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Sample records for fidelis lead failure

  1. Medtronic Sprint Fidelis lead recall: determining the initial 5-year management cost to Medicare.

    Science.gov (United States)

    Mehrotra, Amit K; Knight, Bradley P; Smelley, Matthew P; Shah, Dipak P; Weisberg, Ian; Baez-Escudero, Jose; Beshai, John F; Burke, Martin C

    2011-08-01

    The Medtronic Sprint Fidelis defibrillator lead has a high failure rate and was recalled in October 2007. The purpose of this study was to determine the incremental cost of the management of this lead to Medicare. Real hospital cost data in U.S. dollars were collected on 32 patients with a Medtronic Sprint Fidelis lead who underwent lead revision. Of these patients, 15 were excluded because they had insurance coverage other than that provided by the Centers for Medicare & Medicaid Services. Seventeen patients with Medicare or Medicaid coverage underwent lead revision either electively (n = 6) or after being hospitalized for multiple shocks caused by a lead fracture (n = 11). Eighty-eight percent of the patients underwent extraction of the Fidelis lead at the time of lead revision. A decision model was made that outlines the potential management of the lead recall over time. The existing literature and Medtronic data were reviewed for parameters included in the decision model. The model assumed that 175,000 patients were alive with an implanted Fidelis lead at the time of the recall and that the annual failure rate will be 1.8% over the first 5 years. It was also assumed that 1% of patients without a lead fracture would also undergo elective lead revision each year and that the proportion of patients who would have the Fidelis lead extracted rather than abandoned would be 20:80. Estimates with ranges were used for parameters for which no data are available. The industry standard rate of lead failure was estimated based on the Sprint Quattro model 6947 lead, and this was subtracted from the estimated rates for the Sprint Fidelis lead such that the incremental cost of the lead failure could be estimated. The cost of lead revision trended higher when the Fidelis lead was extracted rather than abandoned ($45,077 ± $11,693 vs $33,802 ± $33, P = .20). In 5 years, the estimated cost impact of the Medtronic Sprint Fidelis lead recall to Medicare will be $287

  2. Failure of implantable cardioverter-defibrillator leads: a matter of lead size?

    Science.gov (United States)

    Rordorf, Roberto; Poggio, Luca; Savastano, Simone; Vicentini, Alessandro; Petracci, Barbara; Chieffo, Enrico; Klersy, Catherine; Landolina, Maurizio

    2013-02-01

    Small-diameter implantable cardioverter-defibrillator (ICD) Sprint Fidelis and Riata leads have been recalled owing to an increased risk of lead failure, thus arousing the suspicion that lead size might be a critical issue. To compare the incidence of failure of small-diameter (≤8 F) and standard-diameter (>8 F) ICD leads implanted in a single center. From January 2003 to December 2010, 190 Sprint Fidelis, 182 Riata/Riata ST, 99 Optim (Riata Optim/Durata), and 419 standard-diameter leads were implanted in our center. During a median follow-up of 33 months, the overall failure rate was 6.3%. Follow-up duration was similar for Sprint Fidelis, Riata, and standard-diameter leads but shorter for the Optim group. The failure rate was significantly higher in Sprint Fidelis leads than in both standard-diameter (4.8%/year vs 0.8%/year; P<.001) and Riata/Riata ST (4.8%/year vs 2.6%/year; P = .03) leads. The incidence of lead failure in Riata/Riata ST leads proved significantly higher than in standard-diameter leads (2.6%/year vs 0.8%/year; P = .001). No cases of lead failure were recorded in the Optim group. On multivariable analyses, small-diameter (hazard ratio [HR] 5.03, 2.53-10.01, P<.001), Sprint Fidelis (HR 6.3, 3.1-13.3, P<.001), or Riata/Riata ST (HR 4.5, 1.9-10.5, P = .001) leads and age<60 years (HR 2.3, 1.3-4.3, P = .005) were found to independently increase the risk of lead failure. Compared with standard-diameter leads, both Sprint Fidelis and Riata/Riata ST small-diameter ICD leads are at an increased risk of failure, although the incidence of events is significantly lower in the Riata than in the Sprint Fidelis group. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  3. The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne Møller; Versteeg, Henneke; Nielsen, Jens C.

    The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients.......The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients....

  4. The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne Møller; Versteeg, Henneke; Nielsen, Jens C.

    The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients.......The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients....

  5. Failure modes of lead/acid batteries

    Science.gov (United States)

    Culpin, B.; Rand, D. A. J.

    The delivery and storage of electrical energy in lead/acid batteries via the conversion of lead dioxide and lead to, and from, lead sulphate is deceptively simple. In fact, battery performance depends upon the cell design, the materials of construction, a complex interplay between the multitudinous parameters involved in plate preparation, the chemical composition/structure of the active materials, and the duty/conditions of battery operation. It is not surprising, therefore, that the factors responsible for the degradation of battery performance, and eventual failure, are many and varied. Apart from occasional field surveys of automotive batteries in the U.S.A., comprehensive failure analyses of units removed from service are rarely published. In general, the information is kept proprietary, or appears as a post mortem report that is subsidiary to some other topic of interest. By contrast, the literature abounds with detailed laboratory investigations of phenomena that are likely to contribute, wholly or in part, to the demise of batteries. In broad terms, this review draws together the fragmented and scattered data presently available on the failure mechanisms of lead/acid batteries in order to provide a platform for further exploration of the phenomena, and for the planning of remedial strategies. The approach taken is to classify, first, the different lead/acid technologies in terms of required duty (i.e., float, cycling and automotive applications), unit design (i.e., flat or tubular plate, flooded or immobilized electrolyte), and grid alloy (i.e., leadantimony or leadcalcium system). A distinction is then made between catastrophic failure, as characterized by a sudden inability of the battery to function, and progressive failure, as demonstrated by some more subtle deviation from optimum performance. Catastrophic failure is attributed to incorrect cell design, poor manufacturing practice, abuse, or misuse. These problems are obvious and, accordingly

  6. Patient-reported outcomes in Danish implantable cardioverter defibrillator patients with a Sprint Fidelis lead advisory notification

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Versteeg, Henneke; Nielsen, Jens Cosedis;

    2011-01-01

    Few studies have investigated the association between implantable cardioverter defibrillators (ICDs) and lead advisory notifications and patient-reported outcomes (PROs). We examined (i) whether the mode used to inform patients about a device advisory is associated with PROs, and (ii) whether pat...

  7. Smoking Thickens Heart Wall, Leading to Heart Failure: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160932.html Smoking Thickens Heart Wall, Leading to Heart Failure: Study ... 13, 2016 TUESDAY, Sept. 13, 2016 (HealthDay News) -- Smoking leads to heart failure by causing thickened heart ...

  8. A cost-effectiveness analysis of a proactive management strategy for the Sprint Fidelis recall: a probabilistic decision analysis model.

    Science.gov (United States)

    Bashir, Jamil; Cowan, Simone; Raymakers, Adam; Yamashita, Michael; Danter, Matthew; Krahn, Andrew; Lynd, Larry D

    2013-12-01

    The management of the recall is complicated by the competing risks of lead failure and complications that can occur with lead revision. Many of these patients are currently undergoing an elective generator change--an ideal time to consider lead revision. To determine the cost-effectiveness of a proactive management strategy for the Sprint Fidelis recall. We obtained detailed clinical outcomes and costing data from a retrospective analysis of 341 patients who received the Sprint Fidelis lead in British Columbia, where patients younger than 60 years were offered lead extraction when undergoing generator replacement. These population-based data were used to construct and populate a probabilistic Markov model in which a proactive management strategy was compared to a conservative strategy to determine the incremental cost per lead failure avoided. In our population, elective lead revisions were half the cost of emergent revisions and had a lower complication rate. In the model, the incremental cost-effectiveness ratio of proactive lead revision versus a recommended monitoring strategy was $12,779 per lead failure avoided. The proactive strategy resulted in 21 fewer failures per 100 patients treated and reduced the chance of an additional complication from an unexpected surgery. Cost-effectiveness analysis suggests that prospective lead revision should be considered when patients with a Sprint Fidelis lead present for pulse generator change. Elective revision of the lead is justified even when 25% of the population is operated on per year, and in some scenarios, it is both less costly and provides a better outcome. © 2013 Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.

  9. Panton Valentine leukocidin MSSA leading to multi-organ failure.

    LENUS (Irish Health Repository)

    Low, T B

    2009-06-01

    We report a case of a 15-year-old boy who developed multiple organ failure secondary to a sport injury leading to infection with a Panton Valentine Leukocidin (PVL) secreting Community-Acquired Methicillin Sensitive Staphylococcus Aureus (CA MSSA). Aggressive antibiotic therapy eventually led to recovery.

  10. Improving the Network Structure can lead to Functional Failures

    CERN Document Server

    Pade, Jan Philipp

    2014-01-01

    In many real-world networks the ability to synchronize is a key property for its performance. Examples include power-grid, sensor, and neuron networks as well as consensus formation. Recent work on undirected networks with diffusive interaction revealed that improvements in the network connectivity such as making the network more connected and homogeneous enhances synchronization. However, real-world networks have directed and weighted connections. In such directed networks, understanding the impact of structural changes on the network performance remains a major challenge. Here, we show that improving the structure of a directed network can lead to a failure in the network function. For instance, introducing new links to reduce the minimum distance between nodes can lead to instabilities in the synchronized motion. This counter-intuitive effect only occurs in directed networks. Our results allow to identify the dynamical importance of a link and thereby have a major impact on the design and control of direct...

  11. Schistosomal specific nephropathy leading to end-stage renal failure.

    Science.gov (United States)

    Sobh, M A; Moustafa, F E; el-Housseini, F; Basta, M T; Deelder, A M; Ghoniem, M A

    1987-04-01

    In this study 17 patients, 11 with end-stage renal failure and six with nephrotic syndrome were selected. The selection criteria were presence of active intestinal schistosomiasis and absence of any surgical or other medical disease which could explain the renal disease. When examined by light microscopy, kidney biopsies showed membranoproliferative glomerulonephritis in nine, membranous in four, focal segmental glomerulosclerosis in two, sclerosing glomerulonephritis in one case, and no changes in another case. Direct immunofluorescence showed IgG deposits in 13 cases, IgM in 10 and different complement components (C3, C1q) in eight cases. Eluates from the kidney biopsies of the 17 schistosomal as well as six control cases were examined by ELISA against schistosoma mansoni adult worm antigen (AWA). This test showed the presence of antibodies against the AWA in 12 out of 17 of the schistosomal cases, and zero out of six of the controls. When examined by direct IFA using sheep anti-circulating anodic antigen/FITC and by indirect IFA using monoclonal antischistosomal CAA IgG3, kidney biopsies of the ELISA positive cases showed granular deposits of circulating anodic antigen (CAA). We conclude that schistosomal specific nephropathy does exist in the clinical settings and can lead to end-stage renal disease, with CAA probably being a major responsible antigen.

  12. Refractory anemia leading to renal hemosiderosis and renal failure

    OpenAIRE

    Sujatha Siddappa; K M Mythri; Kowsalya, R.; Ashish Parekh

    2011-01-01

    Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  13. Refractory anemia leading to renal hemosiderosis and renal failure

    Directory of Open Access Journals (Sweden)

    Sujatha Siddappa

    2011-01-01

    Full Text Available Renal hemosiderosis is a rare cause of renal failure and, as a result, may not be diagnosed unless a detailed history, careful interpretation of blood parameters and renal biopsy with special staining is done. Here, we present a rare case of renal hemosiderosis presenting with renal failure.

  14. How the Seven Deadly Sins can Lead to Project Failure

    Directory of Open Access Journals (Sweden)

    Harold Kerzner

    2013-01-01

    Full Text Available For more than forty years, the project management landscape has seen textbooks, journal articles and presented papers discussing the causes of project failures. Unfortunately, many of the failure analyses seem to look at failure superficially rather than in depth. When trying to discover the root cause of a failure, we usually look first in the contractor’s company for someone to blame rather than in our own company. If that doesn’t work, then we begin climbing the organizational hierarchy in our own company by focusing on the project team, followed by the project manager. Once we find someone to blame, the search seems to end and we feel comfortable that we have discovered the cause of the failure. It is human nature to begin finger-pointing at the bottom of the organizational hierarchy first, rather than at the top. Yet, more often than not, the real cause of failure is the result of actions (or inactions and decisions made at the top of the organizational chart than at the bottom. It is also human nature to make decisions based upon how we are affected by the Seven Deadly Sins, namely: envy, anger, pride, greed, sloth, lust and gluttony. Decisions made based upon the Seven Deadly Sins, whether they are made at the top or bottom of the organization, can have dire consequences on projects. Sometimes the sins are hidden and not easily recognized by ourselves or others. We simply do not see or feel that were are committing a sin. The Seven Deadly Sins affect all of us sooner or later, even though we refuse to admit it. Some of us may be impacted by just one or two of the sins, whereas others may succumb to all seven. What is unfortunate is that the greatest damage can occur on projects when the sins influence the way that senior levels of management must interface with projects, whether as a project sponsor or as a member of a governance group. Bad decisions at the top, especially if based upon emotions rather than practicality, can place the

  15. Pheochromocytoma Presenting as Acute Heart Failure Leading to Cardiogenic Shock and Multiorgan Failure

    OpenAIRE

    Jochen Steppan; Julia Shields; Ralph Lebron

    2011-01-01

    Pheochromocytoma is an endocrine tumor classically presenting with headache, paroxysmal hypertension, and palpitations. We discuss the case of a young male, presenting with acute heart failure and cardiogenic shock requiring stabilization with an intra-aortic balloon pump and a combination of ionotropes and vasopressors. Pheochromocytoma was diagnosed by CT scan, as well as urine and plasma metanephrines. After pretreatment with phenoxy-benzamine, the patient underwent adrenalectomy with subs...

  16. Chronic renal failure with gout: a marker of chronic lead poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Craswell, P.W.; Price, J.; Boyle, P.D.; Heazlewood, V.J.; Baddeley, H.; Lloyd, H.M.; Thomas, B.J.; Thomas, B.W.

    1984-09-01

    EDTA (calcium disodium edetate) lead mobilization and x-ray fluorescence (XRF) finger bone lead tests were done in 42 patients with chronic renal failure and without persisting lead intoxication. Nineteen of 23 patients with gout and 8 of 19 without gout had positive EDTA lead mobilization tests. Those patients with gout excreted significantly more excess lead chelate than those without gout. In the gout group 17 patients denied any childhood or industrial exposure to lead. They had a greater number of positive tests and excreted significantly more excess lead chelate than 14 patients with neither gout nor lead exposure. These results confirm that gout in the presence of chronic renal failure is a useful marker of chronic lead poisoning. Of 27 patients with positive lead mobilization tests, only 13 had elevated XRF finger bone lead concentrations (sensitivity 48%). Three of 15 patients with negative lead mobilization tests had elevated XRF finger bone lead concentrations (specificity 80%). Although the XRF finger bone lead test is a convenient noninvasive addition to the diagnostic evaluation of patients with chronic renal failure and gout, its application is limited due to the lack of sensitivity of the method.

  17. Failure Modes of Lead Free Solder Bumps Formed by Induction Spontaneous Heating Reflow

    Institute of Scientific and Technical Information of China (English)

    Mingyu LI; Hongbo XU; Jongmyung KIM; Hongbae KIM

    2007-01-01

    The shear failure modes and respective failure mechanism of Sn3.5Ag and Sn3.0Ag0.5Cu lead-free solder bumping on Au/Ni/Cu metallization formed by induction spontaneous heating reflow process have been investigated through the shear test after aging at 120℃ for 0, 1, 4, 9 and 16 d. Different typical shear failure behaviors have been found in the loading curves (shear force vs displacement). From the results of interfacial morphology analysis of the fracture surfaces and cross-sections, two main typical failure modes have been identified. The probabilities of the failure modes occurrence are inconsistent when the joints were aged for different times. The evolution of the brittle Ni3Sn4 and Cu-Ni-Au-Sn layers and the grains coarsening of the solder bulk are the basic reasons for the change of shear failure modes.

  18. Additional coronary sinus shocking lead as rescue therapy after multiple internal and external defibrillation failures.

    Science.gov (United States)

    Chauveau, Samuel; Dulac, Arnaud; Sebbag, Laurent; Morel, Elodie; Chevalier, Philippe

    2017-06-01

    High defibrillation threshold (DFT) and defibrillation failure can lead to intractable ventricular arrhythmias. Additional coronary sinus coil is an effective strategy to achieve marked reduction in DFT. However, physicians should retain this might prevent future coronary sinus lead placement in case the patient would develop complete left bundle branch block.

  19. Preimplantation Exposure to Bisphenol A and Triclosan May Lead to Implantation Failure in Humans

    Directory of Open Access Journals (Sweden)

    Mu Yuan

    2015-01-01

    Full Text Available Endocrine disrupting chemicals (EDCs are chemicals that have the capacity to interfere with normal endocrine systems. Two EDCs, bisphenol A (BPA and triclosan (TCS, are mass-produced and widespread. They both have estrogenic properties and similar chemical structures and pharmacokinetic features and have been detected in human fluids and tissues. Clinical evidence has suggested a positive association between BPA exposure and implantation failure in IVF patients. Studies in mouse models have suggested that preimplantation exposure to BPA and TCS can lead to implantation failure. This paper reviews the relationship between preimplantation exposure to BPA and TCS and implantation failure and discusses the remaining problems and possible solutions.

  20. Failure mechanisms of lead/acid automotive batteries in service in the U.S.A.

    Science.gov (United States)

    Hoover, John H.; Boden, David P.

    Discarded lead/acid batteries were selected at random without regard to brand or condition and these were inspected and tested to determine the causes of failure. Samples were limited to 12-V automotive passenger-car batteries. Their age was determined from the manufacturing code and shipping date. In addition to the cause of failure, information on battery components and construction was also noted. Data are presented showing the principal modes of failure, the effect of geographical location, and the influence of grid alloy on life. In particular, the differences observed between those batteries utilizing calcium alloy for the positive grids and those using antimony alloy are discussed.

  1. Proactive behaviour may lead to failure in virtual project-based collaborative learning

    DEFF Research Database (Denmark)

    Bjørn, Pernille; Hertzum, Morten

    2005-01-01

    This paper argues that proactive behaviour, caused by high engagement and motivation of the learners, may lead to failure of collaborative learning. By examining empirical data from real-world text-only virtual negotiations between dispersed participants engaged in project-based collaborative...

  2. 7 CFR 27.93 - Bona fide spot markets.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Bona fide spot markets. 27.93 Section 27.93... REGULATIONS COTTON CLASSIFICATION UNDER COTTON FUTURES LEGISLATION Regulations Spot Markets § 27.93 Bona fide spot markets. The following markets have been determined, after investigation, and are...

  3. Intestinal Hypoganglionosis Leading to Intestinal Failure and the Compassionate Use of Omegaven™

    Science.gov (United States)

    Karjoo, Sara; Danielson, Paul; Wilsey, Michael; Shakeel, Fauzia

    2017-01-01

    Intestinal hypoganglionosis is a rare innervation disorder that provides numerous nutritional, medical and surgical challenges. In this case report, we present a case of a newborn with intestinal hypoganglionosis leading to intestinal failure and intestinal failure-associated liver disease who responded to Omegaven™, a fat emulsion comprised of omega-3 fatty acids. Omegaven™ has been shown to be beneficial in the management of cholestatic liver injury. Clinical success with Omegaven™ was seen in this patient with a clear decrease in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and complete resolution of cholestasis with a direct bilirubin of zero within two weeks of initiation of Omegaven™. No current guidelines for the diagnosis and management of hypoganglionosis are available. We recommend a multidisciplinary approach and the use of novel therapies such as fat emulsions composed of omega-3 fatty acids for improved patient outcomes. Appropriate compassionate use protocols should be obtained from the Food and Drug Administration prior to initiation of Omegaven™.

  4. Different acute cardiovascular stress in response to resistance exercise leading to failure versus not to failure in elderly women with and without hypertension--a pilot study.

    Science.gov (United States)

    Tajra, Vitor; Vieira, Denis C L; Tibana, Ramires A; Teixeira, Tatiane G; Silva, Alessandro O; Farias, Darlan L; Nascimento, Dahan da C; de Sousa, Nuno M F; Willardson, Jeffrey; Prestes, Jonato

    2015-03-01

    The purpose of the present study was to compare the effects of resistance exercise (RE) leading to failure versus not to failure on 24-h blood pressure (BP) and rate-pressure product (RPP) responses in normotensive and hypertensive trained elderly women. Seven normotensive women and seven women with medically documented hypertension randomly performed three experimental sessions: (i) a non-exercise control session that involved 30 min of seated rest, (ii) whole body RE leading to failure that involved three sets with an eight repetitions maximum (8RM) load and (iii) whole body RE not to failure that involved three sets with 70% of an 8RM load. Systolic BP (SBP), diastolic BP (DBP) and mean BP (MBP) responses during each hour of sleep and awake states were measured. Results of all subjects revealed that the RPP was higher (P ≤ 0.05) during afternoon and night hours after the RE session leading to failure versus not to failure and the non-exercise control session. For the hypertensive group during the night hours, SBP remained higher after the RE session not to failure (P = 0.047) versus non-exercise control session. For the normotensive group, DBP remained higher after the RE session leading to failure over the 24-h period (approximately 8 mmHg h(-1), P = 0.044) and the period upon awaking (approximately 5 mmHg h(-1), P = 0.044) versus the hypertensive group. The normotensive elderly women of this pilot study presented a greater cardiovascular response to RE leading to failure, as a consequence of the higher training intensity. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  5. Analysis of electrolyte abnormalities and the mechanisms leading to arrhythmias in heart failure. A literature review.

    Science.gov (United States)

    Urso, C; Canino, B; Brucculeri, S; Firenze, A; Caimi, G

    2016-01-01

    About 50% of deaths from heart failure (HF) are sudden, presumably referable to arrhythmias. Electrolyte and acid-base abnormalities are a frequent and potentially dangerous complication in HF patients. Their incidence is almost always correlated with the severity of cardiac dysfunction; furthermore leading to arrhythmias, these imbalances are associated with a poor prognosis. The frequency of ventricular ectopic beats and sudden cardiac death correlate with both plasma and whole body levels of potassium, especially in alkalemia. The early recognition of these alterations and the knowledge of the pathophysiological mechanisms are useful for the management of these HF patients.

  6. Proactive behaviour may lead to failure in virtual project-based collaborative learning

    DEFF Research Database (Denmark)

    Bjørn, Pernille; Hertzum, Morten

    2005-01-01

    This paper argues that proactive behaviour, caused by high engagement and motivation of the learners, may lead to failure of collaborative learning. By examining empirical data from real-world text-only virtual negotiations between dispersed participants engaged in project-based collaborative...... learning, we discover that volunteering self-initiated activities promotes the participants’ individualistic behaviour. Also, the technology made it easy for participants to include their own statements in new contributions and deconstruct the statements of others, permitting few opportunities for others...

  7. Hypodipsic hypernatremia leading to reversible renal failure following surgery for craniopharyngioma.

    Science.gov (United States)

    Kwon, Ah Reum; Ann, Jung-Min; Shin, Jae Il; Chae, Hyun Wook; Kim, Ho-Seong

    2012-01-01

    Thirst is stimulated by increases in effective plasma osmolality that are detected by cerebral osmoreceptors located in the vascular organ of the lamina terminalis. However, surgical destruction or organic lesions of the lamina terminalis decrease the sensation of thirst in response to increased plasma osmolality. A 17-year-old boy who was diagnosed with craniopharyngioma at the age of 10 years and underwent tumor resection and gamma knife surgery was admitted for non-symptomatic severe hypernatremia. Although the sodium level was 173 mmol/L and serum osmolality was also high (371 mOsm/kg), the patient did not report increased thirst. Laboratory analysis revealed hypertonic dehydration and acute non-oliguric renal failure due to dehydration. Treatment was based on correction of hypernatremia with hydration and education about regular, periodic water ingestion. The patient's hypernatremia and acute non-oliguric renal failure resolved with controlled daily fluid intake. To our knowledge, this is the first report of decreased thirst sensation secondary to craniopharyngioma and tumor resection leading to severe hypernatremia and non-oliguric renal failure in an adolescent.

  8. Macrophages and dendritic cells in the development of liver injury leading to liver failure.

    Science.gov (United States)

    Ananiev, J; Penkova, M; Tchernev, G; Chokoeva, A A; Philipov, S; Tana, C; Gulubova, M; Wollina, U

    2014-01-01

    Liver failure (LF) continues to be a serious problem due to different underlying disorders. Not only hepatocytes but Kupffer cells (KCs) and dendritic cells (DCs) are of importance in this instance. We wanted to investigate the possible role of KCs and liver DCs in the development of liver injury in patients with liver failure. Liver specimens from 23 patients who died after liver failure were examined for the presence and distribution of CD68-positive KCs and CD83-positive DCs by immunohistochemistry. The distribution of the CD83-positive DC in the sinusoidal and the periportal spaces was not even. While 39.1% of patients had a high sinusoidal density of CD83-positive cells, 60.9% demonstrated a high density of CD83-positive cells in the periportal tract. The number of CD83-positive DCs in periportal tracts in patients with advanced liver fibrosis (n=5) were high, while those with mild liver fibrosis (n=18) had low numbers of mature dendritic cells (χ2=4.107; p=0.043). In addition, all patients with intensive fibrosis had low counts of CD68-positive KC’s in portal tracts vs patients with mild fibrosis of which 67% had high counts (χ2=6.97; p=0.008). In seven of the patients with moderate steatosis (87.5%) low numbers of CD68-positive KCs were found in sinusoids, in contrast to those with severe steatosis, where 12 patients (80%) had high KC counts (χ2=13.4; p less than 0.001). The distribution and number of CD68-positive KC and CD83-positive DC reflect the progression of liver fibrosis leading to liver failure.

  9. The Main Causes which Lead to Success or Failure of a Project

    Directory of Open Access Journals (Sweden)

    Cosmina-Simona Toader

    2010-10-01

    Full Text Available In present times any kind of activity is considered as a project, which has a complex characteristic and which involves a new vision starting with the analysis of the project needs and finishing with the efficient re-usage of the project results. The pressures of the global economical and political competitive system of the contemporary world, the competition between producers, a higher respect for the value, and the wellbeing of those who compose the human resources of the project and implicitly for the cost generated by the work factor led to the development of new techniques of project management. The first one who offers what the client wants is the winner and has all the chances to survive in a competitive system. The solution is to realize success projects using an efficient project management. A performing business means an investment in a successful project, with predictable and planned activities. This study wants to identify which are the main causes which lead to the success or failure of a project. In any field some projects were serious and expansive failures and this is the reason why we need to know how we can improve the knowledge and the practice when we conceive and develop a project.

  10. Consolidation and shear failure leading to subsidence and settlement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Abeele, W.; Nyhan, J.W.; Hakonson, T.E.; Drennon, B.J.; Lopez, E.A.; Herrera, W.J.; Langhorst, G.J.; Martinez, J.L.; Trujillo, G.

    1986-02-01

    Subsidence and settlement are phenomena that are much more destructive than generally thought. In shallow land burials they may lead to cracking of the overburden and eventual exposure and escape of waste material. The primary causes are consolidation and cave-ins. Laboratory studies performed at Los Alamos permit us to predict settlement caused by consolidation or natural compaction of the crushed tuff overburden. We have also investigated the shear failure characteristics of crushed tuff that may lead to subsidence. Examples of expected settlement and subsidence are calculated based on the known geotechnical characteristics of crushed tuff. The same thing is done for bentonite/tuff mixes because some field experiments were performed using this additive (bentonite) to reduce the hydraulic conductivity of the crushed tuff. Remedial actions, i.e., means to limit the amount of settlement, are discussed. We finally discuss our field experiment, which studies the influence of subsidence on layered systems in general and on biobarriers in particular. The share of the produced cavities is compared with cavities produced by idealized voids in an idealized environment. Study of root penetration at subsidence sites gives us an indication of the remaining degree of integrity. 30 refs., 24 figs., 19 tabs.

  11. Supersized Atheroma Causing Acquired Coarctation of Aorta Leading to Heart Failure

    Science.gov (United States)

    Karakattu, Sajin; Murtaza, Ghulam; Dinesh, Sharma; Sivagnanam, Kamesh; Schoondyke, Jeffrey; Paul, Timir

    2017-01-01

    Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms. After surgical correction his symptoms resolved. Any patient presenting with heart failure symptoms in the setting of uncontrolled renovascular hypertension, intermittent claudication symptoms, or visceral ischemia with normal ejection fraction but moderate to severe left ventricular hypertrophy should be in high suspicion for acquired coarctation of aorta. The routine thorough examination of pulses in bilateral upper and lower extremities in all hypertensive patients is a very simple and useful clinical tool to diagnose acquired aortic coarctation. PMID:28203578

  12. Supersized Atheroma Causing Acquired Coarctation of Aorta Leading to Heart Failure

    Directory of Open Access Journals (Sweden)

    Sajin Karakattu MD

    2017-01-01

    Full Text Available Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms. After surgical correction his symptoms resolved. Any patient presenting with heart failure symptoms in the setting of uncontrolled renovascular hypertension, intermittent claudication symptoms, or visceral ischemia with normal ejection fraction but moderate to severe left ventricular hypertrophy should be in high suspicion for acquired coarctation of aorta. The routine thorough examination of pulses in bilateral upper and lower extremities in all hypertensive patients is a very simple and useful clinical tool to diagnose acquired aortic coarctation.

  13. Posttraumatic Haematuria with Pseudorenal Failure: A Diagnostic Lead for Intraperitoneal Bladder Rupture

    Science.gov (United States)

    Vagholkar, Suvarna

    2016-01-01

    Bladder rupture is a very morbid injury following blunt or penetrating lower abdominal trauma. Prompt diagnosis is crucial to initiate optimal treatment. Intraperitoneal bladder rupture is associated with haematuria and biochemical features of renal failure. Cystogram is diagnostic. Immediate open surgical repair is the main stay of treatment. A case of intraperitoneal rupture diagnosed preoperatively by the presence of haematuria and pseudorenal failure is presented to highlight the association of posttraumatic haematuria and pseudorenal failure in such injuries. PMID:27547477

  14. Posttraumatic Haematuria with Pseudorenal Failure: A Diagnostic Lead for Intraperitoneal Bladder Rupture

    Directory of Open Access Journals (Sweden)

    Ketan Vagholkar

    2016-01-01

    Full Text Available Bladder rupture is a very morbid injury following blunt or penetrating lower abdominal trauma. Prompt diagnosis is crucial to initiate optimal treatment. Intraperitoneal bladder rupture is associated with haematuria and biochemical features of renal failure. Cystogram is diagnostic. Immediate open surgical repair is the main stay of treatment. A case of intraperitoneal rupture diagnosed preoperatively by the presence of haematuria and pseudorenal failure is presented to highlight the association of posttraumatic haematuria and pseudorenal failure in such injuries.

  15. Failure mechanisms and assembly-process-based solution of FCBGA high lead C4 bump non-wetting

    Institute of Scientific and Technical Information of China (English)

    Li Wenqi; Qiu Yiming; Jin Xing; Wang Lei; Wu Qidi

    2012-01-01

    This paper studies the typical failure modes and failure mechanisms of non-wetting in an FCBGA (flip chip ball grid array) assembly.We have identified that the residual lead and tin oxide layer on the surface of the die bumps as the primary contributor to non-wetting between die bumps and substrate bumps during the chipattach reflow process.Experiments with bump reflow parameters revealed that an optimized reflow dwell time and H2 flow rate in the reflow oven can significantly reduce the amount of lead and tin oxides on the surface of the die bumps,thereby reducing the non-wetting failure rate by about 90%.Both failure analysis results and mass production data validate the non-wetting failure mechanisms identified by this study.As a result of the reflow process optimization,the failure rate associated with non-wetting is significantly reduced,which further saves manufacturing cost and increases capacity utilization.

  16. Root Cause Investigation of Lead-Free Solder Joint Interfacial Failures After Multiple Reflows

    Science.gov (United States)

    Li, Yan; Hatch, Olen; Liu, Pilin; Goyal, Deepak

    2017-03-01

    Solder joint interconnects in three-dimensional (3D) packages with package stacking configurations typically must undergo multiple reflow cycles during the assembly process. In this work, interfacial open joint failures between the bulk solder and the intermetallic compound (IMC) layer were found in Sn-Ag-Cu (SAC) solder joints connecting a small package to a large package after multiple reflow reliability tests. Systematic progressive 3D x-ray computed tomography experiments were performed on both incoming and assembled parts to reveal the initiation and evolution of the open failures in the same solder joints before and after the reliability tests. Characterization studies, including focused ion beam cross-sections, scanning electron microscopy, and energy-dispersive x-ray spectroscopy, were conducted to determine the correlation between IMC phase transformation and failure initiation in the solder joints. A comprehensive failure mechanism, along with solution paths for the solder joint interfacial failures after multiple reflow cycles, is discussed in detail.

  17. Use of sympathomimetic drugs leads to increased risk of hospitalization for arrhythmias in patients with congestive heart failure

    DEFF Research Database (Denmark)

    Bouvy, M L; Heerdink, E R; De Bruin, M L;

    2000-01-01

    BACKGROUND: Sympathomimetic agents have a direct positive chronotropic effect on heart rate and may cause hypokalemia, even when administered by inhalation. In selected patients (e.g., patients with congestive heart failure [CHF]) this can lead to arrhythmias. Despite the potential adverse effects...

  18. Acute tubulo-interstitial nephritis leading to acute renal failure following multiple hornet stings

    Directory of Open Access Journals (Sweden)

    Bambery Pradeep

    2006-11-01

    Full Text Available Abstract Background Hornet stings are generally associated with local and occasionally anaphylactic reactions. Rarely systemic complications like acute renal failure can occur following multiple stings. Renal failure is usually due to development of acute tubular necrosis as a result of intravascular haemolysis, rhabdomyolysis or shock. Rarely it can be following development of acute tubulo-interstitial nephritis. Case presentation We describe a young male, who was stung on face, head, shoulders and upper limbs by multiple hornets (Vespa orientalis. He developed acute renal failure as a result of acute tubulo-interstitial nephritis and responded to steroids. Conclusion Rare causes of acute renal failure like tubulo-interstitial nephritis should be considered in a patient with persistent oliguria and azotemia following multiple hornet stings. Renal biopsy should be undertaken early, as institution of steroid therapy may help in recovery of renal function

  19. Cardiac-specific ablation of glutaredoxin 3 leads to cardiac hypertrophy and heart failure

    Science.gov (United States)

    Experimental and clinical investigations have demonstrated that reactive oxygen species (ROS) production is increased during cardiac hypertrophy and heart failure. Excess ROS can directly impair cardiac contraction through modification of Ca2+ handling proteins or activate multiple effectors and sig...

  20. Risk Factors Leading to Free Flap Failure: Analysis From the National Surgical Quality Improvement Program Database.

    Science.gov (United States)

    Sanati-Mehrizy, Paymon; Massenburg, Benjamin B; Rozehnal, John M; Ingargiola, Michael J; Hernandez Rosa, Jonatan; Taub, Peter J

    2016-11-01

    The objective of this study was to identify risk factors for free flap failure among various anatomically based free flap subgroups. The 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing microvascular free tissue transfer based on current procedural terminology codes. Univariate analysis was performed to identify any association between flap failure and the following factors: age, gender, race, body mass index (BMI), diabetes, smoking, alcohol use, hypertension, intraoperative transfusion, functional health status, American Society of Anesthesiologists class, operative time, and flap location. Factors yielding a significance of P free flap reconstruction met inclusion criteria. Multivariate logistic regression identified BMI (adjusted odds ratio [AOR] = 1.07, P = 0.004) and male gender (AOR = 2.16, P = 0.033) as independent risk factors for flap failure. Among the "breast flaps" subgroup, BMI (AOR = 1.075, P = 0.012) and smoking (AOR = 3.35, P = 0.02) were independent variables associated with flap failure. In "head and neck flaps," operative time (AOR = 1.003, P = 0.018) was an independent risk factor for flap failure. No independent risk factors were identified for the "extremity flaps" or "trunk flaps" subtypes. BMI, smoking, and operative time were identified as independent risk factors for free flap failure among all flaps or within flap subsets.

  1. Left and right ventricular diastolic dysfunction and diastolic heart failure: does one lead to the other?

    Institute of Scientific and Technical Information of China (English)

    Faramarz Tehrani; Anita Phan; Ernst R. Schwarz

    2009-01-01

    Background and Objective Diastolic dysfunction of the left ventricle is a mechanical abnormality diagnosed primarily by echocardiogram, and can be distinguished into three separate degrees based on the severity of reduction in passive compliance and active myocardial relaxation. Methods A literature search was performed for basic science studies, clinical studies and major practice guidelines on the subject of diastolic dysfunction and diastolic heart failure. Important findings were analyzed and correlated with regard to clinical relevance. Results Left ventricular diastolic dysfunction appears to compromise exercise tolerance and is believed to contribute to the pathophysiology in patients with diastolic heart failure. In the clinical setting, however, oftentimes no clear distinction is made between echocardiographically diagnosed diastolic dysfunction and diastolic heart failure, and adequate treatment recommendations are sparse and aimed to prevent worsening and progression of clinical symptoms. To date, there is a lack of high powered trials assessing the possible progression rate from echocardiographically diagnosed diastolic dysfunction to the clinical diagnosis of diastolic heart failure. Furthermore, there are no solid indices to assess the degree of severity of diastolic dysfunction or its progression. Pure right ventricular diastolic dysfunction appears to be even less understood and under-recognized, although it may play a role in the development of both right and left heart failure. Currently there are few but interesting data on the possible interaction between ventricles with diastolic dysfunction and the overall affect on the development of heart failure. Conclusions The timeline and progression of diastolic dysfunction to diastolic heart failure have not been well established and warrant further investigation.

  2. 29 CFR 1604.2 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Sex as a bona fide occupational qualification. 1604.2... GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.2 Sex as a bona fide occupational qualification. (a) The commission believes that the bona fide occupational qualification exception as to sex should be...

  3. DMPD: NOD-like receptors (NLRs): bona fide intracellular microbial sensors. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 18585455 NOD-like receptors (NLRs): bona fide intracellular microbial sensors. Shaw...tml) (.csml) Show NOD-like receptors (NLRs): bona fide intracellular microbial sensors. PubmedID 18585455 Ti...tle NOD-like receptors (NLRs): bona fide intracellular microbial sensors. Authors

  4. Lead

    Science.gov (United States)

    ... found? Who is at risk? What are the health effects of lead? Get educational material about lead Get certified as a Lead Abatement Worker, or other abatement discipline Lead in drinking water Lead air pollution Test your child Check and maintain your home ...

  5. Launch Vehicle Abort Analysis for Failures Leading to Loss of Control

    Science.gov (United States)

    Hanson, John M.; Hill, Ashley D.; Beard, Bernard B.

    2013-01-01

    Launch vehicle ascent is a time of high risk for an onboard crew. There is a large fraction of possible failures for which time is of the essence and a successful abort is possible if the detection and action happens quickly enough. This paper focuses on abort determination based on data already available from the Guidance, Navigation, and Control system. This work is the result of failure analysis efforts performed during the Ares I launch vehicle development program. The two primary areas of focus are the derivation of abort triggers to ensure that abort occurs as quickly as possible when needed, but that false aborts are avoided, and evaluation of success in aborting off the failing launch vehicle.

  6. Precipitating factors leading to decompensation of chronic heart failure in the elderly patient in South-American community hospital

    Institute of Scientific and Technical Information of China (English)

    Alejandro Diaz; Cleto Ciocchini; Mariano Esperatti; Alberto Becerra; Sabrina Mainardi; Alejandro Farah

    2011-01-01

    Background Exacerbations of heart failure appear frequently associated with precipitating factors not directly related to the evolution of cardiac disease. There still a paucity of data on the proportional distribution of precipitating factors specifically in elderly patients. The aim of this study was to examine prospectively the precipitating factors leading to hospitalization in elderly patients with heart failure in our community hospital. Methods We evaluate elderly patients who need admissions for decompensate heart failure. All patients were reviewed daily by the study investigators at the first 24 h and closely followed-up. Decompensafion was defined as the worsening in clinical NYHA class associated with the need for an increase in medical treatment (at minimum intravenously diuretics). Results We included 102 patients (mean age 79 ± 12 years). Precipitating factors were identified in 88.5%. The decompensation was sudden in 35% of the cases.Noncompliance with diet was identified in 52% of the patients, lack of adherence to the prescribed medications amounted to 30%. Others precipitating factors were infections (29%), arrhythmias (25%), acute coronary ischemia (22%), and uncontrolled hypertension (15%),miscellaneous causes were detected in 18% of the cases (progression of renal disease 60%, anemia 30% and iatrogenic factors 10%).Concomitant cause was not recognizable in 11.5%. Conclusions Large proportion heart failure hospitalizations are associated with preventable precipitating factors. Knowledge of potential precipitating factors may help to optimize treatment and provide guidance for patients with heart failure. The presence of potential precipitating factors should be routinely evaluated in patients presenting chronic heart failure.

  7. Radiographically occult intrasinusoidal liver metastases leading to hepatic failure in a case of breast cancer.

    Science.gov (United States)

    Gulia, Seema; Khurana, Sachin; Shet, Tanuja; Gupta, Sudeep

    2016-02-15

    The liver is one of the commonest sites of metastatic involvement in breast cancer, usually evident as focal lesions on imaging tests. Rarely, the pattern of metastatic spread is so diffuse that it remains radiologically occult. Such patients usually present with signs of hepatic insufficiency without any focal lesions on liver imaging. In such cases, liver biopsy is required to make a definitive diagnosis. We report a case of a 56-year-old postmenopausal woman with metastatic breast cancer who presented with subacute progressive liver failure. Repeated imaging of the liver was normal or non-descript. Liver biopsy finally established the diagnosis of intrasinusoidal metastases from breast cancer.

  8. Severe diabetic ketoacidosis leading to cardiac failure, pulmonary oedema and spinal cord oedema resulting in tetraplegia

    Science.gov (United States)

    Christodoulidou, Michelle; Selmi, Fahed

    2012-01-01

    A 23-year-old man with poorly controlled insulin-dependent diabetes mellitus presented to casualty with community-acquired pneumonia and diabetic ketoacidosis. Shortly after admission he deteriorated and developed cardiac failure, pulmonary oedema and further decreased level of consciousness. He was sedated and ventilated for 3 weeks in the intensive care unit. On waking from sedation he was found to be tetraplegic. MRI scan showed gross oedema of the cervical spinal cord with area suspicious of infarction. We describe a rare cause of spinal cord injury and discuss the proposed hypotheses. PMID:23239768

  9. Cytokinesis Failure Leading to Chromosome Instability in v-Src-Induced Oncogenesis.

    Science.gov (United States)

    Nakayama, Yuji; Soeda, Shuhei; Ikeuchi, Masayoshi; Kakae, Keiko; Yamaguchi, Naoto

    2017-04-12

    v-Src, an oncogene found in Rous sarcoma virus, is a constitutively active variant of c-Src. Activation of Src is observed frequently in colorectal and breast cancers, and is critical in tumor progression through multiple processes. However, in some experimental conditions, v-Src causes growth suppression and apoptosis. In this review, we highlight recent progress in our understanding of cytokinesis failure and the attenuation of the tetraploidy checkpoint in v-Src-expressing cells. v-Src induces cell cycle changes-such as the accumulation of the 4N cell population-and increases the number of binucleated cells, which is accompanied by an excess number of centrosomes. Time-lapse analysis of v-Src-expressing cells showed that cytokinesis failure is caused by cleavage furrow regression. Microscopic analysis revealed that v-Src induces delocalization of cytokinesis regulators including Aurora B and Mklp1. Tetraploid cell formation is one of the causes of chromosome instability; however, tetraploid cells can be eliminated at the tetraploidy checkpoint. Interestingly, v-Src weakens the tetraploidy checkpoint by inhibiting the nuclear exclusion of the transcription coactivator YAP, which is downstream of the Hippo pathway and its nuclear exclusion is critical in the tetraploidy checkpoint. We also discuss the relationship between v-Src-induced chromosome instability and growth suppression in v-Src-induced oncogenesis.

  10. In vitro reproduction of device deformation leading to thrombotic complications and failure of flow diversion.

    Science.gov (United States)

    Estrade, Laurent; Makoyeva, Alina; Darsaut, Tim E; Ghostine, Jimmy; Kouznetsov, Evgueni; Salazkin, Igor; Roy, Daniel; Weill, Alain; Raymond, Jean

    2013-12-01

    Flow diverters (FDs) are increasingly used for complex intracranial aneurysms. As these self-expanding devices are deployed across an aneurysm neck, they can undergo deformations. The potential clinical consequences of FD deformations remain unclear. We describe an immediate thrombotic complication attributed to a stereotypical stenotic deformation of an FD extremity that can occur when landing zones are of insufficient length. This case is supplemented with in vitro studies showing the relationship between i) the length of the landing zones and ii) discrepancies between the diameter of the device and recipient vessel, and the severity of FD stenosis. In vitro, a shorter landing zone was associated with a progressive stenotic deformation of the terminal ends of all FDs studied. This deformation was more pronounced when the diameter of the device was oversized compared to the size of the recipient tube. In our clinical case, the presence of this deformation led to an immediate thrombotic complication, requiring deployment of a second stent to correct the observed stenosis. In addition, treatment failure ultimately led to a fatal rupture, a failure that can be explained by residual flows through a more porous transition zone, another characteristic FD deformation which occurs when they are oversized as compared to the parent vessel, but free to expand at the level of the aneurysm. Proper selection of device diameter and length of the landing zone is important, and may decrease the incidence of deformation-related complications.

  11. Low Cardiac Output Leads Hepatic Fibrosis in Right Heart Failure Model Rats.

    Directory of Open Access Journals (Sweden)

    Yoshitaka Fujimoto

    Full Text Available Hepatic fibrosis progresses with right heart failure, and becomes cardiac cirrhosis in a severe case. Although its causal factor still remains unclear. Here we evaluated the progression of hepatic fibrosis using a pulmonary artery banding (PAB-induced right heart failure model and investigated whether cardiac output (CO is responsible for the progression of hepatic fibrosis.Five-week-old Sprague-Dawley rats divided into the PAB and sham-operated control groups. After 4 weeks from operation, we measured CO by echocardiography, and hepatic fibrosis ratio by pathological examination using a color analyzer. In the PAB group, CO was significantly lower by 48% than that in the control group (78.2±27.6 and 150.1±31.2 ml/min, P<0.01. Hepatic fibrosis ratio and serum hyaluronic acid, an index of hepatic fibrosis, were significantly increased in the PAB group than those in the control group (7.8±1.7 and 1.0±0.2%, P<0.01, 76.2±27.5 and 32.7±7.5 ng/ml, P<0.01. Notably, the degree of hepatic fibrosis significantly correlated a decrease in CO. Immunohistological analysis revealed that hepatic stellate cells were markedly activated in hypoxic areas, and HIF-1α positive hepatic cells were increased in the PAB group. Furthermore, by real-time PCR analyses, transcripts of profibrotic and fibrotic factors (TGF-β1, CTGF, procollargen I, procollargen III, MMP 2, MMP 9, TIMP 1, TIMP 2 were significantly increased in the PAB group. In addition, western blot analyses revealed that the protein level of HIF-1α was significantly increased in the PAB group than that in the control group (2.31±0.84 and 1.0±0.18 arbitrary units, P<0.05.Our study demonstrated that low CO and tissue hypoxia were responsible for hepatic fibrosis in right failure heart model rats.

  12. A Novel Method for the Prediction of Critical Inclusion Size Leading to Fatigue Failure

    Science.gov (United States)

    Saberifar, S.; Mashreghi, A. R.

    2012-06-01

    The fatigue behavior of two commercial 30MnVS6 steels with similar microstructure and mechanical properties containing inclusions of different sizes were studied in the 107 cycles fatigue regime. The scanning electron microscopy (SEM) investigations of the fracture surfaces revealed that the nonmetallic inclusions are the main sources of fatigue crack initiation. Calculated according to the Murakami's model, the stress intensity factors were found to be suitable for the assessment of fatigue behavior. In this article, a new method is proposed for the prediction of the critical inclusion size, using Murakami's model. According to this method, a critical stress intensity factor was determined for the estimation of the critical inclusion size causing the fatigue failure.

