levels in the Yahara Lakes, slowly draining lakes that are highly sensitive to runoff volume. The recommendations included the use of "volume trading" to achieve efficient compliance. Such recommendations should be considered for other slowly draining lakes, including those created by artificial structures.
Viejo Moreno, R; Sánchez-Izquierdo Riera, J Á; Molano Álvarez, E; Barea Mendoza, J A; Temprano Vázquez, S; Díaz Castellano, L; Montejo González, J C
To improve critical patient safety in the prevention of venous thromboembolic disease, using failure mode and effects analysis as safety tool. A contemporaneous cohort study covering the period January 2014-March 2015 was made in 4 phases: phase 1) prior to failure mode and effects analysis; phase 2) conduction of mode analysis and implementation of the detected improvements; phase 3) evaluation of outcomes, and phase 4) (post-checklist introduction impact. Patients admitted to the adult polyvalent ICU of a third-level hospital center. A total of 196 patients, older than 18 years, without thromboembolic disease upon admission to the ICU and with no prior anticoagulant treatment. A series of interventions were implemented following mode analysis: training, and introduction of a protocol and checklist to increase preventive measures in relation to thromboembolic disease. Indication and prescription of venous thrombosis prevention measures before and after introduction of the measures derived from the failure mode and effects analysis. A total of 59, 97 and 40 patients were included in phase 1, 3 and 4, respectively, with an analysis of the percentage of subjects who received thromboprophylaxis. The failure mode and effects analysis was used to detect potential errors associated to a lack of training and protocols referred to thromboembolic disease. An awareness-enhancing campaign was developed, with staff training and the adoption of a protocol for the prevention of venous thromboembolic disease. The prescription of preventive measures increased in the phase 3 group (91.7 vs. 71.2%, P=.001). In the post-checklist group, prophylaxis was prescribed in 97.5% of the patients, with an increase in the indication of dual prophylactic measures (4.7, 6.7 and 41%; P<.05). There were no differences in complications rate associated to the increase in prophylactic measures. The failure mode and effects analysis allowed us to identify improvements in the prevention of
It has long been recognized that no emergency core cooling system (ECCS) could be absolutely guaranteed to prevent fuel failures. In 1976 the Atomic Energy Control Board decided that the objective for an ECCS should be to prevent fuel failures, but if the objective could not be met it should be shown that the consequences are acceptable for dual failures comprising any LOCA combined with an assumed impairment of containment. Out of the review of the Bruce A plant came the definition of 'no significant fuel failures': for any postulated LOCA combined with any one mode of containment impairment the resultant dose to a person at the edge of the exclusion zone is less than the reference dose limits for dual failures
Most treatments for chronic heart failure are effective both in preventing its onset and reducing its progression. However, statins prevent the development of heart failure, but they do not decrease morbidity and mortality in those with established heart failure. This apparent discordance cannot be explained by an effect to prevent interval myocardial infarctions. Instead, it seems that the disease that statins were preventing in trials of patients with a metabolic disorder was different from the disease that they were treating in trials of chronic heart failure. The most common phenotype of heart failure in patients with obesity and diabetes is heart failure with a preserved ejection fraction (HFpEF). In this disorder, the anti-inflammatory effects of statins might ameliorate myocardial fibrosis and cardiac filling abnormalities, but these actions may have little relevance to patients with heart failure and a reduced ejection fraction (HFrEF), whose primary derangement is cardiomyocyte loss and stretch. These distinctions may explain why statins were ineffective in trials that focused on HFrEF, but have been reported to produce with favourable effects in observational studies of HFpEF. Similarly, selective cytokine antagonists were ineffective in HFrEF, but have been associated with benefits in HFpEF. These observations may have important implications for our understanding of the effects of antihyperglycaemic medications. Glucagon-like peptide-1 receptor agonists have had neutral effects on heart failure events in people at risk for HFpEF, but have exerted deleterious actions in HFrEF. Similarly, sodium-glucose co-transporter 2 inhibitors, which exert anti-inflammatory effects and reduce heart failure events in patients who are prone to HFpEF, may not be effective in HFrEF. The distinctions between HFrEF and HFpEF may explain why the effects of drugs on heart failure events in diabetes trials may not be relevant to their use in patients with systolic dysfunction
Poplyko, I.Ya.; Nikolaenko, E.V.
The thematic atlas modern and prediction aspects of consequences from Chernobyl NPP failure in the suffered territories of Russia and Belarus will contain materials about radioactive pollution of territories, the grounds of wood fund, the agricultural grounds, and as help section, including analytical and help materials. (authors)
McDonald, Ken; Wilkinson, Mark
Heart failure (HF) remains one of the major cardiovascular challenges to the Western world. Once established, HF is characterized by compromised life expectancy and quality of life with considerable dependence on hospital care for episodic clinical deterioration. Much is understood about the risk factors that predispose to the development of HF. With such a broad range of factors, it is clear that there is a large population at risk, potentially in excess of 25% of the adult population. Therein lies the major challenge at the outset of our efforts to prevent HF. With such a large population at risk, how do we develop an effective prevention strategy? HF prevention requires a multimodal approach. In this review, we focus primarily on the role of natriuretic peptide (NP) as a tool in a prevention strategy. Prevention of HF is a major public health challenge, underlined by the concerning epidemiological trends, the associated costs, and the continued difficulty to find effective therapies for the growing number of patients with preserved systolic function HF. Population-based approaches focusing on lifestyle and risk factor control have made some impact but not to a satisfactory level and also tend to result in a uniform approach across a population with different risk profiles. Individualizing risk is therefore required, with emerging data indicating that NP-guided risk stratification and intervention can reduce downstream incident HF and other cardiovascular events. © 2016 American Association for Clinical Chemistry.
Leavey, Gerard; Mallon, Sharon; Rondon-Sulbaran, Janeet; Galway, Karen; Rosato, Michael; Hughes, Lynette
Although Primary care is crucial for suicide prevention, clinicians tend to report completed suicides in their care as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from the perspectives of bereaved family members and GPs. Qualitative study of 72 relatives or close friends bereaved by suicide and 19 General Practitioners who have experienced the suicide of patients. Relatives highlight failures in detecting symptoms and behavioral changes and the inability of GPs to understand the needs of patients and their social contexts. A perceived overreliance on anti-depressant treatment is a major source of criticism by family members. GPs tend to lack confidence in the recognition and management of suicidal patients, and report structural inadequacies in service provision. Mental health and primary care services must find innovative and ethical ways to involve families in the decision-making process for patients at risk of suicide.
Psychological aspects of the fear of nuclear power are discussed, cancer deaths due to a nuclear accident are predicted and the need for nuclear accident prevention is stressed. A simplified analysis of the safety precautions in a generalised nuclear power station is offered, with reference to loss-of-coolant incidents, and developments in reactor design for fail-safe modes are explained. The importance of learning from the Three Mile Island incident is noted and failure statistics are presented. Tasks to be undertaken at the Austrian Zwentendorf nuclear power station are listed, including improved quality control and acoustic detectors. Precautions against earthquakes are also discussed and it is stated that safe operation of the Zwentendorf station will be achieved. (G.M.E.)
Marshall Brinkley, D; Ali, Omair M; Zalawadiya, Sandip K; Wang, Thomas J
Vitamin D is principally known for its role in calcium homeostasis, but preclinical studies implicate multiple pathways through which vitamin D may affect cardiovascular function and influence risk for heart failure. Many adults with cardiovascular disease have low vitamin D status, making it a potential therapeutic target. We review the rationale and potential role of vitamin D supplementation in the prevention and treatment of chronic heart failure. Substantial observational evidence has associated low vitamin D status with the risk of heart failure, ventricular remodeling, and clinical outcomes in heart failure, including mortality. However, trials assessing the influence of vitamin D supplementation on surrogate markers and clinical outcomes in heart failure have generally been small and inconclusive. There are insufficient data to recommend routine assessment or supplementation of vitamin D for the prevention or treatment of chronic heart failure. Prospective trials powered for clinical outcomes are warranted.
Porter, David C.; Tanggaard, Carsten; G. Weaver, Daniel
With augmented demands on power grids resulting in longer and larger blackouts combined with heightened concerns of terrorist attacks, trading institutions and policy makers have widened their search for systems that avoid market failure during these disturbing events. We provide insight into thi......With augmented demands on power grids resulting in longer and larger blackouts combined with heightened concerns of terrorist attacks, trading institutions and policy makers have widened their search for systems that avoid market failure during these disturbing events. We provide insight...... combined with widely dispersed trading locations may be a viable means of protection against market failure during massive power disruptions or terrorist attacks....
Yu. А. Bunin
Full Text Available Atrial fibrillation (AF, being both a cause and a consequence of chronic heart failure (CHF, occurs with it significantly more often than in the general population. Prevention and treatment of AF in patients with CHF has its own specifics and presents certain difficulties for practical physicians of various specialties. The article presents a modern view of primary and secondary prevention of AF in patients with CHF and a critical analysis of international recommendations on the use of various antiarrhythmics and not antiarrhythmic drugs, anticoagulants and non-drug treatments in these patients. Based on the analysis of a number of studies, it has been shown that in patients with AF and CHF, the sinus rhythm control strategy has no advantages over the rate control strategy. The review also examines the possibilities of drug therapy in rate control strategy in CHF, depending on the size of the left ventricular ejection fraction, as well as indications for interventional prophylaxis of the AF paroxysms. At the same time, it discusses some questions about the choice of tactics for management of patients with AF and CHF, electrical and pharmacological cardioversion and prevention therapy, features of AF treatment in certain diseases and syndromes. The article also presents a critical evaluation of interventions in the treatment of AF, such as catheter ablation of AF, catheter ablation of additional routes and destruction of the AV node in combination with the pacemaker implantation.
Chang, Bor-Chin; Kwatny, Harry G.; Belcastro, Christine; Belcastro, Celeste
Switching control, servomechanism, and H2 control theory are used to provide a practical and easy-to-implement solution for the actuator jam problem. A jammed actuator not only causes a reduction of control authority, but also creates a persistent disturbance with uncertain amplitude. The longitudinal dynamics model of the NASA GTM UAV is employed to demonstrate that a single fixed reconfigured controller design based on the proposed approach is capable of accommodating an elevator jam failure with arbitrary jam position as long as the thrust control has enough control authority. This paper is a first step towards solving a more comprehensive in-flight loss-of-control accident prevention problem that involves multiple actuator failures, structure damages, unanticipated faults, and nonlinear upset regime recovery, etc.
Warenik-Szymankiewicz, Alina; Słopień, Radosław
Among the causes of premature ovarian failure (POF) two groups of factors are reported: factors which lead to decrease of follicular number and factors which stimulate follicular atresia. In the first group genetic factors are the most important whereas in the second: enzymatic autoimmunological, iatrogenic, toxins and infections are reported. In 1986 familiar POF on the background of long arm of chromosome X deletion was reported. Other chromosomes which are important for normal ovarian function are: chromosome 21 (AIRE gene), chromosome 11 (gene of beta FSH, ATM gene), chromosome 3 (gene responsible for BEPS syndrome) and chromosome 2 (genes of FSH and LH receptors). In this review the role of these genes and results of several epidemiological studies are reported.
Chitsulo, L.; Engels, D.; Savioli, L.
Preventive chemotherapy (PC), the large-scale distribution of anthelminthic drugs to population groups at risk, is the core intervention recommended by the WHO for reducing morbidity and transmission of the four main helminth infections, namely lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiasis. The strategy is widely implemented worldwide but its general theoretical foundations have not been described so far in a comprehensive and cohesive manner. Starting from the information available on the biological and epidemiological characteristics of helminth infections, as well as from the experience generated by disease control and elimination interventions across the world, we extrapolate the fundamentals and synthesise the principles that regulate PC and justify its implementation as a sound and essential public health intervention. The outline of the theoretical aspects of PC contributes to a thorough understanding of the different facets of this strategy and helps comprehend opportunities and limits of control and elimination interventions directed against helminth infections. PMID:22040463
Henderson, C. S. [Washington River Protection Solutions, Richland, WA (United States); Mackey, Thomas C. [Washington River Protection Solutions, Richland, WA (United States)
The information and evaluations provided in this report were compiled to address the recurring problem of synthetic sling failure. As safety is the number one priority in all work aspects, a solution must be devised to prevent accidents from occurring. A total of thirteen cases regarding synthetic sling failure were evaluated in order to determine their causes, effects, and preventative measures. From the collected data, it was found that all cases in which the synthetic sling contacted the edge of its load resulted in sling failure. It is required that adequate synthetic sling protection devices be used to protect slings in any lift where the sling comes in direct contact with the edge or corner of its load. However, there are no consensus codes or standards stating the type, material, or purpose of the type of protective device used to protect the sling from being cut. Numerous industry standards and codes provide vague descriptions on how to protect synthetic slings. Without a clear, concise statement of how to protect synthetic slings, it is common for inadequate materials and sling protection devices to be used in an attempt to meet the intent of these requirements. The use of an inadequate sling protection device is the main cause of synthetic sling failure in all researched cases. Commercial sling protection devices come in many shapes and sizes, and have a variety of names, as well as advertised uses. 'Abrasion pads' and 'wear protectors' are two different names for products with the same intended purpose. There is no distinguishable way to determine the extent of sling protection which these devices will provide, or what specific scenarios they are made for. This creates room for error in a field where error is unacceptable. This report provides a recommended action for hoisting and rigging activities which require synthetic slings to contact a load, as well as recommended changes to industry standards which will benefit overall
Kondo, D.; Javadi, B.; Iosup, A.; Epema, D.H.J.
With the increasing functionality and complexity of distributed systems, resource failures are inevitable. While numerous models and algorithms for dealing with failures exist, the lack of public trace data sets and tools has prevented meaningful comparisons. To facilitate the design, validation,
Laakso, K. [VTT Industrial Systems, Espoo (Finland)
The focus in human reliability analysis of nuclear power plants has traditionally been on human performance in disturbance conditions. On the other hand, human maintenance failures and design deficiencies, remained latent in the system, have an impact on the severity of a disturbance, e.g. by disabling safety-related equipment on demand. Especially common cause failures (CCFs) of safety related systems can affect the core damage risk to a significant extent. The topic has been addressed in Finnish studies, where experiences of latent human errors have been searched and analysed systematically from the maintenance history stored in the the power plant information systems of the Loviisa and Olkiluoto NPPs. Both the single and multiple errors (CCFs) were classified in detail and documented as error and event reports. The human CCFs involved human, organisational and technical factors. The review of the analysed single and multiple errors showed that instrumentation and control and electrical equipment are more prone to human error caused failure events than the other maintenance objects. The review of the analysed experience showed that most errors stem from the refuelling and maintenance outage periods. More than half of the multiple errors from the outages remained latent to the power operating periods. The review of the analysed multiple errors showed that difficulties with small plant modifications and planning of maintenance and operability were significant sources of common cause failures. The most dependent human errors originating from small modifications could be reduced by a more tailored planning and coverage of their start-up testing programs. Improvements could also be achieved by identifying better in work planning from the operating experiences those complex or intrusive repair and preventive maintenance work tasks and actions which are prone to errors. Such uncertain cases in important equipment require a more tailored work planning of the installation
The focus in human reliability analysis of nuclear power plants has traditionally been on human performance in disturbance conditions. On the other hand, human maintenance failures and design deficiencies, remained latent in the system, have an impact on the severity of a disturbance, e.g. by disabling safety-related equipment on demand. Especially common cause failures (CCFs) of safety related systems can affect the core damage risk to a significant extent. The topic has been addressed in Finnish studies, where experiences of latent human errors have been searched and analysed systematically from the maintenance history stored in the the power plant information systems of the Loviisa and Olkiluoto NPPs. Both the single and multiple errors (CCFs) were classified in detail and documented as error and event reports. The human CCFs involved human, organisational and technical factors. The review of the analysed single and multiple errors showed that instrumentation and control and electrical equipment are more prone to human error caused failure events than the other maintenance objects. The review of the analysed experience showed that most errors stem from the refuelling and maintenance outage periods. More than half of the multiple errors from the outages remained latent to the power operating periods. The review of the analysed multiple errors showed that difficulties with small plant modifications and planning of maintenance and operability were significant sources of common cause failures. The most dependent human errors originating from small modifications could be reduced by a more tailored planning and coverage of their start-up testing programs. Improvements could also be achieved by identifying better in work planning from the operating experiences those complex or intrusive repair and preventive maintenance work tasks and actions which are prone to errors. Such uncertain cases in important equipment require a more tailored work planning of the installation
Jalashgar, A.; Stoelen, K.
This paper highlights essential aspects of real-time software systems that are strongly related to the failures and their course of propagation. The significant influence of means-oriented and goal-oriented system views in the description, understanding and analysing of those aspects is elaborated. The importance of performing failure analysis prior to reliability analysis of real-time systems is equally addressed. Problems of software reliability growth models taking the properties of such systems into account are discussed. Finally, the paper presents a preliminary study of a goal-oriented approach to model the static and dynamic characteristics of real-time systems, so that the corresponding analysis can be based on a more descriptive and informative picture of failures, their effects and the possibility of their occurrence. (author)
The overall aim of this thesis was to increase the knowledge of the public health economic aspects of chlamydia and other STIs, in terms of risk, prevention and resources. In Study I, we examined the association between demographic, socioeconomic and lifestyle factors and the risk of self-reported chlamydial infection among young adults in the Stockholm public health cohort. We found that the risk of self-reported chlamydia infection among young adults in Sweden was associated with lowe...
Munthe, Christian; Radovic, Susanna
The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy.
Rodríguez Sánchez, Fabio; Rodríguez Andrés, Carlos; Arteagoitia, Iciar
To assess which antibiotic regimen prevents dental implant failures or postoperative infections following dental implant placement. Systematic review and meta-analysis. Pubmed, Cochrane, Science Direct, and EMBASE via OVID were searched up to August 2017. Only randomized controlled clinical trials (RCT) using antibiotics were included. Outcome measures were set on dental implant failures or postoperative infection incidence after dental implant surgery. Three reviewers independently undertook risk of bias assessment and data extraction. Stratified meta-analyses of binary data using fixed-effects models were performed using Stata 14.0. The risk ratio (RR) and 95% confidence interval (CI) were estimated. Nine articles were included corresponding to 15 RCTs. All RCTs tested only oral amoxicillin. Implant-failure analysis: overall RR = 0.53 (P = .005, 95% CI: 0.34-0.82) and overall NNT = 55 (95% CI, 33-167). Single-dose oral amoxicillin preoperatively (SDOAP) is beneficial (RR = 0.50, CI: 0.29-0.86. P = .012), when compared to postoperative oral amoxicillin (POA): RR = 0.60, CI: 0.28-1.30. P = .197. Postoperative-infection analysis: overall RR = 0.76 (P = 0.250, 95% CI: 0.47-1.22). Neither SDOAP (RR = 0.82, CI = 0.46-1.45, P = .488) nor POA (RR = 0.64, CI = 0.27-1.51, P = .309) are beneficial. I 2 = 0.0%, chi-squared tests P ≈ 1. Only SDOAP is effective and efficacious at preventing implant failures, but it was not significant for postoperative infections following dental implant surgeries. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Gabrielli, A-F; Montresor, A; Chitsulo, L; Engels, D; Savioli, L
Preventive chemotherapy (PC), the large-scale distribution of anthelminthic drugs to population groups at risk, is the core intervention recommended by the WHO for reducing morbidity and transmission of the four main helminth infections, namely lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiasis. The strategy is widely implemented worldwide but its general theoretical foundations have not been described so far in a comprehensive and cohesive manner. Starting from the information available on the biological and epidemiological characteristics of helminth infections, as well as from the experience generated by disease control and elimination interventions across the world, we extrapolate the fundamentals and synthesise the principles that regulate PC and justify its implementation as a sound and essential public health intervention. The outline of the theoretical aspects of PC contributes to a thorough understanding of the different facets of this strategy and helps comprehend opportunities and limits of control and elimination interventions directed against helminth infections. Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
Mondal, U. [Candu Owners Group, Toronto, Ontario (Canada)
In recent years the nuclear industry has experienced an increase in circuit card failures due to ageing of components, inadequate Preventive Maintenance (PM), lack of effective circuit card health monitoring, etc. Circuit card failures have caused loss of critical equipment, e.g., electro hydraulic governors, Safety Systems, resulting in loss of function and in some cases loss of generation. INPO completed a root cause analysis of 40 Reactor Trips/Scrams in US reactors and has recommended several actions to mitigate Circuit Card failures. Obsolescence of discrete components has posed many challenges in conducting effective preventative maintenance on circuit cards. In many cases, repairs have resulted in installation of components that compromise performance of the circuit cards. Improper termination and worn edge connectors have caused intermittent contacts contributing to circuit card failures. Traditionally, little attention is paid to relay functions and preventative maintenance of relay. Relays contribute significantly to circuit card failures and have dominated loss of generation across the power industry. The INPO study recommended a number of actions to mitigate circuit card failures, such as; identification of critical components and single point vulnerabilities; strategic preventative maintenance; protection of circuit boards against electrostatic discharge; limiting power cycles; performing an effective burn-in prior to commissioning of the circuit cards; monitoring performance of DC power supplies; limiting cabinet temperatures; managing of component aging/degradation mechanism, etc. A subcommittee has been set up under INPO sponsorship to understand the causes of circuit card failure and to develop an effective mitigation strategy. (author)
Leblanc, Martine; Kellum, John A; Gibney, R T Noel; Lieberthal, Wilfred; Tumlin, James; Mehta, Ravindra
Our purpose is to discuss established risk factors in the development of acute renal failure and briefly overview clinical markers and preventive measures. Findings from the literature support the role of older age, diabetes, underlying renal insufficiency, and heart failure as predisposing factors for acute renal failure. Diabetics with baseline renal insufficiency represent the highest risk subgroup. An association between sepsis, hypovolemia, and acute renal failure is clear. Liver failure, rhabdomyolysis, and open-heart surgery (especially valve replacement) are clinical conditions potentially leading to acute renal failure. Increasing evidence shows that intraabdominal hypertension may contribute to the development of acute renal failure. Radiocontrast and antimicrobial agents are the most common causes of nephrotoxic acute renal failure. In terms of prevention, avoiding nephrotoxins when possible is certainly desirable; fluid therapy is an effective prevention measure in certain clinical circumstances. Supporting cardiac output, mean arterial pressure, and renal perfusion pressure are indicated to reduce the risk for acute renal failure. Nonionic, isoosmolar intravenous contrast should be used in high-risk patients. Although urine output and serum creatinine lack sensitivity and specificity in acute renal failure, they remain the most used parameters in clinical practice. There are identified risk factors of acute renal failure. Because acute renal failure is associated with a worsening outcome, particularly if occurring in critical illness and if severe enough to require renal replacement therapy, preventive measures should be part of appropriate management.
Gilotra, Nisha A; Shpigel, Adam; Okwuosa, Ike S; Tamrat, Ruth; Flowers, Deirdre; Russell, Stuart D
There are few data describing patient-identified precipitants of heart failure (HF) hospitalization. We hypothesized a patient's perception of reason for or preventability of an admission may be related to 30-day readmission rates. Ninety-four patients admitted with decompensated HF from July 2014 to March 2015 completed a brief questionnaire regarding circumstances leading to admission. Thirty-day outcomes were assessed via telephone call and chart review. Mean age was 58 ± 14 years, with 60% blacks (n = 56) and 41% females (n = 39). Median left ventricular ejection fraction was 30%; 27 had preserved ejection fraction. Seventy-two patients identified their hospitalization to be due to HF (± another condition). Most common patient-identified precipitants of admission were worsening HF (n = 37) and dietary nonadherence (n = 11). Readmitted patients tended to have longer time until first follow-up appointment (21 vs 8 days). Seven of the 42 patients who identified their hospitalization as preventable were readmitted compared with 21/49 who believed their hospitalization was unpreventable (P = .012). On multivariate regression analysis, patients who thought their hospitalization was preventable were less likely to be readmitted (odds ratio 0.31; 95% confidence interval 0.10-0.91; P = .04). Almost 50% of patients believe their HF hospitalization is preventable, and these patients appear to be less likely to be readmitted within 30 days. Notably, patients cite nonadherence and lack of knowledge as reasons hospitalizations are preventable. These results lend insight into possible interventions to reduce HF readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.
PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.
BACKGROUND: Disease Management Programmes (DMPs) are successful in reducing hospital readmissions in heart failure (HF). However, there remain a number of patients enrolled in a DMP who are readmitted with HF. The primary aim of the study was to determine the proportion of preventable readmissions (PR). The secondary aim was to recognise patient characteristics which would identify certain patients at risk of having a PR. METHODS: A retrospective chart search was performed on patients readmitted over a 1-year period. RESULTS: 38.5% of readmissions were classified as PR. None of these patients made prior contact with the DMP. Admission levels of BNP, potassium, urea and creatinine were significantly lower in the PR group. CONCLUSION: DMP have proven benefits in reducing hospital readmission nonetheless a significant proportion of these readmissions are preventable. Further work is required to prospectively analyse why these patients fail to contact the DMP.
Shin, Hyun Kook; Nam, Sang Ku; Sohn, Se Do; Chang, Hoon Seon
The advanced digital reactor protection system (ADRPS) with diverse dual processors has been developed to prevent common-mode failure (CMF). The principle of diversity is applied to both hardware design and software design. For hardware diversity, two different types of CPUs are used for the bistable processor and local coincidence logic (LCL) processor. The Versa Module Eurocard-based single board computers are used for the CPU hardware platforms. The QNX operating system and the VxWorks operating system were selected for software diversity. Functional diversity is also applied to the input and output modules, and to the algorithm in the bistable processors and LCL processors. The characteristics of the newly developed digital protection system are described together with the preventive capability against CMF. Also, system reliability analysis is discussed. The evaluation results show that the ADRPS has a good preventive capability against the CMF and is a highly reliable reactor protection system
Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilem...
Porter, David C.; Tanggaard, Carsten; Weaver, Daniel G.
With augmented demands on power grids resulting in longer and larger blackouts combined with heightened concerns of terrorist attacks, trading institutions and policy makers have widened their search for systems that avoid market failure during these disturbing events. We provide insight...... into this issue by examining trading behaviour at the Copenhagen Stock Exchange during a major blackout. We find that although market quality declined, markets remained functional and some price discovery occurred during the blackout period suggesting that the NOREX structure of interlinked trading systems...... combined with widely dispersed trading locations may be a viable means of protection against market failure during massive power disruptions or terrorist attacks....
Fernandez-Rio, Javier; Cecchini, Jose A; Méndez-Gimenez, Antonio; Mendez-Alonso, David; Prieto, Jose A
Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.205 females), 12-17 years old ( M = 13.85, SD = 1.29), enrolled in 17 different schools belonging to the National Network of Schools on Cooperative Learning in Spain agreed to participate. They all had experienced this pedagogical approach a minimum of one school year. Participants were asked to complete the cooperative learning questionnaire, the strategies to control the study questionnaire and the global academic self-efficacy questionnaire. Participants were grouped based on their perceptions on cooperative learning and self-regulated learning in their classes. A combination of hierarchical and κ -means cluster analyses was used. Results revealed a four-cluster solution: cluster one included students with low levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster two included students with high levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster three included students with high levels of cooperative learning, low levels of self-regulated learning and intermediate-low levels of academic self-efficacy, and, finally, cluster four included students with high levels of self-regulated learning, low levels of cooperative learning, and intermediate-high levels of academic self-efficacy. Self-regulated learning was found more influential than cooperative learning on students' academic self-efficacy. In cooperative learning contexts students interact through different types of regulations: self, co, and
Fernandez-Rio, Javier; Cecchini, Jose A.; Méndez-Gimenez, Antonio; Mendez-Alonso, David; Prieto, Jose A.
Learning to learn and learning to cooperate are two important goals for individuals. Moreover, self regulation has been identified as fundamental to prevent school failure. The goal of the present study was to assess the interactions between self-regulated learning, cooperative learning and academic self-efficacy in secondary education students experiencing cooperative learning as the main pedagogical approach for at least one school year. 2.513 secondary education students (1.308 males, 1.205 females), 12–17 years old (M = 13.85, SD = 1.29), enrolled in 17 different schools belonging to the National Network of Schools on Cooperative Learning in Spain agreed to participate. They all had experienced this pedagogical approach a minimum of one school year. Participants were asked to complete the cooperative learning questionnaire, the strategies to control the study questionnaire and the global academic self-efficacy questionnaire. Participants were grouped based on their perceptions on cooperative learning and self-regulated learning in their classes. A combination of hierarchical and κ-means cluster analyses was used. Results revealed a four-cluster solution: cluster one included students with low levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster two included students with high levels of cooperative learning, self-regulated learning and academic self-efficacy, cluster three included students with high levels of cooperative learning, low levels of self-regulated learning and intermediate-low levels of academic self-efficacy, and, finally, cluster four included students with high levels of self-regulated learning, low levels of cooperative learning, and intermediate-high levels of academic self-efficacy. Self-regulated learning was found more influential than cooperative learning on students’ academic self-efficacy. In cooperative learning contexts students interact through different types of regulations: self, co, and
Aghezzaf, El-Houssaine; Khatab, Abdelhakim; Tam, Phuoc Le
This paper investigates the issue of integrating production and maintenance planning in a failure-prone manufacturing system. It is assumed that the system's operating state is stochastically predictable, in terms of its operating age, and that it can accordingly be preventively maintained during preplanned periods. Preventive maintenance is assumed to be imperfect, that is when performed, it brings the manufacturing system to an operating state that lies between ‘as bad as old’ and ‘as good as new’. Only an overhauling of the system brings it to a ‘as good as new’ operating state again. A practical integrated production and preventive maintenance planning model, that takes into account the system's manufacturing capacity and its operational reliability state, is developed. The model is naturally formulated as a mixed-integer non-linear optimization problem, for which an extended mixed-integer linear reformulation is proposed. This reformulation, while it solves the proposed integrated planning problem to optimality, remains quite demanding in terms of computational time. A fix-and-optimize procedure, that takes advantage of some properties of the original model, is then proposed. The reformulation and the fix-and-optimize procedure are tested on some test instances adapted from those available in the literature. The results show that the proposed fix-and-optimize procedure performs quite well and opens new research direction for future improvements. - Highlights: • Integration of production planning and imperfect preventive maintenance is explored. • Imperfect maintenance is modeled using a fitting age reduction hybrid hazard rate. • A practical approximate optimization model for this integration is proposed. • The resulting naturally MINL optimization model is reformulated and solved as a MILP. • An effective fix-and-optimize procedure is proposed for large instances of this MILP.
The specific binding of digitalis glycosides to Na,K-ATPase is used as a tool for Na,K-ATPase quantification with high accuracy and precision. In myocardial biopsies from patients with heart failure, total Na,K-ATPase concentration is decreased by around 40%; a correlation exists between a decrease in heart function and a decrease in Na,K-ATPase concentration. During digitalization, around 30% of remaining pumps are occupied by digoxin. Myocardial Na,K-ATPase is also influenced by other drugs used for the treatment of heart failure. Thus, potassium loss during diuretic therapy has been found to reduce myocardial Na,K-ATPase, whereas angiotensin-converting enzyme inhibitors may stimulate Na,K pump activity. Furthermore, hyperaldosteronism induced by heart failure has been found to decrease Na,K-ATPase activity. Accordingly, treatment with the aldosterone antagonist, spironolactone, may also influence Na,K-ATPase activity. The importance of Na,K pump modulation with heart disease, inhibition in digitalization and other effects of medication should be considered in the context of sodium, potassium and calcium regulation. It is recommended that digoxin be administered to heart failure patients who, after institution of mortality-reducing therapy, still have heart failure symptoms, and that the therapy be continued if symptoms are revealed or reduced. Digitalis glycosides are the only safe inotropic drugs for oral use that improve hemodynamics in heart failure. An important aspect of myocardial Na,K pump affection in heart disease is its influence on extracellular potassium (Ke) homeostasis. Two important aspects should be considered: potassium handling among myocytes, and effects of potassium entering the extracellular space of the heart via the bloodstream. It should be noted that both of these aspects of Ke homeostasis are affected by regulatory aspects, eg, regulation of the Na,K pump by physiological and pathophysiological conditions, as well as by medical
Beraha, D.; Grumbach, R.; Hoeld, A.; Werner, W.
The incentives for improved core surveillance and core control systems are outlined. An efficient code for evaluating the power distribution is indispensable for designing and testing such a system. The characteristics of the core simulator QUABOX/CUBBOX and the features required for off-line and on-line applications are described. The important role of the simulator for the safety assessment of a digital core control system is underlined. With regard to the safety aspects of core control, possible disturbances are classified. Simulation results are given concerning the failure of a control actuator. It is shown that means can be devised to prevent unstable behaviour of the control system and, furthermore, to contribute to a safe reactor operation by accounting for process disturbances. (author)
O’Connell, Timothy D.; Jensen, Brian C.; Baker, Anthony J.
Adrenergic receptors (AR) are G-protein-coupled receptors (GPCRs) that have a crucial role in cardiac physiology in health and disease. Alpha1-ARs signal through Gαq, and signaling through Gq, for example, by endothelin and angiotensin receptors, is thought to be detrimental to the heart. In contrast, cardiac alpha1-ARs mediate important protective and adaptive functions in the heart, although alpha1-ARs are only a minor fraction of total cardiac ARs. Cardiac alpha1-ARs activate pleiotropic downstream signaling to prevent pathologic remodeling in heart failure. Mechanisms defined in animal and cell models include activation of adaptive hypertrophy, prevention of cardiac myocyte death, augmentation of contractility, and induction of ischemic preconditioning. Surprisingly, at the molecular level, alpha1-ARs localize to and signal at the nucleus in cardiac myocytes, and, unlike most GPCRs, activate “inside-out” signaling to cause cardioprotection. Contrary to past opinion, human cardiac alpha1-AR expression is similar to that in the mouse, where alpha1-AR effects are seen most convincingly in knockout models. Human clinical studies show that alpha1-blockade worsens heart failure in hypertension and does not improve outcomes in heart failure, implying a cardioprotective role for human alpha1-ARs. In summary, these findings identify novel functional and mechanistic aspects of cardiac alpha1-AR function and suggest that activation of cardiac alpha1-AR might be a viable therapeutic strategy in heart failure. PMID:24368739
Chronic heart failure is intrinsically associated with exercise intolerance. Understanding the pathophysiological background of exercise intolerance is essential for optimizing the response to current and future therapies aiming at an improvement of exercise capacity. Each step in the oxygen
Lotrean, Lucia Maria; Trofor, Antigona; Mihălţan, Florin; Santillan, Edna Arillo
School-based health education has the potential to inform and educate young people, in order to promote healthy behaviours among them, which will help to prevent diseases and social problems. The present study gives an overview of several ethical issues which must be considered in different phases of school-based smoking prevention programs. This will help health educators, public health professionals and researchers in their activity of health education in schools. The ethical issues must be taken into consideration during all the activities and refer to the involvement of officials, schools, parents, young people who participate into the program, authors and persons/institutions responsible with the implementation, evaluation or funding of the programs. The application into practice of these ethical principles, influence the quality of the health education, its acceptability BY the target group and the correctness of results. Also, it prevents possible problems and misunderstandings between persons and institutions involved in the health education and smoking prevention process, which could seriously affect and even destroy implementation of such health education activities.
Ionica Floriana Elvira
Full Text Available Background and aims: The most recent estimates of International Diabetes Federation indicate that 382 million people have diabetes, and the incidence of this disease is increasing. While in type 1 diabetes mellitus (T1DM beta-cell death is autoimmunemediated, type 2 diabetes mellitus (T2DM results from an interaction between genetic and environmental factors that impair beta-cell function and insulin action. Many people with T2DM remain unaware of their illness for a long time because symptoms may take years to appear or be recognized, while the body is affected by excess blood glucose. These patients are often diagnosed only when diabetes complications have already developed. The aim of this article was to perform a review based on literature data on therapeutic modalities to prevent/delay beta cell function decline. Material and Methods: We searched MEDLINE from 2000 to the present to identify the therapeutic approaches to prevent or delay beta-cell failure in patients with T2DM. Results and conclusions: Several common polymorphisms in genes linked to monogenic forms of diabetes appear to influence the response to T2DM pharmacotherapy. Recent studies report the role of the G protein coupled receptor 40 (GPR40, also known as Free Fatty Acids Receptor 1 (FFAR1 in the regulation of beta-cell function- CNX-011-67 (a GPR40 agonist has the potential to provide good and durable glycemic control in T2DM patients.
Nalla, Ravi Kiran
Over the past few decades, there has been increased interest in the structure and properties of mineralized biological tissues like bone and dentin (a structurally simpler analogue of bone that makes up the bulk of the human tooth). In particular, there has been considerable research into the mechanical properties of such tissues and into how they fracture. An understanding of these properties is of great importance from the perspective of developing a realistic framework for life prediction, particularly in light of the effect of microstructural modifications from aging, disease, remodeling, etc. Central to these issues is the resistance to fracture of these materials, and the microstructural mechanisms that are the source of such resistance. Understanding such properties in the context of the inherent hierarchical complexity of the microstructure of these tissues is of obvious importance. However, surprisingly, such questions have largely remained unanswered and to a large extent, even uninvestigated. The present study initially seeks to focus on the fracture and fatigue behavior of dentin and to extend the observations to cortical bone. Accordingly, fracture mechanics based experiments were conducted to evaluate the fracture toughness of dentin in the context of the anisotropy with respect to the underlying microstructure, and discussed in terms of the salient toughening mechanisms active in this material. In light of the presence of such mechanisms, the fracture toughness properties were then evaluated in terms of resistance-curve (R-curve) behavior, i.e., fracture resistance increasing with crack extension. Furthermore, dentin is known to be susceptible to failure under cyclic loading. The "stress-life" and fatigue-crack propagation data obtained through a systematic investigation of the effects of prolonged cyclical loading are discussed. It is concluded that the presence of small incipient flaws in human teeth of the order of 250 mum in size will not
Xing Liudong; Levitin, Gregory
This paper considers the reliability analysis of binary-state systems, subject to propagated failures with global effect, and failure isolation phenomena. Propagated failures with global effect are common-cause failures originated from a component of a system/subsystem causing the failure of the entire system/subsystem. Failure isolation occurs when the failure of one component (referred to as a trigger component) causes other components (referred to as dependent components) within the same system to become isolated from the system. On the one hand, failure isolation makes the isolated dependent components unusable; on the other hand, it prevents the propagation of failures originated from those dependent components. However, the failure isolation effect does not exist if failures originated in the dependent components already propagate globally before the trigger component fails. In other words, there exists a competition in the time domain between the failure of the trigger component that causes failure isolation and propagated failures originated from the dependent components. This paper presents a combinatorial method for the reliability analysis of systems subject to such competing propagated failures and failure isolation effect. Based on the total probability theorem, the proposed method is analytical, exact, and has no limitation on the type of time-to-failure distributions for the system components. An illustrative example is given to demonstrate the basics and advantages of the proposed method.
Yasemin Öcal Atınç
We investigate the service failures towards diverse customer groups for the purpose to bring insightful proposals to the managers to recover from these failures. Previous literature provided insights regarding the perception of service failures by minorities and the challenge of recovery due to racial implications driven from the failure, however lacked to propose suggestions for the managers so that they can take either corrective steps toward service failure recovery or prevent service fail...
E.A.J. Kalkman (Ed)
textabstractHeart failure can be defined as the pathophysiological state in which the pump function of the heart is insufficient to meet the metabolic demands of the body (Guyton, 1986; Ruggie, 1986). Thus, heart failure is a pathophysiological condition (rather than a disease per se), and can occur
Iorio, A.F.; Crespi, J.C.
After ten years of operation at the Atucha I Nuclear Power Station a gear belonging to a pressurized heavy water reactor refuelling machine, failed. The gear box was used to operate the inlet-outlet heavy-water valve of the machine. Visual examination of the gear device showed an absence of lubricant and that several gear teeth were broken at the root. Motion was transmitted with a speed-reducing device with controlled adjustable times in order to produce a proper fitness of the valve closure. The aim of this paper is to discuss the results of the gear failure analysis in order to recommend the proper solution to prevent further failures. (Author)
Sälzer, S.; Alkilzy, M.; Slot, D.E.; Dörfer, C.E.; Schmoeckel, J.; Splieth, C.H.
AIM: Aim was to systematically review behavioural aspects in the prevention and control of dental caries and periodontal diseases at individual and population level. MATERIAL & METHODS: With regard to caries, MEDLINE/PubMed was searched on three subheadings focusing on early childhood, proximal and
Hansen, J F
heart failure in the SOLVD trials. In post-myocardial infarction patients, the calcium antagonist nifedipine did not affect mortality or morbidity; diltiazem improved prognosis in patients without congestive heart failure and in patients with non-Q-wave infarction; and verapamil improved prognosis...... by prevention of reinfarction and sudden death. Combination treatment with both verapamil, which has pronounced antiischemic properties and prevents sudden death and reinfarction, and an ACE inhibitor, which prevents the progression of heart failure, is a possibility for future cardiovascular therapy...
the Fanconi Anemia Pathway- Regulated Nucleases in Genome Maintenance for Preventing Bone Marrow Failure and Cancer PRINCIPAL INVESTIGATOR...GRANT NUMBER 4. TITLE AND SUBTITLE A Biochemical Approach to Understanding the Fanconi Anemia Pathway-Regulated Nucleases in Genome Maintenance for...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Fanconi anemia is the most prevalent inherited BMF syndromes, caused by mutations in
Ward, Haakon; Bondevik, Jon Olav; Skjerve, Haavard; Tveit, Oeyvind [SeaFlex AS, Asker (Norway)
Exploration and development of new oil and gas fields is heavily dependant on use of flexible pipes and many field developments would not have been possible without them. The number of flexible risers in service is constantly increasing since relatively few offshore projects have reached the estimated operational life and the operational lifetime of several fields in-service has been extended due to new and improved technology. Many risers have been in service over a large number of years. Some risers have been operated under demanding conditions such as severe dynamic loads, high pressure and temperatures. One may in some cases find that risers actually have shorter service life than estimated in the design phase due to the severe operational conditions. In order to extend the use of the riser, some risers may have to be modified and re-terminated and prepared for a new and less demanding application. In order to operate risers safely, it is important to re-assess the fatigue life in order to prevent potential riser failure. The operator should implement methods and tools for in-service monitoring and testing. This paper addresses efficient and reliable methods and tools for monitoring of critical operational parameters as well as in-service riser testing. A brief description of structural failure modes will also be given in order to understand how to interpret test results in view of potential failure modes. (author)
Martins, Maria da Penha Sanches
This work presents a study of human factors and possible human failure reasons that can cause incidents, accidents and workers exposition, associated to risks intrinsic to the profession. The objective is to contribute with the operators of IEA-R1 reactor located at IPEN CNEN/S P. Accidents in the technological field, including the nuclear, have shown that the causes are much more connected to human failure than to system and equipment failures, what has led the regulatory bodies to consider studies on human failure. The research proposed in this work is quantitative/qualitative and also descriptive. Two questionnaires were used to collect data. The first of them was elaborated from the safety culture attributes which are described by the International Atomic Energy Agency - IAEA. The second considered individual and situational factors composing categories that could affect people in the work area. A carefully selected transcription of the theoretical basis according to the study of human factors was used. The methodology demonstrated a good reliability degree. Results lead to mediate factors which need direct actions concerning the needs of the group and of the individual. This research shows that it is necessary to have a really effective unit of planning and organization, not only to the physical and psychological health issues but also to the safety in the work. (author)
This paper outlines a practical failure analysis sequence. Several technical definitions are required. A failure is defined as a component that was operating in a system where the system malfunctioned and the replacement of the device restored system functionality. The failure mode is the malfunctioning behavior of the device. The failure mechanism is the underlying cause or source of the failure mode. The failure mechanism is the root cause of the failure mode. The failure analysis procedure needs to be adequately refined to result in the determination of the cause of failure to the degree that corrective action or design changes will prevent recurrence of the failure mode or mechanism. An example of a root-cause determination analysis performed for a nuclear power industry customer serves to illustrate the analysis methodology
Arnold, J Malcom O; Howlett, Jonathan G; Dorian, Paul; Ducharme, Anique; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Ignaszewski, Andrew; Isaac, Debra; Jong, Philip; Liu, Peter; Mann, Elizabeth; McKelvie, Robert S; Moe, Gordon W; Parker, John D; Svendsen, Anna M; Tsuyuki, Ross T; O'Halloran, Kelly; Ross, Heather J; Rao, Vivek; Sequeira, Errol J; White, Michel
Heart failure is common, yet it is difficult to treat. It presents in many different guises and circumstances in which therapy needs to be individualized. The Canadian Cardiovascular Society published a comprehensive set of recommendations in January 2006 on the diagnosis and management of heart failure, and the present update builds on those core recommendations. Based on feedback obtained through a national program of heart failure workshops during 2006, several topics were identified as priorities because of the challenges they pose to health care professionals. New evidence-based recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. Specific recommendations and practical tips were written for the prevention of heart failure, the management of heart failure during intercurrent illness, the treatment of acute heart failure, and the current and future roles of biomarkers in heart failure care. Specific clinical questions that are addressed include: which patients should be identified as being at high risk of developing heart failure and which interventions should be used? What complications can occur in heart failure patients during an intercurrent illness, how should these patients be monitored and which medications may require a dose adjustment or discontinuation? What are the best therapeutic, both drug and nondrug, strategies for patients with acute heart failure? How can new biomarkers help in the treatment of heart failure, and when and how should BNP be measured in heart failure patients? The goals of the present update are to translate best evidence into practice, to apply clinical wisdom where evidence for specific strategies is weaker, and to aid physicians and other health care providers to optimally treat heart failure patients to result in a measurable impact on patient health and clinical outcomes in Canada.
Kim, Jaehoon; Jeong, Hyun- Yong
The purpose of this study is to improve the efficiency, reliability and safety related to railroad maintenance tasks through an evaluation of the consequences of failures. The brake system was selected based on the failure data obtained from railroad vehicles in operation as one of the safety systems in railroad vehicles. The failure causes, failure effects, and the criticality of the failure mode were drawn for 62 failure modes of the braking system through the use of an FMECA for the 30 sub-devices having primary functions. The various maintenance tasks for the braking system were categorized into the 62 failure modes and failure consequences using the FMECA and the logic of maintenance decisions. Braking systems manufactured by the same manufacturer and operated by two different operators were studied in an effort to analyze preventive maintenance and to evaluate the adequacy of preventive maintenance tasks for the 62 failure modes. Based on results of the evaluation of these preventive maintenance tasks, new maintenance tasks were proposed, and concrete cost-cutting effects were determined from the calculation of the maintenance time and expected costs, using a preventive maintenance template developed specifically for railroad vehicles
Middeljans-Tijssen, C.W.; Jansen, R.W.M.M.
In this article different aspects of chronic heart failure in old age are described. We mainly focus on the place of beta-blocker therapy in chronic heart failure. Beta-blockers are recommended for the treatment of stable chronic heart failure with left ventricular systolic dysfunction. There is
Failure diagnosis invariably involves consideration of both associated material condition and the results of a mechanical analysis of prior operating history. This Review focuses on these aspects with particular reference to creep-fatigue failure diagnosis. Creep-fatigue cracking can be due to a spectrum of loading conditions ranging from pure cyclic to mainly steady loading with infrequent off-load transients. These require a range of mechanical analysis approaches, a number of which are reviewed. The microstructural information revealing material condition can vary with alloy class. In practice, the detail of the consequent cracking mechanism(s) can be camouflaged by oxidation at high temperatures, although the presence of oxide on fracture surfaces can be used to date events leading to failure. Routine laboratory specimen post-test examination is strongly recommended to characterise the detail of deformation and damage accumulation under known and well-controlled loading conditions to improve the effectiveness and efficiency of failure diagnosis. PMID:28793676
Full Text Available In 2011 and 2012, University of Warsaw conducted a two-stage research which goals were: (1 to verify whether students’ access to information showing the characteristics of their learning organization is connected with a sense of efficacy, level of motivation, preferred learning forms and perceived teacher presence; (2 to examine the relations between organizational learning styles and the usage of Spector module. One of the means used in the project was introduction of a mechanism for teaching and learning management in an e-learning setting – Spector. This way, a support for prevention, diagnosis and learning failure therapy was introduced. The mechanism was implemented as a Moodle LMS extension. Its goal was to process activity reports gathered by Moodle and present them in an user-friendly way to both students and teachers. The first-stage research results did not confirm the correlation between mentioned variables, although the majority of students taking part in the research pointed out Spector’s importance to improving their motivation and planning their learning activities. Resolving of all the doubts set in the project required a further, more complex study (including organizational learning styles. The second stage of the research proved that students’ opinion about the usage of Spector is related to their current studies programme (Bachelor’s, Master’s or Doctoral.
This paper duscusses ways of preventing work accidents and increasing work safety in underground black coal mines. Specific conditions of underground operations in coal mines are stressed. Elements of work accident prevention are analyzed: reducing hazards by introducing safer technology, automation and mechanization of operations associated with hazards, introducing special measures within the framework of safety engineering. Dependence of accident rate on such factors as personnel training, age, motivation, qualifications, and labor discipline is discussed. Investigations indicate that miner motivation plays a significant role in accident prevention. A high degree of labor motivation successfully reduces accident rate and a low degree of motivation increases accident rate. Role of labor collective in labor motivation as well as a correct system of wage incentives are evaluated. Methods of personnel training aimed at reducing accident rate are described. Role of a technique by which a group of miners attempts to find a solution to a work safety problem by amassing all ideas spontaneously contributed by participants is stressed.
Kilic, H.; Jensen, B.
This paper deals with those problems concerning safety and environmental aspects of the future fusion reactors (e.g. fuel cycle, magnetic failure, after heat disturbances, radioactive waste and magnetic field)
Martorell, S.; Munoz, A.; Serradell, V.
Surveillance requirements and maintenance activities in a nuclear power plant aim to preserve components' inherent reliability. Up to now, predictive and preventive maintenance mainly concerned plant staff, but the US Nuclear Regulatory Commission Maintenance Rule released in July 1991 will have significant impact on how nuclear power plants perform and document this maintenance. Reliability Centered Maintenance (RCM) is a systematic methodology to establish maintenance tasks for critical components in plant with a high degree of compliance with the goals of the Rule. RCM pursues the identification of applicable and efficient tasks to prevent these components from developing their dominant failure causes, and, in turn, towards achieving proper levels of components availability with low cost. In this paper, we present an approach for identifying the most suitable set of tasks to achieve this goal, which involves the integration of maintenance activities and surveillance requirements for each critical component based on the unavailability and cost associated with each individual task which is performed on it
Zhu, Xiao-Yu; Wu, Si-Qi; Guo, Sheng-Ya; Yang, Hua; Xia, Bo; Li, Ping; Li, Chun-Qi
Heart failure is a leading cause of death and the development of effective and safe therapeutic agents for heart failure has been proven challenging. In this study, taking advantage of larval zebrafish, we developed a zebrafish heart failure model for drug screening and efficacy assessment. Zebrafish at 2 dpf (days postfertilization) were treated with verapamil at a concentration of 200 μM for 30 min, which were determined as optimum conditions for model development. Tested drugs were administered into zebrafish either by direct soaking or circulation microinjection. After treatment, zebrafish were randomly selected and subjected to either visual observation and image acquisition or record videos under a Zebralab Blood Flow System. The therapeutic effects of drugs on zebrafish heart failure were quantified by calculating the efficiency of heart dilatation, venous congestion, cardiac output, and blood flow dynamics. All 8 human heart failure therapeutic drugs (LCZ696, digoxin, irbesartan, metoprolol, qiliqiangxin capsule, enalapril, shenmai injection, and hydrochlorothiazide) showed significant preventive and therapeutic effects on zebrafish heart failure (p failure model developed and validated in this study could be used for in vivo heart failure studies and for rapid screening and efficacy assessment of preventive and therapeutic drugs.
Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva
Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8......-fourth of the population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P risk of heart failure in both men (hazard ratio = 1.93, 95% confidence...... in the population, even a modestly higher risk of heart failure associated with vital exhaustion may be of importance in the planning of future preventive strategies for heart failure....
Rasmuson, D.M.; Kelly, D.L.
This paper reviews the basic concepts of modeling common-cause failures (CCFs) in reliability and risk studies and then applies these concepts to the treatment of CCF in event assessment. The cases of a failed component (with and without shared CCF potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g. failure to start and failure to run) is a new feature of this paper, as is the treatment of asymmetry within a common-cause component group
.... The data examined during research on the causes of levee failure included geologic setting, historic bank migration and previous bank lines, thalweg profiles, width/depth ratios, scour pool movement, and river profiles...
Legchenko, Ekaterina; Chouvarine, Philippe; Borchert, Paul; Fernandez-Gonzalez, Angeles; Snay, Erin; Meier, Martin; Maegel, Lavinia; Mitsialis, S Alex; Rog-Zielinska, Eva A; Kourembanas, Stella; Jonigk, Danny; Hansmann, Georg
Right ventricular (RV) heart failure is the leading cause of death in pulmonary arterial hypertension (PAH). Peroxisome proliferator-activated receptor γ (PPARγ) acts as a vasoprotective metabolic regulator in smooth muscle and endothelial cells; however, its role in the heart is unclear. We report that deletion of PPARγ in cardiomyocytes leads to biventricular systolic dysfunction and intramyocellular lipid accumulation in mice. In the SU5416/hypoxia (SuHx) rat model, oral treatment with the PPARγ agonist pioglitazone completely reverses severe PAH and vascular remodeling and prevents RV failure. Failing RV cardiomyocytes exhibited mitochondrial disarray and increased intramyocellular lipids (lipotoxicity) in the SuHx heart, which was prevented by pioglitazone. Unbiased ventricular microRNA (miRNA) arrays, mRNA sequencing, and lipid metabolism studies revealed dysregulation of cardiac hypertrophy, fibrosis, myocardial contractility, fatty acid transport/oxidation (FAO), and transforming growth factor-β signaling in the failing RV. These epigenetic, transcriptional, and metabolic alterations were modulated by pioglitazone through miRNA/mRNA networks previously not associated with PAH/RV dysfunction. Consistently, pre-miR-197 and pre-miR-146b repressed genes that drive FAO ( Cpt1b and Fabp4 ) in primary cardiomyocytes. We recapitulated our major pathogenic findings in human end-stage PAH: (i) in the pressure-overloaded failing RV (miR-197 and miR-146b up-regulated), (ii) in peripheral pulmonary arteries (miR-146b up-regulated, miR-133b down-regulated), and (iii) in plexiform vasculopathy (miR-133b up-regulated, miR-146b down-regulated). Together, PPARγ activation can normalize epigenetic and transcriptional regulation primarily related to disturbed lipid metabolism and mitochondrial morphology/function in the failing RV and the hypertensive pulmonary vasculature, representing a therapeutic approach for PAH and other cardiovascular/pulmonary diseases. Copyright
Boehmert, J.; Huettig, W.
If the fuel defect rate proves significantly high, failure analysis has to be performed in order to trace down the defect causes, to implement corrective actions, and to take measures of failure prevention. Such analyses are work-consuming and very skill-demanding technical tasks, which require examination methods and devices excellently developed and a rich stock of experience in evaluation of features of damage. For that this work specifies the procedure of failure analyses in detail. Moreover prerequisites and experimental equipment for the investigation of WWER-type fuel elements are described. (author)
Islam, Md Shahidul
"Heart failure: from research to clinical practice", a collection of selected reviews, which comes out also as a book, covers essentially all important aspects of heart failure, including the pathogenesis, clinical features, biomarkers, imaging techniques, medical treatment and surgical treatments, use of pacemakers and implantable cardioverter defibrillators, and palliative care. The reviews include essential background information, state of the art, critical and in-depth analysis, and directions for future researches for elucidation of the unresolved issues. Everyone interested in heart failure is expected to find this compilation helpful for a deeper understanding of some of the complex issues.
Tapolcai, János; Babarczi, Péter; Rónyai, Lajos
This book covers the issues of monitoring, failure localization, and restoration in the Internet optical backbone, and focuses on the progress of state-of-the-art in both industry standard and academic research. The authors summarize, categorize, and analyze the developed technology in the context of Internet fault management and failure recovery under the Generalized Multi-Protocol Label Switching (GMPLS), via both aspects of network operations and theories. Examines monitoring, failure localization, and failure restoration in the Internet backbone Includes problem formulations based on combinatorial group testing and topology coding Covers state-of-the-art development for the Internet backbone fault management and failure recovery
Edmondson, Amy C
Many executives believe that all failure is bad (although it usually provides Lessons) and that Learning from it is pretty straightforward. The author, a professor at Harvard Business School, thinks both beliefs are misguided. In organizational life, she says, some failures are inevitable and some are even good. And successful learning from failure is not simple: It requires context-specific strategies. But first leaders must understand how the blame game gets in the way and work to create an organizational culture in which employees feel safe admitting or reporting on failure. Failures fall into three categories: preventable ones in predictable operations, which usually involve deviations from spec; unavoidable ones in complex systems, which may arise from unique combinations of needs, people, and problems; and intelligent ones at the frontier, where "good" failures occur quickly and on a small scale, providing the most valuable information. Strong leadership can build a learning culture-one in which failures large and small are consistently reported and deeply analyzed, and opportunities to experiment are proactively sought. Executives commonly and understandably worry that taking a sympathetic stance toward failure will create an "anything goes" work environment. They should instead recognize that failure is inevitable in today's complex work organizations.
Full Text Available Background. The noncommunicable disease (NCDs are very common among population around the world. They are the main cause of preventable mortality, cause temporary and permanent disability. NCDs are the major reason for attending for medical care and lead to economic losses. The implementations of preventive strategy, increasing the role of preventive measures are general tasks for all health care system. The analysis of trends of preventive measure for NCD nowadays is the aim of this research. Materials and methods. The study included the result of analysis of science publication and WHO database about NCD and preventive measure used as well as the results of the analysis of data of the Center for Statistics in Medicine of MoH of Ukraine. Results. Diabetes, cardiovascular diseases, cancer, chronic respiratory diseases are the major NCDs. The base factors which lead to NCD are behavioral risk factors, namely tobacco use, unhealthy diet, physical inactivity, and alcohol abuse. The WHO prepared a lot of documents, among which the most significant are the strategies on noncommunicable diseases prevention, convention against smoking, strategy on diet and physical activity, global strategy on reducing alcohol abusing and so on. Nowadays the world population follows Global Action Plan for Prevention of Noncommunicable Diseases for 2013–2020. The documents emphasize the importance of state support, the use of scientific potential and intersectoral interaction to effectively combat noncommunicable diseases. The major of scientific direction are NCD monitoring, detection of the determinant of NCD development and making strategy for usage it in conditions of limited resources. The role of Digital marketing today increases that leads to the acquisition and consolidation of the habits and behavior of modern youth. Internet marketing is very effective to form unhealthy food behavior in children and adolescents that requires adequate and urgent actions. The
Kanel, G. I.
The failure wave is a network of cracks that are nucleated on the surface and propagate into the elastically stressed body. It is a mode of catastrophic fracture in an elastically stressed media whose relevance is not limited to impact events. In the paper, main properties of the failure waves are summarized and discussed. It has been shown that the failure wave is really a wave process which is characterized by small increase of the longitudinal stress and corresponding increments of the particle velocity and the density. The propagation velocity of the failure wave is less than the sound speed; it is not directly related to the compressibility but is determined by the crack growth speed. The failure wave is steady if the stress state ahead of it is supported unchanging. In some sense the process is similar to a subsonic combustion wave. Computer simulations based on the phenomenological combustion-like model reproduces well all kinematical aspects of the phenomenon
Full Text Available Abstract Background The increasing prevalence of chronic disease represents a significant burden on most health systems. This paper explores the market failures and policy failures that exist in the management of chronic diseases. Discussion There are many sources of market failure in health care that undermine the efficiency of chronic disease management. These include incomplete information as well as information asymmetry between providers and consumers, the effect of externalities on consumer behaviour, and the divergence between social and private time preference rates. This has seen government and policy interventions to address both market failures and distributional issues resulting from the inability of private markets to reach an efficient and equitable distribution of resources. However, these have introduced a series of policy failures such as distorted re-imbursement arrangements across modalities and delivery settings. Summary The paper concludes that market failure resulting from a preference of individuals for 'immediate gratification' in the form of health care and disease management, rather than preventative services, where the benefits are delayed, has a major impact on achieving an efficient allocation of resources in markets for the management of chronic diseases. This distortion is compounded by government health policy that tends to favour medical and pharmaceutical interventions further contributing to distortions in the allocation of resources and inefficiencies in the management of chronic disease.
Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia
The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. PMID:24714056
Ghosh, A.; Chakravorty, D.
The failure aspects of composites are available for plates, but studies of the literature on shells unveils that similar reports on them are very limited in number. The aim of this work was to investigate the first-ply-failure of industrially and aesthetically important spherical shells under uniform loadings. Apart from solving benchmark problems, numerical experiments were carried out with different variations of their parameters to obtain the first-ply-failure stresses by using the finite-element method. The load was increased in steps, and the lamina strains and stresses were put into well-established failure criteria to evaluate their first-ply-failure stress, the failed ply, the point of initiation of failure, and failure modes and tendencies. The results obtained are analyzed to extract the points of engineering significance.
Milo-Cotter, O.; Bettari, L.; Kleijn, L.; Bugatti, S.; Lombardi, C.; Rund, M.; Metra, M.; Voors, A. A.; Cotter, G.; Kaluski, E.; Weatherley, B. D.
Hospitalization for acute heart failure (AHF) is one of the burdensome aspects of 21(st) century medicine, leading to significant debilitating symptoms, high morbidity and mortality and consuming significant portion of the health care budget. Management of AHF is thought-provoking given the
Full Text Available Significant progress has been made in the last few years in the management of heart failure. In particular several trials have given significant results. It has become apparent that heart failure may be prevented in some patients by treatment of risk factors such as coronary artery disease. Experience with angiotensin-converting enzyme (ACE inhibitors has shown that the survival and symptomatic benefits do last in the long term, and confirm that they are the first-line treatment in heart failure. The results of a number of trials using the angiotensin receptor blockers (ARBs candesartan, valsartan and losartan are presented and discussed. There is also some experience now in the use of candesartan for patients with heart failure and preserved left ventricular systolic function. The COMET trial compared the β-blockers carvedilol and metoprolol tartrate, and suggests that there may be differences in clinical effect between β-blockers. The selective aldosterone receptor blocker eplerenone was evaluated in the EPHESUS trial in post-MI patients with signs of heart failure. Based on these clinical trials, heart failure guidelines are now being updated.
Deciding on a health policy in practice means dedicating human and financial resources and prioritising spendings. The economic evaluation of prevention strategies attempts to establish a relationship between the medical benefit of prevention and its additional cost (or in some cases cost reduction) compared to no prevention. Decisions on reimbursing drugs, interventions or funding health programmes do not usually follow efficiency criteria which define economic rationality. Politics may for example decide to make prostate cancer a public health priority if mortality in a country or in some regions of the country appears to be excessively high. Economic rationality alone is not an appropriate factor on which to base a decision which may be purely political, reflecting the actual values of the society at a given point in time.
Barr, Ronald G
Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.
Full Text Available BACKGROUND: Bilateral vasectomy is the most effective method of male contraception but there are still some reports on its failure. This study was undertaken to determine the failure rate of the no-scalpel vasectomy in Shiraz Vasectomy Center, Southern Iran. METHODS: From 2001 to 2003, 3900 no-scalpel vasectomies were done in Nader Kazemi Health Center. The records were studied for any failure in the method. Presence of any live sperm 6 months after surgery or any report of pregnancy post-vasectomy were considered as vasectomy failure. RESULTS:Among 3900 cases, 2928 patients had a complete follow up file while failure in the method was visible among 109 (3.72% cases. CONCLUSION: The low failure rate of no-scalpel method indicated its high efficacy to control the fertility in males but there is still need of performance by expert surgeons in well organized centers. KEYWORDS: Iran, no-scalpel vasectomy, failure rate.
J. Nasl Seraji
Full Text Available Background and aims Prevention of potential accidents and safety promotion in chemical processes requires systematic safety management in them. The main objective of this study was analysis of important process equipment components failure modes and effects in H2S and CO2 isolation from extracted natural gas process. Methods This study was done in sweetening unit of an Iranian gas refinery. Failure Mode and Effect Analysis (FMEA used for identification of process equipments failures. Results Totally 30 failures identified and evaluated using FMEA. P-1 blower's blade breaking and sour gas pressure control valve bearing tight moving had maximum risk Priority number (RPN, P-1 body corrosion and increasing plug lower side angle of reach DEAlevel control valve in tower - 1 were minimum calculated RPN. Conclusion By providing a reliable documentation system for equipment failures and incidents recording, maintaining of basic information for later safety assessments would be possible. Also, the probability of failures and effects could be minimized by conducting preventive maintenance.
Braaksma, Anne Johannes Jan; Meesters, A.J.; Klingenberg, W.; Hicks, C.
Failure Mode and Effects Analysis (FMEA) is commonly used for designing maintenance routines by analysing potential failures, predicting their effect and facilitating preventive action. It is used to make decisions on operational and capital expenditure. The literature has reported that despite its
Human failure is not the opposite of successful human action gut follows the same principles. The manner in which humans acquire and process information is influenced by cognitive, social and motivational aspects. Further, human failure generally means a failure of the whole system man/technology/organisation. If serious consequences are to be avoided, the logic of failures must be analyzed in the context of this system, and human staff should be trained in managing failures and not just avoiding them [de
Yamada, Yuko; Kinoshita, Hideyuki; Kuwahara, Koichiro; Nakagawa, Yasuaki; Kuwabara, Yoshihiro; Minami, Takeya; Yamada, Chinatsu; Shibata, Junko; Nakao, Kazuhiro; Cho, Kosai; Arai, Yuji; Yasuno, Shinji; Nishikimi, Toshio; Ueshima, Kenji; Kamakura, Shiro; Nishida, Motohiro; Kiyonaka, Shigeki; Mori, Yasuo; Kimura, Takeshi; Kangawa, Kenji; Nakao, Kazuwa
Dysregulation of autonomic nervous system activity can trigger ventricular arrhythmias and sudden death in patients with heart failure. N-type Ca(2+) channels (NCCs) play an important role in sympathetic nervous system activation by regulating the calcium entry that triggers release of neurotransmitters from peripheral sympathetic nerve terminals. We have investigated the ability of NCC blockade to prevent lethal arrhythmias associated with heart failure. We compared the effects of cilnidipine, a dual N- and L-type Ca(2+) channel blocker, with those of nitrendipine, a selective L-type Ca(2+) channel blocker, in transgenic mice expressing a cardiac-specific, dominant-negative form of neuron-restrictive silencer factor (dnNRSF-Tg). In this mouse model of dilated cardiomyopathy leading to sudden arrhythmic death, cardiac structure and function did not significantly differ among the control, cilnidipine, and nitrendipine groups. However, cilnidipine dramatically reduced arrhythmias in dnNRSF-Tg mice, significantly improving their survival rate and correcting the imbalance between cardiac sympathetic and parasympathetic nervous system activity. A β-blocker, bisoprolol, showed similar effects in these mice. Genetic titration of NCCs, achieved by crossing dnNRSF-Tg mice with mice lacking CACNA1B, which encodes the α1 subunit of NCCs, improved the survival rate. With restoration of cardiac autonomic balance, dnNRSF-Tg;CACNA1B(+/-) mice showed fewer malignant arrhythmias than dnNRSF-Tg;CACNA1B(+/+) mice. Both pharmacological blockade of NCCs and their genetic titration improved cardiac autonomic balance and prevented lethal arrhythmias in a mouse model of dilated cardiomyopathy and sudden arrhythmic death. Our findings suggest that NCC blockade is a potentially useful approach to preventing sudden death in patients with heart failure. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: firstname.lastname@example.org.
Filip, R.; Sieniawski, J.
Investigations conducted in this work were aimed at obtaining information on the influence of the microstructure of the two-phase titanium alloys on fatigue strength. A course of fatigue failure depends on both dispersion and a number of secondary α-phase particles. The lamellar structure is formed during controlled cooling from the temperature range of β-phase stability. The cooling rate influences the geometrical parameters of the microstructure and finally the fatigue strength of the alloy. (author). 20 refs, 12 figs, 2 tabs
Ruwald, A C; Gislason, G H; Vinther, M
Aims: There is a paucity of studies investigating a dose-dependent association between beta-blocker therapy and risk of outcome. In a nationwide cohort of primary prevention implantable cardioverter-defibrillator (ICD) patients, we aimed to investigate the dose-dependent association between beta-blocker...... therapy and risk of ventricular tachyarrhythmias (VT/VF), heart failure (HF) hospitalizations, and death. Methods and results: Information on ICD implantation, endpoints, comorbidities, beta-blocker usage, type, and dose were obtained through Danish nationwide registers. The two major beta-blockers...... carvedilol and metoprolol were examined in three dose levels; low (metoprolol ≤ 25 mg; carvedilol ≤ 12.5 mg), intermediate (metoprolol 26-199 mg; carvedilol 12.6-49.9 mg), and high (metoprolol ≥ 200 mg; carvedilol ≥ 50 mg). Time to events was investigated utilizing multivariate Cox models with beta-blocker...
Lambert, H.E.; Budnitz, R.J.
This study addresses the effect of a strong-motion earthquake on circuit breaker operation. It focuses on the loss of offsite power (LOSP) transient caused by a strong-motion earthquake at the Zion Nuclear Power Plant. This paper also describes the operator action necessary to prevent core melt if the above circuit breaker failure modes occur simultaneously on three 4.16 KV buses. Numerous circuit breakers important to plant safety, such as circuit breakers to diesel generators and engineered safety systems (ESS), must open and/or close during this transient while strong motion is occurring. Potential seismically-induced circuit-breaker failures modes were uncovered while the study was conducted. These failure modes include: circuit breaker fails to close; circuit breaker trips inadvertently; circuit breaker fails to reclose after trip. The causes of these failure modes include: Relay chatter causes the circuit breaker to trip; Relay chatter causes anti-pumping relays to seal-in which prevents automatic closure of circuit breakers; Load sequencer failures. The incorporation of these failure modes as well as other instrumentation and control failures into a limited scope seismic probabilistic risk assessment is also discussed in this paper
Brooks, Wesley W; Conrad, Chester H; Robinson, Kathleen G; Colucci, Wilson S; Bing, Oscar H L
The effects of long-term oral administration of L-arginine, a substrate for nitric oxide (NO) production, on left ventricular (LV) remodeling, myocardial function and the prevention of heart failure (HF) was compared to the angiotensin-converting enzyme (ACE) inhibitor captopril in a rat model of hypertensive HF (aged spontaneously hypertensive rat (SHR)). SHRs and age-matched normotensive Wistar-Kyoto (WKY) rats were assigned to either no treatment, treatment with L-arginine (7.5 g/l in drinking water) or captopril (1 g/l in drinking water) beginning at 14 months of age, a time when SHRs exhibit stable compensated hypertrophy with no hemodynamic impairment; animals were studied at 23 months of age or at the time of HF. In untreated SHR, relative to WKY, there was significant LV hypertrophy, myocardial fibrosis, and isolated LV muscle performance and response to isoproterenol (ISO) were depressed; and, 7 of 10 SHRs developed HF. Captopril administration to six SHRs attenuated hypertrophy and prevented impaired inotropic responsiveness to ISO, contractile dysfunction, fibrosis, increased passive stiffness, and HF. In contrast, L-arginine administration to SHR increased LV hypertrophy and myocardial fibrosis while cardiac performance was depressed; and 7 of 9 SHRs developed HF. In WKY, L-arginine treatment but not captopril resulted in increased LV weight and the contractile response to ISO was blunted. Neither L-arginine nor captopril treatment of WKY changed fibrosis and HF did not occur. These data demonstrate that in contrast to captopril, long-term treatment with L-arginine exacerbates age-related cardiac hypertrophy, fibrosis, and did not prevent contractile dysfunction or the development of HF in aging SHR.
The common cause failure is defined as a multiple failure event due to a common cause. The existence of common failure causes may ruin the potential advantages of applying redundancy for reliability improvement. Examples relevant to large mechanical components are presented. Preventive measures against common cause failures, such as physical separation, equipment diversity, quality assurance, and feedback from experience are discussed. Despite the large number of potential interdependencies, the analysis of common cause failures can be done within the framework of conventional reliability analysis, utilizing, for example, the method of deriving minimal cut sets from a system fault tree. Tools for the description and evaluation of dependencies between components are discussed: these include the model of conditional failure causes that are common to many components, and evaluation of the reliability of redundant components subjected to a common load. (author)
China, Louise; Muirhead, Nicola; Skene, Simon S; Shabir, Zainib; De Maeyer, Roel P H; Maini, Alexander A N; Gilroy, Derek W; O'Brien, Alastair J
Circulating prostaglandin E2 levels are elevated in acutely decompensated cirrhosis and have been shown to contribute to immune suppression. Albumin binds and inactivates this hormone. Human albumin solution could thus be repurposed as an immune restorative drug in these patients.This feasibility study aims to determine whether it is possible and safe to restore serum albumin to >30 g/L and maintain it at this level in patients admitted with acute decompensated cirrhosis using repeated 20% human albumin infusions according to daily serum albumin levels. Albumin To prevenT Infection in chronic liveR failurE (ATTIRE) stage 1 is a multicentre, open label dose feasibility trial. Patients with acutely decompensated cirrhosis admitted to hospital with a serum albumin of albumin solution will be infused, according to serum albumin levels, for up to 14 days or discharge in all patients. The primary end point is daily serum albumin levels for the duration of the treatment period and the secondary end point is plasma-induced macrophage dysfunction. The trial will recruit 80 patients. Outcomes will be used to assist with study design for an 866 patient randomised controlled trial at more than 30 sites across the UK. Research ethics approval was given by the London-Brent research ethics committee (ref: 15/LO/0104). The clinical trials authorisation was issued by the medicines and healthcare products regulatory agency (ref: 20363/0350/001-0001). Will be disseminated through peer reviewed journals and international conferences. Recruitment of the first participant occurred on 26/05/2015. The trial is registered with the European Medicines Agency (EudraCT 2014-002300-24) and has been adopted by the NIHR (ISRCTN 14174793). This manuscript refers to V.4.0 of the protocol; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
A unique book that describes the practical processes necessary to achieve failure free equipment performance, for quality and reliability engineers, design, manufacturing process and environmental test engineers. This book studies the essential requirements for successful product life cycle management. It identifies key contributors to failure in product life cycle management and particular emphasis is placed upon the importance of thorough Manufacturing Process Capability reviews for both in-house and outsourced manufacturing strategies. The readers? attention is also drawn to the ma
Stull, Laura G; McGrew, John H; Salyers, Michelle P
Processes underlying success and failure in assertive community treatment (ACT), a widely investigated treatment model for persons with severe mental illness, are poorly understood. The purpose of the current study was to examine processes in ACT by (1) understanding how consumers and staff describe the processes underlying treatment success and failure and (2) comparing processes identified by staff and consumers. Investigators conducted semi-structured interviews with 25 staff and 23 consumers from four ACT teams. Both staff and consumers identified aspects of the ACT team itself as the most critical in the process of consumer success. For failure, consumers identified consumer characteristics as most critical and staff identified lack of social relationships. Processes underlying failure were not viewed as merely the opposite of processes underlying success. In addition, there was notable disagreement between staff and consumers on important processes. Findings overlap with critical ingredients identified in previous studies, including aspects of the ACT team, social involvement and employment. In contrast to prior studies, there was little emphasis on hospitalizations and greater emphasis on not abusing substances, obtaining wants and desires, and consumer characteristics.
Full Text Available This paper reviews traditional Chinese medicine (TCM physicians′understanding of liver failure including its TCM causes, mechanisms, positions, and syndrome differentiation in various dynasties. The results suggest that modern researchers agree with ancient physicians on these aspects of liver failure. Based on achievements of ancient TCM physicians, modern researchers have further developed and improved their understanding of TCM causes, mechanisms, positions, and syndrome differentiation of liver failure. Moreover, this paper discusses the treatment of chronic liver failure with yang-supporting therapy, which provides a novel perspective and method for treating chronic liver failure.
Bradshaw, Catherine P.; O'Brennan, Lindsey M.; McNeely, Clea A.
There is an increasing awareness that school failure and early school leaving are processes, rather than discrete events, that often co-occur and can have lasting negative effects on children's development. Most of the literature has focused on risk factors for failure and dropout rather than on the promotion of competencies that can increase…
Larsson, Tore J; Hale, Andrew R
The contributions to this Worklife 2000 workshop and special issue of the Safety Science Monitor touch upon several aspects crucial to safety management. The perspectives and concepts presented are from areas which include, but are not specifically dedicated to, occupational health and safety. Safety at work, however, represents the prime target area of the workshop and the discussion initiated here, and hopefully continuing through the year on this site, should be seen as an attempt to seek ...
Kim, J. S.; Kim, H. W.; Park, J. S.; Jung, S. G.
The safety security and efficient management of NPPs (Nuclear Power Plants) have been increased after the accident of TEPCO's Fukushima nuclear power stations. The needs for the safety and efficiency are becoming more important because about 90 percent of the NPPs all over the world are more than 20 operation years old. The preventive maintenance criteria need to be flexible, considering long-term development of the equipment performance and preventive maintenance. The PMBD (Preventive Maintenance Basis Database) program was widely used for optimization of the preventive maintenance criteria. PMBD program contains all kinds of failure mechanisms for each equipment that may occur in the power plant based on RCM(Reliability-Centered Maintenance) and numerically calculate the variation of reliability and failure rate based on PM interval changes. In this study, propriety evaluation of preventive maintenance task, cycle, technical basis for cost effective preventive maintenance strategy and an appropriate evaluation were suggested by the case application of PMBD for major components in the NPPs
de Leeuw, S.L.J.M.; Vis, I.F.A.; Jonkman, S.N.
Floods are often preceded by warnings such as heavy rain that may make preparatory activities possible in order to prevent flooding from actually happening. However, flood emergency preparedness lacks insight in logistical aspects. This paper develops a framework of logistical aspects of emergency
de Leeuw, Sander; Vis, Iris F. A.; Jonkman, Sebastiaan N.
Floods are often preceded by warnings such as heavy rain that may make preparatory activities possible in order to prevent flooding from actually happening. However, flood emergency preparedness lacks insight in logistical aspects. This paper develops a framework of logistical aspects of emergency
Sah, D.N.; Ramadasan, E.; Unnikrishnan, K.
Hydriding of the zircaloy cladding has been one of the important causes of failure in water reactor fuel elements. This report reviews the causes, the mechanisms and the methods for prevention of hydriding failure in zircaloy clad water reactor fuel elements. The different types of hydriding of zircaloy cladding have been classified. Various factors influencing zircaloy hydriding from internal and external sources in an operating fuel element have been brought out. The findings of post-irradiation examination of fuel elements from Indian reactors, with respect to clad hydriding and features of hydriding failure are included. (author)
Ryan, Rodger; Timmerman, Walter J. H.
A valve system incorporating single failure protective logic. The system consists of a valve combination or composite valve which allows actuation or de-actuation of a device such as a hydraulic cylinder or other mechanism, integral with or separate from the valve assembly, by means of three independent input signals combined in a function commonly known as two-out-of-three logic. Using the input signals as independent and redundant actuation/de-actuation signals, a single signal failure, or failure of the corresponding valve or valve set, will neither prevent the desired action, nor cause the undesired action of the mechanism.
Full Text Available Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilemma. Since one of the main reasons of heart failure is cardiovascular diseases, in first phase, the patient may be obese. In the later phases, cachexia may show up. It was shown that cachexia is associated with mortality. Within this period, patients should not be over-fed and the patient should pass from catabolic state to anabolic state slowly. If the gastrointestinal track is functional oral/enteral feeding must be preferred. Multi vitamin and mineral supportsmay be beneficial, which may replace the increased loss, increase anti-inflammatory response and be anti-oxidants. Large, controlled and well-designed studies must be conducted in order to evaluate the benefits of nutritional practices such as nutritional assessment, enteral feeding and nutrient supports in heart failure patients.
Full Text Available Overburden stripping in open cast coal mines is extensively carried out by walking draglines. Draglines’ unavailability and unexpected failures result in delayed productions and increased maintenance and operating costs. Therefore, achieving high availability of draglines plays a crucial role for increasing economic feasibility of mining projects. Applications of methodologies which can forecast the failure type of dragline based on the available failure data not only help to reduce the maintenance and operating costs but also increase the availability and the production rate. In this study, Machine Learning approaches have been applied for data which has been gathered from an operating coal mine in Turkey. The study methodology consists of three algorithms as: i implementation of K-Nearest Neighbors, ii implementation of Multi-Layer Perceptron, and iii implementation of Radial Basis Function. The algorithms have been utilized for predicting the draglines’ failure types. In this sense, the input data, which are mean time-to-failure, and the output data, failure types, have been fed to the algorithms. The regression analysis of methodologies have been compared and showed the K- Nearest Neighbors has a higher rate of regression which is around 70 percent. Thus, the K-Nearest Neighbor algorithm can be applied in order to preventive components replacement which causes to minimized preventive and corrective cost parameters. The accurate prediction of failure type, indeed, causes to optimized number of inspections. The novelty of this study is application of machine learning approaches in draglines’ reliability subject for first time.
Son, Ki Chang; Shin, Hyun Kook; Lee, Nam Hoon; Baek, Seung Min; Kim, Hang Bae
The Advanced Digital Reactor Protection System (ADRPS) with diverse dual processors is being developed by the National Research Lab of KOPEC for ADRPS development. One of the ADRPS goals is to develop digital Plant Protection System (PPS) free of Common Mode Failure (CMF). To prevent CMF, the principle of diversity is applied to both hardware design and software design. For the hardware diversity, two different types of CPUs are used for Bistable Processor and Local Coincidence Logic Processor. The VME based Single Board Computers (SBC) are used for the CPU hardware platforms. The QNX Operating System (OS) and the VxWorks OS are used for software diversity. Rigorous Software Verification and Validation (V and V) is also required to prevent CMF. In this paper, software V and V methodology for the ADRPS is described to enhance the ADRPS software reliability and to assure high quality of the ADRPS software
Zhong, Yaoquan; Guo, Wei; Sun, Weiqiang; Jin, Yaohui; Hu, Weisheng
Optical grid, the integrated computing environment based on optical network, is expected to be an efficient infrastructure to support advanced data-intensive grid applications. In optical grid, the faults of both computational and network resources are inevitable due to the large scale and high complexity of the system. With the optical network based distributed computing systems extensive applied in the processing of data, the requirement of the application failure probability have been an important indicator of the quality of application and an important aspect the operators consider. This paper will present a task-based analysis method of the application failure probability in optical grid. Then the failure probability of the entire application can be quantified, and the performance of reducing application failure probability in different backup strategies can be compared, so that the different requirements of different clients can be satisfied according to the application failure probability respectively. In optical grid, when the application based DAG (directed acyclic graph) is executed in different backup strategies, the application failure probability and the application complete time is different. This paper will propose new multi-objective differentiated services algorithm (MDSA). New application scheduling algorithm can guarantee the requirement of the failure probability and improve the network resource utilization, realize a compromise between the network operator and the application submission. Then differentiated services can be achieved in optical grid.
Lockwood, Penelope; Marshall, Tara C; Sadler, Pamela
In two studies, cross-cultural differences in reactions to positive and negative role models were examined. The authors predicted that individuals from collectivistic cultures, who have a stronger prevention orientation, would be most motivated by negative role models, who highlight a strategy of avoiding failure; individuals from individualistic cultures, who have a stronger promotion focus, would be most motivated by positive role models, who highlight a strategy of pursuing success. In Study 1, the authors examined participants' reported preferences for positive and negative role models. Asian Canadian participants reported finding negative models more motivating than did European Canadians; self-construals and regulatory focus mediated cultural differences in reactions to role models. In Study 2, the authors examined the impact of role models on the academic motivation of Asian Canadian and European Canadian participants. Asian Canadians were motivated only by a negative model, and European Canadians were motivated only by a positive model.
Discusses methods for analyzing case studies of failures of technological systems. Describes two distance learning courses that compare standard models of failure and success with the actuality of given scenarios. Provides teaching and learning materials and information sources for application to aspects of design, manufacture, inspection, use,…
Karina Sanches Machado d’Almeida
Full Text Available Background: Heart failure (HF is a complex syndrome and is recognized as the ultimate pathway of cardiovascular disease (CVD. Studies using nutritional strategies based on dietary patterns have proved to be effective for the prevention and treatment of CVD. Although there are studies that support the protective effect of these diets, their effects on the prevention of HF are not clear yet. Methods: We searched the Medline, Embase, and Cochrane databases for studies that examined dietary patterns, such as dietary approaches to stop hypertension (DASH diet, paleolithic, vegetarian, low-carb and low-fat diets and prevention of HF. No limitations were used during the search in the databases. Results: A total of 1119 studies were identified, 14 met the inclusion criteria. Studies regarding the Mediterranean, DASH, vegetarian, and Paleolithic diets were found. The Mediterranean and DASH diets showed a protective effect on the incidence of HF and/or worsening of cardiac function parameters, with a significant difference in relation to patients who did not adhere to these dietary patterns. Conclusions: It is observed that the adoption of Mediterranean or DASH-type dietary patterns may contribute to the prevention of HF, but these results need to be analyzed with caution due to the low quality of evidence.
Shimokawa, Hiroaki; Miura, Masanobu; Nochioka, Kotaro; Sakata, Yasuhiko
Heart failure (HF) is an epidemic in healthcare worldwide, including Asia. It appears that HF will become more serious in the near future, with the epidemiological transition and ageing of the population. However, in contrast to Western countries, information on HF epidemiology is still limited in Asia, particularly in South Asia. In this review, we will briefly summarize available information regarding the current and future burden of HF in Asia, which indicates the importance of both primary prevention of underlying diseases of HF and secondary prevention, including management of ischaemic HF, HF with preserved EF, and HF in the elderly. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.
Ghosh, D.; Ray, S.; Roy, H.; Mandal, N.; Shukla, A. K.
Failure of boiler tubes is the main cause of unit outages of the plant, which further affects the reliability, availability and safety of the unit. So failure analysis of boiler tubes is absolutely essential to predict the root cause of the failure and the steps are taken for future remedial action to prevent the failure in near future. This paper investigates the probable cause/causes of failure of the primary superheater tube in a thermal power plant boiler. Visual inspection, dimensional measurement, chemical analysis, metallographic examination and hardness measurement are conducted as the part of the investigative studies. Apart from these tests, mechanical testing and fractographic analysis are also conducted as supplements. Finally, it is concluded that the superheater tube is failed due to graphitization for prolonged exposure of the tube at higher temperature.
Carlsson, Fredrik; Eriksson, Emil; Dahlberg, Magnus
The state of existing reliability and failure data in the public sources has been investigated. The prime goal has been to evaluate the data's usefulness for developing damage preventing measures. Some publicly available databases exist, and the data has been presented in several papers in the literature. The results from the investigation can seem quite negative. Detailed data are lacking and the level of detailed reporting has even been decreasing in recent years. Information on the impact of load condition on failures, which is an important question, are lacking throughout in the statistics. Some components dominate the failure statistics. These are for example the gearboxes, where failures lead to long down times. Failures of the electrical system lead to considerably shorter down times but the failure rate is much higher. Severe rotor failures seem to be rare, but they occur and the consequences can be dramatic. Operators and insurance companies are demanding improved insight in damage collection, maintenance and overall damage preventing measures. Closer cooperation with these parties could be a fruitful way of gathering more useful data. Improvements for future databases are suggested. A structure for damage collection is proposed. Comparing experience of damage preventing measures from other industries, knowledge about the nature of the damage mechanism and current practice in the wind industry will be an important tool in the evaluation of different damage preventing measures. This will be done in the following phases of this project
van Soest, Felix J S; Santman-Berends, Inge M G A; Lam, Theo J G M|info:eu-repo/dai/nl/14686820X; Hogeveen, Henk
Mastitis is an important disease from an economic perspective, but most cost assessments of mastitis include only the direct costs associated with the disease (e.g., production losses, culling, and treatment), which we call failure costs (FC). However, farmers also invest time and money in
Accident prevention measures are traditionally classified into technical, organizational and behavioral solutions. A review of some commonly used strategies for accident prevention illustrates some discrepancies between different approaches and the need to develop more comprehensive strategies. Several factors, including protective efficiency and disadvantages at work, must be taken into account when the solutions are evaluated. Some solutions to prevent load disengagement from cranes were evaluated. Measurements of the pressing force showed that the efficiency of the safety latch of a clamp for plate lifting is inadequate to provide protection under all exceptional lifting conditions and in all situations for which the safety latch is intended. The delay caused by the attachment of a lifting hook equipped with a safety latch was measured. The handling of some of the most reliable and technically safe latches requires additional operations and thereby limits their practical application.
Kim, Tae Woon; Singh, Brijendra; Sung, Tae Yong; Park, Jin Hee; Lee, Yoon Hwan
Largely, the RCM approach can be divided in three phases; (1) Functional failure analysis (FFA) on the selected system or subsystem, (2) Failure mode, effect and criticality analysis (FMECA) to identify the impact of failure to plant safety or economics, (3) Logical tree analysis (LTA) to select appropriate preventive maintenance and surveillance tasks. This report presents FMECA results for six mechanical subsystems of the diesel generators of nuclear power plants. The six mechanical subsystems are Starting air, Lub oil, Governor, Jacket water cooling, Fuel, and Engine subsystems. Generic and plant-specific failure and maintenance records are reviewed to identify critical components/failure modes. FMECA was performed for these critical component/failure modes. After reviewing current preventive maintenance activities of Wolsung unit 1, draft RCM recommendations are developed. 6 tabs., 16 refs. (Author)
Kim, Tae Woon; Singh, Brijendra; Sung, Tae Yong; Park, Jin Hee; Lee, Yoon Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)
Largely, the RCM approach can be divided in three phases; (1) Functional failure analysis (FFA) on the selected system or subsystem, (2) Failure mode, effect and criticality analysis (FMECA) to identify the impact of failure to plant safety or economics, (3) Logical tree analysis (LTA) to select appropriate preventive maintenance and surveillance tasks. This report presents FMECA results for six mechanical subsystems of the diesel generators of nuclear power plants. The six mechanical subsystems are Starting air, Lub oil, Governor, Jacket water cooling, Fuel, and Engine subsystems. Generic and plant-specific failure and maintenance records are reviewed to identify critical components/failure modes. FMECA was performed for these critical component/failure modes. After reviewing current preventive maintenance activities of Wolsung unit 1, draft RCM recommendations are developed. 6 tabs., 16 refs. (Author).
Zamora Nava LE
Full Text Available Luis Eduardo Zamora Nava,1 Jonathan Aguirre Valadez,2 Norberto C Chávez-Tapia,3 Aldo Torre21Department of Endoscopy, 2Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, 3Obesity and Digestive Diseases Unit, Medica Sur Clinic and Foundation, Mexico City, MexicoAbstract: There is no universally accepted definition of acute-on-chronic liver failure; however, it is recognized as an entity characterized by decompensation from an underlying chronic liver disease associated with organ failure that conveys high short-term mortality, with alcoholism and infection being the most frequent precipitating events. The pathophysiology involves inflammatory processes associated with a trigger factor in susceptible individuals (related to altered immunity in the cirrhotic population. This review addresses the different definitions developed by leading research groups, epidemiological and pathophysiological aspects, and the latest treatments for this entity.Keywords: acute-on-chronic liver failure, cirrhosis, organ failure, acute kidney injury, infection
Soest, van Felix J.S.; Santman-Berends, Inge M.G.A.; Lam, Theo J.G.M.; Hogeveen, Henk
Mastitis is an important disease from an economic perspective, but most cost assessments of mastitis include only the direct costs associated with the disease (e.g., production losses, culling, and treatment), which we call failure costs (FC). However, farmers also invest time and money in
Barnes, R.W.; Cooper, G.D.
Most non-nuclear process piping systems in Canada and the United States are constructed to the requirements of the piping codes of the American Society of Mechanical Engineers (ASME B31.1 and B31.3). Section III of the ASME Boiler and Pressure Vessel Code, has additional requirements for piping that are expected to provide further assurance of pressure boundary integrity. This project attempted to determine if the additional requirements of Section III were beneficial in preventing failure of the pressure boundary. The approach taken in the study was to determine the causes of failure of non-nuclear piping subjected to service similar to that experienced by piping in CANDU nuclear power plants. The study examined information on carbon steel piping systems filled with water/steam which operate up to a maximum temperature of 600 F and a maximum pressure of 1600 psi. The failure mechanisms were identified and analysed to determine whether application of the requirements of Section III would have prevented the failure. Through a process of interviews and literature search, 186 failures were identified and assembled into a reference database. Many of the records were incomplete; therefore, the reference database was trimmed to include a subset of 65 failure points supported by complete data. This subset formed the basis for this study. The results from the study of other databases assembled for similar purposes were reviewed and compared to the conclusions reached in this study. These reviews confirmed the conclusions reached in this study. (author). 48 refs., 20 tabs
LaFrance, Russell M; Gorczyca, John T; Maloney, Michael D
Anterior cruciate ligament (ACL) reconstruction is common, with >100,000 procedures performed each year in the United States. Several factors are associated with failure, including poor surgical technique, graft incorporation failure, overly aggressive rehabilitation, and trauma. Tibial shaft fracture is also common and frequently requires operative intervention. Failure to reestablish the anatomic alignment of the tibia may cause abnormal forces across adjacent joints, which can cause degenerative joint disease or attritional failure of the surrounding soft tissues. This article describes a case of ACL reconstruction failure after a tibial fracture that resulted in malunion. Excessive force across the graft from lower-extremity malalignment and improper tunnel placement likely contributed to the attritional failure of the graft. This patient required a staged procedure for corrective tibial osteotomy followed by revision ACL reconstruction. This article describes ACL reconstruction failure, tibial shaft malunions, their respective treatments, the technical details of each procedure, and the technical aspects that must be considered when these procedures are done in a staged manner by 2 surgeons. Copyright 2012, SLACK Incorporated.
Trullàs, J C; González-Franco, Á
The European Society of Cardiology has recently published new guidelines on the diagnosis and treatment of acute and chronic heart failure (HF). This article aims to review these recommendations and their level of scientific evidence and to present the most innovative aspects. The most significant deviations from the 2012 edition are: 1) the introduction of the concept of HF with midrange LVEF (40-49%); 2) a new diagnostic algorithm for chronic HF, initially considering the clinical probability; 3) recommendations on preventing or delaying the apparition of HF; 4) indications for the use of the new sacubitril-valsartan compound, the first angiotensin receptor blocker and neprilysin inhibitor; 5) modification of indications for cardiac resynchronisation therapy; and 6) a new algorithm for a combined diagnostic and treatment strategy for acute HF based on the presence or absence of congestion and hypoperfusion. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
Riehle, Christian; Abel, E. Dale
Heart failure is associated with generalized insulin resistance. Moreover, insulin resistant states such as type 2 diabetes and obesity increases the risk of heart failure even after adjusting for traditional risk factors. Insulin resistance or type 2 diabetes alters the systemic and neurohumoral milieu leading to changes in metabolism and signaling pathways in the heart that may contribute to myocardial dysfunction. In addition, changes in insulin signaling within cardiomyocytes develop in the failing heart. The changes range from activation of proximal insulin signaling pathways that may contribute to adverse left ventricular remodeling and mitochondrial dysfunction to repression of distal elements of insulin signaling pathways such as forkhead (FOXO) transcriptional signaling or glucose transport which may also impair cardiac metabolism, structure and function. This article will review the complexities of insulin signaling within the myocardium and ways in which these pathways are altered in heart failure or in conditions associated with generalized insulin resistance. The implications of these changes for therapeutic approaches to treating or preventing heart failure will be discussed. PMID:27034277
Ballard, G.M.; Games, A.M.
The basic design principle used in ensuring the safe operation of nuclear power plant is defence in depth. This normally takes the form of redundant equipment and systems which provide protection even if a number of equipment failures occur. Such redundancy is particularly effective in ensuring that multiple, independent equipment failures with the potential for jeopardising reactor safety will be rare events. However the achievement of high reliability has served to highlight the potentially dominant role of multiple, dependent failures of equipment and systems. Analysis of reactor operating experience has shown that dependent failure events are the major contributors to safety system failures and reactor incidents and accidents. In parallel PSA studies have shown that the results of a safety analysis are sensitive to assumptions made about the dependent failure (CCF) probability for safety systems. Thus a Westinghouse Analysis showed that increasing system dependent failure probabilities by a factor of 5 led to a factor 4 increase in core. This paper particularly refers to the engineering concepts underlying dependent failure assessment touching briefly on aspects of data. It is specifically not the intent of our work to develop a new mathematical model of CCF but to aid the use of existing models
Liu, Hao-Ran; Dong, Ming-Ru; Yin, Rong-Rong; Han, Li
In the practical wireless sensor networks (WSNs), the cascading failure caused by a failure node has serious impact on the network performance. In this paper, we deeply research the cascading failure of scale-free topology in WSNs. Firstly, a cascading failure model for scale-free topology in WSNs is studied. Through analyzing the influence of the node load on cascading failure, the critical load triggering large-scale cascading failure is obtained. Then based on the critical load, a control method for cascading failure is presented. In addition, the simulation experiments are performed to validate the effectiveness of the control method. The results show that the control method can effectively prevent cascading failure. Project supported by the Natural Science Foundation of Hebei Province, China (Grant No. F2014203239), the Autonomous Research Fund of Young Teacher in Yanshan University (Grant No. 14LGB017) and Yanshan University Doctoral Foundation, China (Grant No. B867).