  13. Prenatal exposure to methyldopa leading to hypertensive crisis and cardiac failure in a neonate.

    Science.gov (United States)

    Su, Jennifer A; Tang, William; Rivero, Niurka; Bar-Cohen, Yaniv

    2014-05-01

    A 2-week-old infant with normal intracardiac anatomy presented to the emergency department in a hypertensive crisis with acute cardiac failure. Despite extensive evaluation, no underlying disease was found. The patient's hypertension and cardiac dysfunction resolved after 1 week of supportive care in the PICU, and she was discharged within 2 weeks of presentation. The patient's history revealed transplacental exposure to the α-adrenergic agonist methyldopa for 10 weeks before delivery. Her age at presentation and the self-limited nature of cardiac sequelae with complete resolution of cardiac dysfunction suggest withdrawal effects from this exposure. Whereas the rebound hypertensive effects of α-adrenergic agonists are well established in the adult population, this report shows an unusual adverse outcome of in utero exposure to methyldopa.

  14. The Murine Model of Mucopolysaccharidosis IIIB Develops Cardiopathies over Time Leading to Heart Failure.

    Directory of Open Access Journals (Sweden)

    Gabriele Giacomo Schiattarella

    Full Text Available Mucopolysaccharidosis (MPS IIIB is a lysosomal disease due to the deficiency of the enzyme α-N-acetylglucosaminidase (NAGLU required for heparan sulfate (HS degradation. The disease is characterized by mild somatic features and severe neurological disorders. Very little is known on the cardiac dysfunctions in MPS IIIB. In this study, we used the murine model of MPS IIIB (NAGLU knockout mice, NAGLU(-/- in order to investigate the cardiac involvement in the disease. Echocardiographic analysis showed a marked increase in left ventricular (LV mass, reduced cardiac function and valvular defects in NAGLU(-/- mice as compared to wild-type (WT littermates. The NAGLU(-/- mice exhibited a significant increase in aortic and mitral annulus dimension with a progressive elongation and thickening of anterior mitral valve leaflet. A severe mitral regurgitation with reduction in mitral inflow E-wave-to-A-wave ratio was observed in 32-week-old NAGLU(-/- mice. Compared to WT mice, NAGLU(-/- mice exhibited a significantly lower survival with increased mortality observed in particular after 25 weeks of age. Histopathological analysis revealed a significant increase of myocardial fiber vacuolization, accumulation of HS in the myocardial vacuoles, recruitment of inflammatory cells and collagen deposition within the myocardium, and an increase of LV fibrosis in NAGLU(-/- mice compared to WT mice. Biochemical analysis of heart samples from affected mice showed increased expression levels of cardiac failure hallmarks such as calcium/calmodulin-dependent protein kinase II, connexin43, α-smooth muscle actin, α-actinin, atrial and brain natriuretic peptides, and myosin heavy polypeptide 7. Furthermore, heart samples from NAGLU(-/- mice showed enhanced expression of the lysosome-associated membrane protein-2 (LAMP2, and the autophagic markers Beclin1 and LC3 isoform II (LC3-II. Overall, our findings demonstrate that NAGLU(-/- mice develop heart disease, valvular

  15. Lead

    Science.gov (United States)

    ... Chapter 6 Chapter 7 Chapter 8 Chapter 9 Appendix I Appendix II Tables Figures State Programs Alabama Alaska Arizona ... Tool Kit Resources Healthy Homes and Lead Poisoning Prevention Training Center (HHLPPTC) Training Tracks File Formats Help: ...

  16. ATM protein is located on presynaptic vesicles and its deficit leads to failures in synaptic plasticity.

    Science.gov (United States)

    Vail, Graham; Cheng, Aifang; Han, Yu Ray; Zhao, Teng; Du, Shengwang; Loy, Michael M T; Herrup, Karl; Plummer, Mark R

    2016-07-01

    Ataxia telangiectasia is a multisystemic disorder that includes a devastating neurodegeneration phenotype. The ATM (ataxia-telangiectasia mutated) protein is well-known for its role in the DNA damage response, yet ATM is also found in association with cytoplasmic vesicular structures: endosomes and lysosomes, as well as neuronal synaptic vesicles. In keeping with this latter association, electrical stimulation of the Schaffer collateral pathway in hippocampal slices from ATM-deficient mice does not elicit normal long-term potentiation (LTP). The current study was undertaken to assess the nature of this deficit. Theta burst-induced LTP was reduced in Atm(-/-) animals, with the reduction most pronounced at burst stimuli that included 6 or greater trains. To assess whether the deficit was associated with a pre- or postsynaptic failure, we analyzed paired-pulse facilitation and found that it too was significantly reduced in Atm(-/-) mice. This indicates a deficit in presynaptic function. As further evidence that these synaptic effects of ATM deficiency were presynaptic, we used stochastic optical reconstruction microscopy. Three-dimensional reconstruction revealed that ATM is significantly more closely associated with Piccolo (a presynaptic marker) than with Homer1 (a postsynaptic marker). These results underline how, in addition to its nuclear functions, ATM plays an important functional role in the neuronal synapse where it participates in the regulation of presynaptic vesicle physiology.

  17. Resveratrol improves survival, hemodynamics and energetics in a rat model of hypertension leading to heart failure.

    Directory of Open Access Journals (Sweden)

    Stéphanie Rimbaud

    Full Text Available Heart failure (HF is characterized by contractile dysfunction associated with altered energy metabolism. This study was aimed at determining whether resveratrol, a polyphenol known to activate energy metabolism, could be beneficial as a metabolic therapy of HF. Survival, ventricular and vascular function as well as cardiac and skeletal muscle energy metabolism were assessed in a hypertensive model of HF, the Dahl salt-sensitive rat fed with a high-salt diet (HS-NT. Resveratrol (18 mg/kg/day; HS-RSV was given for 8 weeks after hypertension and cardiac hypertrophy were established (which occurred 3 weeks after salt addition. Resveratrol treatment improved survival (64% in HS-RSV versus 15% in HS-NT, p<0.001, and prevented the 25% reduction in body weight in HS-NT (P<0.001. Moreover, RSV counteracted the development of cardiac dysfunction (fractional shortening -34% in HS-NT as evaluated by echocardiography, which occurred without regression of hypertension or hypertrophy. Moreover, aortic endothelial dysfunction present in HS-NT was prevented in resveratrol-treated rats. Resveratrol treatment tended to preserve mitochondrial mass and biogenesis and completely protected mitochondrial fatty acid oxidation and PPARα (peroxisome proliferator-activated receptor α expression. We conclude that resveratrol treatment exerts beneficial protective effects on survival, endothelium-dependent smooth muscle relaxation and cardiac contractile and mitochondrial function, suggesting that resveratrol or metabolic activators could be a relevant therapy in hypertension-induced HF.

  18. Resveratrol improves survival, hemodynamics and energetics in a rat model of hypertension leading to heart failure.

    Science.gov (United States)

    Rimbaud, Stéphanie; Ruiz, Matthieu; Piquereau, Jérôme; Mateo, Philippe; Fortin, Dominique; Veksler, Vladimir; Garnier, Anne; Ventura-Clapier, Renée

    2011-01-01

    Heart failure (HF) is characterized by contractile dysfunction associated with altered energy metabolism. This study was aimed at determining whether resveratrol, a polyphenol known to activate energy metabolism, could be beneficial as a metabolic therapy of HF. Survival, ventricular and vascular function as well as cardiac and skeletal muscle energy metabolism were assessed in a hypertensive model of HF, the Dahl salt-sensitive rat fed with a high-salt diet (HS-NT). Resveratrol (18 mg/kg/day; HS-RSV) was given for 8 weeks after hypertension and cardiac hypertrophy were established (which occurred 3 weeks after salt addition). Resveratrol treatment improved survival (64% in HS-RSV versus 15% in HS-NT, p<0.001), and prevented the 25% reduction in body weight in HS-NT (P<0.001). Moreover, RSV counteracted the development of cardiac dysfunction (fractional shortening -34% in HS-NT) as evaluated by echocardiography, which occurred without regression of hypertension or hypertrophy. Moreover, aortic endothelial dysfunction present in HS-NT was prevented in resveratrol-treated rats. Resveratrol treatment tended to preserve mitochondrial mass and biogenesis and completely protected mitochondrial fatty acid oxidation and PPARα (peroxisome proliferator-activated receptor α) expression. We conclude that resveratrol treatment exerts beneficial protective effects on survival, endothelium-dependent smooth muscle relaxation and cardiac contractile and mitochondrial function, suggesting that resveratrol or metabolic activators could be a relevant therapy in hypertension-induced HF.

  19. Nimesulide-induced severe hemolytic anemia and acute liver failure leading to liver transplantation.

    Science.gov (United States)

    Rodrigo, L; de Francisco, R; Pérez-Pariente, J M; Cadahia, V; Tojo, R; Rodriguez, M; Lucena, Ma I; Andrade, R J

    2002-11-01

    We present the case of a 63-year-old woman who had undergone 7 months of treatment with Nimesulide (100 mg/b.i.d.) for symptomatic osteoarthritis. The patient was admitted to our unit with a clinical picture of progressive jaundice over 3 weeks. Clinical and analytical studies revealed acute liver failure, this being confirmed by liver biopsy, which showed submassive necrosis. Serological tests for different viral agents causing hepatitis were all negative. In addition, she presented a picture of severe haemolytic anaemia resistant to several treatments and needed multiple transfusions. Twenty-three days after admission, the patient presented hepatic encephalopathy and received an orthotopic liver transplant on day 25. The evolution after transplantation was good and the patient continues in good health with no evidence of haemolysis almost 2 years later. Liver toxicity due to Nimesulide is well known, but to our knowledge the occurrence of haemolytic anaemia has not been related to this drug previously. For these reasons, Nimesulide has been restricted or removed from the market in several countries in recent months.

  20. Heart failure in patients with sick sinus syndrome treated with single lead atrial or dual-chamber pacing:

    DEFF Research Database (Denmark)

    Riahi, Sam; Nielsen, Jens Cosedis; Hjortshøj, Søren

    2012-01-01

    AIMS: Previous studies indicate that ventricular pacing may precipitate heart failure (HF). We investigated occurrence of HF during long-term follow-up among patients with sick sinus syndrome (SSS) randomized to AAIR or DDDR pacing. Furthermore, we investigated effects of percentage of ventricular...... patients (17%) with the leads in a non-apical position, HR 0.67, CI 0.45-1.00, P = 0.05. After adjustments this difference was non-significant. The incidence of HF was not associated with %VP (P = 0.57).CONCLUSION: In patients with SSS, HF was not associated with pacing mode, %VP, or ventricular lead...... localization. This suggests that DDDR pacing is safe in patients with SSS without precipitating HF....

  1. Semper Fidelis: Values of The Marine Retiree Group

    Directory of Open Access Journals (Sweden)

    Virienia Puspita

    2016-01-01

    the group through the method of analysis of fantasy by Bormann. The results of the this study indicate the stories of Marine retiree in Depok are the bridge of experience of Marine retiree in the past with present time. Besides that, it is the formation of behavior in forms of values, culture and communication behavior of them. From the analysis theme shows that the group values of Marine retiree in Depok has manifested by universal's idealism value of Marines Semper Fidelis (loyalty, sacrifice, dedication, pride and self esteem. The group rhetorical visions are pride of the group, desire for being accepted and close to their group's identity.

  2. Short-term Recovery Following Resistance Exercise Leading or not to Failure.

    Science.gov (United States)

    González-Badillo, J J; Rodríguez-Rosell, D; Sánchez-Medina, L; Ribas, J; López-López, C; Mora-Custodio, R; Yañez-García, J M; Pareja-Blanco, F

    2016-04-01

    This study analyzed the time course of recovery following 2 resistance exercise protocols differing in level of effort: maximum (to failure) vs. half-maximum number of repetitions per set. 9 males performed 3 sets of 4 vs. 8 repetitions with their 80% 1RM load, 3×4(8) vs. 3×8(8), in the bench press and squat. Several time-points from 24 h pre- to 48 h post-exercise were established to assess the mechanical (countermovement jump height, CMJ; velocity against the 1 m·s(-1) load, V1-load), biochemical (testosterone, cortisol, GH, prolactin, IGF-1, CK) and heart rate variability (HRV) and complexity (HRC) response to exercise. 3×8(8) resulted in greater neuromuscular fatigue (higher reductions in repetition velocity and velocity against V1-load) than 3×4(8). CMJ remained reduced up to 48 h post-exercise following 3×8(8), whereas it was recovered after 6 h for 3×4(8). Significantly greater prolactin and IGF-1 levels were found for 3×8(8) vs. 3×4(8). Significant reductions in HRV and HRC were observed for 3×8(8) vs. 3×4(8) in the immediate recovery. Performing a half-maximum number of repetitions per set resulted in: 1) a stimulus of faster mean repetition velocities; 2) lower impairment of neuromuscular performance and faster recovery; 3) reduced hormonal response and muscle damage; and 4) lower reduction in HRV and HRC following exercise. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Initial clinical experience with implantation of left ventricular lead guided by Overlay Ref for the treatment of congestive heart failure.

    Science.gov (United States)

    Zhang, Bu-Chun; Tang, Kai; Xu, Ya-Wei

    2011-01-01

    Cardiac resynchronization therapy (CRT) improves clinical outcome in selected patients with advanced congestive heart failure. The Overlay Ref technique may facilitate the procedure for implanting left ventricular (LV) pacing leads to deliver CRT. To assess the feasibility of deploying a LV pacing lead into a coronary sinus side branch guided by Overlay Ref. Data from 88 consecutive patients who met the CRT implantation criteria in our hospital between 28 November 2007 and 30 December 2009 were randomly assigned to two groups. Forty-four patients underwent CRT device implantation using Overlay Ref to guide target vein selection and advance a specifically designed pacing lead into the target vein (Overlay Ref group); 44 patients were conventionally implanted (control group). LV lead implantation was successful in all patients. Mean CRT total procedure times (skin-to-skin) were: Overlay Ref group, 80.7 ± 18.0 min; control group, 98.5 ± 32.2 min; p = 0.029. Mean placement of LV pacing lead into target vein times were: Overlay Ref group, 16.2 ± 7.7 min; control group, 36.4 ± 23.4 min; p=0.004. Mean total fluoroscopy times were: Overlay Ref group, 13.6 ± 4.3 min; control group, 23.8 ± 15.7 min; p=0.007. Mean LV lead fluoroscopy times were: Overlay Ref group, 5.7 ± 2.9 min; control group, 14.4 ± 4.6 min; p=0.003. No major complications occurred. Overlay Ref facilitates location of and entry into the coronary sinus, and shortens the duration of LV pacing lead implantation into the target vein. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  4. Atrogin-1 Deficiency Leads to Myopathy and Heart Failure in Zebrafish

    Directory of Open Access Journals (Sweden)

    Anja Bühler

    2016-01-01

    Full Text Available Orchestrated protein synthesis and degradation is fundamental for proper cell function. In muscle, impairment of proteostasis often leads to severe cellular defects finally interfering with contractile function. Here, we analyze for the first time the role of Atrogin-1, a muscle-specific E3 ubiquitin ligase known to be involved in the regulation of protein degradation via the ubiquitin proteasome and the autophagy/lysosome systems, in the in vivo model system zebrafish (Danio rerio. We found that targeted inactivation of zebrafish Atrogin-1 leads to progressive impairment of heart and skeletal muscle function and disruption of muscle structure without affecting early cardiogenesis and skeletal muscle development. Autophagy is severely impaired in Atrogin-1-deficient zebrafish embryos resulting in the disturbance of the cytoarchitecture of cardiomyocytes and skeletal muscle cells. These observations are consistent with molecular and ultrastructural findings in an Atrogin-1 knockout mouse and demonstrate that the zebrafish is a suitable vertebrate model to study the molecular mechanisms of Atrogin-1-mediated autophagic muscle pathologies and to screen for novel therapeutically active substances in high-throughput in vivo small compound screens (SCS.

  5. Fatigue failure kinetics and structural changes in lead-free interconnects due to mechanical and thermal cycling

    Science.gov (United States)

    Fiedler, Brent Alan

    Environmental and human health concerns drove European parliament to mandate the Reduction of Hazardous Substances (RoHS) for electronics. This was enacted in July 2006 and has practically eliminated lead in solder interconnects. There is concern in the electronics packaging community because modern lead-free solder is rich in tin. Presently, near-eutectic tin-silver-copper solders are favored by industry. These solders are stiffer than the lead-tin near-eutectic alloys, have a higher melting temperature, fewer slip systems, and form intermetallic compounds (IMC) with Cu, Ni and Ag, each of which tend to have a negative effect on lifetime. In order to design more reliable interconnects, the experimental observation of cracking mechanisms is necessary for the correct application of existing theories. The goal of this research is to observe the failure modes resulting from mode II strain and to determine the damage mechanisms which describe fatigue failures in 95.5 Sn- 4.0 Ag - 0.5 Cu wt% (SAC405) lead-free solder interconnects. In this work the initiation sites and crack paths were characterized for SAC405 ball-grid array (BGA) interconnects with electroless-nickel immersion-gold (ENIG) pad-finish. The interconnects were arranged in a perimeter array and tested in fully assembled packages. Evaluation methods included monotonic and displacement controlled mechanical shear fatigue tests, and temperature cycling. The specimens were characterized using metallogaphy, including optical and electron microscopy as well as energy dispersive spectroscopy (EDS) and precise real-time electrical resistance structural health monitoring (SHM). In mechanical shear fatigue tests, strain was applied by the substrates, simulating dissimilar coefficients of thermal expansion (CTE) between the board and chip-carrier. This type of strain caused cracks to initiate in the soft Sn-rich solder and grow near the interface between the solder and intermetallic compounds (IMC). The growth near

  6. 7 CFR 15a.61 - Sex as a bona-fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Sex as a bona-fide occupational qualification. 15a.61... RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs and Activities Prohibited § 15a.61 Sex as a bona-fide...

  7. Failure to Inactivate Nuclear GSK3β by Ser(389)-Phosphorylation Leads to Focal Neuronal Death and Prolonged Fear Response.

    Science.gov (United States)

    Thornton, Tina M; Hare, Brendan; Colié, Sandra; Pendlebury, William W; Nebreda, Angel R; Falls, William; Jaworski, Diane M; Rincon, Mercedes

    2017-08-17

    GSK3β plays an essential role in promoting cell death and is emerging as a potential target for neurological diseases. Understanding the mechanisms that control neuronal GSK3β is critical. A ubiquitous mechanism to repress GSK3β involves Akt-mediated phosphorylation of Ser(9). Here we show that phosphorylation of GSK3β on Ser(389) mediated by p38 MAPK specifically inactivates nuclear GSK3β in the cortex and hippocampus. Using GSK3β Ser(389) to Ala mutant mice, we show that failure to inactivate nuclear GSK3β by Ser(389) phosphorylation causes neuronal cell death in subregions of the hippocampus and cortex. Although this focal neuronal death does not impact anxiety/depression-like behavior or hippocampal-dependent spatial learning, it leads to an amplified and prolonged fear response. This phenotype is consistent with some aspects of post-traumatic stress disorder (PTSD). Our studies indicate that inactivation of nuclear GSK3β by Ser(389) phosphorylation plays a key role in fear response, revealing new potential therapeutic approaches to target PTSD.Neuropsychopharmacology advance online publication, 20 September 2017; doi:10.1038/npp.2017.187.

  8. QT intervals and QT dispersion determined from a 12-lead 24-hour Holter recording in patients with coronary artery disease and patients with heart failure

    DEFF Research Database (Denmark)

    Hansen, S.; Rasmussen, V.; Torp-Pedersen, C.;

    2008-01-01

    modes of lead selection was used: all 12-leads (QTdisp 12), only precordial leads (QTdisp 6), and one pair of preselected leads (QTdisp 2) in a 24-hour Holter recording every fourth hour each comprising 10 consecutive measurements in 54 healthy subjects, 29 patients with coronary artery disease (CAD......), and 29 patients with heart failure (HF). RESULTS: A significant circadian variation was observed in healthy subjects when modes QTdisp 12 and QTdisp 6 were used (Mean +/- SD 35.58 +/- 16.48 ms; P ... in QTdisp 12 (Mean +/- SD 33.13 +/- 14.86 ms; P detected in healthy subjects and in patients with uncomplicated CAD, but not in those who...

  9. Bona fide interaction-driven topological phase transition in correlated symmetry-protected topological states

    Science.gov (United States)

    He, Yuan-Yao; Wu, Han-Qing; You, Yi-Zhuang; Xu, Cenke; Meng, Zi Yang; Lu, Zhong-Yi

    2016-03-01

    It is expected that the interplay between nontrivial band topology and strong electron correlation will lead to very rich physics. Thus a controlled study of the competition between topology and correlation is of great interest. Here, employing large-scale quantum Monte Carlo simulations, we provide a concrete example of the Kane-Mele-Hubbard model on an AA-stacking bilayer honeycomb lattice with interlayer antiferromagnetic interaction. Our simulation identified several different phases: a quantum spin Hall insulator (QSH), an x y -plane antiferromagnetic Mott insulator, and an interlayer dimer-singlet insulator. Most importantly, a bona fide topological phase transition between the QSH and the dimer-singlet insulators, purely driven by the interlayer antiferromagnetic interaction, is found. At the transition, the spin and charge gap of the system close while the single-particle excitations remain gapped, which means that this transition has no mean-field analog and it can be viewed as a transition between bosonic symmetry-protected topological (SPT) states. At one special point, this transition is described by a (2 +1 )d O (4 ) nonlinear sigma model with exact S O (4 ) symmetry and a topological term at exactly Θ =π . The relevance of this work towards more general interacting SPT states is discussed.

  10. Bona fide interaction-driven topological phase transition in correlated SPT states

    Science.gov (United States)

    Meng, Zi Yang; He, Yuan-Yao; Wu, Han-Qing; You, Yi-Zhuang; Xu, Cenke; Lu, Zhong-Yi

    It is expected the interplay between non-trivial band topology and strong electron correlation will lead to very rich physics. Thus a controlled study of the competition between topology and correlation is of great interest. Here, employing large-scale quantum Monte Carlo simulations, we provide a concrete example of the Kane-Mele-Hubbard model on an AA stacking bilayer honeycomb lattice with inter-layer antiferromagnetic interaction. Our simulation identified several different phases: a quantum spin-Hall insulator (QSH), a xy-plane antiferromagnetic Mott insulator (xy-AFM) and an inter-layer dimer-singlet insulator (dimer-singlet). Most importantly, a bona fide topological phase transition between the QSH and the dimer-singlet insulators, purely driven by the inter-layer antiferromagnetic interaction is found. At the transition, the spin and charge gap of the system close while the single-particle excitations remain gapped, which means that this transition has no mean field analogue and it can be viewed as a transition between bosonic SPT states. At one special point, this transition is described by a (2+1)d O(4) nonlinear sigma model with exact SO(4) symmetry, and a topological term at theta=p. Relevance of this work towards more general interacting SPT states is discussed.

  11. Li-ion Battery Separators, Mechanical Integrity and Failure Mechanisms Leading to Soft and Hard Internal Shorts

    Science.gov (United States)

    Zhang, Xiaowei; Sahraei, Elham; Wang, Kai

    2016-09-01

    Separator integrity is an important factor in preventing internal short circuit in lithium-ion batteries. Local penetration tests (nail or conical punch) often produce presumably sporadic results, where in exactly similar cell and test set-ups one cell goes to thermal runaway while the other shows minimal reactions. We conducted an experimental study of the separators under mechanical loading, and discovered two distinct deformation and failure mechanisms, which could explain the difference in short circuit characteristics of otherwise similar tests. Additionally, by investigation of failure modes, we provided a hypothesis about the process of formation of local “soft short circuits” in cells with undetectable failure. Finally, we proposed a criterion for predicting onset of soft short from experimental data.

  12. Oportere ex fide bona. Una construcción decisiva de la jurisprudencia romana

    Directory of Open Access Journals (Sweden)

    Javier Humberto Facco

    2013-06-01

    Full Text Available Verificada la secularización de la antigua fides, asistimos al surgimiento de una construcción cuya valencia técnica parece concretarse en el específico ámbito del proceso. La fides resulta adjetivada con el calificativo de bona. A partir de entonces el sintagma bona fides significará una característica procesal, una cualidad de ciertas acciones que en la intentio de su fórmula se estructuraban en base al oportere ex fide bona. El núcleo de estas acciones estaba representado por los contratos sinalagmáticos, cuya fuerza obligatoria se fundaba en el consentimiento y pertenecían a la órbita del comercio internacional (ius gentium. Con todo, al margen de su aplicación pretoriana, la cláusula quidquid dare facere oportet ex fide bona fue una elaboración eminentemente jurisprudencial, producto del ingenio de los juristas romanos. Fueron ellos quienes idearon buena parte de las soluciones sobre cuestiones ligadas a la eficacia de los contratos consensuales que todavía hoy se consideran emanaciones de la buena fe-lealtad. Recuperar la trascendencia del rol de los juristas en la tarea de hacer que el derecho sea adherente a la realidad constituye la principal invitación que nace de este escrito.

  13. Oportere ex fide bona. Una construcción decisiva de la jurisprudencia romana

    Directory of Open Access Journals (Sweden)

    Javier Humberto Facco

    2013-07-01

    Full Text Available Verificada la secularización de la antigua fides, asistimos al surgimiento de una construcción cuya valencia técnica parece concretarse en el específico ámbito del proceso. La fides resulta adjetivada con el calificativo de bona. A partir de entonces el sintagma bona fides significará una característica procesal, una cualidad de ciertas acciones que en la intentio de su fórmula se estructuraban en base al oportere ex fide bona. El núcleo de estas acciones estaba representado por los contratos sinalagmáticos, cuya fuerza obligatoria se fundaba en el consentimiento y pertenecían a la órbita del comercio internacional (ius gentium. Con todo, al margen de su aplicación pretoriana, la cláusula quidquid dare facere oportet ex fide bona fue una elaboración eminentemente jurisprudencial, producto del ingenio de los juristas romanos. Fueron ellos quienes idearon buena parte de las soluciones sobre cuestiones ligadas a la eficacia de los contratos consensuales que todavía hoy se consideran emanaciones de la buena fe-lealtad. Recuperar la trascendencia del rol de los juristas en la tarea de hacer que el derecho sea adherente a la realidad constituye la principal invitación que nace de este escrito.

  14. Did FIDELIS projects contribute to the detection of new smear-positive pulmonary tuberculosis cases in China?

    Science.gov (United States)

    Lin, Y; Chiang, C-Y; Rusen, I D; Hinderaker, S G; Roldan, A; Heldal, E; Enarson, D A; Zhang, L-X

    2016-09-01

    Setting: The first phase of the Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB (FIDELIS) projects in China started in 2003. Objective: To determine whether the FIDELIS projects contributed to the increased case detection rate for new smear-positive pulmonary tuberculosis (PTB) in China. Methods: We compared the case notification rates (CNRs) in the intervention year with those of the previous year in the FIDELIS areas, then compared the difference between the CNRs of the intervention year and the previous year in the FIDELIS areas with those in the non-FI-DELIS areas within the province. Results: There was an increase in the CNR in the intervention year compared with the previous year for all the project sites. The differences between the CNR in the intervention year and the previous year ranged from 6.4 to 31.1 per 100 000 population in the FIDELIS areas and from 2.9 to 20.4/100 000 in the non-FIDELIS areas. Differences-in-differences analysis shows that the differences in the CNRs in the FIDELIS areas were not statistically significantly different from those in the non-FIDELIS areas (P = 0.393). Conclusion: The FIDELIS projects may have contributed to the increase in case detection of new smear-positive PTB in China, but the level of evidence is low.

  15. Adverse events and treatment failure leading to discontinuation of recently approved antipsychotic drugs in schizophrenia: A network meta-analysis.

    Science.gov (United States)

    Tonin, Fernanda S; Piazza, Thais; Wiens, Astrid; Fernandez-Llimos, Fernando; Pontarolo, Roberto

    2015-12-01

    Objective:We aimed to gather evidence of the discontinuation rates owing to adverse events or treatment failure for four recently approved antipsychotics (asenapine, blonanserin, iloperidone, and lurasidone).Methods: A systematic review followed by pairwise meta-analysis and mixed treatment comparison meta analysis(MTC) was performed, including randomized controlled trials (RCTs) that compared the use of the above-mentioned drugs versus placebo in patients with schizophrenia. An electronic search was conducted in PubMed, Scopus, Science Direct, Scielo, the Cochrane Library, and International Pharmaceutical Abstracts(January 2015). The included trials were at least single blinded. The main outcome measures extracted were discontinuation owing to adverse events and discontinuation owing to treatment failure.Results: Fifteen RCTs were identified (n = 5400 participants) and 13 of them were amenable for use in our meta-analyses. No significant differences were observed between any of the four drugs and placebo as regards discontinuation owing to adverse events, whether in pairwise meta-analysis or in MTC. All drugs presented a better profile than placebo on discontinuation owing to treatment failure, both in pairwise meta-analysis and MTC. Asenapine was found to be the best therapy in terms of tolerability owing to failure,while lurasidone was the worst treatment in terms of adverse events. The evidence around blonanserin is weak.Conclusion: MTCs allowed the creation of two different rank orders of these four antipsychotic drugs in two outcome measures. This evidence-generating method allows direct and indirect comparisons, supporting approval and pricing decisions when lacking sufficient, direct, head-to-head trials.

  16. FIDELIS--innovative approaches to increasing global case detection of tuberculosis.

    Science.gov (United States)

    Rusen, I D; Enarson, Donald A

    2006-01-01

    Tuberculosis was declared a global public health emergency in 1993. In 2003, only 45% of the world's estimated new smear-positive tuberculosis cases were detected-well below the 70% global case detection target set by the World Health Organization. The FIDELIS (Fund for Innovative DOTS Expansion Through Local Initiatives to Stop TB) initiative is a new global disease control initiative that has been developed to rapidly assess and implement innovative approaches to increase tuberculosis case detection. To date, 32 projects have been approved-covering approximately 378 million people in 13 countries-24 (75%) of which are in the world's 6 highest-burden countries. A wide range of target populations and interventions have been incorporated into successful FIDELIS projects. The FIDELIS initiative may serve as a model to discover best practices to address other urgent global public health problems.

  17. Fiat or bona fide boundary--a matter of granular perspective.

    Directory of Open Access Journals (Sweden)

    Lars Vogt

    Full Text Available BACKGROUND: Distinguishing bona fide (i.e. natural and fiat (i.e. artificial physical boundaries plays a key role for distinguishing natural from artificial material entities and is thus relevant to any scientific formal foundational top-level ontology, as for instance the Basic Formal Ontology (BFO. In BFO, the distinction is essential for demarcating two foundational categories of material entity: object and fiat object part. The commonly used basis for demarcating bona fide from fiat boundary refers to two criteria: (i intrinsic qualities of the boundary bearers (i.e. spatial/physical discontinuity, qualitative heterogeneity and (ii mind-independent existence of the boundary. The resulting distinction of bona fide and fiat boundaries is considered to be categorial and exhaustive. METHODOLOGY/PRINCIPAL FINDINGS: By Referring to various examples from biology, we demonstrate that the hitherto used distinction of boundaries is not categorial: (i spatial/physical discontinuity is a matter of scale and the differentiation of bona fide and fiat boundaries is thus granularity-dependent, and (ii this differentiation is not absolute, but comes in degrees. By reducing the demarcation criteria to mind-independence and by also considering dispositions and historical relations of the bearers of boundaries, instead of only considering their spatio-structural properties, we demonstrate with various examples that spatio-structurally fiat boundaries can nevertheless be mind-independent and in this sense bona fide. CONCLUSIONS/SIGNIFICANCE: We argue that the ontological status of a given boundary is perspective-dependent and that the strictly spatio-structural demarcation criteria follow a static perspective that is ignorant of causality and the dynamics of reality. Based on a distinction of several ontologically independent perspectives, we suggest different types of boundaries and corresponding material entities, including boundaries based on function

  18. Congestive heart failure caused by transvenous pacemaker lead prolapse and associated right ventricular outflow tract obstruction in a dog.

    Science.gov (United States)

    Djani, D M; Coleman, A E; Rapoport, G S; Schmiedt, C W; Layher, J; Thomason, J D

    2016-12-01

    A 16-year-old dog was presented for cough as well as increased respiratory rate and effort three years after implantation of a single-lead transvenous artificial pacemaker system. Thoracic radiographs and echocardiography disclosed prolapse of the pacemaker lead into the main pulmonary artery, causing severe pulmonary insufficiency and right-sided volume overload. Repositioning of the pacemaker lead led to improvement of pulmonary insufficiency and resolution of the dog's clinical signs and cavitary effusions. This case describes a late complication of pacemaker implantation that may be avoided by appropriate use of the manufacturer-provided anchoring sleeve and avoidance of excessive lead redundancy. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. [Does telemonitoring lead to health and economic benefits in patients with chronic heart failure? - a systematic review].

    Science.gov (United States)

    Augustin, U; Henschke, C

    2012-12-01

    Chronic heart failure is a severe and common disease combined with high costs for the German health care system. Deficiencies in standard therapy and limited financial capacities of the German health care system necessitate new approaches in the care of chronic heart failure patients.The present study aims to analyse the scientific level of knowledge of clinical, economic and other outcomes of telemonitoring compared with standard therapy for patients with chronic heart failure. Results should provide an evidence base for health-care decision makers.To determine the outcomes, a systematic review was carried out by using the database MEDLINE. In accordance with defined inclusion and exclusion criteria, 10 randomized controlled trials remained. Furthermore, 4 studies of a hand research and the recently published results of one of the largest national studies were included.As a result of the systematic review, there is currently no evidence for the benefits of telemonitoring compared with standard therapy. National studies identified significant improvements or a tendency for improvements in terms of quality of life and costs/cost-effectiveness as well as partly in mortality, hospital duration and medication adherence. International studies diverged in their results. The comparability and validity of the investigated studies are limited due to a low number of national studies, different settings of the telemonitoring programmes, the inclusion of different NYHA classes, the heterogeneity of study endpoints and endpoint-related causes, short observation periods of some studies as well as questionable transferability of international cost-results to the German health care system. Furthermore, differences in standard therapy between national and international studies were identified. None of the international studies performed a comparison between clinical and economic outcomes.With regard to the future prospects of telemonitoring in Germany there is still a need for

  20. Understanding the mechanisms leading to failure in metallic nanowire-based transparent heaters, and solution for stability enhancement.

    Science.gov (United States)

    Lagrange, M; Sannicolo, T; Muñoz-Rojas, D; Lohan, B Guillo; Khan, A; Anikin, M; Jiménez, C; Bruckert, F; Bréchet, Y; Bellet, D

    2017-02-03

    Silver nanowire (AgNW) networks are emerging as one of the most promising alternatives to indium tin oxide (ITO) for transparent electrodes in flexible electronic devices. They can be used in a variety of optoelectronic applications such as solar cells, touch panels and organic light-emitting diodes. Recently they have also proven to be very efficient when used as transparent heaters (THs). In addition to the study of AgNW networks acting as THs in regular use, i.e. at low voltage and moderate temperature, their stability and physical behavior at higher voltages and for longer durations should be studied in view of their integration into real devices. The properties of AgNW networks deposited by spray coating on glass or flexible transparent substrates are thoroughly studied via in situ measurements. The AgNW networks' behavior at different voltages for different durations and under different atmospheric conditions, both in air and under vacuum, has been examined. At low voltage, a reversible electrical response is observed while irreversibility and even failure are observed at higher voltages. In order to gain a deeper insight into the behavior of AgNW networks used as THs, simple but realistic physical models are proposed and are found to be in fair agreement with the experimental data. Finally, as the stability of AgNW networks is a key issue, we demonstrate that coating AgNW networks with a very thin layer of TiO2 using atomic layer deposition (ALD) improves the material's resistance against electrical and thermal instabilities without altering optical transmittance. We show that the critical annealing temperature associated to network breakdown increases from 270 °C for the as-deposited AgNW networks to 420 °C for AgNW networks coated with TiO2. Similarly, the electrical failure which occurs at 7 V for the as-deposited networks increases to 13 V for TiO2-coated networks. TiO2 is also proved to stabilize AgNW networks during long duration operation and at

  1. Understanding the mechanisms leading to failure in metallic nanowire-based transparent heaters, and solution for stability enhancement

    Science.gov (United States)

    Lagrange, M.; Sannicolo, T.; Muñoz-Rojas, D.; Guillo Lohan, B.; Khan, A.; Anikin, M.; Jiménez, C.; Bruckert, F.; Bréchet, Y.; Bellet, D.

    2017-02-01

    Silver nanowire (AgNW) networks are emerging as one of the most promising alternatives to indium tin oxide (ITO) for transparent electrodes in flexible electronic devices. They can be used in a variety of optoelectronic applications such as solar cells, touch panels and organic light-emitting diodes. Recently they have also proven to be very efficient when used as transparent heaters (THs). In addition to the study of AgNW networks acting as THs in regular use, i.e. at low voltage and moderate temperature, their stability and physical behavior at higher voltages and for longer durations should be studied in view of their integration into real devices. The properties of AgNW networks deposited by spray coating on glass or flexible transparent substrates are thoroughly studied via in situ measurements. The AgNW networks’ behavior at different voltages for different durations and under different atmospheric conditions, both in air and under vacuum, has been examined. At low voltage, a reversible electrical response is observed while irreversibility and even failure are observed at higher voltages. In order to gain a deeper insight into the behavior of AgNW networks used as THs, simple but realistic physical models are proposed and are found to be in fair agreement with the experimental data. Finally, as the stability of AgNW networks is a key issue, we demonstrate that coating AgNW networks with a very thin layer of TiO2 using atomic layer deposition (ALD) improves the material’s resistance against electrical and thermal instabilities without altering optical transmittance. We show that the critical annealing temperature associated to network breakdown increases from 270 °C for the as-deposited AgNW networks to 420 °C for AgNW networks coated with TiO2. Similarly, the electrical failure which occurs at 7 V for the as-deposited networks increases to 13 V for TiO2-coated networks. TiO2 is also proved to stabilize AgNW networks during long duration operation and at

  2. Root-cause analysis and health failure mode and effect analysis: two leading techniques in health care quality assessment.

    Science.gov (United States)

    Shaqdan, Khalid; Aran, Shima; Daftari Besheli, Laleh; Abujudeh, Hani

    2014-06-01

    In this review article, the authors provide a detailed series of guidelines for effectively performing root-cause analysis (RCA) and health failure mode and effect analysis (HFMEA). RCA is a retrospective approach used to ascertain the "root cause" of a problem that has already occurred, whereas HFMEA is a prospective risk assessment tool whose aim is to recognize risks to patient safety. RCA and HFMEA are used for the prevention of errors or recurring errors to create a safer workplace, maintain high standards in health care quality, and incorporate time-saving and cost-saving modifications to favorably affect the patient care environment. The principles and techniques provided here should allow reviewers to better understand the features of RCA and HFMEA and how to apply these processes appropriately. These principles include how to organize a team, identify root causes, seed out proximate causes, graphically describe the process, conduct a hazard analysis, and develop and implement potential action plans.

  3. When do ego threats lead to self-regulation failure? Negative consequences of defensive high self-esteem.

    Science.gov (United States)

    Lambird, Kathleen Hoffman; Mann, Traci

    2006-09-01

    High self-esteem (HSE) is increasingly recognized as heterogeneous. By measuring subtypes of HSE, the present research reevaluates the finding that HSE individuals show poor self-regulation following ego threat (Baumeister, Heatherton, & Tice, 1993). In Experiment 1, participants with HSE showed poor self-regulation after ego threat only if they also were defensive (high in self-presentation bias). In Experiment 2, two measures--self-presentation bias and implicit self-esteem--were used to subtype HSE individuals as defensive. Both operationalizations of defensive HSE predicted poor self-regulation after ego threat. The results indicate that (a) only defensive HSE individuals are prone to self-regulation failure following ego threat and (b) measures of self-presentation bias and implicit self-esteem can both be used to detect defensiveness.

  4. Fides: Lightweight Authenticated Cipher with Side-Channel Resistance for Constrained Hardware

    NARCIS (Netherlands)

    Bilgin, Begül; Bogdanov, Andrey; Knezevic, Miroslav; Mendel, Florian; Wang, Qingju; Bertoni, G.; Coron, J.S.

    2013-01-01

    In this paper, we present a novel lightweight authenticated cipher optimized for hardware implementations called Fides. It is an online nonce-based authenticated encryption scheme with authenticated data whose area requirements are as low as 793 GE and 1001 GE for 80-bit and 96-bit security, respect

  5. 78 FR 9330 - Revision of Regulations Defining Bona Fide Cotton Spot Markets

    Science.gov (United States)

    2013-02-08

    ... Cotton Research and Promotion Act and to allow for published spot quotes to consider spot prices of... and Promotion Act and to allow for ] published spot quotes to consider spot prices of cotton marketed... Cotton Research and Promotion Act. Updated bona fide spot market definitions will allow for...

  6. 15 CFR 8a.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 8a.550 Sex as...

  7. 22 CFR 229.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Sex as a bona fide occupational qualification... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 229.550 Sex...

  8. 13 CFR 113.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational... ADMINISTRATOR Nondiscrimination on the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance Discrimination on the Basis of Sex in Employment in Education Programs Or...

  9. 43 CFR 41.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 41.550 Sex as...

  10. 22 CFR 146.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Sex as a bona fide occupational qualification... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 146.550 Sex as...

  11. 29 CFR 36.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Sex as a bona fide occupational qualification. 36.550 Section 36.550 Labor Office of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...

  12. 34 CFR 106.61 - Sex as a bona-fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Sex as a bona-fide occupational qualification. 106.61..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs...

  13. 38 CFR 23.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Sex as a bona fide... VETERANS AFFAIRS (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in...

  14. 45 CFR 618.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Sex as a bona fide occupational qualification. 618... FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or...

  15. 32 CFR 196.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Sex as a bona fide occupational qualification... DEFENSE (CONTINUED) MISCELLANEOUS NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment...

  16. 6 CFR 17.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational qualification... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 17.550 Sex as...

  17. 10 CFR 5.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational qualification. 5.550 Section 5.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...

  18. 40 CFR 5.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 5.550 Sex as...

  19. 24 CFR 3.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Sex as a bona fide occupational... and Urban Development NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in...

  20. 45 CFR 86.61 - Sex as a bona-fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Sex as a bona-fide occupational qualification. 86... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.61 Sex as...

  1. 18 CFR 1317.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Sex as a bona fide... VALLEY AUTHORITY NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs...

  2. 10 CFR 1042.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Sex as a bona fide occupational qualification. 1042.550 Section 1042.550 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of...

  3. 14 CFR 1253.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 1253.550 Sex...

  4. 45 CFR 2555.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Sex as a bona fide occupational qualification... FOR NATIONAL AND COMMUNITY SERVICE NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment...

  5. 41 CFR 101-4.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Sex as a bona fide... ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 101-4.550...

  6. 36 CFR 1211.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sex as a bona fide occupational qualification. 1211.550 Section 1211.550 Parks, Forests, and Public Property NATIONAL ARCHIVES AND... to such action is essential to successful operation of the employment function concerned. A...

  7. 44 CFR 19.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Sex as a bona fide... MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...

  8. 49 CFR 25.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Sex as a bona fide occupational qualification. 25... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 25.550 Sex as...

  9. 31 CFR 28.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 28.550 Sex as...

  10. 28 CFR 54.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Sex as a bona fide occupational... ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 54.550 Sex as...

  11. Corruption of dendritic cell antigen presentation during acute GVHD leads to regulatory T-cell failure and chronic GVHD.

    Science.gov (United States)

    Leveque-El Mouttie, Lucie; Koyama, Motoko; Le Texier, Laetitia; Markey, Kate A; Cheong, Melody; Kuns, Rachel D; Lineburg, Katie E; Teal, Bianca E; Alexander, Kylie A; Clouston, Andrew D; Blazar, Bruce R; Hill, Geoffrey R; MacDonald, Kelli P A

    2016-08-11

    Chronic graft-versus-host disease (cGVHD) is a major cause of late mortality following allogeneic bone marrow transplantation (BMT) and is characterized by tissue fibrosis manifesting as scleroderma and bronchiolitis obliterans. The development of acute GVHD (aGVHD) is a powerful clinical predictor of subsequent cGVHD, suggesting that aGVHD may invoke the immunologic pathways responsible for cGVHD. In preclinical models in which sclerodermatous cGVHD develops after a preceding period of mild aGVHD, we show that antigen presentation within major histocompatibility complex (MHC) class II of donor dendritic cells (DCs) is markedly impaired early after BMT. This is associated with a failure of regulatory T-cell (Treg) homeostasis and cGVHD. Donor DC-restricted deletion of MHC class II phenocopied this Treg deficiency and cGVHD. Moreover, specific depletion of donor Tregs after BMT also induced cGVHD, whereas adoptive transfer of Tregs ameliorated it. These data demonstrate that the defect in Treg homeostasis seen in cGVHD is a causative lesion and is downstream of defective antigen presentation within MHC class II that is induced by aGVHD.

  12. Pore pressure regime leading to shallow failures in a mountain slope: monitoring and interpretation by soil-atmosphere coupled model.

    Science.gov (United States)

    Vaunat, Jean; Hürlimann, Marcel; Luna, Boris

    2016-04-01

    The study deals with the onset of debris flows in the "El Rebaixader" basin, located in South Central Pyrenees. The initiation area of debris flows is located on a lateral moraine with a thickness of tens of meters, in which torrential processes and other shallow mass movements have generated a large scarp with steep slopes. To follow slope evolution towards shallow failure, different sensors have been installed to monitor meteorological data and hydraulic variables at shallow depths (positive and negative pore pressure, water content). Measurements are interpreted by means of a thermo-hydro-mechanical coupled Finite Element code provided with a specific boundary condition to model water mass and heat flux exchanged between the ground and the atmosphere, including infiltration, evaporation, sensible heat and solar radiation. Results evidence the different modes of pore regime variation imposed, on the one hand, by surface infiltration and evaporation and, on the other hand, by the settlement of a slope parallel flow in a loose layer at some decimetres depth. As a conclusion, the analysis highlights the strong dependency of slope stability to the water regime taking place in slightly more permeable horizons connected to the top of the catchment area rather than to surficial climatic input. On this basis, some keys about debris flow mitigation are finally put forward.

  13. Failure of a neutrino-driven explosion after core-collapse may lead to a thermonuclear supernova

    CERN Document Server

    Kushnir, Doron

    2014-01-01

    We demonstrate that $\\sim10$ seconds after core-collapse of a massive star, a thermonuclear explosion of the outer shells is possible for some (tuned) initial density and composition profiles, assuming the neutrinos failed to explode the star. The explosion may lead to a successful supernova, as first suggested by Burbidge, Burbidge, Fowler and Hoyle (1957). We perform a series of one-dimensional (1D) calculations of collapsing massive stars with simplified initial density profiles (similar to the results of stellar evolution calculations) and various compositions (not similar to 1D stellar evolution calculations). We assume that the neutrinos escaped with negligible effect on the outer layers, which inevitably collapse. As the shells collapse, they compress and heat up adiabatically, enhancing the rate of thermonuclear burning. In some cases, where significant shells of mixed helium and oxygen are present with pre-collapsed burning times of $\\lesssim100\\,\\textrm{s}$ ($\\approx10$ times the free-fall time), a ...

  14. TP53 disruptive mutations lead to head and neck cancer treatment failure through inhibition of radiation-induced senescence.

    Science.gov (United States)

    Skinner, Heath D; Sandulache, Vlad C; Ow, Thomas J; Meyn, Raymond E; Yordy, John S; Beadle, Beth M; Fitzgerald, Alison L; Giri, Uma; Ang, K Kian; Myers, Jeffrey N

    2012-01-01

    Mortality of patients with head and neck squamous cell carcinoma (HNSCC) is primarily driven by tumor cell radioresistance leading to locoregional recurrence (LRR). In this study, we use a classification of TP53 mutation (disruptive vs. nondisruptive) and examine impact on clinical outcomes and radiation sensitivity. Seventy-four patients with HNSCC treated with surgery and postoperative radiation and 38 HNSCC cell lines were assembled; for each, TP53 was sequenced and the in vitro radioresistance measured using clonogenic assays. p53 protein expression was inhibited using short hairpin RNA (shRNA) and overexpressed using a retrovirus. Radiation-induced apoptosis, mitotic cell death, senescence, and reactive oxygen species (ROS) assays were carried out. The effect of the drug metformin on overcoming mutant p53-associated radiation resistance was examined in vitro as well as in vivo, using an orthotopic xenograft model. Mutant TP53 alone was not predictive of LRR; however, disruptive TP53 mutation strongly predicted LRR (P = 0.03). Cell lines with disruptive mutations were significantly more radioresistant (P disruptive TP53 mutations significantly decreased radiation-induced senescence, as measured by SA-β-gal staining, p21 expression, and release of ROS. The mitochondrial agent metformin potentiated the effects of radiation in the presence of a disruptive TP53 mutation partially via senescence. Examination of our patient cohort showed that LRR was decreased in patients taking metformin. Disruptive TP53 mutations in HNSCC tumors predicts for LRR, because of increased radioresistance via the inhibition of senescence. Metformin can serve as a radiosensitizer for HNSCC with disruptive TP53, presaging the possibility of personalizing HNSCC treatment. © 2011 AACR.