In this paper, a general framework for child injury prevention and a multi-objective, multi-dimensional mixed 0-1 knapsack model were developed to determine the optimal time to introduce preventive measures against child injuries. Furthermore, the model maximises the prevention of injuries with the highest risks for each age period by combining preventive measures and supervision as well as satisfying budget limits and supervision time constraints. The risk factors for each injury, variable, and time period were based on risk priority numbers (RPNs) obtained from failure mode and effects analysis (FMEA) methodology, and these risk factors were incorporated into the model as objective function parameters. A numerical experiment based on several different situations was conducted, revealing that the model provided optimal timing of preventive measures for child injuries based on variables considered.
Some probabilistic aspects of fracture in structural and mechanical components are examined. The principles of fracture mechanics, material quality and inspection uncertainty are formulated into a conceptual and analytical framework for prediction of failure probability. The role of probabilistic fracture mechanics in a more global context of risk and optimization of decisions is illustrated. An example, where Monte Carlo simulation was used to implement a probabilistic fracture mechanics analysis, is discussed. (orig.)
Alings, M; Smit, M D; Moes, M L; Crijns, H J G M; Tijssen, J G P; Brügemann, J; Hillege, H L; Lane, D A; Lip, G Y H; Smeets, J R L M; Tieleman, R G; Tukkie, R; Willems, F F; Vermond, R A; Van Veldhuisen, D J; Van Gelder, I C
Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.
Manzano, M.; Marzo, J. L.; Calle, E.
on topological characteristics. Recently approaches also consider the services supported by such networks. In this paper we carry out a robustness analysis of five real backbone telecommunication networks under defined multiple failure scenarios, taking into account the consequences of the loss of established......Nowadays the ubiquity of telecommunication networks, which underpin and fulfill key aspects of modern day living, is taken for granted. Significant large-scale failures have occurred in the last years affecting telecommunication networks. Traditionally, network robustness analysis has been focused...... connections. Results show which networks are more robust in response to a specific type of failure....
Yang, Yongsheng; Khan, Faisal; Thodi, Premkumar; Abbassi, Rouzbeh
Pipeline corrosion is one of the main causes of subsea pipeline failure. It is necessary to monitor and analyze pipeline condition to effectively predict likely failure. This paper presents an approach to analyze the observed abnormal events to assess the condition of subsea pipelines. First, it focuses on establishing a systematic corrosion failure model by Bow-Tie (BT) analysis, and subsequently the BT model is mapped into a Bayesian Network (BN) model. The BN model facilitates the modelling of interdependency of identified corrosion causes, as well as the updating of failure probabilities depending on the arrival of new information. Furthermore, an Object-Oriented Bayesian Network (OOBN) has been developed to better structure the network and to provide an efficient updating algorithm. Based on this OOBN model, probability updating and probability adaptation are performed at regular intervals to estimate the failure probabilities due to corrosion and potential consequences. This results in an interval-based condition assessment of subsea pipeline subjected to corrosion. The estimated failure probabilities would help prioritize action to prevent and control failures. Practical application of the developed model is demonstrated using a case study. - Highlights: • A Bow-Tie (BT) based corrosion failure model linking causation with the potential losses. • A novel Object-Oriented Bayesian Network (OOBN) based corrosion failure risk model. • Probability of failure updating and adaptation with respect to time using OOBN model. • Application of the proposed model to develop and test strategies to minimize failure risk.
Waddell, J Neil; Payne, Alan G T; Swain, Michael V; Kieser, Jules A
Soldered or cast bars are used as a standard of care in attachment systems supporting maxillary and mandibular implant overdentures. When failures of these bars occur, currently there is a lack of evidence in relation to their specific etiology, location, or nature. To investigate the failure process of a case series of six failed soldered bars, four intact soldered bars, and one intact cast milled bar, which had been supporting implant overdentures. A total of 11 different overdenture bars were removed from patients with different configuration of opposing arches. A failed bar (FB) group (n = 6) had failed soldered overdenture bars, which were recovered from patients following up to 2 years of wear before requiring prosthodontic maintenance and repair. An intact bar (IB) group (n = 5) had both soldered bars and a single cast milled bar, which had been worn by patients for 2 to 5 years prior to receiving other aspects of prosthodontic maintenance. All bars were examined using scanning electron microscopy to establish the possible mode of failure (FB) or to identify evidence of potential failure in the future (IB). Evidence of a progressive failure mode of corrosion fatigue and creep were observed on all the FB and IB usually around the solder areas and nonoxidizing gold cylinder. Fatigue and creep were also observed in all the IB. Where the level of corrosion was substantial, there was no evidence of wear from the matrices of the attachment system. Evidence of an instantaneous failure mode, ductile and brittle overload, was observed on the fracture surfaces of all the FB, within the solder and the nonoxidizing gold cylinders, at the solder/cylinder interface. Corrosion, followed by corrosion fatigue, appears to be a key factor in the onset of the failure process for overdenture bars in this case series of both maxillary and mandibular overdentures. Limited sample size and lack of standardization identify trends only but prevent broad interpretation of the findings.
Brain oedema leading to intracranial hypertension occurs in a significant proportion of patients with acute liver failure in whom it is a leading cause of death. Although precise pathogenic mechanisms associated to this severe complication remain incompletely understood, increasing evidence points to gut-derived neurotoxins including ammonia as key mediators in cerebral osmotic and perfusion disturbances. The management of brain oedema and intracranial hypertension requires a multidisciplinar approach in a center where liver transplantation is available, as this option is the only treatment modality that provides improvement in outcome. This article reviews the most common causes of acute liver failure and the standard of supportive care management, and describes future potential therapeutic aspects of brain oedema and intracranial hypertension.
Kristiansen, Monica; Winther, Rune
This report looks into some aspects of using Bayesian hypothesis testing to find upper bounds for software failure probabilities. In the first part, the report evaluates the Bayesian hypothesis testing approach for finding upper bounds for failure probabilities of single software components. The report shows how different choices of prior probability distributions for a software component's failure probability influence the number of tests required to obtain adequate confidence in a software component. In the evaluation, both the effect of the shape of the prior distribution as well as one's prior confidence in the software component were investigated. In addition, different choices of prior probability distributions are discussed based on their relevance in a software context. In the second part, ideas on how the Bayesian hypothesis testing approach can be extended to assess systems consisting of multiple software components are given. One of the main challenges when assessing systems consisting of multiple software components is to include dependency aspects in the software reliability models. However, different types of failure dependencies between software components must be modelled differently. Identifying different types of failure dependencies are therefore an important condition for choosing a prior probability distribution, which correctly reflects one's prior belief in the probability for software components failing dependently. In this report, software components include both general in-house software components, as well as pre-developed software components (e.g. COTS, SOUP, etc). (Author)
Bruhn, John G
Making the bottom line is a fact of life in the business and corporate world. However, when organizations and their leaders become fixated on the bottom line and ignore values, an environment conducive to ethics failure is nurtured. Ethics failure has focused almost exclusively on the behavior of organizational leaders. However, it is the interaction of the culture of organizations and the character of their leaders that create the environment and social situations conducive to ethics failure. Although ethics failure is not totally preventable, there are usually warning signs early in the recruitment process of prospective CEOs that predict ethics failure. The author suggests that specific up-front questions be asked to ascertain the ethical fitness of prospective CEOs.
Organization and execution of roentgenofluorographic examinations in the USSR is supervised by laws of the Ministry of public health of the USSR, instructions, methodical recommendations. These documents and their additions concerning preventive measures against tuberculosis, standard norms of medical personnel, necessary preventive examinations and other aspects of conducting roentgenofluorographic examinations are discussed
Turbine Blade design and engineering is one of the most complicated and important aspects of turbine technology. Experiments with blades can be simple or very complicated, depending upon parameters of analysis. Turbine blades are subjected to vigorous environments, such as high temperatures, high stresses, and a potentially high vibration environment. All these factors can lead to blade failures, which can destroy the turbine, and engine, so careful design is the prime consideration to resist those conditions. A high cycle of fatigue of compressor and turbine blades due to high dynamic stress caused by blade vibration and resonance within the operating range of machinery is common failure mode for turbine machine. Continuous study and investigation on failure of turbine blades are going on since last five decades. Some review papers published during these days aiming to present a review on recent studies and investigations done on failures of turbine blades. All the detailed literature related with the turbine blades has not been described but emphasized to provide all the methodologies of failures adopted by various researches to investigate turbine blade. This paper illustrate on various factors of failure.
Rodrigo W A Souza
Full Text Available Heart failure (HF is associated with cachexia and consequent exercise intolerance. Given the beneficial effects of aerobic exercise training (ET in HF, the aim of this study was to determine if the ET performed during the transition from cardiac dysfunction to HF would alter the expression of anabolic and catabolic factors, thus preventing skeletal muscle wasting.We employed ascending aortic stenosis (AS inducing HF in Wistar male rats. Controls were sham-operated animals. At 18 weeks after surgery, rats with cardiac dysfunction were randomized to 10 weeks of aerobic ET (AS-ET or to an untrained group (AS-UN. At 28 weeks, the AS-UN group presented HF signs in conjunction with high TNF-α serum levels; soleus and plantaris muscle atrophy; and an increase in the expression of TNF-α, NFκB (p65, MAFbx, MuRF1, FoxO1, and myostatin catabolic factors. However, in the AS-ET group, the deterioration of cardiac function was prevented, as well as muscle wasting, and the atrophy promoters were decreased. Interestingly, changes in anabolic factor expression (IGF-I, AKT, and mTOR were not observed. Nevertheless, in the plantaris muscle, ET maintained high PGC1α levels.Thus, the ET capability to attenuate cardiac function during the transition from cardiac dysfunction to HF was accompanied by a prevention of skeletal muscle atrophy that did not occur via an increase in anabolic factors, but through anti-catabolic activity, presumably caused by PGC1α action. These findings indicate the therapeutic potential of aerobic ET to block HF-induced muscle atrophy by counteracting the increased catabolic state.
Advanced Materials and Process Technology for Mechanical Failure Prevention (Proceedings of the Meeting of the Mechanical Failures Prevention Group (48th) Held in Wakefield, Massachusetts on 19-21 April 1994,
stress rupture fractured specimens (a) as- ROC’ed, (b) beat treated by schedule 2. (a) (b) (c) (d) Figure 6: SEM fractographs of super-a, tensile... beat 195 - - . -i The microstructure in the weld region and at the fatigue failures was studied and related o the observed failures.Fati ue data are...inspector also can use one or two audio output channels for either mono or stereo ( binaural ) presentation of the aural information. Auralkatlon of
Verdezoto, Nervo; Grönvall, Erik
for self-measuring, the importance of interpretation, understanding and health awareness, sharing self-monitoring information for prevention, various motivational factors, the role of the doctor in prevention, and the home as a distributed information space. An awareness of these aspects can help designers......, to understand existing challenges, and uncover opportunities for self-monitoring technologies to support preventive healthcare activities among older adults. From our study, several important aspects emerged to consider when designing preventive self-monitoring technology, such as the complexity of guidelines...... how these aspects can both inform people engaged in Quantified Self activities and designers alike, and the tools and approaches that have sprung from the so-called Quantified Self movement...
Full Text Available Abstract Left ventricular (LV diastolic dysfunction (DD and diastolic heart failure (HF, that is symptomatic DD, are due to alterations of myocardial diastolic properties. These alterations involve relaxation and/or filling and/or distensibility. Arterial hypertension associated to LV concentric remodelling is the main determinant of DD but several other cardiac diseases, including myocardial ischemia, and extra-cardiac pathologies involving the heart are other possible causes. In the majority of the studies, isolated diastolic HF has been made equal to HF with preserved systolic function (= normal ejection fraction but the true definition of this condition needs a quantitative estimation of LV diastolic properties. According to the position of the European Society of Cardiology and subsequent research refinements the use of Doppler echocardiography (transmitral inflow and pulmonary venous flow and the new ultrasound tools has to be encouraged for diagnosis of DD. In relation to uncertain definitions, both prevalence and prognosis of diastolic heart failure are very variable. Despite an apparent lower death rate in comparison with LV systolic HF, long-term follow-up (more than 5 years show similar mortality between the two kinds of HF. Recent studies performed by Doppler diastolic indexes have identified the prognostic power of both transmitral E/A ratio 1.5 (restrictive patterns. The therapy of LV DD and HF is not well established but ACE-inhibitors, angiotensin inhibitors, aldosterone antagonists and β-blockers show potential beneficial effect on diastolic properties. Several trials, completed or ongoing, have been planned to treat DD and diastolic HF.
Donatella Del Sindaco
Full Text Available Donatella Del Sindaco1, Maria Denitza Tinti2, Luca Monzo2, Giovanni Pulignano2,1Heart Failure Unit, Division of Cardiology, INRCA Institute of Care and Research for Elderly, Rome, Italy; 2Heart Failure Clinic, Division of Cardiology/CCU, San Camillo Hospital, Rome, ItalyAbstract: Heart failure is a common and disabling condition with morbidity and mortality that increase dramatically with advancing age. Large observational studies, retrospective subgroup analyses and meta-analyses of clinical trials in systolic heart failure, and recently published randomized studies have provided data supporting the use of beta-blockers as a baseline therapy in heart failure in the elderly. Despite the available evidence about beta-blockers, this therapy is still less frequently used in elderly compared to younger patients. Nebivolol is a third-generation cardioselective beta-blocker with L-arginine/nitric oxide-induced vasodilatory properties, approved in Europe and several other countries for the treatment of essential hypertension, and in Europe for the treatment of stable, mild, or moderate chronic heart failure, in addition to standard therapies in elderly patients aged 70 years old or older. The effects of nebivolol on left ventricular function in elderly patients with chronic heart failure (ENECA and the study of effects of nebivolol intervention on outcomes and rehospitalization in seniors with heart failure (SENIORS have been specifically aimed to assess the efficacy of beta-blockade in elderly heart failure patients. The results of these two trials demonstrate that nebivolol is well tolerated and effective in reducing mortality and morbidity in older patients, and that the beneficial clinical effect is present also in patients with mildly reduced ejection fraction. Moreover, nebivolol appears to be significantly cost-effective when prescribed in these patients. However, further targeted studies are needed to better define the efficacy as well as
Essam Ali Al-Bahkali
Full Text Available Failure analysis in mechanical components has been investigated in many studies in the last few years. Failure analysis and prevention are important functions in all engineering disciplines. Materials engineers are often the lead role in the analysis of failures, where a component or product fails in service or if a failure occurs during manufacturing or production processing. In any case, one must determine the cause of the failure to prevent future occurrences and/or to improve the performance of the device, component or structure. For example, the vise jaw holders of hacksaws can break due to accidental heavy loads or machine misuse. The parts that break are the stationary and movable vise jaw holders and the connecter power screw between the holders. To investigate the failure of these components, a three-dimensional finite element model for stress analysis was performed. First, the analysis identified the broken components of the hacksaw machine. In addition, the type of materials of the broken parts was identified, a CAD model was built, and the hacksaw mechanism was analyzed to determine the accurate applied loads on the broken parts. After analyzing the model using Abaqus CAE software, the results showed that the location of the high stresses was identical with the high-stress locations in the original, broken parts. Furthermore, the power screw was subjected to a high load, which deformed the power screw. Also, the stationary vise jaw holder was broken by impact because it was not touched by the power screw until the movable vise jaw holder broke. A conclusion is drawn from the failure analysis and a way to improve the design of the broken parts is suggested.
Schauffler, H H
I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.
Paclt, Ivo; Přibilová, Nikol
Next to environmental factors and problems with interpersonal interaction in family represent developmental findings the basic of understanding these disorders (ADHD, conduct disorders, obsessive-compulsive disorders, tic disorders etc.). Knowledges of neurodevelopment disorders represent new possibilities of prevention and treatment.
The traditional approach to preventive maintenance (PM) is based on adherence to manufacturers's requirements and recommended frequencies. When equipment fails, either new procedures are established or the frequency is increased. This leads to an increase in the number of PM activities, overloading not only maintenance resources, but support as well. There is no correlation between more PM and an increase in equipment reliability. More PM may actually induce failures. Reliability-centered maintenance, a new concept in utility maintenance, is based on identifying system/subsystem functions, failures, and dominant failure modes to develop or revise PM tasks. The activities described in this paper are based on actual implementation of this concept on an ongoing project to upgrade the PM program at one of the largest electric utilities in the country. Optimum PM activities are those that, when implemented, will minimize factors that c cause equipment to fail. One technique described illustrates how equipment performance, failure modes, and causes can be related to minimize the occurrence of failures. Operating history and service life of a component are key factors in determining the most effective PM activities, provided that the factors are related to failure modes and causes
Dopamine is widely used in critical care to prevent renal function loss. Nevertheless sufficient evidence is still lacking of reduction in end points like mortality or renal replacement therapy. Dopaminergic treatment in chronic heart failure (CHF) has provided an example of unexpected adverse
Electric motor performance is vital to the reliable and efficient operation of power plants. The failure of one or more critical motors could cause lost capacity and excessive repair and maintenance cost. However, existing maintenance recommendations proposed by vendors for electric motors have sometimes encouraged many overly conservative maintenance practices. These practices have lead to excessive maintenance activities and costs which have provided no extra margin of operability. EPRI has sponsored RP2814-35 to develop a guide which provides power plants with information and guidance for establishing an effective maintenance program which will aid in preventing unexpected motor failures and assist in planning motor maintenance efforts. The guide includes a technical description which summarizes technical data relative to the four basic types of motors and their components in general use in power plants. The significant causes of motor failures are investigated and described in detail and methods to optimize service life and minimize maintenance cost through appropriate preventive maintenance and conditioning program are presented. This guide provides a foundation for an effective electric motor maintenance program and simplifies the selection of predictive and preventive maintenance tasks. Its use will enable maintenance personnel in nuclear and fossil plants to plan motor repairs during scheduled outages and avoid costly unexpected failures
Full Text Available Abstract Background: One of the common and important health problems is failure to thrive in childhood. The purpose of this study was to determine the effect of education on preventive behaviors of failure to thrive in mothers with children based on health belief model. Materials and Methods: This study is an interventional one in which 100 mothers with children one to five years involved (samples divided into two case and control groups, each of 50 sampling was done by a simple random method. For collecting information, a researcher-made questionnaire based on the health belief model and performance check list were used. Then, case group was trained for one month. 3 months after training, data were gathered and analyzed by Spss20 software. In addition to descriptive statistics, tests such as Chi-square, paired t-test and independent T-test were used. Results: The mean age of case and control was 29.98±5.51 and 25.35±5.30 years old, respectively. The average age of children was 23.31 ± 13.14 and 27.55 ± 14.01months, respectively. Before the intervention, no significant difference was seen between groups. The average score in case group before intervention was as: knowledge(31.87±14.24, perceived susceptibility(64.23±5.86, perceived severity(64.41±9.34, perceived benefits(61.75±6.79, perceived barriers(67.91±8.14, self-efficacy(68.00±7.87, cues to action(44.53±6.82 and action(70.00±9.77. However, after the intervention, significant differences between groups in all variables were obserred. Conclusion: According to the results, education based on health belief model is recommended for promoting preventive behaviors of failure to thrive.
I. S. Tartakovsky
Full Text Available The nosocomial or hospital acquired infections is one of the most important medical and social problem. Mo- dern strategy of nosocomial infections prevention include prevention of nosocomial legionellosis. Epidemic outbreaks of nosocomial legionellosis with high mortality rate (20–40% were recognized last years in different countries. The contaminated by Legionella hospital hot water supply system is a source of Legionella infection outbreaks. A risk reduction strategy of waterborne pathogens in hospital water system is important part of mo- dern conception of nosocomial infection prevention, especially among immune compromised patient including transplant patients. In revue discussed different aspects of epidemiology, laboratory diagnostic and prevention of nosocomial legionellosis.
Nelson, H. G.
Premature hydrogen-induced failure observed to occur in many metal systems involves three stages of fracture: (1) crack initiation, (2) stable slow crack growth, and (3) unstable rapid crack growth. The presence of hydrogen at some critical location on the metal surface or within the metal lattice was shown to influence one or both of the first two stages of brittle fracture but has a negligible effect on the unstable rapid crack growth stage. The relative influence of the applied parameters of time, temperature, etc., on the propensity of a metal to exhibit hydrogen induced premature failure was investigated.
Morris, Spencer A; Van Swol, Mark; Udani, Bela
Arrange for echocardiography or radionuclide angiography within 72 hours of a heart failure exacerbation. An ejection fraction >50% in the presence of signs and symptoms of heart failure makes the diagnosis of diastolic heart failure probable. To treat associated hypertension, use angiotensin receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, calcium channel blockers, or diuretics to achieve a blood pressure goal of <130/80 mm Hg. When using beta-blockers to control heart rate, titrate doses more aggressively than would be done for systolic failure, to reach a goal of 60 to 70 bpm. Use ACE inhibitors/ARBs to decrease hospitalizations, decrease symptoms, and prevent left ventricular remodeling.
Walshe, Kieran; Shortell, Stephen M
Concern about patient safety, caused in part by high-profile major failures in which many patients have been harmed, is rising worldwide. This paper draws on examples of such failures from several countries to analyze how these events are dealt with and to identify lessons and recommendations for policy. Better systems are needed for reporting and investigating failures and for implementing the lessons learned. The culture of secrecy, professional protectionism, defensiveness, and deference to authority is central to such major failures, and preventing future failures depends on cultural as much as structural change in health care systems and organizations.
The author debates public health aspects of food irradiation. The effect of food irradiation as a convenience to the consumer is discussed, i.e. the prevention of food deterioration and also the prevention of disease that could be passed on to the consumer by ingestion. On the other hand, the effects that could possibly be created by the application of radiation are also evaluated using toxicological and microbiological considerations. (Auth.)
The medical aspects of surfing include ear and eye injuries and sprains and strains of the lower back and neck, as well as skin cancer from exposure to the sun. Treatment, rehabilitation, and prevention of these problems are discussed. Surfing is recommended as part of an exercise program for reasonably healthy people. (Author/MT)
Gangloff, W.C.; Franke, T.H.
Safety systems for nuclear reactors can be designed using standard reliability engineering techniques such that system failure due to random component faults is extremely unlikely. However, the common-mode failure where several components fail together from a common cause is not susceptible to prevention by the usual tactics. In systems where a high degree of redundancy has been employed, the actual reliability of the system in service may be limited by common-mode failures. A methodical and thorough procedure for evaluation of system vulnerability to common-mode failures is presented. This procedure was developed for use in nuclear reactor safety systems and has been applied specifically to reactor protection. The method offers a qualitative assessment of a system whereby weak points can be identified and the resistance to common-mode failure can be judged. It takes into account all factors influencing system performance including design, manufacturing, installation, operation, testing, and maintenance. It is not a guarantee or sure solution, but rather a practical tool which can provide good assurance that the probability of common-mode protection failure has been made acceptably low. (author)
Full Text Available In recent years, risk analysis techniques have proved to be a useful tool to inform dam safety management. This paper summarizes the outcomes of three themes related to dam risk analysis discussed in the Benchmark Workshops organized by the International Commission on Large Dams Technical Committee on “Computational Aspects of Analysis and Design of Dams.” In the 2011 Benchmark Workshop, estimation of the probability of failure of a gravity dam for the sliding failure mode was discussed. Next, in 2013, the discussion focused on the computational challenges of the estimation of consequences in dam risk analysis. Finally, in 2015, the probability of sliding and overtopping in an embankment was analyzed. These Benchmark Workshops have allowed a complete review of numerical aspects for dam risk analysis, showing that risk analysis methods are a very useful tool to analyze the risk of dam systems, including downstream consequence assessments and the uncertainty of structural models.
Alimani - Jakupi, Jetmire; Iljovska, Snezana; Pavlevska, Meri; Naskova, Sanja
The analysis of the trends of the caries dispersion in the developed countries in the last 40 years, show signifi cantly diminished values of CIA (caries index average) from11 to 4. But, the situati on in the developing countries is completely diff erent. The caries goes upwards, and CIA is increased for 5 points in the last 20 years. (WHO 2000) The purposel of our study would be to suggest a strategy for preventive dental protecti on which will be applied on the whole territory of the countr...
Okoshi, Marina Politi; Capalbo, Rafael Verardino; Romeiro, Fernando G; Okoshi, Katashi
Cachexia is a prevalent pathological condition associated with chronic heart failure. Its occurrence predicts increased morbidity and mortality independent of important clinical variables such as age, ventricular function, or heart failure functional class. The clinical consequences of cachexia are dependent on both weight loss and systemic inflammation, which accompany cachexia development. Skeletal muscle wasting is an important component of cachexia; it often precedes cachexia development and predicts poor outcome in heart failure. Cachexia clinically affects several organs and systems. It is a multifactorial condition where underlying pathophysiological mechanisms are not completely understood making it difficult to develop specific prevention and treatment therapies. Preventive strategies have largely focused on muscle mass preservation. Different treatment options have been described, mostly in small clinical studies or experimental settings. These include nutritional support, neurohormonal blockade, reducing intestinal bacterial translocation, anemia and iron deficiency treatment, appetite stimulants, immunomodulatory agents, anabolic hormones, and physical exercise regimens. Currently, nonpharmacological therapy such as nutritional support and physical exercise are considered central to cachexia prevention and treatment.
Li, Wei; Kennedy, David; Shao, Zhili; Wang, Xi; Kamdar, Andre Klaassen; Weber, Malory; Mislick, Kayla; Kiefer, Kathryn; Morales, Rommel; Agatisa-Boyle, Brendan; Shih, Diana M; Reddy, Srinivasa T; Moravec, Christine S; Tang, W H Wilson
Mitochondrial oxidation is a major source of reactive oxygen species (ROS) and mitochondrial dysfunction plays a central role in development of heart failure (HF). Paraoxonase 2 deficient (PON2-def) mitochondria are impaired in function. In this study, we tested whether PON2-def aggravates HF progression. Using qPCR, immunoblotting and lactonase activity assay, we demonstrate that PON2 activity was significantly decreased in failing hearts despite increased PON2 expression. To determine the cardiac-specific function of PON2, we performed heart transplantations in which PON2-def and wild type (WT) donor hearts were implanted into WT recipient mice. Beating scores of the donor hearts, assessed at 4 weeks post-transplantation, were significantly decreased in PON2-def hearts when compared to WT donor hearts. By using a transverse aortic constriction (TAC) model, we found PON2 deficiency significantly exacerbated left ventricular remodeling and cardiac fibrosis post-TAC. We further demonstrated PON2 deficiency significantly enhanced ROS generation in heart tissues post-TAC. ROS generation was measured through dihydroethidium (DHE) using high-pressure liquid chromatography (HPLC) with a fluorescent detector. By using neonatal cardiomyocytes treated with CoCl 2 to mimic hypoxia, we found PON2 deficiency dramatically increased ROS generation in the cardiomyocytes upon CoCl 2 treatment. In response to a short CoCl 2 exposure, cell viability and succinate dehydrogenase (SDH) activity assessed by MTT assay were significantly diminished in PON2-def cardiomyocytes compared to those in WT cardiomyocytes. PON2-def cardiomyocytes also had lower baseline SDH activity. By using adult mouse cardiomyocytes and mitochondrial ToxGlo assay, we found impaired cellular ATP generation in PON2-def cells compared to that in WT cells, suggesting that PON2 is necessary for proper mitochondrial function. Our study suggests a cardioprotective role for PON2 in both experimental and human heart
Molen, Yara Fleury; Carvalho, Luciane Bizari Coin; Prado, Lucila Bizari Fernandes do; Prado, Gilmar Fernandes do
Insomnia involves difficulty in falling asleep, maintaining sleep or having refreshing sleep. This review gathers the existing informations seeking to explain insomnia, including those that focus on psychological aspects and those considered neurobiological. Insomnia has been defined in psychological (cognitive components, such as worries and rumination, and behavioral aspects, such as classic conditioning) and physiological terms (increased metabolic rate, with increased muscle tone, heart rate and temperature). From the neurobiological point of view, there are two perspectives: one which proposes that insomnia occurs in association with a failure to inhibit wakefulness and another that considers hyperarousal as having an important role in the physiology of sleep. The non-pharmacological interventions developed to face different aspects of insomnia are presented.
Mary T Quinn Griffin
Full Text Available Mary T Quinn Griffin1, Yi-Hui Lee2, Ali Salman1, Yaewon Seo1, Patricia A Marin3, Randall C Starling3, Joyce J Fitzpatrick11Frances Payne Bolton School of Nursing Case Western Reserve University Cleveland, OH; 2College of Nursing and Health Wright State University Dayton, OH; 3Cleveland Clinic, Cleveland, OhioAbstract: Heart failure is a chronic debilitating disease that affects all aspects of a person’s life, including physical, mental and spiritual dimensions. The associations among these dimensions, and the relationship to overall health status, have not been clearly identified. The purpose of this quantitative, descriptive study was to explore differences between spirituality, depressive symptoms, and quality of life among elders with and without heart failure. A total of 44 elders with heart failure and 40 non-heart failure elders completed several questionnaires including: The Daily Spiritual Experiences Scale (DSES, Spirituality Index of Well-Being (SIWB, Center for Epidemiologic Studies Depression Scale (CES-D, and SF-12™ Health Survey. There were significant differences in the groups on gender and ethnicity; thus these variables were controlled in the analyses related to the dependent variables. After controlling for gender and ethnicity, there were significant differences in the physical component of quality of life and spiritual well-being. The heart failure patients had significantly lower physical quality of life but more spiritual well-being than the non-heart failure patients. There were no significant differences in daily spiritual experiences, mental component of quality of life, and depressive symptoms between the two groups.Keywords: spiritual experience, spiritual well-being, heart failure, depressive symptoms, quality of life, elders
Feb 1, 1999 ... Together with the growing clinical problem of heart failure, new information at a .... nificantly raised in the prevention as well as the treatment arms when .... tricular dysfunction and pulmonary oedema in humans; experimentally ... adenine dinucleotide (reduced) and the rate-limiting amino acid (L-arginine).
Full Text Available Immune infertility, in terms of reproductive failure, has become a serious health issue involving approximately 1 out of 5 couples at reproductive age. Semen that is defined as a complex fluid containing sperm, cellular vesicles and other cells and components, could sensitize the female genital tract. The immune rejection of male semen in the female reproductive tract is explained as the failure of natural tolerance leading to local and/or systemic immune response. Present active immune mechanism may induce high levels of anti-seminal/sperm antibodies. It has already been proven that iso-immunization is associated with infertility. Comprehensive studies with regards to the identification of antibody-targets and the determination of specific antibody class contribute to the development of effective immuno-therapy and, on the other hand, potential immuno-contraception, and then of course to complex patient diagnosis. This review summarizes the aspects of female immune infertility.
Kautz, Karlheinz; Cecez-Kecmanovic, Dubravka
The aim of this essay is to put forward a performative, sociomaterial perspective on Information Systems (IS) success and failure in organisations by focusing intently upon the discursive-material nature of IS development and use in practice. Through the application of Actor Network Theory (ANT...... for their inadequate consideration of the materiality of IS, of its underling technologies and of the entanglement of the social and material aspects of IS development and use. From a sociomaterial perspective IS are not seen as objects that impact organisations one way or another, but instead as relational effects...... continually enacted in practice. As enactments in practice IS development and use produce realities of IS success and failure....
Ludmila Aleksandrovna Suplotova
Full Text Available Aim. To evaluate the effectiveness of regional programs for the prevention of iodine deficiency in the Tyumen region and explore the awareness and behaviors of different groups of the population in matters of iodine prophylaxis in the conditions absence of federal law on universal salt iodization. Materials and methods. The results are presented of the realization of regional programs for the prevention of iodine deficiency in the Tyumen region for the period 1994–2014 years. As part of the medical monitoring examined 18,906 prepubertal children 8–12 years with the use of a unified system of identification of iodine deficiency. The results of sociological research are presented, as part of a public health monitoring conducted by surveying students (n = 744 and their parents (n = 677 on a representative sample. Results. Iodine nutrition use was normalization through 3 years against the background of the realization regional program of iodine prophylaxis since 1997 in the Tyumen region, as evidenced by normalization of urinary iodine excretion in prepubertal children. The median urinary iodine in prepubertal children significantly increased from baseline 71.4 mg/l to 142 mg/l in 2009, and as a result decreased the frequency of goiter in children 8–10 years from 87% to 8%, which corresponds to mild endemic goiter region. It noted a lack of awareness of parents of iodine deficiency in the area of residence (54.8% informed their parents of schoolchildren; indicator is linked to gender, age (p < 0.01, education (p < 0.001, and where do you live respondents (p < 0.001. Knowledge of the existence and availability of prevention of iodine deficiency showed 75% of parents and 46.6% of students. Regular use of iodized salt in the home diet (“always used” and “often iodized salt than non-iodised” 57.4% of parents say. To identify various models of preventive behaviors of parents of schoolchildren in the prevention of iodine deficiency
Tepel, Martin; van der Giet, Markus; Statz, Mario
Patients with end-stage renal failure have increased oxidative stress and show elevated cardiovascular mortality. Whether increased cardiovascular events can be prevented by the administration of antioxidants is unknown.......Patients with end-stage renal failure have increased oxidative stress and show elevated cardiovascular mortality. Whether increased cardiovascular events can be prevented by the administration of antioxidants is unknown....
Ho, Chao Chung; Liao, Ching-Jong
Highlights: → This study is based on a real case in a regional teaching hospital in Taiwan. → We use Failure mode and effects analysis (FMEA) as the evaluation method. → We successfully identify the risk factors of infectious waste disposal. → We propose plans for the detection of exceptional cases of infectious waste. - Abstract: In recent times, the quality of medical care has been continuously improving in medical institutions wherein patient-centred care has been emphasized. Failure mode and effects analysis (FMEA) has also been promoted as a method of basic risk management and as part of total quality management (TQM) for improving the quality of medical care and preventing mistakes. Therefore, a study was conducted using FMEA to evaluate the potential risk causes in the process of infectious medical waste disposal, devise standard procedures concerning the waste, and propose feasible plans for facilitating the detection of exceptional cases of infectious waste. The analysis revealed the following results regarding medical institutions: (a) FMEA can be used to identify the risk factors of infectious waste disposal. (b) During the infectious waste disposal process, six items were scored over 100 in the assessment of uncontrolled risks: erroneous discarding of infectious waste by patients and their families, erroneous discarding by nursing staff, erroneous discarding by medical staff, cleaning drivers pierced by sharp articles, cleaning staff pierced by sharp articles, and unmarked output units. Therefore, the study concluded that it was necessary to (1) provide education and training about waste classification to the medical staff, patients and their families, nursing staff, and cleaning staff; (2) clarify the signs of caution; and (3) evaluate the failure mode and strengthen the effects.
Full Text Available Cloud computing is a novel technology in the field of distributed computing. Usage of Cloud computing is increasing rapidly day by day. In order to serve the customers and businesses satisfactorily fault occurring in datacenters and servers must be detected and predicted efficiently in order to launch mechanisms to tolerate the failures occurred. Failure in one of the hosted datacenters may propagate to other datacenters and make the situation worse. In order to prevent such situations one can predict a failure proliferating throughout the cloud computing system and launch mechanisms to deal with it proactively. One of the ways to predict failures is to train a machine to predict failure on the basis of messages or logs passed between various components of the cloud. In the training session the machine can identify certain message patterns relating to failure of data centers. Later on the machine can be used to check whether a certain group of message logs follow such patterns or not. Moreover each cloud server can be defined by a state which indicates whether the cloud is running properly or is facing some failure. Parameters such as CPU usage memory usage etc. can be maintained for each of the servers. Using this parameters we can add a layer of detection where in we develop a decision tree based on these parameters which can classify whether the passed in parameters to the decision tree indicate failure state or proper state.
Petroianni, A; Ceccarelli, D; Conti, V; Terzano, C
Aspiration pneumonias occur more frequently than reported and, in many cases, the disease is not recognised. In hospitalised and institutionalised patients with predisposing diseases prompt diagnosis of this complication and correct preventive measures can drastically reduce the worsening of clinical conditions and the deaths due to aspiration pneumonia. Normal airway structure, effective defence mechanisms, and preventive measures are decisive in reducing aspiration episodes. An increased aspiration risk for food, fluids, medications, or secretions may lead to the development of pneumonia. Pneumonia is the most common respiratory complication in all stroke deaths and in mechanical ventilation patients. In addition, the increased incidence of aspiration pneumonia with aging may be a consequence of impairment of swallowing and the cough reflex. Dysphagia, compromised consciousness, invasive procedures, anaesthesia, insufficient oral care, sleep disorders, and vomiting are all risk factors. Aspiration pneumonia includes different characteristic syndromes based on the amount (massive, acute, chronic) and physical character of the aspirated material (acid, infected, lipoid), needing a different therapeutic approach. Chronic patients education and correct health care practices are the keys for preventing the events of aspiration. In patients at risk a clinical and instrumental assessment of dysphagia should be evaluated. Management includes the removal of etiologic factors (drugs, tubes, mobilisation, oral hygiene), supportive care, and in bacterial pneumonias a specific antibiotic therapy for community-acquired or nosocomial events.
Eva María Guerra-Alia
Full Text Available To carry out a Failure Mode and Effects Analysis (FMEA to the use of oral syringes. Methods: A multidisciplinary team was assembled within the Safety Committee. The stages of oral administration process of liquid medication were analysed, identifying the most critical and establishing the potential modes of failure that can cause errors. The impact associated with each mode of failure was calculated using the Risk Priority Number (RPN. Preventive actions were proposed. Results: Five failure modes were identified, all classified as high risk (RPN> 100. Seven of the eight preventive actions were implemented. Conclusions: The FMEA methodology was a useful tool. It has allowed to know the risks, analyse the causes that cause them, their effects on patient safety and the measures to reduce them
Rising operating costs has caused maintenance professionals to rethink their strategy for preventive maintenance (PM) programs. Maintenance Templates are pre-engineered PM task recommendations for a component type based on application of the component. Development of the maintenance template considers the dominant failure cause of the component and the type of preventive maintenance that can predict or prevent the failure from occurring. Maintenance template development also attempts to replace fixed frequency tasks with condition monitoring tasks such as vibration analysis or thermography. For those components that have fixed frequency PM intervals, consideration is given to the maintenance drivers such as criticality, environment and usage. This helps to maximize the PM frequency intervals and maximize the component availability. Maintenance Templates have been used at PECO Energy's Limerick Generating Station during the Reliability Centered Maintenance (RCM) Process to optimize their PM program. This paper describes the development and uses of the maintenance templates
Full Text Available Internationally, services represent the most important sector of the economy both in terms of economic performance and labor utilization. Becoming essential part of today society, they are considered the basis of a healthy economy, fact that has increased the importance of services and the research in the field.T hrough this work we intend to address a number of issues that require clarification and are relevant to this sector. Increased competition and customers higher demands lead to difficulties in service delivery, so managers of service organizations must work hard towards developing appropiate strategies that can lead to improved customers satisfaction and to increased efficiency. Because it is inevitably for service providers to face situations in which service failure occurs and their customers are not satisfied, understanding the nature of service failures and the ways in which an organization can recover after a failure are considered key factors for achieving customer satisfaction. Since the data suggests that over 50% of customers who are facing problems are not satisfied with the way they were resolved, we consider appropriate to approach this topic. We intend to draw attention to service providers to the importance of proper management of service failure. They can find ways to recover from these failures and even to turn them into some very pleasant situations that can contribute to customer loyalty. This paper begins by highlighting the various features specific to services which contribute to the increased chances of failure, it continues by presenting the concepts of service failure and service recovery and then it presents some links that exist between service recovery and other aspects of providing services that are demonstrated in the literature. We hope that this paper will significantly contribute to the knowledge and development of the sector under analysis and will highlight some practices that will lead to improved
Ralph, Brandon C W; Thomson, David R; Cheyne, James Allan; Smilek, Daniel
Using a series of online self-report measures, we examine media multitasking, a particularly pervasive form of multitasking, and its relations to three aspects of everyday attention: (1) failures of attention and cognitive errors (2) mind wandering, and (3) attentional control with an emphasis on attentional switching and distractibility. We observed a positive correlation between levels of media multitasking and self-reports of attentional failures, as well as with reports of both spontaneous and deliberate mind wandering. No correlation was observed between media multitasking and self-reported memory failures, lending credence to the hypothesis that media multitasking may be specifically related to problems of inattention, rather than cognitive errors in general. Furthermore, media multitasking was not related with self-reports of difficulties in attention switching or distractibility. We offer a plausible causal structural model assessing both direct and indirect effects among media multitasking, attentional failures, mind wandering, and cognitive errors, with the heuristic goal of constraining and motivating theories of the effects of media multitasking on inattention.
Sheerin, Noella J; Newton, Phillip J; Macdonald, Peter S; Leung, Dominic Y C; Sibbritt, David; Spicer, Stephen Timothy; Johnson, Kay; Krum, Henry; Davidson, Patricia M
Acute decompensated heart failure is a common cause of hospitalisation. This is a period of vulnerability both in altered pathophysiology and also the potential for iatrogenesis due to therapeutic interventions. Renal dysfunction is often associated with heart failure and portends adverse outcomes. Identifying heart failure patients at risk of renal dysfunction is important in preventing progression to chronic kidney disease or worsening renal function, informing adjustment to medication management and potentially preventing adverse events. However, there is no working or consensus definition in international heart failure management guidelines for worsening renal function. In addition, there appears to be no concordance or adaptation of chronic kidney disease guidelines by heart failure guideline development groups for the monitoring of chronic kidney disease in heart failure. Our aim is to encourage the debate for an agreed definition given the prognostic impact of worsening renal function in heart failure. We present the case for the uptake of the Acute Kidney Injury Network criteria for acute kidney injury with some minor alterations. This has the potential to inform study design and meta-analysis thereby building the knowledgebase for guideline development. Definition consensus supports data element, clinical registry and electronic algorithm innovation as instruments for quality improvement and clinical research for better patient outcomes. In addition, we recommend all community managed heart failure patients have their baseline renal function classified and routinely monitored in accordance with established renal guidelines to help identify those at increased risk for worsening renal function or progression to chronic kidney disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Yürüşen, N. Y.; Tautz-Weinert, J.; Watson, S. J.; Melero, J. J.
Operation of wind farms is driven by the overall aim of minimising costs while maximising energy sales. However, in certain circumstances investments are required to guarantee safe operation and survival of an asset. In this paper, we discuss the merits of various catastrophic failure prevention strategies in a Spanish wind farm. The wind farm operator was required to replace blades in two phases: temporary and final repair. We analyse the power performance of the turbine in the different states and investigate four scenarios with different timing of temporary and final repair during one year. The financial consequences of the scenarios are compared with a baseline by using a discounted cash flow analysis that considers the wholesale electricity market selling prices and interest rates. A comparison with the UK electricity market is conducted to highlight differences in the rate of return in the two countries.
The APACHE code (Automatic Analysis of Failures of Hydraulic and Thermohydraulic Circuits more particularly of Water) situates in an important program of computer codes development in the field of studies on reliability and safety of systems in nuclear power plants. APACHE is an automatic generation code of failure pattern and of their effects. After a presentation of the theoretical basis, the methodological principles of the theory of networks are developed. Then, the model of the code is developed: model of individual behavior of each classical model component of normal behavior and model of failure pattern with specifications. The global model of hydraulic systems and the resolution systems are then developed. More particularly, some aspects of the theory of graphs, and the algorithms developed for the automatic construction of the equation systems and especially the algorithm of the research of meshes are presented. The computer aspect of the code and the programming of the code with its limits and some specifications are described. The practical aspect of utilization is finally presented [fr
McConnell, Kevin W; Coopersmith, Craig M
Postoperative organ failure is a challenging disease process that is better prevented than treated. Providers should use close observation and clinical judgment, and checklists of best practices to minimize the risk of organ failure in their patients. The treatment of multiorgan dysfunction syndrome (MODS) generally remains supportive, outside of rapid initiation of source control (when appropriate) and targeted antibiotic therapy. More specific treatments may be developed as the complex pathophysiology of MODS is better understood and more homogenous patient populations are selected for study. Copyright Â© 2012 Elsevier Inc. All rights reserved.
Yara Fleury Molen
Full Text Available Insomnia involves difficulty in falling asleep, maintaining sleep or having refreshing sleep. This review gathers the existing informations seeking to explain insomnia, including those that focus on psychological aspects and those considered neurobiological. Insomnia has been defined in psychological (cognitive components, such as worries and rumination, and behavioral aspects, such as classic conditioning and physiological terms (increased metabolic rate, with increased muscle tone, heart rate and temperature. From the neurobiological point of view, there are two perspectives: one which proposes that insomnia occurs in association with a failure to inhibit wakefulness and another that considers hyperarousal as having an important role in the physiology of sleep. The non-pharmacological interventions developed to face different aspects of insomnia are presented.
Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure. © EDP Sciences, SFODF, 2016.
Gupta, Punkaj; Kuperstock, Jacob E; Hashmi, Sana; Arnolde, Vickie; Gossett, Jeffrey M; Prodhan, Parthak; Venkataraman, Shekhar; Roth, Stephen J
The study aimed primarily to evaluate the efficacy of noninvasive ventilation (NIV) and to identify possible predictors for success of NIV therapy in preventing extubation failure in critically ill children with heart disease. The secondary objectives of this study were to assess the efficacy of prophylactic NIV therapy initiated immediately after tracheal extubation and to determine the characteristics, outcomes, and complications associated with NIV therapy in pediatric cardiac patients. A retrospective review examined the medical records of all children between the ages 1 day and 18 years who sustained acute respiratory failure (ARF) that required NIV in the cardiovascular intensive care unit (CVICU) at Lucile Packard Children's Hospital between January 2008 and June 2010. Patients were assigned to a prophylactic group if NIV was started directly after extubation and to a nonprophylactic group if NIV was started after signs and symptoms of ARF developed. Patients were designated as responders if they received NIV and did not require reintubation during their CVICU stay and nonresponders if they failed NIV and reintubation was performed. The data collected included demographic data, preexisting conditions, pre-event characteristics, event characteristics, and outcome data. The outcome data evaluated included success or failure of NIV, duration of NIV, CVICU length of stay (LOS), hospital LOS, and hospital mortality. The two complications of NIV assessed in the study included nasal bridge or forehead skin necrosis and pneumothorax. The 221 eligible events during the study period involved 172 responders (77.8 %) and 49 nonresponders (22.2 %). A total of 201 events experienced by the study cohort received continuous positive airway pressure (CPAP), with 156 responders (78 %), whereas 20 events received bilevel positive airway pressure (BiPAP), with 16 responders (80 %). In the study, 58 events (26.3 %) were assigned to the prophylactic group and 163 events (73
Wang, Wenbin; Zhao, Fei; Peng, Rui
Inspection is always an important preventive maintenance (PM) activity and can have different depths and cover all or part of plant systems. This paper introduces a two-level inspection policy model for a single component plant system based on a three-stage failure process. Such a failure process divides the system′s life into three stages: good, minor defective and severe defective stages. The first level of inspection, the minor inspection, can only identify the minor defective stage with a certain probability, but can always reveal the severe defective stage. The major inspection can however identify both defective stages perfectly. Once the system is found to be in the minor defective stage, a shortened inspection interval is adopted. If however the system is found to be in the severe defective stage, we may delay the maintenance action if the time to the next planned PM window is less than a threshold level, but otherwise, replace immediately. This corresponds to the well adopted maintenance policy in practice such as periodic inspections with planned PMs. A numerical example is presented to demonstrate the proposed model by comparing with other models. - Highlights: • The system′s deterioration goes through a three-stage process, namely, normal, minor defective and severe defective. • Two levels of inspections are proposed, e.g., minor and major inspections. • Once the minor defective stage is found, instead of taking a maintenance action, a shortened inspection interval is recommended. • When the severe defective stage is found, we delay the maintenance according to the threshold to the next PM. • The decision variables are the inspection intervals and the threshold to PM
Full Text Available Recent studies have found that endotoxin not only activates immune response, exacerbates liver injury, and induces liver failure, but also plays an important role in the development of hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, and other fatal complications. The recent progress in research on the pathogenesis of intestinal endotoxemia (IETM and its impact on the development and progression of liver failure is reviewed and summarized. It is suggested that seeking effective methods to prevent and control IETM holds promise as the key to treating severe liver disease and liver failure successfully.
González, M. R.; Torres, F.; Yoldi, V.; Arcega, F.; Plaza, I.
It is proposed an integrated management model for an organization. This model is based on the continuous improvement Plan-Do-Check-Act cycle and it intends to integrate the environmental, risk prevention and ethical aspects as well as research, development and innovation projects management in the general quality management structure proposed by ISO 9001:2008. It aims to fulfill the standards ISO 9001, ISO 14001, OSHAS 18001, SGE 21 y 166002.
Kurniasri Amas Achiar
Full Text Available The success of endodontic treatment depends on the quality of endodontic treatment and the final restoration. The mean reason for endodontic treatment failure is usually microleakage. That is why it becomes one of the priorities for dental research to prevent microleakage. Infection during the root canal treatment can be prevented. First, by employing strict aseptic clinical techniques follows by cleaning all bacteria and preoperative necrotic pulp-tissue remnants from the root canal. Irrigants are essential in this phase. The shaping of the canal is also an important prerequisite for endodontic success. Removal of the smear layer can enhance seal ability. Second, obturation of the root canal should leave the tooth in the most biological inert condition possible, and it must prevent reinfection as well as the growth of any microorganisms remaining in the canal. The application of an antibacterial dressing between appointments is absolutely necessary or the root canal has to be obturated at the first appointment in order to deprive the microorganisms of nutrients and space to multiply. The temporary filling must be at least 3.5 mm thick. Failure occurs because of missed canals, iatrogenic events and radicular fractures have to be avoided. At the end, clinicians have to confirm that the root canal is cleaned and hermetically obturated because hermetic root canal filling will prevent the leakage of an irritant to the apical area.
This paper rpesents a probabilistic approach to quantifying human error dependency when multiple tasks are performed. Dependent human failures are dominant contributors to risks from nuclear power plants. An overview of the Multiple Sequential Failure (MSF) model developed and its use in probabilistic risk assessments (PRAs) depending on the available data are discussed. A small-scale psychological experiment was conducted on the nature of human dependency and the interpretation of the experimental data by the MSF model show remarkable accommodation of the dependent failure data. The model, which provides an unique method for quantification of dependent failures in human reliability analysis, can be used in conjunction with any of the general methods currently used for performing the human reliability aspect in PRAs
F. Daams (Freek); M. Luyer (Misha); J.F. Lange (Johan)
textabstractAll colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years. New techniques of prevention, by innovative anastomotic techniques
Andre Pascal Kengne
Full Text Available Andre Pascal Kengne1, Anastase Dzudie2, Eugene Sobngwi31The George Institute for International Health, University of Sydney, Australia; 2Heart failure and transplantation Unit, Louis Pradel’s Cardiovascular Hospital, Lyon, France; 3National Obesity Centre, Yaounde Central Hospital, CameroonPurpose: Heart failure is the ultimate complication of cardiac involvements in diabetes. The purpose of this review was to summarize current literature on heart failure among people with diabetes mellitus in sub-Saharan Africa (SSA.Method: Bibliographic search of published data on heart failure and diabetes in sub-Saharan Africa over the past 26 years.Results: Heart failure remains largely unexplored in general population and among people with diabetes in Africa. Heart failure accounts for over 30% of hospital admission in specialized cardiovascular units and 3%–7% in general internal medicine. Over 11% of adults with heart failure have diabetes. Risk factors for heart failure among those with diabetes include classical cardiovascular risk factors, without evidence of diabetes distinctiveness for other predictors common in Africa. Prevention, management, and outcomes of heart failure are less well known; recent data suggest improvement in the management of risk factors in clinical settings.Conclusions: Diabetes mellitus is growing in SSA. Related cardiovascular diseases are emerging as potential health problem. Heart failure as cardiovascular complication remains largely unexplored. Efforts are needed through research to improve our knowledge of heart failure at large in Africa. Multilevel preventive measures, building on evidences from other parts of the world must go along side.Keywords: diabetes mellitus, cardiovascular diseases, heart failure, sub-Saharan Africa
Korsah, Kofi; Cetiner, Mustafa Sacit; Muhlheim, Michael David; Poore, Willis P. III
A study sponsored by the Nuclear Regulatory Commission study was conducted to investigate digital instrumentation and control (DI and C) systems and module-level failure modes using a number of databases both in the nuclear and non-nuclear industries. The objectives of the study were to obtain relevant operational experience data to identify generic DI and C system failure modes and failure mechanisms, and to obtain generic insights, with the intent of using results to establish a unified framework for categorizing failure modes and mechanisms. Of the seven databases studied, the Equipment Performance Information Exchange database was found to contain the most useful data relevant to the study. Even so, the general lack of quality relative to the objectives of the study did not allow the development of a unified framework for failure modes and mechanisms of nuclear I and C systems. However, an attempt was made to characterize all the failure modes observed (i.e., without regard to the type of I and C equipment under consideration) into common categories. It was found that all the failure modes identified could be characterized as (a) detectable/preventable before failures, (b) age-related failures, (c) random failures, (d) random/sudden failures, or (e) intermittent failures. The percentage of failure modes characterized as (a) was significant, implying that a significant reduction in system failures could be achieved through improved online monitoring, exhaustive testing prior to installation, adequate configuration control or verification and validation, etc.
Full Text Available Introduction: The mortality from cardiovascular disease in patients with chronic renal failure is much higher than in the general population. In particular, patients with chronic renal failure with replacement therapies (dialysis patients and patients with renal transplantation show both increased traditional risk factors and risk factors due to the dysfunction of the renal system. In combination with necessary medication for renal insufficiency oxidative stress is elevated. Progression of atherosclerosis is promoted due to increased oxidation of lipids and endothelium damage. This link between lipid oxidation and artherogenesis provides the rationale for the supposed beneficial effect of supplementation with antioxidative vitamins (vitamin A, C and E. Such an effect could not be demonstrated for patients with a history of cardiovascular disease and without kidney diseases. However, in high risk patients with chronic renal failure and renal replacement therapies this could be different. Objectives: The objective of this systematic literature review was to assess the clinical effectiveness and cost-effectiveness of supplementation with antioxidative vitamins A, C or E to reduce cardiovascular events in patients with chronic kidney diseases, dialysis-requiring patients and patients after a renal transplantation with or without cardiovascular diseases. Methods: A systematic literature review was conducted with documented search and selection of the literature, using a priori defined inclusion and exclusion criteria as well as a documented extraction and assessment of the literature according to the methods of evidence-based medicine. Results: 21 publications met the inclusion criteria for the evaluation of clinical effectiveness. No study could be identified for the economic evaluation. Two studies (four publications analysed the effect of oral supplementation on the secondary prevention of clinical cardiovascular endpoints. Studies analysing the
Ierodiakonou, C S
Preventive mental health measures can be properly planned only if the various factors leading to the adolescent's personality structure are extensively investigated. Starting with the specific attitudes of a couple towards genetic counselling, the disadvantages of urbanization and of the dissolution of the traditional extended family are discussed with regard to their effect on the younger members. Data are produced concerning the child-rearing practices of Greek in comparison to American parents and their effect on the adolescent's emotional life. Extreme dependence on the family, pressure for school achievements, lack of sexual education, etc. are characteristic of the stresses a Greek adolescent undergoes. Socio-cultural conditions, like immigration, adoption, etc. are shown to have a different psychological effect on an adolescent in Greece than in America. Specific stresses regarding the adolescent's future, like preparing for university entrance examinations, are discussed and preventive measures are proposed.
of delivery types; parts, components and subsystems. The project configuration and orchestrated governance forms are not always successful, and failures emerge. The paper aims at studying governance forms in delivery networks using operational failures as litmus. Operation management approaches is used...... failures occurred during three month observation. The costs were 8 pct. of the production budget. None of the mobilised governance forms fully prevented failures, especially subsystem delivery and internal integration was underperforming....... Supply networks in complex B2B- construction deliver knowledge, materials, components, subsystems, competences, workforce and management. The delivery network and its governance forms are partly permanent, partly project specific. Integration upstream varies by project, constituting a range...
Sudarno; Juarsa, Mulya; Santosa, Kussigit; Deswandri; Sunaryo, Geni Rina
In the nuclear reactor accident of Fukushima Daiichi in Japan, the damages of core and pressure vessel were caused by the failure of its active cooling system (diesel generator was inundated by tsunami). Thus researches on passive cooling system for Nuclear Power Plant are performed to improve the safety aspects of nuclear reactors. The FASSIP system (Passive System Simulation Facility) is an installation used to study the characteristics of passive cooling systems at nuclear power plants. The accuracy of sensor measurement of FASSIP system is essential, because as the basis for determining the characteristics of a passive cooling system. In this research, a sensor failure detection method for FASSIP system is developed, so the indication of sensor failures can be detected early. The method used is Principal Component Analysis (PCA) to reduce the dimension of the sensor, with the Squarred Prediction Error (SPE) and statistic Hotteling criteria for detecting sensor failure indication. The results shows that PCA method is capable to detect the occurrence of a failure at any sensor.
Gronnier, C; Degrandi, O; Collet, D
Surgical treatment of gastro-esophageal reflux disease (ST-GERD) is well-codified and offers an alternative to long-term medical treatment with a better efficacy for short and long-term outcomes. However, failure of ST-GERD is observed in 2-20% of patients; management is challenging and not standardized. The aim of this study is to analyze the causes of failure and to provide a treatment algorithm. The clinical aspects of ST-GERD failure are variable including persistent reflux, dysphagia or permanent discomfort leading to an important degradation of the quality of life. A morphological and functional pre-therapeutic evaluation is necessary to: (i) determine whether the symptoms are due to recurrence of reflux or to an error in initial indication and (ii) to understand the cause of the failure. The most frequent causes of failure of ST-GERD include errors in the initial indication, which often only need medical treatment, and surgical technical errors, for which surgical redo surgery can be difficult. Multidisciplinary management is necessary in order to offer the best-adapted treatment. Copyright © 2018. Published by Elsevier Masson SAS.
Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights From Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARESS-HF).
Lala, Anuradha; McNulty, Steven E; Mentz, Robert J; Dunlay, Shannon M; Vader, Justin M; AbouEzzeddine, Omar F; DeVore, Adam D; Khazanie, Prateeti; Redfield, Margaret M; Goldsmith, Steven R; Bart, Bradley A; Anstrom, Kevin J; Felker, G Michael; Hernandez, Adrian F; Stevenson, Lynne W
Congestion is the most frequent cause for hospitalization in acute decompensated heart failure. Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (eg, peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. A post hoc analysis was performed of 496 patients enrolled in the Diuretic Optimization Strategy Evaluation in Acute Decompensated Heart Failure (DOSE-AHF) and Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS-HF) trials during hospitalization with acute decompensated heart failure and clinical congestion. A simple orthodema congestion score was generated based on symptoms of orthopnea (≥2 pillows=2 points, fails to relieve orthodema during hospitalization or to prevent recurrence after discharge. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00608491, NCT00577135. © 2015 American Heart Association, Inc.
Full Text Available Effective maintenance is crucial for equipment performance in industry. Imperfect maintenance conform to actual failure process. Taking the dynamic preventive maintenance cost into account, the preventive maintenance model was constructed by using age reduction factor. The model regards the minimization of repair cost rate as final target. It use allowed smallest reliability as the replacement condition. Equipment life was assumed to follow two parameters Weibull distribution since it was one of the most commonly adopted distributions to fit cumulative failure problems. Eventually the example verifies the rationality and benefits of the model.
Honeywell, Inc., Minneapolis, Minn.
THIS HONEYWELL PAMPHLET DISCUSSES SOME ASPECTS OF PREVENTIVE MAINTENANCE OF AUTOMATIC CONTROLS, HEATING, VENTILATING, AND AIR CONDITIONING, AND COMPARES IN-PLANT WITH CONTRACT SERVICE, CONCLUDING THAT CONTRACT SERVICE IS PREFERABLE AND DESCRIBING A NUMBER OF MAINTENANCE PLANS WHICH THEY FURNISH. PREVENTIVE MAINTENANCE PROVIDES--(1) MORE EFFICIENT…
Full Text Available Although the efficiency of steel fibres for improving mechanical properties (cracking resistance and failure toughness of the concrete has been broadly discussed in the literature, the number of studies dedicated to the fibre effect on structural behaviour of the externally bonded elements is limited. This experimental study investigates the influence of steel fibres on the failure character of concrete elements strengthened with external carbon fibre reinforced polymer sheets. The elements were subjected to different loading conditions. The test data of four ties and eight beams are presented. Different materials were used for the internal bar reinforcement: in addition to the conventional steel, high-grade steel and glass fibre reinforced polymer bars were also considered. The experimental results indicated that the fibres, by significantly increasing the cracking resistance, alter the failure character from splitting of the concrete to the bond loss of the external sheets and thus noticeably increase the load bearing capacity of the elements.
Warriach, E.U.; Ozcelebi, T.; Lukkien, J.J.
The functional correctness and the performance of smart environment applications can be hampered by faults. Fault tolerance solutions aim to achieve graceful performance degradation in the presence of faults, ideally without leading to application failures. This is a reactive approach and, by
Varbo, Anette; Nordestgaard, Børge G
OBJECTIVE: The prevalence of heart failure is increasing in the aging population, and heart failure is a disease with large morbidity and mortality. There is, therefore, a need for identifying modifiable risk factors for prevention. We tested the hypothesis that high concentrations of nonfasting...... triglycerides and low-density lipoprotein cholesterol are associated with higher risk of heart failure in the general population. APPROACH AND RESULTS: We included 103 860 individuals from the Copenhagen General Population Study and 9694 from the Copenhagen City Heart Study in 2 prospective observational...... association studies. Nonfasting triglycerides and low-density lipoprotein cholesterol were measured at baseline. Individuals were followed for ≤23 years, during which time 3593 were diagnosed with heart failure. Hazard ratios were estimated using Cox proportional hazard regression models. In the Copenhagen...
Grall, A.; Dieulle, L.; Berenguer, C.; Roussignol, M.
This paper deals with a perfectly continuously monitored system which gradually and stochastically deteriorates. The system is renewed by a delayed maintenance operation, which is triggered when the measured deterioration level exceeds an alarm threshold. A mathematical model is developed to study the asymptotic behavior of the reliability function. A procedure is proposed which allows us to identify the asymptotic failure rate of the maintained system. Numerical experiments illustrate the efficiency of the proposed procedure and emphasize the relevance of the asymptotic failure rate as an interesting indicator for the evaluation of the control-limit preventive replacement policy
Grall, A. [Institut des Sciences et Technologies de l' Information de Troyes (CNRS-FRE 2732), Equipe de Modelisation et de Surete des Systemes, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France)]. E-mail: email@example.com; Dieulle, L. [Institut des Sciences et Technologies de l' Information de Troyes (CNRS-FRE 2732), Equipe de Modelisation et de Surete des Systemes, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France)]. E-mail: firstname.lastname@example.org; Berenguer, C. [Institut des Sciences et Technologies de l' Information de Troyes (CNRS-FRE 2732), Equipe de Modelisation et de Surete des Systemes, Universite de Technologie de Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France)]. E-mail: email@example.com; Roussignol, M. [Laboratoire d' Analyse et de Mathematiques Appliquees, Universite de Marne la Vallee, 5 bd Descartes, Champs sur Marne, 77454 Marne la Vallee, Cedex 2 (France)]. E-mail: firstname.lastname@example.org
This paper deals with a perfectly continuously monitored system which gradually and stochastically deteriorates. The system is renewed by a delayed maintenance operation, which is triggered when the measured deterioration level exceeds an alarm threshold. A mathematical model is developed to study the asymptotic behavior of the reliability function. A procedure is proposed which allows us to identify the asymptotic failure rate of the maintained system. Numerical experiments illustrate the efficiency of the proposed procedure and emphasize the relevance of the asymptotic failure rate as an interesting indicator for the evaluation of the control-limit preventive replacement policy.
Paskalev, D.; Balev, B.
Full text: The aim of the presentation is to review the contrast induced nephropathy ? nature, mechanisms of development, risk factors. Summary of the most important ways of prevention, diagnostics and treatment. The definition of CIN according the European Association of Urogenital Radiology is: 'A condition, in which renal function is impaired (elevation of serum creatinine with more than 25% or 44 μmol/l above the initial level) due to intravasal application of contrast media (CM) within 3 days following the application and when no other etiology factors are present'. We summarize the main risk factors of developing CIN - renal failure, diabetic nephropathy, dehydration, congestive heart failure, high blood pressure, age above 70 yrs, nephrotoxic medicines. The most effective ways of preventing CIN are the good hydratation of the patients and the usage of low-osmolar or iso-osmolar CM. Therapeutic treatment is with no proven preventive effect and currently is not routinely recommended. An early hem dialysis does not decrease the risk level of CIN development in patients with chronic renal failure (CRF). In such patients complete elimination of CM is achieved only after several hem dialyses. Hem filtration reliably decreases the risk of CIN in CRF patients, but is expensive and not widely available. We present a case from our hospital of a patient with diabetic nephropathy, who developed CIN following a coronary angiography
Kaminskiy, Mark P.
The article discusses some aspects of analogy between certain classes of distributions used as models for time to failure of nonrepairable objects, and the counting processes used as models for failure process for repairable objects. The notion of quantiles for the counting processes with strictly increasing cumulative intensity function is introduced. The classes of counting processes with increasing (decreasing) rate of occurrence of failures are considered. For these classes, the useful nonparametric bounds for cumulative intensity function based on one known quantile are obtained. These bounds, which can be used for repairable objects, are similar to the bounds introduced by Barlow and Marshall [Barlow, R. Marshall, A. Bounds for distributions with monotone hazard rate, I and II. Ann Math Stat 1964; 35: 1234-74] for IFRA (DFRA) time to failure distributions applicable to nonrepairable objects
Hellen, R.A.J.; Darlaston, B.J.L.; Connors, D.C.
In fitness for purpose studies of pressurized structures containing defects, the concept of leak before break is often invoked. As the assumptions used in the concept are sometimes very pessimistic it is desirable to be able to quantify them more precisely. Two aspects are currently receiving attention; these are the way in which a crack profile develops during fatigue and what happens when the remaining ligament below the crack fails. These aspects are being evaluated experimentally and theoretically. Data are presented from tests on pipes subjected to cyclic pressure and subsequently failed. An analytical approach is proposed on the question of ligament failure, this being based on the development of some recent work on flat plates. The overall question of leak before break is considered. As the understanding and confidence increases, it is possible to reduce the range of interest and focus on specific aspects of the problem. This paper examines these aspects. (author)
Olmos-Jiménez, Raquel; Espuny-Miró, Alberto; Cárceles-Rodríguez, Carlos; Díaz-Carrasco, María Sacramento
Abstract Introduction: Intrathecal chemotherapy is frequently used in clinical practice for treatment and prevention of neoplastic meningitis. Despite its widespread use, there is little information about practical aspects such as the volume of drug to be administered or its preparation and administration. Objective: To conduct a literature review about practical aspects of the use of intrathecal chemotherapy. Materials: Search in PubMed/ Medline using the terms “chemotherapy AND intrat...
Li, Guodong; An, Qi; Goddard, William A.; Hanus, Riley; Zhai, Pengcheng; Zhang, Qingjie; Snyder, G. Jeffrey
CoSb 3 based skutterudite thermoelectric material has superior thermoelectric properties, but the low fracture toughness prevents its widespread commercial application. To determine the origin of its brittle failure, we examined the response of shear deformation in CoSb 3 along the most plausible slip system (010)/<100>, using large-scale molecular dynamics simulations. We find that the brittle failure of CoSb 3 arises from the formation of shear bands due to the destruction of Sb4-rings and the slippage of Co-octahedraes. This leads to the breakage of Co-octahedraes and cavitation, resulting in the crack opening and mechanical failure.
A detailed description is given of the bubble chamber SIMBOL at the HOR reactor in Delft, Netherlands, including drawings, applied materials and dimensions. Attention is paid to the nuclear and radiological aspects of the installation and an overview is given of the procedures for the realization, the testing and the operational safety of the chamber. Also the results of a failure and accident analysis are presented. Finally, the dismantlement aspects are dealt with. 5 appendices, 12 refs.
Wendon, J.; Larsen, Finn Stolze
1. Intracranial pressure is the pressure exerted by the cranial contents on the dural envelope and consists of the partial pressures of the brain, blood, and cerebrospinal fluid. 2. Severe cases of acute liver failure are frequently complicated by brain edema (due to cytotoxic edema...
van der Harst, Pim; Boehm, Michael; van Gilst, Wiek H.; van Veldhuisen, Dirk J.
Both primary and secondary prevention studies have provided a wealth of evidence that statin therapy effectively reduces cardiovascular events. However, this general statement on the efficacy and safety of statin treatment has not been validated in patients with chronic heart failure (CHF).
Yu Haiyang [Institute Charles Delaunay (ICD, FRE CNRS 2848), Troyes University of Technology, Rue Marie Curie, BP 2060, 10010 Troyes (France)]. E-mail: Haiyang.YU@utt.fr; Chu Chengbin [Institute Charles Delaunay (ICD, FRE CNRS 2848), Troyes University of Technology, Rue Marie Curie, BP 2060, 10010 Troyes (France); Management School, Hefei University of Technology, 193 Tunxi Road, Hefei (China); Chatelet, Eric [Institute Charles Delaunay (ICD, FRE CNRS 2848), Troyes University of Technology, Rue Marie Curie, BP 2060, 10010 Troyes (France); Yalaoui, Farouk [Institute Charles Delaunay (ICD, FRE CNRS 2848), Troyes University of Technology, Rue Marie Curie, BP 2060, 10010 Troyes (France)
In a multi-component system, the failure of one component can reduce the system reliability in two aspects: loss of the reliability contribution of this failed component, and the reconfiguration of the system, e.g., the redistribution of the system loading. The system reconfiguration can be triggered by the component failures as well as by adding redundancies. Hence, dependency is essential for the design of a multi-component system. In this paper, we study the design of a redundant system with the consideration of a specific kind of failure dependency, i.e., the redundant dependency. The dependence function is introduced to quantify the redundant dependency. With the dependence function, the redundant dependencies are further classified as independence, weak, linear, and strong dependencies. In addition, this classification is useful in that it facilitates the optimization resolution of the system design. Finally, an example is presented to illustrate the concept of redundant dependency and its application in system design. This paper thus conveys the significance of failure dependencies in the reliability optimization of systems.
Yu Haiyang; Chu Chengbin; Chatelet, Eric; Yalaoui, Farouk
In a multi-component system, the failure of one component can reduce the system reliability in two aspects: loss of the reliability contribution of this failed component, and the reconfiguration of the system, e.g., the redistribution of the system loading. The system reconfiguration can be triggered by the component failures as well as by adding redundancies. Hence, dependency is essential for the design of a multi-component system. In this paper, we study the design of a redundant system with the consideration of a specific kind of failure dependency, i.e., the redundant dependency. The dependence function is introduced to quantify the redundant dependency. With the dependence function, the redundant dependencies are further classified as independence, weak, linear, and strong dependencies. In addition, this classification is useful in that it facilitates the optimization resolution of the system design. Finally, an example is presented to illustrate the concept of redundant dependency and its application in system design. This paper thus conveys the significance of failure dependencies in the reliability optimization of systems
Full Text Available Congenital uremic encephalopathy, progressive dialysis encephalopathy, Wernicke encefalopathy, headache, seizures because of dialysis, disequilibrium syndrome, cerebral hemorrhage and uremic neuropathy are the neurologic complications seen in child with chronic renal failure. Here it is aimed to discuss these complications with literature, and to emphasize the importance of evaluation of patients with these aspects. [Archives Medical Review Journal 2003; 12(4.000: 406-412
Arias Sosa, Luis Alejandro
Heart failure (HF) is a high impact disease that affects all human populations, demanding the development of new strategies and methods to manage this pathology. That's why microRNAs, small noncoding RNAs that regulate gene expression, appear as an important option in the diagnosis, prognosis and treatment of this disease. MiRNAs seems to have a future on HF handling, because can be isolated from body fluids such as blood, and changes in its levels can be associated with the presence, stage and specific disease features, which makes them an interesting option as biomarkers. Also, due to the important role of these molecules on regulation of gene expression and cell homeostasis, it has been explored its potential use as a therapeutic method to prevent or treat HF. That is why this review seeks to show the importance of biomedical research involving the use of miRNAs as a method to approach the HF, showing the impact of disease in the world, aspects of miRNAs biology, and their use as biomarkers and as important therapeutic targets. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.
Full Text Available The failure by the city of Flint, Michigan to properly treat its municipal water system after a change in the source of water, has resulted in elevated lead levels in the city’s water and an increase in city children’s blood lead levels. Lead exposure in young children can lead to decrements in intelligence, development, behavior, attention and other neurological functions. This lack of ability to provide safe drinking water represents a failure to protect the public’s health at various governmental levels. This article describes how the tragedy happened, how low-income and minority populations are at particularly high risk for lead exposure and environmental injustice, and ways that we can move forward to prevent childhood lead exposure and lead poisoning, as well as prevent future Flint-like exposure events from occurring. Control of the manufacture and use of toxic chemicals to prevent adverse exposure to these substances is also discussed. Environmental injustice occurred throughout the Flint water contamination incident and there are lessons we can all learn from this debacle to move forward in promoting environmental justice.
Kadoglou, Nikolaos P E; Bracke, Frank; Simmers, Tim; Tsiodras, Sotirios; Parissis, John
The interaction of influenza infection with the pathogenesis of acute heart failure (AHF) and the worsening of chronic heart failure (CHF) is rather complex. The deleterious effects of influenza infection on AHF/CHF can be attenuated by specific immunization. Our review aimed to summarize the efficacy, effectiveness, safety, and dosage of anti-influenza vaccination in HF. In this literature review, we searched MEDLINE and EMBASE from January 1st 1966 to December 31st, 2016, for studies examining the association between AHF/CHF, influenza infections, and anti-influenza immunizations. We used broad criteria to increase the sensitivity of the search. HF was a prerequisite for our search. The search fields used included "heart failure," "vaccination," "influenza," "immunization" along with variants of these terms. No restrictions on the type of study design were applied. The most common clinical scenario is exacerbation of pre-existing CHF by influenza infection. Scarce evidence supports a potential positive association of influenza infection with AHF. Vaccinated patients with pre-existing CHF have reduced all-cause morbidity and mortality, but effects are not consistently documented. Immunization with higher antigen quantity may confer additional protection, but such aggressive approach has not been generally advocated. Further studies are needed to delineate the role of influenza infection on AHF/CHF pathogenesis and maintenance. Annual anti-influenza vaccination appears to be an effective measure for secondary prevention in HF. Better immunization strategies and more efficacious vaccines are urgently necessary.
Boicourt, G.P.; Kemp, E.L.
High energy density pulse capacitors, typified by the 10-kV, 170-μF unit, have become widely used in recent years. These units primarily were designed for lower cost and higher energy per unit volume. The life characteristics of these units have never been determined fully, but they have already been shown capable of lives much longer than originally expected. The Los Alamos Scientific Laboratory is now conducting an extended program to determine the long-term capabilities of these capacitors. This program is aimed not only at finding the statistical parameters of the failure distribution but also at determining the physical failure modes characteristic of such units. Recently, a new failure mode was found. This failure mode has prevented test samples of polypropylene-paper-dioctyl phthalate units from actually reaching the true potential life of the insulation. In this report, the new failure mechanism is examined and suggestions are made that could eliminate the failure mode
Full Text Available Despite significant therapeutic advancements, heart failure remains a highly prevalent clinical condition associated with significant morbidity and mortality. In 30%-40% patients, the etiology of heart failure is nonischemic. The implantable cardioverter-defibrillator (ICD is capable of preventing sudden death and decreasing total mortality in patients with nonischemic heart failure. However, a significant number of patients receiving ICD do not receive any kind of therapy during follow-up. Moreover, considering the situation in Brazil and several other countries, ICD cannot be implanted in all patients with nonischemic heart failure. Therefore, there is an urgent need to identify patients at an increased risk of sudden death because these would benefit more than patients at a lower risk, despite the presence of heart failure in both risk groups. In this study, the authors review the primary available methods for the stratification of the risk of sudden death in patients with nonischemic heart failure.
Dooley, R. Barry; Bursik, Albert
University 101 courses are typically designed to help incoming first-year undergraduate students to adjust to the university, develop a better understanding of the college environment, and acquire essential academic success skills. Why are we offering a special Boiler and HRSG Tube Failures PPChem 101? The answer is simple, yet very conclusive: There is a lack of knowledge on the identification of tube failure mechanisms and for the implementation of adequate counteractions in many power plants, particularly at industrial power and steam generators. There is a lack of knowledge to prevent repeat tube failures. The vast majority of BTF/HTF have been, and continue to be, repeat failures. It is hoped that the information about the failure mechanisms of BTF supplied in this course will help to put plant engineers and chemists on the right track. The major goal of this course is the avoidance of repeat BTF. This fourth lesson is focused on hydrogen damage of water-touched tubes in conventional boilers and in the high-pressure evaporators of heat recovery steam generators. (orig.)
Dooley, Barry R.; Bursik, Albert
University 101 courses are typically designed to help incoming first-year undergraduate students to adjust to the university, develop a better understanding of the college environment, and acquire essential academic success skills. Why are we offering a special Boiler and HRSG Tube Failures PPChem 101? The answer is simple, yet very conclusive: - There is a lack of knowledge on the identification of tube failure mechanisms and for the implementation of adequate counteractions in many power plants, particularly at industrial power and steam generators. - There is a lack of knowledge to prevent repeat tube failures. The vast majority of BTF/HTF have been, and continue to be, repeat failures. It is hoped that the information about the failure mechanisms of BTF supplied in this course will help to put plant engineers and chemists on the right track. The major goal of this course is the avoidance of repeat BTF. This fifth lesson is focused on caustic gouging of water-touched tubes in conventional boilers and in the high-pressure evaporators of heat recovery steam generators. (orig.)
Bhatt, Kunal N; Butler, Javed
Several novel therapeutics being tested in patients with heart failure are based on myocardial energetics. This review will provide a summary of the recent trials in this area, including therapeutic options targeting various aspects of cellular and mitochondrial metabolism. Agents that improve the energetic balance in myocardial cells have the potential to improve clinical heart failure status. The most promising therapies currently under investigation in this arena include (1) elamipretide, a cardiolipin stabilizer; (2) repletion of iron deficiency with intravenous ferrous carboxymaltose; (3) coenzyme Q10; and (4) the partial adenosine receptor antagonists capadenoson and neladenosone. Myocardial energetics-based therapeutics are groundbreaking in that they utilize novel mechanisms of action to improve heart failure symptoms, without causing the adverse neurohormonal side effects associated with current guideline-based therapies. The drugs appear likely to be added to the heart failure therapy armamentarium as adjuncts to current regimens in the near future.
Liang, H; Bae, J K; Park, C H; Kim, K I; Bae, D K; Song, S J
Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA. Data from a consecutive cohort comprising 1606 knees (1174 patients) of primary TKA patients, and 258 knees (224 patients) of revision TKA patients, in all of whom surgery involved a P.F.C ® prosthesis (Depuy, Johnson & Johnson, Warsaw, IN), was retrospectively reviewed. The mean follow-up periods of primary and revision TKAs were 9.2 and 9.8 years, respectively. The average 10- and 15-year survival rates for primary TKA were 96.7% (CI 95%,±0.7%) and 85.4% (CI 95%,±2.0%), and for revision TKA 91.4% (CI 95%,±2.5%) and 80.5% (CI 95%,±4.5%). Common modes of failure included polyethylene wear, loosening, and infection. The most common mode of failure was polyethylene wear in primary TKA, and infection in revision TKA. The mean periods (i.e., latencies) of polyethylene wear and loosening did not differ between primary and revision TKAs, but the mean period of infection was significantly longer for revision TKA (1.2 vs. 4.8 years, P=0.003). Survival rates decreased with time, particularly more than 10 years post-surgery, for both primary and revision TKAs. Continuous efforts are required to prevent and detect the various modes of failure during long-term follow-up. Greater attention is necessary to detect late infection-induced failure following revision TKA. Case-control study, Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Penzel, Ian B; Persich, Michelle R; Boyd, Ryan L; Robinson, Michael D
When people think that their efforts will fail to achieve positive outcomes, they sometimes give up their efforts after control, which can have negative health consequences. Problematic orientations of this type, such as pessimism, helplessness, or fatalism, seem likely to be associated with a cognitive mindset marked by higher levels of accessibility for failure words or concepts. Thus, the purpose of the present research was to determine whether there are individual differences in the frequency with which people think about failure, which in turn are likely to impact health across large spans of time. Following self-regulatory theories of health and the learned helplessness tradition, two archival studies (total n = 197) scored texts (books or speeches) for their use of failure words, a category within the Harvard IV dictionary of the General Inquirer. People who used failure words more frequently exhibited shorter subsequent life spans, and this relationship remained significant when controlling for birth year. Furthermore, study 2 implicated behavioral factors. For example, the failure/longevity relationship was numerically stronger among people whose causes of death appeared to be preventable rather than non-preventable. These results significantly extend our knowledge of the personality/longevity relationship while highlighting the value of individual differences in word usage as predictors of health and mortality.
End face seals are complex devices which are used widely in shaft sealing of rotating equipment. In the nuclear industry, working at the limits of present sealing technlogy with a massive economic dependence on reliability, the importance of scrutinizing seal failures and thereby attempting to prevent premature failures from recurring was fully realized. This paper describes Canadian nuclear sealing experience. Failed seal data is presented; practical examples are categorized as to cause and type. (author)
Soares, E.C.; Larsson, M.H.M.A.; Yamato, R.J.
Echocardiographic aspects of chronic mitral valvular disease were studied and compared to physical, radiographic and electrocardiographic aspects. Seventy dogs were used, and clinical examination, thoracic radiography, electrocardiogram and echocardiogram were performed. Correlations between regurgitation severity with cardiac failure functional class and murmur intensity were observed. The electrocardiogram showed a low sensibility in detecting cardiac chamber enlargement, caused by mitral regurgitation. All the dogs with severe mitral regurgitation showed cardiomegaly according to thoracic radiographies
Imawari, M.; Hughes, R.D.; Gove, C.D.; Williams, R.
The relationship between plasma fibronectin, in vitro plasma opsonic activity, which measures the biological activity of fibronectin, and in vivo Kupffer cell function, as assessed by the systemic clearance of microaggregated [ 125 I]albumin, were determined simultaneously in 15 patients with fulminant hepatic failure and 12 normal subjects. Both the plasma fibronectin and plasma opsonic activity were significantly reduced in patients with fulminant hepatic failure, while the systemic clearance of microaggregated albumin was decreased. There was a significant correlation between plasma fibronectin and the plasma opsonic activity on admission, but no correlation could be detected between either parameter and the clearance of microaggregated albumin. A gelatin-derived plasma expander was shown to block the plasma opsonic activity both in vitro and in vivo. The low plasma fibronectin and decreased clearance of microaggregated albumin in fulminant hepatic failure reflect different aspects of the overall impairment of Kupffer cell function
common reasons were pregnancy induced hypertension, HELLP syndrome and obstetric haemorrhage and resulted in high risk condition for fetal and maternal mortality. The most effective measures still remain the careful prevention and the aggressive management of the obstetric complications. Ideal care for women with acute renal failure in pregnancy or post-partum requires a multidisciplinary approach that includes maternal-fetal medicine, critical care medicine, nephrology and neonatology specialties.
Siebers, C.; Stegmaier, J.; Kirchhoff, C.; Kanz, K.G. [Chirurgische Klinik, Klinikum der Univ. Muenchen (Germany); Wirth, S.; Koerner, M.; Pfeifer, K.J. [Inst. fuer Klinische Radiologie, Klinikum der Univ. Muenchen (Germany); Kay, M.V. [Plansafe GmbH, Muenchen (Germany)
Purpose: in the case of major trauma, immediate recognition and treatment of life-threatening conditions are essential. An increasing number of European trauma centers use MSCT during the primary trauma survey due to its high diagnostic precision and speed. However, there is currently little empirical data about failures in this process to practice quality assurance. The aim of this study was to evaluate this process under operating resuscitation conditions and to identify failure modes that caused delays in completion. Materials and methods: an independent study monitor documented the course of trauma room treatment during a 10-month period. The inclusion criteria were patients who were admitted directly from the accident scene and the study monitor was present at the time of admission. Results: according to our ATLS-based trauma algorithm whole-body CT (WBCT) consists of non-contrast head CT (CCT) and contrast-enhanced trunk CT (TCT). 57 trauma patients receiving 45 WBCT. 5 single CCT and 4 single TCT studies were evaluated. After initial resuscitation, CCT was obtained within 17 min of trauma room admission (IQR 13.0 - 20.0). In 20% (95%CI 9 - 31%) of the cases, a CCT delay of median 5.0 min (IQR 3.8 - 8.0) was observed caused by e.g. earings, piercings and ECG cables in the scan field or intoxicated patients. Contrast-enhanced TCT was performed after 23.0 min (IQR 19.0 - 27.0). Due to preventable errors 12 of the 49 TCT studies were delayed (25%95%CI 12 - 37%) for 5 min (IQR 3.0 - 8.0). Conclusion: under ''front line'' conditions every fifth CCT and every fourth TCT study was completed with a median delay of 5 min. An independent process analysis revealed that unpreventable delays were due to uncooperative patients or system failure. Preventable delays were due to errors such as short intravenous lines or deviation from trauma room algorithms. Preventable delays could be avoided by addressing human and technical aspects such as revising
As regards the desgin of the EPR, the general strategy is to eliminate, the vessel failure at high pressure by preventive and mitigative measures. The design proposals involved trust in the reliability of dedicated devices (relief valves) for rapid depressurization. The aim is to attain a lower pressure level at the moment of vessel failure, so that the containment is capable to cope with the blowdown impact on the pit walls and the vessel supporting structures. Nevertheless, the potential of a high-pressure failure of the vessel must be kept in mind, whatever well thought-out and reliable preventive depressurization measures might be. Therefore, the reactor pressure blowdown has been studied in order to quantify the ultimate containment load, which might support future design requirements. The calculations were performed with the LWR transient analysis thermal-hydraulics computer code REALAP5/MOD3. In previous analyses, the nodalization of the problem was based on the geometrical conditions of a typical German 1300 MW(e) NPP. In the present analysis a new input model has been used, which was based on the EPR conditions. (orig./HP)
This paper reports the failure assessment curves for semi-elliptical surface cracks located at hot-spot positions in the circular hollow section X- and K-joints. The failure assessment curves derive from the square root of the ratio between the linear–elastic and the elastic–plastic energy release rates, computed from the domain-integral approach. This study examines both the material and geometric dependence of the failure assessment curves. The area reduction factor, used in defining the strength of the cracked joints, imposes a significant effect on the computed failure assessment curve. The failure assessment curves indicate negligible variations with respect to the crack-front locations and the material yield strength. The crack depth ratio exerts a stronger effect on the computed failure assessment curve than does the crack aspect ratio. This study proposes a parametric expression for the failure assessment curves based on the geometric parameters for surface cracks in circular hollow section X- and K-joints. -- Highlights: ► This study proposes geometric dependent expressions of FADs for tubular joints. ► We examine the geometric and material dependence of the FADs for X- and K-joints. ► The proposed FAD is independent of yield strength and is a lower-bound for typical hardening
Gunderson, Bruce D; Gillberg, Jeffrey M; Wood, Mark A; Vijayaraman, Pugazhendhi; Shepard, Richard K; Ellenbogen, Kenneth A
Implantable cardioverter-defibrillator (ICD) lead failures often present as inappropriate shock therapy. An algorithm that can reliably discriminate between ventricular tachyarrhythmias and noise due to lead failure may prevent patient discomfort and anxiety and avoid device-induced proarrhythmia by preventing inappropriate ICD shocks. The goal of this analysis was to test an ICD tachycardia detection algorithm that differentiates noise due to lead failure from ventricular tachyarrhythmias. We tested an algorithm that uses a measure of the ventricular intracardiac electrogram baseline to discriminate the sinus rhythm isoelectric line from the right ventricular coil-can (i.e., far-field) electrogram during oversensing of noise caused by a lead failure. The baseline measure was defined as the product of the sum (mV) and standard deviation (mV) of the voltage samples for a 188-ms window centered on each sensed electrogram. If the minimum baseline measure of the last 12 beats was algorithm to detect lead failures. The minimum baseline measure for the 24 lead failure episodes (0.28 +/- 0.34 mV-mV) was smaller than the 135 ventricular tachycardia (40.8 +/- 43.0 mV-mV, P <.0001) and 55 ventricular fibrillation episodes (19.1 +/- 22.8 mV-mV, P <.05). A minimum baseline <0.35 mV-mV threshold had a sensitivity of 83% (20/24) with a 100% (190/190) specificity. A baseline measure of the far-field electrogram had a high sensitivity and specificity to detect lead failure noise compared with ventricular tachycardia or fibrillation.
The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients. In the 2017 ACC/AHA/HFSA Focused Update of HF guidelines, important additions include new information on biomarkers, specifically on the topics of the diagnostic, prognostic role of natriuretic peptides in heart failure, and the role of natriuretic peptides in screening in patients high risk for HF and prevention of HF. There are important recommendations for treatment of patients with HF with reduced EF (HFrEF), including the beneficial role of angiotensin receptor blocker and neprilysin inhibition (ARNI) treatment in reducing outcomes including mortality, ivabradine in reducing heart failure hospitalizations in stable HFrEF patients with sinus rhythm and heart rate ≥ 70 bpm despite β-blockers. In patients with HF with preserved EF (HFpEF), though there are no studies demonstrating survival benefit, potential benefit with aldosterone antagonism in reducing HF hospitalizations is noted. In treatment of comorbidities, optimization of blood pressure control to less than 130 mmHg is recommended in hypertensive patients to prevent HF or in patients with hypertension and HFrEF or HFpEF. In addition to recognition on the potential role of treatment of iron deficiency anemia to improve symptoms and functional capacity, caution against use of adaptive servo-ventilation in patients with HFrEF and central sleep apnea and against use of erythropoietin stimulating agents in patients with HFrEF is provided. There are new treatment
Harish Kumar N., S.; Choudhary, R. P.; Murthy, Ch. S. N.
The model with failure rate function of bathtub-shaped is helpful in reliability analysis of any system and particularly in reliability associated privative maintenance. The usual Weibull distribution is, however, not capable to model the complete lifecycle of the any with a bathtub-shaped failure rate function. In this paper, failure rate and reliability analysis of the KOMATSU hydraulic excavator/shovel in surface mine is presented and also to improve the reliability and decrease the failure rate of each subsystem of the shovel based on the preventive maintenance. The model of the bathtub-shaped for shovel can also be seen as a simplification of the Weibull distribution.
Lee, Christopher S; Vellone, Ercole; Lyons, Karen S; Cocchieri, Antonello; Bidwell, Julie T; D'Agostino, Fabio; Hiatt, Shirin O; Alvaro, Rosaria; Buck, Harleah G; Riegel, Barbara
Heart failure is a burdensome clinical syndrome, and patients and their caregivers are responsible for the vast majority of heart failure care. This study aimed to characterize naturally occurring archetypes of patient-caregiver dyads with respect to patient and caregiver contributions to heart failure self-care, and to identify patient-, caregiver- and dyadic-level determinants thereof. Dyadic analysis of cross-sectional data on patients and their caregivers. Outpatient heart failure clinics in 28 Italian provinces. 509 Italian heart failure patients and their primary caregivers. Multilevel and mixture modeling were used to generate dyadic averages and incongruence in patient and caregiver contributions to heart failure self-care and identify common dyadic archetypes, respectively. Three distinct archetypes were observed. 22.4% of dyads were labeled as novice and complementary because patients and caregivers contributed to different aspects of heart failure self-care that was generally poor; these dyads were predominantly older adults with less severe heart failure and their adult child caregivers. 56.4% of dyads were labeled as inconsistent and compensatory because caregivers reported greater contributions to the areas of self-care most insufficient on the part of the patients; patients in these dyads had the highest prevalence of hospitalizations for heart failure in the past year and the fewest limitations to performing activities of daily living independently. Finally, 21.2% of dyads were labeled as expert and collaborative because of high contributions to all aspects of heart failure self-care, the best relationship quality and lowest caregiver strain compared with the other archetypes; patients in this archetype were likely the sickest because they also had the worst heart failure-related quality of life. Three distinct archetypes of dyadic contributions to heart failure care were observed that represent a gradient in the level of contributions to self
Raj, Pema; Louis, Xavier Lieben; Thandapilly, Sijo Joseph; Movahed, Ali; Zieroth, Shelley; Netticadan, Thomas
The concept of food has expanded beyond its traditional role of survival and hunger satisfaction, to include a role in the prevention and treatment of disease. Polyphenols are classes of compounds that are synthesized by plants to serve a wide variety of functions including growth pollination and defense. These compounds have recently received increased attention in medical research. In this group, one of the most studied has been resveratrol (3,5,4,-trihydroxystilbene), a polyphenol, which is found predominantly in grapes and berries. Over the past two decades, researchers have studied the ability of resveratrol to prevent or reverse the development of abnormalities in heart structure and function in animal models of heart disease and heart failure. The results from animal studies have been promising, and very recently, this knowledge has been translated into examining the efficacy of resveratrol in humans with heart disease/failure. In this review we will discuss the current status of resveratrol research on cardioprotection. Copyright © 2013 Elsevier Inc. All rights reserved.
Analysis of events with common cause failures (CCF) from the international common cause failure date exchange (ICDE); Analyse von Ereignissen mit gemeinsam verursachten Ausfaellen (GVA) aus dem internationalen GVA-Datenaustauschprojekt ICDE
Brueck, Benjamin; Kreuser, Albert; Simon, Julia; Stiller, Jan
Common-cause-failure (CCF) events can significantly impact the availability of safety systems of nuclear power plants. In recognition of this, CCF data are systematically being collected and analyzed in several countries. A comprehensive evaluation of CCF events derived only from the operating experience in German nuclear power plants is not sufficient due to the low probability of occurrence of such events. Therefore it is necessary to make use of the operating experience of other countries using similar technology. In order to be able to use the CCF operating experience from other countries in the aim to carry on the development of the bases for evaluation of CCF GRS decisively co-initiated the setting up of an international common-cause failure working group. This working group has elaborated the project ''International Common-Cause Failure Data Exchange'' (ICDE). The project's objective is to organize a broad exchange of information concerning observed events with relevance to common-cause failures. The tasks for preparation and evaluation of information of the ICDE working group serve for confirmation and extension of the common-cause failure knowledge with regards to probabilistic safety analyses, the better understanding of causes and mechanisms of common-cause failures and the evaluation of preventive measures against the occurrence of common-cause failures. The objectives of the exchange on a long term basis are to - improve the comprehension of CCF events and their causes and their prevention, - generate qualitative insights into the root causes of CCF events which can then be used to derive and assess preventive measures against the occurrence of such events or their consequences, - establish an efficient feedback of experience gained in connection with observed common-cause failure phenomena which could be used e.g. for the development of indicators for risk based inspections, - provide quantitative information regarding the
Failure Modes Taxonomy for Reliability Assessment of Digital Instrumentation and Control Systems for Probabilistic Risk Analysis - Failure modes taxonomy for reliability assessment of digital I and C systems for PRA
Amri, A.; Blundell, N.; ); Authen, S.; Betancourt, L.; Coyne, K.; Halverson, D.; Li, M.; Taylor, G.; Bjoerkman, K.; Brinkman, H.; Postma, W.; Bruneliere, H.; Chirila, M.; Gheorge, R.; Chu, L.; Yue, M.; Delache, J.; Georgescu, G.; Deleuze, G.; Quatrain, R.; Thuy, N.; Holmberg, J.-E.; Kim, M.C.; Kondo, K.; Mancini, F.; Piljugin, E.; Stiller, J.; Sedlak, J.; Smidts, C.; Sopira, V.
reactor protection system), 2. division level, 3. I and C unit level, 4. I and C unit modules level, 5. basic components level. This structure corresponds to a typical reactor protection system architecture, which is the scope of the DIGREL work. The taxonomy that was developed provides a framework to classify digital system failure modes. Failure propagation, which is essential for analysing failure modes and their effects, is described using a failure model. Four important elements of the failure model on which the taxonomy focuses stand out: 1. fault location, 2. failure mode, 3. uncovering situation, 4. failure effect and the end effect. These concepts are applied in particular at the I and C unit and module levels of abstraction. I and C unit level failure modes are associated with the end effects at the I and C unit module level, depending on the fault location and uncovering situation. The purpose of the taxonomy is to support PRAs and therefore focus is placed on high level functional aspects rather than low level structural aspects. This focus allows handling of the variability of failure modes and mechanisms of I and C components. It reduces the difficulties associated with the complex structural aspects of software in redundant distributed systems. At the level of system, division and I and C units, no significant distinction is made between hardware or software aspects. At the module and basic component levels, the taxonomy differentiates between hardware and software related failure modes. This report can be seen as a step towards more harmonised approach to analyse and model digital I and C in PRA. There is a number of areas where further studies are needed, and many of the recommendations given in the previous digital I and C expert report NEA/CSNI/R(2009)18 are still valid. For instance, the following actions could be considered: - Testing of the applicability of the taxonomy in modelling, including test with different I and C designs and modelling
Al-Naher, Ahmed; Wright, David; Devonald, Mark Alexander John; Pirmohamed, Munir
The second most common cause of hospitalization due to adverse drug reactions in the UK is renal dysfunction due to diuretics, particularly in patients with heart failure, where diuretic therapy is a mainstay of treatment regimens. Therefore, the optimal frequency for monitoring renal function in these patients is an important consideration for preventing renal failure and hospitalization. This review looks at the current evidence for optimal monitoring practices of renal function in patients with heart failure according to national and international guidelines on the management of heart failure (AHA/NICE/ESC/SIGN). Current guidance of renal function monitoring is in large part based on expert opinion, with a lack of clinical studies that have specifically evaluated the optimal frequency of renal function monitoring in patients with heart failure. Furthermore, there is variability between guidelines, and recommendations are typically nonspecific. Safer prescribing of diuretics in combination with other antiheart failure treatments requires better evidence for frequency of renal function monitoring. We suggest developing more personalized monitoring rather than from the current medication-based guidance. Such flexible clinical guidelines could be implemented using intelligent clinical decision support systems. Personalized renal function monitoring would be more effective in preventing renal decline, rather than reacting to it. © 2017 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.