  15. Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative

    Directory of Open Access Journals (Sweden)

    Enarson Donald A

    2011-05-01

    Full Text Available Abstract Background Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected information on treatment delay and some of it was available for research purposes. With this database our objective was to assess the duration and determinants of treatment delay among new smear positive pulmonary tuberculosis (TB patients in FIDELIS projects, and to compare delay according to provider visited prior to diagnosis. Methods Treatment delay among new smear positive TB patients was recorded for each patient at treatment initiation and this information was available and fairly complete in 6 out of 57 districts with FIDELIS projects enrolling patients between 2004 and 2007; other districts had discarded their forms at the time of analysis. It was analysed as a cross sectional study. Results We included 1161 cases, 10% of all patients recruited in the FIDELIS projects in Tanzania. Median delay was 12 weeks. The median duration of cough, weight loss and haemoptysis was 12, 8 and 3 weeks, respectively. Compared to Hai district Handeni had patients with longer delays and Mbozi had patients with shorter delays. Urban and rural patients reported similar delays. Patients aged 15-24 years and patients of 65 years or older had longer delays. Patients reporting contact with traditional healers before diagnosis had a median delay of 15 weeks compared to 12 weeks among those who did not. Patients with dyspnoea and with diarrhoea had longer delays. Conclusion In this patient sample in Tanzania half of the new smear positive pulmonary tuberculosis patients had a treatment delay longer than 12 weeks. Delay was similar in men and women and among urban and rural patients, but longer in the young and older age groups. Patients using traditional healers had

  16. Excess F-actin mechanically impedes mitosis leading to cytokinesis failure in X-linked neutropenia by exceeding Aurora B kinase error correction capacity.

    Science.gov (United States)

    Moulding, Dale A; Moeendarbary, Emad; Valon, Leo; Record, Julien; Charras, Guillaume T; Thrasher, Adrian J

    2012-11-01

    The constitutively active mutant of the Wiskott-Aldrich Syndrome protein (CA-WASp) is the cause of X-linked neutropenia and is linked with genomic instability and myelodysplasia. CA-WASp generates abnormally high levels of cytoplasmic F-actin through dysregulated activation of the Arp2/3 complex leading to defects in cell division. As WASp has no reported role in cell division, we hypothesized that alteration of cell mechanics because of increased F-actin may indirectly disrupt dynamic events during mitosis. Inhibition of the Arp2/3 complex revealed that excess cytoplasmic F-actin caused increased cellular viscosity, slowed all phases of mitosis, and perturbed mitotic mechanics. Comparison of chromosome velocity to the cytoplasmic viscosity revealed that cells compensated for increased viscosity by up-regulating force applied to chromosomes and increased the density of microtubules at kinetochores. Mitotic abnormalities were because of overload of the aurora signaling pathway as subcritical inhibition of Aurora in CA-WASp cells caused increased cytokinesis failure, while overexpression reduced defects. These findings demonstrate that changes in cell mechanics can cause significant mitotic abnormalities leading to genomic instability, and highlight the importance of mechanical sensors such as Aurora B in maintaining the fidelity of hematopoietic cell division.

  17. The alteration of protein prenylation induces cardiomyocyte hypertrophy through Rheb-mTORC1 signalling and leads to chronic heart failure.

    Science.gov (United States)

    Xu, Na; Guan, Shan; Chen, Zhong; Yu, Yang; Xie, Jun; Pan, Fei-Yan; Zhao, Ning-Wei; Liu, Li; Yang, Zhong-Zhou; Gao, Xiang; Xu, Biao; Li, Chao-Jun

    2015-04-01

    G protein-regulated cell function is crucial for cardiomyocytes, and any deregulation of its gene expression or protein modification can lead to pathological cardiac hypertrophy. Herein, we report that protein prenylation, a lipidic modification of G proteins that facilitates their association with the cell membrane, might control the process of cardiomyocyte hypertrophy. We found that geranylgeranyl diphosphate synthase (GGPPS), a key enzyme involved in protein prenylation, played a critical role in postnatal heart growth by regulating cardiomyocyte size. Cardiac-specific knockout of GGPPS in mice led to spontaneous cardiac hypertrophy, beginning from week 4, accompanied by the persistent enlargement of cardiomyocytes. This hypertrophic effect occurred by altered prenylation of G proteins. Evaluation of the prenylation, membrane association and hydrophobicity showed that Rheb was hyperactivated and increased mTORC1 signalling pathway after GGPPS deletion. Protein farnesylation or mTORC1 inhibition blocked GGPPS knockdown-induced mTORC1 activation and suppressed the larger neonatal rat ventricle myocyte size and cardiomyocyte hypertrophy in vivo, demonstrating a central role of the FPP-Rheb-mTORC1 axis for GGPPS deficiency-induced cardiomyocyte hypertrophy. The sustained cardiomyocyte hypertrophy progressively provoked cardiac decompensation and dysfunction, ultimately causing heart failure and adult death. Importantly, GGPPS was down-regulated in the hypertrophic hearts of mice subjected to transverse aortic constriction (TAC) and in failing human hearts. Moreover, HPLC-MS/MS detection revealed that the myocardial farnesyl diphosphate (FPP):geranylgeranyl diphosphate (GGPP) ratio was enhanced after pressure overload. Our observations conclude that the alteration of protein prenylation promotes cardiomyocyte hypertrophic growth, which acts as a potential cause for pathogenesis of heart failure and may provide a new molecular target for hypertrophic heart disease

  18. Adding "hemodynamic and fluid leads" to the ECG. Part I: the electrical estimation of BNP, chronic heart failure (CHF) and extracellular fluid (ECF) accumulation.

    Science.gov (United States)

    Skrabal, Falko; Pichler, Georg P; Gratze, Gerfried; Holler, Albert

    2014-07-01

    In primary care the diagnosis of CHF and ECF accumulation is no triviality. We aimed to predict plasma BNP, CHF and ECF accumulation with segmental impedance spectroscopy while using and extending the electrodes of the conventional electrocardiography. Three combined multiple electrodes were added to the 15 lead ECG for segmental impedance spectroscopy and for measuring the maximal rate of segmental fluid volume change with heart action at the thorax and the legs. The obtained signals were analyzed by partial correlation analyses in comparison with plasma BNP, CHF classes, ejection fraction by echocardiography and cardiac index by double gas re-breathing. 119 subjects (34 healthy volunteers, 50 patients with CHF, NYHA classes II to IV and 35 patients without CHF) were investigated. The maximal rate of volume change with heart action at the thorax and at the legs, as well as the ECF/ICF ratio at the legs contribute equally and independently to the prediction of BNP and heart failure in an unknown test sample of 49 patients (multiple r=0.88, p400 pg/ml gave an AUC=0.93. The absence or the presence of heart failure could be predicted correctly by a binomial logistic regression in 92.9 and 87.5% of cases, respectively. The methodology, which is based on inverse coupling of BNP release and of maximal blood acceleration and on sensitive detection of ECF overload, could enable the diagnosis of CHF with useful sensitivity and specificity while writing a routine-ECG. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

  19. Inhibition of tubular cell proliferation by neutralizing endogenous HGF leads to renal hypoxia and bone marrow-derived cell engraftment in acute renal failure.

    Science.gov (United States)

    Ohnishi, Hiroyuki; Mizuno, Shinya; Nakamura, Toshikazu

    2008-02-01

    During the progression of acute renal failure (ARF), the renal tubular S3 segment is sensitive to ischemic stresses. For reversing tubular damage, resident tubular cells proliferate, and bone marrow-derived cells (BMDC) can be engrafted into injured tubules. However, how resident epithelium or BMDC are involved in tubular repair remains unknown. Using a mouse model of ARF, we examined whether hepatocyte growth factor (HGF) regulates a balance of resident cell proliferation and BMDC recruitment. Within 48 h post-renal ischemia, tubular destruction became evident, followed by two-waved regenerative events: 1) tubular cell proliferation between 2 and 4 days, along with an increase in blood HGF; and 2) appearance of BMDC in the tubules from 6 days postischemia. When anti-HGF IgG was injected in the earlier stage, tubular cell proliferation was inhibited, leading to an increase in BMDC in renal tubules. Under the HGF-neutralized state, stromal cell-derived factor-1 (SDF1) levels increased in renal tubules, associated with the enhanced hypoxia. Administrations of anti-SDF1 receptor IgG into ARF mice reduced the number of BMDC in interstitium and tubules. Thus possible cascades include 1) inhibition of tubular cell proliferation by neutralizing HGF leads to renal hypoxia and SDF1 upregulation; and 2) BMDC are eventually engrafted in tubules through SDF1-mediated chemotaxis. Inversely, administration of recombinant HGF suppressed the renal hypoxia, SDF1 upregulation, and BMDC engraftment in ARF mice by enhancing resident tubular cell proliferation. Thus we conclude that HGF is a positive regulator for eliciting resident tubular cell proliferation, and SDF1 for BMDC engraftment during the repair process of ARF.

  20. Fides: Lightweight Authenticated Cipher with Side-Channel Resistance for Constrained Hardware

    DEFF Research Database (Denmark)

    Bilgin, Begul; Bogdanov, Andrey; Knezevic, Miroslav

    2013-01-01

    In this paper, we present a novel lightweight authenticated cipher optimized for hardware implementations called Fides. It is an online nonce-based authenticated encryption scheme with authenticated data whose area requirements are as low as 793 GE and 1001 GE for 80-bit and 96-bit security, resp......, cryptographically optimal 5-bit and 6-bit S-boxes are used as basic nonlinear components while paying a special attention on the simplicity of providing first order side-channel resistance with threshold implementation....

  1. ‘In fide constans’? Politiek van herinnering in het Mechelse stadsbestuur

    Directory of Open Access Journals (Sweden)

    Bram Caers

    2013-12-01

    Full Text Available Around 1600, the Mechelen mayor Jan van Wachtendonck wrote an urban chronicle of his town that thoroughly revised the existing chronicle dating about a century back. Wachtendonck's text presents a version in which Mechelen sides firmly with the princely authorities, notably the Burgundian dukes. This contribution shows that the revision of Mechelen's history is part of a broader policy of memory initiated by the city council after the calvinist regime (1580-1585. Through text and image, the new council aimed to reassert the city's image as a catholic and loyal capital, in accordance with its motto 'in fide constans'.

  2. Acute liver failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    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....

  3. The Galactic Cepheid period-luminosity relation revisited using bona fide cluster Cepheids

    Science.gov (United States)

    Anderson, Richard I.; Mowlavi, Nami; Eyer, Laurent

    2013-02-01

    Classical Cepheids in Galactic open clusters (cluster Cepheids: CCs) have been studied extensively for multiple decades, thanks to their importance as calibrators of the Galactic Cepheid period-luminosity relation (PLR). Here we revisit the calibration of the Galactic PLR using a new sample of CCs, since even recent calibrations show significant discrepancies. The CC sample employed for the calibration is based on the preliminary results of a self-consistent, eight-dimensional all-sky census. This census is based mostly on literature data, supplemented with high-precision radial-velocity observations from both hemispheres. New CCs are identified from our census and the degree of confidence in membership is quantified for known candidates. Using only bona fide CCs, we obtain MV = (-3.08 +/- 0.50) log P + (-0.94 +/- 0.42) mag, which is in perfect agreement with the results by Sandage, Tammann, and Reindl, albeit with larger error bars and an rms of 0.21 mag. The key to obtaining a meaningful calibration is to employ accurate cluster distance moduli and space reddening values. A homogeneous study of all bona fide host clusters would be desirable to increase precision and confidence in the calibration.

  4. The Failure Models of Lead Free Sn-3.0Ag-0.5Cu Solder Joint Reliability Under Low-G and High-G Drop Impact

    Science.gov (United States)

    Gu, Jian; Lei, YongPing; Lin, Jian; Fu, HanGuang; Wu, Zhongwei

    2017-02-01

    The reliability of Sn-3.0Ag-0.5Cu (SAC 305) solder joint under a broad level of drop impacts was studied. The failure performance of solder joint, failure probability and failure position were analyzed under two shock test conditions, i.e., 1000 g for 1 ms and 300 g for 2 ms. The stress distribution on the solder joint was calculated by ABAQUS. The results revealed that the dominant reason was the tension due to the difference in stiffness between the print circuit board and ball grid array, and the maximum tension of 121.1 MPa and 31.1 MPa, respectively, under both 1000 g or 300 g drop impact, was focused on the corner of the solder joint which was located in the outmost corner of the solder ball row. The failure modes were summarized into the following four modes: initiation and propagation through the (1) intermetallic compound layer, (2) Ni layer, (3) Cu pad, or (4) Sn-matrix. The outmost corner of the solder ball row had a high failure probability under both 1000 g and 300 g drop impact. The number of failures of solder ball under the 300 g drop impact was higher than that under the 1000 g drop impact. The characteristic drop values for failure were 41 and 15,199, respectively, following the statistics.

  5. Fides et ratio: An early enlightenment defence of non-confessional religion by poiret and his circle

    NARCIS (Netherlands)

    H.A. Krop (Henri)

    2010-01-01

    textabstractIn 1707 an anonymous collection of treatises Fides et ratio was published in Amsterdam. The voluminous work of several authors contains a fierce critique of Locke's notion of faith and the moderate Enlightenment's conception of a reasonable Christianity. The sympathiser with mystic

  6. Fides et ratio: An early enlightenment defence of non-confessional religion by poiret and his circle

    NARCIS (Netherlands)

    H.A. Krop (Henri)

    2010-01-01

    textabstractIn 1707 an anonymous collection of treatises Fides et ratio was published in Amsterdam. The voluminous work of several authors contains a fierce critique of Locke's notion of faith and the moderate Enlightenment's conception of a reasonable Christianity. The sympathiser with mystic theol

  7. 78 FR 20642 - Notice of Proposed CERCLA Agreement and Order on Consent for Removal Action by Bona Fide...

    Science.gov (United States)

    2013-04-05

    ... Chromium Operable Unit, 264 W. Spazier Ave., Burbank, California ACTION: Notice; request for public comment... Valley Area 2 Superfund Site, Glendale Chromium Operable Unit, located at 264 W. Spazier Ave., Burbank... May 31, 2012 (Purchaser), the Bona Fide Prospective Purchaser of 264 W. Spazier Ave.,...

  8. Fides et ratio: An early enlightenment defence of non-confessional religion by poiret and his circle

    NARCIS (Netherlands)

    H.A. Krop (Henri)

    2010-01-01

    textabstractIn 1707 an anonymous collection of treatises Fides et ratio was published in Amsterdam. The voluminous work of several authors contains a fierce critique of Locke's notion of faith and the moderate Enlightenment's conception of a reasonable Christianity. The sympathiser with mystic theol

  9. Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

    Directory of Open Access Journals (Sweden)

    R. Charles Welliver

    2014-01-01

    Full Text Available Introduction. We present the case of a patient who received a two-piece Ambicor penile prosthesis for idiopathic recurrent “stuttering” priapism refractory to other treatment options. The patient returned unable to deflate the device due to an interesting anatomically induced mechanical failure. Aims. To describe the method and findings of this inflatable prosthesis failure. Results. Prosthesis failure occurred due to restrictive corporal diameter and the unique characteristics of fluid reservoir location in the two-piece inflatable prosthesis. The patient was successfully converted to a semirigid prosthesis with resolution of the pain that was due to his prosthesis autoinflation. Conclusion. Stuttering priapism remains a challenging clinical problem. Penile implantation is a reasonable long-term solution in a patient refractory to less invasive options. In patients with fibrotic corpora, a malleable device should be considered (at least temporarily if unable to dilate comfortably to 13 mm.

  10. Disruption of Runx1 and Runx3 Leads to Bone Marrow Failure and Leukemia Predisposition due to Transcriptional and DNA Repair Defects

    Directory of Open Access Journals (Sweden)

    Chelsia Qiuxia Wang

    2014-08-01

    Full Text Available The RUNX genes encode transcription factors involved in development and human disease. RUNX1 and RUNX3 are frequently associated with leukemias, yet the basis for their involvement in leukemogenesis is not fully understood. Here, we show that Runx1;Runx3 double-knockout (DKO mice exhibited lethal phenotypes due to bone marrow failure and myeloproliferative disorder. These contradictory clinical manifestations are reminiscent of human inherited bone marrow failure syndromes such as Fanconi anemia (FA, caused by defective DNA repair. Indeed, Runx1;Runx3 DKO cells showed mitomycin C hypersensitivity, due to impairment of monoubiquitinated-FANCD2 recruitment to DNA damage foci, although FANCD2 monoubiquitination in the FA pathway was unaffected. RUNX1 and RUNX3 interact with FANCD2 independently of CBFβ, suggesting a nontranscriptional role for RUNX in DNA repair. These findings suggest that RUNX dysfunction causes DNA repair defect, besides transcriptional misregulation, and promotes the development of leukemias and other cancers.

  11. Cardiac overexpression of constitutively active Galpha q causes angiotensin II type1 receptor activation, leading to progressive heart failure and ventricular arrhythmias in transgenic mice.

    Directory of Open Access Journals (Sweden)

    Naoko Matsushita

    Full Text Available Transgenic mice with transient cardiac expression of constitutively active Galpha q (Gαq-TG exhibt progressive heart failure and ventricular arrhythmias after the initiating stimulus of transfected constitutively active Gαq becomes undetectable. However, the mechanisms are still unknown. We examined the effects of chronic administration of olmesartan on heart failure and ventricular arrhythmia in Gαq-TG mice.Olmesartan (1 mg/kg/day or vehicle was chronically administered to Gαq-TG from 6 to 32 weeks of age, and all experiments were performed in mice at the age of 32 weeks. Chronic olmesartan administration prevented the severe reduction of left ventricular fractional shortening, and inhibited ventricular interstitial fibrosis and ventricular myocyte hypertrophy in Gαq-TG. Electrocardiogram demonstrated that premature ventricular contraction (PVC was frequently (more than 20 beats/min observed in 9 of 10 vehicle-treated Gαq-TG but in none of 10 olmesartan-treated Gαq-TG. The collected QT interval and monophasic action potential duration in the left ventricle were significantly shorter in olmesartan-treated Gαq-TG than in vehicle-treated Gαq-TG. CTGF, collagen type 1, ANP, BNP, and β-MHC gene expression was increased and olmesartan significantly decreased the expression of these genes in Gαq-TG mouse ventricles. The expression of canonical transient receptor potential (TRPC 3 and 6 channel and angiotensin converting enzyme (ACE proteins but not angiotensin II type 1 (AT1 receptor was increased in Gαq-TG ventricles compared with NTG mouse ventricles. Olmesartan significantly decreased TRPC6 and tended to decrease ACE expressions in Gαq-TG. Moreover, it increased AT1 receptor in Gαq-TG.These findings suggest that angiotensin II type 1 receptor activation plays an important role in the development of heart failure and ventricular arrhythmia in Gαq-TG mouse model of heart failure.

  12. Does less frequent routine monitoring of patients on a stable, fully suppressed cART regimen lead to an increased risk of treatment failure?

    DEFF Research Database (Denmark)

    Reekie, Joanne; Mocroft, Amanda; Sambatakou, Helen;

    2008-01-01

    OBJECTIVE: To investigate whether HIV-infected patients on a stable and fully suppressive combination antiretroviral therapy (cART) regimen could safely be monitored less often than the current recommendations of every 3 months. DESIGN: Two thousand two hundred and forty patients from the Euro......SIDA study who maintained a stable and fully suppressed cART regimen for 1 year were included in the analysis. METHODS: Risk of treatment failure, defined by viral rebound, fall in CD4 cell count, development of new AIDS-defining illness, serious opportunistic infection or death, in the 12 months following...... interval (CI) 0.1-0.5], 2.2% (95% CI 1.6-2.8) and 6.0% (95% CI 5.0-7.0) risk of treatment failure, respectively. Patients who spent more than 80% of their time on cART with fully suppressed viraemia prior to baseline had a 38% reduced risk of treatment failure, hazard ratio 0.62 (95% CI 0.42-0.90, P = 0...

  13. White Spot Syndrome Virus Orf514 Encodes a Bona Fide DNA Polymerase

    Directory of Open Access Journals (Sweden)

    Rogerio R. Sotelo-Mundo

    2011-01-01

    Full Text Available White spot syndrome virus (WSSV is the causative agent of white spot syndrome, one of the most devastating diseases in shrimp aquaculture. The genome of WSSV includes a gene that encodes a putative family B DNA polymerase (ORF514, which is 16% identical in amino acid sequence to the Herpes virus 1 DNA polymerase. The aim of this work was to demonstrate the activity of the WSSV ORF514-encoded protein as a DNA polymerase and hence a putative antiviral target. A 3.5 kbp fragment encoding the conserved polymerase and exonuclease domains of ORF514 was overexpressed in bacteria. The recombinant protein showed polymerase activity but with very low level of processivity. Molecular modeling of the catalytic protein core encoded in ORF514 revealed a canonical polymerase fold. Amino acid sequence alignments of ORF514 indicate the presence of a putative PIP box, suggesting that the encoded putative DNA polymerase may use a host processivity factor for optimal activity. We postulate that WSSV ORF514 encodes a bona fide DNA polymerase that requires accessory proteins for activity and maybe target for drugs or compounds that inhibit viral DNA replication.

  14. MN48: a new Galactic bona fide luminous blue variable revealed by Spitzer and SALT

    Science.gov (United States)

    Kniazev, A. Y.; Gvaramadze, V. V.; Berdnikov, L. N.

    2016-07-01

    In this paper, we report the results of spectroscopic and photometric observations of the candidate evolved massive star MN48 disclosed via detection of a mid-infrared circular shell around it with the Spitzer Space Telescope. Follow-up optical spectroscopy of MN48 with the Southern African Large Telescope (SALT) carried out in 2011-2015 revealed significant changes in the spectrum of this star, which are typical of luminous blue variables (LBVs). The LBV status of MN48 was further supported by photometric monitoring which shows that in 2009-2011 this star has brightened by ≈0.9 and 1 mag in the V and Ic bands, respectively, then faded by ≈1.1 and 1.6 mag during the next four years, and apparently started to brighten again recently. The detected changes in the spectrum and brightness of MN48 make this star the 18th known Galactic bona fide LBV and increase the percentage of LBVs associated with circumstellar nebulae to more than 70 per cent. We discuss the possible birth place of MN48 and suggest that this star might have been ejected either from a putative star cluster embedded in the H II region IRAS 16455-4531 or the young massive star cluster Westerlund 1.

  15. MN48: a new Galactic bona fide luminous blue variable revealed by Spitzer and SALT

    CERN Document Server

    Kniazev, A Y; Berdnikov, L N

    2016-01-01

    In this paper, we report the results of spectroscopic and photometric observations of the candidate evolved massive star MN48 disclosed via detection of a mid-infrared circular shell around it with the Spitzer Space Telescope. Follow-up optical spectroscopy of MN48 with the Southern African Large Telescope (SALT) carried out in 2011--2015 revealed significant changes in the spectrum of this star, which are typical of luminous blue variables (LBVs). The LBV status of MN48 was further supported by photometric monitoring which shows that in 2009--2011 this star has brightened by approx 0.9 and 1 mag in the V and I_c bands, respectively, then faded by approx 1.1 and 1.6 mag during the next four years, and apparently started to brighten again recently. The detected changes in the spectrum and brightness of MN48 make this star the 18th known Galactic bona fide LBV and increase the percentage of LBVs associated with circumstellar nebulae to more than 70 per cent. We discuss the possible birth place of MN48 and sugge...

  16. Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps

    Science.gov (United States)

    Wong, Jessica X. H.; Li, Xiaochun; Liu, Frank S. F.; Yu, Hua-Zhong

    2015-06-01

    The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today’s smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps.

  17. Discovery of a new bona fide luminous blue variable in Norma

    CERN Document Server

    Gvaramadze, V V; Berdnikov, L N

    2015-01-01

    We report the results of optical spectroscopy of the candidate evolved massive star MN44 revealed via detection of a circular shell with the Spitzer Space Telescope. First spectra taken in 2009 May--June showed the Balmer lines in emission as well as numerous emission lines of iron, which is typical of luminous blue variables (LBVs) near the visual maximum. New observations carried out in 2015 May--September detected significant changes in the spectrum, indicating that the star became hotter. We found that these changes are accompanied by significant brightness variability of MN44. In particular, the I_c-band brightness decreased by \\approx 1.6 mag during the last six years and after reaching its minimum in 2015 June has started to increase. Using archival data, we also found that the I_c-band brightness increased by \\approx 3 mag in \\approx 30 yr preceding our observations. MN44 therefore represents the seventeenth known example of the Galactic bona fide LBVs. We detected a nitrogen-rich knot to the northwes...

  18. Validity of Contract in Bona Fide Acquisition%论善意取得中合同的效力

    Institute of Scientific and Technical Information of China (English)

    林耕宇

    2012-01-01

    Taking hot social issues as a starting point, the problem of identification of validity of contract in bona fide acquisition is focused on. In the context of general rule of transferring property right which was stipulated in Property Law, claiming the validity of contract of bona fide acquisition would confront obstacles both in theory and practice. The argument that the contract of bona fide acquisition to be validity can only be established on the basis of the admission of juristic act to jus in rein. If the Judicial system of our country still can not adopt such a theory, it should be insisted that the contract of bona fide acquisition shall be consider to be invalid.%以社会热点问题为出发点,重点论述善意取得合同的效力认定问题。认为在我国债权形式主义的物权转移模式背景下,主张善意取得合同有效存在着理论与实践上的障碍。认定无权处分合同有效只能建立在承认物权行为理论的基础上。在我国司法实践中如果尚不能作出这种变革则应当坚持无权处分合同无效的观点,对于其在实践中可能存在的问题可以通过适当司法解释予以解决。

  19. The spread of multi drug resistant infections is leading to an increase in the empirical antibiotic treatment failure in cirrhosis: a prospective survey.

    Directory of Open Access Journals (Sweden)

    Manuela Merli

    Full Text Available The spread of multi-resistant infections represents a continuously growing problem in cirrhosis, particularly in patients in contact with the healthcare environment.Our prospective study aimed to analyze epidemiology, prevalence and risk factors of multi-resistant infections, as well as the rate of failure of empirical antibiotic therapy in cirrhotic patients.All consecutive cirrhotic patients hospitalized between 2008 and 2013 with a microbiologically-documented infection (MDI were enrolled. Infections were classified as Community-Acquired (CA, Hospital-Acquired (HA and Healthcare-Associated (HCA. Bacteria were classified as Multidrug-Resistant (MDR if resistant to at least three antimicrobial classes, Extensively-Drug-Resistant (XDR if only sensitive to one/two classes and Pandrug-Resistant (PDR if resistant to all classes.One-hundred-twenty-four infections (15% CA, 52% HA, 33% HCA were observed in 111 patients. Urinary tract infections, pneumonia and spontaneous bacterial peritonitis were the more frequent. Forty-seven percent of infections were caused by Gram-negative bacteria. Fifty-one percent of the isolates were multi-resistant to antibiotic therapy (76% MDR, 21% XDR, 3% PDR: the use of antibiotic prophylaxis (OR = 8.4; 95%CI = 1.03-76; P = 0,05 and current/recent contact with the healthcare-system (OR = 3.7; 95%CI = 1.05-13; P = 0.04 were selected as independent predictors. The failure of the empirical antibiotic therapy was progressively more frequent according to the degree of resistance. The therapy was inappropriate in the majority of HA and HCA infections.Multi-resistant infections are increasing in hospitalized cirrhotic patients. A better knowledge of the epidemiological characteristics is important to improve the efficacy of empirical antibiotic therapy. The use of preventive measures aimed at reducing the spread of multi-resistant bacteria is also essential.

  20. Breeding performance of blue tits (Cyanistes cæruleus ultramarinus) in relation to lead pollution and nest failure rates in rural, intermediate, and urban sites in Algeria.

    Science.gov (United States)

    Brahmia, Zahra; Scheifler, Renaud; Crini, Nadia; Maas, Samuel; Giraudoux, Patrick; Benyacoub, Slim

    2013-03-01

    The breeding parameters and the egg and nestling morphology of Cyanistes caeruleus populations from rural, intermediate, and urban sites in Algeria and the relationships of those variables with lead contamination were studied during three consecutive years. Breeding success was explained only by predation and vandalism rates. Predation was higher in the rural area, whereas vandalism was higher in the urban site. The other measured breeding parameters and egg characteristics were relatively insensitive to study site. The morphology of urban nestlings exhibited a trend toward smaller body size and mass compared to individuals from intermediate and rural sites. Although lead concentrations were higher in the tissues of urban birds than in intermediate and rural individuals, we did not detect a clear influence of this variable on nestling morphology. We conclude that urbanization influenced blue tit breeding parameters through predation and vandalism and nestling morphology through mechanisms other than lead pollution. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Sustained virologic response rates with telaprevir by response after 4 weeks of lead-in therapy in patients with prior treatment failure.

    Science.gov (United States)

    Foster, Graham R; Zeuzem, Stefan; Andreone, Pietro; Pol, Stanislas; Lawitz, Eric J; Diago, Moises; Roberts, Stuart; Pockros, Paul J; Younossi, Zobair; Lonjon-Domanec, Isabelle; De Meyer, Sandra; Luo, Don; George, Shelley; Beumont, Maria; Picchio, Gaston

    2013-03-01

    For hepatitis C virus (HCV)-infected patients who have not responded to previous PegIFN/ribavirin treatment, it is unclear whether subsequent direct-acting antiviral therapy outcomes are better predicted by prior treatment response or by on-treatment response to a PegIFN/ribavirin lead-in. In REALIZE, treatment-experienced patients randomized to the lead-in telaprevir arm received 4 weeks of PegIFN-α-2a (180 μg/week) and ribavirin (1000-1200 mg/day), then 12 weeks of telaprevir (750 mg every 8h) plus PegIFN-α-2a/ribavirin, followed by 32 weeks of PegIFN-α-2a/ribavirin. This subanalysis only included patients in the lead-in telaprevir arm with available week 4 on-treatment response data (n=240). After 4weeks of PegIFN/ribavirin, 90% of relapsers, 60% of partial responders, and 41% of null responders in the lead-in telaprevir arm had ⩾1 log(10) HCV RNA reduction. Sustained virologic response (SVR) rates for telaprevir-treated patients with ≥1 versus <1 log(10) HCV RNA reduction after the PegIFN/ribavirin lead-in were 94% versus 62% in relapsers, 59% versus 56% in partial responders and 54% versus 15% in null responders. In prior relapsers and partial responders there is no apparent benefit of assessing response after a PegIFN/ribavirin lead-in with the aim of guiding telaprevir-based treatment. For patients known to be prior null responders, on-treatment response after a 4-week PegIFN/ribavirin lead-in may provide clinically useful prognostic information. However, withholding telaprevir-containing therapy in uncategorised treatment-experienced patient populations (i.e., that could include prior relapsers or partial responders), using response after a PegIFN/ribavirin lead-in could potentially exclude some patients with a high chance of SVR. Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  2. SCF(JFK) is a bona fide E3 ligase for ING4 and a potent promoter of the angiogenesis and metastasis of breast cancer.

    Science.gov (United States)

    Yan, Ruorong; He, Lin; Li, Zhongwu; Han, Xiao; Liang, Jing; Si, Wenzhe; Chen, Zhe; Li, Lei; Xie, Guojia; Li, Wanjin; Wang, Peiyan; Lei, Liandi; Zhang, Hongquan; Pei, Fei; Cao, Dengfeng; Sun, Luyang; Shang, Yongfeng

    2015-03-15

    Loss of function/dysregulation of inhibitor of growth 4 (ING4) and hyperactivation of NF-κB are frequent events in many types of human malignancies. However, the molecular mechanisms underlying these remarkable aberrations are not understood. Here, we report that ING4 is physically associated with JFK. We demonstrated that JFK targets ING4 for ubiquitination and degradation through assembly of an Skp1-Cul1-F-box (SCF) complex. We showed that JFK-mediated ING4 destabilization leads to the hyperactivation of the canonical NF-κB pathway and promotes angiogenesis and metastasis of breast cancer. Significantly, the expression of JFK is markedly up-regulated in breast cancer, and the level of JFK is negatively correlated with that of ING4 and positively correlated with an aggressive clinical behavior of breast carcinomas. Our study identified SCF(JFK) as a bona fide E3 ligase for ING4 and unraveled the JFK-ING4-NF-κB axis as an important player in the development and progression of breast cancer, supporting the pursuit of JFK as a potential target for breast cancer intervention.

  3. Pollution of River Mahaweli and farmlands under irrigation by cadmium from agricultural inputs leading to a chronic renal failure epidemic among farmers in NCP, Sri Lanka.

    Science.gov (United States)

    Bandara, J M R S; Wijewardena, H V P; Bandara, Y M A Y; Jayasooriya, R G P T; Rajapaksha, H

    2011-10-01

    Chronic renal failure (CRF) associated with elevated dietary cadmium (Cd) among farming communities in the irrigated agricultural area under the River Mahaweli diversion scheme has reached a significantly higher level of 9,000 patients. Cadmium, derived from contaminated phosphate fertilizer, in irrigation water finds its way into reservoirs, and finally to food, causing chronic renal failure among consumers. Water samples of River Mahaweli and its tributaries in the upper catchment were analyzed to assess the total cadmium contamination of river water and the possible source of cadmium. Except a single tributary (Ulapane Stream, 3.9 μg Cd/l), all other tested tributaries carried more than 5 μg Cd/l, the maximum concentration level accepted to be safe in drinking water. Seven medium-sized streams carrying surface runoff from tea estates had 5.1-10 μg Cd/l. Twenty larger tributaries (Oya), where the catchment is under vegetable and home garden cultivation, carried 10.1-15 μg Cd/l. Nine other major tributaries had extremely high levels of Cd, reaching 20 μg Cd/l. Using geographic information system (GIS), the area in the catchment of each tributary was studied. The specific cropping system in each watershed was determined. The total cadmium loading from each crop area was estimated using the rates and types of phosphate fertilizer used by the respective farmers and the amount of cadmium contained in each type of fertilizer used. Eppawala rock phosphate (ERP), which is mostly used in tea estates, caused least pollution. The amount of cadmium in tributaries had a significant positive correlation with the cadmium loading of the cropping system. Dimbula Tea Estate Stream had the lowest Cd loading (495.9 g/ha/year), compared with vegetable-growing areas in Uma Oya catchment with 50,852.5 g Cd/ha/year. Kendall's τ rank correlation value of total Cd loading from the catchment by phosphate fertilizer used in all crops in the catchment to the Cd content in

  4. Loss of the SPHF homologue Slr1768 leads to a catastrophic failure in the maintenance of thylakoid membranes in Synechocystis sp. PCC 6803.

    Directory of Open Access Journals (Sweden)

    Samantha J Bryan

    Full Text Available BACKGROUND: In cyanobacteria the photosystems are localised to, and maintained in, specialist membranes called the thylakoids. The mechanism driving the biogenesis of the thylakoid membranes is still an open question, with only two potential biogenesis factors, Vipp1 and Alb3 currently identified. METHODOLOGY/PRINCIPAL FINDINGS: We generated a slr1768 knockout using the pGEM T-easy vector and REDIRECT. By comparing growth and pigment content (chlorophyll a fluoresence of the Δslr1768 mutant with the wild-type, we found that Δslr1768 has a conditional phenotype; specifically under high light conditions (130 µmol m(-2 s(-1 thylakoid biogenesis is disrupted leading to cell death on a scale of days. The thylakoids show considerable disruption, with loss of both structure and density, while chlorophyll a density decreases with the loss of thylakoids, although photosynthetic efficiency is unaffected. Under low light (30 µmol m(-2 s(-1 the phenotype is significantly reduced, with a growth rate similar to the wild-type and only a low frequency of cells with evident thylakoid disruption. CONCLUSIONS/SIGNIFICANCE: This is the first example of a gene that affects the maintenance of the thylakoid membranes specifically under high light, and which displays a phenotype dependent on light intensity. Our results demonstrate that Slr1768 has a leading role in acclimatisation, linking light damage with maintenance of the thylakoids.

  5. Reduced expression of Pax6 in lens and cornea of mutant mice leads to failure of chamber angle development and juvenile glaucoma.

    Science.gov (United States)

    Kroeber, Markus; Davis, Noa; Holzmann, Silvia; Kritzenberger, Michaela; Shelah-Goraly, Michal; Ofri, Ron; Ashery-Padan, Ruth; Tamm, Ernst R

    2010-09-01

    Heterozygous mutations in PAX6 are causative for aniridia, a condition that is frequently associated with juvenile glaucoma. Defects in morphogenesis of the iridocorneal angle, such as lack of trabecular meshwork differentiation, absence of Schlemm's canal and blockage of the angle by iris tissue, have been described as likely causes for glaucoma, and comparable defects have been observed in heterozygous Pax6-deficient mice. Here, we employed Cre/loxP-mediated inactivation of a single Pax6 allele in either the lens/cornea or the distal optic cup to dissect in which tissues both alleles of Pax6 need to be expressed to control the development of the tissues in the iridocorneal angle. Somatic inactivation of one allele of Pax6 exclusively from epithelial cells of lens and cornea resulted in the disruption of trabecular meshwork and Schlemm's canal development as well as in an adhesion between iris periphery and cornea in juvenile eyes, which resulted in the complete closure of the iridocorneal angle in the adult eye. Structural changes in the iridocorneal angle presumably caused a continuous increase in intraocular pressure leading to degenerative changes in optic nerve axons and to glaucoma. In contrast, the inactivation of a single Pax6 allele in the distal optic cup did not cause obvious changes in iridocorneal angle formation. We conclude that the defects in iridocorneal angle formation are caused by non-autonomous mechanisms due to Pax6 haploinsufficiency in lens or corneal epithelial cells. Pax6 probably controls the expression of signaling molecules in lens cells that regulate the morphogenetic processes during iridocorneal angle formation.

  6. A Resource for the Transcriptional Signature of Bona Fide Trophoblast Stem Cells and Analysis of Their Embryonic Persistence

    Directory of Open Access Journals (Sweden)

    Georg Kuales

    2015-01-01

    Full Text Available Trophoblast stem cells (TSCs represent the multipotent progenitors that give rise to the different cells of the embryonic portion of the placenta. Here, we analysed the expression of key TSC transcription factors Cdx2, Eomes, and Elf5 in the early developing placenta of mouse embryos and in cultured TSCs and reveal surprising heterogeneity in protein levels. We analysed persistence of TSCs in the early placenta and find that TSCs remain in the chorionic hinge until E9.5 and are lost shortly afterwards. To define the transcriptional signature of bona fide TSCs, we used inducible gain- and loss-of-function alleles of Eomes or Cdx2, and EomesGFP, to manipulate and monitor the core maintenance factors of TSCs, followed by genome-wide expression profiling. Combinatorial analysis of resulting expression profiles allowed for defining novel TSC marker genes that might functionally contribute to the maintenance of the TSC state. Analyses by qRT-PCR and in situ hybridisation validated novel TSC- and chorion-specific marker genes, such as Bok/Mtd, Cldn26, Duox2, Duoxa2, Nr0b1, and Sox21. Thus, these expression data provide a valuable resource for the transcriptional signature of bona fide and early differentiating TSCs and may contribute to an increased understanding of the transcriptional circuitries that maintain and/or establish stemness of TSCs.

  7. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  8. Failure to thrive.

    Science.gov (United States)

    Krugman, Scott D; Dubowitz, Howard

    2003-09-01

    Failure to thrive is a condition commonly seen by primary care physicians. Prompt diagnosis and intervention are important for preventing malnutrition and developmental sequelae. Medical and social factors often contribute to failure to thrive. Either extreme of parental attention (neglect or hypervigilance) can lead to failure to thrive. About 25 percent of normal infants will shift to a lower growth percentile in the first two years of life and then follow that percentile; this should not be diagnosed as failure to thrive. Infants with Down syndrome, intrauterine growth retardation, or premature birth follow different growth patterns than normal infants. Many infants with failure to thrive are not identified unless careful attention is paid to plotting growth parameters at routine checkups. A thorough history is the best guide to establishing the etiology of the failure to thrive and directing further evaluation and management. All children with failure to thrive need additional calories for catch-up growth (typically 150 percent of the caloric requirement for their expected, not actual, weight). Few need laboratory evaluation. Hospitalization is rarely required and is indicated only for severe failure to thrive and for those whose safety is a concern. A multidisciplinary approach is recommended when failure to thrive persists despite intervention or when it is severe.

  9. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  10. Educar para corregir una actitud de los universitarios: el fideísmo Educar para corrigir uma atitude de faculdade: o fideísmo Education to Correct an Attitude among University Students and Teachers: Fideism

    Directory of Open Access Journals (Sweden)

    Juan Fernando Selles

    2009-12-01

    Full Text Available En este trabajo se desvela el error de una actitud educativa que acepta taimadamente el "fideísmo": actitud que afecta a muchos universitarios -docentes y discentes- que quieren ser y se consideran a sí mismos como hombres "buenos". Se describe la índole de este yerro, así como algunas de sus usuales manifestaciones universitarias. Se indica que no es una actitud natural humana ni tampoco cristiana, pues es contraria tanto a la razón natural como a la doctrina de la fe. Al final se ofrecen algunas pautas para hacer frente a esta desorientación educativa.Este artigo se revela o erro de uma atitude educativa que dissimuladamente aceita o fideísmo: esta "atitude" afeta a muitos universitários (professores e alunos que querem ser homens "bons" e se consideram como tais. Descreve-se a natureza deste erro e algumas das suas manifestações freqüentes. Afirma-se que não é uma atitude natural do ser humano, nem do cristão, porque é contrária tanto à razão natural e à doutrina da fé. No final se oferecem algumas diretrizes para resolver esta falta de orientação educacional.The article exposes an educational attitude that stubbornly accepts "fideism": an attitude found among many university teachers and students who want to be and regard themselves as "good" men and women. The nature of this error is described, along with some of its more common manifestations in the university environment. Fideism is cited as being neither a natural human attitude, nor a Christian attitude. It is contrary to both natural reasoning and the doctrine of the faith. The article ends with several guidelines on how to deal with this educational disorientation.

  11. Mutant Forkhead L2 (FOXL2) proteins associated with premature ovarian failure (POF) dimerize with wild-type FOXL2, leading to altered regulation of genes associated with granulosa cell differentiation.

    Science.gov (United States)

    Kuo, Fang-Ting; Bentsi-Barnes, Ikuko K; Barlow, Gillian M; Pisarska, Margareta D

    2011-10-01

    Premature ovarian failure in the autosomal dominant disorder blepharophimosis-ptosis-epicanthus inversus is due to mutations in the gene encoding Forkhead L2 (FOXL2), producing putative truncated proteins. We previously demonstrated that FOXL2 is a transcriptional repressor of the steroidogenic acute regulatory (StAR), P450SCC (CYP11A), P450aromatase (CYP19), and cyclin D2 (CCND2) genes, markers of ovarian follicle proliferation and differentiation. Furthermore, we found that mutations of FOXL2 may regulate wild-type FOXL2, leading to loss of transcriptional repression of CYP19, similar to StAR. However, the regulatory mechanisms underlying these premature ovarian failure-associated mutations remain largely unknown. Therefore, we examined the effects of a FOXL2 mutant protein on the transcriptional repression of the CYP19 promoter by the full-length protein. We found that mutant FOXL2 exerts a dominant-negative effect on the repression of CYP19 by wild-type FOXL2. Both wild-type and mutant FOXL2 and can form homo- and heterodimers. We identified a minimal -57-bp human CYP19 promoter containing two potential FOXL2-binding regions and found that both wild-type and mutant FOXL2 can bind to either of these regions. Mutational analysis revealed that either site is sufficient for transcriptional repression by wild-type FOXL2, and the dominant-negative effect of mutant FOXL2, but these are eliminated when both sites are mutated. These findings confirm that mutant FOXL2 exerts a dominant-negative effect on wild-type FOXL2's activity as a transcriptional repressor of key genes in ovarian follicle differentiation and suggest that this is likely due to heterodimer formation and possibly also competition for DNA binding.

  12. Systems failure.

    OpenAIRE

    Macleod, Anna

    1998-01-01

    Systems Failure A solo exhibition of new work by Anna Macleod developed in conversation with curator Liz Burns. The Dock, Carrick on Shannon, Co Leitrim. Ireland. 12th February – 17th April 2010. The works for the exhibition Systems Failure include drawings, prints and small constructions that examine the delicate balance that exists between need and aspects of failure rooted in the relationship between humanity and land use. The work seeks to question the relationship between scient...

  13. Mechanisms of heart failure in obesity.

    Science.gov (United States)

    Ebong, Imo A; Goff, David C; Rodriguez, Carlos J; Chen, Haiying; Bertoni, Alain G

    2014-01-01

    Heart failure is a leading cause of morbidity and mortality and its prevalence continues to rise. Because obesity has been linked with heart failure, the increasing prevalence of obesity may presage further rise in heart failure in the future. Obesity-related factors are estimated to cause 11% of heart failure cases in men and 14% in women. Obesity may result in heart failure by inducing haemodynamic and myocardial changes that lead to cardiac dysfunction, or due to an increased predisposition to other heart failure risk factors. Direct cardiac lipotoxicity has been described where lipid accumulation in the heart results in cardiac dysfunction inexplicable of other heart failure risk factors. In this overview, we discussed various pathophysiological mechanisms that could lead to heart failure in obesity, including the molecular mechanisms underlying cardiac lipotoxicity. We defined the obesity paradox and enumerated various premises for the paradoxical associations observed in the relationship between obesity and heart failure.

  14. Delayed ICD lead cardiac perforation: comparison of small versus standard-diameter leads implanted in a single center.

    Science.gov (United States)

    Rordorf, Roberto; Canevese, Fabio; Vicentini, Alessandro; Petracci, Barbara; Savastano, Simone; Sanzo, Antonio; Gandolfi, Edoardo; Dore, Roberto; Landolina, Maurizio

    2011-04-01

    An increased risk of delayed cardiac perforation (DCP) with active-fixation small-diameter ICD leads has recently been reported, especially with regard to the St. Jude Riata lead (St. Jude Medical, Sylmar, CA, USA). Few data on the risk of DCP in small versus standard-diameter leads implanted in a single high-volume center are available. Moreover, no data on the performances of St. Jude's new small-diameter Durata lead are as yet available. The aim of this study was to assess the incidence of DCP in small versus standard-diameter leads implanted in our center. Between January 2003 and October 2009, 437 small-diameter leads (190 Medtronic Sprint Fidelis [Medtronic Inc., Minneapolis, MN, USA], 196 Riata, 51 Durata) and 421 standard-diameter (>8 Fr) leads were implanted. After a median follow-up of 421 days seven of 858 (0.8%) patients experienced DCP. The incidence of DCP was higher in patients with small-diameter leads than in those with standard-diameter leads (1.6% vs 0%, P = 0.01). No cases of DCP occurred among 371 passive-fixation leads versus 1.4% of events among active-fixation leads (P = 0.02). The incidence of DCP was 2.5% in Riata, 1% in Sprint Fidelis, 0% in Durata, and 0% in standard-diameter leads (P < 0.01 for Riata vs standard-diameter leads). Small-diameter active-fixation ICD leads are at increased risk of DCP, a finding mostly due to the higher incidence of events in the Riata family. By contrast, passive-fixation small-diameter leads and standard-diameter leads appear to be safe enough regarding the risk of DCP. Our preliminary data suggest that the new Durata lead is not associated with an increased risk of DCP. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

  15. Aging, telomeres and heart failure

    NARCIS (Netherlands)

    Wong, Liza S. M.; van der Harst, Pim; de Boer, Rudolf A.; Huzen, Jardi; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2010-01-01

    During normal aging, the heart undergoes functional, morphological and cellular changes. Although aging per se does not lead to the expression of heart failure, it is likely that age-associated changes lower the threshold for the manifestation of signs and symptoms of heart failure. In patients, the

  16. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008275 Relationship of calcineure in mRNA level in peripheral blood and cardiac muscle of patients with heart failure.WANG Mengmeng(王萌萌),et al.Dept Cardiol,Shandong Prov Hosp,Shandong Univ,Jinan 250021.Chin Cir J 2008;23(2):113-116.Objective To study the relationship of calcineurin mRNA level between peripheral lymphocytes and cardiac muscles of patients with chronic heart failure.Methods

  17. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008037 Factors associated with efficacy of cardiac resynchronization therapy for patients with congestive heart failure. SHI Haoying(史浩颖), et al. Dept Cardiol, Zhongshan Hosp Fudan Univ, Shanghai 200032. Chin J Cardiol 2007;35(12):1099-1163. Objective The efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated. Methods Fifty

  18. Pathophysiology of heart failure.

    Science.gov (United States)

    Chiariello, M; Perrone-Filardi, P

    1999-01-01

    Heart failure is a leading cause of mortality and morbidity in Western countries. Common etiology is mostly represented by ischemic and hypertensive heart disease. Clinically, heart failure can be defined as an impaired cardiac performance, unable to meet the energy requirements of the periphery. Pathophysiologically, the clinical onset of heart failure symptoms already represents an advanced stage of disease when compensatory mechanisms triggered by the underlying decrease in contractility are no longer capable of maintaining adequate cardiac performance during exercise and, subsequently, under resting conditions. Independent of its underlying etiology, cardiac failure is always characterized by an impairment in the intrinsic contractility of myocytes. As a consequence of reduced contractility, a number of central and peripheral compensatory mechanisms take place that are capable of effectively counteracting reduced intravascular intrinsic performance for a long period of time. Among them, recruitment of preload reserve, enhanced neurohormonal stimulation and cardiac hypertrophy are the most important. All of them, however, also carry unfavorable effects that contribute to further deterioration of cardiac function. In fact, increased end-diastolic volume determines increased wall stress that further reduces systolic performance; sympathetic and angiotensin stimulation increases peripheral resistance and contributes to increase volume expansion; hypertrophic myocytes demonstrate impaired intrinsic contractility and relaxation, and hypertrophy causes a clinically relevant deterioration of ventricular relaxation and compliance that substantially participates in increased end-diastolic pressure, and, therefore, to limited exercise performance. Diastolic dysfunction usually accompanies systolic dysfunction, although in some cases it may represent the prevalent mechanism of congestive heart failure in patients in whom systolic performance is preserved. Biological causes

  19. School failure.

    Science.gov (United States)

    Dworkin, P H

    1989-04-01

    Numerous factors may contribute to a child's failure to learn. Certain causes of school failure, such as specific learning disabilities, mental retardation, sensory impairment, and chronic illness may be regarded as intrinsic characteristics of the child. Other causes, such as family dysfunction, social problems, and ineffective schooling, are characteristics of the child's environment. Still other influences on school performance, such as temperamental dysfunction, attention deficits, and emotional illness, may be viewed as the consequence of the interaction between the child and his or her environment. The reasons for a child's school failure must not be considered in isolation but rather within the context of social and environmental circumstances. Evaluation must consider the myriad of reasons for a child's school failure and attempt to identify "clusters" of adverse influences on school performance. Detailed information must be sought from the student, parents, and school system through the history and physical examination. Questionnaires are useful in data gathering. Ancillary methods of assessment that may be of value include neurodevelopmental screening and laboratory studies. Further investigations and referrals, particularly psychoeducational evaluation, are of major importance. Traditional roles of the pediatrician in school failure include the treatment of underlying medical conditions, counseling, the coordination of further investigations and referrals, and the facilitation of communication with community services and resources. Participation with other disciplines in the development of a child's educational plan is feasible and useful.

  20. 加氢反应加热炉管道泄漏失效的分析%Causes Leading to Leakage and Failure of Furnace Tubes Used in Hydroprocessing Furnace

    Institute of Scientific and Technical Information of China (English)

    湛小琳; 刘智勇; 杜翠薇; 梅鹏程; 李晓刚

    2013-01-01

    炼油厂加氢装置受到H2S腐蚀易引发安全事故.采用宏观检测、力学性能测试、金相显微分析、扫描电镜(SEM)观察、裂纹尖端及扩展部位的成分的电子能谱分析,对TP321钢制加氢反应加热炉炉管泄漏原因进行了分析.结果表明:焊接时连续快速加热使碳铬化合物沿晶界析出,导致焊缝晶界附近贫铬使其抗腐蚀性能下降,油气中含有较高浓度的H2S,从而在焊缝晶界处发生高温H2S腐蚀产生裂纹,裂纹在残余应力及其他外力的作用下以穿晶和沿晶混合模式扩展,最终导致炉管泄漏,设备失效.%Causes leading to leakage of the tubes made of TP321 stainless steel used in the heating furnace for hydroprocessing were explored based on macro - inspection and mechanical property testing, as well as observation with metallurgical microscope and scanning electron microscope in association with elemental composition analysis at the crack tips and expanded zones by energy dispersive spectrometry. Results showed that intergranular chromium carbides were precipitated along the grain boundaries because of continuous and rapid heat treatment during welding, which led to decrease of intergranular corrosion resistance owing to Cr depletion in the regions adjacent to the grain boundaries. In the meantime, high concentration of hydrogen sulfide in the oil and gas caused high temperature H2 S corrosion in the grain boundaries at the welded joints and resulted in cracks. Resultant cracks were propagated in transgranular - intergranular mixed mode under residual stress and other external force. This eventually led to leakage of the furnace tube and failure of the hydroprocessing units.

  1. Respiratory failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970318 A study on evoked potentials in cor pul-monale patients with chronic respiratory failure.QIAO Hui(乔慧), et al. Beijing Neurosurg Instit,Beijing, 100050. Chin J Geriatr 1997; 16(1): 43-45. Objective: Evoked protential was used to detect thechange of brain function in cor pulmonale patients with

  2. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009170 Curcumin attenuates left ventricular dysfunction and remodeling in rabbits with chronic heart failure. TANG Yanhong(唐艳红),et al.Dept Cardiol,Renmin Hosp,Wuhan Univ,Wuhan 430060.Chin J Cardiol,2009;37(3):262-267.

  3. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008411 Expression of S100B during heart failure in rats. JIANG Zhenni(蒋珍妮), et al. Dept Cardiol, 2nd Affili Hosp, Zhejiang Univ, Coll Med Hangzhou 310009. Chin J Emerg Med 2008;17(5):475-478. Objective To evaluate the value of S100B gene on cardiovascular remodeling in rats with abdominal aorta coarctation.

  4. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970284 Effects of enalapril on heart rate variabilityin patients with congestive heart failure. ZHANGYouhua(章友华), et a1. Dept Cardiol, Cardiovasc Instit& Fuwai Hosp, CAMS & PUMC, Beijing, 100037. ChinCir J 1996; 11(2): 729-732.

  5. Failure Modes

    DEFF Research Database (Denmark)

    Jakobsen, K. P.; Burcharth, H. F.; Ibsen, Lars Bo;

    1999-01-01

    The present appendix contains the derivation of ten different limit state equations divided on three different failure modes. Five of the limit state equations can be used independently of the characteristics of the subsoil, whereas the remaining five can be used for either drained or undrained...

  6. Lead Poisoning

    Science.gov (United States)

    Lead is a metal that occurs naturally in the earth's crust. Lead can be found in all parts of our ... from human activities such as mining and manufacturing. Lead used to be in paint; older houses may ...

  7. Practical theology as life science: Fides Quaerens Vivendi and its connection to Hebrew thinking (Hālak

    Directory of Open Access Journals (Sweden)

    Daniël J. Louw

    2017-02-01

    Full Text Available The term practical theology is complex and, due to many different religious and cultural settings, a many layered concept. During the past 40 years the paradigm in theory formation for an academic and disciplinary approach to practical theology shifted from the clerical and ecclesial paradigm of ministerial actions to experiences of faith with the emphasis on an empirical based epistemology. Rather than a deductive approach, the shift is towards a more inductive approach within the methodological framework of phenomenology. Currently, in the international discourse on theory formation, there is a tendency towards a hermeneutical approach with the focus on the networking, relational dynamics of civil society Thus, the attempt to describe practical theology as a kind of ‘life science’ (the concern for the mundane and existential reality of everyday life – Alltagsreligion. Within the context of African spiritualties, with its emphasis on the communal dynamics of vital, human relationships, the focus on lifestyles becomes vital. In light of an ontology of life (l’energie spirituelle – Henri Bergson, the notion of fides quaerens vivendi [faith seeking lifestyles] is researched. With reference to the theory of complexification and chaosmos as well as the impact thereof on different theories in life sciences, the connection between sapientia and the vivid praxis of God is critically explored. The focus of this article is on the question: What is the impact of an ontology of life on both praxis thinking and theological reflection? Instead of the Cartesian framework of causative definitions, the notion of the ‘infinition of God’ is proposed within the praxis of Hebrew, wisdom thinking.

  8. Characterizing drug-metabolizing enzymes and transporters that are bona fide CAR-target genes in mouse intestine

    Directory of Open Access Journals (Sweden)

    Shinhee Park

    2016-09-01

    Full Text Available Intestine is responsible for the biotransformation of many orally-exposed chemicals. The constitutive androstane receptor (CAR/Nr1i3 is known to up-regulate many genes encoding drug-metabolizing enzymes and transporters (drug-processing genes/DPGs in liver, but less is known regarding its effect in intestine. Sixty-day-old wild-type and Car−/− mice were administered the CAR-ligand TCPOBOP or vehicle once daily for 4 days. In wild-type mice, Car mRNA was down-regulated by TCPOBOP in liver and duodenum. Car−/− mice had altered basal intestinal expression of many DPGs in a section-specific manner. Consistent with the liver data (Aleksunes and Klaassen, 2012, TCPOBOP up-regulated many DPGs (Cyp2b10, Cyp3a11, Aldh1a1, Aldh1a7, Gsta1, Gsta4, Gstm1-m4, Gstt1, Ugt1a1, Ugt2b34, Ugt2b36, and Mrp2–4 in specific sections of small intestine in a CAR-dependent manner. However, the mRNAs of Nqo1 and Papss2 were previously known to be up-regulated by TCPOBOP in liver but were not altered in intestine. Interestingly, many known CAR-target genes were highest expressed in colon where CAR is minimally expressed, suggesting that additional regulators are involved in regulating their expression. In conclusion, CAR regulates the basal expression of many DPGs in intestine, and although many hepatic CAR-targeted DPGs were bona fide CAR-targets in intestine, pharmacological activation of CAR in liver and intestine are not identical.

  9. Lead Toxicity

    Science.gov (United States)

    ... including some imported jewelry. What are the health effects of lead? • More commonly, lower levels of lead in children over time may lead to reduced IQ, slow learning, Attention Deficit Hyperactivity Disorder (ADHD), or behavioral issues. • Lead also affects other ...

  10. Phenomenological Studies of Macroscale Failure in Metals

    Energy Technology Data Exchange (ETDEWEB)

    Kashiwa, Bryan Andrew [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hull, Lawrence Mark [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-06

    Highlights of recent phenomenological studies of metal failure are given. Failure leading to spallation and fragmentation are typically of interest. The current ‘best model’ includes the following; a full history stress in tension; nucleation initiating dynamic relaxation; toward a tensile yield function; failure dependent on strain, strain rate, and temperature; a mean-preserving ‘macrodefect’ is introduced when failure occurs in tension; and multifield theoretical refinements

  11. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  12. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920647 Comparative effects of commonvasodilators on experimental cardiac fai-lure. LI Zhijian (李志坚), et al. Dept Cardiol,2nd Hosp, Tianjin Med Coll. Tianjin Med J1992; 20(8): 456-458. A 9×9 latin square design was employed forcomparing the effects of (1) placebo, (2) nitr-oprusside, (3) phentolamine, (4) isosorbide dini-trate. (5) captopril, (6) captopril-isosorbide

  13. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005186 The diagnostic application of bedside measurement of plasma brain natriuretic in patients with heart failure. SHAO Le-wen (邵乐文) , Advanced Ward Dept, 1st Hosp, Med Sch, Zhejiang Univ, Hangzhou 310003. Chin J Intern Med, 2005;44(2): 99-101. Objective: To investigate differential diagnosis value of ultra-rapid bedside measurement of brain na-triuretic peptide (BNP) in patients with dyspnea.

  14. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010316 Tissue doppler imaging observation on effect of long-term use of gingko biloba tabtet on left ventricular function in patients with chronic heart failure. ZHANG Hui(张辉),et al. Dept Cardiovasc Med, 2nd Hosp, Hebei Med Univ,Shijiazhuang 050000. Chin J Integr Tradit & West Med 2010;30(5):478-481. Objective To quantitatively observe the effect of long-term

  15. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  16. Nuclear cardiology and heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Giubbini, Raffaele; Bertagna, Francesco [University of Brescia, Department of Nuclear Medicine, Brescia (Italy); Milan, Elisa [Ospedale Di Castelfranco Veneto, Nuclear Medicine Unit, Castelfranco Veneto (Italy); Mut, Fernando; Dondi, Maurizio [International Atomic Energy Agency, Nuclear Medicine Section, Division of Human Health, Vienna (Austria); Metra, Marco [University of Brescia, Department of Cardiology, Brescia (Italy); Rodella, Carlo [Health Physics Department, Spedali Civili di Brescia, Brescia (Italy)

    2009-12-15

    The prevalence of heart failure in the adult population is increasing. It varies between 1% and 2%, although it mainly affects elderly people (6-10% of people over the age of 65 years will develop heart failure). The syndrome of heart failure arises as a consequence of an abnormality in cardiac structure, function, rhythm, or conduction. Coronary artery disease is the leading cause of heart failure and it accounts for this disorder in 60-70% of all patients affected. Nuclear techniques provide unique information on left ventricular function and perfusion by gated-single photon emission tomography (SPECT). Myocardial viability can be assessed by both SPECT and PET imaging. Finally, autonomic dysfunction has been shown to increase the risk of death in patients with heart disease and this may be applicable to all patients with cardiac disease regardless of aetiology. MIBG scanning has a very promising prognostic value in patients with heart failure. (orig.)

  17. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic versus diastolic, valvular) Monitor your heart failure ...

  18. Heart failure - home monitoring

    Science.gov (United States)

    ... failure - discharge Heart failure - fluids and diuretics Heart failure - what to ask ... Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, ...

  19. Corrosion in electronics: Overview of failures and countermeasures

    OpenAIRE

    Jellesen, Morten Stendahl; Verdingovas, Vadimas; Conseil, Helene; Piotrowska, Kamila; Ambat, Rajan

    2014-01-01

    Many field failure returns of electronics are marked as “no failure found”, yet numerous of these failures are likely due to corrosion, since corrosion related failures are not easily detected during subsequent failure analysis. In some cases failures are intermittent and occur because of service life conditions (humidity and contamination) where water film formation on the printed circuit board assembly (PCBA) leads to leakage currents resulting in wrong output signal of the electronic devic...

  20. Lead Poisoning

    Science.gov (United States)

    ... lead is of microscopic size, invisible to the naked eye. More often than not, children with elevated ... majority of the childhood lead poisoning cases we see today. Children and adults too can get seriously ...

  1. Relational Leading

    DEFF Research Database (Denmark)

    2015-01-01

    This first chapter presents the exploratory and curious approach to leading as relational processes – an approach that pervades the entire book. We explore leading from a perspective that emphasises the unpredictable challenges and triviality of everyday life, which we consider an interesting......, relevant and realistic way to examine leading. The chapter brings up a number of concepts and contexts as formulated by researchers within the field, and in this way seeks to construct a first understanding of relational leading....

  2. Leading Generation Y

    Science.gov (United States)

    2008-04-01

    ensure the success of their child, failure is not often experienced. These successes and the ease of childhood lead to not only confidence but an...Messaging, chatting on the cell phone and working on homework is a common place scene for teens and college students. “The level of multiprocessing...to Gen Yers entering the workforce with unrealistic expectations and a sense of entitlement. Barbara Dwyer, CEO of the Job Journey, states that

  3. Generalized Block Failure

    DEFF Research Database (Denmark)

    Jönsson, Jeppe

    2015-01-01

    Block tearing is considered in several codes as a pure block tension or a pure block shear failure mechanism. However in many situations the load acts eccentrically and involves the transfer of a substantial moment in combination with the shear force and perhaps a normal force. A literature study...... yield lines around the block leads to simple interaction formulas similar to other interaction formulas in the codes.......Block tearing is considered in several codes as a pure block tension or a pure block shear failure mechanism. However in many situations the load acts eccentrically and involves the transfer of a substantial moment in combination with the shear force and perhaps a normal force. A literature study...

  4. Lead User Innovation

    DEFF Research Database (Denmark)

    Brem, Alexander; Larsen, Henry

    2015-01-01

    , deliver and capture the value of an innovatively new device together. From the perspective of the lead user, we show antecedents and effects of social interaction between organizational actors and the lead user on the development of social capital, especially trust and shared imagination. The second case......User innovation and especially the integration of lead users is a key topic in the innovation management literature of recent years. This paper contributes by providing a rare perspective into what easily could be seen as innovation failure, shown from two perspectives. We show how a lack of shared...... imagination hampers participation and kills innovation between interdependent stakeholders at the threshold between invention and innovation in practice. We present a first case in the fun-sport industry where an external lead user and diverse firm representatives in different functions fail to create...

  5. In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study

    OpenAIRE

    Maciej Sterliński; Adam Sokal; Radosław Lenarczyk; Frederic Van Heuverswyn; Aldo Rinaldi, C.; Marc Vanderheyden; Vladimir Khalameizer; Darrel Francis; Joeri Heynens; Berthold Stegemann; Richard Cornelussen

    2016-01-01

    Introduction Recent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive. Aim The Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV). Methods Patients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in...

  6. Lead Test

    Science.gov (United States)

    ... months, and at 3, 4, 5, and 6 years of age. A blood lead level test should be done only if the risk ... recommended if the person is symptomatic at any level below 70 mcg/dL. Because lead will pass through the blood to an unborn child, pregnant ...

  7. Creep-Fatigue Failure Diagnosis

    Directory of Open Access Journals (Sweden)

    Stuart Holdsworth

    2015-11-01

    Full Text Available 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.

  8. Respiratory failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930118 Facial or nasal mask pressure supportventilation in managing acute exacerbation ofchronic respiratory failure in COPD patients.CHEN Rongchang(陈荣昌),et al.GuangzhouInstit Respir Dis,Guangzhou 510120.Chin Tu-berc & Respir Dis 1992;15(5)285-287.Eleven COPD patients(age:65±9 yrs)withacute exacerbation of chronic respiratory failure(PaCO2 11.3±1.1kPa)were treated with maskpressure support ventilation,another 10 similarpatients(age:68±12yrs)served as controls.Bi-PAP ventilator was used with the followingmodifications:(1)Non-rehreathing valve set-in proximal to mask;(2)5 LPM oxygen flow de-livered into mask to reduce the dead space ef-fect.Mask ventilation was given 2-3 hours ev-ery time and 1-2 times daily for 7 days.Syn-

  9. The failure-tolerant leader.

    Science.gov (United States)

    Farson, Richard; Keyes, Ralph

    2002-08-01

    "The fastest way to succeed," IBM's Thomas Watson, Sr., once said, "is to double your failure rate." In recent years, more and more executives have embraced Watson's point of view, coming to understand what innovators have always known: Failure is a prerequisite to invention. But while companies may grasp the value of making mistakes at the level of corporate practices, they have a harder time accepting the idea at the personal level. People are afraid to fail, and corporate culture reinforces that fear. In this article, psychologist and former Harvard Business School professor Richard Farson and coauthor Ralph Keyes discuss how companies can reduce the fear of miscues. What's crucial is the presence of failure-tolerant leaders--executives who, through their words and actions, help employees overcome their anxieties about making mistakes and, in the process, create a culture of intelligent risk-taking that leads to sustained innovation. Such leaders don't just accept productive failure, they promote it. Drawing from their research in business, politics, sports, and science, the authors identify common practices among failure-tolerant leaders. These leaders break down the social and bureaucratic barriers that separate them from their followers. They engage at a personal level with the people they lead. They avoid giving either praise or criticism, preferring to take a nonjudgmental, analytical posture as they interact with staff. They openly admit their own mistakes rather than trying to cover them up or shifting the blame. And they try to root out the destructive competitiveness built into most organizations. Above all else, failure-tolerant leaders push people to see beyond traditional definitions of success and failure. They know that as long as a person views failure as the opposite of success, rather than its complement, he or she will never be able to take the risks necessary for innovation.

  10. RECOVERY STRATEGIES FOR SERVICE FAILURES

    Directory of Open Access Journals (Sweden)

    Budeanu Andreea

    2015-07-01

    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

  11. Lead Poisoning

    Science.gov (United States)

    ... Topics Environment & Health Healthy Living Pollution Reduce, Reuse, Recycle Science – How It Works The Natural World Games ... OTHERS: Lead has recently been found in some plastic mini-blinds and vertical blinds which were made ...

  12. Leveraging Failure in Design Research

    Science.gov (United States)

    Lobato, Joanne; Walters, C. David; Hohensee, Charles; Gruver, John; Diamond, Jaime Marie

    2015-01-01

    Even in the resource-rich, more ideal conditions of many design-based classroom interventions, unexpected events can lead to disappointing results in student learning. However, if later iterations in a design research study are more successful, the previous failures can provide opportunities for comparisons to reveal subtle differences in…

  13. Leveraging Failure in Design Research

    Science.gov (United States)

    Lobato, Joanne; Walters, C. David; Hohensee, Charles; Gruver, John; Diamond, Jaime Marie

    2015-01-01

    Even in the resource-rich, more ideal conditions of many design-based classroom interventions, unexpected events can lead to disappointing results in student learning. However, if later iterations in a design research study are more successful, the previous failures can provide opportunities for comparisons to reveal subtle differences in…

  14. La salute del civis-fidelis nei distinti ordini dello Stato e della Chiesa cattolica. Le aspettative ascetiche della persona nella connotazione del bene salute

    Directory of Open Access Journals (Sweden)

    Tiziana Di Iorio

    2015-06-01

    Full Text Available Contributo sottoposto a valutazione SOMMARIO: 1. Autonomia confessionale e sovranità dello Stato: la distinzione tra ordini “distinti” – 2. Il principio di laicità e la valorizzazione delle differenze, nell’inderogabile esigenza di salvaguardia dei diritti della persona – 3. Tutela della salute: diritto fondamentale della Costituzione italiana – 4. La dimensione ascetica dell’individuo nella concezione giuridica del bene salute – 5. La salute nell’ordinamento canonico: connotazione di un bene con valore relativo – 6. La realizzazione “responsabile” della salute e la sua intrinseca connessione con la salvezza nella Chiesa – 7. La sana cooperatiotra Stato e Chiesa nella tutela della salute del civis-fidelis – 8. Conclusioni. ABSTRACT Health of the civis-fidelis in the different systems of the Italian State and the Catholic Church. The spiritual needs of the individual as included in the meaning of health  The meaning of "health" in a legal system depends upon its culture and social development, so that time and space influence the way protection is offered. Nowadays the idea of “health” has enlarged. In the past the meaning of health was intended as a mental-physical well-being; it has now gradually developed to a larger meaning, including a complete physical, mental and social well-being and not merely the absence of disease. Along with Italian constitution, Italy has to pursue and protect the health of any individual, not just citizens. Health is also protected by the Church as a precious gift given by God to man and is closely linked with salvation. Man is called to protect the value of this gift in its widest configuration. Therefore the integral protection of health requires to take into account all the dimensions of the individual, both as civis and fidelis. In order to reach this target it is necessary an open dialogue between civil authorities and religious institution; its importance relies on the

  15. Do Foreign Language Learners Need Failures?

    Directory of Open Access Journals (Sweden)

    Joanna Kic-Drgas

    2016-06-01

    Full Text Available A lack of motivation, incomprehensible content and a high workload are only some of the causes leading to students’ failures in the learning process. Dealing with failures seems to have become a new core competence in the current world, which is why the definition and implementation of an appropriate strategy is essential for prospective learning results. The focus of the contribution is on the meaning of failure and sources of potential student failures in the foreign language learning at the university level. The results presented in the paper base on the survey conducted with English language students at Koszalin University of Technology. Students were asked to identify the field causing learning failures. The described survey delivers information about the sources of failures from learner’s point of view, which can be an incentive to develop and implement strategies to cope with failures in the ESP class.

  16. BUSINESS FAILURE PREDICTION FOR ROMANIAN SMES USING MULTIVARIATE DISCRIMINANT ANALYSIS

    OpenAIRE

    2012-01-01

    Business failure prediction is one of special importance for small and medium sized enterprises (SMEs) due to their increased vulnerability. Consequently, the purpose of this paper is to investigate the utility of financial ratios and other non-financial variables to predict business failure using a sample of Romanian SMEs and applying multiple discriminant analysis. The process that leads to failure is analyzed on a three year time horizon prior to failure and the results showed that failure...

  17. Evaluation of global longitudinal strain of left ventricle and regional longitudinal strain in the region of left ventricular leads predicts the response to cardiac resynchronization therapy in patients with ischemic heart failure.

    Science.gov (United States)

    Ma, Chun-Yan; Liu, Shuang; Yang, Jun; Tang, Li; Zhang, Li-Ming; Li, Nan; Yu, Bo

    2014-09-01

    Myocardium viability in ischemic heart failure (HF) may affect the effect of cardiac resynchronization therapy (CRT). We hypothesized that longitudinal strain of 2D-STE, which reflects myocardium viability, can predict the response to CRT in patients with ischemic HF. 2D-STE was performed in 42 patients with HF, 1 week before and 1 year after CRT. GLS, RLS, and the LV synchrony index (SI), defined as the difference in timing to peak radial strain between LV anterior septal and posterior wall in LV short axis view, were calculated. A decrease in the LV end-systolic volume (LVESV) value of ≥ 15 % 1 year after CRT was defined as response to CRT. Twenty-nine patients responded to CRT (CRT-R group), while 13 patients did not respond and were assigned as CRT-NR group. Pre-CRT RLS and GLS were higher, while SI is lower, in CRT-R patients compared with CRT-NR group (p < 0.001). The ROC curve revealed that RLS of -11.5 % predicted response to CRT with sensitivity of 80.0 % and specificity of 77.9 % (AUC = 0.84, p < 0.001). Further, GLS of -13 % predicted response to CRT with sensitivity of 73.0 % and specificity of 73.4 % (AUC = 0.79, p < 0.001). In conclusion, LV dyssynchrony, GLS, and RLS calculated by 2D-STE can predict long-term response to CRT in patients with ischemic HF.

  18. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  19. Acute kidney failure

    Science.gov (United States)

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  20. Living with Heart Failure

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Failure Currently, heart failure has no cure. You'll ... avoid harmful side effects. Take Steps To Prevent Heart Failure From Getting Worse Certain actions can worsen your ...

  1. Classes of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Classes of Heart Failure Updated:Sep 28,2016 Doctors usually classify patients' ... Blood Pressure Tracker Find additional helpful resources here Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  2. About Heart Failure

    Science.gov (United States)

    ... talk about your health and the medicines About Heart Failure Heart failure is a disease where the heart cannot do ... very important for your health. common causes of heart failure are diseases or conditions that damage the heart. ...

  3. What Is Heart Failure?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  4. Acute Kidney Failure

    Science.gov (United States)

    ... out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over ... 2015. Palevsky PM. Definition of acute kidney injury (acute renal failure). http://www.uptodate.com/home. Accessed April ...

  5. Ecotoxicology: Lead

    Science.gov (United States)

    Scheuhammer, A.M.; Beyer, W.N.; Schmitt, C.J.; Jorgensen, Sven Erik; Fath, Brian D.

    2008-01-01

    Lead (Pb) is a naturally occurring metallic element; trace concentrations are found in all environmental media and in all living things. However, certain human activities, especially base metal mining and smelting; combustion of leaded gasoline; the use of Pb in hunting, target shooting, and recreational angling; the use of Pb-based paints; and the uncontrolled disposal of Pb-containing products such as old vehicle batteries and electronic devices have resulted in increased environmental levels of Pb, and have created risks for Pb exposure and toxicity in invertebrates, fish, and wildlife in some ecosystems.

  6. Surface contact fatigue failures in gears

    CSIR Research Space (South Africa)

    Fernandes, PJL

    1997-06-01

    Full Text Available Surface contact fatigue is the most common cause of gear failure. It results in damage to contacting surfaces which can significantly reduce the load-carrying capacity of components, and may ultimately lead to complete failure of a gear. Three types...

  7. Conservation of major and minor jelly-roll capsid proteins in Polinton (Maverick) transposons suggests that they are bona fide viruses.

    Science.gov (United States)

    Krupovic, Mart; Bamford, Dennis H; Koonin, Eugene V

    2014-04-29

    Polintons (also known as Mavericks) and Tlr elements of Tetrahymena thermophila represent two families of large DNA transposons widespread in eukaryotes. Here, we show that both Polintons and Tlr elements encode two key virion proteins, the major capsid protein with the double jelly-roll fold and the minor capsid protein, known as the penton, with the single jelly-roll topology. This observation along with the previously noted conservation of the genes for viral genome packaging ATPase and adenovirus-like protease strongly suggests that Polintons and Tlr elements combine features of bona fide viruses and transposons. We propose the name 'Polintoviruses' to denote these putative viruses that could have played a central role in the evolution of several groups of DNA viruses of eukaryotes.

  8. Leading men

    DEFF Research Database (Denmark)

    Bekker-Nielsen, Tønnes

    2016-01-01

    Through a systematic comparison of c. 50 careers leading to the koinarchate or high priesthood of Asia, Bithynia, Galatia, Lycia, Macedonia and coastal Pontus, as described in funeral or honorary inscriptions of individual koinarchs, it is possible to identify common denominators but also...

  9. Lead grids

    CERN Multimedia

    1974-01-01

    One of the 150 lead grids used in the multiwire proportional chamber g-ray detector. The 0.75 mm diameter holes are spaced 1 mm centre to centre. The grids were made by chemical cutting techniques in the Godet Workshop of the SB Physics.

  10. Discrimination-pregnancy leave-Pregnancy Discrimination Act not retroactive-bona fide seniority system. AT&T Corp. v. Hulteen, 2009 U.S. LEXIS 3470 (U.S. 5/18/2009).

    Science.gov (United States)

    2009-01-01

    A pension plan whose terms are those of a bona fide seniority system and which treats pregnancy leave, taken before the addition of the Pregnancy Discrimination Act (PDA) to Title VII, differently than other kinds of medical leave, does not amount to sex and pregnancy discrimination under Title VII because PDA does not apply retroactively.

  11. Hypogonadism and renal failure: An update

    Directory of Open Access Journals (Sweden)

    Nannan Thirumavalavan

    2015-01-01

    Full Text Available The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.

  12. Hypogonadism and renal failure: An update.

    Science.gov (United States)

    Thirumavalavan, Nannan; Wilken, Nathan A; Ramasamy, Ranjith

    2015-01-01

    The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.

  13. Who Leads China's Leading Universities?

    Science.gov (United States)

    Huang, Futao

    2017-01-01

    This study attempts to identify the major characteristics of two different groups of institutional leaders in China's leading universities. The study begins with a review of relevant literature and theory. Then, there is a brief introduction to the selection of party secretaries, deputy secretaries, presidents and vice presidents in leading…

  14. Multi-scale modeling of elasto-plastic response of SnAgCu lead-free solder alloys at different ageing conditions: Effect of microstructure evolution, particle size effects and interfacial failure

    Energy Technology Data Exchange (ETDEWEB)

    Maleki, Milad; Cugnoni, Joel, E-mail: joel.cugnoni@epfl.ch; Botsis, John

    2016-04-20

    In microelectronics applications, SnAgCu lead-free solder joints play the important role of ensuring both the mechanical and electrical integrity of the components. In such applications, the SnAgCu joints are subjected to elevated homologous temperatures for an extended period of time causing significant microstructural changes and leading to reliability issues. In this study, the link between the change in microstructures and deformation behavior of SnAgCu solder during ageing is explained by developing a hybrid multi-scale microstructure-based modeling approach. Herein, the SnAgCu solder alloy is seen as a three phase metal matrix composite in which Ag{sub 3}Sn and Cu{sub 6}Sn{sub 5} hard intermetallics play the role of reinforcements and Sn the role of a ductile matrix. The hardening of the Sn matrix due to fine intermetallics in the eutectic mixture is modeled by incorporating the mean field effects of geometrically necessary dislocations. Subsequently, a two level homogenization procedure based on micromechanical finite element (FE) models is used to capture the interactions between the different phases. For this purpose, tomographic images of microstructures obtained by Focused Ion Beam (FIB) and synchrotron X-Ray in different ageing conditions are directly used to generate statistically representative volume elements (RVE) using 3D FE models. The constitutive behavior of the solder is determined by sequentially performing two scales of numerical homogenization at the eutectic level and then at the dendrite level. For simplification, the anisotropy of Sn as well as the potential recovery processes have been neglected in the modeling. The observed decrease in the yield strength of solder due to ageing is well captured by the adopted modeling strategy and allows explaining the different ageing mechanisms. Finally, the effects of potential debonding at the intermetallic particle-matrix interface as well as particle fracture on the overall strength of solder are

  15. Steam generator tube failures

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald, P.E.; Shah, V.N.; Ward, L.W.; Ellison, P.G.

    1996-04-01

    A review and summary of the available information on steam generator tubing failures and the impact of these failures on plant safety is presented. The following topics are covered: pressurized water reactor (PWR), Canadian deuterium uranium (CANDU) reactor, and Russian water moderated, water cooled energy reactor (VVER) steam generator degradation, PWR steam generator tube ruptures, the thermal-hydraulic response of a PWR plant with a faulted steam generator, the risk significance of steam generator tube rupture accidents, tubing inspection requirements and fitness-for-service criteria in various countries, and defect detection reliability and sizing accuracy. A significant number of steam generator tubes are defective and are removed from service or repaired each year. This wide spread damage has been caused by many diverse degradation mechanisms, some of which are difficult to detect and predict. In addition, spontaneous tube ruptures have occurred at the rate of about one every 2 years over the last 20 years, and incipient tube ruptures (tube failures usually identified with leak detection monitors just before rupture) have been occurring at the rate of about one per year. These ruptures have caused complex plant transients which have not always been easy for the reactor operators to control. Our analysis shows that if more than 15 tubes rupture during a main steam line break, the system response could lead to core melting. Although spontaneous and induced steam generator tube ruptures are small contributors to the total core damage frequency calculated in probabilistic risk assessments, they are risk significant because the radionuclides are likely to bypass the reactor containment building. The frequency of steam generator tube ruptures can be significantly reduced through appropriate and timely inspections and repairs or removal from service.

  16. Types of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Types of Heart Failure Updated:Feb 9,2017 Left-sided heart failure ... making. This content was last reviewed April 2015. Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  17. 无铅焊点在电迁移与高低温冲击下的失效机理%Failure mechanism of the lead-free solder joints during the coupling effect between electromigration and high and low temperature impact

    Institute of Scientific and Technical Information of China (English)

    郝虎; 左勇; 鲁玥; 宋永伦; 郭福

    2012-01-01

    Failure mechanism of the Cu/Sn-3.0Ag-0.5Cu/Cu solder joints was investigated during the coupling effect between electromigration and high and low temperature impact. Results indicate that under the high and low temperature impact condition, because of the mismatch of coefficients of thermal expansion of copper, solder alloy and epoxy resin, solder joints cannot stretch and contract freely during the high and low temperature impact cycles, thus, cracks tend to form and propagate at the solder/Cu rod interface under the function of thermal fatigue. The propagation of the cracks leads to the reduce of the effective cross sectional area of solder joints, and that lead to the increment of the solder joints resistance, eventually a lot of joule heat is created which lead to the melting failure of solder joints.%研究了Cu/Sn-3.0Ag-0.5Cu/Cu焊点接头在电迁移与高低温冲击双重耦合作用下的失效机理.结果表明,在高低温冲击条件下,由于铜柱、钎料合金及镶样用环氧树脂的热膨胀系数不匹配,因此,焊点接头在高低温冲击过程中无法自由伸缩,在热疲劳的作用下,焊接接头易于在界面处形成裂纹,且随着时间的延长裂纹会发生扩展,造成焊点接头的有效横截面积减小,使得焊点接头的电阻增大、焦耳热增加,进而导致焊点接头发生熔化而失效.

  18. Leading Cities

    DEFF Research Database (Denmark)

    Pogner, Karl-Heinz

    2017-01-01

    and technical engineering; Smart Cities) is very prominent in the traditional mass media discourse, in PR / PA of tech companies and traditional municipal administrations; whereas the second one (participation; Livable Cities) is mostly enacted in social media, (local) initiatives, movements, (virtual......) communities, new forms of urban governance in municipal administration and co-competitive city networks. Both forms seem to struggle for getting voice and power in the discourses, negotiations, struggles, and conflicts in Urban Governance about the question how to manage or lead (in) a city. Talking about...

  19. Respiratory failure in diabetic ketoacidosis

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Respiratory failure complicating the course of diabeticketoacidosis (DKA) is a source of increased morbidityand mortality. Detection of respiratory failure in DKA requiresfocused clinical monitoring, careful interpretationof arterial blood gases, and investigation for conditionsthat can affect adversely the respiration. Conditions thatcompromise respiratory function caused by DKA can bedetected at presentation but are usually more prevalentduring treatment. These conditions include deficits ofpotassium, magnesium and phosphate and hydrostatic ornon-hydrostatic pulmonary edema. Conditions not causedby DKA that can worsen respiratory function under theadded stress of DKA include infections of the respiratorysystem, pre-existing respiratory or neuromuscular diseaseand miscellaneous other conditions. Prompt recognitionand management of the conditions that can lead torespiratory failure in DKA may prevent respiratory failureand improve mortality from DKA.

  20. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  1. Immune mediated liver failure

    OpenAIRE

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capac...

  2. Understanding contraceptive failure

    OpenAIRE

    Trussell, James

    2009-01-01

    Contraceptive failure is a major source of unintended pregnancy. This chapter will review sources of data and measurement of contraceptive failure, summarize results from the literature on the risks of contraceptive failure during typical and perfect use for available methods of contraception, provide a tool for communicating risks of contraceptive failure to clients, examine determinants of contraceptive failure, and identify methodological pitfalls in the published literature.

  3. Clarification of Failure Terminology by Examining a Generic Failure Development Process

    Directory of Open Access Journals (Sweden)

    Allen S. B. Tam

    2009-10-01

    Full Text Available One key objective of good plant asset management is to prevent undesirable failure that may cause loss of life, destruction of asset, loss of economic benefit or damage to the environment. In order to deploy strategies that prevent failure, one needs to first understand the processes leading to failure, and definitions used for describing the failure of physical assets. A number of different definitions for the same terms related to equipment failure can be found in the literature. The looseness of terminology and often overlapping shades of meaning lead to ambiguity and confusion. This paper aims to offer clearer definitions derived from examining a generic failure development process exhibited by physical assets (herein referred to as "equipment".

  4. Coordination failure caused by sunspots

    DEFF Research Database (Denmark)

    Beugnot, Julie; Gürgüç, Zeynep; Øvlisen, Frederik Roose

    2012-01-01

    In a coordination game with Pareto-ranked equilibria, we study whether a sunspot can lead to either coordination on an inferior equilibrium (mis-coordination) or to out-of equilibrium behavior (dis-coordination). While much of the literature searches for mechanisms to attain coordination...... on the efficient equilibrium, we consider sunspots as a potential reason for coordination failure. We conduct an experiment with a three player 2x2x2 game in which coordination on the efficient equilibrium is easy and should normally occur. In the control session, we find almost perfect coordination on the payoff......-dominant equilibrium, but in the sunspot treatment, dis-coordination is frequent. Sunspots lead to significant inefficiency, and we conclude that sunspots can indeed cause coordination failure....

  5. Corrosion in electronics: Overview of failures and countermeasures

    DEFF Research Database (Denmark)

    Jellesen, Morten Stendahl; Verdingovas, Vadimas; Conseil, Helene

    2014-01-01

    life conditions (humidity and contamination) where water film formation on the printed circuit board assembly (PCBA) leads to leakage currents resulting in wrong output signal of the electronic device. If the leakage current itself will not result in malfunctioning of the electronics, the formed water......Many field failure returns of electronics are marked as “no failure found”, yet numerous of these failures are likely due to corrosion, since corrosion related failures are not easily detected during subsequent failure analysis. In some cases failures are intermittent and occur because of service...... film and potential bias of the PCBA will eventually lead to failure caused by more easy recognisable corrosion. Typical corrosion failure types seen in electronics are galvanic corrosion, electrochemical migration, and other types of bias induced corrosion. This paper describes the most commonly used...

  6. When the heart kills the liver: acute liver failure in congestive heart failure

    Directory of Open Access Journals (Sweden)

    Saner FH

    2009-12-01

    Full Text Available Abstract Congestive heart failure as a cause of acute liver failure is rarely documented with only a few cases. Although the pathophysiology is poorly understood, there is rising evidence, that low cardiac output with consecutive reduction in hepatic blood flow is a main causing factor, rather than hypotension. In the setting of acute liver failure due to congestive heart failure, clinical signs of the latter can be absent, which requires an appropriate diagnostic approach. As a reference center for acute liver failure and liver transplantation we recorded from May 2003 to December 2007 202 admissions with the primary diagnoses acute liver failure. 13/202 was due to congestive heart failure, which was associated with a mortality rate of 54%. Leading cause of death was the underlying heart failure. Asparagine transaminase (AST, bilirubin, and international normalized ratio (INR did not differ significantly in surviving and deceased patients at admission. Despite both groups had signs of cardiogenic shock, the cardiac index (CI was significantly higher in the survival group on admission as compared with non-survivors (2.1 L/min/m2 vs. 1.6 L/min/m2, p = 0.04. Central venous - and pulmonary wedge pressure did not differ significantly. Remarkable improvement of liver function was recorded in the group, who recovered from cardiogenic shock. In conclusion, patients with acute liver failure require an appropriate diagnostic approach. Congestive heart failure should always be considered as a possible cause of acute liver failure.

  7. [Understanding heart failure].

    Science.gov (United States)

    Boo, José Fernando Guadalajara

    2006-01-01

    Heart failure is a disease with several definitions. The term "heart failure" is used by has brougth about confusion in the terminology. For this reason, the value of the ejection fraction (< 0.40 or < 0.35) is used in most meganalyses on the treatment of heart failure, avoiding the term "heart failure" that is a confounding concept. In this paper we carefully analyze the meaning of contractility, ventricular function or performance, preload, afterload, heart failure, compensation mechanisms in heart failure, myocardial oxygen consumption, inadequate, adequate and inappropriate hypertrophy, systole, diastole, compliance, problems of relaxation, and diastolic dysfunction. Their definitions are supported by the original scientific descriptions in an attempt to clarify the concepts about ventricular function and heart failure and, in this way, use the same scientific language about the meaning of ventricular function, heart failure, and diastolic dysfunction.

  8. Real System Failures

    Data.gov (United States)

    National Aeronautics and Space Administration — This resource area contains descriptions of actual electronic systems failure scenarios with an emphasis on the diversity of failure modes and effects that can...

  9. Contraceptive failure in China.

    Science.gov (United States)

    Wang, Duolao

    2002-09-01

    This study examines patterns and differentials of contraceptive failure rates by method and characteristics of users, using the Chinese Two-per-Thousand Fertility Survey data. The results show that contraceptive failure rates for modern methods including sterilization are some of the highest in the world. The first year failure rates are 4.2% for male sterilization, 0.7% for female sterilization, 10.3% for IUD, 14.5% for pill, and 19.0% for condom. There are also some differentials in contraceptive failure rates by users' sociodemographic and fertility characteristics. Contraceptive failure rate declines with women's age for all reversible methods. Rural women have higher sterilization, IUD, and condom contraceptive failure rates than urban women. Women with two or more children have a higher failure rate for sterilization methods but have lower failure rates for other methods.

  10. Modelling the failure behaviour of wind turbines

    Science.gov (United States)

    Faulstich, S.; Berkhout, V.; Mayer, J.; Siebenlist, D.

    2016-09-01

    Modelling the failure behaviour of wind turbines is an essential part of offshore wind farm simulation software as it leads to optimized decision making when specifying the necessary resources for the operation and maintenance of wind farms. In order to optimize O&M strategies, a thorough understanding of a wind turbine's failure behaviour is vital and is therefore being developed at Fraunhofer IWES. Within this article, first the failure models of existing offshore O&M tools are presented to show the state of the art and strengths and weaknesses of the respective models are briefly discussed. Then a conceptual framework for modelling different failure mechanisms of wind turbines is being presented. This framework takes into account the different wind turbine subsystems and structures as well as the failure modes of a component by applying several influencing factors representing wear and break failure mechanisms. A failure function is being set up for the rotor blade as exemplary component and simulation results have been compared to a constant failure rate and to empirical wind turbine fleet data as a reference. The comparison and the breakdown of specific failure categories demonstrate the overall plausibility of the model.

  11. [Perioperative acute kidney injury and failure].

    Science.gov (United States)

    Chhor, Vibol; Journois, Didier

    2014-04-01

    Perioperative period is very likely to lead to acute renal failure because of anesthesia (general or perimedullary) and/or surgery which can cause acute kidney injury. Characterization of acute renal failure is based on serum creatinine level which is imprecise during and following surgery. Studies are based on various definitions of acute renal failure with different thresholds which skewed their comparisons. The RIFLE classification (risk, injury, failure, loss, end stage kidney disease) allows clinicians to distinguish in a similar manner between different stages of acute kidney injury rather than using a unique definition of acute renal failure. Acute renal failure during the perioperative period can mainly be explained by iatrogenic, hemodynamic or surgical causes and can result in an increased morbi-mortality. Prevention of this complication requires hemodynamic optimization (venous return, cardiac output, vascular resistance), discontinuation of nephrotoxic drugs but also knowledge of the different steps of the surgery to avoid further degradation of renal perfusion. Diuretics do not prevent acute renal failure and may even push it forward especially during the perioperative period when venous retourn is already reduced. Edema or weight gain following surgery are not correlated with the vascular compartment volume, much less with renal perfusion. Treatment of perioperative acute renal failure is similar to other acute renal failure. Renal replacement therapy must be mastered to prevent any additional risk of hemodynamic instability or hydro-electrolytic imbalance.

  12. Diuretics as pathogenetic treatment for heart failure

    Directory of Open Access Journals (Sweden)

    Maya Guglin

    2011-01-01

    Full Text Available Maya GuglinUniversity of South Florida, Tampa, FL, USAAbstract: Increased intracardiac filling pressure or congestion causes symptoms and leads to hospital admissions in patients with heart failure, regardless of their systolic function. A history of hospital admission, in turn, predicts further hospitalizations and morbidity, and a higher number of hospitalizations determine higher mortality. Congestion is therefore the driving force of the natural history of heart failure. Congestion is the syndrome shared by heart failure with preserved and reduced systolic function. These two conditions have almost identical morbidity, mortality, and survival because the outcomes are driven by congestion. A small difference in favor of heart failure with preserved systolic function comes from decreased ejection fraction and left ventricular remodeling which is only present in heart failure with decreased systolic function. The magnitude of this difference reflects the contribution of decreased systolic function and ventricular remodeling to the progression of heart failure. The only treatment available for congestion is fluid removal via diuretics, ultrafiltration, or dialysis. It is the only treatment that works equally well for heart failure with reduced and preserved systolic function because it affects congestion, the main pathogenetic feature of the disease. Diuretics are pathogenetic therapy for heart failure.Keywords: heart failure, diuretics, congestion, systolic function, diastolic function, ejection fraction

  13. Bona-fide, strong-variable galactic Luminous Blue Variable stars are fast rotators: detection of a high rotational velocity in HR Carinae

    CERN Document Server

    Groh, Jose H; Hillier, D John; Barba, Rodolfo; Fernandez-Lajus, Eduardo; Gamen, Roberto C; Moises, Alessandro; Solivella, Gladys; Teodoro, Mairan

    2009-01-01

    We report optical observations of the Luminous Blue Variable (LBV) HR Carinae which show that the star has reached a visual minimum phase in 2009. More importantly, we detected absorptions due to Si IV 4088-4116 Angstroms. To match their observed line profiles from 2009 May, a high rotational velocity of vrot=150 +- 20 km/s is needed (assuming an inclination angle of 30 degrees), implying that HR Car rotates at ~0.88 +- 0.2 of its critical velocity for break-up (vcrit). Our results suggest that fast rotation is typical in all strong-variable, bona-fide galactic LBVs, which present S Dor-type variability. Strong-variable LBVs are located in a well-defined region of the HR diagram during visual minimum (the "LBV minimum instability strip"). We suggest this region corresponds to where vcrit is reached. To the left of this strip, a forbidden zone with vrot/vcrit>1 is present, explaining why no LBVs are detected in this zone. Since dormant/ex LBVs like P Cygni and HD 168625 have low vrot, we propose that LBVs can ...