Sieverding, M; Kendel, F
Aspects of gender and gender roles are important factors influencing the interactions between physicians and their patients. On the one hand, gender roles have an impact on the behavior of the patients, such as in health care utilization or use of preventive examinations. On the other hand, gender issues influence doctors' actions with respect to communication, diagnosis, and treatment. Here, a gender bias may lead to misdiagnosis and inadequate treatment. In this paper certain pertinent aspects of gender roles in the doctor-patient relationship are discussed and illustrated by empirical findings.
Bermejo-Pareja, F; Llamas-Velasco, S; Villarejo-Galende, A
This review proposes a more optimistic view of Alzheimer's disease (AD), in contrast to that contributed by the ageing of the population and the failure of potentially curative therapies (vaccines and others). Treatment failure is likely due to the fact that AD gestates in the brain for decades but manifests in old age. This review updates the concept of AD and presents the results of recent studies that show that primary prevention can reduce the incidence and delay the onset of the disease. Half of all cases of AD are potentially preventable through education, the control of cardiovascular risk factors, the promotion of healthy lifestyles and specific drug treatments. These approaches could substantially reduce the future incidence rate of this disease. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
Coria, V.H.; Maximov, S.; Rivas-Dávalos, F.; Melchor, C.L.; Guardado, J.L.
An analytical optimization method for preventive maintenance (PM) policy with minimal repair at failure, periodic maintenance, and replacement is proposed for systems with historical failure time data influenced by a current PM policy. The method includes a new imperfect PM model based on Weibull distribution and incorporates the current maintenance interval T 0 and the optimal maintenance interval T to be found. The Weibull parameters are analytically estimated using maximum likelihood estimation. Based on this model, the optimal number of PM and the optimal maintenance interval for minimizing the expected cost over an infinite time horizon are also analytically determined. A number of examples are presented involving different failure time data and current maintenance intervals to analyze how the proposed analytical optimization method for periodic PM policy performances in response to changes in the distribution of the failure data and the current maintenance interval. - Highlights: • An analytical optimization method for preventive maintenance (PM) policy is proposed. • A new imperfect PM model is developed. • The Weibull parameters are analytically estimated using maximum likelihood. • The optimal maintenance interval and number of PM are also analytically determined. • The model is validated by several numerical examples
Machida, Hideo; Suzuki, Masaaki; Kasahara, Naoto
It is very important to grasp failure probability and failure mode appropriately to carry out risk reduction measures of nuclear power plants. To clarify the important factors for failure probability and failure mode of pipes subjected to fluid thermal fluctuation, failure probability analyses were performed by changing the values of a stress range, stress ratio, stress components and threshold of stress intensity factor range. The important factors for the failure probability are range, stress ratio (mean stress condition) and threshold of stress intensity factor range. The important factor for the failure mode is a circumferential angle range of fluid thermal fluctuation. When a large fluid thermal fluctuation acts on the entire circumferential surface of the pipe, the probability of pipe breakage increases, calling for measures to prevent such a failure and reduce the risk to the plant. When the circumferential angle subjected to fluid thermal fluctuation is small, the failure mode of piping is leakage and the corrective maintenance might be applicable from the viewpoint of risk to the plant. (author)
On July 13, 1977 the entire electric load of the Con Edison system was lost, plunging New York City and Westchester County into darkness. The collapse resulted from a combination of natural events, equipment malfunctions, questionable system-design features, and operating errors. An attempt is made in this report to answer the following: what were the specific causes of the failure; if equipment malfunctions and operator errors contributed, could they have been prevented; to what extent was Con Edison prepared to handle such an emergency; and did Con Edison plan prudently reserve generation, for reserve transmission capability, for automatic equipment to protect its system, and for proper operator response to a critical situation. Following the introductory and summary section, additional sections include: the Consolidated Edison system; prevention of bulk power-supply interruptions; the sequence of failure and restoration; analysis of the July 1977 power failure; restoration sequence and equipment damage assessment; and other investigations of the blackout. (MCW)
In face of the HIV pandemic that still grows, unsuccessful efforts of developing biomedical control measures or the failure of cognitive-behavioral approach to show sustained social level effectiveness, behavioral strategy is now expected to evolve into a structural prevention ("combination prevention") that involves multiple behavioral goals and multilevel approaches. WYSH Project is a combination prevention project for youth developed through socio-epidemiological approach that integrates epidemiology with social science such as social marketing and mixed method. WYSH Project includes mass education programs for youth in schools and programs for out-of-school youth through cyber network and peer communication. Started in 2002, it expanded nationwide with supports from related ministries and parent-teacher associations and has grown into a single largest youth prevention project in Japan.
Özer Işıl Ece
Full Text Available Flood defense failures are rare events but when they do occur lead to significant amounts of damage. The defenses are usually designed for rather low-frequency hydraulic loading and as such typically at least high enough to prevent overflow. When they fail, flood defenses like levees built with modern design codes usually either fail due to wave overtopping or geotechnical failure mechanisms such as instability or internal erosion. Subsequently geotechnical failures could trigger an overflow leading for the breach to grow in size Not only the conditions relevant for these failure mechanisms are highly uncertain, also the model uncertainty in geomechanical, internal erosion models, or breach models are high compared to other structural models. Hence, there is a need for better validation and calibration of models or, in other words, better insight in model uncertainty. As scale effects typically play an important role and full-scale testing is challenging and costly, historic flood defense failures can be used to provide insights into the real failure processes and conditions. The recently initiated SAFElevee project at Delft University of Technology aims to exploit this source of information by performing back analysis of levee failures at different level of detail. Besides detailed process based analyses, the project aims to investigate spatial and temporal patterns in deformation as a function of the hydrodynamic loading using satellite radar interferometry (i.e. PS-InSAR in order to examine its relation with levee failure mechanisms. The project aims to combine probabilistic approaches with the mechanics of the various relevant failure mechanisms to reduce model uncertainty and propose improvements to assessment and design models. This paper describes the approach of the study to levee breach analysis and the use of satellites for breach initiation analysis, both adopted within the SAFElevee project.
Czepluch, Frauke S; Wollnik, Bernd; Hasenfuß, Gerd
The relevance of gene mutations leading to heart diseases and hence heart failure has become evident. The risk for and the course of heart failure depends on genomic variants and mutations underlying the so-called genetic predisposition. Genetic contribution to heart failure is highly heterogenous and complex. For any patient with a likely inherited heart failure syndrome, genetic counselling is recommended and important. In the last few years, novel sequencing technologies (named next-generation sequencing - NGS) have dramatically improved the availability of molecular testing, the efficiency of genetic analyses, and moreover reduced the cost for genetic testing. Due to this development, genetic testing has become increasingly accessible and NGS-based sequencing is now applied in clinical routine diagnostics. One of the most common reasons of heart failure are cardiomyopathies such as the dilated or the hypertrophic cardiomyopathy. Nearly 100 disease-associated genes have been identified for cardiomyopathies. The knowledge of a pathogenic mutation can be used for genetic counselling, risk and prognosis determination, therapy guidance and hence for a more effective treatment. Besides, family cascade screening for a known familial, pathogenic mutation can lead to an early diagnosis in affected individuals. At that timepoint, a preventative intervention could be used to avoid or delay disease onset or delay disease progression. Understanding the cellular basis of genetic heart failure syndromes in more detail may provide new insights into the molecular biology of physiological and impaired cardiac (cell) function. As our understanding of the molecular and genetic pathophysiology of heart failure will increase, this might help to identify novel therapeutic targets and may lead to the development of new and specific treatment options in patients with heart failure. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European
Cooke, Roger; Paulsen, Jette
Measurement of maintenance performance is done on the basis of component history data in which service sojourns are distinguished according to whether they terminate in corrective or preventive maintenance. From the viewpoint of data analysis, corrective and preventive maintenance constitute competing failure nudes. This article examines ways to assess maintenance performance without introducing statistical assumptions, then introduces a plausible statistical model for describing the interaction of preventive and corrective maintenance, and finally illustrates these with examples from the Nordic TUD data system
Leach, John P; Heallen, Todd; Zhang, Min; Rahmani, Mahdis; Morikawa, Yuka; Hill, Matthew C; Segura, Ana; Willerson, James T; Martin, James F
Mammalian organs vary widely in regenerative capacity. Poorly regenerative organs, such as the heart are particularly vulnerable to organ failure. Once established, heart failure commonly results in mortality. The Hippo pathway, a kinase cascade that prevents adult cardiomyocyte proliferation and regeneration, is upregulated in human heart failure. Here we show that deletion of the Hippo pathway component Salvador (Salv) in mouse hearts with established ischaemic heart failure after myocardial infarction induces a reparative genetic program with increased scar border vascularity, reduced fibrosis, and recovery of pumping function compared with controls. Using translating ribosomal affinity purification, we isolate cardiomyocyte-specific translating messenger RNA. Hippo-deficient cardiomyocytes have increased expression of proliferative genes and stress response genes, such as the mitochondrial quality control gene, Park2. Genetic studies indicate that Park2 is essential for heart repair, suggesting a requirement for mitochondrial quality control in regenerating myocardium. Gene therapy with a virus encoding Salv short hairpin RNA improves heart function when delivered at the time of infarct or after ischaemic heart failure following myocardial infarction was established. Our findings indicate that the failing heart has a previously unrecognized reparative capacity involving more than cardiomyocyte renewal.
Gardiner, L R; Oswald, S L; Jahera, J S
This study investigates the ability of discriminant analysis to provide accurate predictions of hospital failure. Using data from the period following the introduction of the Prospective Payment System, we developed discriminant functions for each of two hospital ownership categories: not-for-profit and proprietary. The resulting discriminant models contain six and seven variables, respectively. For each ownership category, the variables represent four major aspects of financial health (liquidity, leverage, profitability, and efficiency) plus county marketshare and length of stay. The proportion of closed hospitals misclassified as open one year before closure does not exceed 0.05 for either ownership type. Our results show that discriminant functions based on a small set of financial and nonfinancial variables provide the capability to predict hospital failure reliably for both not-for-profit and proprietary hospitals.
Capelli, Achille; Reiweger, Ingrid; Schweizer, Jürg
stresses at a small scale. The healing process may then have prevented the self-organization of this small scale damage and, therefore, the total failure of the sample.
Maria Catena Quattropani; Teresa Buccheri
Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusion...
Martens, Pieter; Vercammen, Jan; Ceyssens, Wendy; Jacobs, Linda; Luwel, Evert; Van Aerde, Herwig; Potargent, Peter; Renaers, Monique; Dupont, Matthias; Mullens, Wilfried
In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed. Dobutamine (fixed dose) was infused through a single-lumen central venous catheter with a small pump that was refilled by a nurse on a daily basis. Symptomatic status was longitudinally assessed as the change in New York Heart Association class and patient global assessment scale. Antecedent and incident heart failure hospitalizations were determined in a paired fashion, and cost impact was assessed. A total of 21 patients (age 77 ± 9 years) were followed up for 869 ± 647 days. At first follow-up (6 ± 1 weeks) after the initiation of dobutamine, patients had a significant improvement in New York Heart Association class (-1.29 ± 0.64; P heart failure hospitalizations assessed at 3, 6, and 12 months were significantly reduced (P heart failure hospitalizations over the same time period. Cost expenditure was significantly lower at 3 (P heart failure is feasible and associated with improved symptomatic status, heart failure hospitalizations, and health-care-related costs. Nevertheless, results should be interpreted in the context of the small and retrospective design. Larger studies are necessary to evaluate the effect of dobutamine in palliative end-stage heart failure. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana
The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make
Knobloch, K; Jagodzinski, M; Haasper, C; Zeichen, J; Krettek, C
Gymnastic school sport injuries account for a significant morbidity and mortality among children and adolescents. Preventive issues may be derived from a thorough in-depth analysis of the pattern and circumstances of gymnastic injuries. During a school year among 3993 schools in 43 889 classes with 993 056 pupils 2234 school sport injuries have been reported to the Gemeinde Unfall Versicherung (GUV) Niedersachsen, Germany. Gymnastic sport injuries account for 18 % (403 accidents), which is second after ball sports injuries. Regarding the distribution of the gymnastic disciplines, vault was the major discipline with 34 %, followed by floor exercise (21.3 %), mini- and competition trampoline (16.8 %), and parallel bars (8.2 %). The analysis of the type of injury during vault accidents revealed contusion (31 %) as the predominant injury, followed by sprains (15.4 %), and fractures (15.4 %). Floor exercise injuries distributed among distorsions (26.7 %), contusions (18.6 %), muscle tears (14 %). Back injuries especially of the cervical and thoracic spine, accounted for 40 % of all their injuries. Minor head injuries account for 4.7 % of all floor exercise injuries. Mini-trampoline injuries distribute among contusions (30 %), fractures (22.5 %), distorsions (7.5 %). 21.8 % collisions were noted against a box in comparison to 6.8 % in case of the horse. Gymnast injuries account for a significant number of all school sport related injuries. Vault and floor exercise account for the vast majority of all injuries, with alarming high numbers of spine injuries during floor exercise and mini-trampoline. A preservation of a high level of attention during a sport lesson, safety measures including appropriate mats and landing zones are mandatory to reduce injuries. Muscle injuries and ankle sprains can be prevented by a prospective proprioceptive training intervention to be implemented in school sports.
Full Text Available The stability of water service is a hot point in industrial production, public safety, and academic research. The paper establishes a service evaluation model for the water distribution network (WDN. The serviceability is measured in three aspects: (1 the functionality of structural components under disaster environment; (2 the recognition of cascading failure process; and (3 the calculation of system reliability. The node and edge failures in WDN are interrelated under seismic excitations. The cascading failure process is provided with the balance of water supply and demand. The matrix-based system reliability (MSR method is used to represent the system events and calculate the nonfailure probability. An example is used to illustrate the proposed method. The cascading failure processes with different node failures are simulated. The serviceability is analyzed. The critical node can be identified. The result shows that the aged network has a greater influence on the system service under seismic scenario. The maintenance could improve the antidisaster ability of WDN. Priority should be given to controlling the time between the initial failure and the first secondary failure, for taking postdisaster emergency measures within this time period can largely cut down the spread of cascade effect in the whole WDN.
Krentowski, Janusz R.; Knyziak, Piotr
The article presents the characteristics of several steel structures, among others modernized industrial dye house, school sports hall, truck repair workshop, that have been rebuilt after a disaster or a catastrophe. The structures were analyzed in detail, and the evaluation and reconstruction processes were described. The emergencies that occurred during exploitation of the buildings were the result of multiple mistakes: incorrectly defined intervals between inspections, errors during periodic inspections, incorrect repair work recommendations. The concepts of reinforcement work implemented by the authors, enabling the long-term future failure-free operation of the objects, were presented. Recommendations for monitoring of the facilities, applied after reinforcement or reconstruction, have been formulated. The methodology for the implementation of specialized investigations, such as geodetic, optical, geological, chemical strength tests, both destructive and non-destructive, has been defined. The need to determine the limit values of deformations, deflections, damage or other faults of structural elements and the entire rebuilt facilities, as well as defining conditions for objects’ withdrawal from operation in subsequent exceptional situations was indicated.
Laurinec, R.; Korec, J.; Mitosinka, J.; Zarnovican, V.
A failure record card system was introduced for evaluating the reliability of the measurement and control equipment of the V-1 nuclear power plant. The SPU-800 microcomputer system is used for recording data on magnetic tape and their transmission to the central data processing department. The data are used for evaluating the reliability of components and circuits and a selection is made of the most failure-prone components, and the causes of failures are evaluated as are failure identification, repair and causes of outages. The system provides monthly, annual and total assessment data since the system was commissioned. The results of the statistical evaluation of failures are used for planning preventive maintenance and for determining optimal repair intervals. (E.S.)
FAN Hui Wen
Full Text Available A case of a 37-week pregnant woman who developed a hemorrhagic syndrome and acute renal failure after contact with Lonomia caterpillars is reported. The accident also initiated labour and the patient gave birth to an alive child. Some pathophysiological aspects of the genital bleeding and of the acute renal failure are discussed.
Aspects of design and a procedure for nozzle tensile analysis under loads in project, normal and abnormal, emergency, failure and test conditions. For each condition, considerations about the tensile calculation methods, the tensile classification in corresponding categories and the comparison with admissible limits according to the norms. (M.C.K.) [pt
Hake, T.M.; Heger, A.S.
Many advanced light water reactor (ALWR) concepts proposed for the next generation of nuclear power plants rely on passive systems to perform safety functions, rather than active systems as in current reactor designs. These passive systems depend to a great extent on physical processes such as natural circulation for their driving force, and not on active components, such as pumps. An NRC-sponsored study was begun at Sandia National Laboratories to develop and implement a methodology for evaluating ALWR passive system reliability in the context of probabilistic risk assessment (PRA). This report documents the first of three phases of this study, including methodology development, system-level qualitative analysis, and sequence-level component failure quantification. The methodology developed addresses both the component (e.g. valve) failure aspect of passive system failure, and uncertainties in system success criteria arising from uncertainties in the system's underlying physical processes. Traditional PRA methods, such as fault and event tree modeling, are applied to the component failure aspect. Thermal-hydraulic calculations are incorporated into a formal expert judgment process to address uncertainties in selected natural processes and success criteria. The first phase of the program has emphasized the component failure element of passive system reliability, rather than the natural process uncertainties. Although cursory evaluation of the natural processes has been performed as part of Phase 1, detailed assessment of these processes will take place during Phases 2 and 3 of the program
Kumar, Naresh; Patel, Ravish; Wadhwa, Anshuja Charvi; Kumar, Aravind; Milavec, Helena Maria; Sonawane, Dhiraj; Singh, Gurpal; Benneker, Lorin Michael
The development of spinal implants marks a watershed in the evolution of metastatic spine tumour surgery (MSTS), which has evolved from standalone decompressive laminectomy to instrumented stabilization and decompression with reconstruction when necessary. Fusion may not be feasible after MSTS due to poor quality of graft host bed along with adjunct chemotherapy and/or radiotherapy postoperatively. With an increase in the survival of patients with spinal tumours, there is a probability of an increase in the rate of implant failure. This review aims to help establish a clear understanding of implants/constructs used in MSTS and to highlight the fundamental biomechanics of implant/construct failures. Published literature on implant failure after spine surgery and MSTS has been reviewed. The evolution of spinal implants and their role in MSTS has been briefly described. The review defines implant/construct failures using radiological parameters that are practical, feasible, and derived from historical descriptions. We have discussed common modes of implant/construct failure after MSTS to allow further understanding, interception, and prevention of catastrophic failure. Implant failure rates in MSTS are in the range of 2-8%. Variability in patterns of failure has been observed based on anatomical region and the type of constructs used. Patients with construct/implant failures may or may not be symptomatic and present either as early (failures (> 3months). It has been noted that not all the implant failures after MSTS result in revisions. Based on the observed radiological criteria and clinical presentations, we have proposed a clinico-radiological classification for implant/construct failure after MSTS.
Katare, Rajesh G; Caporali, Andrea; Oikawa, Atsuhiko; Meloni, Marco; Emanueli, Costanza; Madeddu, Paolo
The increasing incidence of diabetes mellitus will result in a new epidemic of heart failure unless novel treatments able to halt diabetic cardiomyopathy early in its course are introduced. This study aimed to determine whether the activity of the Akt/Pim-1 signaling pathway is altered at critical stages of diabetic cardiomyopathy and whether supplementation with vitamin B1 analog benfotiamine (BFT) helps to sustain the above prosurvival mechanism, thereby preserving cardiomyocyte viability and function. Untreated streptozotocin-induced type 1 or leptin-receptor mutant type 2 diabetic mice showed diastolic dysfunction evolving to contractile impairment and cardiac dilatation and failure. BFT (70 mg/kg(-1)/d(-1)) improved diastolic and systolic function and prevented left ventricular end-diastolic pressure increase and chamber dilatation in both diabetic models. Moreover, BFT improved cardiac perfusion and reduced cardiomyocyte apoptosis and interstitial fibrosis. In hearts of untreated diabetic mice, the expression and activity of Akt/Pim-1 signaling declined along with O-N-acetylglucosamine modification of Akt, inhibition of pentose phosphate pathway, activation of oxidative stress, and accumulation of glycation end products. Furthermore, diabetes reduced pSTAT3 independently of Akt. BFT inhibited these effects of diabetes mellitus, thereby conferring cardiomyocytes with improved resistance to high glucose-induced damage. The phosphoinositide-3-kinase inhibitor LY294002 and dominant-negative Akt inhibited antiapoptotic action of BFT-induced and Pim-1 upregulation in high glucose-challenged cardiomyocytes. These results show that BFT protects from diabetes mellitus-induced cardiac dysfunction through pleiotropic mechanisms, culminating in the activation of prosurvival signaling pathway. Thus, BFT merits attention for application in clinical practice.
Boyd, Diane E.; Baudier, Josie; Stromie, Traci
Despite the attempts to target success and predisposition to taking risks to promote innovation, sometimes educational developers encounter moments where they fail to meet expectations set forth--by their institutions, colleagues, or themselves. Attempts to avoid potential failures can stymie the creative process, preventing them from meeting…
Newman, John Steven
failures, and generating better and more consistent reports. Through this approach failures can be more fully understood, existing programs can be evaluated and future failures avoided. The x-fw development involved a review of the historical failure analysis and prevention literature, coupled with examination of numerous failure case studies. Analytical approaches included use of a relational failure "knowledge base" for classification and sorting of x-fw elements and attributes for each case. In addition a novel "management mapping" technique was developed as a means of displaying an integrated snapshot of indirect causes within the management chain. Further research opportunities will extend the depth of knowledge available for many of the component level cases. In addition, the x-fw has the potential to expand the scope of space sector lessons learned, and contribute to knowledge management and organizational learning.
Wang, Xiaojing; Sarin, Shiv Kumar; Ning, Qin
A prominent characteristic of ACLF is rapid hepatic disease progression with subsequent extra-hepatic organ failure, manifesting as either hepatic coma or hepatorenal syndrome, which is associated with a high mortality rate in a short time. The APASL definition mainly emphasizes recognizing patients with hepatic failure. These patients may subsequently develop extra-hepatic multisystem organ failure leading to high mortality. It is therefore worthwhile to identify the short interim period between the development of liver failure and the onset of extra-hepatic organ failure, the potential therapeutic 'golden window.' Interventions during this period may prevent the development of complications and eventually change the course of the illness. Organ failure is suggested to be a central component of ACLF and may behave differently from chronic decompensated liver disease. Clear and practical criteria for the inclusion of organ failure are urgently needed so that patients with these life-threatening complications can be treated in a timely and appropriate manner. Recent studies suggested that the scoring systems evaluating organ failure [acute physiology, age and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores] work better than those addressing the severity of liver disease [Child-Pugh and model of end-stage liver disease (MELD) scores] in ACLF. However, a key problem remains that the former scoring systems are reflective of organ failure and not predictive, thus limiting their value as an early indication for intervention.
Full Text Available Abstract Background The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI. Methods Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data; treatment effectiveness and intolerance (based on literature; and annual number of hospitalization per patient and annual risk of death (based on routine data. Results Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. Conclusion In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services. Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare
Lyratzopoulos, Georgios; Cook, Gary A; McElduff, Patrick; Havely, Daniel; Edwards, Richard; Heller, Richard F
The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI). Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data). Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.
Dalton, K.J.; Kresser, J.V.; Savage, J.W.; Selan, J.C.
This report documents technical evaluations on various aspects pertaining to the seven main transformer failures at the North Anna Power Station, Units 1 and 2. These reports cover the subjects of Probability Risk Assessment (PRA), Failure Modes and Effects Analysis (FMEA), Root Causes, Protection Systems, Modifications, Failure Statistics, and Generic Aspects. The PRA determined that the contribution from a main transformer failure affecting plant safety systems so as to increase the risk to the public health and safety is negligible. The FMEA determined that a main transformer failure can have primary and secondary effects on plant safety system operation. The evaluation of the Root Causes found that no single common cause contributed to the seven failures. Each failure was found to have specific circumstances for initiating the failure. Both the generator and transformer primary protection systems were found to perform correctly and were designed within industry standards and practices. The proposed modifications resulting from the analyses of the failures will improve system reliability and integrity, and will reduce potentially damaging effects. The failure statistic survey found very limited data bases from which a meaningful correlation could be ascertained. The statistical comparison found no appreciable anomalies with the NAPS failures. The evaluation of all the available information and the results of the separate reports on the main transformer failures found that several generic concerns exist
Marianna A. Gulyaeva
Full Text Available The article investigates the phenomenon of refusal from communication in terms of its positive and negative impact, both on the communicative process, and interpersonal relationships in general. It has been analyzed several aspects of the failure to communicate with positive communication position. The identification of constructive or destructive potential was carried out on the basis of three parameters such as productivity/ unproductive conflict resolution with the help of avoiding communication, the choice of an optimum way of non-communication and its role in the communication process on the basis of the functions performed by them. Failure to communicate is often perceived negatively and is considered an inefficient form of communication, so it does not allow to solve interpersonal conflicts. This article discusses the circumstances where refusal from communication advocates an effective way to avoid conflict. In situations where the termination of communication is inevitable, a fundamental factor for the positive, harmonious form of communication acts interrupting the communication process. Functioning in the communicative space, failure to communicate can either destroy an interaction and relationship between the partners, and regulate the communication process by guiding in the right direction, coordinating the behavior of communication.
Schneider, David F.; Sonderman, Philip E.; Jones, Michaela F.; Ojomo, Kristin A.; Chen, Herbert; Jaume, Juan C.; Elson, Diane F.; Perlman, Scott B.; Sippel, Rebecca S.
Introduction Persistent or recurrent hyperthyroidism after treatment with radioactive iodine (RAI) is common, and many patients require either additional doses or surgery before they are cured. The purpose of this study was to identify patterns and predictors of failure of RAI in patients with hyperthyroidism. Methods We conducted a retrospective review of patients treated with RAI from 2007–2010. Failure of RAI was defined as receipt of additional dose(s) and/or total thyroidectomy. Using a Cox proportional hazards model, we conducted univariate analysis to identify factors associated with failure of RAI. A final multivariate model was then constructed with significant (p treatment. 53 (71.6%) received additional RAI, 13 (17.6%) received additional RAI followed by surgery, and the remaining 8 (10.8%) were cured after thyroidectomy. The percentage of patients who failed decreased in a step-wise fashion as RAI dose increased. Similarly, the incidence of failure increased as the presenting T3 level increased. Sensitivity analysis revealed that RAI doses treatment (HR 2.55, 95% CI 1.22–5.33, p=0.01) were associated with failure. Conclusions Laboratory values at presentation can predict which patients with hyperthyroidism are at risk for failing RAI treatment. Higher doses of RAI or surgical referral may prevent the need for repeat RAI in selected patients. PMID:25001092
Constable, M.; Howard, C.G.; Johnson, M.A.; Jolliffe, C.B. (AEA Decommissioning and Waste Management, Winfrith (United Kingdom)); Sellers, R.M. (Nuclear Electric plc, Barnwood (United Kingdom))
Lewatit DN is a phenol formaldehyde based ion exchange resin used to remove radioactive caesium from liquid waste streams such as fuel cooling ponds and effluents. This paper presents the results of a study of the encapsulation of the bead form of the resin in cement with particular reference to the mechanisms of its interaction with the encapsulant. When incorporated in pure ordinary Portland cement (OPC) at loadings in excess of 15 wt % an unstable product results due to expansion of the systems and at higher waste loadings failure results after only a few days. Evidence from differential scanning calorimetry, X-ray diffraction and scanning electron microscopy all indicate the cause of the expansive reaction to be the formation of crystals of calcium salts around and within the resin beads. Addition of BFS and sodium hydroxide prevent the formation of these salts by removal of calcium hydroxide from the system in other reactions. (author).
Full Text Available The purpose of the study: approbation of the prevention program of physical rehabilitation for Chernobyl disaster survivors in lifestyle aspects. Sixty persons who were disaster survivors and workers of Chernobyl Nuclear Power Plant aged 32-60 have rehabilitation during 21 days. The complex of training prevention programs of physical and psycho-emotional rehabilitation methods was elaborated. The study of efficacy of training prevention programs among Chernobyl disaster survivors. The results showed the improvement of psycho-emotional status and normalization of cardiovascular vegetative regulation after training prevention programs in Chernobyl disasters survivors. The studies show that the preventive programs for Chernobyl disaster survivors in lifestyle aspects had the high effect. This displays the decrease of tempo of aging and the improving of physical and psychological health status of Chernobyl disaster survivors during preventive course.
Lipek, Tobias; Igel, Ulrike; Gausche, Ruth; Kiess, Wieland; Grande, Gesine
Childhood obesity is a major concern for public health. There are multiple factors (e.g., genetic, social, and environmental) that contribute to unhealthy weight gain. Drawing from findings on "obesogenic environments" and core principles of preventive strategies to reduce health inequalities, this paper gives an overview of recent childhood prevention programs that target aspects of the physical environment ("environmental changes"). Out of the ten reviews we screened (including more than 300 studies), we identified very few that addressed aspects of the environment. We focus here on 14 programs that follow different approaches to environmental changes (e.g., access to/quality of playgrounds, changes in school cafeterias). Altering the environment offers opportunities for healthier behaviors and seems to be an effective strategy to prevent childhood obesity. However, the evaluation of those (mostly) multidimensional interventions does not allow drawing firm conclusions about the single effect of environmental changes. We conclude that obesity prevention programs should combine person-based and environmental approaches.
Braaksma, Jan; Klingenberg, W.; Veldman, J.
Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design.
Braaksma, Anne Johannes Jan; Klingenberg, W.; Veldman, Jasper
Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design.
Pinna, T.; Caporali, R.; Tesini, A.
A Failure Mode and Effect Analysis (FMEA) at component level was done to study safety-relevant implications arising from possible failures in performing remote handling (RH) operations at ITER facility . Autonomous air cushion transporter, pallet, sealed casks and tractor movers needed for port plug mounting/dismantling operation were analysed. For each sub-system, the breakdown of significant components was outlined and, for each component, possible failure modes have been investigated pointing out possible causes, possible actions to prevent the causes, consequences and actions to prevent or mitigate consequences. Off-normal events which may result in hazardous consequences to the public and the environment have been defined as Postulated Initiating Events (PIEs). Two safety-relevant PIEs have been defined by assessing elementary failures related to the analysed system. Each PIE has been discussed in order to qualitatively identify accident sequences arising from each of them. As an output of this FMEA study, possible incidental scenarios, where the intervention of rescue RH equipments is required to overcome critical situations determined by fault of RH components, were defined as well. Being rescue scenarios of main concern for ITER remote handling activities, such families could be helpful in defining the design requirements of port handling systems in general and on RH transfer system in particular. Furthermore, they could be useful in defining casks and vehicles to be used for rescue activities
Full Text Available Background. Astragalus was broadly used for treating heart failure (HF and arrhythmias in East Asia for thousands of years. Astragalus granule (AG, extracted from Astragalus, shows beneficial effect on the treatment of HF in clinical research. We hypothesized that administration of AG prevents the remodeling of L-type Ca2+ current (ICa-L in HF mice by the downregulation of Ca2+/calmodulin-dependent protein kinase II (CaMKII. Methods. HF mice were induced by thoracic aortic constriction (TAC. After 4 weeks of AG treatment, cardiac function and QT interval were evaluated. Single cardiac ventricular myocyte was then isolated and whole-cell patch clamp was used to record action potential (AP and ICa-L. The expressions of L-type calcium channel alpha 1C subunit (Cav1.2, CaMKII, and phosphorylated protein kinase A (p-PKA were examined by western blot. Results. The failing heart manifested distinct electrical remodeling including prolonged repolarization time and altered ICa-L kinetics. AG treatment attenuated this electrical remodeling, supported by AG-related shortened repolarization time, decreased peak ICa-L, accelerated ICa-L inactivation, and positive frequency-dependent ICa-L facilitation. In addition, AG treatment suppressed the overexpression of CaMKII, but not p-PKA, in the failing heart. Conclusion. AG treatment protected the failing heart against electrical remodeling and ICa-L remodeling by downregulating CaMKII.
Kim, Eugene; Kwon, Hye-Young; Baek, Sang Hong; Lee, Haeyoung; Yoo, Byung-Su; Kang, Seok-Min; Ahn, Youngkeun; Yang, Bong-Min
This study investigated annual medical costs using real-world data focusing on acute heart failure. The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed. On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%. Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated. It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.
Yang, Li; Ma, Xiaobing; Peng, Rui; Zhai, Qingqing; Zhao, Yu
This paper proposes a preventive maintenance policy for a single-unit system whose failure has two competing and dependent causes, i.e., internal deterioration and sudden shocks. The internal failure process is divided into two stages, i.e. normal and defective. Shocks arrive according to a non-homogeneous Poisson process (NHPP), leading to the failure of the system immediately. The occurrence rate of a shock is affected by the state of the system. Both an age-based replacement and finite number of periodic inspections are schemed simultaneously to deal with the competing failures. The objective of this study is to determine the optimal preventive replacement interval, inspection interval and number of inspections such that the expected cost per unit time is minimized. A case study on oil pipeline maintenance is presented to illustrate the maintenance policy. - Highlights: • A maintenance model based on two-stage deterioration and sudden shocks is developed. • The impact of internal system state on external shock process is studied. • A new preventive maintenance strategy combining age-based replacements and periodic inspections is proposed. • Postponed replacement of a defective system is provided by restricting the number of inspections.
In this study I show that simple heuristic models and numerical calculations suggest that an entire class of commonly invoked models of earthquake failure processes cannot explain triggering of seismicity by transient or "dynamic" stress changes, such as stress changes associated with passing seismic waves. The models of this class have the common feature that the physical property characterizing failure increases at an accelerating rate when a fault is loaded (stressed) at a constant rate. Examples include models that invoke rate state friction or subcritical crack growth, in which the properties characterizing failure are slip or crack length, respectively. Failure occurs when the rate at which these grow accelerates to values exceeding some critical threshold. These accelerating failure models do not predict the finite durations of dynamically triggered earthquake sequences (e.g., at aftershock or remote distances). Some of the failure models belonging to this class have been used to explain static stress triggering of aftershocks. This may imply that the physical processes underlying dynamic triggering differs or that currently applied models of static triggering require modification. If the former is the case, we might appeal to physical mechanisms relying on oscillatory deformations such as compaction of saturated fault gouge leading to pore pressure increase, or cyclic fatigue. However, if dynamic and static triggering mechanisms differ, one still needs to ask why static triggering models that neglect these dynamic mechanisms appear to explain many observations. If the static and dynamic triggering mechanisms are the same, perhaps assumptions about accelerating failure and/or that triggering advances the failure times of a population of inevitable earthquakes are incorrect.
the products of purine nucleotide catabolism (xanthine oxidase, xanthine dehydrogenase capable of producing reactive oxygen species, stimulating oxidative stress. Conclusions. The course of acute biliary pancreatitis in patients with diabetes mellitus is accompanied by regular changes in the markers of the syndrome of cytopathic hypoxia, the erythron system and iron metabolism, the severity of these disorders has a direct correlation with the area of morphological changes in the pancreas and the dynamics of markers of liver failure. Using the methods of protocol therapy, you can not carry out preventive correction of existing metabolic disorders that requires the inclusion into the standard conservative treatment for edema form of acute biliary pancreatitis of systemic multifunctional metabolic corrector (Berlithion® for systemic preventive correction of homeostasis and mechanisms of escalation of hepatic insufficiency manifestations, which, in the presence of necrotic forms, requires additional application of low molecular weight heparins (Zibor® for the restoration of hemorheological and hemocoalogulative disorders on the systemic and intraorganic levels.
Libby, Lisa K; Valenti, Greta; Pfent, Alison; Eibach, Richard P
The present research reveals that when it comes to recalling and imagining failure in one's life, changing how one looks at the event can change its impact on well-being; however, the nature of the effect depends on an aspect of one's self-concept, namely, self-esteem. Five studies measured or manipulated the visual perspective (internal first-person vs. external third-person) individuals used to mentally image recalled or imagined personal failures. It has been proposed that imagery perspective determines whether people's reactions to an event are shaped bottom-up by concrete features of the event (first-person) or top-down by their self-concept (third-person; L. K. Libby & R. P. Eibach, 2011b). Evidence suggests that differences in the self-concepts of individuals with low and high self-esteem (LSEs and HSEs) are responsible for self-esteem differences in reaction to failure, leading LSEs to have more negative thoughts and feelings about themselves (e.g., M. H. Kernis, J. Brockner, & B. S. Frankel, 1989). Thus, the authors predicted, and found, that low self-esteem was associated with greater overgeneralization--operationalized as negativity in accessible self-knowledge and feelings of shame--only when participants had pictured failure from the third-person perspective and not from the first-person. Further, picturing failure from the third-person, rather than first-person, perspective, increased shame and the negativity of accessible knowledge among LSEs, whereas it decreased shame among HSEs. Results help to distinguish between different theoretical accounts of how imagery perspective functions and have implications for the study of top-down and bottom-up influences on self-judgment and emotion, as well as for the role of perspective and abstraction in coping.
Schneider, David F; Sonderman, Philip E; Jones, Michaela F; Ojomo, Kristin A; Chen, Herbert; Jaume, Juan C; Elson, Diane F; Perlman, Scott B; Sippel, Rebecca S
Persistent or recurrent hyperthyroidism after treatment with radioactive iodine (RAI) is common and many patients require either additional doses or surgery before they are cured. The purpose of this study was to identify patterns and predictors of failure of RAI in patients with hyperthyroidism. We conducted a retrospective review of patients treated with RAI from 2007 to 2010. Failure of RAI was defined as receipt of additional dose(s) and/or total thyroidectomy. Using a Cox proportional hazards model, we conducted univariate analysis to identify factors associated with failure of RAI. A final multivariate model was then constructed with significant (p treatment, 53 (71.6 %) received additional RAI, 13 (17.6 %) received additional RAI followed by surgery, and the remaining 8 (10.8 %) were cured after thyroidectomy. The percentage of patients who failed decreased in a stepwise fashion as RAI dose increased. Similarly, the incidence of failure increased as the presenting T3 level increased. Sensitivity analysis revealed that RAI doses treatment (HR 2.55; 95 % CI 1.22-5.33; p = 0.01) were associated with failure. Laboratory values at presentation can predict which patients with hyperthyroidism are at risk for failing RAI treatment. Higher doses of RAI or surgical referral may prevent the need for repeat RAI in selected patients.
Cooke, R.; Paulsen, J.L.
competing failure modes. This article examines ways to assess maintenance performance without introducing statistical assumptions, then introduces a plausible statistical model for describing the interaction of preventive and corrective maintenance, and finally illustrates these with examples from...
Full Text Available Background/Aims: Lipopolysaccharides (LPS binding to Toll-like receptor 4 (TLR4 activate NADPH oxidase gp91 subunit-mediated inflammation and oxidative damage. Recognizing the high binding affinity of sialic acid (SA with LPS, we further explored the preventive potential of SA pretreatment on LPS-evoked acute renal failure (ARF. Methods: We determined the effect of intravenous SA 30 min before LPS-induced injury in urethane-anesthetized female Wistar rats by evaluating kidney reactive oxygen species (ROS responses, renal and systemic hemodynamics, renal function, histopathology, and molecular mechanisms. Results: LPS time-dependently reduced arterial blood pressure, renal microcirculation, and increased blood urea nitrogen and creatinine in the rats. LPS enhanced monocyte/macrophage infiltration and ROS production, and subsequently impaired kidneys with the enhancement of TLR4/NADPH oxidase gp91/Caspase 3/poly-(ADP-ribose-polymerase (PARP-mediated apoptosis in the kidneys. SA pretreatment effectively alleviated LPS-induced ARF. The levels of LPS-increased ED-1 infiltration and ROS production in the kidney were significantly depressed by SA pretreatment. Furthermore, SA pretreatment significantly depressed TLR4 activation, gp91 expression, and Caspase 3/PARP induced apoptosis in the kidneys. Conclusion: We suggest that pretreatment of SA significantly and preventively attenuated LPS-induced detrimental effects on systemic and renal hemodynamics, renal ROS production and renal function, as well as, LPS-activated TLR4/gp91/Caspase3 mediated apoptosis signaling.
Vidojkovic, Sonja; Onjia, Antonije; Matovic, Branko; Grahovac, Nebojsa; Maksimovic, Vesna; Nastasovic, Aleksandra
Prevention and minimizing corrosion processes on steam generating equipment is highly important in the thermal power industry. The maintenance of feedwater quality at a level corresponding to the standards of technological designing, followed by timely respond to the fluctuation of measured parameters, has a decisive role in corrosion prevention. In this study, the comprehensive chemical control of feedwater quality in 210 MW Thermal Power Plant (TPP) was carried out in order to evaluate its potentiality to assure reliable function of the boiler and discover possible irregularity that might be responsible for frequent boiler tube failures. Sensitive on-line and off-line analytical instruments were used for measuring key and diagnostic parameters considered to be crucial for boiler safety and performances. Obtained results provided evidences for exceeded levels of oxygen, silica, sodium, chloride, sulfate, copper, and conductivity what distinctly demonstrated necessity of feedwater control improvement. Consequently, more effective feedwater quality monitoring concept was recommended. In this paper, the explanation of presumable root causes of corrosive contaminants was given including basic directions for their maintenance in proscribed limits. -- Highlights: • Feedwater quality monitoring practice in a thermal power plant has been evaluated. • The more efficient feedwater quality control have been applied. • Analysis of feedwater quality parameters has been performed. • Exceeded levels of corrosive contaminants were found. • Recommendations for their maintenance at proscribed values were given
Wang Chaonan; Xing Liudong; Levitin, Gregory
This paper proposes an algorithm for the reliability analysis of non-repairable binary systems subject to competing failure propagation and failure isolation events with both global and selective failure effects. A propagated failure that originates from a system component causes extensive damage to the rest of the system. Global effect happens when the propagated failure causes the entire system to fail; whereas selective effect happens when the propagated failure causes only failure of a subset of system components. In both cases, the failure propagation that originates from some system components (referred to as dependent components) can be isolated because of functional dependence between the dependent components and a component that prevents the failure propagation (trigger components) when the failure of the trigger component happens before the occurrence of the propagated failure. Most existing studies focus on the analysis of propagated failures with global effect. However, in many cases, propagated failures affect only a subset of system components not the entire system. Existing approaches for analyzing propagated failures with selective effect are limited to series-parallel systems. This paper proposes a combinatorial method for the propagated failure analysis considering both global and selective effects as well as the competition with the failure isolation in the time domain. The proposed method is not limited to series-parallel systems and has no limitation on the type of time-to-failure distributions for the system components. The method is verified using the Markov-based method. An example of computer memory systems is analyzed to demonstrate the application of the proposed method.
Full Text Available Availabilities of subsea Blowout Preventers (BOP in the Gulf of Mexico Outer Continental Shelf (GoM OCS is investigated using a Markov method. An updated β factor model by SINTEF is used for common-cause failures in multiple redundant systems. Coefficient values of failure rates for the Markov model are derived using the β factor model of the PDS (reliability of computer-based safety systems, Norwegian acronym method. The blind shear ram preventer system of the subsea BOP components considers a demand rate to reflect reality more. Markov models considering the demand rate for one or two components are introduced. Two data sets are compared at the GoM OCS. The results show that three or four pipe ram preventers give similar availabilities, but redundant blind shear ram preventers or annular preventers enhance the availability of the subsea BOP. Also control systems (PODs and connectors are contributable components to improve the availability of the subsea BOPs based on sensitivity analysis.
Allen, Christopher T.; Wheeler, Joshua A.
Violence prevention groups on college campuses, in schools, and in communities are increasingly aware that violence against women cannot end unless men take an active role in stopping it, and the failure of many men to take the issue of violence against women seriously cannot be overlooked. At the University of South Carolina (USC), collaboration…
Full Text Available Purpose – The paper examines the main regulatory frameworks of the telecommunications industry through the concept of market failure and analyses how and why the policy often leads to undesirable outcomes that might be considered as regulatory failure. Methodology/approach/design – The research uses the EU regulatory framework for electronic communications as a base for the analysis of the main policy objectives through the prism of the market failure theory with an eye to the interests of the main market players in the telecommunications markets. Findings – About any aspect of regulation allows to find ways to create opportunities for some groups of the industry and stifle activity of others. Despite the theory of market failure provides reasonable justifications for regulation of telecommunications markets, it is possible to argue that many of these problems are mainly the consequence of the policy and could be better solved by market mechanisms. Originality/value – The results of the research allow to look at the problems of telecommunications development and issues of the high level of concentration of the telecommunications markets as regulatory formed problems rather than consequences of the inherited industry’s characteristics.
Grady, D.E. [Applied Research Associates, Albuquerque, NM (United States); Kipp, M.E. [Sandia National Labs., Albuquerque, NM (United States)
In the present study we describe the development of an experimental fracture material property test method specific to dynamic fragmentation. Spherical test samples of the metals of interest are subjected to controlled impulsive stress loads by acceleration to high velocities with a light-gas launcher facility and subsequent normal impact on thin plates. Motion, deformation and fragmentation of the test samples are diagnosed with multiple flash radiography methods. The impact plate materials are selected to be transparent to the x-ray method so that only test metal material is imaged. Through a systematic series of such tests both strain-to-failure and fragmentation resistance properties are determined through this experimental method. Fragmentation property data for several steels, copper, aluminum, tantalum and titanium have been obtained to date. Aspects of the dynamic data have been analyzed with computational methods to achieve a better understanding of the processes leading to failure and fragmentation, and to test an existing computational fragmentation model.
Ichim Thomas E
Full Text Available Abstract Patients with congestive heart failure (CHF that are not eligible for transplantation have limited therapeutic options. Stem cell therapy such as autologous bone marrow, mobilized peripheral blood, or purified cells thereof has been used clinically since 2001. To date over 1000 patients have received cellular therapy as part of randomized trials, with the general consensus being that a moderate but statistically significant benefit occurs. Therefore, one of the important next steps in the field is optimization. In this paper we discuss three ways to approach this issue: a increasing stem cell migration to the heart; b augmenting stem cell activity; and c combining existing stem cell therapies to recapitulate a "therapeutic niche". We conclude by describing a case report of a heart failure patient treated with a combination stem cell protocol in an attempt to augment beneficial aspects of cord blood CD34 cells and mesenchymal-like stem cells.
Teverovsky, Alexander A.
Soldering of molded case tantalum capacitors can result in damage to Ta205 dielectric and first turn-on failures due to thermo-mechanical stresses caused by CTE mismatch between materials used in the capacitors. It is also known that presence of moisture might cause damage to plastic cases due to the pop-corning effect. However, there are only scarce literature data on the effect of moisture content on the probability of post-soldering electrical failures. In this work, that is based on a case history, different groups of similar types of CWR tantalum capacitors from two lots were prepared for soldering by bake, moisture saturation, and longterm storage at room conditions. Results of the testing showed that both factors: initial quality of the lot, and preconditioning affect the probability of failures. Baking before soldering was shown to be effective to prevent failures even in lots susceptible to pop-corning damage. Mechanism of failures is discussed and recommendations for pre-soldering bake are suggested based on analysis of moisture characteristics of materials used in the capacitors' design.
Jin, Li; Piao, Zhe Hao; Sun, Simei; Liu, Bin; Ryu, Yuhee; Choi, Sin Young; Kim, Gwi Ran; Kim, Hyung-Seok; Kee, Hae Jin; Jeong, Myung Ho
Gallic acid, a trihydroxybenzoic acid found in tea and other plants, attenuates cardiac hypertrophy, fibrosis, and hypertension in animal models. However, the role of gallic acid in heart failure remains unknown. In this study, we show that gallic acid administration prevents heart failure-induced pulmonary fibrosis. Heart failure induced in mice, 8weeks after transverse aortic constriction (TAC) surgery, was confirmed by echocardiography. Treatment for 2weeks with gallic acid but not furosemide prevented cardiac dysfunction in mice. Gallic acid significantly inhibited TAC-induced pathological changes in the lungs, such as increased lung mass, pulmonary fibrosis, and damaged alveolar morphology. It also decreased the expression of fibrosis-related genes, including collagen types I and III, fibronectin, connective tissue growth factor (CTGF), and phosphorylated Smad3. Further, it inhibited the expression of epithelial-mesenchymal transition (EMT)-related genes, such as N-cadherin, vimentin, E-cadherin, SNAI1, and TWIST1. We suggest that gallic acid has therapeutic potential for the treatment of heart failure-induced pulmonary fibrosis. Copyright © 2017 Elsevier Inc. All rights reserved.