  14. CHRONIC RENAL FAILURE TODAY

    Directory of Open Access Journals (Sweden)

    Svetislav Kostić

    2004-07-01

    Full Text Available The syndrome of chronic renal failure (CRF is already known for more than 150 years. Current research in this domain changed our understanding in epidemiology, aetiology, prevention of disease progression, classifications, definition, and adequate treatment of comorbid conditions in predialytic period. With data collection and registration on CRF patients it is obvious an increase in prevalence and incidence of patients with CRF in the world. The diabetic nephropathy is the most common disease leading in 40% of cases to terminal CRF. In the follow up of these patients the most important goal is slowing down the disease progression with low protein diet (0,6-0,8 g/kg BW/day and vigorous blood pressure control (target values: 120-135/75-85 mmHg. The adequate therapy of anaemia and secondary hyperparathyroidism including predialytic use of erythopoietin and vitamin D significantly slow down the progression of CRF and postpones the beginning of dialytic treatment. Numerous comorbid conditions present in predialytic period fasten the progression of CRF. The most common are of cardiovascular origin (congestive heart failure and coronary artery disease. Those cardiovascular comorbid conditions have an impact on CRF progresion as well as on the outcome in dialytic therapy. The most common causes of cardiovascular comorbidity are hypertension, anemia and secondary hyperparathyroidism, all of which should be treated in predialytic period. Of special concern is use of nephrotoxic drugs, particularly nephrotoxic antibioticsaminoglycosides. The optimal timing of creation of permanent vascular access and vaccination against hepatitis B in predialytic period are cost-effective and have an impact on quality of dialysis.

  15. In Support of Failure

    Science.gov (United States)

    Carr, Allison

    2013-01-01

    In this essay, I propose a concerted effort to begin devising a theory and pedagogy of failure. I review the discourse of failure in Western culture as well as in composition pedagogy, ultimately suggesting that failure is not simply a judgement or indication of rank but is a relational, affect-bearing concept with tremendous relevance to…

  16. STATISTICAL EVALUATION OF HISTORICAL DIKE FAILURE MECHANISM

    Directory of Open Access Journals (Sweden)

    L. NAGY

    2012-12-01

    Full Text Available Statistical evaluation of historical dike failure mechanism The failure mechanism of flood protection dikes includes physical (geotechnical, seepage processes leading to a dike breach. An awareness of the failure mechanism is required directly in dike stability calculations and indirectly for risk calculations. Statistics of historical data indicate among others the distribution and frequency of failure mechanisms associated with dikes. These data may be used in estimations of the expected likelihood of occurrence of non-quantifiable failure mechanisms. In addition to a comparative evaluation of statistics collected in several countries, this publication also presents data for the Carpathian Basin. One of the most important conclusions drawn from statistical information suggests that most dike breaches develop as a consequence of poor safety strategy

  17. Failure of bacterial streamers in creeping flows

    Science.gov (United States)

    Biswas, Ishita; Ghosh, Ranajay; Sadrzadeh, Mohtada; Kumar, Aloke

    2016-11-01

    In the recent years, the dynamical response of filamentous bacterial aggregates called bacterial streamer in creeping flows has attracted attention. We report the observation of 'necking-type' instability leading to failure in bacterial (Pseudomonas fluorescens) streamers formed in creeping flows. Quantification of the failure process was made possible through the use of 200 nm red fluorescent polystyrene tracer particles embedded in the bacterial extracellular polymeric substances (EPS). The nonlinear failure behavior shows distinct phases of deformation with mutually different characteristic times, which end with a distinct localized failure of the streamer. We also develop a simplified analytical model to describe the experimental observations of the failure phenomena. The theoretical power law relationship between critical stretch ratio and the fluid velocity scale matches closely experimental observations.

  18. Component failures that lead to reactor scrams. [PWR; BWR

    Energy Technology Data Exchange (ETDEWEB)

    Burns, E. T.; Wilson, R. J.; Lim, E. Y.

    1980-04-01

    This report summarizes the operating experience scram data compiled from 35 operating US light water reactors (LWRs) to identify the principal components/systems related to reactor scrams. The data base utilized to identify the scram causes is developed from a EPRI-utility sponsored survey conducted by SAI coupled with recent data from the USNRC Gray Books. The reactor population considered in this evaluation is limited to 23 PWRs and 12 BWRs because of the limited scope of the program. The population includes all the US NSSS vendors. It is judged that this population accurately characterizes the component-related scrams in LWRs over the first 10 years of plant operation.

  19. Bone Marrow Failure Secondary to Cytokinesis Failure

    Science.gov (United States)

    2015-12-01

    have assessed the role of FA pathway in mitosis and confirmed that murine FA-deficient hematopoietic stem cells exhibit p53- mediated growth defects...results suggest that bone marrow failure in FA may be caused, in part, by p53- mediated cellular defects and underscore the importance of... mediated apoptosis of HSCs due to cytokinesis failure. The major goal of the project was to assess whether the p53- mediated apoptosis due to

  20. Insulin Signaling and Heart Failure.

    Science.gov (United States)

    Riehle, Christian; Abel, E Dale

    2016-04-01

    Heart failure is associated with generalized insulin resistance. Moreover, insulin-resistant states such as type 2 diabetes mellitus and obesity increases the risk of heart failure even after adjusting for traditional risk factors. Insulin resistance or type 2 diabetes mellitus 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 box O 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.

  1. Molecular Dynamics Simulations of Interface Failure

    Science.gov (United States)

    Bachlechner, Martina E.; Cao, Deng; Leonard, Robert H.; Owens, Eli T.; Swan, Wm. Trevor, III; Ducatman, Samuel C.

    2007-03-01

    The mechanical integrity of silicon/silicon nitride interfaces is of great importance in their applications in micro electronics and solar cells. Large-scale molecular dynamics simulations are an excellent tool to study mechanical and structural failure of interfaces subjected to externally applied stresses and strains. When pulling the system parallel to the interface, cracks in silicon nitride and slip and pit formation in silicon are typical failure mechanisms. Hypervelocity impact perpendicular to the interface plane leads to structural transformation and delamination at the interface. Influence of system temperature, strain rate, impact velocity, and system size on type and characteristics of failure will be discussed.

  2. 论中国有限公司股权善意取得的一般结构%The General Structure of the Equity Bona Fide Acquisition of Limited Companies in China

    Institute of Scientific and Technical Information of China (English)

    朱晓娟; 姚篮

    2013-01-01

    《公司法司法解释三》的颁布实施,使得对股权善意取得制度的探究从理论延伸到立法,甚至到司法实践的回应与检讨。在肯定股权善意取得制度的存在价值及对有限公司股权善意取得的现行规范进行分析后,认为现行立法并未固定股权流转的模式,这不是法律漏洞,而是在私法自治的精神下还原学说的工具价值。以分离原则为基础解析股权变动的一般结构,是构建股权善意取得一般结构的基础。基于股权的特殊性与商法外观主义设置前置条件、考虑股权善意取得的构成要件并结合当事人是否承认无因性原则来构建股权善意取得的一般结构是非常必要的。%With the promulgation and implementation of Company Law's Judicial Interpretation Three , the academic circles pay attention to The Equity Bona Fide Acquisition from theory to legislation , even to The judicial practice's re-sponse and review .This article admits the value of The Equity Bona Fide Acquisition , and based on analyzing its cur-rent legal norm , thinks that the fact of current legislation's not fixing the mode of equity transferring is not legal loop-hole, but regression of theory's tool value in the spirit of the autonomy of private law .Analyzing general structure of equity transferring on the basis of separation principle , is the basis of constructing general structure of The Equity Bo-na Fide Acquisition .Setting up a precondition based on equity's particularity and appearance doctrine of merchant law, considering constitutive requirements of The Equity Bona Fide Acquisition , and combining with the parties'atti-tude whether admitting No-cause principle or not , are essential to constructing general structure of The Equity Bona Fide Acquisition .

  3. Managing Feelings about Heart Failure

    Science.gov (United States)

    ... About Heart Failure Module 6: Managing Feelings About Heart Failure Download Module Order Hardcopy Heart failure can cause ... professional help for emotional problems. Common Feelings About Heart Failure It is common for people to feel depressed ...

  4. Diuretics as pathogenetic treatment for heart failure

    Science.gov (United States)

    Guglin, Maya

    2011-01-01

    Increased intracardiac filling pressure or congestion causes symptoms and leads to hospital admissions in patients with heart failure, regardless of their systolic function. A history of hospital admission, in turn, predicts further hospitalizations and morbidity, and a higher number of hospitalizations determine higher mortality. Congestion is therefore the driving force of the natural history of heart failure. Congestion is the syndrome shared by heart failure with preserved and reduced systolic function. These two conditions have almost identical morbidity, mortality, and survival because the outcomes are driven by congestion. A small difference in favor of heart failure with preserved systolic function comes from decreased ejection fraction and left ventricular remodeling which is only present in heart failure with decreased systolic function. The magnitude of this difference reflects the contribution of decreased systolic function and ventricular remodeling to the progression of heart failure. The only treatment available for congestion is fluid removal via diuretics, ultrafiltration, or dialysis. It is the only treatment that works equally well for heart failure with reduced and preserved systolic function because it affects congestion, the main pathogenetic feature of the disease. Diuretics are pathogenetic therapy for heart failure. PMID:21403798

  5. Mitochondria in cardiac hypertrophy and heart failure.

    Science.gov (United States)

    Rosca, Mariana G; Tandler, Bernard; Hoppel, Charles L

    2013-02-01

    Heart failure (HF) frequently is the unfavorable outcome of pathological heart hypertrophy. In contrast to physiological cardiac hypertrophy, which occurs in response to exercise and leads to full adaptation of contractility to the increased wall stress, pathological hypertrophy occurs in response to volume or pressure overload, ultimately leading to contractile dysfunction and HF. Because cardiac hypertrophy impairs the relationship between ATP demand and production, mitochondrial bioenergetics must keep up with the cardiac hypertrophic phenotype. We review data regarding the mitochondrial proteomic and energetic remodeling in cardiac hypertrophy, as well as the temporal and causal relationships between mitochondrial failure to match the increased energy demand and progression to cardiac decompensation. We suggest that the maladaptive effect of sustained neuroendocrine signals on mitochondria leads to bioenergetic fading which contributes to the progression from cardiac hypertrophy to failure. This article is part of a Special Issue entitled "Focus on Cardiac Metabolism". Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Mitochondria in cardiac hypertrophy and heart failure

    Science.gov (United States)

    Rosca, Mariana G.; Tandler, Bernard; Hoppel, Charles L.

    2013-01-01

    Heart failure (HF) frequently is the unfavorable outcome of pathological heart hypertrophy. In contrast to physiological cardiac hypertrophy, which occurs in response to exercise and leads to full adaptation of contractility to the increased wall stress, pathological hypertrophy occurs in response to volume or pressure overload, ultimately leading to contractile dysfunction and HF. Because cardiac hypertrophy impairs the relationship between ATP demand and production, mitochondrial bioenergetics must keep up with the cardiac hypertrophic phenotype. We review data regarding the mitochondrial proteomic and energetic remodeling in cardiac hypertrophy, as well as the temporal and causal relationship between mitochondrial failure to match the increased energy demand and progression to cardiac decompensation. We suggest that the maladaptive effect of sustained neuroendocrine signals on mitochondria leads to bioenergetic fading which contributes to the progression from cardiac hypertrophy to failure. PMID:22982369

  7. Bituminous Pavement Failures

    Directory of Open Access Journals (Sweden)

    Surajo Abubakar Wada

    2016-02-01

    Full Text Available Pavement deterioration is a serious problem for road and traffic sector in almost every country, the most affecting causes of bituminous pavement failures have been studied in this paper. The paper describes the lessons learnt from pavement failures and problems experienced. Failures of bituminous pavements are caused due to many reasons or combination of reasons. Application of correction in the existing surface will enhance the life of maintenance works as well as that of strengthening layer. Along with the maintenance techniques there are various methods for pavement preservation which will help in enhancing the life of pavement and delaying of its failure.This paper discusses the possible causes of pavement failures, and recommendbetter ways to minimize and hopefully eliminate the causes of failures in bituminous pavements.

  8. NASA DOD Lead Free Electronics Project

    Science.gov (United States)

    Kessel, Kurt R.

    2008-01-01

    The primary'technical objective of this project is to undertake comprehensive testing to generate information on failure modes/criteria to better understand the reliability of: Packages (e.g., Thin Small Outline Package [TSOP], Ball Grid Array [BGA], Plastic Dual In-line Package [PDIPD assembled and reworked with lead-free alloys Packages (e.g., TSOP, BGA, PDIP) assembled and reworked with mixed (lead/lead-free) alloys.

  9. Failure Analysis Handbook

    Science.gov (United States)

    1989-08-18

    47) described a method they called the "failure-experience matrix." This matrix was a three-dimensional array of cells , with failure modes along one...Russo, DFat ý , compiled by McDonnell-Dcuglas Astrovautics Cmpany, Huntington Beach, California, published by Metals and Ceramics Information Center...matrix." This matrix was a three dimensional array of cells , with failure modes along one axis, ryont "mechardcal function along a second axis and

  10. Deriving Function-failure Similarity Information for Failure-free Rotorcraft Component Design

    Science.gov (United States)

    Roberts, Rory A.; Stone, Robert B.; Tumer, Irem Y.; Clancy, Daniel (Technical Monitor)

    2002-01-01

    Performance and safety are the top concerns of high-risk aerospace applications at NASA. Eliminating or reducing performance and safety problems can be achieved with a thorough understanding of potential failure modes in the design that lead to these problems. The majority of techniques use prior knowledge and experience as well as Failure Modes and Effects as methods to determine potential failure modes of aircraft. The aircraft design needs to be passed through a general technique to ensure that every potential failure mode is considered, while avoiding spending time on improbable failure modes. In this work, this is accomplished by mapping failure modes to certain components, which are described by their functionality. In turn, the failure modes are then linked to the basic functions that are carried within the components of the aircraft. Using the technique proposed in this paper, designers can examine the basic functions, and select appropriate analyses to eliminate or design out the potential failure modes. This method was previously applied to a simple rotating machine test rig with basic functions that are common to a rotorcraft. In this paper, this technique is applied to the engine and power train of a rotorcraft, using failures and functions obtained from accident reports and engineering drawings.

  11. Liquefaction, flow, and associated ground failure

    Science.gov (United States)

    Youd, T. Leslie

    1973-01-01

    Ambiguities in the use of the term liquefaction and in defining the relation between liquefaction and ground failure have led to encumbered communication between workers in various fields and between specialists in the same field, and the possibility that evaluations of liquefaction potential could be misinterpreted or misapplied. Explicit definitions of liquefaction and related concepts are proposed herein. These definitions, based on observed laboratory behavior, are then used to clarify the relation between liquefaction and ground failure. Soil liquefaction is defined as the transformation of a granular material from a solid into a liquefied state as a consequence of increased pore-water pressures. This definition avoids confusion between liquefaction and possible flow-failure conditions after liquefaction. Flow-failure conditions are divided into two types: (1) unlimited flow if pore-pressure reductions caused by dilatancy during flow deformation are not sufficient to solidify the material and thus arrest flow, and (2) limited flow if they are sufficient to solidify the material after a finite deformation. After liquefaction in the field, unlimited flow commonly leads to flow landslides, whereas limited flow leads at most to lateral-spreading landslides. Quick-condition failures such as loss of bearing capacity form a third type of ground failure associated with liquefaction.

  12. Chronic heart failure

    African Journals Online (AJOL)

    population, and up to 10% in people aged 75 years and older. It is also estimated that ... The first step in the development of heart failure is an injury to the myocardium ... treatment of heart failure by blocking the compensatory mechanisms with ... pulmonary disease, cognitive dysfunction, depression, chronic kidney disease ...

  13. Heart failure overview

    Science.gov (United States)

    ... symptoms) You feel a severe crushing chest pain Prevention Most cases of heart failure can be prevented by living a healthy lifestyle and taking steps aimed at reducing your risk for heart disease . . Alternative Names CHF; Congestive heart failure; Left-sided ...

  14. Economic impact of heart failure according to the effects of kidney failure.

    Science.gov (United States)

    Sicras Mainar, Antoni; Navarro Artieda, Ruth; Ibáñez Nolla, Jordi

    2015-01-01

    To evaluate the use of health care resources and their cost according to the effects of kidney failure in heart failure patients during 2-year follow-up in a population setting. Observational retrospective study based on a review of medical records. The study included patients ≥ 45 years treated for heart failure from 2008 to 2010. The patients were divided into 2 groups according to the presence/absence of KF. Main outcome variables were comorbidity, clinical status (functional class, etiology), metabolic syndrome, costs, and new cases of cardiovascular events and kidney failure. The cost model included direct and indirect health care costs. Statistical analysis included multiple regression models. The study recruited 1600 patients (prevalence, 4.0%; mean age 72.4 years; women, 59.7%). Of these patients, 70.1% had hypertension, 47.1% had dyslipidemia, and 36.2% had diabetes mellitus. We analyzed 433 patients (27.1%) with kidney failure and 1167 (72.9%) without kidney failure. Patients with kidney failure were associated with functional class III-IV (54.1% vs 40.8%) and metabolic syndrome (65.3% vs 51.9%, P<.01). The average unit cost was €10,711.40. The corrected cost in the presence of kidney failure was €14,868.20 vs €9,364.50 (P=.001). During follow-up, 11.7% patients developed ischemic heart disease, 18.8% developed kidney failure, and 36.1% developed heart failure exacerbation. Comorbidity associated with heart failure is high. The presence of kidney failure increases the use of health resources and leads to higher costs within the National Health System. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  15. Predicting Electronic Failure from Smoke

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, T.J.

    1999-01-15

    Smoke can cause electronic equipment to fail through increased leakage currents and shorts. Sandia National Laboratories is studying the increased leakage currents caused by smoke with varying characteristics. The objective is to develop models to predict the failure of electronic equipment exposed to smoke. This requires the collection of data on the conductivity of smoke and knowledge of critical electrical systems that control high-consequence operations. We have found that conductivity is a function of the type of fuel, how it is burned, and smoke density. Video recordings of highly biased dc circuits exposed in a test chamber show that during a fire, smoke is attracted to high voltages and can build fragile carbon bridges that conduct leakage currents. The movement of air breaks the bridges, so the conductivity decreases after the fire is extinguished and the test chamber is vented. During the fire, however, electronic equipment may not operate correctly, leading to problems for critical operations dependent on electronic control. The potential for electronic failure is highly dependent on the type of electrical circuit, and Sandia National Laboratories plans to include electrical circuit modeling in the failure models.

  16. Fiat and bona fide boundaries

    OpenAIRE

    Smith, B.; Varzi, A.

    1997-01-01

    Consider John, the moon, a lump of cheese. These are objects possessed of divisible bulk. They can be divided, in reality or in thought, into spatially extended parts. They have interiors. They also have boundaries, which we can think of (roughly) asinfinitely thin extremal slices. The boundary of the moon is its surface. The boundary of John is the surface of his skin. But what of inner boundaries, the boundaries of the interior parts of things? There are many genuine two-dimensional (sphere...

  17. Functional validation of putative toxin-antitoxin genes from the Gram-positive pathogen Streptococcus pneumoniae: phd-doc is the fourth bona-fide operon

    Directory of Open Access Journals (Sweden)

    Wai Ting eChan

    2014-12-01

    Full Text Available Bacterial toxin-antitoxin (TAs loci usually consist of two genes organized as an operon, where their products are bound together and inert under normal conditions. However, under stressful circumstances the antitoxin, which is more labile, will be degraded more rapidly, thereby unleashing its cognate toxin to act on the cell. This, in turn, causes cell stasis or cell death, depending on the type of TAs and/or time of toxin exposure. Previously based on in silico analyses, we proposed that Streptococcus pneumoniae, a pathogenic Gram-positive bacterium, may harbor between four to ten putative TA loci depending on the strains. Here we have chosen the pneumococcal strain Hungary19A-6 which contains all possible ten TA loci. In addition to the three well-characterized operons, namely relBE2, yefM-yoeB, and pezAT, we show here the functionality of a fourth operon that encodes the pneumococcal equivalent of the phd-doc TA. Transcriptional fusions with gene encoding Green Fluorescent Protein showed that the promoter was slightly repressed by the Phd antitoxin, and exhibited almost background values when both Phd-Doc were expressed together. These findings demonstrate that phd-doc shows the negative self-regulatory features typical for an authentic TA. Further, we also show that the previously proposed TAs XreA-Ant and Bro-XreB, although they exhibit a genetic organization resembling those of typical TAs, did not appear to confer a functional behavior corresponding to bona fide TAs. In addition, we have also discovered new interesting bioinformatics results for the known pneumococcal TAs RelBE2 and PezAT. A global analysis of the four identified toxins-antitoxins in the pneumococcal genomes (PezAT, RelBE2, YefM-YoeB, and Phd-Doc showed that RelBE2 and Phd-Doc are the most conserved ones. Further, there was good correlation among TA types, clonal complexes and sequence types in the 48 pneumococcal strains analyzed.

  18. Epigenetics in heart failure phenotypes

    Directory of Open Access Journals (Sweden)

    Alexander Berezin

    2016-12-01

    Full Text Available Chronic heart failure (HF is a leading clinical and public problem posing a higher risk of morbidity and mortality in different populations. HF appears to be in both phenotypic forms: HF with reduced left ventricular ejection fraction (HFrEF and HF with preserved left ventricular ejection fraction (HFpEF. Although both HF phenotypes can be distinguished through clinical features, co-morbidity status, prediction score, and treatment, the clinical outcomes in patients with HFrEF and HFpEF are similar. In this context, investigation of various molecular and cellular mechanisms leading to the development and progression of both HF phenotypes is very important. There is emerging evidence that epigenetic regulation may have a clue in the pathogenesis of HF. This review represents current available evidence regarding the implication of epigenetic modifications in the development of different HF phenotypes and perspectives of epigenetic-based therapies of HF.

  19. Failures in the treatment of pseudoarthroses; Problem niepowodzen w leczeniu stawow rzekomych

    Energy Technology Data Exchange (ETDEWEB)

    Konarski, K.; Piotrowski, W.; Trubisz, L.; Michalski, S. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    Failure analysis in the treatment of pseudoarthroses has been presented. It was noted that ankylosis within adjacent joints may lead to nonunion or refracture. Vascular disorders of various origins remain the dominant cause of failure. (author). 5 refs, 10 figs.

  20. [Heart failure and comorbidities].

    Science.gov (United States)

    Boully, Clémence; Hanon, Olivier

    2015-03-01

    Heart failure is a frequent disease in the elderly. Its clinical presentation is less typical and the prognosis more severe than in younger subjects because heart failure occurs in patients with multiple comorbidities. A comprehensive geriatric assessment should therefore be performed to detect the vulnerabilities and manage the comorbidities. The main diseases associated with heart failure are dementia, depression, malnutrition, atrial fibrillation, coronary artery disease, orthostatic hypotension, renal failure, anemia and iron deficiency. Comorbidities worsen heart failure and makes its treatment more difficult. The identification and treatment of comorbidities improve the prognosis in terms of mortality but especially in terms of quality of life. Caution with drugs is necessary because of pharmacokinetic or pharmacodynamic changes related to aging and the comorbidities. In this context, clinical and laboratory monitoring should be increased, mostly during an acute event (acute heart failure, infection, dehydration, fall, new therapy…). Therefore, the follow-up of elderly patients with heart failure requires a multidisciplinary approach that involves close cooperation between cardiologists, geriatricians, general practitioners, nurses, and pharmacists.

  1. Angiotensin II vaccine promising for patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    CHEN Yang-xin; YAO You-jie; NIE Ru-qiong; ZHOU Shu-xian; WANG Jing-feng

    2009-01-01

    @@ Chronic heart failure (CHF), as the end-stage presentation of all kinds of heart diseases, is a major public health problem as well as a pressing public policy issue. There are more than 5 million patients diagnosed with CHF in USA alone and approximately 550 000 new cases appear per year. About 0.4%-2% of the European population is affected by symptomatic heart failure. Hence heart failure is the leading cause of hospitalization especially in older people around the world.

  2. Ultrasonography in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Buturovic-Ponikvar, Jadranka E-mail: jadranka.buturovic@mf.uni-lj.si; Visnar-Perovic, Alenka

    2003-05-01

    Many chronic renal diseases lead to the final common state of decrease in renal size, parenchymal atrophy, sclerosis and fibrosis. The ultrasound image show a smaller kidney, thinning of the parenchyma and its hyperechogenicity (reflecting sclerosis and fibrosis). The frequency of renal cysts increases with the progression of the disease. Ultrasound generally does not allow for the exact diagnosis of an underlying chronic disease (renal biopsy is usually required), but it can help to determine an irreversible disease, assess prognosis and avoid unnecessary diagnostic or therapeutic procedures. The main exception in which the ultrasound image does not show a smaller kidney with parenchymal atrophy is diabetic nephropathy, the leading cause of chronic and end-stage renal failure in developed countries in recent years. In this case, both renal size and parenchymal thickness are preserved until end-stage renal failure. Doppler study of intrarenal vessels can provide additional information about microvascular and parenchymal lesions, which is helpful in deciding for or against therapeutic intervention and timely planning for optimal renal replacement therapy option.

  3. Cascading Node Failure with Continuous States in Random Geometric Networks

    CERN Document Server

    Kamran, Khashayar

    2016-01-01

    The increasing complexity and interdependency of today's networks highlight the importance of studying network robustness to failure and attacks. Many large-scale networks are prone to cascading effects where a limited number of initial failures (due to attacks, natural hazards or resource depletion) propagate through a dependent mechanism, ultimately leading to a global failure scenario where a substantial fraction of the network loses its functionality. These cascading failure scenarios often take place in networks which are embedded in space and constrained by geometry. Building on previous results on cascading failure in random geometric networks, we introduce and analyze a continuous cascading failure model where a node has an initial continuously-valued state, and fails if the aggregate state of its neighbors fall below a threshold. Within this model, we derive analytical conditions for the occurrence and non-occurrence of cascading node failure, respectively.

  4. Damage mechanics - failure modes

    Energy Technology Data Exchange (ETDEWEB)

    Krajcinovic, D.; Vujosevic, M. [Arizona State Univ., Tempe, AZ (United States)

    1996-12-31

    The present study summarizes the results of the DOE sponsored research program focused on the brittle failure of solids with disordered microstructure. The failure is related to the stochastic processes on the microstructural scale; namely, the nucleation and growth of microcracks. The intrinsic failure modes, such as the percolation, localization and creep rupture, are studied by emphasizing the effect of the micro-structural disorder. A rich spectrum of physical phenomena and new concepts that emerges from this research demonstrates the reasons behind the limitations of traditional, deterministic, and local continuum models.

  5. The Contributing Factors of Pragmatic Failure in China's ELT Classrooms

    Science.gov (United States)

    Shen, Qi-yuan

    2013-01-01

    Pragmatic failure is the inability to understand what is meant by what is said, which can often lead to misunderstanding or confusion in cross-cultural communication. For this reason, the present article explores the contributing factors of pragmatic failure in China's ELT Classrooms. According to the exploration, the following factors are found…

  6. The puzzle of kidney dysfunction in heart failure : an introduction

    NARCIS (Netherlands)

    Metra, Marco; Voors, Adriaan A.

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well.

  7. The puzzle of kidney dysfunction in heart failure : an introduction

    NARCIS (Netherlands)

    Metra, Marco; Voors, Adriaan A.

    2012-01-01

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well. Mu

  8. The puzzle of kidney dysfunction in heart failure : an introduction

    NARCIS (Netherlands)

    Metra, Marco; Voors, Adriaan A.

    2012-01-01

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well. Mu

  9. Advanced Heart Failure

    Science.gov (United States)

    ... patients and their doctors, making good decisions requires teamwork. Through shared decision making, doctors and patients consider ... Heart Failure and Knowing Your Options Planning Ahead Communicating With Your Healthcare Provider Overcoming Barriers to Shared ...

  10. Hyperkalemia in Heart Failure.

    Science.gov (United States)

    Sarwar, Chaudhry M S; Papadimitriou, Lampros; Pitt, Bertram; Piña, Ileana; Zannad, Faiez; Anker, Stefan D; Gheorghiade, Mihai; Butler, Javed

    2016-10-01

    Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure.

  11. Heart failure - medicines

    Science.gov (United States)

    ... are working and to measure your potassium levels. Beta Blockers Beta blockers slow your heart rate and decrease the strength ... muscle contracts in the short term. Long term beta blockers help keep your heart failure from becoming worse. ...

  12. Central oxygen pipeline failure

    African Journals Online (AJOL)

    Anaesthetic and critical care staff play a governing role in the comprehension of a ... complete central oxygen pipeline failure occurred throughout. Tygerberg Hospital. ..... emergency stations and at plant room emergency supply manifolds.

  13. Acute heart failure syndrome

    African Journals Online (AJOL)

    tandfonline.com/ ... When heart failure develops gradually, there is time for the compensatory ... of this can be seen in acute brain injury, some forms of takotsubo syndrome or .... reduce blood pressure in cases presenting with elevated blood pressure.

  14. Lungs in Heart Failure

    Directory of Open Access Journals (Sweden)

    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  15. Lead Poisoning Prevention Tips

    Science.gov (United States)

    ... or removed safely. How are children exposed to lead? Lead-based paint and lead contaminated dust are ... What can be done to prevent exposure to lead? It is important to determine the construction year ...

  16. Lead (Pb) Air Pollution

    Science.gov (United States)

    ... States Environmental Protection Agency Search Search Lead (Pb) Air Pollution Share Facebook Twitter Google+ Pinterest Contact Us As ... and protect aquatic and terrestrial ecosystems. Lead (Pb) Air Pollution Lead Air Pollution Basics How does lead get ...

  17. Acute liver failure and self-medication.

    Science.gov (United States)

    de Oliveira, André Vitorio Câmara; Rocha, Frederico Theobaldo Ramos; Abreu, Sílvio Romero de Oliveira

    2014-01-01

    Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. To warn about how the practice of self-medication can be responsible for acute liver failure. Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them.

  18. Sample Preservation - The Key to a Successful Failure Analysis

    Science.gov (United States)

    2008-09-01

    carburized tool steel. The outer surface rehardened, transforming into unstable, untempered martensite. The case below this layer was affected...Rehardening and retempering burn in a carburized tool steel subjected to abusive grinding. Litigation: High visibility failures leading to

  19. La cláusula ‘ex fide bona’ y su influencia en el ‘quantum respondeatur’ como herramienta para recuperar el equilibrio patrimonial en derecho romano

    Directory of Open Access Journals (Sweden)

    Lilian C. San Martín Neira

    2015-06-01

    Full Text Available Este artículo se refiere a la relación existente entre la cláusula ex fide bona y la cuantía de la condena en derecho romano. Mediante la exégesis de dos pasajes del Digesto se pone en evidencia que, gracias a la elasticidad de la cláusula ex fide bona, los juristas romanos utilizaron el quantum respondeatur como un mecanismo para restablecer el equilibrio patrimonial, excluyendo de la summa condemnationis cantidades que en principio habrían debido incluirse. En consecuencia, en Roma la buena fe no era solo un mecanismo de integración del contrato mediante la ampliación de las obligaciones contraídas por las partes, sino también un mecanismo de atenuación de dichas obligaciones, cuando su exigencia en términos literales resultaba contraria al equilibrio propio de los contratos de buena fe.

  20. Temporal and spatial distribution of dam failure events in China

    Institute of Scientific and Technical Information of China (English)

    X.Y.HE; Z.Y.WANG; J.C.HUANG

    2008-01-01

    Reservoirs play a vital role in economic development and flood control.Nevertheless,both human and natural factors may lead to dam failures with catastrophic consequences.Analyzing the data of dam failure events from 1954 to 2003 and using the method of energy spectrum analysis,this paper studies the periodicity of dam failures.The rate of failure of different dam ages is analyzed.The climate is the main factor affecting the rate of dam failure.Climate diagrams are used to analyze the spatial distribution of dam failure events in China.High rate of dam failure occurs with 25-year and 12.5-year periods.The distribution of the percentage of dam failure shows an L-shape as a function of service age.The first 5 years of operation is known as the "infant period",during which,the probability of dam failure is much higher than during any other periods.The failure rate in areas near or north to the 400 mm annual isopluvial line is notably higher than other areas.In areas with high temperature difference among seasons have a high annual average dam failure rate.

  1. Mechanical circulatory devices in acute heart failure.

    Science.gov (United States)

    Teuteberg, Jeffrey J; Chou, Josephine C

    2014-07-01

    Cardiogenic shock remains a leading cause of mortality despite advances in the treatment of myocardial infarction and advanced heart failure. Medical therapy can be inadequate, and patients may need mechanical circulatory support (MCS). The proper application of MCS requires knowledge of the underlying cause of acute heart failure, familiarity with the circulatory support devices, and the potential benefits and limitations of device therapy. This article describes the most commonly used temporary ventricular assist devices and their use in the various causes of cardiogenic shock.

  2. Acute Renal Failure in the Neonate.

    Science.gov (United States)

    Khan, Owais A; Hageman, Joseph R; Clardy, Christopher

    2015-10-01

    Acute renal failure (ARF) in a neonate is a serious condition that impacts 8% to 24% of hospitalized neonates. There is a need for prompt evaluation and treatment to avoid additional complications. In this review, a neonate was found to have renal failure associated with renal vein thrombosis. There are varying etiologies of ARF. Causes of ARF are typically divided into three subsets: pre-renal, renal or intrinsic, and post-renal. Treatment of ARF varies based on the cause. Renal vein thrombosis is an interesting cause of renal or intrinsic ARF and can be serious, often leading to a need for dialysis.

  3. Lead Aprons Are a Lead Exposure Hazard.

    Science.gov (United States)

    Burns, Kevin M; Shoag, Jamie M; Kahlon, Sukhraj S; Parsons, Patrick J; Bijur, Polly E; Taragin, Benjamin H; Markowitz, Morri

    2017-05-01

    To determine whether lead-containing shields have lead dust on the external surface. Institutional review board approval was obtained for this descriptive study of a convenience sample of 172 shields. Each shield was tested for external lead dust via a qualitative rapid on-site test and a laboratory-based quantitative dust wipe analysis, flame atomic absorption spectrometry (FAAS). The χ(2) test was used to test the association with age, type of shield, lead sheet thickness, storage method, and visual and radiographic appearance. Sixty-three percent (95% confidence interval [CI]: 56%-70%) of the shields had detectable surface lead by FAAS and 50% (95% CI: 43%-57%) by the qualitative method. Lead dust by FAAS ranged from undetectable to 998 μg/ft(2). The quantitative detection of lead was significantly associated with the following: (1) visual appearance of the shield (1 = best, 3 = worst): 88% of shields that scored 3 had detectable dust lead; (2) type of shield: a greater proportion of the pediatric patient, full-body, and thyroid shields were positive than vests and skirts; (3) use of a hanger for storage: 27% of shields on a hanger were positive versus 67% not on hangers. Radiographic determination of shield intactness, thickness of interior lead sheets, and age of shield were unrelated to presence of surface dust lead. Sixty-three percent of shields had detectable surface lead that was associated with visual appearance, type of shield, and storage method. Lead-containing shields are a newly identified, potentially widespread source of lead exposure in the health industry. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. [Heart failure and anemia].

    Science.gov (United States)

    Reda, S; Motloch, L J; Hoppe, U C

    2013-09-01

    Chronic heart failure has an age-dependent prevalence of 2% and is therefore one of the most frequent diseases in western societies. A reduced hemoglobin concentration according to the definition of the World Health Organization is a common comorbidity affecting more than half of all heart failure patients. Elderly patients, patients suffering from renal impairment and women are more likely to develop anemia but a definitive etiology of anemia is only identified in the minority of cases. Anemia is associated with a poor clinical status and a greater risk of hospitalization and is a predictive factor for increased mortality. The incidence of anemia appears to increase with a poorer functional class. Intravenous iron therapy improves the exercise capacity in patients with systolic heart failure and iron deficiency and is currently being recommended for patients with persistent symptoms despite optimal medical and device therapy. However, erythropoietin-stimulating agents as a treatment for anemia in chronic heart failure have failed to improve clinical outcome in a large randomized trial. In patients with heart failure but with maintained ejection fraction, anemia is also associated with a poor prognosis. Specific therapeutic recommendations for these patients are still not available.

  5. Ejection Fraction Heart Failure Measurement

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Ejection Fraction Heart Failure Measurement Updated:Feb 15,2017 The ejection fraction ( ... failure This content was last reviewed April 2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  6. BIOASSAY VESSEL FAILURE ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Vormelker, P

    2008-09-22

    Two high-pressure bioassay vessels failed at the Savannah River Site during a microwave heating process for biosample testing. Improper installation of the thermal shield in the first failure caused the vessel to burst during microwave heating. The second vessel failure is attributed to overpressurization during a test run. Vessel failure appeared to initiate in the mold parting line, the thinnest cross-section of the octagonal vessel. No material flaws were found in the vessel that would impair its structural performance. Content weight should be minimized to reduce operating temperature and pressure. Outer vessel life is dependent on actual temperature exposure. Since thermal aging of the vessels can be detrimental to their performance, it was recommended that the vessels be used for a limited number of cycles to be determined by additional testing.

  7. Ductile failure modeling

    DEFF Research Database (Denmark)

    Benzerga, Ahmed Amine; Leblond, Jean Baptiste; Needleman, Alan

    2016-01-01

    anisotropy, or the influence of nonlocal effects that bring a material size scale into the models. Often the voids are not present in the material from the beginning, and realistic nucleation models are important. The final failure process by coalescence of neighboring voids is an issue that has been given......Ductile fracture of structural metals occurs mainly by the nucleation, growth and coalescence of voids. Here an overview of continuum models for this type of failure is given. The most widely used current framework is described and its limitations discussed. Much work has focused on extending void...... growth models to account for non-spherical initial void shapes and for shape changes during growth. This includes cases of very low stress triaxiality, where the voids can close up to micro-cracks during the failure process. The void growth models have also been extended to consider the effect of plastic...

  8. Cardiovascular failure and cardiogenic shock.

    Science.gov (United States)

    Patel, Ankitkumar K; Hollenberg, Steven M

    2011-10-01

    Cardiovascular system failure is commonly faced by the intensivist. Heart failure can occur due to a host of predisposing cardiac disorders or as secondary effects of systemic illness. When the heart is unable to provide an adequate cardiac output to maintain adequate tissue perfusion, cardiogenic shock ensues. Without prompt diagnosis and appropriate management, these patients have significant morbidity and mortality, with in-hospital mortality approaching 60% for all age groups. Accurate and rapid identification of cardiogenic shock as a medical emergency, with expeditious implementation of appropriate therapy, can lead to improved clinical outcomes. In this review, we discuss optimal strategies for diagnosis and monitoring of cardiogenic shock. We discuss the diverse therapeutic strategies employed for cardiogenic shock, including pharmacological (e.g., vasoactive agents, fibrinolytic agents), mechanical (e.g., intraaortic balloon pumps, left ventricular assist devices, percutaneous coronary intervention [PCI]), and surgical approaches such as coronary artery bypass graft (CABG), valvular repair or replacement (e.g., for acute mitral regurgitation, ventricular septal rupture, or free wall rupture).

  9. Lead and the Romans

    Science.gov (United States)

    Reddy, Aravind; Braun, Charles L.

    2010-01-01

    Lead poisoning has been a problem since early history and continues into modern times. An appealing characteristic of lead is that many lead salts are sweet. In the absence of cane and beet sugars, early Romans used "sugar of lead" (lead acetate) to sweeten desserts, fruits, and sour wine. People most at risk would have been those who…

  10. Lead and the Romans

    Science.gov (United States)

    Reddy, Aravind; Braun, Charles L.

    2010-01-01

    Lead poisoning has been a problem since early history and continues into modern times. An appealing characteristic of lead is that many lead salts are sweet. In the absence of cane and beet sugars, early Romans used "sugar of lead" (lead acetate) to sweeten desserts, fruits, and sour wine. People most at risk would have been those who consumed the…

  11. Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy.

    Science.gov (United States)

    Sarcon, Annahita; Liu, Xiaoli; Ton, David; Haywood, James; Hitchcock, Todd

    2015-01-01

    Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one. Congestive heart failure continues to remain a major cause of morbidity and mortality despite advances in medical therapies. Thus far, the precise role of coagulation factors in congestive heart failure is unknown. Further investigations are needed to elucidate the pathophysiology of congestive heart failure and coagulation factors.

  12. Failure is an option: Reactions to failure in elementary engineering design projects

    Science.gov (United States)

    Johnson, Matthew M.

    Recent reform documents in science education have called for teachers to use epistemic practices of science and engineering researchers to teach disciplinary content (NRC, 2007; NRC, 2012; NGSS Lead States, 2013). Although this creates challenges for classroom teachers unfamiliar with engineering, it has created a need for high quality research about how students and teachers engage in engineering activities to improve curriculum development and teaching pedagogy. While framers of the Next Generation Science Standards (NRC, 2012; NGSS Lead States 2013) focused on the similarities of the practices of science researchers and engineering designers, some have proposed that engineering has a unique set of epistemic practices, including improving from failure (Cunningham & Carlsen, 2014; Cunningham & Kelly, in review). While no one will deny failures occur in science, failure in engineering is thought of in fundamentally different ways. In the study presented here, video data from eight classes of elementary students engaged in one of two civil engineering units were analyzed using methods borrowed from psychology, anthropology, and sociolinguistics to investigate: 1) the nature of failure in elementary engineering design; 2) the ways in which teachers react to failure; and 3) how the collective actions of students and teachers support or constrain improvement in engineering design. I propose new ways of considering the types and causes of failure, and note three teacher reactions to failure: the manager, the cheerleader, and the strategic partner. Because the goal of iteration in engineering is improvement, I also studied improvement. Students only systematically improve when they have the opportunity, productive strategies, and fair comparisons between prototypes. I then investigate the use of student engineering journals to assess learning from the process of improvement after failure. After discussion, I consider implications from this work as well as future research

  13. Failure of granular assemblies

    OpenAIRE

    Welker, Philipp

    2011-01-01

    This work investigates granular assemblies subjected to increasing external forces in the quasi-static limit. In this limit, the system’s evolution depends on static properties of the system, but is independent of the particles’ inertia. At the failure, which occurs at a certain value of the external forces, the particles’ motions increase quickly. In this thesis, the properties of granular systems during the weakening process and at the failure are investigated with the Discrete Element Meth...

  14. Modeling Epidemic Network Failures

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Fagertun, Anna Manolova

    2013-01-01

    the SID model’s behavior and impact on the network performance, as well as the severity of the infection spreading. The simulations are carried out in OPNET Modeler. The model provides an important input to epidemic connection recovery mechanisms, and can due to its flexibility and versatility be used......This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...

  15. Modeling Epidemic Network Failures

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Fagertun, Anna Manolova

    2013-01-01

    This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...... the SID model’s behavior and impact on the network performance, as well as the severity of the infection spreading. The simulations are carried out in OPNET Modeler. The model provides an important input to epidemic connection recovery mechanisms, and can due to its flexibility and versatility be used...... to evaluate multiple epidemic scenarios in various network types....

  16. Automotive component failures

    CSIR Research Space (South Africa)

    Heyes, AM

    1998-06-01

    Full Text Available be expected[ 023 A[ M[ HEYES Fig[ 6[ Low magni_cation fractograph showing the seam defect "S#\\ fatigue area "F# and the brittle fracture area "B#[ Fig[ 7[ Fracture surface marked F in Fig[ 6\\ typical of a fatigue fracture surface in a high strength steel... Ltd[ All rights reserved[ Keywords] Accident investigation\\ automotive failures\\ decarburization\\ fatigue\\ weld fatigue[ 0[ INTRODUCTION Failure of automotive components is an occurrence which a}ects the life of almost every person at one stage...

  17. Lactulose and renal failure.

    Science.gov (United States)

    Vogt, B; Frey, F J

    1997-01-01

    The introduction of lactulose as a new therapeutic agent for treatment of hepatic encephalopathy was a major breakthrough in this field. It was hypothesized that lactulose might prevent postoperative renal impairment after biliary surgery in patients with obstructive jaundice. The presumable mechanism purported was the diminished endotoxinemia by lactulose. Unfortunately, such a reno-protective effect has not been shown conclusively until now in clinical studies. In chronic renal failure lactulose is known to promote fecal excretion of water, sodium, potassium, amonium, urea, creatinine and protons. Thus, lactulose could be useful for the treatment of chronic renal failure. However, compliance to the therapy represents a major problem.

  18. Acute-on-chronic Liver Failure.

    Science.gov (United States)

    Sarin, Shiv Kumar; Choudhury, Ashok

    2016-12-01

    Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame. ACLF is characterized by a state of deregulated inflammation. Initial cytokine burst presenting as SIRS, progression to CARS and associated immunoparalysis leads to sepsis and multi-organ failure. Early identification of the acute insult and mitigation of the same, use of nucleoside analogue in HBV-ACLF, steroid in severe alcoholic hepatitis, steroid in severe autoimmune hepatitis and/or bridging therapy lead to recovery, with a 90-day transplant-free survival rate of up to 50 %. First-week presentation is crucial concerning SIRS/sepsis, development, multiorgan failure and consideration of transplant. A protocol-based multi-disciplinary approach including critical care hepatology, early liver transplant before multi-organ involvement, or priority for organ allocation may improve the outcome. Presentation with extrahepatic organ involvement or inclusion of sepsis as an acute insult in definition restricts the therapy, i.e., liver transplant or bridging therapy, and needs serious consideration. Augmentation of regeneration, cell-based therapy, immunotherapy, and gut microbiota modulation are the emerging areas and need further research.

  19. Jinde Lead lead smelting project starts construction

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>On Dec.20,the lead smelting project of Jiangxi Jinde Lead started construction in Dexin as a technical renovation project on environmental treatment of Jiangxi Metallurgical Group.The project is the one with the largest investment of Provincial Metallurgical Group in non-ferrous

  20. A streamlined failure mode and effects analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ford, Eric C., E-mail: eford@uw.edu; Smith, Koren; Terezakis, Stephanie; Croog, Victoria; Gollamudi, Smitha; Gage, Irene; Keck, Jordie; DeWeese, Theodore; Sibley, Greg [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD 21287 (United States)

    2014-06-15

    Purpose: Explore the feasibility and impact of a streamlined failure mode and effects analysis (FMEA) using a structured process that is designed to minimize staff effort. Methods: FMEA for the external beam process was conducted at an affiliate radiation oncology center that treats approximately 60 patients per day. A structured FMEA process was developed which included clearly defined roles and goals for each phase. A core group of seven people was identified and a facilitator was chosen to lead the effort. Failure modes were identified and scored according to the FMEA formalism. A risk priority number,RPN, was calculated and used to rank failure modes. Failure modes with RPN > 150 received safety improvement interventions. Staff effort was carefully tracked throughout the project. Results: Fifty-two failure modes were identified, 22 collected during meetings, and 30 from take-home worksheets. The four top-ranked failure modes were: delay in film check, missing pacemaker protocol/consent, critical structures not contoured, and pregnant patient simulated without the team's knowledge of the pregnancy. These four failure modes hadRPN > 150 and received safety interventions. The FMEA was completed in one month in four 1-h meetings. A total of 55 staff hours were required and, additionally, 20 h by the facilitator. Conclusions: Streamlined FMEA provides a means of accomplishing a relatively large-scale analysis with modest effort. One potential value of FMEA is that it potentially provides a means of measuring the impact of quality improvement efforts through a reduction in risk scores. Future study of this possibility is needed.

  1. Acid-base balance in heart failure.

    Science.gov (United States)

    Frangiosa, A; De Santo, L S; Anastasio, P; De Santo, N G

    2006-01-01

    In end-stage heart failure, various acid-base disorders can be discovered due to the renal loss of hydrogen ions and hydrogen ion movements into cells, the reduction of the effective circulating volume, hypoxemia and renal failure. This justifies the occurrence of metabolic alkalosis, metabolic acidosis, respiratory alkalosis, as well as respiratory acidosis alone or in combination. Several studies have been published on the acid-base state in heart failure. In a 1951 study, Squires et al analyzed the distribution of body fluid in congestive heart failure by taking into consideration the abnormalities in serum electrolyte concentration and in acid-base equilibrium. A recent study by Milionis et al, analyzed 86 patients with congestive heart failure receiving conventional treatment; the majority of these patients exhibited hypokalemia, hyponatremia, hypocalcemia and hypophosphatemia. Disorders in acid-base balance were noted in 37.2% of patients. In a recent study, 70 patients with severe congestive heart failure before heart transplantation showed high-normal pH, slightly reduced pCO 2 and a slight loss of hydrogen ions. After heart transplantation, stability of blood pH and hydrogen ion concentrations was found. In contrast, bicarbonate and pCO 2 increased significantly. The data led us to formulate the diagnosis of a mixed acid-base disorder that includes respiratory alkalosis and metabolic alkalosis before heart transplantation. In heart failure, the presence of acid-base imbalance associated with the activation of mechanisms that lead to salt and water retention reveals evidence concerning the pivotal role of the kidney in determining the outcome of these patients.

  2. Lead - nutritional considerations

    Science.gov (United States)

    Lead poisoning - nutritional considerations; Toxic metal - nutritional considerations ... Markowitz M. Lead poisoning. In: Kliegman RM, Behrman RE, Jenson HB, ... Emergency Medicine: Concepts and Clinical Practice . 8th ed. ...

  3. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this behaviora

  4. Acute liver failure

    DEFF Research Database (Denmark)

    Bernal, William; Lee, William M; Wendon, Julia

    2015-01-01

    Over the last three decades acute liver failure (ALF) has been transformed from a rare and poorly understood condition with a near universally fatal outcome, to one with a well characterized phenotype and disease course. Complex critical care protocols are now applied and emergency liver...

  5. Heart failure in COPD

    NARCIS (Netherlands)

    Rutten, Frans Hendrik

    2005-01-01

    The main aim of the thesis was to assess the prevalence of heart failure in patients with a diagnosis of chronic obstructive pulmonary disease (COPD). Furthermore, to explore diagnostic strategies (including natriuretic peptides and cardiovascular magnetic resonance imaging (CMR)) to identify heart

  6. Copeptin in Heart Failure

    DEFF Research Database (Denmark)

    Balling, Louise; Gustafsson, Finn

    2016-01-01

    Heart failure (HF) is one of the most common causes of hospitalization and mortality in the modern Western world and an increasing proportion of the population will be affected by HF in the future. Although HF management has improved quality of life and prognosis, mortality remains very high...

  7. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    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.

  8. Failure to thrive

    Science.gov (United States)

    ... caused by medical problems or factors in the child’s environment, such as abuse or neglect. There are many medical causes of failure to thrive. These include: Problems with genes, such as Down syndrome Organ problems Hormone problems Damage to the brain ...

  9. Equilibria with Coordination Failures

    NARCIS (Netherlands)

    Herings, P.J.J.; van der Laan, G.; Talman, A.J.J.

    2004-01-01

    This paper extends the recent literature on equilibria with coordination failures to arbitrary convex sets of admissible prices.We introduce a new equilibrium concept, called quantity constrained equilibrium (QCE), giving a uni.ed treatment to all cases considered in the literature so far.At a QCE

  10. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this behaviora

  11. Cascading failures in ac electricity grids

    Science.gov (United States)

    Rohden, Martin; Jung, Daniel; Tamrakar, Samyak; Kettemann, Stefan

    2016-09-01

    Sudden failure of a single transmission element in a power grid can induce a domino effect of cascading failures, which can lead to the isolation of a large number of consumers or even to the failure of the entire grid. Here we present results of the simulation of cascading failures in power grids, using an alternating current (AC) model. We first apply this model to a regular square grid topology. For a random placement of consumers and generators on the grid, the probability to find more than a certain number of unsupplied consumers decays as a power law and obeys a scaling law with respect to system size. Varying the transmitted power threshold above which a transmission line fails does not seem to change the power-law exponent q ≈1.6 . Furthermore, we study the influence of the placement of generators and consumers on the number of affected consumers and demonstrate that large clusters of generators and consumers are especially vulnerable to cascading failures. As a real-world topology, we consider the German high-voltage transmission grid. Applying the dynamic AC model and considering a random placement of consumers, we find that the probability to disconnect more than a certain number of consumers depends strongly on the threshold. For large thresholds the decay is clearly exponential, while for small ones the decay is slow, indicating a power-law decay.

  12. Renal neurohormonal regulation in heart failure decompensation.

    Science.gov (United States)

    Jönsson, Sofia; Agic, Mediha Becirovic; Narfström, Fredrik; Melville, Jacqueline M; Hultström, Michael

    2014-09-01

    Decompensation in heart failure occurs when the heart fails to balance venous return with cardiac output, leading to fluid congestion and contributing to mortality. Decompensated heart failure can cause acute kidney injury (AKI), which further increases mortality. Heart failure activates signaling systems that are deleterious to kidneys such as renal sympathetic nerve activity (RSNA), renin-angiotensin-aldosterone system, and vasopressin secretion. All three reduce renal blood flow (RBF) and increase tubular sodium reabsorption, which may increase renal oxygen consumption causing AKI through renal tissue hypoxia. Vasopressin contributes to venous congestion through aquaporin-mediated water retention. Additional water retention may be mediated through vasopressin-induced medullary urea transport and hyaluronan but needs further study. In addition, there are several systems that could protect the kidneys and reduce fluid retention such as natriuretic peptides, prostaglandins, and nitric oxide. However, the effect of natriuretic peptides and nitric oxide are blunted in decompensation, partly due to oxidative stress. This review considers how neurohormonal signaling in heart failure drives fluid retention by the kidneys and thus exacerbates decompensation. It further identifies areas where there is limited data, such as signaling systems 20-HETE, purines, endothelin, the role of renal water retention mechanisms for congestion, and renal hypoxia in AKI during heart failure.

  13. Unusual "ratchet syndrome": spontaneous lead retraction after a generator exchange.

    Science.gov (United States)

    Ejima, Koichiro; Shoda, Morio; Yashiro, Bun; Yoshida, Kentaro; Nuki, Toshiaki; Kato, Ken; Manaka, Tetsuyuki; Hagiwara, Nobuhisa

    2014-07-01

    A 72-year-old female with idiopathic dilated cardiomyopathy underwent a generator exchange for a cardiac resynchronization therapy defibrillator with a full-pocket capsulectomy. The lead position after the operation was identical to that before the operation on the chest X-ray. After 4 months, a subacute exacerbation of her heart failure was caused by cardiac resynchronization therapy failure due to a dislodgement of the left ventricular lead. An aggressive adhesiotomy of the connective tissue around the leads made it possible for the lead to retract by a ratchet-like movement through the suture sleeve, so-called "ratchet syndrome", after the generator exchange.

  14. Respiratory failure in elderly patients.

    Science.gov (United States)

    Sevransky, Jonathan E; Haponik, Edward F

    2003-02-01

    the physician focuses management on physiologic measurements, mechanical ventilator settings, and other technologic nuances of care [40]. Review of the literature suggests that the development of respiratory failure in patients with certain disease processes such as COPD, IPF, and ARDS in elderly patients may lead to worsened outcome but it appears that the disease process itself, rather than the age of the patient, is the major determinant of outcome. Additional studies suggest that other comorbid factors may be more important than age. Only when comorbid processes are taken into account should decisions be made about the efficacy of instituting mechanical ventilation. In addition, because outcome prediction appears to be more accurate for groups of patients rather than for individual patients a well-structured therapeutic trial of instituting mechanical ventilation, even if comorbidities are present, may be indicated in certain patients if appropriately informed patients wish to pursue this course. This approach requires careful and realistic definition of potential outcomes, focus on optimizing treatment of the reversible components of the illness, and continuous communication with the patient and family. Although many clinicians share a nihilistic view regarding the potential usefulness of mechanical ventilation in elderly patients few data warrant this negative prognostication and more outcome studies are needed to delineate the optimum application of this element of supportive care. As with other interventions individualization of the decision must take into account the patient's premorbid status, concomitant conditions, the nature of the precipitating illness and its prospects for improvement, and most important, patient preferences. In this determination pursuing the course most consistent with the patient's wishes is essential and it must be appreciated that caregivers' impressions regarding the vigor of support desired by the patient are often erroneous. The

  15. Long-term performance of epimyocardial pacing leads in adults: comparison with endocardial leads.

    Science.gov (United States)

    Helguera, M E; Maloney, J D; Woscoboinik, J R; Trohman, R G; McCarthy, P M; Morant, V A; Wilkoff, B L; Castle, L W; Pinski, S L

    1993-03-01

    The long-term performance of epimyocardial pacing leads in children is well established, but few studies have analyzed the performance in adults. This issue has clinical relevance in view of the increased use of epimyocardial leads with implantable cardioverter defibrillator and antitachycardia pacing systems. We analyzed 93 epimyocardial pacing "systems" (121 leads: 65 unipolar, 28 bipolar) in adult patients (age 57 +/- 16 years), implanted since January 1980. Two different models were studied: Medtronic 4951 "Stab-on" (n = 35) and Medtronic 6917/6917A "Screw-in" (n = 58). A control group was created by randomly matching each epimyocardial system with two endocardial leads, according to age and year of implant. Epimyocardial and endocardial leads were followed-up for 44 +/- 35 and 43 +/- 35 months, respectively (P = NS). Freedom from failure for epimyocardial leads was 0.91 (95% Confidence Interval [95% CI] = 0.82 to 0.96) at 5 years, and 0.91 (95% CI = 0.69 to 0.98) at 10 years. No difference was found between the two analyzed models. Freedom from failure for endocardial leads was 0.97 (95% CI = 0.93 to 0.99) and 0.90 (95% CI = 0.61 to 0.97) at 5 and 10 years, respectively. Epimyocardial leads had a significantly poorer short-term survival than endocardial leads, secondarily to earlier "technique related" failures (P = 0.03; relative risk 3.0; Wilcoxon test). However, overall long-term performance was similar to endocardial leads. Epimyocardial pacing leads, meticulously implanted and tested, have a long-term performance similar to endocardial pacing leads.

  16. Sexual dysfunction in chronic renal failure.

    Science.gov (United States)

    Soffer, O

    1980-12-01

    Sexual dysfunction in end-stage renal disease is a troublesome, multifactorial disorder. Abnormality of the hypothalamo-pituitary-gonadal axis is but one of the causes leading to the impotence and infertility commonly encountered in chronic renal failure. Short of kidney transplantation, no therapy is available. Though infertility is the rule in end-stage renal disease, successful fatherhood and deliveries have occurred on rare occasions.

  17. Cryogenic current leads

    Energy Technology Data Exchange (ETDEWEB)

    Zizek, F.

    1982-01-01

    Theoretical, technical and design questions are examined of cryogenic current leads for SP of magnetic systems. Simplified mathematical models are presented for the current leads. To illustrate modeling, the calculation is made of the real current leads for 500 A and three variants of current leads for 1500 A for the enterprise ''Shkoda.''

  18. Learn about Lead

    Science.gov (United States)

    ... old and younger are most susceptible to the effects of lead. Children Even low levels of lead in the blood ... simple blood test to check you or your child for lead exposure. You may also want to test your home for sources ... and Technology Lead Laws and Regulations Outreach and Grants En ...

  19. Time between failures model and failure analysis of CNC system

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hai-bo; JIA Ya-zhou; ZHOU Guang-wen

    2007-01-01

    To provide basis for the reliability improvement design of CNC system, the failure data of a type of CNC system in one year are collected under field conditions in workshops. The distribution model parameters of time between failures are estimated by least square method and hypothesis testing is done by d-test method. It is proved that the time between failures of the CNC system follows Weibull distribution and the system has entered into the wear-out failure period. The failure positions and failure causes are analyzed further to indicate the weak subsystems of the CNC system. It can be found that servo unit, electrical system, detecting unit and power supply are principal failure positions and the main failure cause is breakage of components. The corresponding improvement measures are put forward. The paper provides a reference to reliability design and analysis of CNC system for the manufacturer and has great guidance to using and maintaining CNC system for the user.

  20. Bazı arpa genotiplerinin Drechslera teres f. maculata(Smed.-Pet., 1971)'ya karşı fide dönemi reaksiyonlarının belirlenmesi

    OpenAIRE

    AKTAŞDOĞAN, Duygu; KARAKAYA, Aziz; ÇELİK OĞUZ, Arzu; MERT, Zafer; SAYİM, İsmail; ERGÜN, Namuk; AYDOĞAN, Sinan

    2013-01-01

    Üç arpa çeşidinin, 2 arpa çeşit adayının ve 20 ileri kademe arpa hattının Drechslera teres f. maculata (Smed.-Pet., 1971)'nın Sivas ve Eskişehir illerinden elde edilmiş iki izolatına karşı sera koşullarında fide dönemi reaksiyonları belirlenmiştir. Bülbül 89 çeşidi Sivas izolatına orta derecede hassas-hassas reaksiyon gösterirken Eskişehir izolatına orta derecede hassas reaksiyon göstermiştir. Avcı 2002 çeşidi her iki izolata da dayanıklı-orta derecede dayanıklı reaksiyon göstermiştir. Aydanh...

  1. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    Rajeshwari

    2015-11-01

    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

  2. Productive failure in learning math.

    Science.gov (United States)

    Kapur, Manu

    2014-06-01

    When learning a new math concept, should learners be first taught the concept and its associated procedures and then solve problems, or solve problems first even if it leads to failure and then be taught the concept and the procedures? Two randomized-controlled studies found that both methods lead to high levels of procedural knowledge. However, students who engaged in problem solving before being taught demonstrated significantly greater conceptual understanding and ability to transfer to novel problems than those who were taught first. The second study further showed that when given an opportunity to learn from the failed problem-solving attempts of their peers, students outperformed those who were taught first, but not those who engaged in problem solving first. Process findings showed that the number of student-generated solutions significantly predicted learning outcomes. These results challenge the conventional practice of direct instruction to teach new math concepts and procedures, and propose the possibility of learning from one's own failed problem-solving attempts or those of others before receiving instruction as alternatives for better math learning. © 2014 Cognitive Science Society, Inc.

  3. Extracorporeal Membrane Oxygenation as a Bridge for Heart Failure and Cardiogenic Shock

    OpenAIRE

    Zhao-peng Zhong; Hong Wang; Xiao-tong Hou

    2016-01-01

    Heart failure (HF) can be defined as cardiac structural or functional abnormality leading to a series of symptoms due to deficiency of oxygen delivery. In the clinical practice, acute heart failure (AHF) is usually performed as cardiogenic shock (CS), pulmonary edema, and single or double ventricle congestive heart failure. CS refers to depressed or insufficient cardiac output (CO) attributable to myocardial infarction, fulminant myocarditis, acute circulatory failure attributable to intracta...

  4. [Nutrition and liver failure].

    Science.gov (United States)

    Plauth, M

    2013-06-01

    In the critically ill liver patient, nutrition support is not very different from that given for other illnesses. In hyperacute liver failure, nutrition support is of less importance than in the other subtypes of acute liver failure that take a more protracted course. Nasoenteral tube feeding using a polymeric standard formula should be the first-line approach, while parenteral nutrition giving glucose, fat, amino acids, vitamins, and trace elements is initiated when enteral nutrition is insufficient or impracticable. In chronic liver disease, notably cirrhosis, there is frequently protein malnutrition indicating a poor prognosis and requiring immediate initiation of nutrition support. Enteral nutrition ensuring an adequate provision of energy and protein should be preferred. Particular care should be taken to avoid refeeding syndrome and to treat vitamin and trace element deficiency.

  5. Predicting Small Bank Failure

    OpenAIRE

    Heyliger, Wilton E.; Don P. Holdren

    1991-01-01

    There are many studies of bank performance and bank failure in the literature. Most of these studies used banking ratios as variables in their models without giving consideration to their appropriateness, nor was much consideration given to the stability of those ratios through time and across asset size. Many studies also failed to recognize that bank structure may differ by asset size. This study evaluates a large number of banking variables in order to identify stable ratios. These ratios ...

  6. LHC Magnet test failure

    CERN Multimedia

    2007-01-01

    "On Tueday, March 22, a Fermilab-built quadrupole magnet, one of an "inner triplet" of three focusing magnets, failed a high-pressure test at Point 5 in the tunnel of the LHC accelerator at CERN. Since Tuesday, teams at CERN and Fermilab have worked closely together to address the problem and have identified the cause of the failure. Now they are at work on a solution.:" (1 page)

  7. Peat slope failure in Ireland

    OpenAIRE

    Boylan, Noel; Jennings, Paul; Long, Michael

    2008-01-01

    Recent peat failures in Ireland in the autumn of 2003 at Pollatomish, County Mayo and Derrybrien, County Galway have focused attention on such events. However, peat failures are not a recent phenomenon with possible evidence of peat failures in Ireland having been identified as far back as the Early Bronze Age. This paper summarises the issues surrounding peat failures in Ireland that would be of interest to an engineer\\engineering geologist assessing this geohazard. The distri...

  8. CRITERIA FOR ROCK ENGINEERING FAILURE

    Institute of Scientific and Technical Information of China (English)

    ZHUDeren; ZHANGYuzhuo

    1995-01-01

    A great number of underground rock projects are maintained in the rock mass which is subject to rock damage and failure development. In many cases, the rock. engineering is still under normal working conditions even though rock is already fails to some extent. This paper introduces two different concepts: rock failure and rock engineering failure. Rock failure is defined as a mechanical state under which an applicable characteristic is changed or lost.However, the rock engineering failure is an engineering state under which an applicable function is changed or lost. The failure of surrounding rocks is the major reason of rock engineering failure. The criterion of rock engineering failure depends on the limit of applicable functions. The rock engineering failure state possesses a corresponding point in rock failure state. In this paper, a description of rock engineering failure criterion is given by simply using a mechanical equation or expression. It is expected that the study of rock engineering failure criterion will be an optimal approach that combines research of rock mechanics with rock engineering problems.

  9. Novel therapies in heart failure

    NARCIS (Netherlands)

    Liu, Licette Cécile Yang

    2016-01-01

    Heart failure is a clinical condition that is characterized by the inability of the heart to meet the oxygen requirements of peripheral tissues and organs, despite normal filling pressures. Despite recent developments in the treatment of heart failure, the prognosis of heart failure patients remains

  10. Novel therapies in heart failure

    NARCIS (Netherlands)

    Liu, Licette Cécile Yang

    2016-01-01

    Heart failure is a clinical condition that is characterized by the inability of the heart to meet the oxygen requirements of peripheral tissues and organs, despite normal filling pressures. Despite recent developments in the treatment of heart failure, the prognosis of heart failure patients remains

  11. Kidney failure related to broad-spectrum antibiotics in critically ill patients

    DEFF Research Database (Denmark)

    Jensen, Jens-Ulrik Stæhr; Hein, Lars; Lundgren, Bettina;

    2012-01-01

    To explore whether a strategy of more intensive antibiotic therapy leads to emergence or prolongation of renal failure in intensive care patients.......To explore whether a strategy of more intensive antibiotic therapy leads to emergence or prolongation of renal failure in intensive care patients....

  12. Lead and tap water

    Science.gov (United States)

    Water contaminated with lead ... The Environmental Protection Agency (EPA) monitors drinking water in the United States. It requires water suppliers to produce annual water quality reports. These reports include information about lead amounts, and they ...

  13. Lead and Your Baby

    Science.gov (United States)

    ... who works with lead, like in auto repair, construction or in a plant that makes paint, batteries, ... who works with lead, like in auto repair, construction or in a plant that makes paint, batteries, ...

  14. Exposures to lead.

    Science.gov (United States)

    Callan, Anna C; Hinwood, Andrea L

    2011-01-01

    The Pacific Basin Consortium for Environment and Health hosted a workshop on Exposures to Lead. Speakers from Australia and the United States of America addressed current research knowledge on lead exposures and health effects in children, risk assessment and communication issues in dealing with lead exposure sources, different methods for assessing exposure, and the variety of scenarios where lead still remains a pollutant of concern. Mining continues to be a source of lead for many communities, and approaches to reducing exposures in these settings present particular challenges. A Perth Declaration for the Global Reduction of Childhood Lead Exposure was signed by participants of the meeting and is aimed at increasing attention to the need to continue to assess lead in the environment and to develop strategies to reduce lead in the environment and exposure by communities.

  15. Rapid Lead Screening Test

    Science.gov (United States)

    ... Vitro Diagnostics Tests Used In Clinical Care Rapid Lead Screening Test Share Tweet Linkedin Pin it More ... reducing the need for a follow-up visit. Lead Risk Links Centers for Disease Control and Prevention ( ...

  16. Lead Poisoning (For Parents)

    Science.gov (United States)

    ... organs and tissues that need it, thus causing anemia. Most lead ends up in the bone, where it causes ... vomiting or nausea constipation pallor (pale skin) from ... look for lead poisoning or other health problems. Treatment Treatment for ...

  17. Leading the Wagon Train

    Science.gov (United States)

    Gimenez, Suzanne L.

    2012-01-01

    The author's journey as a strategic staffing principal in the Charlotte-Mecklenburg Schools has been one of ups and downs, scary turns and some great success for students. It began in May 2008 when she was asked to move to Devonshire Elementary School with marching orders to "turn the school around." Because of its failure to meet annual…

  18. Leading the Wagon Train

    Science.gov (United States)

    Gimenez, Suzanne L.

    2012-01-01

    The author's journey as a strategic staffing principal in the Charlotte-Mecklenburg Schools has been one of ups and downs, scary turns and some great success for students. It began in May 2008 when she was asked to move to Devonshire Elementary School with marching orders to "turn the school around." Because of its failure to meet annual…

  19. Routes to failure in rotating MEMS devices experiencing sliding friction

    Energy Technology Data Exchange (ETDEWEB)

    Miller, S.L.; LaVigne, G.; Rodgers, M.S.; Sniegowski, J.J.; Waters, J.P.; McWhorter, P.J.

    1997-08-01

    Gear systems rotating on hubs have been operated to failure using Sandia`s microengine as the actuation device. Conventional failure modes such as fatigue induced fracture did not occur, indicating that the devices are mechanically extremely robust. The generic route to failure observed for all rotating devices involves sticking of structures that are in sliding contact. This sticking evidently results from microscopic changes in the sliding surfaces during operation. The rate at which these changes occur is accelerated by excessive applied forces, which originate from non-optimized designs or inappropriate drive voltages. Precursors to failure are observed, enabling further understanding of the microscopic changes that occur in the sliding surfaces that ultimately lead to failure.

  20. Non-transplant surgical alternatives for heart failure

    Institute of Scientific and Technical Information of China (English)

    Robroy H. MacIver; Edwin C. McGee

    2006-01-01

    Although surgical options exist, treatment for heart failure remains dominated by medical therapy. Even with optimal medical therapy, the mortality of heart failure continues to be high. Conventional wisdom in heart failure treatment leads many practitioners to believe that the patient is "too sick" for further operative procedures such as revascularization, valve repair or replacement and ventricular reconstruction. Improvements in intra and peri-operative care over the last 20 years have allowed for more complex procedures to be performed, and have improved the mortality rates of the more traditional surgeries. As the complexity of the operative procedure and morbidity of the patient has elevated so has the importance of a multidisciplinary approach in choosing treatment plans for patients. As the age of the population increases and acute management of ischemic heart disease improves, the prevalence of heart failure will likely increase. Improving access and changing treatment algorithms to include operative procedures can improve the treatment of heart failure patients.

  1. Cascading failure analysis and restoration strategy in an interdependent network

    Science.gov (United States)

    Hong, Sheng; Lv, Chuan; Zhao, Tingdi; Wang, Baoqing; Wang, Jianghui; Zhu, Juxing

    2016-05-01

    In modern society, many infrastructures are interdependent owing to functional and logical relations among components in different systems. These networked infrastructures can be modeled as interdependent networks. In the real world, different networks carry different traffic loads whose values are dynamic and stem from the load redistribution in the same network and disturbance from the interdependent network. Interdependency makes interdependent networks so fragile that even a slight initial disturbance may lead to a cascading failure of the entire systems. In this paper, interdependencies among networks are modeled and a failure cascade process is studied considering their effects on failure propagation. Meanwhile, an in-process restoration strategy after the initial failure is investigated. The restoration effects depend strongly on the trigger timing, restoration probability and priority of the restoration actions along with the additional disturbances. Our findings highlight the necessity to decrease the large-scale cascading failure by structuring and managing an interdependent network reasonably.

  2. NA49: lead-lead collision

    CERN Multimedia

    1996-01-01

    This is an image of an actual lead ion collision taken from tracking detectors on the NA49 experiment, part of the heavy ion project at CERN. These collisions produce a very complicated array of hadrons as the heavy ions break up. It is hoped that one of these collisions will eventually create a new state of matter known as quark-gluon plasma.

  3. Occupational lead poisoning

    OpenAIRE

    Ramírez, Augusto V; Médico del Trabajo. American College of Occupational and Environmental Medicine.

    2013-01-01

    Lead, a ubiquitous heavy metal, has been found in places as unlikely as Greenland’s fossil ice. Egyptians and Hebrews used it. In Spain, Phoenicians c. 2000 BC worked ores of lead. At the end of the XX century, occupational lead’s poisoning became a public health problem in developed countries. In non-developed countries occupational lead poisoning is still frequent. Diagnosis is directed to recognize lead existence at the labor environment and good clinical and occupational documentation. Di...

  4. Coronary Sinus Lead Removal: A Comparison between Active and Passive Fixation Leads.

    Directory of Open Access Journals (Sweden)

    Simon Pecha

    Full Text Available Implantation of coronary sinus (CS leads may be a difficult procedure due to different vein anatomies and a possible lead dislodgement. The mode of CS lead fixation has changed and developed in recent years.We compared the removal procedures of active and passive fixation leads.Between January 2009 and January 2014, 22 patients at our centre underwent CS lead removal, 6 active and 16 passive fixation leads were attempted using simple traction or lead locking devices with or without laser extraction sheaths. Data on procedural variables and success rates were collected and retrospectively analyzed.The mean patient age was 67.2 ± 9.8 years, and 90.9% were male. The indication for lead removal was infection in all cases. All active fixation leads were Medtronic® Attain StarFix™ Model 4195 (Medtronic Inc., Minneapolis, MN, USA. The mean time from implantation for the active and passive fixation leads was 9.9 ± 11.7 months (range 1.0-30.1 and 48.7 ± 33.6 months (range 5.7-106.4, respectively (p = 0.012. Only 3 of 6 StarFix leads were successfully removed (50% compared to 16 of 16 (100% of the passive fixation CS leads (p = 0.013. No death or complications occurred during the 30-day follow-up.According to our experience, removal of the Starfix active fixation CS leads had a higher procedural failure rate compared to passive.

  5. Lead Poisoning in Children.

    Science.gov (United States)

    Drummond, A. H., Jr.

    1981-01-01

    Early symptoms of lead poisoning in children are often overlooked. Lead poisoning has its greatest effects on the brain and nervous system. The obvious long-term solution to the lead poisoning problem is removal of harmful forms of the metal from the environment. (JN)

  6. Atrioventricular Pacemaker Lead Reversal

    Directory of Open Access Journals (Sweden)

    Mehmet K Aktas, MD

    2007-01-01

    Full Text Available During cardiac surgery temporary epicardial atrial and ventricular leads are placed in case cardiac pacing is required postoperatively. We present the first reported series of patients with reversal of atrioventricular electrodes in the temporary pacemaker without any consequent deleterious hemodynamic effect. We review the electrocardiographic findings and discuss the findings that lead to the discovery of atrioventricular lead reversal.

  7. Animation of boom failure processes

    Energy Technology Data Exchange (ETDEWEB)

    An, C. F.; Brown, H. M.; Goodman, R. H. [Imperial Oil Resources, Calgary, AB (Canada); Clavelle, E. J. [Calgary Univ., AB (Canada)

    1997-10-01

    Computer animations of oil boom failure mechanisms were discussed. The animations are useful in demonstrating the transient processes of boom failure. They consist of a series of images obtained from the graphical output of a computational fluid dynamics program, FLUENT, while the modeling is based on boom failure experiments carried out in flowing water channels. The animations can be viewed on a PC running under Windows `95. Three types of failures are presented, i. e. drainage failure, droplet entrainment and critical accumulation. 11 refs., 3 figs.

  8. Acute renal failure in patients with tumour lysis sindrome

    OpenAIRE

    Poskurica Mileta; Petrović Dejan; Poskurica Mina

    2016-01-01

    Hematologic malignancies (leukemia, lymphoma, multiple myeloma, et al.), as well as solid tumours (renal, liver, lung, ovarian, etc.), can lead to acute or chronic renal failure. The most common clinical manifestation is acute renal failure within the tumour lysis syndrome (TLS). It is characterized by specific laboratory and clinical criteria in order to prove that kidney disorders result from cytolysis of tumour cells after chemotherapy regimen given, alt...

  9. Latent-failure risk estimates for computer control

    Science.gov (United States)

    Dunn, William R.; Folsom, Rolfe A.; Green, Owen R.

    1991-01-01

    It is shown that critical computer controls employing unmonitored safety circuits are unsafe. Analysis supporting this result leads to two additional, important conclusions: (1) annual maintenance checks of safety circuit function do not, as widely believed, eliminate latent failure risk; (2) safety risk remains even if multiple, series-connected protection circuits are employed. Finally, it is shown analytically that latent failure risk is eliminated when continuous monitoring is employed.

  10. Comprehensive Approach to Heart Failure: an Urgent Need

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2015-11-01

    Full Text Available Heart failure leads to the activation of a neurohormonal response that interacts with the hemodynamic changes, which are joined by functional and structural myocardial abnormalities, that may exist. This paper addresses the role of the renin-angiotensin system in the pathophysiology of heart failure and the use of non-invasive complementary methods that provide additional information necessary for the assessment and comprehensive management of patients, without losing the essential connection between the doctor and the patient.

  11. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

  12. Proactive restoration of slow-failures in optical networks

    DEFF Research Database (Denmark)

    Siracusa, Domenico; Pederzolli, Federico; Salvadori, Elio;

    2014-01-01

    , which leads to traffic losses while such operation completes. In this paper we propose a technique, applicable to optical networks with centralized control, to better handle failures with slow transients. The idea is to proactively perform the backup lightpath's setup, triggered by either a fixed......Current optical networks, while offering outstanding reliability, still suffer from occasional failures. A resource-efficient procedure to handle these failures in un-protected scenarios is to perform restoration, i.e., to dynamically setup a backup lightpath after the primary one stops working...

  13. Intercellular communication lessons in heart failure.

    Science.gov (United States)

    Bang, Claudia; Antoniades, Charalambos; Antonopoulos, Alexios S; Eriksson, Ulf; Franssen, Constantijn; Hamdani, Nazha; Lehmann, Lorenz; Moessinger, Christine; Mongillo, Marco; Muhl, Lars; Speer, Thimoteus; Thum, Thomas

    2015-11-01

    Cell-cell or inter-organ communication allows the exchange of information and messages, which is essential for the coordination of cell/organ functions and the maintenance of homeostasis. It has become evident that dynamic interactions of different cell types play a major role in the heart, in particular during the progression of heart failure, a leading cause of mortality worldwide. Heart failure is associated with compensatory structural and functional changes mostly in cardiomyocytes and cardiac fibroblasts, which finally lead to cardiomyocyte hypertrophy and fibrosis. Intercellular communication within the heart is mediated mostly via direct cell-cell interaction or the release of paracrine signalling mediators such as cytokines and chemokines. However, recent studies have focused on the exchange of genetic information via the packaging into vesicles as well as the crosstalk of lipids and other paracrine molecules within the heart and distant organs, such as kidney and adipose tissue, which might all contribute to the pathogenesis of heart failure. In this review, we discuss emerging communication networks and respective underlying mechanisms which could be involved in cardiovascular disease conditions and further emphasize promising therapeutic targets for drug development.

  14. [Acute renal failure in neuroleptic malignant syndrome].

    Science.gov (United States)

    Wagner, G; Rónai, L

    1995-10-01

    The neuroleptic malignant syndrome is characterized by hyperpyrexia, muscle rigidity, extrapyramidal motion disorder, vegetative symptoms and mental disorientation. This group of symptoms develops abruptly and may lead to serious complications. One of these complications is the acute renal failure. Permanent muscle rigidity causes the damage of muscle cells which result in myoglobinaemia, myoglobinuria and elevations in muscle related creatine phosphokinase. The authors report the case of a young man who underwent neuroleptic medication because of hebephrenia. During the medication the following symptoms were developed: extrapyramidal symptoms, restlessness, muscle rigidity, high fever. These symptoms eventually lead to acute renal failure caused by rhabdomyolysis (characteristic urine finding, significant elevations in serum creatine phosphokinase). With regards to the neuroleptic malignant syndrome dantrolenum and bromocriptin treatment were applied with the discontinuation of neuroleptic medication. As a part of the complex therapy a massive volumen-supplementing and alkalizing treatment was used but haemodialysis had also become necessary. During the above mentioned treatment symptoms referring to the neuroleptic malignant syndrome resolved and the acute renal failure was cured. The case report calls attention to a specific group of symptoms and the possibilities for prevention and treatment. The above case report is the first observation in Hungary.

  15. Long-term performance of the St Jude Riata 1580-1582 ICD lead family

    NARCIS (Netherlands)

    S.D.A. Valk (Suzanne); D.A.M.J. Theuns (Dominic); L.J.L.M. Jordaens (Luc)

    2013-01-01

    textabstractObjective Safety concerns about the Riata ICD shock lead were recently raised, with insulation failure due to conductor externalisation. Its incidence and presentation were assessed, and predictors of insulation failure and lead survival of the Riata 1580-1582 were studied, retrospective

  16. ALICE: Simulated lead-lead collision

    CERN Multimedia

    2003-01-01

    This track is an example of simulated data modelled for the ALICE detector on the Large Hadron Collider (LHC) at CERN, which will begin taking data in 2008. ALICE will focus on the study of collisions between nuclei of lead, a heavy element that produces many different particles when collided. It is hoped that these collisions will produce a new state of matter known as the quark-gluon plasma, which existed billionths of a second after the Big Bang.

  17. Scaling of structural failure

    Energy Technology Data Exchange (ETDEWEB)

    Bazant, Z.P. [Northwestern Univ., Evanston, IL (United States); Chen, Er-Ping [Sandia National Lab., Albuquerque, NM (United States)

    1997-01-01

    This article attempts to review the progress achieved in the understanding of scaling and size effect in the failure of structures. Particular emphasis is placed on quasibrittle materials for which the size effect is complicated. Attention is focused on three main types of size effects, namely the statistical size effect due to randomness of strength, the energy release size effect, and the possible size effect due to fractality of fracture or microcracks. Definitive conclusions on the applicability of these theories are drawn. Subsequently, the article discusses the application of the known size effect law for the measurement of material fracture properties, and the modeling of the size effect by the cohesive crack model, nonlocal finite element models and discrete element models. Extensions to compression failure and to the rate-dependent material behavior are also outlined. The damage constitutive law needed for describing a microcracked material in the fracture process zone is discussed. Various applications to quasibrittle materials, including concrete, sea ice, fiber composites, rocks and ceramics are presented.

  18. Heart Failure Readmission Reduction.

    Science.gov (United States)

    Drozda, Joseph P; Smith, Donna A; Freiman, Paul C; Pursley, Janet; VanSlette, Jeffrey A; Smith, Timothy R

    Little is known regarding effectiveness of readmission reduction programs over time. The Heart Failure Management Program (HFMP) of St. John's Physician Group Practice (PGP) Demonstration provided an opportunity to assess outcomes over an extended period. Data from an electronic health record, an inpatient database, a disease registry, and the Social Security Death Master File were analyzed for patients admitted with heart failure (HF) for 5 years before (Period 1) and 5 years after (Period 2) inception of PGP. HF admissions decreased (Period 1, 58.3/month; Period 2, 52.4/month, P = .007). Thirty-day all-cause readmission rate dropped from Period 1 (annual average 18.8% [668/3545]) to year 1 of Period 2 (16.9% [136/804], P = .04) and remained stable thereafter (annual average 16.8% [589/3503]). Thirty-day mortality rate was flat throughout. HFMP was associated with decreased readmissions, primarily related to outpatient case management, while mortality remained stable.

  19. Insomnia Self-Management in Heart Failure

    Science.gov (United States)

    2016-12-07

    Cardiac Failure; Heart Failure; Congestive Heart Failure; Heart Failure, Congestive; Sleep Initiation and Maintenance Disorders; Chronic Insomnia; Disorders of Initiating and Maintaining Sleep; Fatigue; Pain; Depressive Symptoms; Sleep Disorders; Anxiety

  20. Deteriorated function of cutaneous microcirculation in chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Marie-Louise Edvinsson; Erik Uddman; Sven E Andersson

    2011-01-01

    Background Chronic congestive heart failure is a complex condition that leads to dysfunction in the peripheral microcirculation. We have previously shown that vascular reactivity is reduced with increasing age.In this study,we examined a group of very old patients with severe chronic heart failure to test the hypothesis that vascular function is further compromised by a combination of heart failure and aging.Methods Cutaneous forearm blood flow was measured by laser Doppler flownretry and compared among three groups:Group 1 (n=20,men±SE:85.54 years),heart failure patients with New York Heart Association class Ⅳ(NYHA IV) and with a NT-proBNP level =10,mean±SE:67.6 ± 3.0 years),healthy controls with no clinical signs of heart failure.The vasodilator response to the iontophoretic administration of acetylcholine (ACh),acting via an endothelial mechanism,and sodium nitroprusside (SNP),acting via a smooth muscle cell mechanism,were studied. Results All patients with heart failure had significantly reduced vascular reactivity independent of the mode of stimulation (ACh,SNP or heat) when compared to healthy controls.However,the responses did not differ between the two groups of heart failure patients.Conclusions Cutaneous vascular reactivity is reduced in heart failure patients and does not correlate with the severity of the condition or age of patients.

  1. Identification of systems failures in successful paediatric cardiac surgery.

    Science.gov (United States)

    Catchpole, K R; Giddings, A E B; de Leval, M R; Peek, G J; Godden, P J; Utley, M; Gallivan, S; Hirst, G; Dale, T

    Patient safety will benefit from an approach to human error that examines systemic causes, rather than blames individuals. This study describes a direct observation methodology, based on a threat and error model, prospectively to identify types and sources of systems failures in paediatric cardiac surgery. Of substantive interest were the range, frequency and types of failures that could be identified and whether minor failures could accumulate to form more serious events, as has been the case in other industries. Check lists, notes and video recordings were employed to observe 24 successful operations. A total of 366 failures were recorded. Coordination and communication problems, equipment problems, a relaxed safety culture, patient-related problems and perfusion-related problems were most frequent, with a smaller number of skill, knowledge and decision-making failures. Longer and more risky operations were likely to generate a greater number of minor failures than shorter and lower risk operations, and in seven higher-risk cases frequently occurring minor failures accumulated to threaten the safety of the patient. Non-technical errors were more prevalent than technical errors and task threats were the most prevalent systemic source of error. Adverse events in surgery are likely to be associated with a number of recurring and prospectively identifiable errors. These may be co-incident and cumulative human errors predisposed by threats embedded in the system, rather than due to individual incompetence or negligence. Prospectively identifying and reducing these recurrent failures would lead to improved surgical standards and enhanced patient safety.

  2. Cascading Edge Failures: A Dynamic Network Process

    CERN Document Server

    Zhang, June

    2016-01-01

    This paper considers the dynamics of edges in a network. The Dynamic Bond Percolation (DBP) process models, through stochastic local rules, the dependence of an edge $(a,b)$ in a network on the states of its neighboring edges. Unlike previous models, DBP does not assume statistical independence between different edges. In applications, this means for example that failures of transmission lines in a power grid are not statistically independent, or alternatively, relationships between individuals (dyads) can lead to changes in other dyads in a social network. We consider the time evolution of the probability distribution of the network state, the collective states of all the edges (bonds), and show that it converges to a stationary distribution. We use this distribution to study the emergence of global behaviors like consensus (i.e., catastrophic failure or full recovery of the entire grid) or coexistence (i.e., some failed and some operating substructures in the grid). In particular, we show that, depending on...

  3. Lead-Free Piezoelectrics

    CERN Document Server

    Nahm, Sahn

    2012-01-01

    Ecological restrictions in many parts of the world are demanding the elimination of Pb from all consumer items. At this moment in the piezoelectric ceramics industry, there is no issue of more importance than the transition to lead-free materials. The goal of Lead-Free Piezoelectrics is to provide a comprehensive overview of the fundamentals and developments in the field of lead-free materials and products to leading researchers in the world. The text presents chapters on demonstrated applications of the lead-free materials, which will allow readers to conceptualize the present possibilities and will be useful for both students and professionals conducting research on ferroelectrics, piezoelectrics, smart materials, lead-free materials, and a variety of applications including sensors, actuators, ultrasonic transducers and energy harvesters.

  4. Chronic heart failure and micronutrients.

    Science.gov (United States)

    Witte, K K; Clark, A L; Cleland, J G

    2001-06-01

    Heart failure (HF) is associated with weight loss, and cachexia is a well-recognized complication. Patients have an increased risk of osteoporosis and lose muscle bulk early in the course of the disease. Basal metabolic rate is increased in HF, but general malnutrition may play a part in the development of cachexia, particularly in an elderly population. There is evidence for a possible role for micronutrient deficiency in HF. Selective deficiency of selenium, calcium and thiamine can directly lead to the HF syndrome. Other nutrients, particularly vitamins C and E and beta-carotene, are antioxidants and may have a protective effect on the vasculature. Vitamins B6, B12 and folate all tend to reduce levels of homocysteine, which is associated with increased oxidative stress. Carnitine, co-enzyme Q10 and creatine supplementation have resulted in improved exercise capacity in patients with HF in some studies. In this article, we review the relation between micronutrients and HF. Chronic HF is characterized by high mortality and morbidity, and research effort has centered on pharmacological management, with the successful introduction of angiotensin-converting enzyme inhibitors and beta-adrenergic antagonists into routine practice. There is sufficient evidence to support a large-scale trial of dietary micronutrient supplementation in HF.

  5. Heart failure in the elderly

    Institute of Scientific and Technical Information of China (English)

    Elizabete Viana de Freitas; Michel Batlouni; Roberto Gamarsky

    2012-01-01

    The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure (HF) is a condition in which the heart can not pump enough blood to meet the body's needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady.

  6. Heart Failure in Older Adults.

    Science.gov (United States)

    Butrous, Hoda; Hummel, Scott L

    2016-09-01

    Heart failure (HF) is a leading cause of morbidity, hospitalization, and mortality in older adults and a growing public health problem placing a huge financial burden on the health care system. Many challenges exist in the assessment and management of HF in geriatric patients, who often have coexisting multimorbidity, polypharmacy, cognitive impairment, and frailty. These complex "geriatric domains" greatly affect physical and functional status as well as long-term clinical outcomes. Geriatric patients have been under-represented in major HF clinical trials. Nonetheless, available data suggest that guideline-based medical and device therapies improve morbidity and mortality. Nonpharmacologic strategies, such as exercise training and dietary interventions, are an active area of research. Targeted geriatric evaluation, including functional and cognitive assessment, can improve risk stratification and guide management in older patients with HF. Clinical trials that enroll older patients with multiple morbidities and HF and evaluate functional status and quality of life in addition to mortality and cardiovascular morbidity should be encouraged to guide management of this age group.

  7. Cognitive Impairment in Heart Failure

    Directory of Open Access Journals (Sweden)

    Efthimios Dardiotis

    2012-01-01

    Full Text Available Cognitive impairment (CI is increasingly recognized as a common adverse consequence of heart failure (HF. Although the exact mechanisms remain unclear, microembolism, chronic or intermittent cerebral hypoperfusion, and/or impaired cerebral vessel reactivity that lead to cerebral hypoxia and ischemic brain damage seem to underlie the development of CI in HF. Cognitive decline in HF is characterized by deficits in one or more cognition domains, including attention, memory, executive function, and psychomotor speed. These deficits may affect patients’ decision-making capacity and interfere with their ability to comply with treatment requirements, recognize and self-manage disease worsening symptoms. CI may have fluctuations in severity over time, improve with effective HF treatment or progress to dementia. CI is independently associated with disability, mortality, and decreased quality of life of HF patients. It is essential therefore for health professionals in their routine evaluations of HF patients to become familiar with assessment of cognitive performance using standardized screening instruments. Future studies should focus on elucidating the mechanisms that underlie CI in HF and establishing preventive strategies and treatment approaches.

  8. Lead Poison Detection

    Science.gov (United States)

    1976-01-01

    With NASA contracts, Whittaker Corporations Space Science division has developed an electro-optical instrument to mass screen for lead poisoning. Device is portable and detects protoporphyrin in whole blood. Free corpuscular porphyrins occur as an early effect of lead ingestion. Also detects lead in urine used to confirm blood tests. Test is inexpensive and can be applied by relatively unskilled personnel. Similar Whittaker fluorometry device called "drug screen" can measure morphine and quinine in urine much faster and cheaper than other methods.

  9. New product failure

    DEFF Research Database (Denmark)

    Dijksterhuis, Garmt Bernard

    2016-01-01

    When new consumer products are developed and later launched, 50 to 75 percent of them are removed from the market far short of meeting their projected financial targets. In short: they fail. We conclude that this failure is due to institutionalized insufficiencies in the use of the sciences...... these factors: (1) 'pillars' (too many different functions addressing different aspects of the consumers and of product development), (2) 'higher management focus' (not geared towards understanding consumer behaviour), (3) 'popular science books' (out-dated research directives resulting from a hierarchical...... that are best geared to understand and predict consumer behaviour, viz. the behavioural sciences. These are not necessarily the same as the marketing science that is performed by marketing departments. A scientific approach to understanding consumer behaviour appears to be lacking in many corporate research...

  10. Premature ovarian failure.

    Science.gov (United States)

    Shelling, Andrew N

    2010-11-01

    Premature ovarian failure (POF) is a common cause of infertility in women, and is characterised by amenorrhoea, hypo-oestrogenism and elevated gonadotrophin levels in women under the age of 40. Known causes include iatrogenic agents that cause permanent damage to the ovaries, such as chemotherapy, radiation therapy and surgery, autoimmune conditions, X-chromosome abnormalities and autosomal genetic conditions. However, few genes have been identified that can explain a substantial proportion of cases of POF. Most women with POF are deeply upset by the diagnosis, partly due to the unexpected menopausal symptoms, but also due to infertility. Therefore, early detection would provide better opportunity for early intervention, and furthermore, the identification of specific gene defects will help to direct potential targets for future treatment.

  11. Iridium: failures & successes

    Science.gov (United States)

    Christensen, CarissaBryce; Beard, Suzette

    2001-03-01

    This paper will provide an overview of the Iridium business venture in terms of the challenges faced, the successes achieved, and the causes of the ultimate failure of the venture — bankruptcy and system de-orbit. The paper will address technical, business, and policy issues. The intent of the paper is to provide a balanced and accurate overview of the Iridium experience, to aid future decision-making by policy makers, the business community, and technical experts. Key topics will include the history of the program, the objectives and decision-making of Motorola, the market research and analysis conducted, partnering strategies and their impact, consumer equipment availability, and technical issues — target performance, performance achieved, technical accomplishments, and expected and unexpected technical challenges. The paper will use as sources trade media and business articles on the Iridium program, technical papers and conference presentations, Wall Street analyst's reports, and, where possible, interviews with participants and close observers.

  12. Premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Vujović Svetlana

    2012-01-01

    Full Text Available Premature ovarian failure (POF is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc. The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone, karyotype (<30 years of age, ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

  13. STUDY OF RENAL FAILURE IN MALARIA

    Directory of Open Access Journals (Sweden)

    Girish Pamappa

    2016-01-01

    Full Text Available Renal failure is a serious complication of malaria, with a mortality of 14 to 33%. In view of the significant morbidity and mortality due to acute renal failure in malaria, there is need to identify patients at an early stage and to intensify care given to reduce morbidity and mortality. AIMS  To evaluate the clinical profile of Acute Renal Failure (ARF in malaria.  To evaluate the factors associated with adverse outcome, relation of severity of renal impairment on final outcome in patients with ARF due to malaria. MATERIAL AND METHODS This study was conducted at a tertiary care hospital over a period of 12 months. STUDY DESIGN  Type of study: Prospective Analytical, Observational Study.  Sample Size: 50 patients admitted to ICU, Kidney Unit, and the Medicine Wards with Malaria and ARF. Inclusion Criteria Clinically screened patients with evidence of malarial parasites in the blood smears or by antigen detection with clinical features or biochemical evidence of acute renal failure. Exclusion Criteria  Presence of any disease or condition leading to ARF or affecting the outcome of malarial ARF.  Other causes of Fever, Jaundice and Oliguria, like Leptospirosis, Dengue. METHODOLOGY Fifty patients who fulfilled the inclusion criteria were interrogated with regards to the complaints, clinical signs. Blood tests were sent on admission. Details were recorded as per the clinical proforma. The patients were followed until their discharge/death. RESULTS Oliguria was present in only 30% of patients. 30% of patients received haemodialysis. The mortality was 12% for severe renal failure. On Univariate analysis, Acidosis and Cerebral malaria were highly significant predictors of mortality. Other significant predictors were Renal failure, Oliguria, Shock, DIC, Hyperparasitemia, Leukocytosis (TLC. On Multivariate analysis, Oliguria, Cerebral malaria, Acidosis, Shock and two or more complications were the independent predictors of mortality

  14. A Failure Criterion for Concrete

    DEFF Research Database (Denmark)

    Ottosen, N. S.