Giuliani, Meredith E.; Lindsay, Patricia E.; Sun, Alexander; Bezjak, Andrea; Le, Lisa W.; Brade, Anthony; Cho, John; Leighl, Natasha B.; Shepherd, Frances A.; Hope, Andrew J.
Purpose: To determine the patterns of loco-regional (LR) and distant failure in patients with limited-stage small cell lung carcinoma (LS-SCLC) treated with curative intent. Methods: From 1997 to 2008, 253 LS-SCLC patients were treated with curative intent chemo-radiation at our institution. A retrospective review identified sites of failure. The cumulative LR failure (LRF) rate was calculated. Distant failure-free survival (FFS) and overall survival (OS) were calculated using the Kaplan–Meier method. Volumetric images of LR failures were delineated and registered with the original radiation treatment plans if available. Dosimetric parameters for the delineated failure volumes were calculated from the original treatment information. Results: The median follow-up was 19 months. The site of first failure was LR in 34, distant in 80 and simultaneous LR and distant in 31 patients. The cumulative LRF rate was 29% and 38% at 2 and 5 years. OS was 44% at 2 years. Seventy patients had electronically archived treatment plans of which there were 16 LR failures (7 local and 39 regional failure volumes). Of the local and regional failure volumes 29% and 31% were in-field, respectively. Conclusions: The predominant pattern of LR failure was marginal or out-of-field. LR failures may be preventable with improved radiotherapy target definition.
Pironi, Loris; Arends, Jann; Bozzetti, Federico
: The following topics were addressed: management of HPN; parenteral nutrition formulation; intestinal rehabilitation, medical therapies, and non-transplant surgery, for short bowel syndrome, chronic intestinal pseudo-obstruction, and radiation enteritis; intestinal transplantation; prevention/treatment of CVC-related...... organ failure. Home parenteral nutrition (HPN) is the primary treatment for CIF. No guidelines (GLs) have been developed that address the global management of CIF. These GLs have been devised to generate comprehensive recommendations for safe and effective management of adult patients with CIF. METHODS......: The GLs were developed by the Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of ESPEN. The GRADE system was used for assigning strength of evidence. Recommendations were discussed, submitted to Delphi rounds, and accepted in an online survey of ESPEN members. RESULTS...
Núñez, Julio; Miñana, Gema; Santas, Enrique; Bertomeu-González, Vicente
Cardiorenal syndrome has been defined as the simultaneous dysfunction of both the heart and the kidney. Worsening renal function that occurs in patients with acute heart failure has been classified as cardiorenal syndrome type 1. In this setting, worsening renal function is a common finding and is due to complex, multifactorial, and not fully understood processes involving hemodynamic (renal arterial hypoperfusion and renal venous congestion) and nonhemodynamic factors. Traditionally, worsening renal function has been associated with worse outcomes, but recent findings have revealed mixed and heterogeneous results, perhaps suggesting that the same phenotype represents a diversity of pathophysiological and clinical situations. Interpreting the magnitude and chronology of renal changes together with baseline renal function, fluid overload status, and clinical response to therapy might help clinicians to unravel the clinical meaning of renal function changes that occur during an episode of heart failure decompensation. In this article, we critically review the contemporary evidence on the pathophysiology and clinical aspects of worsening renal function in acute heart failure. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Lutter, Stacy L; Thompson, Cheryl W; Condon, Marian C
Failure on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a devastating experience. Most research related to NCLEX-RN is focused on predicting and preventing failure. Despite these efforts, more than 20,000 nursing school graduates experience failure on the NCLEX-RN each year, and there is a paucity of literature regarding remediation after failure. The aim of this article is to describe an individualized tutoring approach centered on establishing a trusting relationship and incorporating two core strategies for remediation: the nugget method, and a six-step strategy for question analysis. This individualized tutoring method has been used by three nursing faculty with a 95% success rate on an NCLEX retake attempt. Further research is needed to identify the elements of this tutoring method that influence success. [J Nurs Educ. 2017;56(12):758-761.]. Copyright 2017, SLACK Incorporated.
Tallian, T. E.
This Atlas is structured as a supplement to the book: T.E. Tallian: Failure Atlas for Hertz Contact Machine Elements, 2nd edition, ASME Press New York, (1999). The content of the atlas comprises plate pages from the book that contain bearing failure images, application data, and descriptions of failure mode, image, and suspected failure causes. Rolling bearings are a critical component of the mainshaft system, gearbox and generator in the rapidly developing technology of power generating wind turbines. The demands for long service life are stringent; the design load, speed and temperature regimes are demanding and the environmental conditions including weather, contamination, impediments to monitoring and maintenance are often unfavorable. As a result, experience has shown that the rolling bearings are prone to a variety of failure modes that may prevent achievement of design lives. Morphological failure diagnosis is extensively used in the failure analysis and improvement of bearing operation. Accumulated experience shows that the failure appearance and mode of failure causation in wind turbine bearings has many distinguishing features. The present Atlas is a first effort to collect an interpreted database of specifically wind turbine related rolling bearing failures and make it widely available. This Atlas is structured as a supplement to the book: T. E. Tallian: Failure Atlas for Hertz Contact Machine Elements, 2d edition, ASME Press New York, (1999). The main body of that book is a comprehensive collection of self-contained pages called Plates, containing failure images, bearing and application data, and three descriptions: failure mode, image and suspected failure causes. The Plates are sorted by main failure mode into chapters. Each chapter is preceded by a general technical discussion of the failure mode, its appearance and causes. The Plates part is supplemented by an introductory part, describing the appearance classification and failure classification
Gurchiek, Larry; Mokha, Monique Butcher
Most coaches recognize the importance of creating a safe environment and preventing injuries of their athletes. Domain 2 is dedicated to this important aspect of coaching, and outlines specific areas within safety and injury prevention that coaches should address. Domain 2 sets the standards for facility, equipment, and environmental safety…
Whiteside, M.B.; Pinho, S.T.; Robinson, P.
Stochastic failure envelopes are generated through parallelised Monte Carlo Simulation of a physically based failure criteria for unidirectional carbon fibre/epoxy matrix composite plies. Two examples are presented to demonstrate the consequence on failure prediction of both statistical interaction of failure modes and uncertainty in global misalignment. Global variance-based Sobol sensitivity indices are computed to decompose the observed variance within the stochastic failure envelopes into contributions from physical input parameters. The paper highlights a selection of the potential advantages stochastic methodologies offer over the traditional deterministic approach.
Bafail, Arwa S; Alamri, Ahmed M; Spivakovsky, Silvia
Medline and hand search of the British Journal of Oral and Maxillofacial Surgery, Clinical Implant Dentistry and Related Research, Clinical Oral Investigations, Clinical Oral Implants Research, European Journal of Oral Implantology, Implant Dentistry, International Journal of Oral and Maxillofacial Implants, International Journal of Oral and Maxillofacial Surgery, Journal of Clinical Periodontology, Journal of Oral Implantology, Journal of Oral and Maxillofacial Surgery, Journal of Periodontology Medicina Oral, Patologa Oral y Cirugía Bucal, and Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. Search of the literature was made to identify randomised controlled trials (RCTs) on the efficacy of antibiotics compared with a control group (not receiving antibiotics or receiving placebo. All articles selected from the electronic and manual searches were independently assessed by the first and second authors of this study, in accordance with the established inclusion criteria. Two reviewers independently and in duplicate evaluated the quality of the included RCTs as part of the data extraction process. Four RCTs were included in the final review. These four RCTs grouped a total of 2063 implants and a total of 1002 patients. Antibiotic use significantly lowered the implant failure rate (P = 0.003), with an odds ratio of 0.331, implying that antibiotic treatment reduced the odds of failure by 66.9%. The number needed to treat (NNT) to prevent one patient from having an implant failure was 48 (95% confidence interval 31-109). In contrast, antibiotic use did not significantly reduce the incidence of postoperative infection (P = 0.754). Based on the results of this meta-analysis, and pending further research in the field, it can be concluded that there is evidence in favour of systematic antibiotic use in patients receiving dental implants, since such treatment significantly reduces implant failure. In contrast, antibiotic use does not exert a
Caviedes Bottner, Paola; Córdova Fernández, Tamara; Larraín Valenzuela, Marcos; Cruces Romero Presentación de Casos Clínicos, Pablo
Dilated cardiomyopathy is the main cause of heart failure leading to heart transplant. Its prognosis is variable and depends on the etiology, the patient's age at onset, and the severity. The management of dilated cardiomyopathy is aimed at minimizing symptoms and preventing disease progression; it requires a comprehensive screening for comorbidities and the prevention of complications to improve the overall status of these children and mitigate their prognosis. Here we present a review oriented at the multidisciplinary management that pediatricians should consider when seeing these patients. Sociedad Argentina de Pediatría.
This Venezuelan standard establishes the aspects that must be included in the elaboration and monitoring of an Hygiene and Industrial Security Program (Prevention of Accidents and Occupational Diseases Program). It is applicable to any type of exploitation company, or any kind of task (in nature or importance) where people work, no matter the number workers [es
Taleghani, Yasamin Molavi; Rezaei, Fatemeh; Sheikhbardsiri, Hojat
Ensuring about the patient's safety is the first vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care. In this study, in combination (qualitative action research and quantitative cross-sectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis (HFMEA). To classify the failure modes from the "nursing errors in clinical management model (NECM)", the classification of the effective causes of error from "Eindhoven model" and determination of the strategies to improve from the "theory of solving problem by an inventive method" were used. To analyze the quantitative data of descriptive statistics (total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used. In 5 selected processes by "voting method using rating", 23 steps, 61 sub-processes and 217 potential failure modes were identified by HFMEA. 25 (11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors (54.7%) and knowledge and skill (9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy. "Revision and re-engineering of processes", "continuous monitoring of the works", "preparation and revision of operating procedures and policies", "developing the criteria for evaluating the performance of the personnel", "designing a suitable educational content for needs of employee", "training patients", "reducing the workload and power shortage", "improving team
Näsström, Lena; Luttik, Marie Louise; Idvall, Ewa; Strömberg, Anna
To describe the partners' perspectives on participation in the care for patients with heart failure receiving home care. Partners are often involved in care of patients with heart failure and have an important role in improving patients' well-being and self-care. Partners have described both negative and positive experiences of involvement, but knowledge of how partners of patients with heart failure view participation in care when the patient receives home care is lacking. A convergent parallel mixed-method design was used, including data from interviews and questionnaires. A purposeful sample of 15 partners was used. Data collection lasted between February 2010 - December 2011. Interviews were analysed with content analysis and data from questionnaires (participation, caregiving, health-related quality of life, depressive symptoms) were analysed statistically. Finally, results were merged, interpreted and labelled as comparable and convergent or as being inconsistent. Partners were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation: adapting to the caring needs and illness trajectory, coping with caregiving demands, interacting with healthcare providers and need for knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context. The results revealed different levels of partner participation. Heart failure home care included good opportunities for both participation and contact during home visits, necessary to meet partners' ongoing need for information to comprehend the situation. © 2016 John Wiley & Sons Ltd.
Sujalmo Saiful; Kuntoro Iman; Sato, Mitsugu; Isshiki, Masahiko.
A fuel failure detection system (FFDS) has been designed for the Reactor GA. Siwabessy. The FFDS is aimed to detect fuel failure by observing delayed neutron released by fission products such as N-17, I-137, Br-87 and Br-88 in the primary cooling system. The delayed neutrons will be detected by using four neutron detectors, type BF-3, which are located inside a Sampling Tank. The detector location has been determined and the location is associated with the transit time from the reactor core outlet to the Sampling Tank, which is approximately 60 seconds. The neutron detection efficiency was calculated by using a computer code named MORSE. The FFDS has the capability to detect as quickly as possible, even a small failure of a fuel element occurring in the reactor core. Therefore the presence of FFDS in a reactor must be considered, in order to prevent further progress if the fuel failure occurs. (author)
Okazaki, Masakazu; Muzvidziwa, Milton; Iwasaki, Akira; Kasahara, Naoto
High cycle thermal fatigue failure of pipes induced by fluid temperature change is one of the interdisciplinary issues to be concerned for long term structural reliability of high temperature components in energy systems. In order to explore advanced life assessment methods to prevent the failure, fatigue crack propagation tests were carried out in a low alloy steel and an austenitic stainless steel under typical thermal and thermo-mechanical histories. Special attention was paid to both the effect of thermo-mechanical loading history on the fatigue crack threshold, as well as to the applicability of continuum fracture mechanics treatment to small or short cracks. It was shown experimentally that the crack-based remaining fatigue life evaluation provided more reasonable assessment than the traditional method based on the semi-empirical law in terms of 'usage factor' for high cycle thermal fatigue failure that is employed in JSME Standard, S017. The crack propagation analysis based on continuum fracture mechanics was almost successfully applied to the small fatigue cracks of which size was comparable to a few times of material grain size. It was also shown the thermo-mechanical histories introduced unique effects to the prior fatigue crack wake, resulting in occasional change in the fatigue crack threshold. (author)
Vaurio, Jussi K.
Simultaneous failures of multiple components due to common causes at random times are modelled by constant multiple-failure rates. A procedure is described for quantification of common cause failure (CCF) basic event probabilities for system models using plant-specific and multiple-plant failure-event data. Methodology is presented for estimating CCF-rates from event data contaminated with assessment uncertainties. Generalised impact vectors determine the moments for the rates of individual systems or plants. These moments determine the effective numbers of events and observation times to be input to a Bayesian formalism to obtain plant-specific posterior CCF-rates. The rates are used to determine plant-specific common cause event probabilities for the basic events of explicit fault tree models depending on test intervals, test schedules and repair policies. Three methods are presented to determine these probabilities such that the correct time-average system unavailability can be obtained with single fault tree quantification. Recommended numerical values are given and examples illustrate different aspects of the methodology
Hauke, Angelika; Flaspöler, Eva; Reinert, Dietmar
Global trends such as digitalisation, globalisation and demographic change are changing workplaces, and accordingly occupational safety and health (OSH) needs. To better prepare for the future and to foster proactive prevention, the German Social Accident Insurance (DGUV) established an OSH risk observatory (RO OSH). The RO OSH relies on an online survey and calls upon the expertise of labour inspectors. 398 labour inspectors participated in the first RO OSH enquiry. They rated developments with regard to their sector-specific relevance for OSH in the near future. The RO OSH also provides ideas for preventive measures that can be implemented by the German Social Accident Insurance Institutions. Work intensity, demographic aspects, and digitalisation play a major role for most or all sectors. However, familiar OSH issues such as musculoskeletal strain and noise also continue to be of major importance and require further consideration and specific solutions in prevention. For the DGUV, training and consulting bear great potential for proactive prevention in the above priority areas, e.g. by fostering a prevention culture and supporting companies in (psychosocial) risk assessment (also for mobile work). For instance, concepts for increasing physical activity at sedentary workplaces, and data security require continued research.
Popa, C.; Patachia, M.; Banita, S.; Matei, C.; Bratu, A. M.; Dumitras, D. C.
In recent years there has been a large increase in the areas related to developments in the prevention of diseases, especially in explaining the role of oxidative stress. Lipid peroxidation and oxidative stress contributes to morbidity in hemodialysis (HD) patients. It is therefore relevant to analyze the impact of oxidative stress and its related species (ethylene) immediately after dialysis treatment in order to prevent trauma in the renal failure of elderly patients. In this paper we describe recent progress in laser photoacoustic spectroscopy detection of ethylene in renal failure patients. We have found that HD treatment increases ethylene concentration in the exhaled breath of elderly patients and may intensify oxidative stress.
Najimi, Arash; Sharifirad, Gholamreza; Amini, Mehdi Mohammad; Meftagh, Sayyed Davood
Educational failure is one of the most important problems in higher education institutes in Iran. This study was performed to investigate the factors affecting students' academic failure in Isfahan University of Medical Sciences. In this cross-sectional descriptive study, 280 students of Isfahan University of Medical Sciences were studied in 2009. They were chosen using multiple cluster sampling. The students' demographic characteristics and study information were collected by a valid and reliable questionnaire. Data were analyzed with SPSS (15) software. The most important factors affecting educational failure from students' point of view were: curriculum (4.23 ± 0.63), factors related to educator (3.88 ± 0.55), learning environment (3.63 ± 0.62), family factors (3.53 ± 0.6), socioeconomic factors (3.45 ± 0.69). There is a significant relationship between attitudes of students in two sexes and educator (P = 0.03) and socioeconomic environment (P = 0.003). In addition, the results did not show a significant difference between attitudes of students with age, marital status and employment status (P > 0.05). More attention to curriculum, factors related to educator and learning environment can prevent students' educational failure, in addition to preventing loss of resources and contribute to develop a more effective educational system.
Most cases of hospitalisation for heart failure are preceded by episodes of cardiac decompensation. Preventing these episodes would improve quality of life and reduce mortality and treatment costs. The monitoring of intracardiac pressures, using innovative sensors, coupled with telemedicine, offers interesting perspectives. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
It is anticipated that the change of frequency of surveillance tests, preventive maintenance or parts replacement of safety related components may cause the change of component failure probability and result in the change of core damage probability. It is also anticipated that the change is different depending on the initiating event frequency or the component types. This study assessed the change of core damage probability using simplified PSA model capable of calculating core damage probability in a short time period, which is developed by the US NRC to process accident sequence precursors, when various component's failure probability is changed between 0 and 1, or Japanese or American initiating event frequency data are used. As a result of the analysis, (1) It was clarified that frequency of surveillance test, preventive maintenance or parts replacement of motor driven pumps (high pressure injection pumps, residual heat removal pumps, auxiliary feedwater pumps) should be carefully changed, since the core damage probability's change is large, when the base failure probability changes toward increasing direction. (2) Core damage probability change is insensitive to surveillance test frequency change, since the core damage probability change is small, when motor operated valves and turbine driven auxiliary feed water pump failure probability changes around one figure. (3) Core damage probability change is small, when Japanese failure probability data are applied to emergency diesel generator, even if failure probability changes one figure from the base value. On the other hand, when American failure probability data is applied, core damage probability increase is large, even if failure probability changes toward increasing direction. Therefore, when Japanese failure probability data is applied, core damage probability change is insensitive to surveillance tests frequency change etc. (author)
Park, J.H.; Chang, Woojin; Lie, C.H.
We develop a preventive maintenance (PM) model for a unit operated under stressful environment. The PM model in this paper consists of a failure rate model and two cost models to determine the optimal PM scheduling which minimizes a cost rate. The assumption for the proposed model is that stressful environment accelerates the failure of the unit and periodic maintenances reduce stress from outside. The failure rate model handles the maintenance effect of PM using improvement and stress factors. The cost models are categorized into two failure recognition cases: immediate failure recognition and periodic failure detection. The optimal PM scheduling is obtained by considering the trade-off between the related cost and the lifetime of a unit in our model setting. The practical usage of our proposed model is tested through a numerical example.
Failure analyses were performed on cracked FS-85 tubing and ASTAR-811C and caps which had been fabricated as components of biaxial creep specimens meant to support materials testing for the NR Space program. During the failure analyses of cracked FS-85 tubing, it was determined that the failure potentially could be due to two effects: possible copper contamination from the EDM (electro-discharge machined) recast layer and/or an insufficient solution anneal. to prevent similar failures in the future, a more formal analysis should be done after each processing step to ensure the quality of the material before further processing. During machining of the ASTAR-811FC rod to form end caps for biaxial creep specimens, linear defects were observed along the center portion of the end caps. These defects were only found in material that was processed from the top portion of the ingot. The linear defects were attributed to a probable residual ingot pipe that was not removed from the ingot. During the subsequent processing of the ingot to rod, the processing temperatures were not high enough to allow self healing of the ingot's residual pipe defect. To prevent this from occurring in the future, it is necessary to ensure that complete removal of the as-melted ingot pipe is verified by suitable non-destructive evaluation (NDE)
Shives, T. R.; Willard, W. A.
The design and application of advanced composites is discussed with emphasis on aerospace, aircraft, automotive, marine, and industrial applications. Failure modes in advanced composites are also discussed.
Koyama, Jill P.
A little-discussed aspect of the No Child Left Behind Act (NCLB) is a mandate that requires failing schools to hire after-school tutoring companies--the largest of which are private, for-profit corporations--and to pay them with federal funds. "Making Failure Pay" takes a hard look at the implications of this new blurring of the…
Chacon Nava, Jose G; Martinez Villafane, Alberto [Instituto de Investigaciones Electricas, Cuernavaca (Mexico); Fuentes Samaniego, Raul [Universidad Autonoma de Nuevo Leon (Mexico); Mojica Calderon, Cecilio [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)
In this article the general aspects of the steam generator superheater fixed spacers failures are analyzed, emphasis is made on the influence several aspects such as the operation of the unit have, the appropriate execution of welds and the selection of binding materials. Likewise several recommendations are made to bring the failures to a minimum. [Espanol] En este articulo se analizan aspectos generales de fallas en espaciadores fijos de sobrecalentadores de generadores de vapor, y se hace hincapie en la influencia que tienen diversos aspectos tales como la operacion de la unidad, la adecuada ejecucion de soldaduras y la seleccion del material de aporte. Asimismo, se proponen algunas recomendaciones para reducir al minimo las fallas.
Full Text Available Banyak metode dalam Total Quality Management (TQM yang dapat digunakan untuk melakukan perbaikan kualitas produk dan jasa. Salah satunya adalah Multi Attribute Failure Mode Analysis (MAFMA, yang dapat digunakan untuk mengeliminasi atau mengurangi kemungkinan terjadinya kegagalan bila dilihat dari faktor penyebabnya, sehingga dapat mencegah terulang kembali kegagalan tersebut. MAFMA merupakan pengembangan dari Failure Mode and Effect Analysis (FMEA, yang mengintegrasikan atribut severity, occurance, dan detectability dengan aspek ekonomi yakni expected cost. Pada FMEA, penentuan penyebab kegagalan potensial suatu produk dilakukan dengan memberikan nilai (score pada atribut severity, occurance, dan detectability, yang dilanjutkan dengan menghitung nilai Risk Priority Number (RPN tertinggi. Sedangkan pada MAFMA, penentuan penyebab kegagalan potensial dilakukan dengan pemberian bobot pada ke-empat atribut. Pemberian bobot tersebut menggunakan Analytic Hierarchy Process (AHP dengan logika fuzy. Atribut severity, occurance, detectability dan expected cost pada MAFMA dimasukkan sebagai level kriteria dalam struktur hirarkhi AHP, sedangkan penyebab-penyebab kegagalan akan menjadi level alternatif pada struktur hirarkhi tersebut. Studi kasus pada PT Pelita Cengkareng Paper & Co. menunjukkan bahwa bobot kriteria severity sebesar 0.3461, kriteria occurance sebesar 0.0848, kriteria detectability sebesar 0.1741 dan kriteria expected cost sebesar 0.3950.Sedangkan penyebab kegagalan potensial adalah penggumpalan chemical dengan bobot tertinggi sebesar 0.210. Kata kunci: AHP, logika fuzzy, MAFMA There are several methods of Total Quality Management (TQM that can be used to improve quality of product and service. One of those is Multi Attribute Failure Mode Analysis (MAFMA, which can be used to eliminate or minimize the failure probability based on its causal factor, so we can prevent the same failure in the future. MAFMA is development of Failure Mode
Gallagher, Sean; Schall, Mark C
Mounting evidence suggests that musculoskeletal disorders (MSDs) may be the result of a fatigue failure process in musculoskeletal tissues. Evaluations of MSD risk in epidemiological studies and current MSD risk assessment tools, however, have not yet incorporated important principles of fatigue failure analysis in their appraisals of MSD risk. This article examines the evidence suggesting that fatigue failure may play an important role in the aetiology of MSDs, assesses important implications with respect to MSD risk assessment and discusses research needs that may be required to advance the scientific community's ability to more effectively prevent the development of MSDs. Practitioner Summary: Evidence suggests that musculoskeletal disorders (MSDs) may result from a fatigue failure process. This article proposes a unifying framework that aims to explain why exposure to physical risk factors contributes to the development of work-related MSDs. Implications of that framework are discussed.
Thornton, Eavan; Brook, Olga R; Mendiratta-Lala, Mishal; Hallett, Donna T; Kruskal, Jonathan B
With increasing deployment, complexity, and sophistication of equipment and related processes within the clinical imaging environment, system failures are more likely to occur. These failures may have varying effects on the patient, ranging from no harm to devastating harm. Failure mode and effect analysis (FMEA) is a tool that permits the proactive identification of possible failures in complex processes and provides a basis for continuous improvement. This overview of the basic principles and methodology of FMEA provides an explanation of how FMEA can be applied to clinical operations in a radiology department to reduce, predict, or prevent errors. The six sequential steps in the FMEA process are explained, and clinical magnetic resonance imaging services are used as an example for which FMEA is particularly applicable. A modified version of traditional FMEA called Healthcare Failure Mode and Effect Analysis, which was introduced by the U.S. Department of Veterans Affairs National Center for Patient Safety, is briefly reviewed. In conclusion, FMEA is an effective and reliable method to proactively examine complex processes in the radiology department. FMEA can be used to highlight the high-risk subprocesses and allows these to be targeted to minimize the future occurrence of failures, thus improving patient safety and streamlining the efficiency of the radiology department. RSNA, 2010
Full Text Available Maya Guglin, Marc KaufmanUniversity of South Florida, Tampa, FL, USAAbstract: Inotrope use is one of the most controversial topics in the management of heart failure. While the heart failure community utilizes them and recognizes the state of inotrope dependency, retrospective analyses and registry data have overwhelmingly suggested high mortality, which is logically to be expected given the advanced disease states of those requiring their use. Currently, there is a relative paucity of randomized control trials due to the ethical dilemma of creating control groups by withholding inotropes from patients who require them. Nonetheless, results of such trials have been mixed. Many were also performed with agents no longer in use, on patients without an indication for inotropes, or at a time before automatic cardio-defibrillators were recommended for primary prevention. Thus, their results may not be generalizable to current clinical practice. In this review, we discuss current indications for inotrope use, specifically dobutamine and milrinone, depicting their mechanisms of action, delineating their patterns of use in clinical practice, defining the state of inotrope dependency, and ultimately examining the literature to ascertain whether evidence is sufficient to support the current view that these agents increase mortality in patients with heart failure. Our conclusion is that the evidence is insufficient to link inotropes and increased mortality in low output heart failure.Keywords: inotropes, dobutamine, milrinone, heart failure
Full Text Available BACKGROUND AND OBJECTIVES: Congestive heart failure (CHF continues to be a major clinical and public health problem. Conflicting data exists about its rate of occurrence in general population, relative frequencies of predisposing heart diseases and the prognosis of the patient. In the present study, gender aspects, age wise distribution, drug distribution pattern were assessed in these patients. MATERIALS AND METHODS: A total number of 100 patients from the medical outpatient department of medicine, M.G.M. Hospital Warangal were en rolled into the study. All male and female patients between 30 to 85 years of age, diagnosed with heart failure falling into the category of functional New York Heart Association (NYHA class II or III with left ventricular ejection fraction (LVEF ≤35% we re included in the study. RESULTS: Of the 100 subjects studied 55 (40 - 75 yr were male and 45 (35 - 73 yr were female. 94 patients presented with ischemic heart failure compared to only 6 patients with non - ischemic heart failure. Out of total subjects enrol led, 61 were put on Digoxin, 71 on Diuretics, 47 on ACEI, 20 on Beta Blocker (Carvedilol, 30 on Nitrates, 64 on Anticoagulants, 19 on Statins. CONCLUSION: The incidence of heart failure was more in advanced age groups and slightly more common in males. Is chemic heart disease accounted for heart failure in majority of patients in our study we found that Digoxin, Diuretics, ACEI and Anticoagulants followed by Nitrates, Beta blockers and Statins were the most prescribed medications in the management of heart failure
A pollution prevention plan is an organized, comprehensive, and continual effort to systematically reduce waste generation. The Hanford Site Pollution Prevention Plan is designed to eliminate or minimize pollutant releases to all environmental media from all aspects of Site operations. These efforts offer increased protection of public health and the environment. This plan reflects the goals and policies for pollution prevention at the Hanford Site and represents an ongoing effort to make pollution prevention part of the Site operating philosophy. The plan encompasses hazardous waste only and excludes radioactive waste and radioactive mixed waste
Wisgerhof, Hermina Christina
The risk of (skin) cancer is highly increased in organ-transplant recipients who are kept on immunesuppressive drugs to prevent graft rejection. This thesis dealt with the epidemiologic aspects and risk factors for cancer focused on cutaneous squamous cell carcinoma and basal cell carcinoma.
LaDonna, Kori A; Ginsburg, Shiphra; Watling, Christopher
Medical practice is uncertain and complex. Consequently, even outstanding performers will inevitably experience moments of underperformance and failure. Coping relies on insight and resilience. However, how physicians develop and use these skills to navigate struggle remains underexplored. A better understanding may reveal strategies to support both struggling learners and stressed practitioners. In 2015, 28 academic physicians were interviewed about their experiences with underperformance or failure. Constructivist grounded theory informed data collection and analysis. Participants' experiences with struggle ranged from patient errors and academic failures to frequent, smaller moments of interpersonal conflict and work-life imbalance. To buffer impact, participants sometimes shifted their focus to an aspect of their identity where they felt successful. Additionally, while participants perceived that insight develops by acknowledging and reflecting on error, they sometimes deflected blame for performance gaps. More often, participants seemed to accept personal responsibility while simultaneously sharing accountability for underperformance or failure with external forces. Paradoxically, participants perceived learners who used these strategies as lacking in insight. Participants demonstrated the protective and functional value of distributing responsibility for underperformance and failure. Shifting and sharing may be an element of reflection and resilience; recognizing external factors may provide a way to gain perspective and to preserve the self. However, this strategy challenges educators' assumptions that learners who deflect are avoiding personal responsibility. The authors' findings raise questions about what it means to be resilient, and how assumptions about learners' responses to failure may affect strategies to support underperforming learners.
Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...
Prevention has received a peculiar conceptual formulation in working activities with radiation risk. In order to point out the operative aspects of this formulation the authors relates here the considerations, the criteria an the precautionary measures which have guided the choice or that have been actuated to reduce the risk for the workers of the EUREX reprocessing plant. The general aspect of this formulationa has a philosophical and doctrinarian course, peculiar in the probabilistic safety approach and in radioprotection methodology. The authors quotes here some concepts and some specific application of both but he shows above all the medical aspects of the radioprotection
As time goes by and experience is gained, modernization and technological development show the need to implement more complex programs and procedures to ensure a high level of compliance with radiation safety, particularly in those activities in which radioactive material is used in industry. A relevant aspect of present technology is the concern to introduce mechanisms to prevent radiological accidents or incidents, to ensure early detection of failures. This includes systems that either individually or as a whole, increase the level of responsibility of the different disciplines involved, so as to avoid a situation that could lead to loss of control of the facility or part of it. The prevention of an abnormal situation, overexposure of workers or unwanted risks, should be considered in the level of vulnerability of the facility, a concept drawn from international protection systems and which is applied directly in radiation safety. Preventive management, risk communication and proposals for change or improvement along with the detection of risks and training, constitute all the factors contained within prevention policies. Dose limitation, optimization and justification, old tools used for decades, could not be replaced by other modern concepts and criteria. ALARA culture (including performance indicators) should be considered. The atmosphere at work, working under pressure as well as other factors such as quality issues, ethics of prevention, etc. align with this idea of prevention and safety, besides changes in attitude, towards risk prevention (methods, reports, intervention guides, working instructions, and any other helpful tool), are followed by preventive, as well as predictive and corrective maintenance, applied to minimize the dose absorbed by workers. A clear policy of prevention is needed as well as an appropriate level of radiation safety which should be taken into account since the very beginning of the development of a given practice. All these
Truppa, Walter Adrian
As time goes by and experience is gained, modernization and technological development show the need to implement more complex programs and procedures to ensure a high level of compliance with radiation safety, particularly in those activities in which radioactive material is used in industry. A relevant aspect of present technology is the concern to introduce mechanisms to prevent radiological accidents or incidents, to ensure early detection of failures. This includes systems that either individually or as a whole, increase the level of responsibility of the different disciplines involved, so as to avoid a situation that could lead to loss of control of the facility or part of it. The prevention of an abnormal situation, overexposure of workers or unwanted risks, should be considered in the level of vulnerability of the facility, a concept drawn from international protection systems and which is applied directly in radiation safety. Preventive management, risk communication and proposals for change or improvement along with the detection of risks and training, constitute all the factors contained within prevention policies. Dose limitation, optimization and justification, old tools used for decades, could not be replaced by other modern concepts and criteria. ALARA culture (including performance indicators) should be considered. The atmosphere at work, working under pressure as well as other factors such as quality issues, ethics of prevention, etc. align with this idea of prevention and safety, besides changes in attitude, towards risk prevention (methods, reports, intervention guides, working instructions, and any other helpful tool), are followed by preventive, as well as predictive and corrective maintenance, applied to minimize the dose absorbed by workers. A clear policy of prevention is needed as well as an appropriate level of radiation safety which should be taken into account since the very beginning of the development of a given practice. All these
Full Text Available A patient with miliary tuberculosis and a chronic urogenital focus is described, who had a borderline renal function at diagnosis and developed overt renal failure upon daily treatment with rifampin (RMP, isoniazid (INH and ethambutol (EMB. This is the first Brazilian report of BMP induced renal damage. A renal biopsy taken on the third day of oliguria showed recent tubular necrosis with acute interstitial inflammation and granuloma formation. The aspect of the granulomatous lesion hightly suggested drug etiology because of the lack of palisading, high incidence of neutrophils and absence of facid-fast bacilli. This is the first presentation of an acute granulomatous interstitial nephritis probably due to RMP. Furthermore the pathogenesis of the renal damage caused by tuberculosis and RMP are discussed.
Katz, Jason; Wandersman, Abraham; Goodman, Robert M.; Griffin, Sarah; Wilson, Dawn K.; Schillaci, Michael
Historically, there has been considerable variability in how formative evaluation has been conceptualized and practiced. FORmative Evaluation Consultation And Systems Technique (FORECAST) is a formative evaluation approach that develops a set of models and processes that can be used across settings and times, while allowing for local adaptations and innovations. FORECAST integrates specific models and tools to improve limitations in program theory, implementation, and evaluation. In the period since its initial use in a federally funded community prevention project in the early 1990s, evaluators have incorporated important formative evaluation innovations into FORECAST, including the integration of feedback loops and proximal outcome evaluation. In addition, FORECAST has been applied in a randomized community research trial. In this article, we describe updates to FORECAST and the implications of FORECAST for ameliorating failures in program theory, implementation, and evaluation. PMID:23624204
A reduction in academic achievement over the course of adolescence has been observed. School failure is characterized by difficulties to teaching school goals. A variety of other behavioral problems are often associated with school failure. Child-to-parent violence has been associated with different school problems. The main objective of current study was to examine the contribution of family variables (parental education level, family cohesion, and positive family discipline) on academic failure and child-to-parent violence of adolescents from a community sample. Moreover, a goal was to explore if academic failure was a valid predictor of child-to-parent violence. To this end, it has been developed a comprehensive statistical model through Structural Equation Modeling (SEM). Participants were 584 children from eight secondary schools in the Basque Country (Spain) and aged between 12 and 18. Among other scales Conflict Tactics Scale and Family Environment Scale were administrated for measuring child-to-parent violence and family cohesion environment, respectively. The structural model revealed that parental education level is a relevant protective factor against academic failure. Positive family discipline (inductive discipline, supervision, and penalty) show a significant association with child-to-parent violence and academic failure. Disciplinary practices could be more efficient to prevent child-to-parent violence or school failure if children perceive a positive environment in their home. However, these findings could be explained by inverse causality, because some parents respond to child-to-parent violence or academic failure with disciplinary strategies. School failure had indirect effects on child-to-parent violence through family cohesion. For all that, education policies should focus on parental education courses for disadvantaged families in order to generate appropriate learning environments at home and to foster improvement of parent
The objective of this work is to develop basic data for examination on efficiency of preventive maintenance and actuation test from the standpoint of failure probability. This work consists of a statistical trend analysis of valve failure probability in a failure-to-open/close mode on time since installation and time since last open/close action, based on the field data of operating- and failure-experience. In this work, the terms both dependent and independent on time were considered in the failure probability. The linear aging model was modified and applied to the first term. In this model there are two terms with both failure rates in proportion to time since installation and to time since last open/close-demand. Because of sufficient statistical population, motor-operated valves (MOV's) in sodium system were selected to be analyzed from the CORDS database which contains operating data and failure data of components in the fast reactors and sodium test facilities. According to these data, the functional parameters were statistically estimated to quantify the valve failure probability in a failure-to-open/close mode, with consideration of uncertainty. (J.P.N.)
Mary Colleen Bhalla
Full Text Available Exertional rhabdomyolysis is sequela that is occasionally seen after strenuous exercise. The progression to compartment syndrome or renal failure is a rare complication that requires prompt recognition and treatment to prevent morbidity (Giannoglou et al. 2007. We present a case of a 22-year-old college football player who presented to the emergency department (ED after a typical leg workout as part of his weight conditioning. He was found to have rhabdomyolysis with evidence of renal insufficiency. His condition progressed to bilateral compartment syndrome and renal failure requiring dialysis. After bilateral fasciotomies were performed he had resolution of his compartment syndrome. He continued to be dialysis dependent and had no return of his renal function at discharge 12 days after admission.
Thomas, R.; Huntley, A.; Mann, M.; Huws, D.; Paranjothy, S.; Elwyn, G.; Purdy, S.
Unplanned admissions for heart failure are common and some are considered preventable. OBJECTIVE: Undertake a systematic literature review and meta-analysis to evaluate the effectiveness of specialist clinics in reducing unplanned hospital admissions in people with heart failure. DATA SOURCES: 18
Xiao, Guan-Yu; Liu, I-Hsuan; Cheng, Chun-Chun; Chang, Chia-Chun; Lee, Yen-Hua; Cheng, Winston Teng-Kuei; Wu, Shinn-Chih
Chemotherapy used to treat cancer may cause irreversible premature ovarian failure (POF). Of late, amniotic fluid stem cells (AFSCs) provide a novel source for regenerative medicine because of their primitive stage, low immunogenicity, and easy accessibility. In this study, we isolated AFSCs from transgenic mice that ubiquitously express enhanced green fluorescence protein (EGFP). These AFSCs exhibited morphologies, immunophenotypes, and mesoderm trilineage differentiation potentials similar to mesenchymal stem cells (MSCs). Further, AFSCs proliferated faster than MSCs and expressed OCT4, a marker for pluripotency. To investigate their potential in recovering fertility in POF model, AFSCs were transplanted into the ovaries of mice with POF six weeks post induction using chemotherapeutic drugs, busulfan and cyclophosphamide. AFSCs could rescue the reproductive ability of mice with POF by preventing follicle atresia and sustaining the healthy follicles. Notably, the transplanted AFSCs did not differentiate into granulosa and germline cells in vivo. After one month, the decreased numbers of transplanted AFSCs accompanied with the reduced beneficial effects indicated that the therapeutic efficacy were directly from AFSCs. These findings demonstrated the therapeutic effects of AFSCs and suggested the promise of AFSCs for treating infertility and POF caused by chemotherapy.
Full Text Available Chemotherapy used to treat cancer may cause irreversible premature ovarian failure (POF. Of late, amniotic fluid stem cells (AFSCs provide a novel source for regenerative medicine because of their primitive stage, low immunogenicity, and easy accessibility. In this study, we isolated AFSCs from transgenic mice that ubiquitously express enhanced green fluorescence protein (EGFP. These AFSCs exhibited morphologies, immunophenotypes, and mesoderm trilineage differentiation potentials similar to mesenchymal stem cells (MSCs. Further, AFSCs proliferated faster than MSCs and expressed OCT4, a marker for pluripotency. To investigate their potential in recovering fertility in POF model, AFSCs were transplanted into the ovaries of mice with POF six weeks post induction using chemotherapeutic drugs, busulfan and cyclophosphamide. AFSCs could rescue the reproductive ability of mice with POF by preventing follicle atresia and sustaining the healthy follicles. Notably, the transplanted AFSCs did not differentiate into granulosa and germline cells in vivo. After one month, the decreased numbers of transplanted AFSCs accompanied with the reduced beneficial effects indicated that the therapeutic efficacy were directly from AFSCs. These findings demonstrated the therapeutic effects of AFSCs and suggested the promise of AFSCs for treating infertility and POF caused by chemotherapy.
Sonoda, Yukio; Tamaoki, Tetsuo
Noise components in a normal state contained in detection signals from delayed neutron monitors disposed to a coolant inlet, etc. of an intermediate heat exchanger are forecast by self-recurring model and eliminated, and resultant detection signals are monitored thereby detecting fuel failure high sensitivity. Subsequently, the reactor is controlled to a low power operation state and a new self-recurring model to the detection signals from the delayed neutron monitors are prepared. Then, noise components in this state are removed and control rods near the delayed neutron monitors are extracted in a short stroke successively to examine the change of response of the delayed neutron monitors. Accordingly, the failed position for each of the fuels can be estimated at a level of one fuel assembly or a level of several assemblies containing the above-mentioned fuel assembly. Since the fuel failure can be detected at a high sensitivity and the position can be estimated, diffusion of abnormality can be prevented and plant shutdown for fuel exchange can be minimized. (I.S.)
Pouranvari, M.; Marashi, S.P.H.
Highlights: → Interfacial to pullout failure mode transition for AHSS RSWs is studied. → An analytical mode is proposed to predict failure mode of AHSS RSWs. → Hardness characteristics of RSWs plays key role in the failure mode transition. - Abstract: Failure mode of resistance spot welds is a qualitative indicator of weld performance. Two major types of spot weld failure are pull-out and interfacial fracture. Interfacial failure, which typically results in reduced energy absorption capability, is considered unsatisfactory and industry standards are often designed to avoid this occurrence. Advanced High Strength Steel (AHSS) spot welds exhibit high tendency to fail in interfacial failure mode. Sizing of spot welds based on the conventional recommendation of 4t 0.5 (t is sheet thickness) does not guarantee the pullout failure mode in many cases of AHSS spot welds. Therefore, a new weld quality criterion should be found for AHSS resistance spot welds to guarantee pull-out failure. The aim of this paper is to investigate and analyze the transition between interfacial and pull-out failure modes in AHSS resistance spot welds during the tensile-shear test by the use of analytical approach. In this work, in the light of failure mechanism, a simple analytical model is presented for estimating the critical fusion zone size to prevent interfacial fracture. According to this model, the hardness ratio of fusion zone to pull-out failure location and the volume fraction of voids in fusion zone are the key metallurgical factors governing type of failure mode of AHSS spot welds during the tensile-shear test. Low hardness ratio and high susceptibility to form shrinkage voids in the case of AHSS spot welds appear to be the two primary causes for their high tendency to fail in interfacial mode.
Sacks, S. I.
Seismologists have had poor success in earthquake prediction. However, wide ranging observations from earlier great earthquakes show that precursory data can exist. In particular, two aspects seem promising. In agreement with simple physical modeling, b-values decrease in highly loaded fault zones for years before failure. Potentially more usefully, in high stress regions, breakdown of dilatant patches leading to failure can yield expelled water-related observations. The volume increase (dilatancy) caused by high shear stresses decreases the pore pressure. Eventually, water flows back in restoring the pore pressure, promoting failure and expelling the extra water. Of course, in a generally stressed region there may be many small patches that fail, such as observed before the 1975 Haicheng earthquake. Only a few days before the major event will most of the dilatancy breakdown occur in the fault zone itself such as for the Tangshan, 1976 destructive event. Observations of 'water release' effects have been observed before the 1923 great Kanto earthquake, the 1984 Yamasaki event, the 1975 Haicheng and the 1976 Tangshan earthquakes and also the 1995 Kobe earthquake. While there are obvious difficulties in water release observations, not least because there is currently no observational network anywhere, historical data does suggest some promise if we broaden our approach to this difficult subject.
Luz, Andre Ferreira da
In this work, a Particle Swarm Optimization Algorithm (PSO) is developed for preventive maintenance optimization. The proposed methodology, which allows the use flexible intervals between maintenance interventions, instead of considering fixed periods (as usual), allows a better adaptation of scheduling in order to deal with the failure rates of components under aging. Moreover, because of this flexibility, the planning of preventive maintenance becomes a difficult task. Motivated by the fact that the PSO has proved to be very competitive compared to other optimization tools, this work investigates the use of PSO as an alternative tool of optimization. Considering that PSO works in a real and continuous space, it is a challenge to use it for discrete optimization, in which scheduling may comprise variable number of maintenance interventions. The PSO model developed in this work overcome such difficulty. The proposed PSO searches for the best policy for maintaining and considers several aspects, such as: probability of needing repair (corrective maintenance), the cost of such repairs, typical outage times, costs of preventive maintenance, the impact of maintaining the reliability of systems as a whole, and the probability of imperfect maintenance. To evaluate the proposed methodology, we investigate an electro-mechanical system consisting of three pumps and four valves, High Pressure Injection System (HPIS) of a PWR. Results show that PSO is quite efficient in finding the optimum preventive maintenance policies for the HPIS. (author)
Full Text Available Racheli Magnezi,1 Asaf Hemi,1 Rina Hemi2 1Department of Management, Public Health and Health Systems Management Program, Bar Ilan University, Ramat Gan, 2Endocrine Service Unit, Sheba Medical Center, Tel Aviv, Israel Background: Risk management in health care systems applies to all hospital employees and directors as they deal with human life and emergency routines. There is a constant need to decrease risk and increase patient safety in the hospital environment. The purpose of this article is to review the laboratory testing procedures for parathyroid hormone and adrenocorticotropic hormone (which are characterized by short half-lives and to track failure modes and risks, and offer solutions to prevent them. During a routine quality improvement review at the Endocrine Laboratory in Tel Hashomer Hospital, we discovered these tests are frequently repeated unnecessarily due to multiple failures. The repetition of the tests inconveniences patients and leads to extra work for the laboratory and logistics personnel as well as the nurses and doctors who have to perform many tasks with limited resources.Methods: A team of eight staff members accompanied by the Head of the Endocrine Laboratory formed the team for analysis. The failure mode and effects analysis model (FMEA was used to analyze the laboratory testing procedure and was designed to simplify the process steps and indicate and rank possible failures.Results: A total of 23 failure modes were found within the process, 19 of which were ranked by level of severity. The FMEA model prioritizes failures by their risk priority number (RPN. For example, the most serious failure was the delay after the samples were collected from the department (RPN =226.1.Conclusion: This model helped us to visualize the process in a simple way. After analyzing the information, solutions were proposed to prevent failures, and a method to completely avoid the top four problems was also developed. Keywords: failure mode
Mullin, Scott; Panday, Ashoutosh; Balsara, Nitash Pervez; Singh, Mohit; Eitouni, Hany Basam; Gomez, Enrique Daniel
A polymer that combines high ionic conductivity with the structural properties required for Li electrode stability is useful as a solid phase electrolyte for high energy density, high cycle life batteries that do not suffer from failures due to side reactions and dendrite growth on the Li electrodes, and other potential applications. The polymer electrolyte includes a linear block copolymer having a conductive linear polymer block with a molecular weight of at least 5000 Daltons, a structural linear polymer block with an elastic modulus in excess of 1.times.10.sup.7 Pa and an ionic conductivity of at least 1.times.10.sup.-5 Scm.sup.-1. The electrolyte is made under dry conditions to achieve the noted characteristics. In another aspect, the electrolyte exhibits a conductivity drop when the temperature of electrolyte increases over a threshold temperature, thereby providing a shutoff mechanism for preventing thermal runaway in lithium battery cells.
The meeting discussed the new provisions for civil defense on account of the amended Disaster Control Act which had been recently adopted by the Lower House of Parliament. In 6 working groups it was discussed how appropriate and sensible the attempt is to make provisions for civil defence in order to protect the population, and how adequate legislative measures are in the face of true threat and var scenarios. Ethical aspects and aspects of international law were considered, as well as the role of public health and free charitable institutions concering preventive measures in emergencies. (orig. HSCH) [de
Vicente-Herrero, M T; Ramírez Iñiguez de la Torre, M V; Capdevila García, L M; López-González, Á A; Terradillos García, M J
Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
This paper presents an inspection-based maintenance optimisation model where the inspections are imperfect and potentially failure-inducing. The model is based on the basic delay-time model in which a system has three states: perfectly functioning, defective and failed. The system is deteriorating through these states and to reveal defective systems, inspections are performed periodically using a procedure by which the system fails with a fixed state-dependent probability; otherwise, an inspection identifies a functioning system as defective (false positive) with a fixed probability and a defective system as functioning (false negative) with a fixed probability. The system is correctively replaced upon failure or preventively replaced either at the N'th inspection time or when an inspection reveals the system as defective, whichever occurs first. Replacement durations are assumed to be negligible and costs are associated with inspections, replacements and failures. The problem is to determine the optimal inspection interval T and preventive age replacement limit N that jointly minimise the long run expected cost per unit of time. The system may also be thought of as a passive two-state system subject to random demands; the three states of the model are then functioning, undetected failed and detected failed; and to ensure the renewal property of replacement cycles the demand process generating the ‘delay time’ is then restricted to the Poisson process. The inspiration for the presented model has been passive safety critical valves as used in (offshore) oil and gas production and transportation systems. In light of this the passive system interpretation is highlighted, as well as the possibility that inspection-induced failures are associated with accidents. Two numerical examples are included, and some potential extensions of the model are indicated
Full Text Available With the total cases and economic burden of heart failure continuing to rise, there is an overwhelming need for novel therapies. Several drugs for heart failure have succeeded in preclinical and early-phase clinical trials, but most of them failed to show the real benefit in pivotal clinical trials. Meanwhile, the US Food and Drug Administration recently approved two promising new drugs to treat heart failure: ivabradine and sacubitril/valsartan. Furthermore, some of the newer agents in testing offer the potential for significant progress in addition to these drugs. Patiromer and zirconium cyclosilicate are attractive agents that are expected to prevent hyperkalemia during renin-angiotensin-aldosterone system inhibition, and serelaxin and urodilatin are promising drugs in the treatment of acute heart failure. Future clinical trials with more appropriate study designs, optimal clinical endpoints, and proper patient selection are mandatory to assess the true efficacy of these attractive compounds in clinical practice.