    1977-01-01

    A four-parameter failure criterion containing all the three stress invariants explicitly is proposed for short-time loading of concrete. It corresponds to a smooth convex failure surface with curved meridians, which open in the negative direction of the hydrostatic axis, and the trace in the devi......A four-parameter failure criterion containing all the three stress invariants explicitly is proposed for short-time loading of concrete. It corresponds to a smooth convex failure surface with curved meridians, which open in the negative direction of the hydrostatic axis, and the trace...

  15. A Failure Criterion for Concrete

    DEFF Research Database (Denmark)

    Ottosen, N. S.

    1977-01-01

    A four-parameter failure criterion containing all the three stress invariants explicitly is proposed for short-time loading of concrete. It corresponds to a smooth convex failure surface with curved meridians, which open in the negative direction of the hydrostatic axis, and the trace in the devi......A four-parameter failure criterion containing all the three stress invariants explicitly is proposed for short-time loading of concrete. It corresponds to a smooth convex failure surface with curved meridians, which open in the negative direction of the hydrostatic axis, and the trace...

  16. Strategies of learning from failure.

    Science.gov (United States)

    Edmondson, Amy C

    2011-04-01

    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.

  17. Failure Mode/Mechanism Distributions

    Science.gov (United States)

    1991-09-01

    nsc. Modas /Mach Dist. Dist. Suurce(,%)/Detai19 Bolt, MahineSources :1 Brcikon 𔃺.1% 59.0% Broken Bolt(s) (25j01-(000,Qty:l) C25101-000,Qty:Ij., Part...Center (RAC) * 201 Mill St., Rome, NY 13440 * 315-337-0900 3-114 Failure Distribution Summaries FMD-91 ? art Failure Norm Fail Data Docm. Mode/Moch Dist... Deco . Mode/Mech Dist. Dist. Source(s)/Details Lamp,Bulb Sourcent 4 Lamp Failure 68.8% 53.8% Light Bulb Failure (23038-00l,Qty:3) (23038-004,Qty:l

  18. Lead free solder mechanics and reliability

    CERN Document Server

    Pang, John Hock Lye

    2012-01-01

    Lead-free solders are used extensively as interconnection materials in electronic assemblies and play a critical role in the global semiconductor packaging and electronics manufacturing industry. Electronic products such as smart phones, notebooks and high performance computers rely on lead-free solder joints to connect IC chip components to printed circuit boards. Lead Free Solder: Mechanics and Reliability provides in-depth design knowledge on lead-free solder elastic-plastic-creep and strain-rate dependent deformation behavior and its application in failure assessment of solder joint reliability. It includes coverage of advanced mechanics of materials theory and experiments, mechanical properties of solder and solder joint specimens, constitutive models for solder deformation behavior; numerical modeling and simulation of solder joint failure subject to thermal cycling, mechanical bending fatigue, vibration fatigue and board-level drop impact tests. This book also: Discusses the mechanical prope...

  19. Lead toxicity: Current concerns

    Energy Technology Data Exchange (ETDEWEB)

    Goyer, R.A. (Univ. of Western Ontario, London (Canada))

    1993-04-01

    Over the 20-year period since the first issue of Environmental Health Perspectives was published, there has been considerable progress in the understanding of the potential toxicity of exposure to lead. Many of these advances have been reviewed in published symposia, conferences, and review papers in EHP. This brief review identifies major advances as well as a number of current concerns that present opportunities for prevention and intervention strategies. The major scientific advance has been the demonstration that blood lead (PbB) levels of 10-15 micrograms/dL in newborn and very young infants result in cognitive and behavioral deficits. Further support for this observation is being obtained by prospective or longitudinal studies presently in progress. The mechanism(s) for the central nervous system effects of lead is unclear but involve lead interactions within calcium-mediated intracellular messenger systems and neurotransmission. Effects of low-level lead exposure on blood pressure, particularly in adult men, may be related to the effect of lead on calcium-mediated control of vascular smooth muscle contraction and on the renin-angiotensin system. Reproductive effects of lead have long been suspected, but low-level effects have not been well studied. Whether lead is a carcinogen or its association with renal adenocarcinoma is a consequence of cystic nephropathy is uncertain. Major risk factors for lead toxicity in children in the United States include nutrition, particularly deficiencies of essential metals, calcium, iron, and zinc, and housing and socioeconomic status. A goal for the year 2000 is to reduce prevalence of blood lead levels exceeding 15 micrograms/dL. 97 refs.

  20. Public Choice, Market Failure, and Government Failure in Principles Textbooks

    Science.gov (United States)

    Fike, Rosemarie; Gwartney, James

    2015-01-01

    Public choice uses the tools of economics to analyze how the political process allocates resources and impacts economic activity. In this study, the authors examine twenty-three principles texts regarding coverage of public choice, market failure, and government failure. Approximately half the texts provide coverage of public choice and recognize…

  1. Public Choice, Market Failure, and Government Failure in Principles Textbooks

    Science.gov (United States)

    Fike, Rosemarie; Gwartney, James

    2015-01-01

    Public choice uses the tools of economics to analyze how the political process allocates resources and impacts economic activity. In this study, the authors examine twenty-three principles texts regarding coverage of public choice, market failure, and government failure. Approximately half the texts provide coverage of public choice and recognize…

  2. Mechanical Reliability of Aged Lead-­Free Solders

    OpenAIRE

    Lewin, Susanne

    2012-01-01

    The usage of lead-­free solder joints in electronic packaging is of greatest concern to the electronic industry due to the health and environmental hazards arising with the use of lead. As a consequence, lead is legally prohibited in the European Union and the industry is aiming to produce lead-free products.            The reliability of solder joints is an important issue as the failure could destroy the whole function of a product. SnAgCu is a commonly used alloy for lead-­free solders. Co...

  3. Increased in vivo mitochondrial oxygenation with right ventricular failure induced by pulmonary arterial hypertension: Mitochondrial inhibition as driver of cardiac failure?

    NARCIS (Netherlands)

    G.M. Balestra (Gianmarco); E.G. Mik (Egbert); O. Eerbeek (Otto); P. Specht (Patricia); W.J. van der Laarse (Willem J.); C.J. Zuurbier (Coert J.)

    2015-01-01

    textabstractBackground: The leading cause of mortality due to pulmonary arterial hypertension (PAH) is failure of the cardiac right ventricle. It has long been hypothesized that during the development of chronic cardiac failure the heart becomes energy deprived, possibly due to shortage of oxygen at

  4. A Utopian Failure

    Institute of Scientific and Technical Information of China (English)

    LILI

    2011-01-01

    In 1959,the late Beijing-bom writer Shi Tiesheng,then a primary school second grader,was enthralled by his teacher's descriptions of the idyllic life residents in a nine-story building under construction near his school would lead.

  5. Instrumented failure of hillslope models with soil-pipes

    Science.gov (United States)

    Sharma, Raj H.; Konietzky, Heinz

    2011-07-01

    Soil-pipes (porous pipes inside a hillslope) are often detected in collapsed slopes indicating their influence on slope failure processes. Only limited studies can be found regarding the impacts of soil-pipes on landslide mechanisms. Hillslope models prepared in a flume are experimented with different soil-pipe configurations: a) no pipe, b) closed pipe and c) open pipe. Pore-water pressures were measured at six different locations along a slope. Discharges at the outlet of soil-pipe and groundwater seepage were also recorded. For the above mentioned pipe configurations two types of experiments were conducted: a) rainfall-induced failure and b) seepage-induced failure. Experimental results show that a closed pipe accumulates water around its lower end and continuously increases pore-water pressure till a failure. An open pipe works as a means of hillslope drainage and reduces the pore-water pressure of an entire slope. However, if open pipe is blocked, pore-water pressure close to its lower end rises rapidly, leading to immediate soil mass movement. For both seepage and rainfall-induced failure experiments, the maximum pressure before the failure was larger at a slope with an open pipe (once it is closed) than a slope with a pipe closed from the beginning or that without a soil-pipe. This indicates that the blockage of soil-pipes makes a slope more susceptible to failure. Displacement vectors show that soil movement velocity close to the surface was highest at slopes with open pipes after closure and lowest at slopes without pipes because of a higher degree of saturation and pore-water pressure at the time of failure of the former. Before a large failure, small fluctuations in pore-water pressure were also observed which can be an indicator of impending failure.

  6. Cardiac Resynchronization Therapy for Heart Failure.

    Science.gov (United States)

    Ojo, Amole; Tariq, Sohaib; Harikrishnan, Prakash; Iwai, Sei; Jacobson, Jason T

    2017-07-01

    Cardiac resynchronization therapy (CRT) has emerged as a valued nonpharmacologic therapy in patients with heart failure, reduced ejection fraction (EF), and ventricular dyssynchrony manifest as left bundle branch block. The mechanisms of benefit include remodeling of the left ventricle leading to decreased dimensions and increased EF, as well as a decrease in the severity of mitral regurgitation. This article reviews the rationale, effects, and indications for CRT, and discusses the patient characteristics that predict response and considerations for nonresponders. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Obesity paradox, cachexia, frailty, and heart failure.

    Science.gov (United States)

    Lavie, Carl J; De Schutter, Alban; Alpert, Martin A; Mehra, Mandeep R; Milani, Richard V; Ventura, Hector O

    2014-04-01

    Overweight and obesity adversely affect cardiovascular (CV) risk factors and CV structure and function, and lead to a marked increase in the risk of developing heart failure (HF). Despite this, an obesity paradox exists, wherein those who are overweight and obese with HF have a better prognosis than their leaner counterparts, and the underweight, frail, and cachectic have a particularly poor prognosis. In light of this, the potential benefits of exercise training and efforts to improve cardiorespiratory fitness, as well as the potential for weight reduction, especially in severely obese patients with HF, are discussed.

  8. Plastic pipe systems failure investigation and diagnosis

    CERN Document Server

    Farshad, Mehdi

    2011-01-01

    Industrial and domestic piping is increasingly made from various plastics and composites, and these materials withstand heavy use over long periods. They are, however, affected by environmental and other factors over time and can degrade, causing major problems within piping systems. Farshad's book deals with why plastic pipes and systems fail, and with how to investigate and diagnose such failures. Pipes may buckle, fracture, change in dimensions and colour, blister and delaminate, corrode through stress, be abraded and obstructed: all these cause problems and lead to loss of efficient operat

  9. Introduction to multiple organ dysfunction and failure.

    Science.gov (United States)

    Hackett, Timothy B

    2011-07-01

    Multiple organ failure and multiple organ dysfunction syndrome (MODS) were first recognized as undesirable complications of advancements in emergency and critical care. MODS remains the leading cause of death and resource expenditure in human intensive care units. MODS has been documented in small animal veterinary patients raising similar concerns. The understanding of the pathogenesis of MODS has evolved from uncontrolled infection to uncontrolled inflammation. Management is primarily through supportive care, early and aggressive monitoring of organ function, and intensive care nursing. Tissue hypoxia, microvascular thrombosis, increased vascular permeability, and disrupted cell-cell communication are prominent features of MODS. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Structural Bases of Postresuscitative Heart Failure

    Directory of Open Access Journals (Sweden)

    V. T. Dolgikh

    2005-01-01

    Full Text Available An experiment on 106 non-inbred male albino rats undergone 4-minute clinical death from acute blood loss has revealed that the first three days after resuscitation are marked by a concomitance of vascular disorders and cardiomyocytic dystrophic changes, the leading role being played by sludge, stasis, thrombosis, increased vascular permeability, perivascular edema, and hemorrhages. Cardiomyocytic destruction (various contractures, block-like myofibrillolysis, myocytoly-sis is a structural basis of postresuscitative heart failure. Three days later the heart displayed concomitant processes of recovery and damage. Three types of cardiac morphological changes have been identified in relation to the ratio of these processes.

  11. Role of Complement in Multiorgan Failure

    Directory of Open Access Journals (Sweden)

    Daniel Rittirsch

    2012-01-01

    Full Text Available Multiorgan failure (MOF represents the leading cause of death in patients with sepsis and systemic inflammatory response syndrome (SIRS following severe trauma. The underlying immune response is highly complex and involves activation of the complement system as a crucial entity of innate immunity. Uncontrolled activation of the complement system during sepsis and SIRS with in excessive generation of complement activation products contributes to an ensuing dysfunction of various organ systems. In the present review, mechanisms of the inflammatory response in the development of MOF in sepsis and SIRS with particular focus on the complement system are discussed.

  12. Pacemaker lead fracture without an increase in lead impedance caused by cardiac fibroma

    Directory of Open Access Journals (Sweden)

    Daisuke Sato

    2013-12-01

    Full Text Available We report the case of a 64-year-old man who had a permanent pacemaker with a unipolar silicone electrode positioned in the right ventricle in 1989 for sinus node dysfunction. On a routine checkup in June 2011, a 28-mm-diameter mass was discovered, which appeared to adhere to the tricuspid valve and the ventricular lead. The size of the mass did not change for the next 6 months, and the lead impedance was maintained at around 500–600 Ω. Because pacing failure was observed in January 2012, he underwent an urgent pacemaker check; however, the lead impedance was found not to have increased greatly (689 Ω. Nevertheless, the pacemaker lead was noted to be fractured at the tricuspid level. His echocardiogram showed new severe tricuspid regurgitation and a floating mass around the lead. We extracted the fractured lead, enucleated the tumor, replaced the tricuspid valve, and placed an epicardial lead. Macroscopic examination revealed that the tumor surrounded the fractured lead and covered the stump. Pathological examination revealed that the tumor was composed of fibrous connective tissue. We presumed that electric current continued to flow through the stump of the fractured unipolar lead to the generator, and this might have caused the limited increase in lead impedance.

  13. Lead Time Study,

    Science.gov (United States)

    1982-05-01

    AD-A128 318 LEAD TIME STUDY (U) ARMY ARMAMENT RESEARCH AND DEVELOPMENT CDMMAND DOVER NJ SYSTEMS ANALYSIS DIV dI-T~~ CHU MAY 82 ARRAA 82- 3/ /l N...EhhEEE--E 1111.0 U 1 - I 1120 1.25I1,,-. 11.6 MICROCOPY RESOLUTION TESI CHARI NATIONAL BUREAU 01 STANDARDt 19t,3 A co LEAD TIME STUDY c*A JULIE CHU MAY...188 D I.-f . . .... .. - r - .. " ’- -~ L - - _ _ __ ARRAA 82-3 LEAD TIME STUDY Prepared by:_ JL CHU Reviewed by:Li t’ ( LAWRENCE J. QWUNI Chief, Sys

  14. Lead effects on fungi

    Energy Technology Data Exchange (ETDEWEB)

    Gullino, M.L.; Fiussello, N.

    1976-01-01

    Addition of 0.01M lead nitrate to media caused complete inhibition of most of a group of 80 strains of fungi of several genera. Those which did grow at all had an extended lag period in comparison to controls. At 0.001M all the fungi grew, but had thinner-than-normal mycelia and delayed fruiting body formation. Fusarium species and members of Class Basidiomycetes were among the most sensitive, and Penicillium and Aspergillus species were the most tolerant. Lead uptake rates varied positively with lead nitrate concentration in the media. 9 references, 2 figures, 3 tables.

  15. Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure.

    Science.gov (United States)

    Adda, Mélanie; Coquet, Isaline; Darmon, Michaël; Thiery, Guillaume; Schlemmer, Benoît; Azoulay, Elie

    2008-10-01

    The current trend to manage critically ill hematologic patients admitted with acute respiratory failure is to perform noninvasive ventilation to avoid endotracheal intubation. However, failure of noninvasive ventilation may lead to an increased mortality. Retrospective study to determine the frequency of noninvasive ventilation failure and identify its determinants. Medical intensive care unit in a University hospital. All consecutive patients with hematologic malignancies admitted to the intensive care unit over a 10-yr period who received noninvasive ventilation. A total of 99 patients were studied. Simplified Acute Physiology Score II at admission was 49 (median, interquartile range, 39-57). Fifty-three patients (54%) failed noninvasive ventilation and required endotracheal intubation. Their PaO2/FiO2 ratio was significantly lower (175 [101-236] vs. 248 [134-337]) and their respiratory rate under noninvasive ventilation was significantly higher (32 breaths/min [30-36] vs. 28 [27-30]). Forty-seven patients (89%) who failed noninvasive ventilation required vasopressors. Hospital mortality was 79% in those who failed noninvasive ventilation, and 41% in those who succeeded. Patients who failed noninvasive ventilation had a significantly longer intensive care unit stay (13 days [8-23] vs. 5 [2-8]) and a significantly higher rate of intensive care unit-acquired infections (32% compared with 7%). Factors independently associated with noninvasive ventilation failure by multivariate analysis were respiratory rate under noninvasive ventilation, longer delay between admission and noninvasive ventilation first use, need for vasopressors or renal replacement therapy, and acute respiratory distress syndrome. Failure of noninvasive ventilation occurs in half the critically ill hematologic patients and is associated with an increased mortality. Predictors of noninvasive ventilation failure might be used to guide decisions regarding intubation.

  16. Early failure of bioabsorbable anterior cervical fusion plates: case report and failure analysis.

    Science.gov (United States)

    Brkaric, Mario; Baker, Kevin C; Israel, Raj; Harding, Trevor; Montgomery, David M; Herkowitz, Harry N

    2007-05-01

    Case report with forensic failure analysis. To determine the failure modes of 3 explanted 70:30 PLDLA Mystique (Medtronic Sofamor Danek, Memphis, TN) graft containment plates retrieved from revision surgery for early device failure. To reduce the problems of stress-shielding and radiopacity associated with metallic systems, bioabsorbable polymers have been used in anterior cervical discectomy and fusion procedures. Degradation of mechanical properties in vivo is a major concern when using bioabsorbable systems. Three of 6 patients who underwent anterior cervical discectomy with instrumented fusion, using Mystique graft containment systems experienced early failure requiring revision to alternate hardware. Devices were retrieved after failure and analyzed by light microscopy and environmental scanning electron microscopy. Simulations were performed with an unused plating system to induce damage for comparison with the retrieved devices. A detailed case review was performed to identify possible sources of extraordinary loading or damage. One plating system failed at 6 weeks postimplantation due to fatigue fracture of the screws. Crack initiation sites were identified at the interface of the thread root and mold line of the screw. Another plating system failed at 16 weeks postimplantation due to the coalescence of radial microcracking between holes in the plate, leading to catastrophic failure of the plate. The final plating system failed during the implantation surgery, when the screw fractured in torsion. Stress concentrations at the screw head-shaft interface and thread-shaft interface reduce the fatigue performance of bioabsorbable screws. Hydrolysis of the polymer may also play a role in the reduction of resistance to crack initiation and propagation.

  17. Lead levels - blood

    Science.gov (United States)

    Blood lead levels ... A blood sample is needed. Most of the time blood is drawn from a vein located on the inside ... may be used to puncture the skin. The blood collects in a small glass tube called a ...

  18. Sex differences in heart failure

    NARCIS (Netherlands)

    Meyer, Sven

    2016-01-01

    This thesis examined differences between men and women with heart failure. First, it was shown that biological sex is a strong modulator in the clinical expression of various cardiomyopathies. In the general population it was shown that men are more likely to develop heart failure with reduced eject

  19. Failure Rates in Introductory Programming

    DEFF Research Database (Denmark)

    Bennedsen, Jens; Caspersen, Michael Edelgaard

    2007-01-01

    It is a common conception that CS1 is a very difficult course and that failure rates are high. However, until now there has only been anecdotal evidence for this claim. This article reports on a survey among institutions around the world regarding failure rates in introductory programming courses...

  20. Failure Engineered Heavy Metal Penetrators

    Science.gov (United States)

    1992-12-01

    ARMY RESEARCH LABORATORY Failure Engineered Heavy Metal Penetrators, Phase I, SBIR ARL-CR-5· R. Cavalieri, W. Tiarn, and D. Nicholson prepared...REPORT DATE S. REPORT TYPE AND DATES COVERED December 1992 Final Report-1/1/92 - 7/31/92 4. TITLE AND SUBTITLE FAILURE ENGINEERED HEAVY METAL PENETRATORS

  1. Corrosion Failures in Marine Environment

    Directory of Open Access Journals (Sweden)

    R. Krishnan

    1985-04-01

    Full Text Available This paper gives a brief description of typical marine environments and the most common form of corrosion of materials used in this environment. Some typical case histories of failures pertaining to pitting, bimetallic corrosion, dealloying, cavitation and stress corrosion cracking are illustrated as typical examples of corrosion failures.

  2. Test of Poisson Failure Assumption.

    Science.gov (United States)

    1982-09-01

    o. ....... 37 00/ D itlr.: DVI r TEST OF POISSON FAILURE ASSUMPTION Chapter 1. INTRODUCTION 1.1 Background. In stockage models... precipitates a regular failure pattern; it is also possible that the coding of scheduled vs unscheduled does not reflect what we would expect. Data

  3. Intestinal failure in obstructive jaundice

    Institute of Scientific and Technical Information of China (English)

    Stelios F. Assimakopoulos; Constantine E. Vagianos; Aristides Charonis; Vassiliki N. Nikolopoulou; Chrisoula D. Scopa

    2005-01-01

    @@ TO THE EDITOR We read with great interest the article by Ding LA and LiJS, which aimed to review the current knowledge on the physiology of normal intestinal barrier function and highlight the role of intestinal failure after various injurious insults in the development of septic complications or multiple organ failure with subsequent rapid clinical deterioration or even death.

  4. Biomarkers in acute heart failure.

    Science.gov (United States)

    Mallick, Aditi; Januzzi, James L

    2015-06-01

    The care of patients with acutely decompensated heart failure is being reshaped by the availability and understanding of several novel and emerging heart failure biomarkers. The gold standard biomarkers in heart failure are B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, which play an important role in the diagnosis, prognosis, and management of acute decompensated heart failure. Novel biomarkers that are increasingly involved in the processes of myocardial injury, neurohormonal activation, and ventricular remodeling are showing promise in improving diagnosis and prognosis among patients with acute decompensated heart failure. These include midregional proatrial natriuretic peptide, soluble ST2, galectin-3, highly-sensitive troponin, and midregional proadrenomedullin. There has also been an emergence of biomarkers for evaluation of acute decompensated heart failure that assist in the differential diagnosis of dyspnea, such as procalcitonin (for identification of acute pneumonia), as well as markers that predict complications of acute decompensated heart failure, such as renal injury markers. In this article, we will review the pathophysiology and usefulness of established and emerging biomarkers for the clinical diagnosis, prognosis, and management of acute decompensated heart failure. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Heart failure - fluids and diuretics

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000112.htm Heart failure - fluids and diuretics To use the sharing features on ... at Home When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you ...

  6. Acute heart failure: Epidemiology, risk factors, and prevention.

    Science.gov (United States)

    Farmakis, Dimitrios; Parissis, John; Lekakis, John; Filippatos, Gerasimos

    2015-03-01

    Acute heart failure represents the first cause of hospitalization in elderly persons and is the main determinant of the huge healthcare expenditure related to heart failure. Despite therapeutic advances, the prognosis of acute heart failure is poor, with in-hospital mortality ranging from 4% to 7%, 60- to 90-day mortality ranging from 7% to 11%, and 60- to 90-day rehospitalization from 25% to 30%. Several factors including cardiovascular and noncardiovascular conditions as well as patient-related and iatrogenic factors may precipitate the rapid development or deterioration of signs and symptoms of heart failure, thus leading to an acute heart failure episode that usually requires patient hospitalization. The primary prevention of acute heart failure mainly concerns the prevention, early diagnosis, and treatment of cardiovascular risk factors and heart disease, including coronary artery disease, while the secondary prevention of a new episode of decompensation requires the optimization of heart failure therapy, patient education, and the development of an effective transition and follow-up plan. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Uremic encephalopathy and other brain disorders associated with renal failure.

    Science.gov (United States)

    Seifter, Julian Lawrence; Samuels, Martin A

    2011-04-01

    Kidney failure is one of the leading causes of disability and death and one of the most disabling features of kidney failure and dialysis is encephalopathy. This is probably caused by the accumulation of uremic toxins. Other important causes are related to the underlying disorders that cause kidney failure, particularly hypertension. The clinical manifestations of uremic encephalopathy include mild confusional states to deep coma, often with associated movement disorders, such as asterixis. Most nephrologists consider cognitive impairment to be a major indication for the initiation of renal replacement therapy with dialysis with or without subsequent transplantation. Sleep disorders, including Ekbom's syndrome (restless legs syndrome) are also common in patients with kidney failure. Renal replacement therapies are also associated with particular neurologic complications including acute dialysis encephalopathy and chronic dialysis encephalopathy, formerly known as dialysis dementia. The treatments and prevention of each are discussed. © Thieme Medical Publishers.

  8. Fracasos en la adhesión Adhesion failures

    Directory of Open Access Journals (Sweden)

    I. Esteban Herrera

    2005-04-01

    Full Text Available Los fracasos en la adhesión se van a traducir en fallos a distintos niveles de las distintas interfases. Puede haber: (1 fallos adhesivos entre esmalte y material adhesivo, dentina y material adhesivo, resina compuesta y material adhesivo; o (2 fallos cohesivos en esmalte, dentina, resina compuesta, material adhesivo. Se examinan las distintas razones que los provocan así como los factores que influyen en las interfases estudiadas.The failures in adhesion will turn into failures at different levels of the interface. There can be (1 adhesive failures, between the enamel and the adhesive material, dentine and the adhesive material, composite and the adhesive material; or (2 cohesive failures, in enamel, dentine, composite or adhesive material. The different reasons that lead to such situation as well as the aspects that influence the studied interfaces are analysed here.

  9. Very fast LHC Crab cavity failures and their mitigation

    CERN Document Server

    Baer, T; De Maria, R; Fartoukh, S D; Jensen, E; Tomas, R; Tuckmantel, J; Wenninger, J; Yee Rendon, B; Zimmermann, F

    2012-01-01

    For the high-luminosity LHC upgrade program (HL-LHC), the installation of crab cavities (CCs) is needed to compensate the geometric luminosity loss due to the crossing angle and for luminosity leveling [1]. The baseline is a local scheme with CCs around the ATLAS and CMS experiments. In a failure case (e.g. a control failure or arcing in the coupler), the voltage and/or phase of a CC can change significantly with a very fast time constant of the order of 1 to 10 LHC turns. This can lead to large, global betatron oscillations of the beam. The impact of CC failures on the beam dynamics is discussed and the results of dedicated simulations are presented. Mitigation strategies to limit the impact of CC failures to an acceptable level are proposed.

  10. Failure Probability Estimation of Wind Turbines by Enhanced Monte Carlo

    DEFF Research Database (Denmark)

    Sichani, Mahdi Teimouri; Nielsen, Søren R.K.; Naess, Arvid

    2012-01-01

    This paper discusses the estimation of the failure probability of wind turbines required by codes of practice for designing them. The Standard Monte Carlo (SMC) simulations may be used for this reason conceptually as an alternative to the popular Peaks-Over-Threshold (POT) method. However......, estimation of very low failure probabilities with SMC simulations leads to unacceptably high computational costs. In this study, an Enhanced Monte Carlo (EMC) method is proposed that overcomes this obstacle. The method has advantages over both POT and SMC in terms of its low computational cost and accuracy...... is controlled by the pitch controller. This provides a fair framework for comparison of the behavior and failure event of the wind turbine with emphasis on the effect of the pitch controller. The Enhanced Monte Carlo method is then applied to the model and the failure probabilities of the model are estimated...

  11. Adult intestinal failure

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J., E-mail: Jdavidson@doctors.org.u [Salford Royal Hospital, Salford (United Kingdom); Plumb, A.; Burnett, H. [Salford Royal Hospital, Salford (United Kingdom)

    2010-05-15

    Intestinal failure (IF) is the inability of the alimentary tract to digest and absorb sufficient nutrition to maintain normal fluid balance, growth, and health. It commonly arises from disease affecting the mesenteric root. Although severe IF is usually managed in specialized units, it lies at the end of a spectrum with degrees of nutritional compromise being widely encountered, but commonly under-recognized. Furthermore, in the majority of cases, the initial enteric insult occurs in non-specialist IF centres. The aim of this article is to review the common causes of IF, general principles of its management, some commoner complications, and the role of radiology in the approach to a patient with severe IF. The radiologist has a crucial role in helping provide access for feeding solutions (both enteral and parenteral) and controlling sepsis (via drainage of collections) in an initial restorative phase of treatment, whilst simultaneously mapping bowel anatomy and quality, and searching for disease complications to assist the clinicians in planning a later, restorative phase of therapy.

  12. Failure to recall.

    Science.gov (United States)

    Laming, Donald

    2009-01-01

    Mathematical analysis shows that if the pattern of rehearsal in free-recall experiments (of necessity, the pattern observed when participants rehearse aloud) be continued without any further interruption by stimuli (as happens during recall), it terminates with the retrieval of the same 1 word over and over again. Such a terminal state is commonly reached before some of the words in the list have been retrieved even once; those words are not recalled. The 1 minute frequently allowed for recall in free-recall experiments is ample time for retrieval to seize up in this way. The author proposes a model that represents the essential features of the pattern of rehearsal; validates that model by reference to the overt rehearsal data from B. B. Murdock, Jr., and J. Metcalfe (1978) and the recall data from B. B. Murdock, Jr., and R. Okada (1970); demonstrates the long-term properties of continued sequences of retrievals and, also, a fundamental relation linking recall to the total time of presentation; and, finally, compares failure to recall in free-recall experiments with forgetting in general.

  13. Lead-210 contamination

    Energy Technology Data Exchange (ETDEWEB)

    Gray, P. [Peter Gray and Associates, Tulsa, OK (United States)

    1997-12-31

    Nearly all scrap dealers, smelters and other recyclers routinely monitor for radioactivity in shipments entering their facility. These sensitive radiation gate monitors easily detect radium-226 and most other radioactive nuclides. However, the type of detector normally used, sodium iodide scintillation crystals, will not detect the low energy gamma radiation emitted by lead-210 and its progeny. Since lead-210 is a common radioactive contaminant in certain industries, contaminated scrap metal from these industries may avoid detection at the recycler. Lead-210 is a decay product of radon-222 which is produced in small concentrations with natural gas. As the natural gas liquids, particularly ethane and propane, are separated from the natural gas, the radon concentrates in the ethane/propane fraction. The natural gas industry, particularly gas processing facilities and industries using ethane and propane as feed stocks can be significantly contaminated with the radon decay products, especially lead-210, bismuth-210 and polonium-210. Unless the scrap metal is decontaminated before sending to the recycler, the lead-210 contaminated scrap may be processed, resulting in some degree of radioactive contamination of the recycling facilities. Methods of detecting the low energy gamma radiation associated with lead-210 include the pancake G-M detector and the thin crystal-thin window scintillation detector.

  14. Failure Diagnosis on Discrete Event Systems

    Directory of Open Access Journals (Sweden)

    Sihem Kechida

    2005-01-01

    Full Text Available The modern technology advances to a point where it is possible and extensively desirable to improve reliability and the technical process safety. This is achieved by computer implanted FDI procedures (Fault Detection and Isolation. However, the malfunction of actuators, sensors and of the process components, as well as erroneous actions of human operators can have some disastrous consequences in high risk systems such as: Spatial engines (Astronomy, aircrafts (Aviation, nuclear reactors and chemical plants. Thus, each failure or fault can lead to shutdowns or a rupture of service and consequently a plant output reduction. There is an improvement of consciousness and attitude to possible disaster provoked by failures that could enable a failure tolerating system development. Such system must maintain a optimal performance during normal operating conditions and must handle encountered critical situations during which the system’s conditions are abnormal that is by performing of detection and diagnosis procedures and reconfiguration according to accurate software programs. In this study, we focus on the diagnosis of the flexible manufacturing systems which are described by a model based on the Petri nets. The basic idea consists of residuals generators resulting from the equation of marking evolution of the process and having appropriated structures to facilitate fault isolation.

  15. Failure Criteria for Reinforced Materials

    DEFF Research Database (Denmark)

    Rathkjen, Arne

    Failure of materials is often characterized as ductile yielding, brittle fracture, creep rupture, etc., and different criteria given in terms of different parameters have been used to describe different types of failure. Only criteria expressing failure in terms of stress are considered in what...... place until the matrix, the continuous component of the composite, fails. When an isotropic matrix is reinforced as described above, the result is an anisotropic composite material. Even if the material is anisotropic, it usually exhibits a rather high degree of symmetry and such symmetries place...... certain restrictions on the form of the failure criteria for anisotropic materials. In section 2, some failure criteria for homogenous materials are reviewed. Both isotropic and anisotropic materials are described, and in particular the constraints imposed on the criteria from the symmetries orthotropy...

  16. Bisoprolol for congestive heart failure

    DEFF Research Database (Denmark)

    Rosenberg, J.; Gustafsson, F.

    2008-01-01

    Background: beta-Blockers are a cornerstone in the treatment of systolic heart failure treatment, but not all beta-blockers are effective or in this setting. Objective: To define the role of bisoprolol, a highly selective beta(1)-antagonist in congestive heart failure due to systolic dysfunction....... Methods: Using the keywords 'bisoprolol' and 'heart failure' PubMed and BIOSIS databases were searched for information regarding pharmacology and relevant randomised clinical trials. Supplementary publications were acquired by scrutinising reference lists of relevant papers. Additional information...... was obtained from the FDA website. Conclusion: Bisoprolol is an effective and well-tolerated first-line beta-blocker for patients with systolic heart failure. The knowledge is primarily based on study patients with moderate-to-severe heart failure from the three CIBIS trials Udgivelsesdato: 2008/2...

  17. Addiction as a Systems Failure: Focus on Adolescence and Smoking

    Science.gov (United States)

    Baler, Ruben D.; Volkow, Nora D.

    2011-01-01

    Objective: Scientific advances in the field of addiction have forever debunked the notion that addiction reflects a character flaw under voluntary control, demonstrating instead that it is a bona fide disease of the brain. The aim of this review is to go beyond this consensus understanding and explore the most current evidence regarding the vast…

  18. Addiction as a Systems Failure: Focus on Adolescence and Smoking

    Science.gov (United States)

    Baler, Ruben D.; Volkow, Nora D.

    2011-01-01

    Objective: Scientific advances in the field of addiction have forever debunked the notion that addiction reflects a character flaw under voluntary control, demonstrating instead that it is a bona fide disease of the brain. The aim of this review is to go beyond this consensus understanding and explore the most current evidence regarding the vast…

  19. Magnesium Diboride Current Leads

    Science.gov (United States)

    Panek, John

    2010-01-01

    A recently discovered superconductor, magnesium diboride (MgB2), can be used to fabricate conducting leads used in cryogenic applications. Dis covered to be superconducting in 2001, MgB2 has the advantage of remaining superconducting at higher temperatures than the previously used material, NbTi. The purpose of these leads is to provide 2 A of electricity to motors located in a 1.3 K environment. The providing environment is a relatively warm 17 K. Requirements for these leads are to survive temperature fluctuations in the 5 K and 11 K heat sinks, and not conduct excessive heat into the 1.3 K environment. Test data showed that each lead in the assembly could conduct 5 A at 4 K, which, when scaled to 17 K, still provided more than the required 2 A. The lead assembly consists of 12 steelclad MgB2 wires, a tensioned Kevlar support, a thermal heat sink interface at 4 K, and base plates. The wires are soldered to heavy copper leads at the 17 K end, and to thin copper-clad NbTi leads at the 1.3 K end. The leads were designed, fabricated, and tested at the Forschungszentrum Karlsruhe - Institut foer Technische Physik before inclusion in Goddard's XRS (X-Ray Spectrometer) instrument onboard the Astro-E2 spacecraft. A key factor is that MgB2 remains superconducting up to 30 K, which means that it does not introduce joule heating as a resistive wire would. Because the required temperature ranges are 1.3-17 K, this provides a large margin of safety. Previous designs lost superconductivity at around 8 K. The disadvantage to MgB2 is that it is a brittle ceramic, and making thin wires from it is challenging. The solution was to encase the leads in thin steel tubes for strength. Previous designs were so brittle as to risk instrument survival. MgB2 leads can be used in any cryogenic application where small currents need to be conducted at below 30 K. Because previous designs would superconduct only at up to 8 K, this new design would be ideal for the 8-30 K range.

  20. Briefing: Lessons learned from failures of flood defences

    NARCIS (Netherlands)

    Jonkman, S.N.; Schweckendiek, T.

    2015-01-01

    Failure of flood defences during extreme events can lead to enormous damage and loss of life. This paper presents lessons learned from investigations of flood events over recent years, including the 2005 flooding in New Orleans, USA, caused by hurricane Katrina. Based on these findings, new developm

  1. factors that precipitate heart failure among children with rheumatic ...

    African Journals Online (AJOL)

    2011-11-11

    Nov 11, 2011 ... Objective: To identify factors that precipitates heart failure in children with rheumatic ... Arrhythmia, recurrent rheumatic fever, pneumonia, infective endocarditis, ... heart disease is a leading cause of cardiac morbidity and mortality although the exact disease burden is unknown (3). .... review of literature.

  2. Diuretic response and renal function in heart failure

    NARCIS (Netherlands)

    ter Maaten, Jozine Magdalena

    2016-01-01

    In patients with heart failure fluid overload is a frequently occurring problem, which is among others caused by an impaired function of the heart. This fluid overload may lead to severe dyspnea warranting an acute hospitalization. The first choice treatment of this fluid overload is administration

  3. Plasma bilirubin and late graft failure in renal transplant recipients

    NARCIS (Netherlands)

    Deetman, Petronella E.; Zelle, Dorien M.; van der Heide, Jaap J. Homan; Navis, Gerjan J.; Gans, Reinold O. B.; Bakker, Stephan J. L.

    2012-01-01

    Exogenous bilirubin has been shown to protect against oxidative stress in ischemia-reperfusion injury. Oxidative stress has been implicated in the pathophysiology of chronic transplant dysfunction leading to late graft failure after renal transplantation. We prospectively investigated whether high e

  4. Briefing: Lessons learned from failures of flood defences

    NARCIS (Netherlands)

    Jonkman, S.N.; Schweckendiek, T.

    2015-01-01

    Failure of flood defences during extreme events can lead to enormous damage and loss of life. This paper presents lessons learned from investigations of flood events over recent years, including the 2005 flooding in New Orleans, USA, caused by hurricane Katrina. Based on these findings, new

  5. Heart failure in the elderly: a U.S. Perspective

    Institute of Scientific and Technical Information of China (English)

    Michael W. Rich

    2006-01-01

    @@ Heart failure (HF) affects 5 million Americans, of whom three-fourths are over age 65 and half are over age 75.1 HF is currently the leading cause of hospitalization among older adults in the U.S., and it is the most costly medical illness by a factor of almost two.

  6. Red cell dynamics and haemodynamics in cardiorenal failure

    NARCIS (Netherlands)

    Emans, M.E.

    2012-01-01

    The combination of chronic heart failure (CHF) and chronic kidney disease (CKD) is prevalent and associated with a higher mortality and morbidity than can be expected solely on the combination of both conditions. This combination leads to a “dangerous liaison”, also called the cardiorenal syndrome,

  7. Briefing: Lessons learned from failures of flood defences

    NARCIS (Netherlands)

    Jonkman, S.N.; Schweckendiek, T.

    2015-01-01

    Failure of flood defences during extreme events can lead to enormous damage and loss of life. This paper presents lessons learned from investigations of flood events over recent years, including the 2005 flooding in New Orleans, USA, caused by hurricane Katrina. Based on these findings, new developm

  8. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases.

  9. New medications for heart failure.

    Science.gov (United States)

    Gordin, Jonathan S; Fonarow, Gregg C

    2016-08-01

    Heart failure is common and results in substantial morbidity and mortality. Current guideline-based therapies for heart failure with reduced ejection fraction, including beta blockers, angiotensin converting enzyme (ACE) inhibitors, and aldosterone antagonists aim to interrupt deleterious neurohormonal pathways and have shown significant success in reducing morbidity and mortality associated with heart failure. Continued efforts to further improve outcomes in patients with heart failure with reduced ejection fraction have led to the first new-in-class medications approved for heart failure since 2005, ivabradine and sacubitril/valsartan. Ivabradine targets the If channels in the sinoatrial node of the heart, decreasing heart rate. Sacubitril/valsartan combines a neprilysin inhibitor that increases levels of beneficial vasodilatory peptides with an angiotensin receptor antagonist. On a background of previously approved, guideline-directed medical therapies for heart failure, these medications have shown improved clinical outcomes ranging from decreased hospitalizations in a select group of patients to a reduction in all-cause mortality across all pre-specified subgroups. In this review, we will discuss the previously established guideline-directed medical therapies for heart failure with reduced ejection fraction, the translational research that led to the development of these new therapies, and the results from the major clinical trials of ivabradine and sacubitril/valsartan. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Leading healthcare in complexity.

    Science.gov (United States)

    Cohn, Jeffrey

    2014-12-01

    Healthcare institutions and providers are in complexity. Networks of interconnections from relationships and technology create conditions in which interdependencies and non-linear dynamics lead to surprising, unpredictable outcomes. Previous effective approaches to leadership, focusing on top-down bureaucratic methods, are no longer effective. Leading in complexity requires leaders to accept the complexity, create an adaptive space in which innovation and creativity can flourish and then integrate the successful practices that emerge into the formal organizational structure. Several methods for doing adaptive space work will be discussed. Readers will be able to contrast traditional leadership approaches with leading in complexity. They will learn new behaviours that are required of complexity leaders, along with challenges they will face, often from other leaders within the organization.

  11. Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

    OpenAIRE

    Feras Sendy; Eman AlShehri; Amani AlAjmi; Elham Bamanie; Surekha Appani; Taghreed Shams

    2015-01-01

    Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in th...

  12. The war against heart failure: the Lancet lecture.

    Science.gov (United States)

    Braunwald, Eugene

    2015-02-28

    Heart failure is a global problem with an estimated prevalence of 38 million patients worldwide, a number that is increasing with the ageing of the population. It is the most common diagnosis in patients aged 65 years or older admitted to hospital and in high-income nations. Despite some progress, the prognosis of heart failure is worse than that of most cancers. Because of the seriousness of the condition, a declaration of war on five fronts has been proposed for heart failure. Efforts are underway to treat heart failure by enhancing myofilament sensitivity to Ca(2+); transfer of the gene for SERCA2a, the protein that pumps calcium into the sarcoplasmic reticulum of the cardiomyocyte, seems promising in a phase 2 trial. Several other abnormal calcium-handling proteins in the failing heart are candidates for gene therapy; many short, non-coding RNAs--ie, microRNAs (miRNAs)--block gene expression and protein translation. These molecules are crucial to calcium cycling and ventricular hypertrophy. The actions of miRNAs can be blocked by a new class of drugs, antagomirs, some of which have been shown to improve cardiac function in animal models of heart failure; cell therapy, with autologous bone marrow derived mononuclear cells, or autogenous mesenchymal cells, which can be administered as cryopreserved off the shelf products, seem to be promising in both preclinical and early clinical heart failure trials; and long-term ventricular assistance devices are now used increasingly as a destination therapy in patients with advanced heart failure. In selected patients, left ventricular assistance can lead to myocardial recovery and explantation of the device. The approaches to the treatment of heart failure described, when used alone or in combination, could become important weapons in the war against heart failure.

  13. Dilemmas in end-stage heart failure.

    Science.gov (United States)

    Chen-Scarabelli, Carol; Saravolatz, Louis; Hirsh, Benjamin; Agrawal, Pratik; Scarabelli, Tiziano M

    2015-01-01

    Heart failure (HF), a complex clinical syndrome due to structural or functional disorder of the heart, is a major global health issue, with a prevalence of over 5.8 million in the USA alone, and over 23 million worldwide. As a leading cause of hospitalizations among patients aged 65 years or older, HF is a major consumer of healthcare resources, creating a substantial strain on the healthcare system. This paper discusses the epidemiology of HF, financial impact, and multifaceted predicaments in end-stage HF care. A search was conducted on the U.S. National Library of Medicine website (www.pubmed.gov) using keywords such as end-stage heart failure, palliative care, ethical dilemmas. Despite the poor prognosis of HF (worse than that for many cancers), many HF patients, caregivers, and clinicians are unaware of the poor prognosis. In addition, the unpredictable clinical trajectory of HF complicates the planning of end-of-life care, such as palliative care and hospice, leading to underutilization of such resources. In conclusion, ethical dilemmas in end-stage HF are numerous, embroiling not only the patient, but also the caregiver, healthcare team, and society.

  14. Failure probability under parameter uncertainty.

    Science.gov (United States)

    Gerrard, R; Tsanakas, A

    2011-05-01

    In many problems of risk analysis, failure is equivalent to the event of a random risk factor exceeding a given threshold. Failure probabilities can be controlled if a decisionmaker is able to set the threshold at an appropriate level. This abstract situation applies, for example, to environmental risks with infrastructure controls; to supply chain risks with inventory controls; and to insurance solvency risks with capital controls. However, uncertainty around the distribution of the risk factor implies that parameter error will be present and the measures taken to control failure probabilities may not be effective. We show that parameter uncertainty increases the probability (understood as expected frequency) of failures. For a large class of loss distributions, arising from increasing transformations of location-scale families (including the log-normal, Weibull, and Pareto distributions), the article shows that failure probabilities can be exactly calculated, as they are independent of the true (but unknown) parameters. Hence it is possible to obtain an explicit measure of the effect of parameter uncertainty on failure probability. Failure probability can be controlled in two different ways: (1) by reducing the nominal required failure probability, depending on the size of the available data set, and (2) by modifying of the distribution itself that is used to calculate the risk control. Approach (1) corresponds to a frequentist/regulatory view of probability, while approach (2) is consistent with a Bayesian/personalistic view. We furthermore show that the two approaches are consistent in achieving the required failure probability. Finally, we briefly discuss the effects of data pooling and its systemic risk implications. © 2010 Society for Risk Analysis.

  15. Determination of the catalytic activity of LEOPARD syndrome-associated SHP2 mutants toward parafibromin, a bona fide SHP2 substrate involved in Wnt signaling

    Energy Technology Data Exchange (ETDEWEB)

    Noda, Saori [Division of Microbiology, Graduate School of Medicine, The University of Tokyo, Tokyo (Japan); Department of Biochemistry, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba (Japan); Takahashi, Atsushi; Hayashi, Takeru [Division of Microbiology, Graduate School of Medicine, The University of Tokyo, Tokyo (Japan); Tanuma, Sei-ichi [Department of Biochemistry, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba (Japan); Hatakeyama, Masanori, E-mail: mhata@m.u-tokyo.ac.jp [Division of Microbiology, Graduate School of Medicine, The University of Tokyo, Tokyo (Japan)

    2016-01-22

    SHP2, encoded by the PTPN11 gene, is a protein tyrosine phosphatase that plays a key role in the proliferation of cells via RAS-ERK activation. SHP2 also promotes Wnt signaling by dephosphorylating parafibromin. Germline missense mutations of PTPN11 are found in more than half of patients with Noonan syndrome (NS) and LEOPARD syndrome (LS), both of which are congenital developmental disorders with multiple common symptoms. However, whereas NS-associated PTPN11 mutations give rise to gain-of-function SHP2 mutants, LS-associated SHP2 mutants are reportedly loss-of-function mutants. To determine the phosphatase activity of LS-associated SHP2 more appropriately, we performed an in vitro phosphatase assay using tyrosine-phosphorylated parafibromin, a biologically relevant substrate of SHP2 and the positive regulator of Wnt signaling that is activated through SHP2-mediated dephosphorylation. We found that LS-associated SHP2 mutants (Y279C, T468M, Q506P, and Q510E) exhibited a substantially reduced phosphatase activity toward parafibromin when compared with wild-type SHP2. Furthermore, each of the LS-associated mutants displayed a differential degree of decrease in phosphatase activity. Deviation of the SHP2 catalytic activity from a certain range, either too strong or too weak, may therefore lead to similar clinical outcomes in NS and LS, possibly through an imbalanced Wnt signal caused by inadequate dephosphorylation of parafibromin. - Highlights: • LS-associated SHP2 mutants dephosphorylate parafibromin on Y290, Y293, and Y315. • LS-associated SHP2 mutants display a reduced tyrosine phosphatase activity. • LS-specific SHP2-Y279C is catalytically less active than LS-specific SHP2-T468M. • NS/LS-associated SHP2-Q506P has both hyper- and hypomorphic enzymatic properties.