Three children with renal disorders managed at the University of Ilorin Teaching Hospital are reported as case studies to underscore the need for preventive nephrology . The first case illustrates the inevitability of rapidly progressive renal failure when remedial management desired in the early stages of the nephropathy is ...
Branco, Bernardino C; Inaba, Kenji; Lam, Lydia; Salim, Ali; Barmparas, Galinos; Teixeira, Pedro G R; Talving, Peep; Demetriades, Demetrios
Donor availability remains the primary limiting factor for organ transplantation today. The purpose of this study was to examine the causes of procurement failure amongst potential organ donors. After Institutional Review Board approval, all surgical intensive care unit (SICU) patients admitted to the LAC+USC Medical Center from 01/2006 to 12/2008 who became potential organ donors were identified. Demographics, clinical data, and procurement data were abstracted. In non-donors, the causes of procurement failure were documented. During the 3-year study period, a total of 254 patients were evaluated for organ donation. Mean age was 44.8±18.7 years; 191 (75.2%) were male, 136 (53.5%) were Hispanic, and 148 (58.3%) were trauma patients. Of the 254 patients, 116 (45.7%) were not eligible for donation: 34 had multi-system organ failure, 24 did not progress to brain death and had support withdrawn, 18 had uncontrolled sepsis, 15 had malignancy, 6 had human immunodeficiency virus or hepatitis B or C, and 19 patients had other contraindications to organ donation. Of the remaining 138 eligible patients, 83 (60.2%) did not donate: 56 because the family denied consent, 9 by their own choice. In six, next of kin could not be located, five died because of hemodynamic instability before organ procurement was possible, four had organs that could not be placed, and three had their organs declined by the organ procurement organization. The overall consent rate was 57.5% (n=67). From the 55 donors, 255 organs were procured (yield 4.6 organs/donor). Of all patients screened for organ donation, only a fifth actually donated. Denial of consent was the major potentially preventable cause of procurement failure, whereas hemodynamic instability accounted for only a small percentage of donor losses. With such low conversion rates, the preventable causes of procurement failure warrant further study.
Daams, Freek; Luyer, Misha; Lange, Johan F
All colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years. New techniques of prevention, by innovative anastomotic techniques should improve results in the future, but standardization and "teachability" should be guaranteed. Risk scoring enables intra-operative decision-making whether to restore continuity or deviate. Early detection can lead to reduction in delay of diagnosis as long as a standard system is used. For treatment options, no firm evidence is available, but future studies could focus on repair and saving of the anastomosis on the one hand or anastomotical breakdown and definitive colostomy on the other hand.
David Šuran; Vojko Kanič; Tatjana Golob Gulič; Husam Franjo Naji; Robert Lipovec
Background Prosthetic heart valve thrombosis (PHVT) represents a dangerous postoperative complication following prosthetic heart valve replacement. Incidence varies according to different data from 0.5–4 % per year following mitral or aortic valve replacement in spite of adequate oral anticoagulation with coumarins. Case report We are presenting a case of prosthetic mitral valve thrombosis as a result of 6-month lowmolecular-weight heparin (LMWH) (nadroparine) treatment failure. Our pat...
Katare, Rajesh G.; Caporali, Andrea; Oikawa, Atsuhiko; Meloni, Marco; Emanueli, Costanza; Madeddu, Paolo
Background The increasing incidence of diabetes mellitus will result in a new epidemic of heart failure unless novel treatments able to halt diabetic cardiomyopathy early in its course are introduced. This study aimed to determine whether the activity of the Akt/Pim-1 signaling pathway is altered at critical stages of diabetic cardiomyopathy and whether supplementation with vitamin B1 analog benfotiamine (BFT) helps to sustain the above prosurvival mechanism, thereby preserving cardiomyocyte viability and function. Methods and Results Untreated streptozotocin-induced type 1 or leptin-receptor mutant type 2 diabetic mice showed diastolic dysfunction evolving to contractile impairment and cardiac dilatation and failure. BFT (70 mg/kg−1/d−1) improved diastolic and systolic function and prevented left ventricular end-diastolic pressure increase and chamber dilatation in both diabetic models. Moreover, BFT improved cardiac perfusion and reduced cardiomyocyte apoptosis and interstitial fibrosis. In hearts of untreated diabetic mice, the expression and activity of Akt/Pim-1 signaling declined along with O-N-acetylglucosamine modification of Akt, inhibition of pentose phosphate pathway, activation of oxidative stress, and accumulation of glycation end products. Furthermore, diabetes reduced signal transducer and activator of transcription 3 phosphorylation independently of Akt. BFT inhibited these effects of diabetes mellitus, thereby conferring cardiomyocytes with improved resistance to high glucose-induced damage. The phosphoinositide-3-kinase inhibitor LY294002 and dominant-negative Akt inhibited antiapoptotic action of BFT and Pim-1 upregulation in high glucose-challenged cardiomyocytes. Conclusions These results show that BFT protects from diabetes mellitus-induced cardiac dysfunction through pleiotropic mechanisms, culminating in the activation of prosurvival signaling pathway. Thus, BFT merits attention for application in clinical practice. PMID:20107192
PWR steam generators have suffered from a variety of degradation phenomena. This paper identifies the corrosion-related defects and their probable causes and suggests approaches to correct and prevent corrosive activity. In the attempt to solve the degradation problems, research programs have concentrated on modifying materials, stresses, and the chemical environment in both new and operating steam generators. The following corrosion-related defects have been studied: tube wastage, denting, primary side (ID) intergranular stress corrosion cracking (IGSCC), OD-initiated intergranular attack (IGA), pitting, and corrosion fatigue. Plants affected by wastage have greatly reduced their problem by adopting an all volatile treatment (AVT). In the case of denting, a less aggressive chemical environment is recommended. Primary side IGSCC responds to temperature reduction, stress relief, and material improvements, while flushing and boric acid addition minimizes OD-initiated IGA. It has further been shown that pitting can be minimized by sludge lancing and by reducing impurity ingress. (author)
Cohn, S.H.; Ellis, K.J.; Caselnova, R.C.; Asad, S.N.; Letteri, J.M.
The widespread prevalence of bone disease in chronic renal failure both prior to and during hemodialysis is an important aspect of uremia. Loss of bone mineral of the skeleton in renal disease can be measured directly by total-body neutron activation analysis (TBNAA). The absorptiometric technique, using monochromatic photons from 125 I, applied to the appendicular skeleton (radius) also reflects the loss of bone mineral content (BMC) in renal disease. The results of these two techniques were compared in 25 patients with renal insufficiency, 53 with end stage renal failure on dialysis, and 24 normal control subjects. (U.S.)
Danquechin Dorval, Antoine; Meredieu, Céline; Danjon, Frédéric
Background and Aims Storms can cause huge damage to European forests. Even pole-stage trees with 80-cm rooting depth can topple. Therefore, good anchorage is needed for trees to survive and grow up from an early age. We hypothesized that root architecture is a predominant factor determining anchorage failure caused by strong winds. Methods We sampled 48 seeded or planted Pinus pinaster trees of similar aerial size from four stands damaged by a major storm 3 years before. The trees were gathered into three classes: undamaged, leaning and heavily toppled. After uprooting and 3D digitizing of their full root architectures, we computed the mechanical characteristics of the main components of the root system from our morphological measurements. Key Results Variability in root architecture was quite large. A large main taproot, either short and thick or long and thin, and guyed by a large volume of deep roots, was the major component that prevented stem leaning. Greater shallow root flexural stiffness mainly at the end of the zone of rapid taper on the windward side also prevented leaning. Toppling in less than 90-cm-deep soil was avoided in trees with a stocky taproots or with a very big leeward shallow root. Toppled trees also had a lower relative root biomass – stump excluded – than straight trees. Conclusions It was mainly the flexural stiffness of the central part of the root system that secured anchorage, preventing a weak displacement of the stump. The distal part of the longest taproot and attached deep roots may be the only parts of the root system contributing to anchorage through their maximum tensile load. Several designs provided good anchorage, depending partly on available soil depth. Pole-stage trees are in-between the juvenile phase when they fail by toppling and the mature phase when they fail by uprooting. PMID:27456136
Takahashi, Toshiaki; Murayama, Ryoko; Oe, Makoto; Nakagami, Gojiro; Tanabe, Hidenori; Yabunaka, Koichi; Arai, Rika; Komiyama, Chieko; Uchida, Miho; Sanada, Hiromi
Short peripheral catheter (SPC) failure is an important clinical problem. The purpose of this study was to clarify the relationship between SPC failure and etiologies such as thrombus, subcutaneous edema, and catheter dislodgment using ultrasonography and to explore the risk factors associated with the etiologies. Two hundred catheters that were in use for infusion, excluding chemotherapy, were observed. Risk factors were examined by logistic regression analysis. Sixty catheters were removed as the result of SPC failure. Frequency of thrombus with subcutaneous edema in SPC failure cases was significantly greater than in those cases where therapy was completed without complications (P edema. Results suggest that subsurface skin assessment for catheterization could prevent SPC failure.
Full Text Available Abstract Background Optimal management of acute right heart failure following the implantation of a left ventricular assist device requires a reliable estimation of left ventricular preload and contractility. This is possible by real-time pump blood flow measurements. Clinical case We performed implantation of a continuous flow left ventricular assist device in a 66 years old female patient with an end-stage heart failure on the grounds of a dilated cardiomyopathy. Real-time pump blood flow was directly measured by an ultrasonic flow probe placed around the outflow graft. Diagnosis The progressive decline of real time flow and the loss of pulsatility were associated with an increase of central venous pressure, inotropic therapy and progressive renal failure suggesting the presence of an acute right heart failure. Diagnosis was validated by echocardiography and thermodilution measurements. Treatment Temporary mechanical circulatory support of the right ventricle was successfully performed. Real time flow measurement proved to be a useful tool for the diagnosis and ultimately for the management of right heart failure including the weaning from extracorporeal membrane oxygenation.
Lambrus, Bramwell G.; Uetake, Yumi; Clutario, Kevin M.; Daggubati, Vikas; Snyder, Michael; Sluder, Greenfield
Centriole function has been difficult to study because of a lack of specific tools that allow persistent and reversible centriole depletion. Here we combined gene targeting with an auxin-inducible degradation system to achieve rapid, titratable, and reversible control of Polo-like kinase 4 (Plk4), a master regulator of centriole biogenesis. Depletion of Plk4 led to a failure of centriole duplication that produced an irreversible cell cycle arrest within a few divisions. This arrest was not a result of a prolonged mitosis, chromosome segregation errors, or cytokinesis failure. Depleting p53 allowed cells that fail centriole duplication to proliferate indefinitely. Washout of auxin and restoration of endogenous Plk4 levels in cells that lack centrioles led to the penetrant formation of de novo centrioles that gained the ability to organize microtubules and duplicate. In summary, we uncover a p53-dependent surveillance mechanism that protects against genome instability by preventing cell growth after centriole duplication failure. PMID:26150389
Ashtari, Sara; Pourhoseingholi, Mohamad Amin; Sharifian, Afsaneh; Zali, Mohamad Reza
To review all of epidemiological and etiological aspects of hepatocellular carcinoma (HCC) and examined the prevention of this disease in Asia. We conducted a systematic review according to the PRISMA guidelines. We were chosen articles that published previously, from PubMed (MEDLINE), the Cochrane database and Scopus. The key words used in this research were as follows: HCC in Asia and the way of prevention of this disease, with no language limitations. We selected those papers published before 2014 that we considered to be most important and appropriate. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. More than 70% of all new cases of liver cancer were diagnosed in Asia, a region that 75% of all those chronically infected with hepatitis B virus (HBV) in the world. Chronic HBV infection is the main cause of HCC in Asia, where the virus is endemic and vertical transmission is common. Japan, Saudi Arabia, Egypt and Pakistan are exception because of high prevalence of HCV infection in these regions. The prevalence of this cancer is high in Eastern and South-Eastern Asia, But Middle Eastern countries are characterized as moderate prevalence rate of HCC region and Central Asia and some part of Middle Eastern countries are known as low prevalence rate of HCC. In addition of HBV and HCV the other factors such as aflatoxin, alcohol, obesity, diabetes and non-alcoholic fatty liver disease (NAFLD) might be responsible for a low prevalence of HCC in Asian countries. Currently available HCC therapies, chemotherapy, surgical are inefficient, mainly due to usually late diagnosis and high recurrence rates after surgical resection, and usually end with treatment failure. Liver transplantation also remains as a difficult strategy in patients with HCC. Thus prevention of HCC by treating and prevention HBV and HCV infection, the major causative agents of HCC, and the other risk factors such as aflatoxin, alcohol, obesity
Miller, Peter G; de Groot, Florentine; McKenzie, Stephen; Droste, Nicolas
It has been proposed that alcohol industry 'social aspects/public relations' organizations (SAPROs) serve the agenda of lending credibility to industry claims of corporate responsibility while promoting ineffective industry-friendly interventions (such as school-based education or TV advertising campaigns) and creating doubt about interventions which have a strong evidence base (such as higher taxes on alcoholic beverages). This paper investigated whether submissions to Australia's National Preventative Health Taskforce (NPHT) from alcohol industry bodies regarding the Australian SAPRO, Drinkwise, have used this organization to demonstrate corporate responsibility while promoting industry-friendly interventions. Submissions to the Australian National Preventative Health Taskforce (NPHT) discussion paper Australia, the healthiest country by 2020 (n = 375) were examined to identify those with primary alcohol content. A thematic analysis of the resulting 33 submissions was conducted to determine which organization, institution or individual discussed Drinkwise. Australia. Nine of the 33 submissions discussed Drinkwise; all were submitted by the alcohol industry or its affiliates. Every industry submission referred to Drinkwise either as providing evidence of social responsibility or by suggesting the industry-friendly actions of Drinkwise as alternatives to those recommended by the NPHT report. Drinkwise has been used by the alcohol industry to create an impression of social responsibility while promoting interventions that maintain profits and campaigning against effective interventions such as higher taxes on alcohol. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
The author reviews literature on childrens' reactions to perceived failure and offers "learned helplessness" as a model to explain why a child who makes a mistake gives up. Suggestions for preventing these reactions are given. (Author/JMK)
Berner, Wolfgang; Briken, Peer
In modern psychiatric classifications the term paraphilia has replaced the term perversion by changing the scope of the definitions from avoided procreation to failures of relationship-aspects of sexuality. Contemporary psychoanalysts also seem less interested in pleasure seeking aspects, which were so important within original Freudian thought, and instead concentrate interpretation on hostility and the history of the representation of objects. This paper discusses the connection between distinct object representations in perversions and attachment theory and neurobiological representations. It will discuss the observation that the neglect of pleasure seeking in perversion often results in a failure to recognise the addiction-like aspects of perversion, which seem to be particularly relevant to modern psychiatric and psychological thinking. The SEEKING-system (Panksepp, 1998) is used to conceptualise a neurobiological basis for pleasure seeking. This SEEKING-system may be "hijacked" by rewards in different forms of addiction as well as in sexual obsessions. The polarity between "drive representation" and "object representation," as created by Freud (1933, 1940a), may correspond to the polarity identified in contemporary thinking between the addictive or compulsive characteristics of sexual gratification (drive representation) and the influence of early object representation on the later ability to integrate instinctual wishes into relationships (object representation).
Perico, Norberto; Remuzzi, Giuseppe
Chronic kidney disease (CKD) is an important determinant of the poor health outcome for major noncommunicable diseases that are the leading cause of death worldwide. Early recognition with screening programs of CKD and co-morbid conditions, like hypertension, diabetes, or toxic environments, can potentially slow progression to renal failure, improve quality of life and reduce healthcare cost. Effective multimodal tools are available to prevent CKD by managing its risk factors, and to slow or even halt disease progression to end-stage renal failure (ESRF). They can be adapted even to poor-resource settings of low- and middle-income countries for individual at high risk of CKD. CKD is also linked to acute kidney injury (AKI), that in poorest part of Africa, Asia and Latin America is preventable, treatable and often reversible, if managed adequately and in timely manner as proposed by the program "AKI 0by25" launched by the international Society of Nephrology in 2013. In addition to saving lives, prevention programs will create major heath gains, eventually reducing the current health inequity that arises from unaffordable or unobtainable renal replacement therapies in many part of the developing world if ESRF is not prevented.
Montierth, L.; Morse, R.
This chapter discusses small amplitude growth of the outside surface instability and modes of failure resulting from nonlinear development of the inside surface instability. It is demonstrated that pellets with initial pellet aspect ratio, A /SUB p/ >5 may have difficulty with Rayleigh-Taylor instability and that shells with A /SUB p/ greater than or equal to10 will probably demand stringent smoothness specification in order not to experience failure in the final implosion. The linear amplification of the outside surface instability can easily exceed 10 3 for A /SUB p/ and resulting A values in the range of programmatic interest. Amplifications of this order, starting from attainable surface finishes, can then penetrate to the inside shell surface, producing perturbations there which approach the nonlinear development amplitude and at the start of the final deceleration. It is shown that such inside surface perturbations can be amplified to large amplitude by the inside instability and cause failure through reduction of the maximum fuel temperature achieved. Insight into the scaling of failure mechanisms is offered
Heri-Syaeful; Suharji; Sartapa; Suparjo-AS
Failures in reverse side of 50 and 52 building, first en occurred in early 2002, temporary treatment on slope failure which conducted in the middle of the year 2002 has not solved the problem, because it did not consider the aspect of geo technique and geohydrology that causing the failure. Geo technique and geohydrology study in failure area covered field work, laboratory work and geo technic/geohydrology analysis. Field works includes topographic mapping, core drilling, hand auger, groundwater level monitoring, standard penetration test and undisturbed sampling. Laboratory work includes index properties and engineering properties test. Studio works covered geotechnical analysis for the calculation of safety factor, while geohydrology analysis to understand the groundwater system. Slope stability analysis resulting the small number of safety factor, between 0,305-1,637 on normal condition, 0,293-1,597 on saturated condition and 0,205-1,075 on earthquake condition. From the geohydrology analysis, concluded that water clogging still occurs in several areas of slope, causing the excess of pore water pressure and decreasing the value of soil shear strength. (author)
Full Text Available Cardiac fibrosis attributed to excessive deposition of extracellular matrix proteins is a major cause of heart failure and death. Cardiac fibrosis is extremely difficult and challenging to treat in a clinical setting due to lack of understanding of molecular mechanisms leading to cardiac fibrosis and effective anti-fibrotic therapies. The objective in this study was to examine whether unfolded protein response (UPR pathway mediates cardiac fibrosis and whether a pharmacological intervention to modulate UPR can prevent cardiac fibrosis and preserve heart function.We demonstrate here that the mechanism leading to development of fibrosis in a mouse with increased expression of calreticulin, a model of heart failure, stems from impairment of endoplasmic reticulum (ER homeostasis, transient activation of the unfolded protein response (UPR pathway and stimulation of the TGFβ1/Smad2/3 signaling pathway. Remarkably, sustained pharmacologic inhibition of the UPR pathway by tauroursodeoxycholic acid (TUDCA is sufficient to prevent cardiac fibrosis, and improved exercise tolerance.We show that the mechanism leading to development of fibrosis in a mouse model of heart failure stems from transient activation of UPR pathway leading to persistent remodelling of cardiac tissue. Blocking the activation of the transiently activated UPR pathway by TUDCA prevented cardiac fibrosis, and improved prognosis. These findings offer a window for additional interventions that can preserve heart function.
Ahmad, Faraz S; Ning, Hongyan; Rich, Jonathan D; Yancy, Clyde W; Lloyd-Jones, Donald M; Wilkins, John T
This study was designed to quantify the relationship between the absence of heart failure risk factors in middle age and incident heart failure, heart failure-free survival, and overall survival. Quantification of years lived free from heart failure in the context of risk factor burden in mid-life may improve risk communication and prevention efforts. We conducted a pooled, individual-level analysis sampling from communities across the United States as part of 4 cohort studies: the Framingham Heart, Framingham Offspring, Chicago Heart Association Detection Project in Industry, and ARIC (Atherosclerosis Risk In Communities) studies. Participants with and without hypertension (blood pressure ≥140/90 mm Hg or treatment), obesity (body mass index ≥30 kg/m 2 ), or diabetes (fasting glucose ≥126 mg/dl or treatment), and combinations of these factors, at index ages of 45 years and 55 years through 95 years. Competing risk-adjusted Cox models, a modified Kaplan-Meier estimator, and Irwin's restricted mean were used to estimate the association between the absence of risk factors at mid-life and incident heart failure, heart failure-free survival, and overall survival. For participants at age 45 years, over 516,537 person-years of follow-up, 1,677 incident heart failure events occurred. Men and women with no risk factors, compared to those with all 3, had 73% to 85% lower risks of incident heart failure. Men and women without hypertension, obesity, or diabetes at age 45 years lived on average 34.7 years and 38.0 years without incident heart failure, and they lived on average an additional 3 years to 15 years longer free of heart failure than those with 1, 2, or 3 risk factors. Similar trends were seen when stratified by race and at index age 55 years. Prevention of hypertension, obesity, and diabetes by ages 45 years and 55 years may substantially prolong heart failure-free survival, decrease heart failure-related morbidity, and reduce the public health impact of
Kabir, Golam; Tesfamariam, Solomon; Sadiq, Rehan
To develop an effective preventive or proactive repair and replacement action plan, water utilities often rely on water main failure prediction models. However, in predicting the failure of water mains, uncertainty is inherent regardless of the quality and quantity of data used in the model. To improve the understanding of water main failure, a Bayesian framework is developed for predicting the failure of water mains considering uncertainties. In this study, Bayesian model averaging method (BMA) is presented to identify the influential pipe-dependent and time-dependent covariates considering model uncertainties whereas Bayesian Weibull Proportional Hazard Model (BWPHM) is applied to develop the survival curves and to predict the failure rates of water mains. To accredit the proposed framework, it is implemented to predict the failure of cast iron (CI) and ductile iron (DI) pipes of the water distribution network of the City of Calgary, Alberta, Canada. Results indicate that the predicted 95% uncertainty bounds of the proposed BWPHMs capture effectively the observed breaks for both CI and DI water mains. Moreover, the performance of the proposed BWPHMs are better compare to the Cox-Proportional Hazard Model (Cox-PHM) for considering Weibull distribution for the baseline hazard function and model uncertainties. - Highlights: • Prioritize rehabilitation and replacements (R/R) strategies of water mains. • Consider the uncertainties for the failure prediction. • Improve the prediction capability of the water mains failure models. • Identify the influential and appropriate covariates for different models. • Determine the effects of the covariates on failure
... Patient Page Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease Mariana Mirabel , Kumar Narayanan , Xavier Jouven , Eloi Marijon ... regurgitant ) valves. Over time, there is progressive damage (rheumatic heart disease, RHD) that may lead to heart failure, stroke, ...
Akbarian, M.A.; Kahrom, M.; Kahrom, H.
Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis and intervention to adequately restore mesenteric blood flow and to prevent bowel necrosis and patient death. While, almost always superior and inferior mesenteric arteries are involved, we report a 57-year-old male with an unusual celiac artery trunk thrombosis leading to gastero-duodenal and hepato-splenic infarction, and presenting an acute liver failure. (author)
prevention studies, all of which are performed outside Denmark. Thus, this paper is not a classical review but rather a highlight of some aspects that the author finds important. The latest Danish national figures show a marked increase in the prevalence of obesity, especially among young men-a sevenfold...... regarding a national action plan against obesity. CONCLUSION: This paper highlights some important aspects of the epidemiology, prevention and actions in the field of paediatric obesity with special focus on Denmark.......UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...
Full Text Available This is a rare case of serpine gene polymorphism causing thrombophilia and recurrent implantation failure following intrauterine insemination. SERPINE1 gene encodes plasminogen activator inhibitor type 1 and inhibits fibrinolysis, or clot dissolution. The 4G variant results in increased expression of SERPINE1 and consequently higher inhibition of fibrinolysis, thus leading to thrombophilia. The patient had unexplained primary infertility for 9 years. Ovulation induction was done with gonadotropin releasing hormone (GnRH agonist long protocol. Recombinant follicle stimulating hormone (FSH with step down protocol was used. Ovulation trigger was given with recombinant human chorionic gonadotrophin (HCG. Ovum pick up was done after 40 h of trigger. A total of 13 eggs were collected. Patient was put on Cabergoline to prevent ovarian hyperstimulation syndrome (OHSS. Four frozen embryos were transferred on day 14 after Laser-assisted hatching. EmbryoGlue was used to prevent implantation failure. Luteal phase support was given. She was put on enoxaparin and pregnancy has now been confirmed. The patient was on strict monitoring as this gene is also associated with preeclampsia during pregnancy.
Lodewicus Charl Coetzee
Full Text Available Can the conception of a child ever constitute damage recoverable in law? This article considers the liability of healthcare practitioners for failing to prevent a pregnancy. Developments leading to the recognition of wrongful pregnancy as a cause of (legal action in South Africa (SA, are briefly outlined. The salient points of the relevant judgments by SA courts are set out to expose the rationale underlying the judgments and to highlight that recognition of liability for wrongful pregnancy resulted from an application of fair and equitable principles of general application. Conduct that could expose practitioners to liability is identified from reported cases and inferred from general principles laid down in case law.
Jaarsma, Tiny; Nikolova-Simons, Mariana; van der Wal, Martje H L
Despite an increasing body of knowledge on self-care in heart failure patients, the need for effective interventions remains. We sought to deepen the understanding of interventions that heart failure nurses use in clinical practice to improve patient adherence to medication and symptom monitoring. A qualitative study with a directed content analysis was performed, using data from a selected sample of Dutch-speaking heart failure nurses who completed booklets with two vignettes involving medication adherence and symptom recognition. Nurses regularly assess and reassess patients before they decide on an intervention. They evaluate basic/factual information and barriers in a patient's behavior, and try to find room for improvement in a patient's behavior. Interventions that heart failure nurses use to improve adherence to medication and symptom monitoring were grouped into the themes of increasing knowledge, increasing motivation, and providing patients with practical tools. Nurses also described using technology-based tools, increased social support, alternative communication, partnership approaches, and coordination of care to improve adherence to medications and symptom monitoring. Despite a strong focus on educational strategies, nurses also reported other strategies to increase patient adherence. Nurses use several strategies to improve patient adherence that are not incorporated into guidelines. These interventions need to be evaluated for further applications in improving heart failure management. Copyright © 2012 Elsevier Inc. All rights reserved.
Full Text Available Pressure overload-induced hypertrophy is a key step leading to heart failure. The Ca(2+-induced Ca(2+ release (CICR process that governs cardiac contractility is defective in hypertrophy/heart failure, but the molecular mechanisms remain elusive. To examine the intermolecular aspects of CICR during hypertrophy, we utilized loose-patch confocal imaging to visualize the signaling between a single L-type Ca(2+ channel (LCC and ryanodine receptors (RyRs in aortic stenosis rat models of compensated (CHT and decompensated (DHT hypertrophy. We found that the LCC-RyR intermolecular coupling showed a 49% prolongation in coupling latency, a 47% decrease in chance of hit, and a 72% increase in chance of miss in DHT, demonstrating a state of "intermolecular failure." Unexpectedly, these modifications also occurred robustly in CHT due at least partially to decreased expression of junctophilin, indicating that intermolecular failure occurs prior to cellular manifestations. As a result, cell-wide Ca(2+ release, visualized as "Ca(2+ spikes," became desynchronized, which contrasted sharply with unaltered spike integrals and whole-cell Ca(2+ transients in CHT. These data suggested that, within a certain limit, termed the "stability margin," mild intermolecular failure does not damage the cellular integrity of excitation-contraction coupling. Only when the modification steps beyond the stability margin does global failure occur. The discovery of "hidden" intermolecular failure in CHT has important clinical implications.
Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...
... envelope, ``Comments on MSB Amendment 14 NOA.'' Fax: (978) 281-9135, Attn: Aja Szumylo. Instructions... compromises the safety of the vessel, (2) mechanical failure prevents the catch from being brought aboard, or... slipping was safety or mechanical failure, would be required to return to port. This aspect of the measure...
The lack of success, not to say failure, of seismic microzonation projects in the Latin America and Caribbean nations-and for that matter elsewhere in the world-should not be attributed to the lack of technical and scientific expertise of our engineers and scientists as there exists in our continent sufficient knowledge and information about the techniques and procedures that have been successfully used elsewhere in the world in the implementation of seismic microzonation projects. The main constrains to the implementation of seismic microzonation projects in Latin America and the Caribbean are of an economic, social, political, and cultural aspects rather than the purely scientific and engineering aspects. Another very important factor contributing to this lack of success has been the apparent failure of the scientific and technical community to convince decision makers (both official and private) that the sound implementation of seismic microzonation projects are a valid instrument to mitigate the negative effects that earthquakes have on the population, on the physical infrastructure and on the environment. An attempt will be made in this paper to analyze these "non technical" aspects and try to arrive at some conclusions as well as to some possible lines of action for the successful implementation of seismic microzonation projects in the seismic risk prone Latin American and Caribbean nations.
This report documents a study performed on the set of common cause failures (CCF) of motor operated valves (MOV). The data studied here were derived from the International CCF Data Exchange (ICDE) database, to which several countries have submitted CCF event data. The purpose of the ICDE is to allow multiple countries to collaborate and exchange CCF data to enhance the quality of risk analyses that include CCF modeling. Because CCF events are typically rare events, most countries do not experience enough CCF events to perform meaningful analyses. Data combined from several countries, however, yields sufficient data for more rigorous analyses. This report is the result of an in-depth review of the MOV events and presents several insights about them. The objective of this document is to look beyond the CCF parameter estimates that can be obtained from the CCF data, to gain further understanding of why CCF events occur and what measures may be taken to prevent, or at least mitigate the effect of MOV CCF events. The report presents details of the ICDE project, a quantitative presentation of the MOV events, and a discussion of some engineering aspects of the events. (authors)
Romero García, M; Delgado Hito, P; de la Cueva Ariza, L
Acute renal failure affects from 1% to 25% of patients admitted to intensive care units. These figures vary depending on the population studied and criteria. The complications of acute renal failure (fluid overload, metabolic acidosis, hyperkalemia, bleeding) are treated. However, mortality remains high despite the technological advances of recent years because acute renal failure is usually associated with sepsis, respiratory failure, serious injury, surgical complications or consumption coagulopathy. Mortality ranges from 30% to 90%. Although there is no universally accepted definition, the RIFLE classification gives us an operational tool to define the degree of acute renal failure and to standardize the initiation of renal replacement techniques as well as to evaluate the results. Therefore, nurses working within the intensive care unit must be familiar with this disease, with its treatment (drug or alternative) and with the prevention of possible complications. Equally, they must be capable of detecting the manifestations of dependency each one of the basic needs and to be able to identify the collaboration problems in order to achieve an individualized care plan. Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.
Li, Jian; Dueñas-Osorio, Leonardo; Chen, Changkun; Shi, Congling
Quantifying the criticality of individual components of power systems is essential for overall reliability and management. This paper proposes an AC-based power flow element importance measure, while considering multi-element failures. The measure relies on a proposed AC-based cascading failure model, which captures branch overflow, bus load shedding, and branch failures, via AC power flow and optimal power flow analyses. Taking the IEEE 30, 57 and 118-bus power systems as case studies, we find that N-3 analyses are sufficient to measure the importance of a bus or branch. It is observed that for a substation bus, its importance is statistically proportional to its power demand, but this trend is not observed for power plant buses. While comparing with other reliability, functionality, and topology-based importance measures popular today, we find that a DC power flow model, although better correlated with the benchmark AC model as a whole, still fails to locate some critical elements. This is due to the focus of DC-based models on real power that ignores reactive power. The proposed importance measure is aimed to inform decision makers about key components in complex systems, while improving cascading failure prevention, system backup setting, and overall resilience. - Highlights: • We propose a novel importance measure based on joint failures and AC power flow. • A cascading failure model considers both AC power flow and optimal power flow. • We find that N-3 analyses are sufficient to measure the importance of an element. • Power demand impacts the importance of substations but less so that of generators. • DC models fail to identify some key elements, despite correlating with AC models.
CONCLUSION: Several factors are mentioned as the cause of heart failure or heart weakness in PM, only a few of which are considered in modern medicine. However, some of these less considered theories can be used as new assumptions to prevent and control this disease
... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:May 9,2017 When heart failure (HF) ... Making This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure • Causes and Risks for ...
Liu, Jin-Tao; Li, Ke-Ping
In this paper, a new cascading failure model is proposed for quantitatively analyzing the railway accident causation. In the model, the loads of nodes are redistributed according to the strength of the causal relationships between the nodes. By analyzing the actual situation of the existing prevention measures, a critical threshold of the load parameter in the model is obtained. To verify the effectiveness of the proposed cascading model, simulation experiments of a train collision accident are performed. The results show that the cascading failure model can describe the cascading process of the railway accident more accurately than the previous models, and can quantitatively analyze the sensitivities and the influence of the causes. In conclusion, this model can assist us to reveal the latent rules of accident causation to reduce the occurrence of railway accidents.
Yang, Seung-Ie [Department of Civil, Enviromental, and Architectural Enginnering, University of Colorado, Campus Box 428, Boulder, CO 80309-0428 (United States)]. E-mail: email@example.com; Frangopol, Dan M. [Department of Civil, Enviromental, and Architectural Enginnering, University of Colorado, Campus Box 428, Boulder, CO 80309-0428 (United States)]. E-mail: firstname.lastname@example.org; Kawakami, Yoriko [Hanshin Expressway Public Corporation, Kobe Maintenance Department, 16-1 Shinko-cho Chuo-ku Kobe City, Hyogo, 650-0041 (Japan)]. E-mail: email@example.com; Neves, Luis C. [Department of Civil, Enviromental, and Architectural Enginnering, University of Colorado, Campus Box 428, Boulder, CO 80309-0428 (United States)]. E-mail: firstname.lastname@example.org
In the last decade, it became clear that life-cycle cost analysis of existing civil infrastructure must be used to optimally manage the growing number of aging and deteriorating structures. The uncertainties associated with deteriorating structures require the use of probabilistic methods to properly evaluate their lifetime performance. In this paper, the deterioration and the effect of maintenance actions are analyzed considering the performance of existing structures characterized by lifetime functions. These functions allow, in a simple manner, the consideration of the effect of aging on the decrease of the probability of survival of a structure, as well as the effect of maintenance actions. Models for the effects of proactive and reactive preventive maintenance, and essential maintenance actions are presented. Since the probability of failure is different from zero during the entire service life of a deteriorating structure and depends strongly on the maintenance strategy, the cost of failure is included in this analysis. The failure of one component in a structure does not usually lead to failure of the structure and, as a result, the safety of existing structures must be analyzed using a system reliability framework. The optimization consists of minimizing the sum of the cumulative maintenance and expected failure cost during the prescribed time horizon. Two examples of application of the proposed methodology are presented. In the first example, the sum of the maintenance and failure costs of a bridge in Colorado is minimized considering essential maintenance only and a fixed minimum acceptable probability of failure. In the second example, the expected lifetime cost, including maintenance and expected failure costs, of a multi-girder bridge is minimized considering reactive preventive maintenance actions.
Yang, Seung-Ie; Frangopol, Dan M.; Kawakami, Yoriko; Neves, Luis C.
In the last decade, it became clear that life-cycle cost analysis of existing civil infrastructure must be used to optimally manage the growing number of aging and deteriorating structures. The uncertainties associated with deteriorating structures require the use of probabilistic methods to properly evaluate their lifetime performance. In this paper, the deterioration and the effect of maintenance actions are analyzed considering the performance of existing structures characterized by lifetime functions. These functions allow, in a simple manner, the consideration of the effect of aging on the decrease of the probability of survival of a structure, as well as the effect of maintenance actions. Models for the effects of proactive and reactive preventive maintenance, and essential maintenance actions are presented. Since the probability of failure is different from zero during the entire service life of a deteriorating structure and depends strongly on the maintenance strategy, the cost of failure is included in this analysis. The failure of one component in a structure does not usually lead to failure of the structure and, as a result, the safety of existing structures must be analyzed using a system reliability framework. The optimization consists of minimizing the sum of the cumulative maintenance and expected failure cost during the prescribed time horizon. Two examples of application of the proposed methodology are presented. In the first example, the sum of the maintenance and failure costs of a bridge in Colorado is minimized considering essential maintenance only and a fixed minimum acceptable probability of failure. In the second example, the expected lifetime cost, including maintenance and expected failure costs, of a multi-girder bridge is minimized considering reactive preventive maintenance actions
Alberto Morales Salinas
Full Text Available There is consensus on clinical guidelines that beta-blockers (BB provide unquestionable benefits in several environments of secondary prevention, such as heart failure and myocardial infarction. However, in everyday practice they are underused in contexts where they are not contraindicated. Such is the case of heart failure with ejection fraction. This article presents an analysis on the available evidence of beta blockers’ effectiveness in heart failure with ejection fraction. It is concluded that overwhelming evidence favours the use of beta-blockers in chronic heart failure with ejection fraction, whereas in episodes of acute decompensated heart failure, their suspension should be avoided whenever it is possible.
Haugen, Knut; Hokstad, Per; Sandtorv, Helge
Reported failures are often classified into severityclasses, e.g., as critical or degraded. The critical failures correspond to loss of function(s) and are those of main concern. The rate of critical failures is usually estimated by the number of observed critical failures divided by the exposure time, thus ignoring the observed degraded failures. In the present paper failure data are analyzed, applying an alternative estimate for the critical failure rate, also taking the number of observed degraded failures into account. The model includes two alternative failure mechanisms, one being of the shock type, immediately leading to a critical failure, another resulting in a gradual deterioration, leading to a degraded failure before the critical failure occurs. Failure data on safety valves from the OREDA (Offshore REliability DAta) data base are analyzed using this model. The estimate for the critical failure rate is obtained and compared with the standard estimate
On launch, one of Swarm's absolute scalar magnetometers (ASMs) failed to function, leaving an asymmetrical arrangement of redundant spares on different spacecrafts. A decision was required concerning the deployment of individual satellites into the low-orbit pair or the higher "lonely" orbit. I analyse the probabilities for successful operation of two of the science components of the Swarm mission in terms of a classical probabilistic failure analysis, with a view to concluding a favourable assignment for the satellite with the single working ASM. I concentrate on the following two science aspects: the east-west gradiometer aspect of the lower pair of satellites and the constellation aspect, which requires a working ASM in each of the two orbital planes. I use the so-called "expert solicitation" probabilities for instrument failure solicited from Mission Advisory Group (MAG) members. My conclusion from the analysis is that it is better to have redundancy of ASMs in the lonely satellite orbit. Although the opposite scenario, having redundancy (and thus four ASMs) in the lower orbit, increases the chance of a working gradiometer late in the mission; it does so at the expense of a likely constellation. Although the results are presented based on actual MAG members' probabilities, the results are rather generic, excepting the case when the probability of individual ASM failure is very small; in this case, any arrangement will ensure a successful mission since there is essentially no failure expected at all. Since the very design of the lower pair is to enable common mode rejection of external signals, it is likely that its work can be successfully achieved during the first 5 years of the mission.
Fonseca, Cândida; Brito, Dulce; Cernadas, Rui; Ferreira, Jorge; Franco, Fátima; Rodrigues, Teresa; Morais, João; Silva Cardoso, José
Heart failure is a syndrome with high prevalence, morbidity and mortality, but awareness of the disease is poor among the general public and policy makers. This document, which was prepared by a group of experts consisting of cardiologists, internists and general practitioners, aims to set out in detail the problem of heart failure in Portugal at several levels: burden of the disease, diagnosis, treatment and monitoring. To this aim, different aspects of the management of the various stages of the disease are identified and discussed in detail, covering both outpatients and hospitalized patients. In order to optimize the medical care provided to these patients, various short-, medium- and long-term solutions and strategies are put forward that have the potential to improve the integration and use of available resources. The intention is to highlight strategies that are not based on a single model but can be adapted to different regional circumstances, in order to increase awareness and improve management of heart failure in Portugal. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.
Laugsand, Lars E; Strand, Linn B; Platou, Carl; Vatten, Lars J; Janszky, Imre
Insomnia is highly prevalent among heart failure patients, but only a few small studies have investigated insomnia symptoms and risk of heart failure. We aimed to assess the prospective association between self-reported insomnia symptoms and the risk of incident heart failure in a large Norwegian cohort. Baseline data on insomnia symptoms, including difficulty initiating sleep, difficulty maintaining sleep and having non-restorative sleep, socio-demographic variables, and health status, including established cardiovascular risk factors, were collected from 54 279 men and women 20-89 years of age who participated in the Nord-Trøndelag Health study (HUNT) between 1995 and 1997 and were free from known heart failure at baseline. The cohort was followed for incident heart failure from baseline through 2008. We used Cox proportional hazard models to assess the association of baseline insomnia symptoms with the risk of heart failure. A total of 1412 cases of heart failure occurred during a mean follow-up of 11.3 years (SD = 2.9 years), either identified at hospitals or by the National Cause of Death Registry. There was a dose-dependent association between the number of insomnia symptoms and risk of heart failure. The multi-adjusted hazard ratios were 0.96 (0.57-1.61), 1.35 (0.72-2.50), and 4.53 (1.99-10.31) for people with one, two, and three insomnia symptoms, compared with people with none of the symptoms (P for trend 0.021). Insomnia is associated with an increased risk of incident heart failure. If our results are confirmed by others and causation is proved, evaluation of insomnia symptoms might have consequences for cardiovascular prevention. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: email@example.com.
Noll-Hussong, M; Herberger, S; Grauer, M T; Otti, A; Gündel, H
Post-traumatic stress disorder (PTSD) occurs most frequently in the general population after traffic accidents and affects up to 15 % of those involved. Mental and physical comorbidity, preliminary damage or injury can herald the development of PTSD, but the scope of social support after the accident plays a crucial role in whether and to what extent potential PTSD develops. Against this background, preventive and injury reduction aspects of the interaction between insurance companies and their customers are conceivable, which could also positively affect health economic and aspects of job or customer satisfaction.
cur- 55. Mitchell MF, Hittelman WN, Hong WK et al. The natural history cumin , a chemo preventive agent, in patients with high-risk or of cervical...chromosomal DNA loops during oxidative stress . Genes & Dev 13:1553-1560. 16 1999 Chen AY, Choy H and Rothenberg ML. DNA topoisomerase I-targeting drugs as
Viecelli, Andrea K; Irish, Ashley B; Polkinghorne, Kevan R; Hawley, Carmel M; Johnson, David W; Mori, Trevor A; Pascoe, Elaine M; Strippoli, Giovanni F M; Lok, Charmaine E; Palmer, Suetonia C
Arteriovenous access failure frequently occurs in people on hemodialysis and is associated with morbidity, mortality and large healthcare expenditures. Omega-3 polyunsaturated fatty acids (omega-3 PUFA) may improve access outcomes via pleiotropic effects on access maturation and function, but may cause bleeding complications. Systematic review with meta-analysis. Adults requiring hemodialysis via arteriovenous fistula or graft. Trials evaluating omega-3 PUFA for arteriovenous access outcomes identified by searches in CENTRAL, MEDLINE, and Embase to 24 January 2017. Omega-3 PUFA. Primary patency loss, dialysis suitability failure, access abandonment, interventions to maintain patency or assist maturation, bleeding, gastrointestinal side-effects, all-cause and cardiovascular mortality, hospitalization, and treatment adherence. Treatment effects were summarized as relative risks (RR) and 95% confidence intervals (CI). Evidence was assessed using GRADE. Five eligible trials (833 participants) with a median follow-up of 12 months compared peri-operative omega-3 PUFA supplementation with placebo. One trial (n=567) evaluated treatment for fistulae and four (n=266) for grafts. Omega-3 PUFA supplementation prevented primary patency loss with moderate certainty (761 participants, RR 0.81, CI 0.68-0.98). Low quality evidence suggested, that omega-3 PUFA may have had little or no effect on dialysis suitability failure (536 participants, RR 0.95, CI 0.73-1.23), access abandonment (732 participants, RR 0.78, CI 0.59-1.03), need for interventions (732 participants, RR 0.82, CI 0.64-1.04), or all-cause mortality (799 participants, RR 0.99, CI 0.51-1.92). Bleeding risk (793 participants, RR 1.40, CI 0.78-2.49) or gastrointestinal side-effects (816 participants, RR 1.22, CI 0.64-2.34) from treatment were uncertain. There was no evidence of different treatment effects for grafts and fistulae. Small number and methodological limitations of included trials. Omega-3 PUFA supplementation
Benmeir, P; Rosenberg, L; Sagi, A; Ben-Yakar, Y
During the last 13 years 80 patients have been admitted to our department suffering from burns caused by a vehicle's radiator. Ten of them were deeply burned and had to be treated surgically. The preventive aspect of this injury is emphasized.
Full Text Available Sacubitril/Valsartan in now being prescribed by heart failure/cardiology teams across the United Kingdom following the publication of the NICE technology appraisal guidance, but is everyone ready for it? This article discusses the practical aspects of what to do and what not to do in relation to the drug, based on real world experience from our centre.
Full Text Available Failure analysis of the dam-foundation interface in concrete dams is characterized by complexity, uncertainties on models and parameters, and a strong non-linear softening behavior. In practice, these uncertainties are dealt with a well-structured mixture of experience, best practices and prudent, conservative design approaches based on the safety factor concept. Yet, a sound, deep knowledge of some aspects of this failure mode remain unveiled, as they have been offset in practical applications by the use of this conservative approach. In this paper we show a strategy to analyse this failure mode under a reliability-based approach. The proposed methodology of analysis integrates epistemic uncertainty on spatial variability of strength parameters and data from dam monitoring. The purpose is to produce meaningful and useful information regarding the probability of occurrence of this failure mode that can be incorporated in risk-informed dam safety reviews. In addition, relationships between probability of failure and factors of safety are obtained. This research is supported by a more than a decade of intensive professional practice on real world cases and its final purpose is to bring some clarity, guidance and to contribute to the improvement of current knowledge and best practices on such an important dam safety concern.
Rienzi, Laura; Bariani, Fiorenza; Dalla Zorza, Michela; Romano, Stefania; Scarica, Catello; Maggiulli, Roberta; Nanni Costa, Alessandro; Ubaldi, Filippo Maria
Traceability of cells during IVF is a fundamental aspect of treatment, and involves witnessing protocols. Failure mode and effects analysis (FMEA) is a method of identifying real or potential breakdowns in processes, and allows strategies to mitigate risks to be developed. To examine the risks associated with witnessing protocols, an FMEA was carried out in a busy IVF centre, before and after implementation of an electronic witnessing system (EWS). A multidisciplinary team was formed and moderated by human factors specialists. Possible causes of failures, and their potential effects, were identified and risk priority number (RPN) for each failure calculated. A second FMEA analysis was carried out after implementation of an EWS. The IVF team identified seven main process phases, 19 associated process steps and 32 possible failure modes. The highest RPN was 30, confirming the relatively low risk that mismatches may occur in IVF when a manual witnessing system is used. The introduction of the EWS allowed a reduction in the moderate-risk failure mode by two-thirds (highest RPN = 10). In our experience, FMEA is effective in supporting multidisciplinary IVF groups to understand the witnessing process, identifying critical steps and planning changes in practice to enable safety to be enhanced. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Full Text Available Acute liver failure (ALF is a rare life-threatening disease with rapid progression and a low survival rate and affects the function of multiple organ systems. Early identification of cause and protection of vital organs are critical for patients' survival. With the development in artificial liver, stem cell transplantation, and liver transplantation in recent years, the outcome of ALF has been greatly improved. This article elaborates on the treatment of ALF from the aspects of the etiology of ALF and major organ systems involved and introduces the latest advances in artificial liver and stem cell transplantation.