  16. [Baroreflex failure after chemodectoma resection].

    Science.gov (United States)

    Gómez Esteban, J C; Boyero, S; Fernández, C; Sagasta, A; Pérez, T; Velasco, F; Allue, I; Lezcano, E; Zarranz, J J

    2004-10-01

    Baroreflex failure after chemodectoma resection We present a case of baroreflex failure secondary to a unilateral injury of the glossopharyngeal nerve. The patient was operated for a left-sided chemodectoma in the carotid body. Some months after surgery she started to report presyncopal episodes exacerbated by mental stress and when standing up. During these episodes, the patient presented hypertensive crises and tachycardia. However, blood pressure was below normal ranges at rest. The diagnosis was baroreflex failure secondary to unilateral injury of the glossopharyngeal nerve. The case reported herein illustrates the fact that the presence of a bilateral injury is not essential for the occurrence of this disorder.

  17. Cardiomyocytic apoptosis and heart failure

    Institute of Scientific and Technical Information of China (English)

    Quanzhou Feng

    2008-01-01

    Heart failure is a major disease seriously threatening human health.Once left ventricular dysfunction develops,cardiac function usually deteriorates and progresses to congestive heart failure in several months or years even if no factors which accelerate the deterioration repeatedly exist.Mechanism through which cardiac function continually deteriorates is still unclear.Cardiomyocytic apoptosis can occur in acute stage of ischemic heart diseases and the compensated stage of cardiac dysfunction.In this review,we summarize recent advances in understanding the role of cardiomyocytic apoptosis in heart failure.

  18. Wind Turbine Failures - Tackling current Problems in Failure Data Analysis

    Science.gov (United States)

    Reder, M. D.; Gonzalez, E.; Melero, J. J.

    2016-09-01

    The wind industry has been growing significantly over the past decades, resulting in a remarkable increase in installed wind power capacity. Turbine technologies are rapidly evolving in terms of complexity and size, and there is an urgent need for cost effective operation and maintenance (O&M) strategies. Especially unplanned downtime represents one of the main cost drivers of a modern wind farm. Here, reliability and failure prediction models can enable operators to apply preventive O&M strategies rather than corrective actions. In order to develop these models, the failure rates and downtimes of wind turbine (WT) components have to be understood profoundly. This paper is focused on tackling three of the main issues related to WT failure analyses. These are, the non-uniform data treatment, the scarcity of available failure analyses, and the lack of investigation on alternative data sources. For this, a modernised form of an existing WT taxonomy is introduced. Additionally, an extensive analysis of historical failure and downtime data of more than 4300 turbines is presented. Finally, the possibilities to encounter the lack of available failure data by complementing historical databases with Supervisory Control and Data Acquisition (SCADA) alarms are evaluated.

  19. Snow fracture: From micro-cracking to global failure

    Science.gov (United States)

    Capelli, Achille; Reiweger, Ingrid; Schweizer, Jürg

    2017-04-01

    Slab avalanches are caused by a crack forming and propagating in a weak layer within the snow cover, which eventually causes the detachment of the overlying cohesive slab. The gradual damage process leading to the nucleation of the initial failure is still not entirely understood. Therefore, we studied the damage process preceding snow failure by analyzing the acoustic emissions (AE) generated by bond failure or micro-cracking. The AE allow studying the ongoing progressive failure in a non-destructive way. We performed fully load-controlled failure experiments on snow samples presenting a weak layer and recorded the generated AE. The size and frequency of the generated AE increased before failure revealing an acceleration of the damage process with increased size and frequency of damage and/or microscopic cracks. The AE energy was power-law distributed and the exponent (b-value) decreased approaching failure. The waiting time followed an exponential distribution with increasing exponential coefficient λ before failure. The decrease of the b-value and the increase of λ correspond to a change in the event distribution statistics indicating a transition from homogeneously distributed uncorrelated damage producing mostly small AE to localized damage, which cause larger correlated events which leads to brittle failure. We observed brittle failure for the fast experiment and a more ductile behavior for the slow experiments. This rate dependence was reflected also in the AE signature. In the slow experiments the b value and λ were almost constant, and the energy rate increase was moderate indicating that the damage process was in a stable state - suggesting the damage and healing processes to be balanced. On a shorter time scale, however, the AE parameters varied indicating that the damage process was not steady but consisted of a sum of small bursts. We assume that the bursts may have been generated by cascades of correlated micro-cracks caused by localization of

  20. Lead Neurotoxicity and Socioeconomic Status: Conceptual and Analytical Issues

    Science.gov (United States)

    Bellinger, David C.

    2008-01-01

    Socioeconomic status (SES) is usually considered to be a potential confounder of the association between lead exposure and children’s neurodevelopment, but experimental and epidemiological data suggest that SES might also modify lead neurotoxicity. The basis of this effect modification is uncertain, but might include differences among SES strata in co-exposures to other neurotoxicants, genetic susceptibilities, environmental enrichment, and stress. The role of SES in the causal nexus is likely to include other dimensions, however. It conveys information about lead exposure opportunities as well as about predictors of child outcome that are correlated with but causally independent of lead. Failure to distinguish these aspects of SES will lead to an underestimate of lead’s contribution, and might even result in attributing to SES health effects that should be attributed to lead. Conventional models, which treat SES and SES-related factors solely as potential confounders, do not capture the possibility that a child’s early lead exposure alters the behaviors that the child elicits from others. Failure to model lead’s contribution to such time-varying covariates will also tend to bias estimates of lead neurotoxicity toward the null. On a transgenerational level, low SES might be a proxy for vulnerability to lead. To estimate the burden of lead-associated neurotoxicity on a population level, we need to apply analytical approaches that model a child’s development and its context as a complex system of interdependent relationships that change over time. PMID:18501967

  1. Relational Perspectives on Leading

    DEFF Research Database (Denmark)

    Larsen, Mette Vinther; Rasmussen, Jørgen Gulddahl

    2015-01-01

    Relational Perspectives on Leading discusses leadership from a relational and social constructionism perspective as practiced on an everyday basis between people. The book pursues a fast growing, practice-based approach - particularly within the Anglo-Saxon parts of the world - to organization...... studies and organizational phenomena....

  2. lead glass brick

    CERN Multimedia

    As well as accelerators to boost particles up to high energy, physicists need detectors to see what happens when those particles collide. This lead glass block is part of a CERN detector called OPAL. OPAL uses some 12 000 blocks of glass like this to measure particle energies.

  3. Girls Leading Outward

    Science.gov (United States)

    Hamed, Heather; Reyes, Jazmin; Moceri, Dominic C.; Morana, Laura; Elias, Maurice J.

    2011-01-01

    The authors describe a program implemented in Red Bank Middle School in New Jersey to help at-risk, minority middle school girls realize their leadership potential. The GLO (Girls Leading Outward) program was developed by the Developing Safe and Civil Schools Project at Rutgers University and is facilitated by university students. Selected middle…

  4. Leading by Learning

    Science.gov (United States)

    Brookhart, Susan M.; Moss, Connie M.

    2013-01-01

    A lot has changed in the principalship since the principal was the head teacher in a school. Current principals are building administrators and that is likely to continue, the authors posit. Nonetheless, they report their study focusing on leadership's role in formative assessment concluded that in order to lead learning the principal must become…

  5. Change, Lead, Succeed

    Science.gov (United States)

    Munger, Linda; von Frank, Valerie

    2010-01-01

    Redefine leadership in your school, and create capacity through school leadership teams that successfully coordinate professional learning. "Change, Lead, Succeed" shows school leaders and teachers in leadership roles what they need to know to effectively create a culture for change. Find out what distinguishes a school leadership team from other…

  6. Monitoring and remote failure detection of grid-connected PV systems based on satellite observations

    NARCIS (Netherlands)

    Drews, A.; de Keizer, A.C.; Beyer, H.G.; Lorenz, E.; Betcke, J.W.H.; van Sark, W.G.J.H.M.; Heydenreich, W.; Wiemken, E.; Stettler, S.; Toggweiler, P.; Bofinger, S.; Schneider, M.; Heilscher, G.; Heinemann, D.

    2007-01-01

    Small grid-connected photovoltaic systems up to 5 kWp are often not monitored because advanced surveillance systems are not economical. Hence, some system failures which lead to partial energy losses stay unnoticed for a long time. Even a failure that results in a larger energy deficit can be diffic

  7. Your Heart Failure Healthcare Team

    Science.gov (United States)

    ... them know how you're doing. With good teamwork and communication, you can improve the quality of ... Failure Recognition and Knowing Your Options Planning Ahead Communicating with Your Healthcare Provider Overcoming Barriers to Shared ...

  8. Severe Obesity and Heart Failure

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_161011.html Severe Obesity and Heart Failure Study sees link even without ... 2016 FRIDAY, Sept. 16, 2016 (HealthDay News) -- Severe obesity appears to be an independent risk factor for ...

  9. Warning Signs of Heart Failure

    Science.gov (United States)

    ... of heart failure may not be cause for alarm. But if you have more than one of ... also causing fluid retention in the tissues. Tiredness, fatigue ...a tired feeling all the time and difficulty ...

  10. Planning Ahead: Advanced Heart Failure

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Planning Ahead: Advanced Heart Failure Updated:Sep 30,2016 ... making your preferences known is called advance care planning. It allows you to speak for yourself, even ...

  11. Decongestion in acute heart failure

    NARCIS (Netherlands)

    Mentz, Robert J.; Kjeldsen, Keld; Rossi, Gian Paolo; Voors, Adriaan A.; Cleland, John G. F.; Anker, Stefan D.; Gheorghiade, Mihai; Fiuzat, Mona; Rossignol, Patrick; Zannad, Faiez; Pitt, Bertram; O'Connor, Christopher; Felker, G. Michael

    2014-01-01

    Congestion is a major reason for hospitalization in acute heart failure (HF). Therapeutic strategies to manage congestion include diuretics, vasodilators, ultrafiltration, vasopressin antagonists, mineralocorticoid receptor antagonists, and potentially also novel therapies such as gut sequesterants

  12. Predicting Failures in Power Grids

    CERN Document Server

    Chertkov, Michael; Stepanov, Mikhail G

    2010-01-01

    Here we develop an approach to predict power grid weak points, and specifically to efficiently identify the most probable failure modes in load distribution for a given power network. This approach is applied to two examples: Guam's power system and also the IEEE RTS-96 system, both modeled within the static Direct Current power flow model. Our algorithm is a power network adaption of the worst configuration heuristics, originally developed to study low probability events in physics and failures in error-correction. One finding is that, if the normal operational mode of the grid is sufficiently healthy, the failure modes, also called instantons, are sufficiently sparse, i.e. the failures are caused by load fluctuations at only a few buses. The technique is useful for discovering weak links which are saturated at the instantons. It can also identify overutilized and underutilized generators, thus providing predictive capability for improving the reliability of any power network.

  13. Antibiotic managment in renal failure.

    Science.gov (United States)

    Winter, R E

    1976-06-01

    This is a brief compilation of the work of many investigators. It includes facts about toxicity and recommendations about antibiotic management in patients with renal failure. As new data are accrued, changes in these recommendations will be necessary.

  14. [Does diastolic heart failure exist?].

    Science.gov (United States)

    Guadalajara Boo, José Fernando

    2003-01-01

    This paper reviews the concepts of systolic function, diastolic function, heart failure, diastolic dysfunction, and diastolic heart failure. We refer to the historic evolution of the concept of heart failure and the origin of the term diastolic heart failure. Based on the current concepts of the physiology of the heart and its pathophysiology, we discuss the inappropriateness of the term and to the confusion it has generated in clinical practice, treatment, and prognosis, as well as in numerous research papers (of which some examples are given) when terming as "heart failure" the diastolic dysfunction and using both terms indistinctively. We conclude that an increasing need has arisen, ever more imperative, to identify clearly the concepts of heart failure and diastolic dysfunction, emphasizing on their differences to recognize them as distinct clinical entities with their own personality and, hence, having different prognosis and treatment. This would be of great help to achieve more accuracy in the clinical guidelines, standards, and consensus, especially regarding treatment. Besides it would be useful to avoid, inconsistencies in the design of research, which appear in some of the publications just by the lack of a clear meaning of the terms. Finally, at present we have the necessary elements to conclude that the terms "diastolic heart failure" and "cardiac failure with preserved systolic function" are inexact, poorly gauged, and far away from the actual problem they try to define. Therefore, they should be substituted by the concept of Diastolic Dysfunction, which defines clearly the pathophysiology of the functional alteration, without having to state that "the heart is failing".

  15. Edge effects and delamination failures

    Science.gov (United States)

    Herakovich, C. T.

    1989-01-01

    The fundamental relationship between the morphology of a composite laminate and the resulting free edge effects is explored and related to delamination failures. Cross-ply, angle-ply, and quasi-isotropic laminates are discussed in detail. It is shown that the local mismatch in elastic properties of adjacent layers and the global stacking sequence of a laminate both have a significant influence on the interlaminar stresses and delamination failures.

  16. Circular RNAs in heart failure.

    Science.gov (United States)

    Devaux, Yvan; Creemers, Esther E; Boon, Reinier A; Werfel, Stanislas; Thum, Thomas; Engelhardt, Stefan; Dimmeler, Stefanie; Squire, Iain

    2017-06-01

    Cardiovascular disease, and particularly heart failure, is still a serious health care issue for which novel treatments and biomarkers are needed. The RNA family comprises different subgroups, among which the small-sized microRNAs and the larger long non-coding RNAs have shown some potential to aid in moving personalized health care of heart failure patients a step forward. Here, members of the Cardiolinc network review the recent findings suggesting that the less well-known circular RNAs may constitute a novel reservoir of therapeutic targets and biomarkers of heart failure. The knowledge of the mode of biogenesis of circular RNAs will first be reported, followed by a description of different features that make these RNA molecules of interest for the heart failure community. The functions of circular RNAs in the heart will be described, with some emphasis given to their regulation in the failing heart. Circulating in the bloodstream, circular RNAs have appeared as potential biomarkers and recent findings associated with the use of circular RNAs as heart failure biomarkers will be discussed. Finally, some directions for future research will be provided. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  17. Reassessing guidelines for heart failure

    Directory of Open Access Journals (Sweden)

    Helmut Drexler

    2004-03-01

    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.

  18. History repeats itself in Japan: Failure to learn from rubella epidemic leads to failure to provide the HPV vaccine.

    Science.gov (United States)

    Tanaka, Yusuke; Ueda, Yutaka; Yoshino, Kiyoshi; Kimura, Tadashi

    2017-08-03

    Eradication of vaccine-preventable diseases is one of the most important goals of public health interventions. Herd immunity can be established by national vaccination programs. However, once the national vaccination program stops for any reason, unprotected group will be generated depending on an unfortunate year of birth. Currently, there are 2 major concerns regarding vaccine cohort gaps in Japan: one is for the rubella vaccine, the other for the human papillomavirus (HPV) vaccine.

  19. Experimental methods for identifying failure mechanisms

    Science.gov (United States)

    Daniel, I. M.

    1983-01-01

    Experimental methods for identifying failure mechanisms in fibrous composites are studied. Methods to identify failure in composite materials includes interferometry, holography, fractography and ultrasonics.

  20. Common Cause Failures and Ultra Reliability

    Science.gov (United States)

    Jones, Harry W.

    2012-01-01

    A common cause failure occurs when several failures have the same origin. Common cause failures are either common event failures, where the cause is a single external event, or common mode failures, where two systems fail in the same way for the same reason. Common mode failures can occur at different times because of a design defect or a repeated external event. Common event failures reduce the reliability of on-line redundant systems but not of systems using off-line spare parts. Common mode failures reduce the dependability of systems using off-line spare parts and on-line redundancy.

  1. Central Mechanisms of Abnormal Sympathoexcitation in Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Takuya Kishi

    2012-01-01

    Full Text Available It has been recognized that the sympathetic nervous system is abnormally activated in chronic heart failure, and leads to further worsening chronic heart failure. In the treatment of chronic heart failure many clinical studies have already suggested that the inhibition of the abnormal sympathetic hyperactivity by beta blockers is beneficial. It has been classically considered that abnormal sympathetic hyperactivity in chronic heart failure is caused by the enhancement of excitatory inputs including changes in peripheral baroreceptor and chemoreceptor reflexes and chemical mediators that control sympathetic outflow. Recently, the abnormalities in the central regulation of sympathetic nerve activity mediated by brain renin angiotensin system-oxidative stress axis and/or proinflammatory cytokines have been focused. Central renin angiotensin system, proinflammatory cytokines, and the interaction between them have been determined as the target of the sympathoinhibitory treatment in experimental animal models with chronic heart failure. In conclusion, we must recognize that chronic heart failure is a syndrome with an abnormal sympathoexcitation, which is caused by the abnormalities in the central regulation of sympathetic nerve activity.

  2. Qualitative examination of compliance in heart failure patients in The Netherlands

    NARCIS (Netherlands)

    van der Wal, Martje H. L.; Jaarsma, Tiny; Moser, Debra K.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2010-01-01

    BACKGROUND: Noncompliance with pharmacological and nonpharmacological recommendations is a problem in many heart failure (HF) patients, leading to worse symptoms and readmission. Although knowledge is available regarding factors related to compliance with HF regimens, little is known about patients'

  3. Qualitative examination of compliance in heart failure patients in The Netherlands

    NARCIS (Netherlands)

    van der Wal, Martje H. L.; Jaarsma, Tiny; Moser, Debra K.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2010-01-01

    BACKGROUND: Noncompliance with pharmacological and nonpharmacological recommendations is a problem in many heart failure (HF) patients, leading to worse symptoms and readmission. Although knowledge is available regarding factors related to compliance with HF regimens, little is known about patients'

  4. Changes in cerebral oxidative metabolism in patients with acute liver failure

    DEFF Research Database (Denmark)

    Bjerring, P N; Larsen, F S

    2013-01-01

    acid cycle, induces substrate depletion through marked glutamate utilization for glutamine synthesis and leads to mitochondrial dysfunction. In patients with acute liver failure cerebral microdialysis studies show a linear correlation between the lactate to pyruvate ratio and the glutamine...

  5. Impaired myocardial oxygen availability contributes to abnormal exercise hemodynamics in heart failure with preserved ejection fraction

    NARCIS (Netherlands)

    van Empel, Vanessa P M; Mariani, Justin; Borlaug, Barry A; Kaye, David M

    2014-01-01

    BACKGROUND: Hypertension is a frequent risk factor for the development of heart failure with preserved ejection fraction (HFPEF). Progressive extracellular matrix accumulation has been presumed to be the fundamental pathophysiologic mechanism that leads to the transition to impaired diastolic reserv

  6. Targeted deletion of kidney glucose-6 phosphatase leads to nephropathy

    NARCIS (Netherlands)

    Clar, Julie; Gri, Blandine; Calderaro, Julien; Birling, Marie-Christine; Herault, Yann; Smit, G. Peter A.; Mithieux, Gilles; Rajas, Fabienne

    2014-01-01

    Renal failure is a major complication that arises with aging in glycogen storage disease type 1a and type 1b patients. In the kidneys, glucose-6 phosphatase catalytic subunit (encoded by G6pc) deficiency leads to the accumulation of glycogen, an effect resulting in marked nephromegaly and

  7. CMS lead tungstate crystals

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    These crystals are made from lead tungstate, a crystal that is as clear as glass yet with nearly four times the density. They have been produced in Russia to be used as scintillators in the electromagnetic calorimeter on the CMS experiment, part of the LHC project at CERN. When an electron, positron or photon passes through the calorimeter it will cause a cascade of particles that will then be absorbed by these scintillating crystals, allowing the particle's energy to be measured.

  8. Veining Failure and Hydraulic Fracturing in Shales

    Science.gov (United States)

    Mighani, S.; Sondergeld, C. H.; Rai, C. S.

    2014-12-01

    During the hydraulic fracturing, the pressurized fluid creates new fractures and reactivates existing natural fractures forming a highly conductive Stimulated Reservoir Volume (SRV) around the borehole. We extend the previous work on Lyons sandstone and pyrophyllite to anisotropic shale from the Wolfcamp formation. We divide the rock anisotropy into two groups: a) conventional and b) unconventional (shaly) anisotropy. X-ray Computed Tomography (CT), compressional velocity anisotropy, and SEM analysis are used to identify three causes of anisotropy: bedding planes, clay lamination, and calcite veins. Calcite vein is a subsequently filled with calcite bonded weakly to the matrix. Velocity anisotropy and visual observations demonstrate the calcite filled veins to be mostly subparallel to the fabric direction. Brazilian tests are carried out to observe the fracture initiation and propagation under tension. High speed photography (frame rate 300,000 frame/sec) was used to capture the failure. Strain gauges and Acoustic Emission (AE) sensors recorded the deformation leading up to and during failure. SEM imaging and surface profilometry were employed to study the post-failure fracture system and failed surface topology. Fracture permeability was measured as a function of effective stress. Brazilian tests on small disks containing a centered single vein revealed the shear strength of the veins. We interpret the strain data and number, frequency, and amplitude of AE events which are correlated well with the observed fracture process zone, surface roughness, and permeability. The unpropped fracture has enhanced permeability by two orders of magnitude. The observed anisotropic tensile failure seems to have a universal trend with a minimum strength occurring at 15o orientation with respect to the loading axis. The veins at 15o orientation with respect to the loading axis were easily activated at 30% of the original failure load. The measured strength of the vein is as low as 6

  9. Resistance remains a problem in treatment failure

    Directory of Open Access Journals (Sweden)

    Martin Obermeier

    2014-11-01

    Full Text Available Introduction: Proven resistance against HIV drugs, either by phenotyping or genotyping is a rare event in clinical trials. The overall assumption of drug resistance disappearing is additionally driven by the recommendations to screen for transmitted drug resistance, leading to large numbers of examinations with relatively low rates of resistance. Goal of our analysis was to assess if drug resistance in treatment failure is also decreasing outside of clinical trials. Materials and Methods: The MIB database at timepoint of analysis consists of data from 2876 HIV infected patients. Besides various laboratory parameters, clinical data and treatment history is included. HIV-1 protease and reverse transcriptase sequences were analyzed using the HIV-GRADE drug resistance algorithm. As in only a small number of patients genotypic resistance testing for integrase inhibitors was performed, mainly due to reimbursement reasons, it was assumed that failing treatment on a previous integrase inhibitor containing regimen is equate to resistance. Results: Of the 2876 patients in the database, 220 had a treatment change due to treatment failure between 2009 and 2012, a genotypic resistance testing at an appropriate timepoint of maximum four weeks before treatment change and a treatment duration of at least six months before treatment failure. In 2009, 61% of patients showed no drug resistance while 39% showed resistance against one or more drug classes (two or more drug classes: 19.5%; three or more drug classes: 2.4%, four drug classes 2.4%. In 2012, no resistance was found in 52% of patients while resistance against three or more drug classes was found in nearly 14% of patients (one or more: 48%; two or more 23%; four classes: 4.5%. Conclusions: Treatment failure with viral load sufficiently high for drug resistance testing was not frequently observed in our database. Nevertheless, treatment failure was often associated with drug resistance against at least one

  10. Nano Coated Lead Free Solders for Sustainable Electronic Waste Management

    Directory of Open Access Journals (Sweden)

    K. Arun Vasantha Geethan

    Full Text Available ABSTRACT Lead has been used in a wide range of applications, but in the past decades it became clear that its high toxicity could cause various problems. Studies indicate that exposure to high concentrations of lead can cause harmful damages to humans. To eliminate the usage of lead in electronic products as an initiative towards electronic waste management (e waste, lead free solders were produced with suitable methods by replacing lead. But lead free solders are not preferred as a substitute of lead because they are poor in their mechanical properties such as tensile strength, shear strength and hardness which are ultimately required for a material to resist failure.Nano-Structured materials and coatings offer the potential for Vital improvements in engineering properties based on improvements in physical and mechanical properties resulting from reducing micro structural features by factors of 100 to 1000 times compared to current engineering materials.

  11. Influence of social factors on lead exposure and child development

    Energy Technology Data Exchange (ETDEWEB)

    Bornschein, R.L.

    1985-10-01

    A brief overview of current views of child development is provided, with particular attention given to the role the child's physical and social environment plays in influencing the developmental process. Examples from the recent literature are used to illustrate how these factors can influence lead exposure and most importantly how they might interact with lead to ameliorate or exacerbate possible lead effects. An example is provided which demonstrates that failure to control adequately and to adjust the data statistically to correct for the influence of these factors can lead one erroneously to attribute cognitive and behavioral changes to lead. Finally, data from the Cincinnati Prospective Lead Study are presented to illustrate the application of structural equation modeling as a means for unraveling the complex web of sociodemographic, environmental and behavioral influences on childhood lead exposure.

  12. Superconductivity of lead

    Energy Technology Data Exchange (ETDEWEB)

    Boorse, H.A.; Cook, D.B.; Zemansky, W.M.

    1950-06-01

    Numerous determinations of the zero-field transition temperature of lead have been made. All of these observations except that of Daunt were made by the direct measurement of electrical resistance. Daunt`s method involved the shielding effect of persistent currents in a hollow cylinder. In the authors work on columbium to be described in a forthcoming paper an a.c. induction method was used for the measurement of superconducting transitions. The superconductor was mounted as a cylindrical core of a coil which functioned as the secondary of a mutual inductance. The primary coil was actuated by an oscillator which provided a maximum a.c. field within the secondary of 1.5 oersteds at a frequency of 1000 cycles per second. The secondary e.m.f. which was dependent for its magnitude on the permeability of the core was amplified, rectifie, and observed on a recording potentiometer. During the application of this method to the study of columbium it appeared that a further check on the zero-field transition temperature of lead would be worth while especially if agreement between results for very pure samples could be obtained using this method. Such result would help in establishing the lead transition temperature as a reasonably reproducible reference point in the region between 4 deg and 10 deg K.

  13. Failure of chaos control

    Science.gov (United States)

    van De Water W; de Weger J

    2000-11-01

    We study the control of chaos in an experiment on a parametrically excited pendulum whose excitation mechanism is not perfect. This imperfection leads to a weakly excited degree of freedom with an associated small eigenvalue. Although the state of the pendulum could be characterized well and although the perturbation is weak, we fail to control chaos. From a numerical model we learn that the small eigenvalue cannot be ignored when attempting control. However, the estimate of this eigenvalue from an (experimental) time series is elusive. The reason is that points in an experimental time series are distributed according to the natural measure. It is this extremely uneven distribution of points that thwarts attempts to measure eigenvalues that are very different. Another consequence of the phase-space distribution of points for control is the occurrence of logarithmic-oscillations in the waiting time before control can be attempted. We come to the conclusion that chaos needs to be destroyed before the information needed for its control can be obtained.

  14. Preventing school failure: the physician as child advocate.

    Science.gov (United States)

    Landman, G B

    1986-08-01

    Attending school heralds the end of the relative protection and nurture of home life. During the school day, a child experiences successes and failures that portend future feelings of self-worth and self-esteem. Usually children experiencing difficulty at school are identified by teachers, however, children are overlooked. When they are and subsequently experience chronic failure and frustration, long-term morbidity may ensue. Ideally, methods to identify potential learning problems should be available. Unfortunately, the state of the art does not allow accurate identification of problems before they occur. After any number of screening tests, we can accurately predict school successes, but predicting failure is elusive. Early school failure, however, like many maladies, can be diagnosed, particularly if a physician has a high index of suspicion and looks for signs and symptoms of ongoing failure and frustration. Family history, neonatal course, presence of minor congenital anomalies and soft neurological signs, attention problems and lack of age-appropriate processing skills in the preschool period should place a child at risk. Close observation should designate those children who fail to mobilize associated strengths that maintain development. Early intervention will reduce morbidity associated with academic difficulty. Longitudinally, reduction of chronic failure may be the most crucial intervention. The unfortunate cycle of developmental dysfunction leading to school failure and lowered self esteem with subsequent social pathology and delinquency is well known. To the extent that physicians are able to ensure appropriate school services for children experiencing failure, this cycle can be short circuited, adding significantly to the physician's traditional armamentarium.

  15. Organ failure associated with severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Ai-Jun Zhu; Jing-Sen Shi; Xue-Jun Sun

    2003-01-01

    AIM: To investigate the relationship between severe acute pancreatitis (SAP) and organ failure.METHODS: Clinical data of 74 cases of SAP from Jan. 1993 to Dec. 2002 were retrospectively reviewed, and the relationship between organ failure and age, gender, etiology,extent of necrosis, infection of necrosis and mortality was analyzed.RESULTS: A total of 47 patients (63.5 %) showed organ failure, 20 patients (27.0 %) multiple organ failure, whereas 27 patients (36.5 %) with dysfunction of a single organ system. Pulmonary failure was the most common organ dysfunction (23.0 %) among single organ failures. There were no significant differences in age, gender and gallstone pancreatitis among patients with or without organ failure (P>0.05). The incidence of organ failure in infected necrosis was not higher compared with sterile necrosis, and patients with increased amount of necrosis did not have an increased prevalence of organ failure (P>0.05). Patients with organ failure had a higher mortality rate compared with those without organ failure (P<0.05). The death of SAP was associated with multiple organ failure (P<0.005), pulmonary failure (P<0.005), cardiovascular dysfunction (P<0.05) and gastrointestinal dysfunction (P<0.05).CONCLUSION: Organ failure is common in patients with SAP, and patients with multiple organ failure and pulmonary failure have a higher mortality rate. Prevention and active treatment of organ failure can improve the outcome of patients with SAP.

  16. [Failure effects and gender differences in perfectionism].

    Science.gov (United States)

    Masson, A M; Cadot, M; Ansseau, M

    2003-01-01

    perfectionism are described: SOP (Self Oriented Perfectionism) related to high standards and self criticism, SPP (Socially Prescribed Perfectionism) related to the need of approval from others and fear of negative evaluation, OOP (Other-Oriented Perfectionism) reflecting a tendency to set high expectations for others and to evaluate them in a demanding way; this component is related, especially for males, to self-esteem, hostility and authoritarianism. Validity and internal consistency have been established too (30, 31, 35). The Frost and al's Multidimensional Perfectionism Scale and the Hewitt and Flett's scales are closely associated, except concerning the OOP. Because this component could provide new information, we have chosen the second scale, referring to the French translation and validation of Labrecque (45). EMP is the French name of MPS; it is a self-report questionnaire of 45 questions, in fact three subscales of 15 items rated on a 7-point Likert-type scale. MPS was administered to 617 first year students at the university of Liège (table II). Differences are considered according to gender and experience of failure i.e. the fact of repeating an academic year. We realized a component analysis with promax rotation. Among the different possibilities offered by the scree-test the choice of a 4 factor solution stresses the original structure: SOP (14 items), SPP (12 items), OOP (9 items) and anti OOP (10 items); the last one is additional but allows for respecting semantics and saturation of the items. The first aim of confirming validity and internal consistency is satisfactory. In other respects the multidimensional structure of the concept leads to consideration of a positive, adaptive perfectionism and a more negative perfectionism, facilitating psychopathology (59, 60, 61). So it seems interesting to compare the different components of MPS in order to find an eventual sex-failure effect. The evaluation of perfectionism is obvious, considering it as a personality

  17. Optimization leads to symmetry

    Institute of Scientific and Technical Information of China (English)

    Chenghong WANG; Yuqian GUO; Daizhan CHENG

    2004-01-01

    The science of complexity studies the behavior and properties of complex systems in nature and human society.Particular interest has been put on their certain simple common properties.Symmetry is one of such properties.Symmetric phenomena can be found in many complex systems.The purpose of this paper is to reveal the internal reason of the symmetry.Using some physical systems and geometric objects,the paper shows that many symmetries are caused by optimization under certain criteria.It has also been revealed that an evolutional process may lead to symmetry.

  18. Leading change: 2--planning.

    Science.gov (United States)

    Kerridge, Joanna

    National initiatives have outlined the importance of involving frontline staff in service improvement, and the ability to influence and manage change has been identified as an essential skill for delivering new models of care. Nurses often have to take the lead in managing change in clinical practice. The second in a three-part series is designed to help nurses at all levels develop the knowledge and skills to function as change agents within their organisations. This article focuses on planning the change and dealing with resistance.

  19. lead glass brick

    CERN Multimedia

    When you look through the glass at a picture behind, the picture appears raised up because light is slowed down in the dense glass. It is this density (4.06 gcm-3) that makes lead glass attractive to physicists. The refractive index of the glass is 1.708 at 400nm (violet light), meaning that light travels in the glass at about 58% its normal speed. At CERN, the OPAL detector uses some 12000 blocks of glass like this to measure particle energies.

  20. Turning lead into gold

    DEFF Research Database (Denmark)

    Jensen, Steffen Moltrup Ernø

    For years the field of entrepreneurship has been blinded by the alchemical promise of turning lead into gold, of finding the ones most likely to become the next Branson, Zuckerberg or Gates. The promise has been created in the midst of political and scientific agendas where certain individuals...... is not to accumulate state or market wealth, but for entrepreneurial skills to become tools towards the liberation of the individual from oppressive systems of control – essentially to add public value rather than economic value. In this presentation I will sketch an anarchist perspective on entrepreneurship, looking...

  1. Gene therapy for heart failure.

    Science.gov (United States)

    Greenberg, Barry

    2017-04-01

    Novel strategies are needed to treat the growing population of heart failure patients. While new drug and device based therapies have improved outcomes over the past several decades, heart failure patients continue to experience amongst the lowest quality of life of any chronic disease, high likelihood of being hospitalized and marked reduction in survival. Better understanding of many of the basic mechanisms involved in the development of heart failure has helped identify abnormalities that could potentially be targeted by gene transfer. Despite success in experimental animal models, translating gene transfer strategies from the laboratory to the clinic remains at an early stage. This review provides an introduction to gene transfer as a therapy for treating heart failure, describes some of the many factors that need to be addressed in order for it to be successful and discusses some of the recent studies that have been carried out in heart failure patients. Insights from these studies highlight both the enormous promise of gene transfer and the obstacles that still need to be overcome for this treatment approach to be successful. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Failure to thrive: an update.

    Science.gov (United States)

    Cole, Sarah Z; Lanham, Jason S

    2011-04-01

    Failure to thrive in childhood is a state of undernutrition due to inadequate caloric intake, inadequate caloric absorption, or excessive caloric expenditure. In the United States, it is seen in 5 to 10 percent of children in primary care settings. Although failure to thrive is often defined as a weight for age that falls below the 5th percentile on multiple occasions or weight deceleration that crosses two major percentile lines on a growth chart, use of any single indicator has a low positive predictive value. Most cases of failure to thrive involve inadequate caloric intake caused by behavioral or psychosocial issues. The most important part of the outpatient evaluation is obtaining an accurate account of a child's eating habits and caloric intake. Routine laboratory testing rarely identifies a cause and is not generally recommended. Reasons to hospitalize a child for further evaluation include failure of outpatient management, suspicion of abuse or neglect, or severe psychosocial impairment of the caregiver. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parent-child relationships, and cognitive development. The long-term effects of failure to thrive on cognitive development and future academic performance are unclear.

  3. A Case Study of Environmental Injustice: The Failure in Flint

    Directory of Open Access Journals (Sweden)

    Carla Campbell

    2016-09-01

    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.

  4. Micromechanical Failure Analyses for Finite Element Polymer Modeling

    Energy Technology Data Exchange (ETDEWEB)

    CHAMBERS,ROBERT S.; REEDY JR.,EARL DAVID; LO,CHI S.; ADOLF,DOUGLAS B.; GUESS,TOMMY R.

    2000-11-01

    Polymer stresses around sharp corners and in constrained geometries of encapsulated components can generate cracks leading to system failures. Often, analysts use maximum stresses as a qualitative indicator for evaluating the strength of encapsulated component designs. Although this approach has been useful for making relative comparisons screening prospective design changes, it has not been tied quantitatively to failure. Accurate failure models are needed for analyses to predict whether encapsulated components meet life cycle requirements. With Sandia's recently developed nonlinear viscoelastic polymer models, it has been possible to examine more accurately the local stress-strain distributions in zones of likely failure initiation looking for physically based failure mechanisms and continuum metrics that correlate with the cohesive failure event. This study has identified significant differences between rubbery and glassy failure mechanisms that suggest reasonable alternatives for cohesive failure criteria and metrics. Rubbery failure seems best characterized by the mechanisms of finite extensibility and appears to correlate with maximum strain predictions. Glassy failure, however, seems driven by cavitation and correlates with the maximum hydrostatic tension. Using these metrics, two three-point bending geometries were tested and analyzed under variable loading rates, different temperatures and comparable mesh resolution (i.e., accuracy) to make quantitative failure predictions. The resulting predictions and observations agreed well suggesting the need for additional research. In a separate, additional study, the asymptotically singular stress state found at the tip of a rigid, square inclusion embedded within a thin, linear elastic disk was determined for uniform cooling. The singular stress field is characterized by a single stress intensity factor K{sub a} and the applicable K{sub a} calibration relationship has been determined for both fully bonded and

  5. Everyday Attention Failures: An Individual Differences Investigation

    Science.gov (United States)

    Unsworth, Nash; McMillan, Brittany D.; Brewer, Gene A.; Spillers, Gregory J.

    2012-01-01

    The present study examined individual differences in everyday attention failures. Undergraduate students completed various cognitive ability measures in the laboratory and recorded everyday attention failures in a diary over the course of a week. The majority of attention failures were failures of distraction or mind wandering in educational…

  6. Epidemic Network Failures in Optical Transport Networks

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Katsikas, Dimitrios; Fagertun, Anna Manolova

    2013-01-01

    This paper presents a failure propagation model for transport networks which are affected by epidemic failures. The network is controlled using the GMPLS protocol suite. The Susceptible Infected Disabled (SID) epidemic model is investigated and new signaling functionality of GMPLS to support epid...... epidemic failure resolution is proposed. The results provide important input to service recovery mechanisms under epidemic failures....

  7. Everyday Attention Failures: An Individual Differences Investigation

    Science.gov (United States)

    Unsworth, Nash; McMillan, Brittany D.; Brewer, Gene A.; Spillers, Gregory J.

    2012-01-01

    The present study examined individual differences in everyday attention failures. Undergraduate students completed various cognitive ability measures in the laboratory and recorded everyday attention failures in a diary over the course of a week. The majority of attention failures were failures of distraction or mind wandering in educational…

  8. Understand Your Risk for Heart Failure

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Causes and Risks for Heart Failure Updated:Feb 1,2017 Who Develops Heart Failure ( ... HF. This content was last reviewed April 2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  9. SAFETY ALERT - Failure of brass non-return valves in gas point installations

    CERN Multimedia

    HSE Unit

    2016-01-01

    There have been three recent failures in brass non-return valves in separate high pressure gas point installations across CERN. Whilst each was in a different gas service, the visual nature of the failure has been similar.   In all three cases, these components were connected to stainless steel flexible connections and stainless steel pipework. From the metallurgical investigation of the failed component, it appears that the failure is linked to uncontrolled tightening, leading to a localised weakening resulting in premature failure when subjected to pressure. Lead levels in the examined components appear to be a contributing factor to the reduction in ductility but are not identified as the root cause. It has also not been possible to attribute failure to a particular batch of material. The Occupational Health & Safety and Environmental Protection Unit prescribes the following actions to be taken, aligned with the CERN Safety Rules: Verification of all brass non-return valves (prioritising...

  10. Learning from Failures in Operations

    DEFF Research Database (Denmark)

    Koch, Christian

    2005-01-01

    product. The analysis showed that, among others, design review, project review, commencing and finalizing operations turned out to be critical junctions in the control of failures. Practical implications and improvements are discussed. The focus on critical junctions, points to supply chain management......This paper discusses failures and quality in operations in design and production of buildings. The importance of human action, interpretations and interactions in tackling complexity, fragmentation and disturbances in the building industry is underlined. Building processes encompass requisite...... parallelism and fragmentation due to their predominantly quantitative complexity. It is suggested that a number of critical junctions occur in these processes and that obtaining quality and avoiding failures quite often requires a series of competent and situational operation management actions. An empirical...

  11. DEALING WITH DENTAL IMPLANT FAILURES

    Science.gov (United States)

    Levin, Liran

    2008-01-01

    An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them. PMID:19089213

  12. Dealing with dental implant failures

    Directory of Open Access Journals (Sweden)

    Liran Levin

    2008-06-01

    Full Text Available An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options.When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

  13. Ciprofloxacin-Induced Renal Failure

    Directory of Open Access Journals (Sweden)

    Audra Fuller

    2015-10-01

    Full Text Available Acute renal failure (ARF is a common diagnosis in hospitalized patients, particularly in intensive care units (ICU. Determining the cause and contributing factors associated with ARF is crucial during treatment. The etiology is complex, and several factors often contribute to its development. Medications can cause acute tubular necrosis, acute interstitial nephritis, and crystal-induced or post-obstructive nephropathy. There have been several case reports of ARF secondary to fluoroquinolones. Here we report the development of acute renal failure within a few days of initiating oral ciprofloxacin therapy and briefly describe the different types of renal failure secondary to fluoroquinolone administration. Clinical studies demonstrate that using fluoroquinolones with other potentially nephrotoxic medications requires monitoring of renal function to limit the renal toxicity with these medications. Also, the risk-benefit profile of patients requiring fluoroquinolones should be considered.

  14. Pseudoporphyria secondary to renal failure

    Directory of Open Access Journals (Sweden)

    Lilianna Kulczycka-Siennicka

    2017-04-01

    Full Text Available Introduction . Pseudoporphyria is a rare disease associated with chronic renal failure. Symptoms of pseudoporphyria may develop in response to UV exposure and medications. The literature reports cases of pseudoporphyria in patients infected with hepatis C virus, HIV and undergoing dialysis therapy. Objective . Presentation of the case of a patient with pseudoporphyria and uraemic pruritus, and overview of therapeutic management. Case report . A 64-year-old male patient, who had been on dialysis for chronic renal failure secondary to type 2 diabetes for the past 11 years, presented with tense bullae located on sun-exposed skin which had persisted for the previous 5 months. The patient was diagnosed with pseudoporphyria, and treatment was prescribed including N-acetylcysteine, chloroquine, paroxetine and mianserin. An improvement in the patient’s clinical condition and a regression of pruritus were achieved. Conclusions . Patients with renal failure may develop symptoms of pseudoporphyria requiring differentiation from porphyria cutanea tarda.

  15. Make Failure a Stepping Stone to Success

    Institute of Scientific and Technical Information of China (English)

    徐燕青

    2004-01-01

    People have different opinions on failure, and they think of failure in different ways. Some of them may connect failure with their pursuit of fame, others may connect failure with wealth and still others may connect failure with achievements. For most students,failure means failing to pass exams. Without good grades, a student may consider himself to be useless and he may even think he is doomed to failure. Whenever he is given a test, he focuses all his attention on the marks. High marks bring him hope and happiness. So every day, all he does is stay inside and study.

  16. [Academic problems and school failure in adolescence].

    Science.gov (United States)

    Catheline, Nicole

    2005-05-31

    Success at school increases self-esteem. Any difficulty will have consequential effects on the psychological health of the subject. The conditions now prevailing in the educational institutions (mass schooling without any individual orientation before the end of college) oblige the teenager to submit to teaching methods and to the school system. School can reveal the subject's personal problems (anxiety, phobia or depression), but may equally create pathology by not recognising the heterogeneity of individual development and differences in cognitive functioning. In adolescence, the ego is particularly vulnerable. Anything that may induce its instability can create behavioural problems (instability, aggressiveness, inhibition) or problems of thought (anxiety links, difficulties in abstraction). In order to cope with such a haemorrhage of the ego, the adolescent may have recourse to certain behaviours (e.g. use of drugs leading to dependence). So it is important the know well the links between school failure and behavioural problems or drug consumption because, in one way or another, by their sanction or by lack of motivation, these situations will lead very quickly to school disengagement, which in turn leads to the breakdown of the ego.

  17. Critical care ultrasonography in acute respiratory failure.

    Science.gov (United States)

    Vignon, Philippe; Repessé, Xavier; Vieillard-Baron, Antoine; Maury, Eric

    2016-08-15

    Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and the identification of a potential underlying cardiopathy. In addition, CCE precisely depicts the consequences of pulmonary vascular lesions on right ventricular function and helps in adjusting the ventilator settings in patients sustaining moderate-to-severe acute respiratory distress syndrome. Similarly, CCE helps in identifying patients at high risk of ventilator weaning failure, depicts the mechanisms of weaning pulmonary edema in those patients who fail a spontaneous breathing trial, and guides tailored therapeutic strategy. In all these clinical settings, CCE provides unparalleled information on both the efficacy and tolerance of therapeutic changes. Chest ultrasonography provides further insights into pleural and lung abnormalities associated with ARF, irrespective of its origin. It also allows the assessment of the effects of treatment on lung aeration or pleural effusions. The major limitation of lung ultrasonography is that it is currently based on a qualitative approach in the absence of standardized quantification parameters. CCE combined with chest ultrasonography rapidly provides highly relevant information in patients sustaining ARF. A pragmatic strategy based on the serial use of CCUS for the management of patients presenting with ARF of various origins is detailed in the present manuscript.

  18. Mechanotransduction in cardiac hypertrophy and failure.

    Science.gov (United States)

    Lyon, Robert C; Zanella, Fabian; Omens, Jeffrey H; Sheikh, Farah

    2015-04-10

    Cardiac muscle cells have an intrinsic ability to sense and respond to mechanical load through a process known as mechanotransduction. In the heart, this process involves the conversion of mechanical stimuli into biochemical events that induce changes in myocardial structure and function. Mechanotransduction and its downstream effects function initially as adaptive responses that serve as compensatory mechanisms during adaptation to the initial load. However, under prolonged and abnormal loading conditions, the remodeling processes can become maladaptive, leading to altered physiological function and the development of pathological cardiac hypertrophy and heart failure. Although the mechanisms underlying mechanotransduction are far from being fully elucidated, human and mouse genetic studies have highlighted various cytoskeletal and sarcolemmal structures in cardiac myocytes as the likely candidates for load transducers, based on their link to signaling molecules and architectural components important in disease pathogenesis. In this review, we summarize recent developments that have uncovered specific protein complexes linked to mechanotransduction and mechanotransmission within the sarcomere, the intercalated disc, and at the sarcolemma. The protein structures acting as mechanotransducers are the first step in the process that drives physiological and pathological cardiac hypertrophy and remodeling, as well as the transition to heart failure, and may provide better insights into mechanisms driving mechanotransduction-based diseases. © 2015 American Heart Association, Inc.

  19. [Severe acute liver failure: a case study].

    Science.gov (United States)

    Moreno Arroyo, M Carmen; Puig Llobet, Montserrat; Cuervo Lavado, Luis

    2012-01-01

    Fulminant hepatic failure (FHF), also known as fulminant hepatitis, is a rare and extremely serious condition with a high mortality rate. Its rapid evolution and complexity in managing the treatment, creates the need to provide some immediate care by a team that specialises in intensive care. This acute decompensation is usually associated with other disorders, such as coagulopathy and hepatic encephalopathy, being responsible for major complications that can lead to organ failure. In our region the most common origin is unknown, followed by acute infection with hepatitis B. The treatment of this syndrome is based on the general measures applicable to any critically ill patient: treat the cause and early detection of extrahepatic complications, urgent liver transplantation being one of the alternatives with a better prognosis. This article presents a case report describing the monitoring of an Irish woman of 20 years who was transferred from a hospital in Ibiza to a hospital in Barcelona, with a suspected diagnosis of FHF. Following the conceptual model of Virginia Henderson, the collaborative problems and nursing diagnoses are described, presenting a care plan according to NANDA (North American Nursing Association), NIC (Nursing Intervention Classification), NOC (Nursing Outcomes Classification). This case helps to establish an individualised care plan that provides guidance to nurse professionals in critical patient care by increasing the knowledge of FHF.

  20. Calm Before the Storm: An Uncomplicated Epicardial Lead Extraction Resulting in DIC and Patient Demise.

    Science.gov (United States)

    Bernstein, Wendy K

    2016-08-15

    A previously stable 77-year-old man with significant cardiac history underwent an uneventful extraction of a Citrobacter-infected and eroded pacemaker lead. His postoperative course was acutely complicated by respiratory failure and quickly progressed into disseminated intravascular coagulation, acute renal failure, shock liver, and ventricular tachycardic arrest. I believe that this is the first case report of such a drastic turn of events after a routine pacemaker lead extraction.