Full Text Available Introduction: Reasons for acute renal failure in hospitalized infants were sepsis, hypovolemia, asphyxia, respiratory distress syndrome, surgical interventions and congenital heart defects. The aim of this study was to determine the frequency and and main etiologies, and early outcome of neonatal acute renal failure. Materials and Methods: At Intensive Care Unit, Clinical Center Tuzla, from 15. 01. 2013 to 15. 01. 2015 in 21 newborn was diagnosed renal failure, based on the amount of excreted urine and serum creatinine. Results: The prevalence of renal failure was 6.84%, with a higher incidence of female. 33.3% of infants were term neonates. Oliguria was diagnosed in 71.4% of newborns. Sepsis was the most common predisposing factor for the development of renal failure, associated with high mortality. Other causes of renal failure were perinatal hypoxia, RDS, surgical interventions and congenital heart defects. There was a positive correlation between the gestational age of the newborn and serum creatinine. Discussion: Early prevention of risk factors with rapid diagnosis and effective treatment, can affect further outcome of acute renal failure in infants.
Hopper, Ingrid; Easton, Kellie
1. The common symptoms and signs of chronic heart failure are dyspnoea, ankle swelling, raised jugular venous pressure and basal crepitations. Other conditions may be confused with chronic heart failure, including dependent oedema or oedema due to renal or hepatic disease. Shortness of breath may be due to respiratory disease or severe anaemia. Heart failure secondary to lung disease (cor pulmonale) should be distinguished from congestive cardiac failure. Heart failure may also present with l...
Cho, In Ha; Panzera, Lauren C; Chin, Morven; Hoppa, Michael B
Neurotransmitter release depends on voltage-gated Na + channels (Na v s) to propagate an action potential (AP) successfully from the axon hillock to a synaptic terminal. Unmyelinated sections of axon are very diverse structures encompassing branch points and numerous presynaptic terminals with undefined molecular partners of Na + channels. Using optical recordings of Ca 2+ and membrane voltage, we demonstrate here that Na + channel β2 subunits (Na v β2s) are required to prevent AP propagation failures across the axonal arborization of cultured rat hippocampal neurons (mixed male and female). When Na v β2 expression was reduced, we identified two specific phenotypes: (1) membrane excitability and AP-evoked Ca 2+ entry were impaired at synapses and (2) AP propagation was severely compromised with >40% of axonal branches no longer responding to AP-stimulation. We went on to show that a great deal of electrical signaling heterogeneity exists in AP waveforms across the axonal arborization independent of axon morphology. Therefore, Na v β2 is a critical regulator of axonal excitability and synaptic function in unmyelinated axons. SIGNIFICANCE STATEMENT Voltage-gated Ca 2+ channels are fulcrums of neurotransmission that convert electrical inputs into chemical outputs in the form of vesicle fusion at synaptic terminals. However, the role of the electrical signal, the presynaptic action potential (AP), in modulating synaptic transmission is less clear. What is the fidelity of a propagating AP waveform in the axon and what molecules shape it throughout the axonal arborization? Our work identifies several new features of AP propagation in unmyelinated axons: (1) branches of a single axonal arborization have variable AP waveforms independent of morphology, (2) Na + channel β2 subunits modulate AP-evoked Ca 2+ -influx, and (3) β2 subunits maintain successful AP propagation across the axonal arbor. These findings are relevant to understanding the flow of excitation in the
Menon, Vidthiya; Davis, Rebecca; Shackel, Nick; Espedido, Bjorn A; Beukers, Alicia G; Jensen, Slade O; van Hal, Sebastiaan J
Daptomycin β-Lactam combination therapy offers "protection" against daptomycin non-susceptibility (DNS) development in Enterococcus faecium. We report failure of this strategy and the importance of source control. Mutations were detected in the LiaF and cls genes in DNS isolates. A single DNS isolate contained an unrecognized mutation, which requires confirmation. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available This paper discusses integrated model of batch production scheduling and machine maintenance scheduling. Batch production scheduling uses minimize total actual flow time criteria and machine maintenance scheduling uses the probability of machine failure based on Weibull distribution. The model assumed no nonconforming parts in a planning horizon. The model shows an increase in the number of the batch (length of production run up to a certain limit will minimize the total actual flow time. Meanwhile, an increase in the length of production run will implicate an increase in the number of PM. An example was given to show how the model and algorithm work.
Yamagami, T [Tokushima Univ., Tokushima (Japan). Faculty of Engineering
Although landslide, slope failure, debris flow, rock fall, etc. are included in disasters caused by earth and sand, this report focuses only on slope failures. It is very difficult to discuss various soil engineering problems concerning earth and sand disasters in the Shikoku district from dynamic aspect. Therefore, this report is made focusing on perfunctory classification. As regards slope failures, there are natural and embankment (artificial) slope failures, but only natural slope failures are discussed in this report. The numbers of annually investigated areas in 4 prefectures in the Shikoku district and frequencies of failures for each geological group are tabulated for explanation. Transverse shape figure, longitudinal section, slope of ground level, land form where surface water and ground water tend to concentrate, etc. can be considered as factors for the occurrence of landslides. The relationship between those topographical factors and the frequency of failure occurrence is investigated. Failure of cut slope and the relation between rainfall and slope failure are outlined. Examples of rock fall disasters are introduced to point out the difficulty in predicting the occurrence of rock falls. 12 refs., 2 figs., 7 tabs.
Fleischhauer, Felix; Tiefenauer, Andreas; Graule, Thomas; Danzer, Robert; Mai, Andreas; Kuebler, Jakob
For solid oxide fuel cells (SOFCs) one key aspect is the structural integrity of the cell and hence its thermo mechanical long term behaviour. The present study investigates the failure mechanisms and the actual causes for fracture of electrolyte supported SOFCs which were run using the current μ-CHP system of Hexis AG, Winterthur - Switzerland under lab conditions or at customer sites for up to 40,000 h. In a first step several operated stacks were demounted for post-mortem inspection, followed by a fractographic evaluation of the failed cells. The respective findings are then set into a larger picture including an analysis of the present stresses acting on the cell like thermal and residual stresses and the measurements regarding the temperature dependent electrolyte strength. For all investigated stacks, the mechanical failure of individual cells can be attributed to locally acting bending loads, which rise due to an inhomogeneous and uneven contact between the metallic interconnect and the cell.
Pampa Pathi Goud
Full Text Available OBJECTIVE: A simple treatment for perichondritis to prevent reaccumulation by using a drain. Existing treatment for this condition is initially medical, surgical (incision and drainage and compression to prevent recurrence with accompanying medical management. However the result is often a failure, resulting in partial or complete cauliflower ear deformity. PROCEDURE: Treatment involves to drain the site of infection and placing a drain to prevent reaccumulation. RESULT: The prescribed treatment avoids reaccumulation of fluid and repeated drainage. CONCLUSION: This method can be implemented for routine minor OT practice.
Effect of a telemonitoring-facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study.
Dendale, Paul; De Keulenaer, Gilles; Troisfontaines, Pierre; Weytjens, Caroline; Mullens, Wilfried; Elegeert, Ivan; Ector, Bavo; Houbrechts, Marita; Willekens, Koen; Hansen, Dominique
Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow-up of patients through a telemonitoring-facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate. One hunderd and sixty CHF patients [mean age 76 ± 10 years, 104 males, mean left ventricular ejection fraction (LVEF) 35 ± 15%] were block randomized by sealed envelopes and assigned to 6 months of intense follow-up facilitated by telemonitoring (TM) or usual care (UC). The TM group measured body weight, blood pressure, and heart rate on a daily basis with electronic devices that transferred the data automatically to an online database. Email alerts were sent to the GP and heart failure clinic to intervene when pre-defined limits were exceeded. All-cause mortality was significantly lower in the TM group as compared with the UC group (5% vs. 17.5%, P = 0.01). The total number of follow-up days lost to hospitalization, dialysis, or death was significantly lower in the TM group as compared with the UC group (13 vs. 30 days, P = 0.02). The number of hospitalizations for heart failure per patient showed a trend (0.24 vs. 0.42 hospitalizations/patient, P = 0.06) in favour of TM. Telemonitoring-facilitated collaboration between GPs and a heart failure clinic reduces mortality and number of days lost to hospitalization, death, or dialysis in CHF patients. These findings need confirmation in a large trial.
Yang, Y. P.; Mohr, W. C.
Creep-fatigue induced failures are often observed in engineering components operating under high temperature and cyclic loading. Understanding the creep-fatigue damage process and identifying failure root cause are very important for preventing such failures and improving the lifetime of engineering components. Finite element analyses including a heat transfer analysis and a creep-fatigue analysis were conducted to model the cyclic thermal and mechanical process of a furnace roll in a continuous hot-dip coating line. Typically, the roll has a short life, modeling heat convection from hot air inside the furnace. The creep-fatigue analysis was performed by inputting the predicted temperature history and applying mechanical loads. The analysis results showed that the failure was resulted from a creep-fatigue mechanism rather than a creep mechanism. The difference of material properties between the filler metal and the base metal is the root cause for the roll failure, which induces higher creep strain and stress in the interface between the weld and the HAZ.
Neznal, M.; Neznal, M.; Jiranek, M.; Fronka, A.
structure in contact with soil, i.e. even under walls. Special attention should be devoted to the sealing of joints and pipe penetrations through the insulation. The high-quality insulation may be replaced by a common damp-proofing if some special conditions are met: the house is built with a cellar under the complete house area; no residential rooms are found in the cellar; all year reliable natural ventilation of the cellar is provided; the cellar entrance from the floors above is provided with an automatic closing door system and with door sealing. The above mentioned approach is considered to be sufficient even in cases when the building site is classified close to the lower limit of the high radon index (the radon concentration in soil does not exceed twice the concentration that separates the medium and high radon index). In all other cases, the radon-proof insulation in all structures in direct contact with soil must be completed with either a a sub-slab ventilation system or an air gap ventilation under the insulation. The sub-slab ventilation system should reduce the radon concentration under the foundation plate, or create negative pressure in subsoil compared to indoor air pressure. It is a system of perforated drainage pipes that are inserted into a gravel layer under the foundation plate. To ensure effective operation of sub-slab ventilation, it is recommended to extract the soil air from the sub-slab region by the vertical exhaust pipes. The ventilation system can operate in two ways: a passive ventilation, i.e. the ventilation system is controlled by temperature and pressure indoor/sub-floor differences, or an active one, using a fan. Because the fan is usually installed on the vertical exhaust pipes, each passive system may be easily transformed into an active one. A failure of preventive protective measures in a new-built family house will be described and analysed in the paper. Detailed measurements of sub-slab parameters, continual monitoring of indoor
Askari, Roohollah; Shafii, Milad; Rafiei, Sima; Abolhassani, Mohammad Sadegh; Salarikhah, Elaheh
Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.
As the study of an installation aimed at the detection of sheath failure requires the knowledge of a great number of data related to all the fields of nuclear technology (fission mechanisms, sheath failure mechanisms, recoil of fission products, distribution of the heat transfer fluid in the reactor, techniques of measurement of beta and gamma neutrons, nuclear safety, and so on), this report aims at highlighting some specific issues, more particularly those related to sensors based on delayed neutrons. After having recalled the principles of sheath failure detection, the author presents the various aspects of the study of the formation of fission products and of their passage into the heat transfer fluid: detection by using delayed neutrons, detection by electrostatic collection, passage of fuel fission products into the coolant (recoil, corrosion, gaseous diffusion in the fuel), formation of fission products in the fuel (fission product efficiency). He reports the study of the transport of fission products by the coolant from their place of birth to the place of measurement. He presents the system of measurement by detection of delayed neutrons and by electrostatic collection, reports a sensitivity calculation, a background noise assessment, the determination of detection threshold, and the application of sensitivity and detection thresholds calculations [fr
... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System § 25.981 Fuel tank... system where catastrophic failure could occur due to ignition of fuel or vapors. This must be shown by... established, as necessary, to prevent development of ignition sources within the fuel tank system pursuant to...
Kato, Kyoichi; Sato, Hisaya; Abe, Yoshihisa; Ishimori, Yoshiyuki; Hirano, Hiroshi; Higashimura, Kyoji; Amauchi, Hiroshi; Yanakita, Takashi; Kikuchi, Kei; Nakazawa, Yasuo
How the maintenance checks of the medical treatment system, including start of work check and the ending check, was effective for preventive maintenance and the safety improvement was verified. In this research, date on the failure of devices in multiple facilities was collected, and the data of the trouble repair record was analyzed by the technique of reliability engineering. An analysis of data on the system (8 general systems, 6 Angio systems, 11 CT systems, 8 MRI systems, 8 RI systems, and the radiation therapy system 9) used in eight hospitals was performed. The data collection period assumed nine months from April to December 2008. Seven items were analyzed. (1) Mean time between failures (MTBF) (2) Mean time to repair (MTTR) (3) Mean down time (MDT) (4) Number found by check in morning (5) Failure generation time according to modality. The classification of the breakdowns per device, the incidence, and the tendency could be understood by introducing reliability engineering. Analysis, evaluation, and feedback on the failure generation history are useful to keep downtime to a minimum and to ensure safety.
Gonzalez Gonzalez, F.; Jimenez Fernandez, A.
The management guides in severe accidents are very important to know the procedures in these accidents. The present articles summarizes the methodological aspects to elaborate the management guides, in order to prevent the severe accidents
Rothschild, Jeffrey M; Federico, Frank A; Gandhi, Tejal K; Kaushal, Rainu; Williams, Deborah H; Bates, David W
Adverse drug events (ADEs) may lead to serious injury and may result in malpractice claims. While ADEs resulting in claims are not representative of all ADEs, such data provide a useful resource for studying ADEs. Therefore, we conducted a review of medication-related malpractice claims to study their frequency, nature, and costs and to assess the human factor failures associated with preventable ADEs. We also assessed the potential benefits of proved effective ADE prevention strategies on ADE claims prevention. We conducted a retrospective analysis of a New England malpractice insurance company claims records from January 1, 1990, to December 31, 1999. Cases were electronically screened for possible ADEs and followed up by independent review of abstracts by 2 physician reviewers (T.K.G. and R.K.). Additional in-depth claims file reviews identified potential human factor failures associated with ADEs. Adverse drug events represented 6.3% (129/2040) of claims. Adverse drug events were judged preventable in 73% (n = 94) of the cases and were nearly evenly divided between outpatient and inpatient settings. The most frequently involved medication classes were antibiotics, antidepressants or antipsychotics, cardiovascular drugs, and anticoagulants. Among these ADEs, 46% were life threatening or fatal. System deficiencies and performance errors were the most frequent cause of preventable ADEs. The mean costs of defending malpractice claims due to ADEs were comparable for nonpreventable inpatient and outpatient ADEs and preventable outpatient ADEs (mean, $64,700-74,200), but costs were considerably greater for preventable inpatient ADEs (mean, $376,500). Adverse drug events associated with malpractice claims were often severe, costly, and preventable, and about half occurred in outpatients. Many interventions could potentially have prevented ADEs, with error proofing and process standardization covering the greatest proportion of events.
Full Text Available Students of Mathematics education often struggle with integration problem, but yet the root of the problem related to critical thinking is rarely investigated. This article reports research where the first-year students of Mathematics Education of PGRI University Semarang were given an integral problem, then individually they were interviewed related to the answer they have made. The findings of students' difficulties in working on integration problem were confirmed through several questions in the interview which aimed to uncover their critical thinking process related to concepts, procedures, and problem solving. This study shows that student difficulties in Integration by disc method such as failure in identifying radius of a rotary object, specify partition, and integration bounds are closely related to their failure to think critically related to concept, skills, and problem solving aspects of critical thinking.
Full Text Available This research analyzes the issue from the jurisprudential and social aspects. The social aspect focuses on the existing viewpoints regarding the grounds for addiction and also looks into the jurisprudential decrees by Shiite and Sunni jurisprudents regarding opium, hashish and tobacco. In other words, the research focuses on the impacts of jurisprudential decrees on social issues and vice-versa. The research in order to offer strong proof for subjects under discussion conducts documental studies and extracts jurisprudential, historical and scientific texts. In all, this research promotes one’s knowledge about the chronology of drugs including opiates, hashish and tobacco, their side effects, reasons behind drug addiction and jurisprudential decrees in this regard from the viewpoint of jurisprudents. From the viewpoint of social philosophy it raises the thought that there is a dialectic relationship between the thought and the environment and necessitates the need for changes in jurisprudential thoughts. As far as is applied aspect is concerned, it offers solutions for preventing drug addiction.
Che C. Colpitts
Full Text Available Chronic hepatitis C is a major cause of chronic liver disease, including liver cirrhosis and hepatocellular carcinoma. The development of direct-acting antivirals (DAAs revolutionized hepatitis C virus (HCV treatment by offering genuine prospects for the first comprehensive cure of a chronic viral infection in humans. While antiviral resistance is a significant limitation for interferon-based therapies, resistance and treatment failure still appear to be present in a small fraction of patients even in state-of-the-art DAA combination therapies. Therefore, treatment failure and resistance still remain a clinical challenge for the management of patients not responding to DAAs. In this special issue of Viruses on HCV drug resistance, mechanisms of antiviral resistance for different classes of antiviral drugs are described. Furthermore, the detection and monitoring of resistance in clinical practice, the clinical impact of resistance in different patient groups and strategies to prevent and address resistance and treatment failure using complementary antiviral strategies are reviewed.
Colpitts, Che C; Baumert, Thomas F
Chronic hepatitis C is a major cause of chronic liver disease, including liver cirrhosis and hepatocellular carcinoma. The development of direct-acting antivirals (DAAs) revolutionized hepatitis C virus (HCV) treatment by offering genuine prospects for the first comprehensive cure of a chronic viral infection in humans. While antiviral resistance is a significant limitation for interferon-based therapies, resistance and treatment failure still appear to be present in a small fraction of patients even in state-of-the-art DAA combination therapies. Therefore, treatment failure and resistance still remain a clinical challenge for the management of patients not responding to DAAs. In this special issue of Viruses on HCV drug resistance, mechanisms of antiviral resistance for different classes of antiviral drugs are described. Furthermore, the detection and monitoring of resistance in clinical practice, the clinical impact of resistance in different patient groups and strategies to prevent and address resistance and treatment failure using complementary antiviral strategies are reviewed.
Sumaya Giarola Cecilio
Full Text Available Objective: to analyze the psychosocial aspects of living with diabetes mellitus. Methods: a descriptive exploratory study with qualitative approach, made with 16 patients with diabetes mellitus type 2. The data were collected through telephone calls using a semi-structured script approaching the care in health, barriers and family support, analyzed by Bardin’s content. Results: two categories emerged related to the practice of self-care: Self-care, containing three sub-categories: diet, physical activity and emotional aspects and support networks. Conclusion: the results of the study showed the importance of understanding the emotional aspects and attitudes of patients regarding educational practices for self care, in order to establish strategies to prevent and control the disease.
Souers, Clark; Vitello, Peter
Linked CHEETAH is a thermo-chemical code coupled to a 2-D hydrocode. Initially, a quadratic-pressure dependent kinetic rate was used, which worked well in modeling prompt detonation of explosives of large size, but does not work on other aspects of explosive behavior. The variable-pressure Tarantula reactive flow rate model was developed with JWL++ in order to also describe failure and initiation, and we have moved this model into Linked CHEETAH. The model works by turning on only above a pressure threshold, where a slow turn-on creates initiation. At a higher pressure, the rate suddenly leaps to a large value over a small pressure range. A slowly failing cylinder will see a rapidly declining rate, which pushes it quickly into failure. At a high pressure, the detonation rate is constant. A sequential validation procedure is used, which includes metal-confined cylinders, rate-sticks, corner-turning, initiation and threshold, gap tests and air gaps. The size (diameter) effect is central to the calibration. This work was performed under the auspices of the U.S. Department of Energy by the University of California Lawrence Livermore National Laboratory under contract No. W-7405-Eng-48.
Evanthia E. Tripoliti
Full Text Available Heart failure is a serious condition with high prevalence (about 2% in the adult population in developed countries, and more than 8% in patients older than 75 years. About 3–5% of hospital admissions are linked with heart failure incidents. Heart failure is the first cause of admission by healthcare professionals in their clinical practice. The costs are very high, reaching up to 2% of the total health costs in the developed countries. Building an effective disease management strategy requires analysis of large amount of data, early detection of the disease, assessment of the severity and early prediction of adverse events. This will inhibit the progression of the disease, will improve the quality of life of the patients and will reduce the associated medical costs. Toward this direction machine learning techniques have been employed. The aim of this paper is to present the state-of-the-art of the machine learning methodologies applied for the assessment of heart failure. More specifically, models predicting the presence, estimating the subtype, assessing the severity of heart failure and predicting the presence of adverse events, such as destabilizations, re-hospitalizations, and mortality are presented. According to the authors' knowledge, it is the first time that such a comprehensive review, focusing on all aspects of the management of heart failure, is presented. Keywords: Heart failure, Diagnosis, Prediction, Severity estimation, Classification, Data mining
van Hemel, N.M.; Dijkman, B.; de Voogt, W.G.; Beukema, W.P.; Bosker, H.A.; de Cock, C.C.; Jordaens, L.J.L.M.; van Gelder, I.C.; van Gelder, L.M.; van Mechelen, R.; Ruiter, J.H.; Sedney, M.I.; Slegers, L.C.
Today, new pacing algorithms and stimulation methods for the prevention and interruption of atrial tachyarrhythmias can be applied on patients who need bradycardia pacing for conventional reasons. In addition, biventricular pacing as additive treatment for patients with severe congestive heart failure due to ventricular systolic dysfunction and prolonged intraventricular conduction has shown to improve symptoms and reduce hospital admissions. These new pacing technologies and the optimising of the pacing programmes are complex, expensive and time-consuming. Based on many clinical studies the indications for these devices are beginning to emerge. To support the cardiologist's decision-making and to prevent waste of effort and resources, the 'ad hoc committee' has provided preliminary recommendations for implantable devices to treat atrial tachyarrhythmias and to extend the treatment of congestive heart failure respectively. PMID:25696255
The Cochrane Oral Health Group's Trials Registry, the Cochrane Central Register of Controlled Trials, Medline and Embase were consulted to find relevant work. Searches were made by hand of numerous journals pertinent to oral implantology. There were no language restrictions. Randomised controlled clinical trials (RCT) with a followup of at least 3 months were chosen. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Two reviewers independently assessed the quality and extracted relevant data from included studies. The estimated effect of the intervention was expressed as a risk ratio together with its 95% confidence interval (CI). Numbers-needed-to-treat (NNT) were calculated from numbers of patients affected by implant failures. Meta-analysis was done only if there were studies with similar comparisons that reported the same outcome measure. Significance of any discrepancies between studies was assessed by means of the Cochran's test for heterogeneity and the I2 statistic. Only two RCT met the inclusion criteria. Meta-analysis of these two trials showed a statistically significantly higher number of patients experiencing implant failures in the group not receiving antibiotics (relative risk, 0.22; 95% CI, 0.06-0.86). The NNT to prevent one patient having an implant failure is 25 (95%CI, 13-100), based on a patient implant failure rate of 6% in people not receiving antibiotics. The following outcomes were not statistically significantly linked with implant failure: prosthesis failure, postoperative infection and adverse events (eg, gastrointestinal effects, hypersensitivity). There is some evidence suggesting that 2 g of amoxicillin given orally 1 h preoperatively significantly reduces failures of dental implants placed in ordinary conditions. It remains unclear whether postoperative antibiotics are beneficial, and which is the most effective antibiotic. One dose of
Nikole J. Byrne, BSc
Full Text Available This study sought to determine whether the sodium/glucose cotransporter 2 (SGLT2 inhibitor empagliflozin improved heart failure (HF outcomes in nondiabetic mice. The EMPA-REG OUTCOME (Empagliflozin, Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients trial demonstrated that empagliflozin markedly prevented HF and cardiovascular death in subjects with diabetes. However, despite ongoing clinical trials in HF patients without type 2 diabetes, there are no objective and translational data to support an effect of SGLT2 inhibitors on cardiac structure and function, particularly in the absence of diabetes and in the setting of established HF. Male C57Bl/6 mice were subjected to either sham or transverse aortic constriction surgery to induce HF. Following surgery, mice that progressed to HF received either vehicle or empagliflozin for 2 weeks. Cardiac function was then assessed in vivo using echocardiography and ex vivo using isolated working hearts. Although vehicle-treated HF mice experienced a progressive worsening of cardiac function over the 2-week treatment period, this decline was blunted in empagliflozin-treated HF mice. Treatment allocation to empagliflozin resulted in an improvement in cardiac systolic function, with no significant changes in cardiac remodeling or diastolic dysfunction. Moreover, isolated hearts from HF mice treated with empagliflozin displayed significantly improved ex vivo cardiac function compared to those in vehicle-treated controls. Empagliflozin treatment of nondiabetic mice with established HF blunts the decline in cardiac function both in vivo and ex vivo, independent of diabetes. These data provide important basic and translational clues to support the evaluation of SGLT2 inhibitors as a treatment strategy in a broad range of patients with established HF.
CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...
Full Text Available Arlet G Kurkchubasche,1 Thomas J Herron,2 Marion F Winkler31Department of Surgery and Pediatrics, 2Department of Surgery, Alpert Medical School of Brown University, 3Department of Surgery/Nutritional Support Service, Rhode Island Hospital, Providence, RI, USAAbstract: Intestinal failure is a consequence of extensive surgical resection resulting in anatomic loss and/or functional impairment in motility or absorptive capacity. The condition is clinically characterized by the inability to maintain fluid, energy, protein, electrolyte, or micronutrient balance when on a conventionally accepted, normal diet. Parenteral nutrition (PN is the cornerstone of management until intestinal adaptation returns the patient to a PN-independent state. Intestinal length, residual anatomic segments and motility determine the need for and duration of parenteral support. The goals of therapy are to provide sufficient nutrients to enable normal growth and development in children, and support a healthy functional status in adults. This review addresses indications for PN, the formulation of the PN solution, patient monitoring, and considerations for prevention of PN-associated complications. With the ultimate goal of achieving enteral autonomy, the important role of diet, pharmacologic interventions, and surgery is discussed.Keywords: intestinal failure, short-bowel syndrome, parenteral nutrition, home nutrition support, intestinal rehabilitation
... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and procedures related to heart disease and stroke. Heart Failure Questions to Ask Your Doctor Use these questions ...
Mahfoudhi, Madiha; Mamlouk, Habiba; Turki, Sami; Kheder, Adel
The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It's a retrospective study implicating 12 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and then to indicate the interest to consider the diagnosis of sarcoidosis in cases of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 12 women with an average age of 40 years. Biological investigations showed an abnormal normocalcemia in 7 cases, a hypercalcemia in 5 cases, a hypercalciuria in 10 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 520 umol/L. For all patients, the renal echography was normal however, the kidney biopsy showed tubulo-interstitial nephritis. The extra-renal signs highlighting pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymph nodes in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 2 cases and a polyarthritis in 5 cases. Five patients benefited of hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis must be done quickly to prevent renal failure.
Tsacoyeanes, J.C.; Raju, P.P.
The pilot program described has been initiated under the Department of Energy Light Water Reactor Safety Research and Development Program and has the following specific objectives: to identify the principal types and causes of failures in valves, valve operators and their controls and associated hardware, which lead to, or could lead to plant trip; and to suggest possible remedies for the prevention of these failures and recommend future research and development programs which could lead to minimizing these valve failures or mitigating their effect on plant operation. The data surveyed cover incidents reported over the six-year period, beginning 1973 through the end of 1978. Three sources of information on valve failures have been consulted: failure data centers, participating organizations in the nuclear power industry, and technical documents
Solntzev, D.I.; Sorkov, V.S.; Sokoloff, V.P.
Laboratory and field data on electrochemical stabilization of clays, by three Russian authors, are here presented in translation. Abstracts of the Russian papers were published in May 1947 issue of the Engineering News Record (pp. 100-101). There exists also a small body of literature, in German and English, dealing with the electrochemical stabilization and related subjects. Elements of the electrochemical process were patented by Casagrande in Germany, shortly before the last war. Results of the Russians and of others, including the German patent, appear to be sound and interesting accordingly. Mechanism of the electrochemical stabilization, however, appears to be surmised rather than established. Unless the mechanism of such stabilization is understood in detail, little progress may be expected in field applications of the electrochemical method. Electroosmosis, a poorly reversible coagulation of the soil colloids, and introduction of exchangeable aluminum into the clay complex have been given credit for the ground-stabilizing effects of direct electrical current. Much remains to be done, as the reader may see, in developing further the theory of the method. A critical study is indicated, in this connection, by agencies or individuals qualified and equipped for basic research in soil physics. Optimum schedules for field treatments need be ascertained with particular care, to suit any given kind of material and environment. A wide range of variation in such schedules, is most certainly to be encountered in dealing with materials as diverse in their composition and properties as are clays. Any generalization on relationships between soil, electrolytes, moisture, and current could be premature if based on the Russian work alone. Stabilization of ground is a major engineering geologic problem of national interest. Needless to say, perhaps, that failures are to be expected, in laboratory and in the field, in this as well as in any other kind of research. To minimize
... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...
Mukhamediev, Sh. A.
In the present paper, we consider ideas suggesting various kinds of industrial impact on the close-to-failure block of the Earth’s crust in order to break a pending strong earthquake (PSE) into a number of smaller quakes or aseismic slips. Among the published proposals on the prevention of a forthcoming strong earthquake, methods based on water injection and vibro influence merit greater attention as they are based on field observations and the results of laboratory tests. In spite of this, the cited proofs are, for various reasons, insufficient to acknowledge the proposed techniques as highly substantiated; in addition, the physical essence of these methods has still not been fully understood. First, the key concept of the methods, namely, the release of the accumulated stresses (or excessive elastic energy) in the source region of a forthcoming strong earthquake, is open to objection. If we treat an earthquake as a phenomenon of a loss in stability, then, the heterogeneities of the physicomechanical properties and stresses along the existing fault or its future trajectory, rather than the absolute values of stresses, play the most important role. In the present paper, this statement is illustrated by the classical examples of stable and unstable fractures and by the examples of the calculated stress fields, which were realized in the source regions of the tsunamigenic earthquakes of December 26, 2004 near the Sumatra Island and of September 29, 2009 near the Samoa Island. Here, just before the earthquakes, there were no excessive stresses in the source regions. Quite the opposite, the maximum shear stresses τmax were close to their minimum value, compared to τmax in the adjacent territory. In the present paper, we provide quantitative examples that falsify the theory of the prevention of PSE in its current form. It is shown that the measures for the prevention of PSE, even when successful for an already existing fault, can trigger or accelerate a catastrophic
McNeil, Paul L.; Steinhardt, Richard A.
Many metazoan cells inhabit mechanically stressful environments and, consequently, their plasma membranes are frequently disrupted. Survival requires that the cell rapidly repair or reseal the disruption. Rapid resealing is an active and complex structural modification that employs endomembrane as its primary building block, and cytoskeletal and membrane fusion proteins as its catalysts. Endomembrane is delivered to the damaged plasma membrane through exocytosis, a ubiquitous Ca2+-triggered response to disruption. Tissue and cell level architecture prevent disruptions from occurring, either by shielding cells from damaging levels of force, or, when this is not possible, by promoting safe force transmission through the plasma membrane via protein-based cables and linkages. Prevention of disruption also can be a dynamic cell or tissue level adaptation triggered when a damaging level of mechanical stress is imposed. Disease results from failure of either the preventive or resealing mechanisms.
Sato, Masahiro [Institute of Nuclear Safety System Inc., Mihama, Fukui (Japan)
Although a large number of expansion joints are used in nuclear power plants with light water reactors, their failure events have not been paid as much attention as those of vessels and pipes. However, as the operation period of nuclear power plants becomes longer, it is necessary to pay attention to their failure events as well as those of vessels and pipes, because aging problems and latent troubles originated in design or fabrication of expansion joints may appear during their long period operation. In this work, we investigated failure event reports of expansion joints in nuclear power plants both in Japan and in U.S.A. and analyzed (1) the influence to output power level, (2) the position and (3) the cause of each failure. It is revealed that the failure events of expansion joints have continuously occurred, some of which have exerted influence upon power level and have caused fatal or injury accidents of personnel, and hence the importance of corrective actions to prevent the recurrence of such events is pointed out. The importance of countermeasures to the following individual events is also pointed out: (1) corrosion of expansion joints in service water systems, (2) degradation of rubber expansion joints in main condensers, (3) vibration and fatigue of expansion joints in extraction steam lines and (4) transgranular stress corrosion cracking of penetration bellows of containments. (author)
Herron, Sherry; Gandy, Rex; Ye, Ningjun; Syed, Nasser
A unique aspect of the implementation of a computer algebra system (CAS) at a comprehensive university in the U.S. allowed us to compare the student success and failure rates to the traditional method of teaching college algebra. Due to space limitations, the university offered sections of both CAS and traditional simultaneously and, upon…
Rezaei, Fatemeh; Yarmohammadian, Mohmmad H.; Haghshenas, Abbas; Fallah, Ali; Ferdosi, Masoud
Background: Methodology of Failure Mode and Effects Analysis (FMEA) is known as an important risk assessment tool and accreditation requirement by many organizations. For prioritizing failures, the index of “risk priority number (RPN)” is used, especially for its ease and subjective evaluations of occurrence, the severity and the detectability of each failure. In this study, we have tried to apply FMEA model more compatible with health-care systems by redefining RPN index to be closer to reality. Methods: We used a quantitative and qualitative approach in this research. In the qualitative domain, focused groups discussion was used to collect data. A quantitative approach was used to calculate RPN score. Results: We have studied patient's journey in surgery ward from holding area to the operating room. The highest priority failures determined based on (1) defining inclusion criteria as severity of incident (clinical effect, claim consequence, waste of time and financial loss), occurrence of incident (time - unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) then, (2) risks priority criteria quantified by using RPN index (361 for the highest rate failure). The ability of improved RPN scores reassessed by root cause analysis showed some variations. Conclusions: We concluded that standard criteria should be developed inconsistent with clinical linguistic and special scientific fields. Therefore, cooperation and partnership of technical and clinical groups are necessary to modify these models. PMID:29441184
Full Text Available Background: Methodology of Failure Mode and Effects Analysis (FMEA is known as an important risk assessment tool and accreditation requirement by many organizations. For prioritizing failures, the index of “risk priority number (RPN” is used, especially for its ease and subjective evaluations of occurrence, the severity and the detectability of each failure. In this study, we have tried to apply FMEA model more compatible with health-care systems by redefining RPN index to be closer to reality. Methods: We used a quantitative and qualitative approach in this research. In the qualitative domain, focused groups discussion was used to collect data. A quantitative approach was used to calculate RPN score. Results: We have studied patient's journey in surgery ward from holding area to the operating room. The highest priority failures determined based on (1 defining inclusion criteria as severity of incident (clinical effect, claim consequence, waste of time and financial loss, occurrence of incident (time - unit occurrence and degree of exposure to risk and preventability (degree of preventability and defensive barriers then, (2 risks priority criteria quantified by using RPN index (361 for the highest rate failure. The ability of improved RPN scores reassessed by root cause analysis showed some variations. Conclusions: We concluded that standard criteria should be developed inconsistent with clinical linguistic and special scientific fields. Therefore, cooperation and partnership of technical and clinical groups are necessary to modify these models.
Mitu, O; Mitu, F; Constantin, S; Cojocaru, Elena; Leon, Maria-Magdalena
Atrial fibrillation is a supraventricular tachyarrhythmia very common in medical practice, often associated with heart failure. Pathophysiological relationship between atrial fibrillation and heart failure is in the attention of numerous case studies, being incomplete elucidated. We made a retrospective study on patients with both diseases, hospitalized in Cardiovascular Rehabilitation Hospital, Iasi, during 01.01.2013 - 31.12.2013. The obtained data allowed the classification of patients according to gender distribution, age groups, area of origin, clinical aspects, and association with other diseases, instituted treatment and appreciation of CHADS2 score. Data interpretation was performed with appropriate statistical methods. We found a higher frequency of the disease among male patients, male: female ratio being 2:1; the most of the patients lived in urban area. The pick of diseases incidence was in patients over 65 years with a total percentage of 70.84% of cases. We noted that the most common symptoms were exertional dyspnea (in all patients), palpitations, dizziness, headache, fatigue, asthenia, dyspnea at rest and pain/chest pressure. In our study, the majority of patients received the beta-blocker--digoxin combination (46 patients, 40 patients respectively). The coexistence of the two disorders could be explained by identifying common risk factors. Beta blockers should be the first therapeutic option in patients with chronic heart failure and atrial fibrillation because they have the effect of controlling heart rate and improve survival in patients with these disorders. Meanwhile, digoxin is a drug, only certain conditions of high accuracy monitoring; whose major clinical indications are heart failure and atrial rhythm disturbances.
Kruyt, J.W.; Heijst, Van G.F.; Altshuler, D.L.; Lentink, David
Airplanes and helicopters use high aspect ratio wings to reduce the power required to fly, but must operate at low angle of attack to prevent flow separation and stall. Animals capable of slow sustained flight, such as hummingbirds, have low aspect ratio wings and flap their wings at high angle
It was in the autumn of 1976 that the SOR-ring (synchrotron radiation storage ring) has commenced the regular operation. Since then, the period when the operation was interrupted due to the failures of SOR-ring itself is in total about 8 weeks. Failures and accidents have occurred most in the vacuum system. Those failure experiences are described on the vacuum, electromagnet, radio-frequency acceleration and beam transport systems with their interrupted periods. The eleven failures in the vacuum system have been reported, such as bellows breakage in a heating-evacuating period, leakage from the bellows of straight-through valves (made in U.S.A. and Japan), and leakage from the joint flange of the vacuum system. The longest interruption was 5 weeks due to the failure of a domestically manufactured straight-through valve. The failures of the electromagnet system involve the breakage in a cooling water system, short circuit of a winding in the Q magnet power transformer, blow of a fuse protecting the deflection magnet power source by the current less than the rating, and others. The failures of the RF acceleration system include the breakage of an output electronic tube the breakage of a cavity ceramic, RF voltage fluctuation due to the contact deterioration at a cavity electrode, and the failure of grid bias power source. It is necessary to select the highly reliable components for the vacuum system because the vacuum system failures require longer time for recovery, and very likely to induce secondary and tertiary failures. (Wakatsuki, Y.)
Full Text Available This paper presents the results of observations and measurements of the impedance of the metal resistor for grounding neutral of the 35 kV network, before and after damaging event. The proposed measures are to be taken in order to eliminate a failure in this particular case, as well as the prevention of similar events.
Juglans Souto Alvarez
Full Text Available Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003 and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.
Larsen, Fin Stolze; Bjerring, Peter Nissen
Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....
Ms. Irina V. Tseveleva
Full Text Available The article deals with criminological aspects of juvenile crime in the narcotics and psychotropic substances trafficking. The authors analyzed the main reasons of committing these crimes by teenagers. The proposals for the prevention of minors’ criminal behavior in drug trafficking are drafted.
Xiao, Lei; Song, Sanling; Chen, Xiaohui; Coit, David W.
Joint optimization models were developed combining group preventive maintenance of a series system and production scheduling. In this paper, we propose a joint optimization model to minimize the total cost including production cost, preventive maintenance cost, minimal repair cost for unexpected failures and tardiness cost. The total cost depends on both the production process and the machine maintenance plan associated with reliability. For the problems addressed in this research, any machine unavailability leads to system downtime. Therefore, it is important to optimize the preventive maintenance of machines because their performance impacts the collective production processing associated with all machines. Too lengthy preventive maintenance intervals may be associated with low scheduled machine maintenance cost, but may incur expensive costs for unplanned failure due to low machine reliability. Alternatively, too frequent preventive maintenance activities may achieve the desired high reliability machines, but unacceptably high scheduled maintenance cost. Additionally, product scheduling plans affect tardiness and maintenance cost. Two results are obtained when solving the problem; the optimal group preventive maintenance interval for machines, and the assignment of each job, including the corresponding start time and completion time. To solve this non-deterministic polynomial-time problem, random keys genetic algorithms are used, and a numerical example is solved to illustrate the proposed model. - Highlights: • Group preventive maintenance (PM) planning and production scheduling are jointed. • Maintenance interval and assignment of jobs are decided by minimizing total cost. • Relationships among system age, PM, job processing time are quantified. • Random keys genetic algorithms (GA) are used to solve the NP-hard problem. • Random keys GA and Particle Swarm Optimization (PSO) are compared.
Honda, Nobuhiro; Hirooka, Yoshitaka; Ito, Koji; Matsukawa, Ryuichi; Shinohara, Keisuke; Kishi, Takuya; Yasukawa, Keiji; Utsumi, Hideo; Sunagawa, Kenji
Enhanced central sympathetic outflow is an indicator of the prognosis of heart failure. Although the central sympatholytic drug moxonidine is an established therapeutic strategy for hypertension, its benefits for hypertensive heart failure are poorly understood. In the present study, we investigated the effects of central sympathoinhibition by intracerebral infusion of moxonidine on survival in a rat model of hypertensive heart failure and the possible mechanisms involved. As a model of hypertensive heart failure, we fed Dahl salt-sensitive rats an 8% NaCl diet from 7 weeks of age. Intracerebroventricular (ICV) infusion of moxonidine (moxonidine-ICV-treated group [Mox-ICV]) or vehicle (vehicle-ICV-treated group [Veh-ICV]) was performed at 14-20 weeks of age, during the increased heart failure phase. Survival rates were examined, and sympathetic activity, left ventricular function and remodelling, and brain oxidative stress were measured. Hypertension and left ventricular hypertrophy were established by 13 weeks of age. At around 20 weeks of age, Veh-ICV rats exhibited overt heart failure concomitant with increased urinary norepinephrine (uNE) excretion as an index of sympathetic activity, dilated left ventricle, decreased percentage fractional shortening, and myocardial fibrosis. Survival rates at 21 weeks of age (n = 28) were only 23% in Veh-ICV rats, and 76% (n = 17) in Mox-ICV rats with concomitant decreases in uNE, myocardial fibrosis, collagen type I/III ratio, brain oxidative stress, and suppressed left ventricular dysfunction. Moxonidine-induced central sympathoinhibition attenuated brain oxidative stress, prevented cardiac dysfunction and remodelling, and improved the prognosis in rats with hypertensive heart failure. Central sympathoinhibition can be effective for the treatment of hypertensive heart failure.
.... It has been found on many occasions that failures, while unexpected, could have been prevented had currently known information been used in the design, construction, maintenance, and inspection of the ship...
Ata-Ali, J; Ata-Ali, F; Ata-Ali, F
The purpose of this study was to systematically review and perform a comprehensive meta-analysis of the current literature to answer the following question: among patients receiving dental implants, does the use of antibiotics, when compared with a control group, reduce the frequency of implant failure and postoperative infection? A manual and electronic PubMed search of the literature was made to identify randomized controlled trials (RCTs) on the efficacy of antibiotics compared with a control group (not receiving antibiotics or receiving placebo). Four RCTs were included in the final review. These four RCTs grouped a total of 2063 implants and a total of 1002 patients. Antibiotic use significantly lowered the implant failure rate (P = 0.003), with an odds ratio of 0.331, implying that antibiotic treatment reduced the odds of failure by 66.9%. The number needed to treat (NNT) to prevent one patient from having an implant failure was 48 (95% confidence interval 31-109). In contrast, antibiotic use did not significantly reduce the incidence of postoperative infection (P = 0.754). Based on the results of this meta-analysis, and pending further research in the field, it can be concluded that there is evidence in favour of systematic antibiotic use in patients receiving dental implants, since such treatment significantly reduces implant failure. In contrast, antibiotic use does not exert a significant preventive effect against postoperative infection. Our recommendations for future research focus on the performance of large-scale RCTs to identify the best choice of antibiotic, timing of administration, and dose. Increased effort is also required to reach consensus and define the most effective antibiotic treatment protocol for patients who are allergic to beta-lactams and for those who are not. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Wang, Huai; Liserre, Marco; Blaabjerg, Frede
Power electronics has progressively gained important status in power generation, distribution and consumption. With more than 70% of electricity processed through power electronics, recent research endeavors to improve the reliability of power electronic systems to comply with more stringent...... constraints on cost, safety and availability in various applications. This paper serves to give an overview of the major aspects of reliability in power electronics and to address the future trends in this multidisciplinary research direction. The ongoing paradigm shift in reliability research is presented...... first. Then the three major aspects of power electronics reliability are discussed, respectively, which cover from physics-of-failure analysis of critical power elec-tronic components, state-of-the-art design for reliability process and robustness validation, and intelligent control and condition...
McMurray, John; Ponikowski, Piotr
Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure.
G.V. Korobeynikov; V.U. Drojjin
The purpose of the study: approbation of the prevention program of physical rehabilitation for Chernobyl disaster survivors in lifestyle aspects. Sixty persons who were disaster survivors and workers of Chernobyl Nuclear Power Plant aged 32-60 have rehabilitation during 21 days. The complex of training prevention programs of physical and psycho-emotional rehabilitation methods was elaborated. The study of efficacy of training prevention programs among Chernobyl disaster survivors. The results...
Gonzalez, David M; Graciano, Sandy J; Karlstad, John; Leblanc, Mathias; Clark, Tom; Holmes, Scott; Reuter, Jon D
Automated watering systems provide a reliable source of ad libitum water to animal cages. Our facility uses an automated water delivery system to support approximately 95% of the housed population (approximately 14,000 mouse cages). Drinking valve failure rates from 2002 through 2006 never exceeded the manufacturer standard of 0.1% total failure, based on monthly cage census and the number of floods. In 2007, we noted an increase in both flooding and cases of clinical dehydration in our mouse population. Using manufacturer's specifications for a water flow rate of 25 to 50 mL/min, we initiated a wide-scale screening of all valves used. During a 4-mo period, approximately 17,000 valves were assessed, of which 2200 failed according to scoring criteria (12.9% overall; 7.2% low flow; 1.6% no flow; 4.1% leaky). Factors leading to valve failures included residual metal shavings, silicone flash, introduced debris or bedding, and (most common) distortion of the autoclave-rated internal diaphragm and O-ring. Further evaluation revealed that despite normal autoclave conditions of heat, pressure, and steam, an extreme negative vacuum pull caused the valves' internal silicone components (diaphragm and O-ring) to become distorted and water-permeable. Normal flow rate often returned after a 'drying out' period, but components then reabsorbed water while on the animal rack or during subsequent autoclave cycles to revert to a variable flow condition. On the basis of our findings, we recalibrated autoclaves and initiated a preventative maintenance program to mitigate the risk of future valve failure.
Lee, Chao-Yi; Su, Bai-Horng; Lin, Tsung-Wen; Lin, Hung-Chih; Li, Tsai-Chung; Wang, Nai-Phon
Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation therapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3 +/- 140.4 gm. The mean gestational age was 25.8 +/- 1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistant staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent post-extubation atelectasis and nosocomial pneumonia.
The objective of this program was to determine the technical feasibility and cost effectiveness of constructing three separate devices for the prevention of catastrophic roller bearing-initiated, railroad journal failure. 1. Construction of a low cos...
Full Text Available Inflammation of oral mucosa induced by anti neoplastic drugs is an important, dose limiting and costly side effect of cancer therapy. Here is presented an exacerbated case of oral mucositis associated with renal failure in a patient who underwent bone marrow transplantation. The clinical aspects and an integrated rehabilitation program are discussed below.
Lee, Y.-H.; Wu, C.-H.; Wang, L.-J.; Wong, Y.-C.; Chen, H.-W.; Wang, C.-J.; Lin, B.-C.; Hsu, Y.-P.
Aim: To evaluate the early success of transarterial embolization (TAE) in patients with traumatic liver haemorrhage and to determine independent factors for its failure. Materials and methods: From January 2009 to December 2012, TAE was performed in 48 patients for traumatic liver haemorrhage. Their medical charts were reviewed for demographic information, pre-TAE vital signs and laboratory data, injury grade, type of contrast medium extravasation (CME) at CT, angiography findings, and early failure. “Early failure” was defined as the need for repeated TAE or a laparotomy for hepatic haemorrhage within 4 days after TAE. Variables were compared between the early success and early failure groups. Variables with univariate significance were also analysed using multivariate logistic regression for predictors of early failure. Results: Among 48 liver TAE cases, nine (18.8%) were early failures due to liver haemorrhage. Early failure was associated with injury grade (p = 0.039), major liver injury (grades 4 and 5; p = 0.007), multiple CMEs at angiography (p = 0.031), incomplete TAE (p = 0.002), and elevated heart rate (p = 0.026). Incomplete embolization (OR = 8; p = 0.042), and heart rate >110 beats/min (bpm; OR = 8; p = 0.05) were independent factors for early failure of TAE in the group with major liver injuries. Conclusion: Major hepatic injury is an important factor in early failure. Patients with a heart rate >110 bpm and incomplete embolization in the major injury group have an increased rate of early failure. The success rate of proximal TAE was comparable to that of the more time-consuming, superselective, distal TAE. - Highlights: • Early failure of TAE is associated with a higher grade of liver injury. • Incomplete embolization is more likely to suffer early failure of TAE. • A heart rate greater than 110 bpm is more likely to suffer early failure of TAE. • We recommend proximal embolization to prevent early failure of TAE